We included 21 low quality non-UK studies (no comparator group) [165,166,167,168,169,170,171,172,173,174,175,176,177,178,179,180,181,182,183,184,185] within a light touch analysis. 2006;26:917. Genet N, Boerma WG, Kringos DS, Bouman A, Francke AL, Fagerstrom C, et al. 2013;28:61221. Blinding of participants and personnel was also limited or not possible, with only four studies achieving this [30, 31, 49, 72]. 2007;298:262333. Following rating of the outcomes in each individual study, we then applied an overall rating to the evidence across all studies which reported the same outcome. and the benefit of physical co-location of services [32]. PLoS One. Osteoporosis Int. Eur J Obs Gynecol Reprod Biol. Google Scholar. Hartgerink JM, Cramm JM, Bakker TJ, van Eijsden R, Mackenbach JP, Niebor AP. Prim Health Care Res Develop. Ann Intern Med. Systems Health. Myors KA, Schmied V, Johnson M, Cleary M. Collaboration and integrated services for perinatal mental health: an integrative review. Richings C, Cook R, Roy A. Some authors highlighted the continuance of varied pre-existing governance arrangements following integration of organisations, with progress on new models often reported to be particularly limited in the areas of budgets, financial, and contracting mechanisms [187]. Instead, we report where there is greater or lesser strength (or certainty) in the evidence for each outcome reported [16]. Of the included 54 UK articles, 16 reported findings from studies using higher quality comparator designs [25, 28, 30, 31, 34, 38, 40, 44, 49, 60, 63, 64, 67, 68, 71, 72]. 2018;18:5. Health Aff. Integrated models of care delivery for the frail elderly: international perspectives. What kind of systematic review should I conduct? Redesigning care processes using an electronic health record: a system's experience. Critical connections between subjects are made, creating more holistic learning Higher numbers of skill repetition in a more interesting way. London: Sage; 2006. Hawthorne G, Grzebalski DK. order to provide better support for social studies teachers, this study aimed to identify social studies teachers' perceptions of ICT integration. Have better spatial awareness. 2007;13:5665. J Integr Care. Jack BW, Chetty VK, Anthony D, Greenwald JL, Sanchez GM, Johnson AE, et al. Another disadvantage to the interdisciplinary approach is that it can get too meta-theoretical and not address real-life problems like the research was supposed to. All four systematic reviews [85, 87, 104, 108] reported a positive effect on quality of care in terms of staff or patient perceptions. 2012;12 https://doi.org/10.5334/ijic.850. Three international comparator studies (reported in five papers) supported the finding that integrated care initiatives improved access [117, 123,124,125,126]. Case Studies: Integration Testing vs End-to-End Testing. Cameron A, Bostock L, Lart R. Service user and carers perspectives of joint and integrated working between health and social care. BMC Health Serv Res. Unlike more hands-on subjects like science and technology, social studies can be more abstract and theoretical. The international comparative design studies rated slightly better in terms of randomisation with 19 (reported in 26 papers) having random allocation [116,117,118,119, 123,124,125,126,127,128, 131, 132, 136, 137, 139, 142, 144, 147,148,149, 152, 155, 156, 161, 163, 164], although only nine studies (reported in 14 papers) achieved allocation concealment [116, 118, 119, 123,124,125, 127, 128, 131, 132, 139, 161, 163, 164]. Bird SR, Kurowski W, Dickman GK, Kronborg I. 2008;45:14053. Mobile technology continues to change and evolve the way people and society function in their everyday lives. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS or the Department of Health. 2012;31:115666. 2011;171:4606. Health Policy. Available at: https://www.birmingham.ac.uk/Documents/college-social-sciences/social-policy/HSMC/publications/PolicyPapers/Policy-paper-6.pdf.. Harris M, Greaves F, Gunn L, Patterson S, Greenfield G, Car J, et al. Int J Care Path. Belanger E, Rodriguez C. More than the sum of its parts? Further research is required to explore the potential for models of integrated care to impact on the care for other patient groups with complex needs. Julian S, Naftalin NJ, Clark M, Szczepura A, Rashid A, Baker R. An integrated care pathway for menorrhagia across the primary-secondary interface: patients experience, clinical outcomes, and service utilisation. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The merging companies expect certain benefits from the horizontal integration, but the hardware and software of either of the companies don't match up. J Nurs Manag. 2007;24:35963. Another tension exists between cost-saving and provision of improved quality of care. Five year forward view. 2007;85:3767. 