How can the spatial equity of health services be defined and measured? A systematic review of spatial equity definitions and methods

2019 ◽  
Vol 24 (4) ◽  
pp. 270-278 ◽  
Author(s):  
Jesse Whitehead ◽  
Amber L. Pearson ◽  
Ross Lawrenson ◽  
Polly Atatoa-Carr
Keyword(s):  
Systematic Review ◽  
Health Services ◽  
Future Research ◽  
Equity Analysis ◽  
Spatial Equity ◽  
Equity Research ◽  
Definition Of ◽  
Distributional Fairness ◽  
The Impact

Background Spatial equity analysis has been carried out in a variety of contexts and on a range of health services. However, there is no clear consensus on spatial equity definitions or measures. This review seeks to summarize spatial equity definitions and methods of analysis. Methods We systematically searched two electronic databases and six journals for papers providing a definition of spatial equity or performing a spatial equity analysis on health services. Studies were classified according to four definition themes: (1) distributional fairness; (2) needs-based distribution; (3) focus on outcomes or causes and (4) none provided. Results Seventy-five studies met our inclusion criteria. Sixty-one papers provided a definition of spatial equity, while a further 14 papers analysed the spatial equity of health services without providing a definition. Most authors used a needs-based definition of spatial equity, while the Gini coefficient was the most commonly used equity measure. However, analysis approaches varied according to the definition provided by each paper. Among the needs-based definitions, spatial autocorrelation was the most common spatial equity measure. Conclusions To our knowledge, this is the first systematic review summarizing spatial equity definitions and analysis methods. A lack of consensus on definitions and measures persists. The classification of measures according to definition themes makes this review a useful tool for planning and interpreting spatial equity investigations. Future research should examine the impact different measures of accessibility and need have on the results of spatial equity research.

scholarly journals THU0528 NAILFOLD VIDEOCAPILLAROSCOPY REPORTING IN CLINICAL RESEARCH: INTERNATIONAL DELPHI BASED CONSENSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 503.1-504
Author(s):  
F. Ingegnoli ◽  
T. Schioppo ◽  
A. Herrick ◽  
A. Sulli ◽  
F. Bartoli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Research ◽  
Rheumatic Diseases ◽  
Unmet Need ◽  
Future Research ◽  
Invasive Technique ◽  
Delphi Consensus ◽  
Research Support ◽  
The Impact ◽  
Research Studies

Background:Nailfold capillaroscopy (NVC), a non-invasive technique to assess microcirculation, is increasingly being incorporated into rheumatology routine clinical practice. Currently, the degree of description of NVC methods varies amongst research studies, making interpretation and comparison between studies challenging. In this field, an unmet need is the standardization of items to be reported in research studies using NVC.Objectives:To perform a Delphi consensus on minimum reporting standards in methodology for clinical research, based on the items derived from a systematic review focused on this topic.Methods:The systematic review of the literature on NVC methodology relating to rheumatic diseases was performed according to PRISMA guidelines (PROSPERO CRD42018104660) to July 22nd2018 using MEDLINE, Embase, Scopus. Then, a three-step web-based Delphi consensus was performed in between members of the EULAR study group on microcirculation in rheumatic diseases and the Scleroderma Clinical Trials Consortium. Participants were asked to rate each item from 1 (not appropriate) to 9 (completely appropriate).Results:In total, 3491 references were retrieved in the initial search strategy, 2862 were excluded as duplicates or after title/abstract screening. 632 articles were retrieved for full paper review of which 319 fulfilled the inclusion criteria. Regarding patient preparation before the exam, data were scarce: 38% reported acclimatization, 5% to avoid caffeine and smoking, 3% to wash hands and 2% to avoid manicure. Concerning the device description: 90% reported type of instrument, 77% brand/model, 72% magnification, 46% oil use, 40% room temperature and 35% software for image analysis. As regards to examination details: 76% which fingers examined, 75% number of fingers examined, 15% operator experience, 13% reason for finger exclusion, 9% number of images, 8% quality check of the images and 3% time spent for the exam. Then, a three-round Delphi consensus on the selected items was completed by 80 participants internationally, from 31 countries located in Australia, Asia, Europe, North and South America. Some items reached the agreement at the second round (85 participants), and other items were suggested as important to consider in a future research agenda (e.g. temperature for acclimatization, the impact of smoking, allergies at the application of the oil to the nailbed, significance of pericapillary edema, methods of reporting hemorrhages, ramified and giant capillaries). The final agreement results are reported below:Conclusion:On the basis of the available literature the description of NVC methods was highly heterogeneous and individual published studies differed markedly. These practical suggestions developed using a Delphi process among international participants provide a guidance to improve and to standardize the NVC methodology in future clinical research studies.Disclosure of Interests:Francesca Ingegnoli: None declared, Tommaso Schioppo: None declared, Ariane Herrick: None declared, Alberto Sulli Grant/research support from: Laboratori Baldacci, Francesca Bartoli: None declared, Nicola Ughi: None declared, John Pauling: None declared, Maurizio Cutolo Grant/research support from: Bristol-Myers Squibb, Actelion, Celgene, Consultant of: Bristol-Myers Squibb, Speakers bureau: Sigma-Alpha, Vanessa Smith Grant/research support from: The affiliated company received grants from Research Foundation - Flanders (FWO), Belgian Fund for Scientific Research in Rheumatic diseases (FWRO), Boehringer Ingelheim Pharma GmbH & Co and Janssen-Cilag NV, Consultant of: Boehringer-Ingelheim Pharma GmbH & Co, Speakers bureau: Actelion Pharmaceuticals Ltd, Boehringer-Ingelheim Pharma GmbH & Co and UCB Biopharma Sprl

