Bridging Health Disparity Gaps through the Use of Medical Legal Partnerships in Patient Care: A Systematic Review

Over the past two decades, we have seen an increase in the use of medical-legal partnerships (MLPs) in health-care and/or legal settings to address health disparities affecting vulnerable populations. MLPs increase medical teams' capacity to address social and environmental threats to patients' health, such as unsafe housing conditions, through partnership with legal professionals. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, we systematically reviewed observational studies published from January 1993-January 2016 to investigate the capacity of MLPs to address legal and health disparities. We identified 13 articles for qualitative analysis from an initial pool of 355 records. The resulting pool of 13 articles revealed more information regarding the capacity of MLPs to address legal outcomes than their capacity to address health outcomes; only 4 studies directly addressed the impact of MLP intervention on patient wellbeing and/or patient utilization of healthcare services. We call for further evaluation/longitudinal studies that specifically address MLPs' short and long term effects upon patient health disparities. Finally, given the demonstrated capacity of MLPs to address unmet legal needs, and their evident potential in regards to improving health outcomes, we present the MLP model as a framework to address HIV-related legal and health disparities.

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Impact of COVID-19 and other pandemics and epidemics on people with pre-existing mental disorders: a systematic review protocol and suggestions for clinical care

BMJ Open ◽

10.1136/bmjopen-2020-040229 ◽

2020 ◽

Vol 10 (9) ◽

pp. e040229

Author(s):

Anjali Sergeant ◽

Emma Alaine van Reekum ◽

Nitika Sanger ◽

Alexander Dufort ◽

Tea Rosic ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Mental Disorders ◽

Health Outcomes ◽

Clinical Care ◽

Health Resources ◽

Healthcare Services ◽

Mental Health Outcomes ◽

Meta Analyses ◽

The Impact

IntroductionThe current COVID-19 pandemic has resulted in high rates of infection and death, as well as widespread social disruption and a reduction in access to healthcare services and support. There is growing concern over how the pandemic, as well as measures put in place to curb the pandemic, will impact people with mental disorders. We aim to study the effect of pandemics and epidemics on mental health outcomes for people with premorbid mental disorders.Methods and analysisWith our predefined search strategy, we will search five databases for studies reporting on mental health outcomes in people with pre-existing mental disorders during pandemic and epidemic settings. Search dates are planned as follows: 5 May 2020 and 23 July 2020. The following databases will be searched: MEDLINE/PubMed, CINAHL, PsycINFO, MedRxiv and EMBASE. Data will be screened and extracted in duplicate by two independent reviewers. Studies involving non-clinical populations or patients diagnosed with a mental disorder during a pandemic/epidemic will be excluded. We will include data collected from all pandemics and epidemics throughout history, including the present COVID-19 pandemic. If possible, study findings will be combined in meta-analyses, and subgroup analyses will be performed. We hope that this review will shed light on the impact of pandemics and epidemics on those with pre-existing mental disorders. Knowledge generated may inform future intervention studies as well as healthcare policies. Given the potential implications of the current pandemic measures (ie, disruption of healthcare services) on mental health, we will also compile a list of existing mental health resources.Ethics and disseminationNo ethical approval is required for this protocol and proposed systematic review as we will only use data from previously published papers that have themselves received ethics clearance and used proper informed consent procedures.Systematic review registrationPROSPERO registration number: CRD42020179611.

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Telemedicine in acute stroke management: Systematic review

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462310000139 ◽

2010 ◽

Vol 26 (2) ◽

pp. 149-155 ◽

Cited By ~ 44

Author(s):

Tim Johansson ◽

Claudia Wild

Keyword(s):

