scholarly journals Mergers of primary care organizations: a systematic review of the literature

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Pascucci ◽  
A Sindoni ◽  
C De Vito ◽  
G Damiani
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Large Scale ◽  
Economies Of Scale ◽  
Assessment Tool ◽  
Developed Countries ◽  
Cross Sectional ◽  
Practice List ◽  
Keywords Screening ◽  
The Impact

Abstract Background Mergers as large-scale collaborations in primary care organizations have become a commonplace in developed countries to offer economies of scale and more efficient delivery of care to population. The aim of this systematic review is to summarize the scientific evidence on the relationship between the increase in the size of organizations providing primary care services and their performance. Methods The PICO model was adopted and three electronic databases (Medline, Scopus, ISI Web of Knowledge) were searched using appropriate keywords. Screening by title and abstract and data extraction were performed by two independent investigators. Articles, written in English, evaluating the performance after increasing the size of an organization were included. Selected articles were assessed for quality and risk of bias using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Process and outcome quality indicators were used for evaluation. Results From a total of 1337, 12 studies met the inclusion criteria and 103 indicators were identified: 59.2% did not show any variation, 33.9% improved significantly after the merger, 6.9% worsened after the merger. In particular, diabetes care did not show any statistically significant variation in 40.0 % of the indicators, while 10.0 % showed an improvement and 10.0% a worsening in clinical outcomes. A significant negative association was found between practice list size and reported non-urgent or urgent doctors’ availability (P < 0.05, both). The process of merging also created perceptions of takeover and had a negative effect on staff. Conclusions The effects of mergers are conflicting and there is little evidence that the performance is associated with the size of the structures involved. Assessment on the impact of primary care mergers should to be related to the population needs and the context where these processes are carried out. Key messages Merging processes may lead to contrasting results. To assess periodically and systematically the impact of mergers in a continuous quality improvement cycle.

scholarly journals IMPACT OF COVID-19 PANDEMIC ON MENTAL AND EMOTIONAL WELLBEING AMONG CHILDREN: A SYSTEMATIC REVIEW

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Dior Manta Tambunan ◽  
Nunung Nurjanah ◽  
Siti Dewi Rahmayanti ◽  
Rahmi Imelisa ◽  
Faridah binti Mohd Said ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Status ◽  
Online Survey ◽  
Assessment Tool ◽  
Academic Research ◽  
Psychological Status ◽  
Systematic Research ◽  
Emotional Wellbeing ◽  
Cross Sectional ◽  
The Impact

Background: Coronavirus pandemic represents a huge threat and phenomenal risks on mental and emotional wellness among children. This systematic review expects to integrate academic research literature that provides details regarding the impact of COVID-19 on emotional wellbeing and mental status among children. Methods: A systematic research engine was escorted on PubMed, Proquest, ScienceDirect, and Google Scholar with keywords: Children, COVID-19, Mental Status, Psychological Status from December 2019 to 18 November 2020 following the PRISMA guidelines. Articles were chosen dependent on the predetermined eligibility criteria. The included articles to review used the Quality Assessment Tool Adapted from the National Institutes of Health (NIH). Results: A total of 17,059 records were identified using the keywords. After removal of duplicates and initial screening, seven articles met the inclusion criteria of COVID-19 influence on mental and emotional wellbeing among children. The research design was a longitudinal and cross-sectional online survey with the children age range was 3 – 18 years old. Conclusions: COVID-19 Pandemic has a significant influence on mental and emotional wellbeing among children. Some children experienced depressive indication, difficulty concentrating, anxiety, touchy and easy to get irritated. Limitations: Online survey generalized the results, younger children might need assistance from parents during filling up the questionnaire, small sampling size.

scholarly journals Seroprevalence and lethality by SARS-CoV-2 in indigenous populations of Latin America and the Caribbean: a systematic review

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12552
Author(s):  
Akram Hernández-Vásquez ◽  
Fabian Chavez-Ecos ◽  
Antonio Barrenechea-Pulache ◽  
Daniel Comandé ◽  
Guido Bendezu-Quispe
Keyword(s):  
Systematic Review ◽  
Latin America ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Indigenous Communities ◽  
Indigenous Populations ◽  
Qualitative Synthesis ◽  
Cross Sectional ◽  
The Caribbean ◽  
The Impact

