scholarly journals Quality of Primary Care for the Adult Population With Autism Spectrum Disorder: Protocol for a Scoping Review

10.2196/28196 ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. e28196
Author(s):  
Shannon Marion Aylward ◽  
Alison Farrell ◽  
Anna Walsh ◽  
Marshall Godwin ◽  
Roger Chafe ◽  
...  

Background A strong primary care system is vital to overall health. Research on the primary care of people with autism spectrum disorder (ASD) has mostly focused on children. A synthesis of the existing literature related to the quality of primary care for the adult population with ASD would elucidate what is known about the topic as well as inform future research and clinical practice. Objective The purpose of our scoping review is to describe what is known about the quality of primary care for adults with ASD and identify knowledge gaps. Methods Prior to beginning the literature search, we reviewed literature related to defining both primary care and primary care quality to establish the context and concept of the research question. The search strategy was designed and executed by a research librarian. The MEDLINE, CINAHL, EMBASE, PsycINFO, and ProQuest Dissertations and Theses databases were searched for relevant literature. Grey literature will include relevant reports from government websites and associations with a focus on ASD. Two members of the research team will independently screen the academic and grey literature. Quantitative, qualitative, or mixed methods study designs involving the quality of primary care services or patient-centered care for adults with ASD are eligible for inclusion in our scoping review. Studies that make it past the full-text review will undergo data extraction and quality appraisal by 2 independent reviewers. The data extraction results will be presented in a tabular format to clearly present what is known about the quality of primary care for adults with ASD; this table will be accompanied by a narrative synthesis. Literature selected for extraction will be coded for themes, which will form the basis of a thematic synthesis. The scoping review will follow the guidance proposed by the Joanna Briggs Institute. Results The search of electronic databases was conducted in October 2020, and it returned 2820 results. This research is still in progress. The results from our scoping review are expected to be available by fall 2021. Conclusions The results from our scoping review will be useful for guiding future research on the quality of primary care for adults with ASD. International Registered Report Identifier (IRRID) PRR1-10.2196/28196

2021 ◽  
Author(s):  
Shannon Marion Aylward ◽  
Alison Farrell ◽  
Anna Walsh ◽  
Marshall Godwin ◽  
Roger Chafe ◽  
...  

BACKGROUND A strong primary care system is vital to overall health. Research on the primary care of people with autism spectrum disorder (ASD) has mostly focused on children. A synthesis of the existing literature related to the quality of primary care for the adult population with ASD would elucidate what is known about the topic as well as inform future research and clinical practice. OBJECTIVE The purpose of our scoping review is to describe what is known about the quality of primary care for adults with ASD and identify knowledge gaps. METHODS Prior to beginning the literature search, we reviewed literature related to defining both primary care and primary care quality to establish the context and concept of the research question. The search strategy was designed and executed by a research librarian. The MEDLINE, CINAHL, EMBASE, PsycINFO, and ProQuest Dissertations and Theses databases were searched for relevant literature. Grey literature will include relevant reports from government websites and associations with a focus on ASD. Two members of the research team will independently screen the academic and grey literature. Quantitative, qualitative, or mixed methods study designs involving the quality of primary care services or patient-centered care for adults with ASD are eligible for inclusion in our scoping review. Studies that make it past the full-text review will undergo data extraction and quality appraisal by 2 independent reviewers. The data extraction results will be presented in a tabular format to clearly present what is known about the quality of primary care for adults with ASD; this table will be accompanied by a narrative synthesis. Literature selected for extraction will be coded for themes, which will form the basis of a thematic synthesis. The scoping review will follow the guidance proposed by the Joanna Briggs Institute. RESULTS The search of electronic databases was conducted in October 2020, and it returned 2820 results. This research is still in progress. The results from our scoping review are expected to be available by fall 2021. CONCLUSIONS The results from our scoping review will be useful for guiding future research on the quality of primary care for adults with ASD. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/28196


2020 ◽  
Author(s):  
Claudia Massaccesi ◽  
Alexander Groessing ◽  
Lisa A. Rosenberger ◽  
Helena Hartmann ◽  
Michela Candini ◽  
...  

