scholarly journals Telemedicine in Depression Care by Physicians: Scoping Review (Preprint)

2021 ◽  
Author(s):  
Jean-François Echelard
Keyword(s):  
Information And Communication Technologies ◽  
Cultural Sensitivity ◽  
Conflicts Of Interest ◽  
Traditional Approach ◽  
Data Extraction ◽  
Depression Care ◽  
Eligibility Criteria ◽  
Depressed Patients ◽  
Virtual Care ◽  
The Usa

BACKGROUND Depression is a common disorder and is burdensome regarding mental and physical health as well as societal costs. Although traditional in-person consultations are the usual way of caring for depressed patients, telemedicine may be well-suited to psychiatric assessment and management. Telepsychiatry can be defined as the use of information and communication technologies such as videoconferencing and telephoning for the care of psychopathologies. OBJECTIVE This review aims to evaluate the extent and nature of the existing literature on telemedicine for the care of depression by physicians. This review also aims to examine the effects and perceptions regarding this virtual care, and how it compares to traditional in-person care. METHODS Identification of relevant articles was done through a search on three databases. Eligibility criteria were applied to select studies about the use of telemedicine for the care of depressed patients by physicians specifically. A data extraction grid was used to chart data from all included articles. RESULTS The search resulted in 28 articles and all 13 non-review studies were analyzed in detail. Most non-review studies were conducted in the USA, during the last decade, mostly with telemedicine programs lead by psychiatrists instead of general practioners, and mostly included a randomization process. The average study population size was 135. Only a small majority of included articles had a clear and explicit declared absence of conflicts of interest. Non-review papers articles contained measured outcomes related to depression variables, perceptions and other variables. All applicable studies resulted in improvement in depression with the use of telepsychiatry, and it was at least equivalent to in-person care. Telepsychiatry again performed at least as well as in-person care according to almost every metric studied for patient satisfaction and other perceptions. Quality of life, functioning and similar variables were significantly improved with virtual care. In regard to cost-effectiveness, telepsychiatry performed better than in-person care. Furthermore, some studied telemedicine programs were designed with cultural sensitivity or based on collaborative care. CONCLUSIONS More research is recommended regarding various outcomes from the use of telemedicine in relation to the wide-ranging burden of this disease, including depression variables, perceptions, health care outcomes and other outcomes. Studies should be conducted in various clinical contexts including primary care and developing countries. Although in-person consultations are the traditional approach to depression care, telepsychiatry is a promising modality of care for patients suffering from this burdensome disease. CLINICALTRIAL N/A

scholarly journals Gender disparity between authors in leading medical journals during the COVID-19 pandemic: a cross-sectional review

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051224
Author(s):  
Vaidehi Misra ◽  
Frozan Safi ◽  
Kathryn A Brewerton ◽  
Wei Wu ◽  
Robin Mason ◽  
...  
Keyword(s):  
Data Extraction ◽  
Gender Disparity ◽  
High Impact ◽  
Original Research ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Medical Journals ◽  
The Usa ◽  
Study Characteristics ◽  
Data Elements

ObjectivesEvaluate gender differences in authorship of COVID-19 articles in high-impact medical journals compared with other topics.DesignCross-sectional review.Data sourcesMedline database.Eligibility criteriaArticles published from 1 January to 31 December 2020 in the seven leading general medical journals by impact factor. Article types included primary research, reviews, editorials and commentaries.Data extractionKey data elements were whether the study topic was related to COVID-19 and names of the principal and the senior authors. A hierarchical approach was used to determine the likely gender of authors. Logistic regression assessed the association of study characteristics, including COVID-19 status, with authors’ likely gender; this was quantified using adjusted ORs (aORs).ResultsWe included 2252 articles, of which 748 (33.2%) were COVID-19-related and 1504 (66.8%) covered other topics. A likely gender was determined for 2138 (94.9%) principal authors and 1890 (83.9%) senior authors. Men were significantly more likely to be both principal (1364 men; 63.8%) and senior (1332 men; 70.5%) authors. COVID-19-related articles were not associated with the odds of men being principal (aOR 0.99; 95% CI 0.81 to 1.21; p=0.89) or senior authors (aOR 0.96; 95% CI 0.78 to 1.19; p=0.71) relative to other topics. Articles with men as senior authors were more likely to have men as principal authors (aOR 1.49; 95% CI 1.21 to 1.83; p<0.001). Men were more likely to author articles reporting original research and those with corresponding authors based outside the USA and Europe.ConclusionsWomen were substantially under-represented as authors among articles in leading medical journals; this was not significantly different for COVID-19-related articles. Study limitations include potential for misclassification bias due to the name-based analysis. Results suggest that barriers to women’s authorship in high-impact journals during COVID-19 are not significantly larger than barriers that preceded the pandemic and that are likely to continue beyond it.PROSPERO registration numberCRD42020186702.