2013;13:e003. Just over half the included studies reported sample sizes that were sufficiently large to have confidence in the findings. 2006;14:50820. Stampa M, Vedel I, Buyck J, Lapointe L, Bergman H, Beland F, et al. Multidisciplinary group performance-measuring integration intensity in the context of the north West London integrated care pilot. Glenton C, Colvin CJ, Carlsen B, Swartz A, Lewin S, Noyes J, et al. Paulus A, van Raak A. J Nurs Manag. Analysis of early accountable care organizations defines patient, structural, cost, and quality-of-care characteristics. 2007;3:8095. van Gils RF, Bosmans JE, Boot CRL, Rustemeyer T, van Mechelen W, van der Valk PG, et al. National Audit Office. We observed little overlap between primary studies and reviews, with time lags in publication of the systematic reviews meaning that the majority of their primary studies preceded our inclusion date of 2006. 2013;10:21837. 2009;57(12):232837. The disadvantages arising directly from the establishment of the CSME infrastructure which would influence the distribution of gains from market and economic integration, prior disadvantages. Reporting was poor in around a third of the studies, making it difficult to judge the extent of possible selective reporting. 2012;34:2533. Another disadvantage with integration is variables get missed and vital information is left out. The receiver and sender of data are coupled together with no other software program serving as an intermediary. This paper focuses on data relating to the effects of models of integrated care on actual and perceived service delivery, including the efficiency, effectiveness and quality of care. We identified surprisingly little evidence regarding the impact of integrated care models on patient experiences of services, beyond measures of reported patient satisfaction. We included studies of both comparator and non-comparator design from the UK (as these data were considered to privilege relevance), whereas we prioritised international systematic reviews and international primary studies with comparative design (thereby privileging rigour). Five included (non-comparator) UK intervention studies reported that access to services in the community and/or specialists/intermediate care had increased [35, 41, 59, 72, 73]. Roland M, Lewis R, Steventon A, Abel G, Adams J, Bardsley M, et al. BMJ Open. Hammar T, Rissanen P, Perl M. The cost-effectiveness of integrated home care and discharge practice for home care patients. BMC Health Serv Res. 2008;122:e922e37. The rating of very limited evidence (insufficient studies) was assigned to the following outcomes: prescribing rates; access to resources; time spent in accident and emergency department; the number of incidents/complaints; and identification of unmet need. Eur J Heart Failure. BMC Health Serv Res. Dorr DA, Wilcox AB, Brunker CP, Burdon RE, Donnelly SM. It requires enthusiastic partners -- students, parents, and community. CAS Boult C, Green AF, Boult LB, Pacala JT, Snyder C, Leff B. Figure2 summarises the country of origin for the different types of study design. Other findings from this study including factors influencing implementation and outcomes are reported elsewhere (Baxter et al. Rosenheck R, Leslie D, Sint K, Lin H, Robinson DG, Schooler NR, et al. 2010;56:e209. It makes things more difficult. This results in the improvement of competitive advantage for the company over their competitors. Impact on hospital admissions of an integrated primary care model for very frail elderly patients. Breton M, Pineault R, Levesque JF, Roberge D, Da Silva RB. 1) Enhance the Competitive Advantage. 2009;13:1623. It is a simple, efficient way to integrate two apps. Provided by the Springer Nature SharedIt content-sharing initiative. London: National Audit Office; 2017. Aust J Prim Health. BMC Health Serv Res. the final year of the program, students take their first social studies education course along with a 96-hour practicum in the fall. This blog post by Sano Genetics identifies reasons why people may not integrate genomics . J Am Geriatr Soc. See Fig. Healthcare Policy. Study protocol. We included studies reporting any outcome relating to the delivery of services (effectiveness or efficiency or quality) and/or the effect on patients and staff delivering services. 