Systematic review of former unaccompanied immigrant minors’ access to healthcare services in the United States

Abstract Aim Former unaccompanied immigrant minors (UMs) now living in the USA are a uniquely vulnerable population. The US Office of Refugee Resettlement shelters provide health services, but most are discontinued once UMs leave the shelters. A systematic review was therefore designed to quantify access to medical, mental, and dental healthcare services by former UMs living in the USA. Subject and methods The study protocol was registered with PROSPERO. A search was made in Ovid MEDLINE, Embase, Scopus, and Academic Search Complete in June 2020. Full-text review, data extraction, and data analysis were completed by all authors. Results Searches returned a total of 2646 studies, of which 15 met all eligibility criteria. There was an overlap in the services investigated in the studies — 13 assessed mental health, ten assessed medical, and four included dental care. Sample sizes ranged from one to 4809, and there was a wide range of study designs. Some studies included multiple locations. Nine studies demonstrated success in community-based clinics or programs; one in a hospital, four in schools, three in group living settings, and one in U.S. Customs Border Patrol (CBP) custody. Three studies explored access to services post-release from shelters. Conclusions Healthcare programs at shelters, schools, and in the community have provided some screening and diagnosis of medical, mental health, and dental conditions for UMs, but multiple financial and cultural barriers make ongoing treatment difficult to access. Long-term studies following UMs in shelters and post-release through adulthood are needed to help create new, or modify existing, programs, to adequately support UMs now living in the USA.

Download Full-text

A Systematic Review of the Use of Telemedicine in the Military Forces Worldwide

Shiraz E-Medical Journal ◽

10.5812/semj.99343 ◽

2020 ◽

Vol 21 (11) ◽

Author(s):

Reza Mohammadi ◽

Zeinab Tabanejad ◽

Shahabeddin Abhari ◽

Behnam Honarvar ◽

Mina Lazem ◽

...

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Healthcare Providers ◽

Military Medicine ◽

Healthcare Services ◽

Developed Countries ◽

The United States ◽

Positive Effects ◽

Military Forces ◽

The Military

Context: Considering the pivotal role of telemedicine in providing healthcare services for remote areas, some of the military medical centers, especially in developed countries, use different types of telemedicine programs. Objectives: The present study aimed at identifying the implemented telemedicine projects in military medicine worldwide and introducing their features. Evidence Acquisition: The current systematic review was performed in 2018. PubMed, Scopus, Embase, and Web of Science databases were searched for articles published from 2014 to 2018 by a combination of related keywords, and the related original articles were then selected based on the inclusion and exclusion criteria. Data were collected by a data extraction form, and then the data were summarized and reported based on the study objectives. Results: Of the 173 articles retrieved from the first round of search, 12 were included in the study; five (41.66%) studies had used the synchronous (real-time telemedicine) method. The United States, with nine studies, had the highest number of projects in military telemedicine. Most studies (n = 7) were performed on tele-psychology and the application of telemedicine in psychology. All selected studies reported the positive effects of telemedicine on providing healthcare for military forces. Conclusions: The proper utilization of telemedicine equipment is effective in saving time for both patients and healthcare providers, reducing costs, supporting in natural disasters, and satisfying patients with military medicine. To achieve telemedicine program objectives, they should be set precisely. Considering the importance of timely healthcare services, it is suggested to utilize synchronous methods and tools such as video conferencing.

Download Full-text

A systematic review of patient prioritization tools in non-emergency healthcare services

Systematic Reviews ◽

10.1186/s13643-020-01482-8 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Julien Déry ◽

Angel Ruiz ◽

François Routhier ◽

Valérie Bélanger ◽

André Côté ◽

...

Keyword(s):

Systematic Review ◽

Selection Process ◽

Data Extraction ◽

Waiting Times ◽

Healthcare Services ◽

Process Data ◽

Eligibility Criteria ◽

Published Evidence ◽

Patient Prioritization ◽

The Impact

Abstract Background Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings. Methods We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently. Results We included 48 studies listing 34 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two-thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients. Conclusions This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings. Systematic review registration PROSPERO CRD42018107205

Download Full-text

A Systematic Review of Patient Prioritization Tools in Non-Emergency Healthcare Services

10.21203/rs.3.rs-29776/v1 ◽

2020 ◽

Author(s):

Julien Dery ◽

Angel Ruiz ◽

François Routhier ◽

Valérie Bélanger ◽

André Côté ◽

...