scholarly journals Impact of abortion law reforms on women’s health services and outcomes: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Foluso Ishola ◽  
U. Vivian Ukah ◽  
Arijit Nandi
Keyword(s):  
Systematic Review ◽  
Health Services ◽  
Women’S Health ◽  
Women's Health ◽  
Abortion Law ◽  
Women’S Health Services ◽  
Abortion Laws ◽  
Quasi Experimental ◽  
Study Designs ◽  
The Impact

Abstract Background A country’s abortion law is a key component in determining the enabling environment for safe abortion. While restrictive abortion laws still prevail in most low- and middle-income countries (LMICs), many countries have reformed their abortion laws, with the majority of them moving away from an absolute ban. However, the implications of these reforms on women’s access to and use of health services, as well as their health outcomes, is uncertain. First, there are methodological challenges to the evaluation of abortion laws, since these changes are not exogenous. Second, extant evaluations may be limited in terms of their generalizability, given variation in reforms across the abortion legality spectrum and differences in levels of implementation and enforcement cross-nationally. This systematic review aims to address this gap. Our aim is to systematically collect, evaluate, and synthesize empirical research evidence concerning the impact of abortion law reforms on women’s health services and outcomes in LMICs. Methods We will conduct a systematic review of the peer-reviewed literature on changes in abortion laws and women’s health services and outcomes in LMICs. We will search Medline, Embase, CINAHL, and Web of Science databases, as well as grey literature and reference lists of included studies for further relevant literature. As our goal is to draw inference on the impact of abortion law reforms, we will include quasi-experimental studies examining the impact of change in abortion laws on at least one of our outcomes of interest. We will assess the methodological quality of studies using the quasi-experimental study designs series checklist. Due to anticipated heterogeneity in policy changes, outcomes, and study designs, we will synthesize results through a narrative description. Discussion This review will systematically appraise and synthesize the research evidence on the impact of abortion law reforms on women’s health services and outcomes in LMICs. We will examine the effect of legislative reforms and investigate the conditions that might contribute to heterogeneous effects, including whether specific groups of women are differentially affected by abortion law reforms. We will discuss gaps and future directions for research. Findings from this review could provide evidence on emerging strategies to influence policy reforms, implement abortion services and scale up accessibility. Systematic review registration PROSPERO CRD42019126927

scholarly journals Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review

2021 ◽  
Vol 10 (8) ◽  
pp. 1740
Author(s):  
Marion Bareille ◽  
Michaël Hardy ◽  
Jonathan Douxfils ◽  
Stéphanie Roullet ◽  
Dominique Lasne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Strength ◽  
Small Sample ◽  
The Common ◽  
Small Sample Sizes ◽  
Definition Of ◽  
Reported Data ◽  
Prophylactic Anticoagulation ◽  
The Impact ◽  
Heparin Neutralization