Systematic Review ◽

Health Outcomes ◽

Acute Stroke ◽

Healthcare Services ◽

Functional Health ◽

Transfer Of Knowledge ◽

Stroke Management ◽

Acute Stroke Care ◽

Permanent Disability ◽

The Impact

Objectives: Stroke is the third largest cause of death and a major factor in permanent disability. Disparities in access to healthcare services exist due to geographical barriers and limited resources. Rural locations often lack the resources for adequate acute stroke care. Telestroke is intended to enable the transfer of knowledge of acute stroke management to areas with limited neurological services. The objective of this study is to assess the feasibility, acceptability, and treatment delivery reliability of telemedicine systems in acute stroke management.Methods: A systematic review was undertaken.Results: Eighteen studies were included in this systematic review. Telestroke services have been reported to lead to better functional health outcomes, including reduced mortality and dependency, compared with conventional care. Most studies report that systemic tissue plasminogen activator (tPA) treatment increased in hospitals providing telestroke services, although patients were often transferred to a stroke center for continuing monitoring and surveillance. Patients and healthcare providers reported high levels of satisfaction. There was limited evidence regarding the impact on resource utilization and cost-effectiveness.Conclusions: Telemedicine systems can be safe, feasible, and acceptable in acute stroke management. Telestroke is associated with increased delivery of tPA. The lack of standardized measuring and reporting of resources and health outcomes hinder comparisons between telestroke networks and the determination of best practices. More research is needed to explore the clinical and economic impact of telemedicine technologies in acute stroke management, so as to support policy makers in making informed decisions.

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Technology-based Health Solutions for Cancer Caregivers to Better Shoulder the Impact of COVID-19: A Systematic Review Protocol

10.21203/rs.3.rs-66218/v1 ◽

2020 ◽

Author(s):

Zhaohui Su ◽

Dean McDonnell ◽

Bin Liang ◽

Jennifer Kue ◽

Xiaoshan Li ◽

...

Keyword(s):

Systematic Review ◽

Digital Health ◽

A Priori ◽

Healthcare Services ◽

Daily Basis ◽

Eligibility Criteria ◽

Healthcare Needs ◽

Cancer Caregivers ◽

Meta Analyses ◽

The Impact

Abstract Background Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning the distinctive challenges cancer caregivers face amid COVID-19. Additionally, this paper will present practical insights into the diverse intervention approaches that can assist in the delivery of digital health solutions for cancer caregivers amid and beyond COVID-19.Methods A systematic review of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus in September, 2020. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy was developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process.Results NA—This is a protocol study.Conclusions COVID-19 has uprooted cancer care as we know it. Due to barriers introduced by the COVID-19 pandemic, such as medical resources rationing, cancer caregivers often have to step up to address patients' healthcare needs and wants. This, in turn, will exert substantial stress on informal caregivers, above and beyond COVID-19-related burdens the general public shoulders on a daily basis. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond.Study Protocol Registration: PROSPERO CRD42020196301

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Technology-based Health Solutions for Cancer Caregivers to Better Shoulder the Impact of COVID-19: A Systematic Review Protocol

10.21203/rs.3.rs-66218/v2 ◽

2021 ◽

Author(s):

Zhaohui Su ◽

Dean McDonnell ◽

Bin Liang ◽

Jennifer Kue ◽

Xiaoshan Li ◽

...

Keyword(s):

Systematic Review ◽

A Priori ◽

Healthcare Services ◽

Eligibility Criteria ◽

Healthcare Needs ◽

Protocol Registration ◽

Review Protocol ◽

Cancer Caregivers ◽

Meta Analyses ◽

The Impact

Abstract Background: Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. Methods: A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March, 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. Conclusions: COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. Study Protocol Registration: PROSPERO CRD42020196301

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Technology-based health solutions for cancer caregivers to better shoulder the impact of COVID-19: a systematic review protocol

Systematic Reviews ◽

10.1186/s13643-021-01592-x ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Zhaohui Su ◽

Dean McDonnell ◽

Bin Liang ◽

Jennifer Kue ◽

Xiaoshan Li ◽

...