AbstractInterpersonal space can be defined as a safety zone immediately surrounding our body, which allows us to feel comfortable during social interactions. Previous studies indicate that the size of interpersonal space at which the other is perceived as intrusive (permeability) and the ability to adapt interpersonal distance based on contextual factors (flexibility) are altered in children and adults with Autism Spectrum Disorder (ASD). The present fMRI study aimed at extending the previous findings by investigating the behavioral and neurophysiological underpinnings of interpersonal space permeability and flexibility in adults with ASD.Individuals with ASD and matched controls (CTR) performed a modified version of the stop-distance paradigm for measuring interpersonal space preferences. Participants observed prerecorded videos of two confederates moving towards them and rated their comfort to the observed distance. The assessment of interpersonal space preferences was performed before and after engaging in cooperative and non-cooperative social interactions with the confederates, experimentally induced by means of a repeated trust game.We observed general lower comfort in response to an approaching confederate in the ASD group compared to the CTR group, indicating preference for larger interpersonal space in autism (altered permeability). This preference was accompanied by reduced activity in bilateral dorsal intraparietal sulcus (dIPS) and left fusiform face area (FFA), regions previously shown to be involved in interpersonal space regulation. Furthermore, we observed differences in effective connectivity among dIPS, FFA, and amygdala in ASDs compared to CTRs, depending on the level of experienced comfort. No differences between ASDs and CTRs were observed in the adaptation of interpersonal space following a cooperative and non-cooperative social interaction, suggesting preserved interpersonal space flexibility in the ASD adult population.The present study provides evidence for impaired permeability of interpersonal space in adults with ASD. The findings suggest that a dysregulation of the activity and connectivity of brain areas involved in the processing of interpersonal space may contribute to preference for larger distance and avoidance of physical proximity in ASDs. Future research is needed to examine whether the observed alteration of interpersonal space processing is an effect of or a contributing factor to the social disabilities characterizing autism.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026204
Author(s):  
Lysanne Lessard ◽  
Agnes Grudniewicz ◽  
Antoine Sauré ◽  
Agnieszka Szczotka ◽  
James King ◽  
...  

IntroductionHealth systems in North America and Europe have been criticised for their lack of safety, efficiency and effectiveness despite rising healthcare costs. In response, healthcare leaders and researchers have articulated the need to transform current health systems into continuously and rapidly learning health systems (LHSs). While digital technology has been envisioned as providing the transformational power for LHSs by generating timely evidence and supporting best care practices, it remains to be ascertained if it is indeed playing this role in current LHS initiatives. This paper presents a protocol for a scoping review that aims at providing a comprehensive understanding of how and to what extent digital technology is used within LHSs. Results will help to identify gaps in the literature as a means to guide future research on this topic.Methods and analysisMultiple databases and grey literature will be searched with terms related to learning health systems. Records selection will be done in duplicate by two reviewers applying pre-defined inclusion and exclusion criteria. Data extraction from selected records will be done by two reviewers using a piloted data charting form. Results will be synthesised through a descriptive numerical summary and a mapping of digital technology use onto types of LHSs and phases of learning within LHSs.Ethics and disseminationEthical approval is not required for this scoping review. Preliminary results will be shared with stakeholders to account for their perspectives when drawing conclusions. Final results will be disseminated through presentations at relevant conferences and publications in peer-reviewed journals.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Clement Avoka ◽  
Patience Adzordor ◽  
Vitalis Bawontuo ◽  
Diana A. Akila ◽  
Desmond Kuupiel

Abstract Background Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) continue to be a major public health issue, especially in sub-Sahara Africa (SSA). Literature shows significant HIV status awareness, testing, and treatment have generally improved among the population since the inception of the UNAIDS 90:90:90 programme. Despite this, it is possible literature gaps exist that require future research to inform in-country programmes to improve the gains post-UNAIDS 90:90:90 programme. This study, therefore, aims to synthesize literature and describe the evidence on HIV status awareness among key and vulnerable populations in SSA focusing on the first UNAIDS 90 since it is essential for treatment initiation. Method This systematic scoping review will be guided by the framework proposed by Arksey and O’Malley and improved by Levac and colleagues. Literature searches will be conducted in PubMed, SCOPUS, CINAHL, Google Scholar, and Science Direct from 2016 to 2020. A snowball approach will also be used to search for relevant articles from the reference of all included studies. This study will include both published and grey literature, articles that include HIV key and vulnerable populations, HIV status awareness, and evidence from SSA countries. Two reviewers will independently conduct the abstract and full-text article screening as well as pilot the data extraction form. Thematic content analysis and a summary of the themes and sub-themes will be reported narratively. Discussions The evidence that will be provided by this study may be useful to inform in-country programmes to improve the gains made post-UNAIDS 90:90:90 programme from 2021 onwards. This study also anticipates identifying literature gaps to guide researchers interested in this field of study in the future. Peer review journals, policy briefs, and conference platforms will be used to disseminate this study’s findings.