Infection by SARS-CoV-2 is associated with a high risk of thrombosis. The laboratory documentation of hypercoagulability and impaired fibrinolysis remains a challenge. Our aim was to assess the potential usefulness of viscoelastometric testing (VET) to predict thrombotic events in COVID-19 patients according to the literature. We also (i) analyzed the impact of anticoagulation and the methods used to neutralize heparin, (ii) analyzed whether maximal clot mechanical strength brings more information than Clauss fibrinogen, and (iii) critically scrutinized the diagnosis of hypofibrinolysis. We performed a systematic search in PubMed and Scopus databases until December 31st, 2020. VET methods and parameters, and patients’ features and outcomes were extracted. VET was performed for 1063 patients (893 intensive care unit (ICU) and 170 non-ICU, 44 studies). There was extensive heterogeneity concerning study design, VET device used (ROTEM, TEG, Quantra and ClotPro) and reagents (with non-systematic use of heparin neutralization), timing of assay, and definition of hypercoagulable state. Notably, only 4 out of 25 studies using ROTEM reported data with heparinase (HEPTEM). The common findings were increased clot mechanical strength mainly due to excessive fibrinogen component and impaired to absent fibrinolysis, more conspicuous in the presence of an added plasminogen activator. Only 4 studies out of the 16 that addressed the point found an association of VETs with thrombotic events. So-called functional fibrinogen assessed by VETs showed a variable correlation with Clauss fibrinogen. Abnormal VET pattern, often evidenced despite standard prophylactic anticoagulation, tended to normalize after increased dosing. VET studies reported heterogeneity, and small sample sizes do not support an association between the poorly defined prothrombotic phenotype of COVID-19 and thrombotic events.

scholarly journals Sustainability of Food Placement in Retailing during the COVID-19 Pandemic

2021 ◽  
Vol 13 (11) ◽  
pp. 5956
Author(s):  
Jelena Končar ◽  
Radenko Marić ◽  
Goran Vukmirović ◽  
Sonja Vučenović
Keyword(s):  
Supply Chain ◽  
Academic Research ◽  
Food Prices ◽  
Future Research ◽  
Retail Sector ◽  
Western Balkans ◽  
Skilled Workers ◽  
Empirical Survey ◽  
Definition Of ◽  
The Impact

This work aims to define the impact of different indicators on the sustainability of food placement in the retail sector, during periods of crisis and emergencies, such as the COVID-19 pandemic. An empirical survey conducted in the Western Balkans (WB) region showed that indicators such as developed infrastructure, consistency, and transparency of the supply chain, skilled workers, costs, food safety, food prices, energy consumption, and changes in consumer needs are statistically significant since they affect the sustainability of food placement in the retail sector. As food placement and the retail sector itself are inseparable from other participants in the food supply chain (FSC), an analysis was conducted at the level of all FSC sectors. The results showed some deviations viewed individually in the sectors of production, physical distribution, wholesale, and retail, and in selected Western Balkan countries. Based on the results obtained, the sustainability model of food placement in the retail sector has been defined. The model will serve as the basis for defining the set of measures and incentives that competent institutions and FSC management need to undertake, to minimize the impact of indicators that endanger sustainability. The originality of the study lies in the fact that it fills the research gap that exists in this subject matter in academic research and studies in the WB region. In addition, some indicators important for food placement have been precisely isolated, with the definition of the intensity of their impact, observed overall at the level of the entire FSC as well as by individual sectors. Guidelines and suggestions for future research are listed in the paper.

The Impact of the Privacy Rule on Cancer Research: Variations in Attitudes and Application of Regulatory Standards

2009 ◽  
Vol 27 (24) ◽  
pp. 4014-4020 ◽  
Author(s):  
Elizabeth Goss ◽  
Michael P. Link ◽  
Suanna S. Bruinooge ◽  
Theodore S. Lawrence ◽  
Joel E. Tepper ◽  
...  
Keyword(s):  
Cancer Research ◽  
Future Research ◽  
Research Committee ◽  
Data Repositories ◽  
Privacy Rule ◽  
Regulatory Standards ◽  
American Society ◽  
Definition Of ◽  
High Level ◽  
The Impact

Purpose The American Society of Clinical Oncology (ASCO) Cancer Research Committee designed a qualitative research project to assess the attitudes of cancer researchers and compliance officials regarding compliance with the US Privacy Rule and to identify potential strategies for eliminating perceived or real barriers to achieving compliance. Methods A team of three interviewers asked 27 individuals (13 investigators and 14 compliance officials) from 13 institutions to describe the anticipated approach of their institutions to Privacy Rule compliance in three hypothetical research studies. Results The interviews revealed that although researchers and compliance officials share the view that patients' cancer diagnoses should enjoy a high level of privacy protection, there are significant tensions between the two groups related to the proper standards for compliance necessary to protect patients. The disagreements are seen most clearly with regard to the appropriate definition of a “future research use” of protected health information in biospecimen and data repositories and the standards for a waiver of authorization for disclosure and use of such data. Conclusion ASCO believes that disagreements related to compliance and the resulting delays in certain projects and abandonment of others might be eased by additional institutional training programs and consultation on Privacy Rule issues during study design. ASCO also proposes the development of best practices documents to guide 1) creation of data repositories, 2) disclosure and use of data from such repositories, and 3) the design of survivorship and genetics studies.