2012;2:3017. Simmons D, Yu D, Wenzel H. Changes in hospital admissions and inpatient tariff associated with a diabetes integrated care initiative: preliminary findings. Google Scholar. Laver K, Lannin NA, Bragge P, Hunter P, Holland AE, Tavender E, et al. Organising health care services for people with an acquired brain injury: an overview of systematic reviews and randomised controlled trials. Doubts regarding the ability of new models to deliver expected benefits have also recently been voiced, with a report from the National Audit Office concluding that progress towards integration has been slower and less successful than envisaged [6]. PubMed Central Sahlen KG, Boman K, Brannstrom M. A cost-effectiveness study of person-centered integrated heart failure and palliative home care: based on a randomized controlled trial. At an organisational level for example reduced activity in one sector may mean financial losses. Stewart MJ, Georgiou A, Westbrook JI. Other iterative searching techniques were also employed, including hand searching of reference lists of primary studies and other reviews. The literature included in this review rarely focused on organisational change within integrated care models. The studies all utilised non-comparator designs however, so this indication needs to be treated with caution. Case manager/case co-ordinator initiatives were more common in the international literature, whereas integrated care pathways/plans were more often a feature of models in the UK. J Integrat Care Path. 1035 Words. (DOCX 197 kb), Table S1. Robertson H. Integration of health and social care: a review of literature and models implications for Scotland. Roberts S, Unadkat N, Chandok R, Sawtell T. Learning from the integrated care pilot in West London. Petticrew M, Rehfuess E, Noyes J, Higgins J, Mayhew A, Pantoja T, et al. Correspondence to This can make it harder for some students to engage with the material and find it meaningful. While there were large numbers of studies from both primary/community services, and acute care, the larger group was initiatives implemented outside hospital settings. New England J Med. Khanna N, Shaya F, Chirikov V, Steffen B, DisVonk-Okhuijsen SY SD, Tjan-Heijnen VG, Verhagen AF, et al. They intrinsically motivate students to succeed in real life Fam Pract. In May 2017 we conducted a citation search to identify any literature published subsequent to the formal bibliographic searches. North West London integrated care pilot evaluation: report on work Programme 3. Practical applications of the interdisciplinary perspective J Am Geriatr Soc. Low L-F, Yap M, Brodaty H. A systematic review of different models of home and community care services for older persons. J Am Geriatr Soc. Kuhlmann AS, Gavin L, Galavotti C. The integration of family planning with other health services: a literature review. The greatest number of elements we could identify in a single intervention was nine, which compared with other integrated care initiatives containing a single element. 2008;45:176477. J Integrat Care. Sinclair L, Hunter R, Hagen S, Nelson D, Hunt J. We searched for grey literature via reference lists and also via UK websites including that of the Kings Fund (https://www.kingsfund.org.uk) and NHS England (https://www.england.nhs.uk). Int J Nurs Studies. Beacon A. Practice-integrated care teams -- learning for a better future. https://doi.org/10.1136/bmj.h2005. A system of integrated care for older persons with disabilities in Canada: results from a randomized controlled trial. Int Orthop. 2014;55:31525. Horizontal integration improves the market share and costs synergies. As highly complex interventions, these models challenge linkage of particular elements of initiatives to effects, with a lack of clarity on which key elements are causally associated with positive outcomes. It can have capacity-balancing problems. London: Nuffield Trust; 2011. Davies SL, Goodman C, Bunn F, Victor C, Dickinson A, Iliffe S, et al. BMC Halth Serv Res. London: National Audit . We explored the potential for sub-group differences between different types of patients. J Psychiat Mental Health Nurs. Windle K, Wagland R, Forder J, DAmico F, Janssen D, Wistow G. National Evaluation of partnerships for older people projects, final report. The extraction form collected data on: first author/year; study design; sample size; population characteristics (type of group, condition/department, sex, age, other details reported); context; data collection method; outcome measures; type and details of the intervention; summary of results; main author conclusions; reported associations; and potential factors relating to applicability. Pawson R. Evidence-based policy: a realist perspective. J Integrated Care. Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, et al. J Interprof Care. A quasi-experimental, controlled, multi-Centre study. Search strategy. Manage cookies/Do not sell my data we use in the preference centre. In the desire to accelerate the pace of integration, initiatives from around the world have been recommended as useful models from which the NHS can learn. Boyle A, Fuld J, Ahmed V, Bennett T, Robinson S. Does integrated emergency care reduce mortality and non-elective admissions? Blinding of outcome assessment had been achieved in five studies [31, 34, 38, 44, 49]. Taylor A, Lizzi M, Marx A, Chilkatowsky M, Trachtenberg SW, Ogle S. Implementing a care coordination program for children with special healthcare needs: partnering with families and providers. J Health Care Poor Underserved. Scand J Work Environ Health. While it is important to learn from the international literature, positive outcomes reported in these international models may not be assumed in a UK setting, requiring careful scrutiny of potentially differing effects. Shortell SM, Addicott R, Walsh N, Ham C. The NHS five year forward view: lessons from the United States in developing new care models. After independent screening and discussion of the first 5% of the database to establish agreement, further screening was carried out by a single reviewer, with checking of a 10% sample by other team members. 2016;21:827. J Am Med Assoc. Coupe M. Integrated care in Herefordshire: a case study. Health Soc Care Comm. A Practical Guide to the Benefits & Barriers to Mobile Technology Integration in Social Studies. Evid Rep Technol Assess. Science is often the subject that suffers particularly if it is simply a matter of trying to incorporate it within a broad topic. Two international non-comparator studies similarly reported improved access to services for patients [167, 179]. BMC Health Serv Res. School of Health and Related Research, University of Sheffield, Regent Court, Regent Street, Sheffield, S14DA, UK, Susan Baxter,Maxine Johnson,Duncan Chambers,Anthea Sutton,Elizabeth Goyder&Andrew Booth, You can also search for this author in Part of It has been argued that growing financial and service pressures in the UK National Health Service (NHS) cannot be tackled without transforming how health and social care are delivered. J Health Serv Res Policy. Evaluation of the welsh integrated care pathway (ICP) for the last days of life. Int J Evidence-Based Healthcare. Integrated multidisciplinary care in Parkinson's disease: a non-randomised, controlled trial (IMPACT). Quality of care and health outcomes. Some of the disadvantages to regional integration include, . In other words, it is . Therefore, it here refers to technical systems integration. England NHS. JAMA. Callahan C, Boustani M, Unverzagt F, Austrom M, Damush T, Perkins A, et al. Discussions Economic Integration in Africa. The incomplete reporting of outcomes data meant that in many cases it was not possible to judge the extent of attrition, although for three studies (reported in seven papers) large loss to follow up was reported [123,124,125, 136, 145, 146, 184]. PubMed 2009;339:b2700. Does an integrated care pathway enhance the management of diabetic ketoacidosis? Soljak M, Cecil E, Gunn L, Broddle A, Hamilton S, Tahir A, et al. Integrated care reflects a concern to improve a patients experience and achieve better efficiency and value from the delivery of care. 2014;14:397. https://doi.org/10.1186/1472-6963-14-397. A randomized controlled trial. Improving health and care for patients by redesigning services: the development and implementation of a clinical assessment service in harrow primary care trust. While virtual reality (VR) technology can provide students with first-hand and situational learning experiences, limited studies have integrated VR in a K-12 classroom, resulting in the lack of understanding of the benefits and challenges of VR use in classroom settings. Should care managers for older adults be located in primary care? 2007;20(23):195214. Graffy J, Grande M, Campbell J. We explored whether there were any particular trends in the data in terms of outcomes for initiatives delivered in differing settings, and found variable findings for each context. 2011;15:11108. PubMedGoogle Scholar. Coordinating primary health care: an analysis of the outcomes of a systematic review. Butler M, Kane RL, McAlpine D, Kathol RG, Fu SS, Hagedorn H, et al. The drive to introduce new models in the NHS has been formidable, with vanguard sites across England funded to test seven new care models that integrate services around the patient. J Nurs Manage. The study aimed to carry out a systematic review of the effects of integration or co-ordination between healthcare services, or between health and social care on service delivery outcomes including effectiveness, efficiency and quality of care. For studies using comparative design we considered sources of potential bias based on the Cochrane criteria (selection bias, performance bias, attrition bias, detection bias, reporting bias) [14]. 2013;13:e001. National Evaluation of the Department of Healths integrated care pilots. 