Keyword(s):

Systematic Review ◽

A Priori ◽

Healthcare Services ◽

Eligibility Criteria ◽

Healthcare Needs ◽

Academic Librarian ◽

Review Protocol ◽

Cancer Caregivers ◽

Meta Analyses ◽

The Impact

Abstract Background Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. Methods A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. Conclusions COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. Systematic review registration PROSPERO CRD42020196301

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The adverse health effects of punitive immigrant policies in the United States: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0244054 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244054

Author(s):

Nicholas A. Vernice ◽

Nicola M. Pereira ◽

Anson Wang ◽

Michelle Demetres ◽

Lisa V. Adams

Keyword(s):

United States ◽

Systematic Review ◽

Health Outcomes ◽

Healthcare Services ◽

The United States ◽

Cochrane Library ◽

Original Research ◽

The Us ◽

Immigrant Policies ◽

The Impact

Background Immigrants in the United States (US) today are facing a dynamic policy landscape. The Trump administration has threatened or curtailed access to basic services for 10.5 million undocumented immigrants currently in the US. We sought to examine the historical effects that punitive laws have had on health outcomes in US immigrant communities. Methods In this systematic review, we searched the following databases from inception–May 2020 for original research articles with no language restrictions: Ovid MEDLINE, Ovid EMBASE, Cochrane Library (Wiley), Web of Science Core Collection (Clarivate), CINAHL (EBSCO), and Social Work Abstracts (Ovid). This study is registered with PROSPERO, CRD42019138817. Articles with cohort sizes >10 that directly evaluated the health-related effects of a punitive immigrant law or policy within the US were included. Findings 6,357 studies were screened for eligibility. Of these, 32 studies were selected for inclusion and qualitatively synthesized based upon four themes that appeared throughout our analysis: (1) impact on healthcare utilization, (2) impact on women’s and children’s health, (3) impact on mental health services, and (4) impact on public health. The impact of each law, policy, mandate, and directive since 1990 is briefly discussed, as are the limitations and risk of bias of each study. Interpretation Many punitive immigrant policies have decreased immigrant access to and utilization of basic healthcare services, while instilling fear, confusion, and anxiety in these communities. The federal government should preserve and expand access for undocumented individuals without threat of deportation to improve health outcomes for US citizens and noncitizens.

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Physically active lessons in schools and their impact on physical activity, educational, health and cognition outcomes: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-100502 ◽

2019 ◽

Vol 54 (14) ◽

pp. 826-838 ◽

Cited By ~ 13

Author(s):

Emma Norris ◽

Tommy van Steen ◽

Artur Direito ◽

Emmanuel Stamatakis

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Health Outcomes ◽

Educational Outcomes ◽

Meta Analysis ◽

Risk Of Bias ◽

Control Group ◽

Physically Active ◽

Meta Analyses ◽

The Impact

ObjectiveThis review provides the first meta-analysis of the impact of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes.DesignSystematic review and meta-analysis of controlled studies. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias.Data sourcesPubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019.Studies eligibility criteriaPhysically active lessons compared with a control group in a randomised or non-randomised design, within single component interventions in general school populations.Results42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible to be included in the systematic review and 37 of them were included across the six meta-analyses (n=12 663). Physically active lessons were found to produce large, significant increases in lesson-time PA (d=2.33; 95% CI 1.42 to 3.25: k=16) and small, increases on overall PA (d=0.32; 95% CI 0.18 to 0.46: k=8), large, improvement in lesson-time educational outcomes (d=0.81; 95% CI 0.47 to 1.14: k=7) and a small improvement in overall educational outcomes (d=0.36; 95% CI 0.09 to 0.63: k=25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least two domains.ConclusionIn elementary and preschool settings, when physically active lessons were added into the curriculum they had positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool setting.Trial registration numberCRD42017076933.

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Interventions directed at men for preventing intimate partner violence: a systematic review protocol

Systematic Reviews ◽

10.1186/s13643-021-01712-7 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Dina Idriss-Wheeler ◽

Julia Hajjar ◽

Sanni Yaya

Keyword(s):