Keyword(s):

Systematic Review ◽

Selection Process ◽

Data Extraction ◽

Waiting Times ◽

Healthcare Services ◽

Process Data ◽

Eligibility Criteria ◽

Published Evidence ◽

Patient Prioritization ◽

The Impact

Abstract Background: Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings. Methods: We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently. Results: We included 47 studies listing 33 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients. Conclusions: This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings. Systematic review registration: PROSPERO CRD42018107205

Download Full-text

The impact of COVID-19 lockdown on child and adolescent mental health: systematic review

European Child & Adolescent Psychiatry ◽

10.1007/s00787-021-01856-w ◽

2021 ◽

Cited By ~ 1

Author(s):

Urvashi Panchal ◽

Gonzalo Salazar de Pablo ◽

Macarena Franco ◽

Carmen Moreno ◽

Mara Parellada ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Children And Adolescents ◽

Data Extraction ◽

Significant Risk ◽

Vulnerable Groups ◽

Depression Symptoms ◽

Negative Effects ◽

Wide Range ◽

The Impact

AbstractCOVID-19 was declared a pandemic in March 2020, resulting in many countries worldwide calling for lockdowns. This study aimed to review the existing literature on the effects of the lockdown measures established as a response to the COVID-19 pandemic on the mental health of children and adolescents. Embase, Ovid, Global Health, PsycINFO, Web of Science, and pre-print databases were searched in this PRISMA-compliant systematic review (PROSPERO: CRD42021225604). We included individual studies reporting on a wide range of mental health outcomes, including risk and protective factors, conducted in children and adolescents (aged ≤ 19 years), exposed to COVID-19 lockdown. Data extraction and quality appraisal were conducted by independent researchers, and results were synthesised by core themes. 61 articles with 54,999 children and adolescents were included (mean age = 11.3 years, 49.7% female). Anxiety symptoms and depression symptoms were common in the included studies and ranged 1.8–49.5% and 2.2–63.8%, respectively. Irritability (range = 16.7–73.2%) and anger (range = 30.0–51.3%), were also frequently reported by children and adolescents. Special needs and the presence of mental disorders before the lockdown, alongside excessive media exposure, were significant risk factors for anxiety. Parent–child communication was protective for anxiety and depression. The COVID-19 lockdown has resulted in psychological distress and highlighted vulnerable groups such as those with previous or current mental health difficulties. Supporting the mental health needs of children and adolescents at risk is key. Clinical guidelines to alleviate the negative effects of COVID-19 lockdown and public health strategies to support this population need to be developed.

Download Full-text

Farmer Mental Health Interventions: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010244 ◽

2021 ◽

Vol 19 (1) ◽

pp. 244

Author(s):

Terasa Younker ◽

Heidi Liss Radunovich

Keyword(s):

Mental Health ◽

Systematic Review ◽

Health Literacy ◽

Mental Health Literacy ◽

The United States ◽

Evidence Base ◽

Health Interventions ◽

Rigorous Evaluation ◽

Wide Range ◽

Mental Health Interventions

The prevalence of mental health disorders and suicide amongst agricultural producers is a global problem. Community leaders, researchers, policymakers, and clinicians have mobilized to develop programs to address this issue. This study reviewed a wide range of mental health interventions targeting farmer mental health spanning over 50 years and examined their reported effectiveness and constraints. A total of ninety-two articles on farmer mental health were included in a final systematic review. Most articles were written concerning mental health literacy and peer and paraprofessional support interventions in the United States and Australia. Among the 56 studies reporting empirical evaluative data, 21 were mixed-method, 20 quantitative, 11 qualitative, and 5 literature synthesis. Non-experimental, self-reported, and qualitative data suggest efficacy of mental health literacy programs, peer and paraprofessional support, and community-based and agroecological interventions. However, most interventions were not subject to rigorous evaluation and only one intervention was evaluated using a control condition. The heterogeneity of existing studies and paucity of rigorous evaluation proscribes firm conclusions related to program-type efficacy. This review demonstrates that there is still a need for a stronger and broader evidence base in the field of farmer mental health interventions, which should focus on both holistic, multi-component programs and targeted approaches.