Herbal smoking products: a systematic content analysis and mapping of the e-retail market

2021 ◽  
pp. tobaccocontrol-2020-056340
Author(s):  
Arpit Gupta ◽  
Shweta Sharda ◽  
Pothamsetty Yogitha ◽  
Sonu Goel ◽  
Ashima Goyal ◽  
...  
Keyword(s):  
Data Extraction ◽  
Age Groups ◽  
Health Benefit ◽  
Marketing Strategies ◽  
Retail Market ◽  
Health Warnings ◽  
Eligibility Criteria ◽  
Data Extraction Form ◽  
The Usa ◽  
Online Availability

ObjectiveTo assess the online availability and e-marketing strategies of herbal smoking products (HSPs).MethodologyGoogle, Yahoo and Bing were searched using relevant keywords related to HSPs. The first 50 records were retrieved and duplicates were removed. Two trained and calibrated authors screened the records according to the eligibility criteria and extracted data from each selected retail-webpage as per the pre-tested data extraction form.ResultsOut of the initial 1044 records obtained, 73 retail webpages were finally included. Most of the webpages about HSPs hailed from India followed by the USA. The results showed 24 brands with about 189 flavour variants that are readily available online to all age groups including minors, with price per pack (20 sticks) of herbal cigarettes ranging from INR (₹) 51 to 1830 (median 588). There are no regulations regarding the sale and marketing of HSPs concerning age restrictions and display of health warnings.ConclusionHSPs are readily available online at affordable prices and attractive variants for customers of all ages. The flavour appeal and the health benefit appeal is being used to target minors and young women. There is an urgent need for some regulations on the sale and e-marketing of such products that have an enormous potential to be used as a gateway to tobacco smoking.

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

2021 ◽  
Author(s):  
Sanghamitra M. Misra ◽  
Natalie Holdstock ◽  
Johanna Creswell Baez ◽  
Nohemi Garcia ◽  
Adriana Guiterrez ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Data Extraction ◽  
Group Living ◽  
Healthcare Services ◽  
The United States ◽  
Cultural Barriers ◽  
Eligibility Criteria ◽  
Wide Range ◽  
The Usa

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

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

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025166 ◽  
Author(s):  
Daniel S J Costa ◽  
Rebecca Mercieca-Bebber ◽  
Stephanie Tesson ◽  
Zac Seidler ◽  
Anna-Lena Lopez
Keyword(s):  
Cancer Survivorship ◽  
Data Extraction ◽  
Reporting Quality ◽  
Healthcare Services ◽  
Eligibility Criteria ◽  
Scoping Study ◽  
Healthcare Settings ◽  
Mental Health Settings ◽  
The Usa ◽  
Study Characteristics

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

scholarly journals Diversity in health professional education scholarship: a document analysis of international author representation in leading journals

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e043970
Author(s):  
Brittany Buffone ◽  
Ilena Djuana ◽  
Katherine Yang ◽  
Kyle J Wilby ◽  
Maguy S El Hajj ◽  
...  
Keyword(s):  
Health Professional ◽  
Professional Education ◽  
Teaching And Learning ◽  
Western Europe ◽  
English Language ◽  
Data Extraction ◽  
Document Analysis ◽  
Original Research ◽  
Health Professional Education ◽  
Eligibility Criteria

ObjectivesThe global distribution of health professionals and associated training programmes is wide but prior study has demonstrated reported scholarship of teaching and learning arises from predominantly Western perspectives.DesignWe conducted a document analysis to examine authorship of recent publications to explore current international representation.Data sourcesThe table of contents of seven high-impact English-language health professional education journals between 2008 and 2018 was extracted from Embase.Eligibility criteriaThe journals were selected according to highest aggregate ranking across specific scientific impact indices and stating health professional education in scope; only original research and review articles from these publications were included for analysis.Data extraction and synthesisThe table of contents was extracted and eligible publications screened by independent reviewers who further characterised the geographic affiliations of the publishing research teams and study settings (if applicable).ResultsA total 12 018 titles were screened and 7793 (64.8%) articles included. Most were collaborations (7048, 90.4%) conducted by authors from single geographic regions (5851, 86%). Single-region teams were most often formed from countries in North America (56%), Northern Europe (14%) or Western Europe (10%). Overall lead authorship from Asian, African or South American regions was less than 15%, 5% and 1%, respectively. Geographic representation varied somewhat by journal, but not across time.ConclusionsDiversity in health professional education scholarship, as marked by nation of authors’ professional affiliations, remains low. Under-representation of published research outside Global North regions limits dissemination of novel ideas resulting in unidirectional flow of experiences and a concentrated worldview of teaching and learning.