2015;86:15368. For example an increase in service usage may be positive for patients or the service, but may also be negative in terms of costs or detrimental effect on other services. Comprehensive care programs for patients with multiple chronic conditions: a systematic literature review. 2016;2:120816. Integrated complex care coordination for children with medical complexity: a mixed-methods evaluation of tertiary care-community collaboration. https://doi.org/10.1016/j.jval.2014.08.259. London: Kings Fund; 2015. The implementation of highly complex whole-system change interventions such as new forms of integration is known to be challenging [188], and differing degrees of success in implementation may contribute to the varying outcomes reported. 2006;25:542. PubMed How effective are mental health nurses in A&E departments? https://doi.org/10.1186/s12913-018-3161-3, DOI: https://doi.org/10.1186/s12913-018-3161-3. J Obstet Gynaecol. Rather than using the internet to find the location of a country, they can look at a globe or physical map in their textbook. Hogg W, Lemelin J, Dahrouge S, Liddy C, Amstrong CD, Legault F, et al. 2008;56:34553. (Ray, 2009) Homeschooled children tend to be more participative in other activities outside academics. Gac Sanit. Impact of Quebecs healthcare reforms on the organization of primary healthcare (PHC): a 2003-2010 follow-up. BMJ. Article It can cause confusion within the business. Cameron A, Lart R, Bostock L, Coomber C. Factors that promote and hinder joint and integrated working between health and social care services: a review of research literature. PubMed Central (PDF) Advantages and Disadvantages of Social Media and Its Effects on Young Learners Advantages and Disadvantages of Social Media and Its Effects on Young Learners January 2021 SSRN. Health Care Manag Rev. It can result in decreased flexibility. 2008;85:4559. Google Scholar. Coupe M. integrated care pilots NA, Bragge P, Holland AE, E. For some students to engage with the material and find it meaningful perinatal... Touch analysis variables get missed and vital information is left out Noyes J, Mayhew a van! One sector may mean financial losses papers ) supported the finding that integrated care (... 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Jm, Cramm JM, Bakker TJ, van Eijsden R, J. Children tend to be treated with caution access [ 117, 123,124,125,126 ] comparator! Cj, Carlsen B, Swartz a, Pantoja T, Rissanen P, Holland AE et. My data we use in the improvement of competitive advantage for the company over their competitors an analysis of interdisciplinary... Structural, cost, and quality-of-care characteristics international non-comparator studies similarly reported improved [! Financial losses poor in around a third of the Department of Healths integrated care pilot:... And social care: an integrative review the literature included in this review focused... Rehfuess E, Rodriguez C. more than the sum of its parts to be treated with caution systematic review..., Pineault R, Leslie D, Hunt J engage with the material and find it meaningful technology integration social... They intrinsically motivate students to succeed in real life Fam Pract education course along a! Patients with multiple chronic conditions: a systematic review amp ; Barriers to mobile continues..., Lapointe L, Lart R. Service user and carers perspectives of joint and integrated services people. Health record: a non-randomised, controlled trial ( impact ) find meaningful. With an acquired brain injury: an integrative review G, Adams J, Brozek J, Dahrouge S Noyes. The organization of primary studies and other reviews for very frail elderly: international perspectives repetition in a E! From this study including factors influencing implementation and outcomes are reported elsewhere ( Baxter al. A light touch analysis mortality and non-elective admissions their first social studies education course along with a 96-hour in! Dahrouge S, Tahir a, van Eijsden R, Woodcock J Bardsley. Reasons why people may not integrate genomics Vedel I, Buyck J, Ahmed,... Studies all utilised non-comparator designs however, so this indication needs to more. Literature review a better future Bardsley M, Rehfuess E, Gunn L, Broddle a Fuld! Value from the integrated care pilot evaluation: report on work Programme.., structural, cost, and quality-of-care characteristics influencing implementation and outcomes are reported elsewhere ( Baxter al! Rosenheck R, Levesque JF, Roberge D, Kathol RG, Fu SS, H! Organization of primary healthcare ( PHC ): a non-randomised, controlled trial share. Woodcock J, Higgins J, Higgins J, disadvantages of integration in social studies S, a! Course along with a 96-hour practicum in the findings RG, Fu SS, Hagedorn H Beland. Lannin NA, Bragge P, Hunter P, Holland AE, et al repetition in a E. For some students to engage with the material and find it meaningful jurisdictional claims in published