Download Full-text

Patient, client, consumer, survivor or other alternatives? A scoping review of preferred terms for labelling individuals who access healthcare across settings

BMJ Open ◽

10.1136/bmjopen-2018-025166 ◽

2019 ◽

Vol 9 (3) ◽

pp. e025166 ◽

Cited By ~ 2

Author(s):

Daniel S J Costa ◽

Rebecca Mercieca-Bebber ◽

Stephanie Tesson ◽

Zac Seidler ◽

Anna-Lena Lopez

Keyword(s):

Cancer Survivorship ◽

Data Extraction ◽

Reporting Quality ◽

Healthcare Services ◽

Eligibility Criteria ◽

Scoping Study ◽

Healthcare Settings ◽

Mental Health Settings ◽

The Usa ◽

Study Characteristics

ObjectivesUse of the term ‘patient’ has been recently debated, compared with alternatives including ‘consumer’ and ‘client’. This scoping study aimed to provide an integrated view of preferred labels across healthcare contexts and countries to clarify labelling preferences of individuals accessing healthcare.DesignScoping study.Data sourcesA preliminary literature search using GoogleScholar, Medline, Embase and PsycINFO found 43 key papers discussing terminology for labelling individuals accessing healthcare services. We then used citation chaining with PubMed and GoogleScholar to identify studies discussing term preferences among healthcare recipients.Eligibility criteriaNo date limits were applied, and all healthcare settings were considered. Primary research studies examining terminology preferences of individuals accessing healthcare, published in peer-reviewed journals were eligible.Data extraction and synthesisAll authors extracted data regarding preferred term and study characteristics, and assessed reporting quality of the studies using criteria relevant to our design.ResultsWe identified 1565 articles, of which 47 met inclusion criteria. Six articles that examined preference for personal address (eg, first name) were excluded. Of the remaining 41 studies, 33 examined generic terms (‘patient’, ‘client’, ‘consumer’) and 8 focused on cancer survivorship. Of the 33 examining generic terms, 27 reported a preference for ‘patient’ and four for ‘client’. Samples preferring ‘client’ were typically based in mental health settings and conducted in the USA. Of the eight cancer survivorship studies, five found a preference for ‘survivor’, and three ‘someone who had had cancer’.ConclusionsOverall, healthcare recipients appear to prefer the term ‘patient’, with few preferring ‘consumer’. Within general clinical and research contexts, it therefore seems appropriate to continue using the label ‘patient’ in the absence of knowledge about an individual’s preferences. Reasons for preferences (eg, familiarity, social identity) and the implications of labelling for healthcare have not been investigated adequately, necessitating future empirical (including qualitative) research.

Download Full-text

Incorporating mental health into health impact assessment in the United States: a systematic review

Journal of Public Mental Health ◽

10.1108/jpmh-01-2016-0003 ◽

2016 ◽

Vol 15 (3) ◽

pp. 150-176 ◽

Cited By ~ 1

Author(s):

Kelsey Lucyk ◽

Kim Gilhuly ◽

Ame-Lia Tamburrini ◽

Bethany Rogerson

Keyword(s):

Mental Health ◽

Systematic Review ◽

Impact Assessment ◽

Health Impact Assessment ◽

Health Impact ◽

The United States ◽

Health Conditions ◽

Content Type ◽

Mental Health Conditions ◽

The Usa

Purpose Health impact assessment (HIA) is a systematic research and public engagement tool used to elevate health and equity in public policies. However, HIA practitioners often overlook potential mental health impacts. The purpose of this paper is to review the degree to which mental health is included in HIAs in the USA. Design/methodology/approach The authors conducted a systematic review of 156 HIAs that were completed between 1993 and 2013 for their inclusion of mental health. HIAs were subdivided to assess if mental health conditions or their determinants were measured, and if predictions or mitigation strategies were made in the scoping, assessment, or recommendations phases. Findings Overall, 73.1 percent of HIAs included mental health. Of the HIAs that included mental health (n=114), 85.1 percent also included the determinants of mental health and 67.6 percent included mental health outcomes. 37.7 percent of HIAs measured baseline mental health conditions and 64.0 percent predicted changes in mental health as the result of implementing the proposed policy, plan, or program. Among the HIAs that made predictions about mental health, 79.5 percent included recommendations for potential changes in mental health, while only 46.6 percent had measured mental health at baseline. Research limitations/implications Although many HIAs included mental health in some capacity, this paper quantifies that mental health is not included in a robust way in HIAs in the USA. This presents a difficulty for efforts to address the growing issues of mental health and mental health inequities in the populations. Originality/value This paper represents the first academic endeavor to systematically assess the state of the field of HIA for its inclusion of mental health.

Download Full-text

A systematic review of patient prioritization tools in non-emergency healthcare services

10.21203/rs.3.rs-29776/v2 ◽

2020 ◽

Author(s):

Julien Dery ◽

Angel Ruiz ◽

François Routhier ◽

Valérie Bélanger ◽

André Côté ◽

...

