Although we found the redistribution program to be safe, caregivers stated a preference not to be transferred again. The redistribution system did not substantially alter tertiary care center ED use.
Currently, there is no global consensus about the essentiality of dietary chromium. To provide evidence to this debate, an examination of blood chromium levels and common chronic health conditions was undertaken. Using a subsample from the 2015–2016 US National Health and Nutrition Examination Survey (n = 2894; 40 years+), chi-square and binary logistic regression analyses were conducted to examine blood chromium levels (0.7–28.0 vs. <0.7 µg/L) and their associations with cardiovascular diseases (CVDs; self-report), diabetes mellitus (DM; glycohemoglobin ≥5.7%), and depression (Patient Health Questionnaire-9 score ≥5), while controlling for socio-demographic (age/sex/income/education/relationship status) and health-related (red blood cell folate/medications/co-morbidities/body mass index (BMI)/substance use) factors. The sample was almost evenly distributed between men and women (n = 1391, 48.1% (men); n = 1503, 51.9% (women)). The prevalence estimates of low blood chromium levels tended to be higher among those with CVDs (47.4–47.6%) and DM (50.0–51.6%). Comparisons between those with low vs. normal blood chromium levels indicate men have increased odds of CVDs (adjusted odds ratio (aOR) = 1.86, 95% confidence interval (CI): 1.22–2.85, p < 0.001) and DM (aOR = 1.93, 95% CI: 1.32–2.83, p < 0.001) and lower odds of depression (aOR = 0.42, 95% CI: 0.22–0.77, p < 0.05). Dietary chromium may be important in the prevention and management of CVDs and DM for men. Continued exploration of chromium’s role in chronic diseases, including differences by biological factors, is needed.
This study aimed to address knowledge gaps related to the prevention and management of mental health responses among those with a condition that presents risk of severe COVID-19 infection. A scoping review that mapped English and Chinese-language studies (2019–2020) located in MEDLINE (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Sociological Abstracts, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Airiti Library was undertaken. Search terms related to COVID-19, mental health, and physical health were used and articles that included all three of these factors were extracted (n = 77). With the exception of one hospital-based pilot study, there were no intervention studies targeting mental health in those at risk of severe COVID-19 infection. Promising practices such as integrated care models that appropriately screen for mental health issues, address health determinants, and include use of digital resources were highlighted. Patient navigator programs, group online medical visits, peer support, and social prescribing may also support those with complex needs. Future policies need to address digital health access inequities and the implementation of multi-integrated health and social care. Furthermore, research is needed to comprehensively assess multi-integrated interventions that are resilient to public health crises.
Patient engagement is a mechanism used to facilitate person-centred care, however, has not been realized in all patient populations. Often, many marginalized populations still remain under-and/or never-engaged. The purpose of this systematic review was to: 1) identify methods or interventions that have been used to engage under-and/or neverengaged populations in health services and 2) identify outcomes that are associated with engaging under-and/or neverengaged populations in health services. A comprehensive search using the Ovid MEDLINE, EMBASE and CINAHL databases was conducted to examine literature between January 2002 and January 2015. Twenty-nine studies met the inclusion criteria. Data was extracted from these studies and findings are synthesized based on discrete themes that map to the research objectives. The majority of studies were quantitative, repeated-measures designs and concentrated in the United States. Hispanic and Latino/a populations were most frequently included in these studies. The main methods of recruitment included: 1) referral from a healthcare provider, 2) patient self-referral after seeing advertisements on mass media or targeted media, 3) directly approached by researcher in-person or telephone, and 4) administrative databases. Interventions occurred primarily at the individual-level, however some system-level interventions were identified. Five main outcomes resulted from the interventions, including: 1) behavioural change, 2) physiological, 3) psychosocial, 4) system and 5) process. Finally, culture-specific components were embedded in the interventions, both as surface and deep structures. This study provides future direction for patient engagement related projects, as it relates to under-and never-engaged population in healthcare. KeywordsPatient-centred care, patient and family engagement, health equity, patient participation, health services research, systematic review
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