Background Latin America and the Caribbean (LAC) has presented some of the highest numbers of cases and deaths due to COVID-19 in the world. Even though indigenous communities represent 8% of the total population in this region, the impact of COVID-19 on this historically vulnerable population has only been briefly explored. Thus, this study aimed to estimate the seroprevalence and lethality attributable to SARS-CoV-2 in the indigenous population of LAC. Methods A systematic review was conducted utilizing multiple databases (registry PROSPERO: CRD42020207862). Studies published in English, Spanish or Portuguese were selected between December 1st, 2019, and April 14th, 2021. The evaluation of the quality of the study was carried out utilizing the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A qualitative synthesis of the data analyzed was conducted following the MOOSE and PRISMA declarations. Results Fifteen studies met the inclusion criteria. Eleven studies were carried out in a Brazilian population, three in a Mexican population, and one in a Colombian population. Four studies reported data about the seroprevalence of SARS-CoV-2 in indigenous populations of Brazil (range: 4.2–81.65%). Twelve studies reported lethality in indigenous people (eight in Brazil, three in Mexico, and one in Colombia). In Brazil, a lethality of 53.30% was described in a hospital setting and between 1.83% and 4.03% in community studies. In Mexico, the lethality of COVID-19 ranged between 16.5% and 19.9%. Meanwhile, in Colombia, a lethality of 3.41% was reported. Most studies were deemed to be of good quality. Conclusions Despite COVID-19 affecting indigenous populations of LAC, there is limited evidence of the seroprevalence and lethality of the infection by SARS-CoV-2 in this population. Future investigations should ensure standardized methods that allow comparability among studies and ensure the precision of the results obtained.

scholarly journals The impact of large scale licensing examinations in highly developed countries: a systematic review

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Julian Archer ◽  
Nick Lynn ◽  
Lee Coombes ◽  
Martin Roberts ◽  
Tom Gale ◽  
...  
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Developed Countries ◽  
The Impact ◽  
Licensing Examinations

The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Central Obesity ◽  
Assessment Tool ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Dietary Factors ◽  
Cross Sectional ◽  
Inflammatory Status ◽  
Obesity Indices

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.

scholarly journals Anti-meningococcal B vaccination in Italian adolescents: a cost-effective health opportunity

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Panatto ◽  
P Landa ◽  
D Amicizia ◽  
P L Lai ◽  
E Lecini ◽  
...  
Keyword(s):  
Large Scale ◽  
Public Health Problem ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Dose Schedule ◽  
Developed Countries ◽  
Invasive Disease ◽  
International Setting ◽  
The Impact

Abstract Background Invasive disease due to Neisseria meningitidis (Nm) is a serious public health problem even in developed countries, owing to its high lethality rate (8-15%) and the invalidating sequelae suffered by many (up to 60%) survivors. As the microorganism is transmitted via the airborne route, the only available weapon in the fight against Nm invasive disease is vaccination. Our aim was to carry out an HTA to evaluate the costs and benefits of anti-meningococcal B (MenB) vaccination with Trumenba® in adolescents in Italy, while also considering the impact of this new vaccination strategy on organizational and ethics aspects. Methods A lifetime Markov model was developed. MenB vaccination with the two-dose schedule of Trumenba® in adolescents was compared with 'non-vaccination'. Two perspectives were considered: the National Health Service (NHS) and society. Three disease phases were defined: acute, post-acute and long-term. Epidemiological, economic and health utilities data were taken from Italian and international literature. The analysis was conducted by means of Microsoft Excel 2010®. Results Our study indicated that vaccinating adolescents (11th year of life) with Trumenba® was cost-effective with an ICER = € 7,912/QALY from the NHS perspective and € 7,758/QALY from the perspective of society. Vaccinating adolescents reduces the number of cases of disease due to meningococcus B in one of the periods of highest incidence of the disease, resulting in significant economic and health savings. Conclusions This is the first study to evaluate the overall impact of free MenB vaccination in adolescents both in Italy and in the international setting. Although cases of invasive disease due to meningococcus B are few, if the overall impact of the disease is adequately considered, it becomes clear that including anti-meningococcal B vaccination into the immunization program for adolescents is strongly recommended from the health and economic standpoints. Key messages Free, large-scale MenB vaccination is key to strengthening the global fight against invasive meningococcal disease. Anti-meningococcal B vaccination in adolescents is a cost-effective health opportunity.

scholarly journals Assessing the Impact of Multi-Morbidity and Related Constructs on Patient Reported Safety in Primary Care: Generalized Structural Equation Modelling of Observational Data

