Objectives: To review current understanding of the knowledge and information needs of informal caregivers in palliative settings. Data sources: Seven electronic databases were searched for the period January 1994-November 2006: Medline, CINAHL, PsychINFO, Embase, Ovid, Zetoc and Pubmed using a meta-search engine (Metalib®). Key journals and reference lists of selected papers were hand searched. Review methods: Included studies were peer-reviewed journal articles presenting original research. Given a variety of approaches to palliative care research, a validated systematic review methodology for assessing disparate evidence was used in order to assign scores to different aspects of each study (introduction and aims, method and data, sampling, data analysis, ethics and bias, findings/results, transferability/generalizability, implications and usefulness). Analysis was assisted by abstraction of key details of study into a table. Results: Thirty-four studies were included from eight different countries. The evidence was strongest in relation to pain management, where inadequacies in caregiver knowledge and the importance of education were emphasized. The significance of effective communication and information sharing between patient, caregiver and service provider was also emphasized. The evidence for other caregiver knowledge and information needs, for example in relation to welfare and social support was weaker. There was limited literature on non-cancer conditions and the care-giving information needs of black and minority ethnic populations. Overall, the evidence base was predominantly descriptive and dominated by small-scale studies, limiting generalizability. Conclusions: As palliative care shifts into patients' homes, a more rigorously researched evidence base devoted to understanding caregivers knowledge and information needs is required. Research design needs to move beyond the current focus on dyads to incorporate the complex, three-way interactions between patients, service providers and caregivers in end-of-life care settings. Palliative Medicine (2008); xxx: 1-19

Health professionals may contribute to the reduction of the negative effects of uncertainty through communication of information regarding process of care as well as medical issues. Strategies tailored to individual differences in information requirements and to changing needs may facilitate positive adjustment.

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Current evidence supports the use of procedural changes that improve the documentation of suspected child maltreatment and that enhance professional awareness. The lack of an evidence based approach to the implementation of child protection training may restrict the ability of all health professionals to fulfil their role in the child protection process. Formal evaluation of a variety of models for the delivery of this training is urgently needed with subsequent dissemination of results that highlight those found to be most effective.

The aim of this study is to describe the impact of patient knowledge and awareness of prostate cancer on their medical process from initial symptom detection to post treatment. Although research is gradually increasing in relation to prostate cancer, limited attention has been paid to the impact of inadequate knowledge on patient and spouse experience of the medical process despite the often complex and varied nature of the disease trajectory, treatment, and outcomes. An in-depth focus group design that incorporates open-structured questions was used to identify the attitudes and experiences of a sample of 12 prostate cancer patients and spouses. The findings of this study show that inadequacies in patient and spouse knowledge and awareness of prostate cancer contributed to delayed contact, shock at diagnosis, preferences regarding decision making, health judgments, including the use of the Prostate Specific Antigen test and physical well-being as accurate health indicators, and patient coping, incorporating the use of comparison with other patients. In conclusion, hospital staff, in particular the consultant and cancer nurse specialist, must be aware of the potential for inadequacy in patient and spouse knowledge and counter this through the provision of accurate and relevant information and support throughout the medical process. A series of recommendations have been generated.

WHAT IS ALREADY KNOWN IN THIS AREA • E-learning is being increasingly used within learning and teaching including its application within healthcare education and service provision. Multiple advantages have been identified including enhanced accessibility and increased flexibility of learning. Guidance on the generic-design and development of e-learning courses has been generated. WHAT THIS WORK ADDS • This paper provides a detailed understanding of the barriers and facilitators to e-learning as perceived by students on a continuing professional development (CPD); course arid highlights its multifaceted values. In addition, the paper ṕrovides evidence-based guidance for the development of courses within CPD utilising e-learning. SUGGESTIONS FOR FUTURE RESEARCH • Future research would benefit from, focusing upon the perceptions of staff including barriers and facilitators to the implementation of e-learning and awareness of student experience to generate a balanced and informed understanding of e-learning within the context-of CPD.

Background: The objectives of this study were twofold (i) to develop the Diabetes Manual, a selfmanagement educational intervention aimed at improving biomedical and psychosocial outcomes (ii) to produce early phase evidence relating to validity and clinical feasibility to inform future research and systematic reviews.

Background: There is increasing interest in developing peer-led and 'expert patient'-type interventions, particularly to meet the support and informational needs of those with long term conditions, leading to improved clinical outcomes, and pressure relief on mainstream health services. There is also increasing interest in telephone support, due to its greater accessibility and potential availability than face to face provided support. The evidence base for peer telephone interventions is relatively weak, although such services are widely available as support lines provided by user groups and other charitable services.