Abstract NS6: To Rest or Mobilize... When to Start Early Mobilization in Acute Stroke: a Systematic Review

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Michelle Whaley ◽  
Wendy Dusenbury ◽  
Andrei V Alexandrov ◽  
Georgios Tsivgoulis ◽  
Anne W Alexandrov
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Early Mobilization ◽  
Future Research ◽  
Cochrane Central Register ◽  
Large Artery ◽  
Stroke Subtype ◽  
Vascular Insufficiency ◽  
The Impact

Background: Recent nursing initiatives encourage early mobilization of neurocritical care patients, but whether this intervention can be safely generalized to acute stroke is debatable. We performed a systematic review of findings from recent studies to provide direction for patient management and future research. Methods: An exhaustive literature search was performed in Medline, SCOPUS and the Cochrane Central Register of Controlled Trials to identify published clinical trial research using a very early mobility intervention (within 24 hours) in acute ischemic stroke patients. The primary efficacy outcome supporting the search was neurologic disability reduction or improved functional outcomes, and the primary safety outcome was neurologic deterioration. Studies were critically reviewed for inclusion by 3 separate investigators, findings were synthesized, and an overall recommendation for very early mobilization use in acute stroke was assigned according to GRADE criteria. Results: We initially identified 12 papers focused on early mobilization in acute stroke; of these, 6 observational studies were excluded, 1 study was excluded due to an ambiguous population, and 3 studies were excluded due to first initial mobilization out of bed occurring greater than 24 hours after admission. Two prospective randomized outcome blinded evaluation (PROBE) studies were retained, consisting of a total 2160 patients; ischemic stroke subtype was not disclosed in either study, limiting an understanding of the impact of very early mobilization on small versus large artery occlusion. Slower mobilization occurring beyond the first 24 hours was associated with higher rates of favorable outcome (mRS 0-2) at 90 days, whereas very early mobilization within the first 24 hours was associated with a number needed to harm of 25. Conclusions: In acute stroke, evidence supports a rested approach to care within the first 24 hours of hospitalization (GRADE: Strong recommendation, high quality of evidence). Similar to acute myocardial infarction, vascular insufficiency experienced in stroke likely warrants a more guarded approach to mobility. Additional studies exploring timing beyond 24 hours and dose of mobility interventions are warranted in discreet populations.

Consumerism

2014 ◽  
pp. 1-17
Author(s):  
Ioanna Papasolomou
Keyword(s):  
Historical Development ◽  
Sustainable Consumption ◽  
Compulsive Buying ◽  
Future Research ◽  
Sustainable Marketing ◽  
Definition Of ◽  
Corporate Social ◽  
The Impact ◽  
The Relationship ◽  
Insight Into

This chapter reveals that the term ‘consumerism' encompasses a number of meanings which create confusion regarding the term. The discussion that follows, attempts to distinguish the different perspectives regarding the term by presenting its historical development and discussing the three definitions that have marked it. It explores the relationship between consumerism, marketing and corporate social responsibility (CSR). The growth of consumerism has led to the over-use of marketing which provided a flourishing ground for compulsive buying and consumption. There is evidence in the literature to suggest that in an era of increasing social problems and environmental challenges, there is a need for CSR and sustainable marketing. In fact, the second definition of consumerism is inextricably linked with CSR and societal marketing. The chapter is conceptual in nature and provides an in-depth review and discussion of some fundamental dimensions associated to consumerism based on the existent literature. The overarching aim is to provide an insight into the evolution and growth of consumerism based on the existent literature related to the topic. The discussion also focuses on exploring the relationship between marketing and consumerism shedding light onto compulsive buying, consumer attitudes and concerns on the micro consumerism issues, sustainable consumption and sustainable marketing. The chapter proceeds to raise some concerns related to the impact of the global economic crisis on consumerism by using as an example Cyprus based on the author's observations and thoughts. The chapter concludes with a list of suggestions to practitioners and directions for future research.