2021 ◽  
Vol 10 (8) ◽  
pp. 1782
Author(s):  
Ignacio Ricci-Cabello ◽  
Aina María Yañez-Juan ◽  
Maria A. Fiol-deRoque ◽  
Alfonso Leiva ◽  
Joan Llobera Canaves ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Cross Sectional ◽  
Morbidity Burden ◽  
Patient Reported ◽  
Patient Complexity ◽  
Complex Relationships ◽  
The Impact

We aimed to examine the complex relationships between patient safety processes and outcomes and multimorbidity using a comprehensive set of constructs: multimorbidity, polypharmacy, discordant comorbidity (diseases not sharing either pathogenesis nor management), morbidity burden and patient complexity. We used cross-sectional data from 4782 patients in 69 primary care centres in Spain. We constructed generalized structural equation models to examine the associations between multimorbidity constructs and patient-reported patient safety (PREOS-PC questionnaire). These associations were modelled through direct and indirect (mediated by increased interactions with healthcare) pathways. For women, a consistent association between higher levels of the multimorbidity constructs and lower levels of patient safety was observed via either pathway. The findings for men replicated these observations for polypharmacy, morbidity burden and patient complexity via indirect pathways. However, direct pathways showed unexpected associations between higher levels of multimorbidity and better safety. The consistent association between multimorbidity constructs and worse patient safety among women makes it advisable to target this group for the development of interventions, with particular attention to the role of comorbidity discordance. Further research, particularly qualitative research, is needed for clarifying the complex associations among men.

scholarly journals What is the impact of multimorbidity on the risk of hospitalisation in older adults? A systematic review study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049974
Author(s):  
Luciana Pereira Rodrigues ◽  
Andréa Toledo de Oliveira Rezende ◽  
Letícia de Almeida Nogueira e Moura ◽  
Bruno Pereira Nunes ◽  
Matias Noll ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Study Protocol ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Increased Risk ◽  
Review Study ◽  
The Impact

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.

scholarly journals The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2123
Author(s):  
Daniela Pollakova ◽  
Aikaterini Andreadi ◽  
Francesca Pacifici ◽  
David Della-Morte ◽  
Davide Lauro ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Assessment Tool ◽  
Vegan Diet ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Observational Cohort ◽  
Meta Analyses ◽  
The Impact

A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta–Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women.

Breast Density Notification: A Systematic Review of the Impact on Primary Care Practitioners

2021 ◽  
Author(s):  
Brooke Nickel ◽  
Tessa Copp ◽  
Meagan Brennan ◽  
Rachel Farber ◽  
Kirsten McCaffery ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Breast Density ◽  
Primary Care Practitioners ◽  
The Impact

scholarly journals Measuring and assessing the impact of using volunteers in UK libraries: issues and methods

2014 ◽  
Vol 15 (3) ◽  
pp. 112-121 ◽  
Author(s):  
Judith Broady-Preston
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Third Sector ◽  
Professional Staff ◽  
Research Centre ◽  
Content Type ◽  
Qualitative Approaches ◽  
Starting Point ◽  
Third Sector Organisations ◽  
The Impact

Purpose – The purpose of this paper is to examine a range of issues and methods in relation to measuring the impact of volunteer labour on the design and delivery of all types of library services. With the increasing use of volunteers to deliver library and information services in all sectors, managers need to assess their effectiveness and evaluate the impact of their use in relation to operational service design and delivery, and on the development of the profession and professional practice as a whole. Presented here is an initial scoping study, outlining a range of issues, methods and challenges for more detailed future investigation. Design/methodology/approach – A number of methodological challenges and perspectives are identifiable. Contemporary libraries exhibit increasing similarities with Third Sector organisations, namely a complex stakeholder community, and increasing use of volunteers to supplement or replace services delivered by professional staff. Therefore, a starting point for the research is a systematic review and analysis of the methodologies developed by the Third Sector Research Centre, and those studies in the ESRC contemporary Developing Impact Evaluation strand. As a rich picture is required, both quantitative and qualitative approaches are necessary, with the overall study adopting a mixed methods approach. Findings – This paper reports the findings of the preliminary documentary analysis, literature review and scoping aspects of a large-scale study. Originality/value – Research undertaken to date (June 2014) has failed to identify any published systematic review and examination of these issues.

Sign in / Sign up

Export Citation Format

Share Document