scholarly journals Sleep quality in the chronic stage of concussion is associated with poorer recovery: A systematic review

2021 ◽  
Vol 5 ◽  
pp. 205970022110208
Author(s):  
Rebecca Ludwig ◽  
Eryen Nelson ◽  
Prasanna Vaduvathiriyan ◽  
Michael A Rippee ◽  
Catherine Siengsukon
Keyword(s):  
Physical Activity ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Data Extraction ◽  
Grey Literature ◽  
Chronic Phase ◽  
Emotional Symptoms ◽  
Eligibility Criteria ◽  
Chronic Stage ◽  
Prior Review

Background Recovery from a concussion varies based on a multitude of factors. One such factor is sleep disturbances. In our prior review, it was observed that in the acute phase, sleep disturbances are predictive of poor outcomes following a concussion. The literature gap remains on how sleep in the chronic phase of recovery affects outcomes. Objective To examine the association between sleep quality during the chronic stage of concussion and post-concussion outcomes. Literature Survey: Literature searches were performed during 1 July to 1 August 2019 in selected databases along with searching grey literature. Out of the 733 results, 702 references were reviewed after duplicate removal. Methods Three reviewers independently reviewed and consented on abstracts meeting eligibility criteria ( n = 35). The full-text articles were assessed independently by two reviewers. Consensus was achieved, leaving four articles. Relevant data from each study was extracted using a standard data-extraction table. Quality appraisal was conducted to assess potential bias and the quality of articles. Results One study included children (18–60 months) and three studies included adolescents and/or adults (ranging 12–35 years). The association between sleep and cognition (two studies), physical activity (one study), and emotion symptoms (one study) was examined. Sleep quality was associated with decreased cognition and emotional symptoms, but not with meeting physical activity guidelines six months post-concussion injury. Conclusions The heterogeneity in age of participants and outcomes across studies and limited number of included studies made interpretations difficult. Future studies may consider if addressing sleep quality following concussion will improve outcomes.

scholarly journals Measuring frailty in younger populations: a rapid review of evidence

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047051
Author(s):  
Gemma F Spiers ◽  
Tafadzwa Patience Kunonga ◽  
Alex Hall ◽  
Fiona Beyer ◽  
Elisabeth Boulton ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Predictive Validity ◽  
Data Extraction ◽  
Grey Literature ◽  
Frailty Index ◽  
Study Data ◽  
Rapid Review ◽  
Eligibility Criteria ◽  
Adult Age ◽  
The Impact

ObjectivesFrailty is typically assessed in older populations. Identifying frailty in adults aged under 60 years may also have value, if it supports the delivery of timely care. We sought to identify how frailty is measured in younger populations, including evidence of the impact on patient outcomes and care.DesignA rapid review of primary studies was conducted.Data sourcesFour databases, three sources of grey literature and reference lists of systematic reviews were searched in March 2020.Eligibility criteriaEligible studies measured frailty in populations aged under 60 years using experimental or observational designs, published after 2000 in English.Data extraction and synthesisRecords were screened against review criteria. Study data were extracted with 20% of records checked for accuracy by a second researcher. Data were synthesised using a narrative approach.ResultsWe identified 268 studies that measured frailty in samples that included people aged under 60 years. Of these, 85 studies reported evidence about measure validity. No measures were identified that were designed and validated to identify frailty exclusively in younger groups. However, in populations that included people aged over and under 60 years, cumulative deficit frailty indices, phenotype measures, the FRAIL Scale, the Liver Frailty Index and the Short Physical Performance Battery all demonstrated predictive validity for mortality and/or hospital admission. Evidence of criterion validity was rare. The extent to which measures possess validity across the younger adult age (18–59 years) spectrum was unclear. There was no evidence about the impact of measuring frailty in younger populations on patient outcomes and care.ConclusionsLimited evidence suggests that frailty measures have predictive validity in younger populations. Further research is needed to clarify the validity of measures across the adult age spectrum, and explore the utility of measuring frailty in younger groups.