Systematic Review ◽

Intimate Partner Violence ◽

Health Outcomes ◽

Partner Violence ◽

Intimate Partner ◽

Cochrane Central Register ◽

Female Partners ◽

Key Characteristics ◽

Unpublished Manuscripts ◽

The Impact

Abstract Background Intimate partner violence (IPV) is a population health problem linked to a myriad of negative psychological, physical, emotional, sexual and reproductive health outcomes for women. The movement towards working with boys and men over the past couple of decades has increased the number of interventions specifically directed at men who perpetrate violence against a female partner. There is little evidence-based research on key characteristics of effective interventions directed at men to reduce or prevent IPV against female partners. The objective of this systematic review is to identify interventions specifically directed at males , as the perpetrators of violence against women, that have proven to be effective in preventing or reducing intimate partner violence. Methods The following electronic databases will be used to search for peer-reviewed studies: MEDLINE (OVID), Embase (OVID), PsycInfo (OVID), CINAHL (EBSCO), Global Health (EBSCO), Gender Watch (ProQuest), Web of Science (Web of Knowledge), PROSPERO, Cochrane Central Register of Controlled Trials Database (Ovid) and SCOPUS. We will include randomized control trials, non-randomized studies of interventions published in peer-reviewed journals and relevant unpublished manuscripts, books/chapters and clinical or programme study reports. Studies have to demonstrate direction of effect (i.e. pre-post intervention/difference between groups) in terms of prevention or reduction in the outlined outcomes. Primary outcomes include change in behaviour and knowledge of male perpetrator regarding the impact of IPV on women as well as women’s experience of IPV. Secondary outcomes include change in behaviours around substance use and social activities, decrease in negative mental health outcomes and interactions with law enforcement. Studies will be screened, appraised and extracted by two reviewers; any conflicts will be resolved through discussion. Narrative synthesis will be used to analyse and present findings. If sufficient and comparable data is available, a meta-analysis will be conducted. Discussion This review will provide synthesized evidence on interventions directed at males to reduce or prevent their perpetration of intimate partner violence against female partners. Implications for practice will include key characteristics of interventions proven to be effective based on evidence synthesis and certainty of findings. Recommendations for further research will also be considered. Systematic review registration This protocol was submitted for registration in the International Prospective Register of Systematic Reviews (PROSPERO) on September 4, 2020.

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More than 50 long-term effects of COVID-19: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-95565-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sandra Lopez-Leon ◽

Talia Wegman-Ostrosky ◽

Carol Perelman ◽

Rosalinda Sepulveda ◽

Paulina A. Rebolledo ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Management Strategies ◽

Original Data ◽

Long Term Effects ◽

Pooled Prevalence ◽

Attention Disorder ◽

Initial Recovery ◽

Meta Analyses

AbstractCOVID-19 can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery. This systematic review and meta-analysis aims to identify studies assessing the long-term effects of COVID-19. LitCOVID and Embase were searched to identify articles with original data published before the 1st of January 2021, with a minimum of 100 patients. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. PRISMA guidelines were followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included (age 17–87 years). The included studies defined long-COVID as ranging from 14 to 110 days post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.

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Between Level Up and Game Over: A Systematic Literature Review of Gamification in Education

Sustainability ◽

10.3390/su13042247 ◽

2021 ◽

Vol 13 (4) ◽

pp. 2247 ◽

Cited By ~ 1

Author(s):

Ana Manzano-León ◽

Pablo Camacho-Lazarraga ◽

Miguel A. Guerrero ◽

Laura Guerrero-Puerta ◽

José M. Aguilar-Parra ◽

...

Keyword(s):

Systematic Review ◽

Academic Performance ◽

Game Design ◽

Learning Strategy ◽

Experimental Studies ◽

Quasi Experimental ◽

Current Lines ◽

Meta Analyses ◽

Game Elements ◽

The Impact

Educational gamification consists of the use of game elements and game design techniques in the educational context. The objective of this study is to examine the existing evidence on the impact of educational gamification on student motivation and academic performance in the last five years in order to analyze its distribution over time, educational level, variables, and most used game elements, and know the advantages of its implementation in the classroom. For this, a systematic review is proposed through the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) methodology in three multidisciplinary databases, through an exhaustive search with inclusion and exclusion criteria on quantitative experimental studies that explore gamification in educational centers, which provide information about the most current lines of research. Fourteen studies were included in this review. These used experimental or quasi-experimental designs. Most of them report gamification as a valid learning strategy. The results support the conclusion that educational gamification has a potential impact on the academic performance, commitment, and motivation of students. Therefore, this study implies the need to expand research on the needs and challenges of students when learning with gamified techniques.

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