IntroductionYouth with childhood-onset physical disabilities receiving rehabilitation services often present with many complex needs. Emerging evidence confirms co-occurrence of mental health problems in this population is common, and mental health is often overlooked during rehabilitation for chronic physical conditions. For example, symptoms of depression and anxiety are frequently present in adolescents with physical disability such as spina bifida or Duchenne muscular dystrophy, and access to mental health services is often limited. Addressing mental health concerns for this age group is particularly critical as it encompasses a challenging transition to adulthood.ObjectivesBuilding upon findings from a recent scoping review on the co-occurrence of physical disabilities and mental health problems, this paper synthesizes scientific literature related to the organization and delivery of services for youth with co-occurring childhood-onset physical disabilities (e.g., cerebral palsy, spina bifida) and mental health problems (e.g., depression, anxiety).MethodsA scoping review protocol stemming from Arksey & O'Malley's framework and updated guidelines from the Joanna Briggs Institute was developed. Four databases (Medline, PsycINFO, CINAHL, Embase) were searched. The search was limited to French or English peer-reviewed articles published between 2000 and 2021. Articles included were primary papers addressing: 1) youth aged 15 to 24 with a childhood-onset physical disability, 2) mental health problems, and 3) healthcare service organization or delivery. They were screened by two reviewers and discussed with a third to establish consensus on the inclusion criteria and resolve disagreements.ResultsSixteen articles were retained from the 1,010 screened. Many (9/16) were from the United States. Two models were found: the Biopsychosocial, Collaborative, Agency-Based Service Integration Approach (including psychiatry in a pediatric rehabilitation hospital) and the Client Network Consultation (an interagency collaboration in mental health care for children with complex healthcare needs). Twelve key principles for service organization and delivery were identified and categorized into: collaboration and coordination, training and support, and delivery of care.ConclusionIdentified principles can guide improved service delivery for this population. Highlighted research gaps include the need for developing models of collaborative healthcare delivery and subsequently evaluating their effectiveness.
Background Imbalances in global health authorship have previously been documented, but the extent of the problem has yet to be examined longitudinally across many journals. This paper investigates the gender (2002-2020) and geographic distribution (2014-2020) of authors publishing in peer-reviewed global health journals. We also examined the amount of global health research collaboration among different income groups and continents. Methods This cohort study analyzes articles published in 46 peer-reviewed global health journals. Gender-API assigned genders to 190,809 individuals who authored a combined 33,854 articles. The country affiliations of authors were categorized by continent and World Bank income groups. Descriptive analyses were conducted to assess collaboration between first and last authors belonging to different World Bank income groups and continents. Findings Women made up 39.3% of global health authors, and there was a statistically significant increase in the proportion of women authors between 2002 and 2020. The proportion of all global health authors who are women was highest in high income countries (45.9%) and lowest in low income countries (28.2%). Authors from middle income countries comprised of an increasing proportion of global health authors between 2014 and 2020. For articles with multiple authors, 16.0% and 24.1% have first and last authors from different income groups and continents, respectively. Conclusions While women and LMIC researchers are increasingly represented in global health publications, authorship gaps continue to persist. More research on structural determinants is necessary to elucidate how we improve authorship equity and support underrepresented global health expertise.
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