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

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e044917
Author(s):  
Tao Xu ◽  
You Wang ◽  
Jinxian Yuan ◽  
Yangmei Chen ◽  
Haiyan Luo
Keyword(s):  
Systematic Review ◽  
Ischaemic Stroke ◽  
Functional Outcome ◽  
Endovascular Therapy ◽  
Acute Ischaemic Stroke ◽  
Data Extraction ◽  
Meta Analysis ◽  
Poor Functional Outcome ◽  
Eligibility Criteria ◽  
Contrast Extravasation

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

scholarly journals Identifying enablers and barriers to referral, uptake and completion of lifestyle modification programmes: a rapid literature review

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045094
Author(s):  
Yvonne Zurynski ◽  
Carolynn Smith ◽  
Joyce Siette ◽  
Bróna Nic Giolla Easpaig ◽  
Mary Simons ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Lifestyle Modification ◽  
Data Extraction ◽  
Empirical Studies ◽  
Grey Literature ◽  
International Health ◽  
Rapid Review ◽  
Eligibility Criteria ◽  
Relevant Evidence ◽  
Literature Reviews

ObjectiveTo identify current, policy-relevant evidence about barriers and enablers associated with referral, uptake and completion of lifestyle modification programmes (LMPs) for secondary prevention of chronic disease in adults.DesignA rapid review, co-designed with policymakers, of peer-reviewed and grey literature using a modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework.Data sourcesMedline, Embase, Scopus, PsycINFO and CINAHL were searched for relevant studies and literature reviews. Grey literature was identified through Advanced Google searching and targeted searching of international health departments’ and non-government organisations’ websites.Eligibility criteria for selecting studiesDocuments published 2010–2020, from high-income countries, reporting on programmes that included referral of adults with chronic disease to an LMP by a health professional (HP).Data extraction and synthesisData from grey and peer-reviewed literature were extracted by two different reviewers. Extracted data were inductively coded around emergent themes. Regular meetings of the review group ensured consistency of study selection and synthesis.ResultsTwenty-nine documents were included: 14 grey literature, 11 empirical studies and four literature reviews. Key barriers to HPs referring patients included inadequate HP knowledge about LMPs, perceptions of poor effectiveness of LMPs and perceptions that referral to LMPs was not part of their role. Patient barriers to uptake and completion included poor accessibility and lack of support to engage with the LMPs. Enablers to HP referral included training/education, effective interdisciplinary communication and influential programme advocates. Support to engage with LMPs after HP referral, educational resources for family members and easy accessibility were key enablers to patient engagement with LMPs.ConclusionsFactors related to HPs’ ability and willingness to make referrals are important for the implementation of LMPs, and need to be coupled with support for patients to engage with programmes after referral. These factors should be addressed when implementing LMPs to maximise their impact.

scholarly journals Risk of dementia in gout and hyperuricaemia: a meta-analysis of cohort studies

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e041680
Author(s):  
Shu-Yue Pan ◽  
Rui-Juan Cheng ◽  
Zi-Jing Xia ◽  
Qiu-Ping Zhang ◽  
Yi Liu
Keyword(s):  
Cohort Studies ◽  
Quality Assessment ◽  
Publication Bias ◽  
Data Extraction ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Crystal Formation ◽  
Medical Subject Headings ◽  
Eligibility Criteria

ObjectivesGout, characterised by hyperuricaemia with monosodium urate crystal formation and inflammation, is the most common inflammatory arthritis in adults. Recent studies have found that elevated uric acid levels are related to the occurrence of dementia. We conducted a study to investigate the association between dementia and gout or hyperuricaemia.DesignSystematic review and meta-analysis of cohort studies.Data sourcesStudies were screened from inception to 28 June 2019 by searching Medline, Embase and the Cochrane Library databases.Eligibility criteriaCohort studies comparing the risk of dementia in patients with gout and hyperuricaemia versus non-gout and non-hyperuricaemia controls were enrolled.Data extraction and analysisTwo reviewers separately selected studies and extracted data using the Medical Subject Headings without restriction on languages or countries. The adjusted HRs were pooled using the DerSimonian and Laird random effects model. Sensitivity analyses were conducted to evaluate the stability of the results. Publication bias was evaluated using Egger’s and Begg’s tests. Quality assessment was performed according to the Newcastle-Ottawa Scale.ResultsFour cohort studies that met the inclusion criteria were included in our meta-analysis. We found that gout and hyperuricaemia did not increase the risk of dementia, with a pooled HR of 0.94 (95% CI 0.69 to 1.28), but might decrease the risk of Alzheimer’s disease (AD), with a pooled HR of 0.78 (95% CI 0.64 to 0.95). There was little evidence of publication bias. Quality assessment of the included studies was high (range: 6–8 points).ConclusionsOur study shows that gout and hyperuricaemia do not increase the risk of dementia. However, gout and hyperuricaemia might have a protective effect against AD. Due to the limited number of research articles, more investigations are needed to demonstrate the potential relationship between dementia and gout or hyperuricaemia.

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