The Imposter Phenomenon in the Medical Profession

2020 ◽  
pp. 148-166
Author(s):  
Rebecca C. Grossman
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Coping Strategies ◽  
Ethnic Minorities ◽  
Medical Profession ◽  
Future Research ◽  
Review Of The Literature ◽  
Imposter Phenomenon ◽  
Internal Experience ◽  
The Impact

The imposter phenomenon, or imposter syndrome, is defined as an internal experience of feeling like an intellectual fraud, despite external evidence of an individual's accomplishments, and results in an inability to internalise a sense of success. It is common among high-achieving people, and appears to be more common in women and ethnic minorities. In this chapter, a systematic review of the literature will be presented on imposter syndrome in the medical profession. Topics covered include purported aetiology, implications (including the impact on mental health and career progression), limitations of research, potential coping strategies, and avenues for future research.

scholarly journals Arts-Based Interventions for Professionals in Caring Roles During and After Crisis: A Systematic Review of the Literature

2020 ◽  
Vol 11 ◽  
Author(s):  
Dominik Havsteen-Franklin ◽  
Megan Tjasink ◽  
Jacqueline Winter Kottler ◽  
Claire Grant ◽  
Veena Kumari
Keyword(s):  
Systematic Review ◽  
Future Research ◽  
Safe Place ◽  
Practice Elements ◽  
Qualitative Approaches ◽  
The Arts ◽  
Crisis Events ◽  
Wide Range ◽  
The Impact

Crisis events, such as the COVID-19 pandemic, can have a devastating effect on communities and the care professionals within them. Over recent years, arts-based interventions have helped in a wide range of crisis situations, being recommended to support the workforce during and after complex crisis but there has been no systematic review of the role of arts-based crisis interventions and whether there are cogent themes regarding practice elements and outcomes. We, therefore, conducted a systematic review to (i) define the arts-based change process used during and after crisis events, and (ii) explore the perceptions of intermediate and long-term mental health benefits of arts-based interventions for professionals in caring roles. Our search yielded six studies (all qualitative). All data were thematically aggregated and meta-synthesized, revealing seven practice elements (a safe place, focusing on strengths and protective factors, developing psychosocial competencies to support peers, emotional expression and processing, identifying and naming the impact of the crisis, using an integrative creative approach, and cultural and organizational sensitivity) applied across all six studies, as well as a range of intermediate and long-term benefits shared common features (adapting, growing, and recovering; using the community as a healing resource; reducing or preventing symptoms of stress or trauma reactions, psychophysiological homeostasis). The ways in which these studies were designed independently from one another and yet used the same practice elements in their crisis interventions indicates that there is comparability about how and why the arts-based practice elements are being used and to what effect. Our findings provide a sound basis and meaningful parameters for future research incorporating quantitative and qualitative approaches to firmly establish the effectiveness of art-based interventions, and how arts can support cultural sensitivity, acceptability and indicated outcomes, particularly those relating to stress and trauma during or following a crisis.

scholarly journals Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis

Heart ◽  
2020 ◽  
Vol 106 (15) ◽  
pp. 1142-1147 ◽  
Author(s):  
Xintao Li ◽  
Bo Guan ◽  
Tong Su ◽  
Wei Liu ◽  
Mengyao Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Hospital Mortality ◽  
Mortality Risk ◽  
Meta Analysis ◽  
Cardiac Injury ◽  
Sensitivity Analyses ◽  
Future Research ◽  
Cardiovascular Comorbidities ◽  
The Impact

BackgroundCoronavirus disease 2019 (COVID-19) has produced a significant health burden worldwide, especially in patients with cardiovascular comorbidities. The aim of this systematic review and meta-analysis was to assess the impact of underlying cardiovascular comorbidities and acute cardiac injury on in-hospital mortality risk.MethodsPubMed, Embase and Web of Science were searched for publications that reported the relationship of underlying cardiovascular disease (CVD), hypertension and myocardial injury with in-hospital fatal outcomes in patients with COVID-19. The ORs were extracted and pooled. Subgroup and sensitivity analyses were performed to explore the potential sources of heterogeneity.ResultsA total of 10 studies were enrolled in this meta-analysis, including eight studies for CVD, seven for hypertension and eight for acute cardiac injury. The presence of CVD and hypertension was associated with higher odds of in-hospital mortality (unadjusted OR 4.85, 95% CI 3.07 to 7.70; I2=29%; unadjusted OR 3.67, 95% CI 2.31 to 5.83; I2=57%, respectively). Acute cardiac injury was also associated with a higher unadjusted odds of 21.15 (95% CI 10.19 to 43.94; I2=71%).ConclusionCOVID-19 patients with underlying cardiovascular comorbidities, including CVD and hypertension, may face a greater risk of fatal outcomes. Acute cardiac injury may act as a marker of mortality risk. Given the unadjusted results of our meta-analysis, future research are warranted.

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