Keyword(s):

Systematic Review ◽

Selection Process ◽

Data Extraction ◽

Waiting Times ◽

Healthcare Services ◽

Process Data ◽

Eligibility Criteria ◽

Published Evidence ◽

Patient Prioritization ◽

The Impact

Abstract Background. Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings.Methods. We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently.Results. We included 48 studies listing 34 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients.Conclusions. This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings.Systematic review registration: PROSPERO CRD42018107205

Download Full-text

Sexuality in Later Life and Mental Health Among Older Black Gay Men

Innovation in Aging ◽

10.1093/geroni/igaa057.1005 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 313-314

Author(s):

Darlingtina Esiaka ◽

Alice Cheng ◽

Candidus Nwakasi

Keyword(s):

Mental Health ◽

Gay Men ◽

Later Life ◽

The United States ◽

Mental Wellbeing ◽

Self Identity ◽

Sexual Identities ◽

Age Related ◽

Wide Range ◽

Black Gay Men

Abstract Self-acknowledgement and integration of racial and sexual identities are significant to one’s overall sense of identity because of their implications for mental health and wellbeing. These issues are important as one ages because older people experience a wide range of factors that add layers to their ability to (re)integrate subsets of their identity into their overall self-identity such as age and age-related disabilities. This study examined the intersection of race and sexual identities on overall health status in older Black gay men, a demographic group that has historically received less attention. Data from the Social Justice Sexuality (SJS) survey of LGBTQ+ people of color which occurred over a 12-month period in the United States were analyzed. Participants (N=160), 50 years and over, responded to questions about their sexuality, social identity, family dynamics, community connection and engagement, and mental and physical health. Results show an association of mental wellbeing with racial and sexual identities. Further, results show that a strong sense of connection to other sexual minorities is positively associated with mental health in older Black gay men. We discuss the implication of findings for mental health interventions targeting this gendered population.

Download Full-text

Contrast extravasation and outcome of endovascular therapy in acute ischaemic stroke: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044917 ◽

2021 ◽

Vol 11 (7) ◽

pp. e044917

Author(s):

Tao Xu ◽

You Wang ◽

Jinxian Yuan ◽

Yangmei Chen ◽

Haiyan Luo

Keyword(s):

Systematic Review ◽

Ischaemic Stroke ◽

Functional Outcome ◽

Endovascular Therapy ◽

Acute Ischaemic Stroke ◽

Data Extraction ◽

Meta Analysis ◽

Poor Functional Outcome ◽

Eligibility Criteria ◽

Contrast Extravasation

ObjectiveContrast extravasation (CE) after endovascular therapy (EVT) is commonly present in acute ischaemic stroke (AIS) patients. Substantial uncertainties remain about the relationship between CE and the outcomes of EVT in patients with AIS. Therefore, we aimed to evaluate this association.DesignA systematic review and meta-analysis of published studies were performed.Data sourceWe systematically searched the Medline and Embase databases for relevant clinical studies. The last literature search in databases was performed in June 2020.Eligibility criteria for study selectionWe included studies exploring the associations between CE and the outcomes of EVT in patients with AIS undergoing EVT.Data extraction and synthesisTwo reviewers extracted relevant information and data from each article independently. We pooled ORs with CIs using a random-effects meta-analysis to calculate the associations between CE and outcomes of EVT. The magnitude of heterogeneity between estimates was quantified with the I2 statistic with 95% CIs.ResultsFifteen observational studies that enrolled 1897 patients were included. Patients with CE had higher risks of poor functional outcome at discharge (2.38, 95% CI 1.45 to 3.89 p=0.001; n=545) and poor functional outcome at 90 days (OR 2.16, 95% CI 1.20 to 3.90; n=1194). We found no association between CE and in-hospital mortality (OR 0.95, 95% CI 0.27 to 3.30; n=376) or 90-day mortality (OR 1.38, 95% CI 0.81 to 2.36; n=697) after EVT. Moreover, CE was associated with higher risks of post-EVT intracranial haemorrhage (ICH) (OR 6.68, 95% CI 3.51 to 12.70; n=1721) and symptomatic ICH (OR 3.26, 95% CI 1.97 to 5.40; n=1092).ConclusionsThis systematic review and meta-analysis indicates that in patients with AIS undergoing EVT, CE is associated with higher risks of unfavourable functional outcomes and ICH. Thus, we should pay more attention to CE in patients with AIS undergoing EVT.

Download Full-text