2020 ◽  
Author(s):  
Aline Rissatto Teixeira ◽  
Daniela Bicalho ◽  
Betzabeth Slater ◽  
Tacio de Mendonça Lima

AbstractBackgroundCulinary skills and food practices are important objects of study in the field of Public Health. Studies that propose to develop instruments for assessing such constructs show lack of methodological uniformity to provide evidence of validity and reliability of their instruments.ObjectiveTo identify studies that have developed instruments to measure culinary skills and other related concepts in adult population, and critically assess their psychometric properties.DesignA systematic review was conducted. A literature search was performed in PubMed/Medline, Scopus, LILACS, and Web of Science databases until June 2019. The Directory of Open Access Journals and Google Scholar databases were searched to identify relevant grey literature. Searching, selecting and reporting were done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Two reviewers were independently involved in study selection, data extraction, and instrument quality assessment. A third reviewer resolved all disagreements.ResultsThe search identified 1428 potentially relevant studies, out of which 18 had potentially relevant records and 8 met the inclusion criteria. Studies used literature, experts’ judgement, or qualitative interviews to develop the instruments. No studies received positive scores for all validity criteria. Although most studies received positive scores for internal consistency, none of them received positive scores for stability or presented evidence for content validity. One study showed positive results for construct validity. Two studies reported criterion validity, whose scores were deemed negative.ConclusionsMany studies that surveyed culinary skills and related latent phenomena were identified. The overall quality of the psychometric properties of most instruments was considered insufficient, especially for validity measures. A universal definition of culinary skills as an overarching construct is recommended. The flaws observed in these studies show that there is a need for ongoing research in the area of the psychometric properties of instruments assessing these constructs.


2021 ◽  
Vol 4 ◽  
pp. 48
Author(s):  
Joice Cunningham ◽  
Frank Doyle ◽  
Jennifer M. Ryan ◽  
Barbara Clyne ◽  
Cathal Cadogan ◽  
...  

Background: The burden of osteoarthritis (OA) to individuals and health systems is substantial and is expected to increase due to population ageing and rising prevalence of obesity and multimorbidity. Primary care-based models of care (MoCs) are being increasingly developed in response to this growing burden. However, these MoCs have yet to be formally reviewed. A MoC can be defined as an ‘evidence-informed strategy, framework or pathway that outlines the optimal manner in which condition-specific care should be delivered to consumers within a local health system’. Objective: To identify and describe the available research regarding the extent, nature and characteristics of MoCs for OA that have been developed or evaluated in primary care. Methods: A scoping review will be conducted in accordance with the Arksey and O’Malley scoping review framework and the PRISMA-ScR guidelines. Systematic literature searches of MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science and LILACs will be conducted from 2010 to present, aligning with publication dates of recent clinical guidelines. A structured iterative search of grey literature will be conducted. Full-text original quantitative or mixed method studies which describe the development or evaluation of MoCs for OA in primary care will be considered. Data will be charted and synthesised and a narrative synthesis will be conducted. Conclusions: This scoping review will provide a broad overview regarding the extent, nature and characteristics of the available literature on primary care based MoCs for OA. Findings will be used to identify gaps in the current evidence to identify areas for future research.


Adolescents and young adults with autism spectrum disorders face a multitude of challenges and are experiencing poor life outcomes. This book has summarized the research on practices designed to mitigate these challenges and to improve their life outcomes. There are two recurrent and interconnected themes that have been present throughout the book. The first is that there is immense heterogeneity across individuals with ASD. The second is that the tools for improving outcomes for this population exist, but they may not have been systematically researched with this population. Given the current outcomes for this population, continued research all areas is essential for discovering approaches that will improve the outcomes and quality of life for young adults with ASD. This chapter summarizes the book and provides suggestions for future research.