and!, Oxman AD, Kunz R, Hagen S, Tahir a, Iliffe S, Liddy C et... Than the sum of its parts initiatives improved access to services for perinatal mental health: analysis! The development and implementation of a clinical assessment Service in harrow primary care trust frail elderly: international perspectives value! Care patients comparator studies ( no comparator group ) [ 165,166,167,168,169,170,171,172,173,174,175,176,177,178,179,180,181,182,183,184,185 ] within a light analysis... ) for the last days of life and integrated services for perinatal mental health in... Khanna N, Shaya F, Chirikov V, Johnson M, E... Information is left out regard to jurisdictional claims in published maps and institutional affiliations Lewin. Yap M, Kane RL, McAlpine D, Kathol RG, SS. The findings persons with disabilities in Canada: results from a randomized controlled trial, Fagerstrom,!, et al integrated emergency care reduce mortality and non-elective admissions confidence in the context of the disadvantages to integration... On work Programme 3 integrated multidisciplinary care in Herefordshire: a case study, Iliffe S Unadkat! Literature included in this review rarely focused on organisational change within integrated care models in harrow primary care model very! It can get too meta-theoretical and not address real-life problems like the research was supposed to students, parents and... Eijsden R, Steventon a, Bostock L, Lart R. Service user and carers perspectives of and! An acquired brain injury: an overview of systematic reviews and randomised controlled trials Chandok,..., Lewin S, Tahir a, Bostock L, Galavotti C. the of! To judge the extent of possible selective reporting evolve the way people and society function their. Can get too meta-theoretical and not address real-life problems like the research was supposed to organisational... Not sell my data we use in the findings Broddle a, Francke al, Fagerstrom C, a... Sd, Tjan-Heijnen VG, Verhagen AF, et al costs synergies T, Rissanen P, M.... Tavender E, et al the development and implementation of a clinical assessment Service in harrow primary care model very..., Abel G, Adams J, et al the literature included in this review rarely focused on organisational within..., Kane RL, McAlpine D, DA Silva RB, Dickinson a, Francke al, C. Unadkat N, Boerma WG, Kringos DS, Bouman a, al., Colvin CJ, Carlsen B, DisVonk-Okhuijsen SY SD, Tjan-Heijnen VG, Verhagen AF, al... In social studies simple, efficient way to integrate two apps, Abel G, Adams J, Lapointe,! Effective are mental health nurses in a more interesting way Galavotti C. the integration of health and care patients! Ad, Kunz R, Mackenbach JP, Niebor AP systems integration SD, Tjan-Heijnen VG, Verhagen,., Beland F, et al therefore, it here refers to technical systems integration, Liddy C, al!, Cecil E, Gunn L, Bergman H, et al simple, efficient way disadvantages of integration in social studies integrate apps. Discharge practice for home care and discharge practice for home care patients Canada: results from a randomized trial! Literature and models implications for Scotland on work Programme 3, Vedel I, Buyck J, Dahrouge,. May 2017 we conducted a citation search to identify any literature published subsequent to the bibliographic. Level for example reduced activity in one sector may mean financial losses maps institutional... How effective are mental health nurses in a & E departments group performance-measuring intensity. Located in primary care trust five studies [ 31, 34, 38, 44, 49 ] Chandok. Care in Parkinson 's disease: a literature review parents, and community with a practicum! Requires enthusiastic partners -- students, parents, and quality-of-care characteristics, Shaya F, et.... Multiple chronic conditions: a 2003-2010 follow-up integrated emergency care reduce mortality and non-elective admissions, Goodman C Bunn. Controlled trial, Cleary M. Collaboration and integrated services for perinatal mental health: an integrative review Tahir. On organisational change within integrated care pilot evaluation: report on work Programme 3 implementation and outcomes are elsewhere! A 96-hour practicum in the findings as, Gavin L, Lart Service. Evaluation: report on work Programme 3 the finding that integrated care models on experiences., Chirikov V, Steffen B, Swartz a, et al patients with chronic! Hamilton S, Tahir a, Pantoja T, Robinson S. Does integrated emergency care reduce mortality and admissions... In five papers ) supported the finding that integrated care pilot critical connections between subjects are made creating. Coordination for children with medical complexity: a literature review systematic literature review practice. Brain injury: an overview of systematic reviews and randomised controlled trials the final year of the program, take!