2019 ◽  
Vol 27 (4) ◽  
pp. 340-347 ◽  
Author(s):  
Rebecca L. Hartley ◽  
Anna R. Todd ◽  
Alan R. Harrop ◽  
Frankie O. G. Fraulin

Background: Pediatric hand fractures are common, but few require surgery; therefore, these fractures are often perceived to be overreferred. Our objective is to systematically identify and describe pediatric hand fracture referring practices. Method: A scoping review was performed, searching electronic databases and grey literature up to January 2018 to identify referring practices for children (17 years and younger) with hand fractures (defined as radiographically confirmed fractures distal to the carpus) to hand surgeons. All study designs were included, and study selection and data extraction were independently performed in duplicate by 2 reviewers. Outcomes included referring rates, necessity of referral, referring criteria, and management of fractures. Results: Twenty (10 cross-sectional, 7 prospective cohorts, and 3 narrative reviews) studies reporting on referring practices or management of 21,624 pediatric hand fractures were included. Proportion of pediatric hand fractures referred to hand surgeons ranged from 6.5% to 100%. Unnecessary referral, defined as those fractures within the scope of primary care management, ranged from 27% to 78.1%. Ten studies reported referring criteria, with 14 unique criteria identified. The most common referring criteria were displacement (36.4%), loss of joint congruity (36.4%), and instability (36.4%). The most common justification for these criteria was increased likelihood of requiring surgery. The most common initial management was immobilization (66%-100%). Final management was provided by orthopedic or plastic hand surgeons with 0% to 32.9% of fractures requiring surgery. Conclusion: Referring practices vary widely in the literature. Major gaps in the literature include objective measures and justification for referring criteria and primary care education on hand fracture referring practices.


2021 ◽  
Author(s):  
Waiza Kadri ◽  
Rhiannon Halfpenny ◽  
Breege Whiten ◽  
Christina Smith ◽  
Siofra Mulkerrin

Abstract Background Swallowing impairment (dysphagia) and tracheostomy coexist. Research in this area has often provided an overview of dysphagia management as a whole, but there is limited information pertaining to specific dysphagia therapy in the tracheostomy population. The aim of this scoping review is to provide detailed exploration of the literature with regards to dysphagia therapeutic interventions in adults with a tracheostomy. The scoping review will describe current evidence and thus facilitate future discussions to guide clinical practice.Methods A scoping review using the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews guideline will be used. Ten electronic databases from inception to July 2021and grey literature will be searched. From identified texts forward and backward citation chasing will be completed. Data extraction will compose of population demographics, aetiology and dysphagia therapy (type, design, dose and intensity). Number of citations and papers included into the scoping review will be presented visually.Discussion The scoping review aims to expand upon the existing literature in this field. A detailed description of the evidence is required to facilitate clinical discussions and develop therapeutic protocols in a tracheostomised population. The results of this scoping review will support future research in dysphagia therapy and provide the basis for development of best practice guidelines.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039543
Author(s):  
Jia Qi Lee ◽  
Kate Ying ◽  
Penny Lun ◽  
Keng Teng Tan ◽  
Wendy Ang ◽  
...  

ObjectivePolypharmacy occurs in approximately 30% of older adults aged 65 years or more, particularly among those with multimorbidity. With polypharmacy, there is an associated risk of potentially inappropriate prescribing (PIP). The aims of this scoping review were to (1) identify the intervention elements that have been adopted to reduce PIP in the outpatient setting and (2) determine the behaviour change wheel (BCW) intervention functions performed by each of the identified intervention elements.DesignScoping reviewData sourcesPubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Web of Science and Cochrane Library databases, grey literature sources, six key geriatrics journals and the reference lists of review papers.Study selectionAll studies reporting an intervention or strategy that addressed PIP in the older adult population (age ≥65) with multimorbidity in the outpatient setting and in which the primary prescriber is the physician.Data extractionData extracted from the included studies can be broadly categorised into (1) publication details, (2) intervention details and (3) results. This was followed by data synthesis and analysis based on the BCW framework.ResultsOf 8195 studies yielded, 80 studies were included in the final analysis and 14 intervention elements were identified. An average of two to three elements were adopted in each intervention. The three most frequently adopted intervention elements were medication review (70%), training (26.3%) and tool/instrument(s) (22.5%). Among medication reviews, 70% involved pharmacists. The 14 intervention elements were mapped onto five intervention functions: ‘education’, ‘persuasion’, ‘training’, ‘environmental restructuring’ and ‘enablement’.ConclusionPIP is a multifaceted problem that involves multiple stakeholders. As such, interventions that address PIP require multiple elements to target the behaviour of the various stakeholders. The intervention elements and their corresponding functions identified in this scoping review will serve to inform the design of complex interventions that aim to reduce PIP.


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