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INTRODUCTION: The GRADE-ADOLOPMENT methodology has been widely used to adopt, adapt or de novo develop recommendations from existing or new guideline and evidence synthesis efforts. This guidance refines the operationalization for applying GRADE-ADOLOPMENT. METHODS: Through iterative discussions, online meetings and email communications, the GRADE-ADOLOPMENT Project Group drafted the updated guidance. We then conducted a review of handbooks of guideline-producing organizations, and a scoping review of published and planned Adolopment guideline projects. The lead authors refined the existing approach based on the scoping review findings and feedback from members of the GRADE Working Group. We presented the revised approach to the group in November 2022 (approximately 115 people), in May 2023 (approximately 100 people) and twice in September 2023 (approximately 60 and 90 people) for approval. RESULTS: This GRADE guidance shows how to effectively and efficiently contextualize recommendations using the GRADE-ADOLOPMENT approach by: (1) showcasing alternative pathways for starting an adolopment effort; (2) elaborating on the different essential steps of this approach, such as building on existing EtDs when available or developing new EtDs if necessary; and (3) providing examples from adolopment case studies to facilitate the application of the approach. We demonstrate how to use contextual evidence to make judgments about EtD criteria, and highlight the importance of making the resulting EtDs available to facilitate adolopment efforts by others. CONCLUSION: This updated GRADE guidance further operationalizes the application of GRADE-ADOLOPMENT based on over six years of experience. It serves to support uptake and application by end users interested in contextualizing recommendations to a local setting or specific reality in a short period of time or with limited resources.
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OBJECTIVE: Today's healthcare system requires interprofessional collaborative practice (IPCP) to improve health outcomes. IPCP often begins with interprofessional education (IPE), which should stimulate meaningful idea exchange. This study's purpose was to assess the impact of a photovoice-based IPE experience on the attitudes and beliefs of students in two health professions programs. METHODS: Forty-two Doctor of Physical Therapy students and 13 Radiation Therapy students created photovoice slides representing the most significant "thing" in their professional education. Students discussed their slides in small groups followed by a large-group discussion. A pretest-posttest survey containing researcher-generated questions and the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R2) and a post-activity evaluation were administered. RESULTS: Forty-two students completed the pretest survey; 35 completed the posttest survey. A statistically significant difference was found between pretest (M=4.07, SD=0.91) and posttest (M=4.45, SD=0.70) SPICE-R2 total scores, t(928)=7.22, p<0.001. Statistically significant differences were found for all SPICE-R2 factor scores. Thematic analysis revealed three themes: 1) students learned about the other profession, 2) the IPE experience was meaningful, and 3) the IPE experience could be improved. CONCLUSIONS: The photovoice IPE experience stimulated student reflection, interprofessional collaboration, and new perceptions about the other health profession. Future studies should focus on similar activities offered earlier in the education program.
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Conducta Cooperativa , Educación Interprofesional , Relaciones Interprofesionales , Fotograbar , Estudiantes del Área de la Salud , Humanos , Educación Interprofesional/organización & administración , Estudiantes del Área de la Salud/psicología , Femenino , Masculino , Actitud del Personal de Salud , Empleos en Salud/educación , AdultoRESUMEN
Adolescent venous thromboembolism (VTE) has unique challenges in management, complications, and compliance to anticoagulants. Direct oral anticoagulants (DOACs) have been approved for pediatric VTE management, with an increasing use especially in adolescents. Primary objective is to evaluate the safety and efficacy of DOAC therapy in adolescent VTE. Secondary objectives include adverse events, bleeding events, and overall mortality. A SR protocol was registered in PROSPERO 2022 (CRD42022363928). Databases were searched from inception to September 22, 2022. Studies with children aged 10-18 years, VTE diagnosis, DOAC therapy, randomized control trials (RCTs), cohort, and relevant study types were included. Studies including prophylaxis, non-DOAC therapy, arterial thrombosis, age outliers, non-relevant study types were excluded. Findings are reported in accordance to PRISMA 2020. Nine reports from five studies, published between 2016 and 2022, were included. Rivaroxaban was the most common DOAC. VTE recurrence was 0.02% in the rivaroxaban phase III trial and one patient in the dabigatran phase IIb/III trial. Complete/partial thrombus resolution (CR/PR) was 76.6% in the rivaroxaban phase III trial, and 83.9% in the dabigatran phase IIb/III trial. CR/PR was found to be 68.4% in Dhaliwal et al. study and 83.3% in Hassan et al. study. Major bleeding occurred in one patient. Headache and gastrointestinal symptoms were commonly seen. All-cause mortality occurred in a patient due to cancer progression. DOAC therapy in adolescent VTE had CR/PR in two-thirds of the patients, with low incidence of VTE recurrence and major bleeding. As there are only two randomized controlled trial (RCTs), future adolescents' studies are required to validate our results.
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Anticoagulantes , Tromboembolia Venosa , Humanos , Adolescente , Tromboembolia Venosa/tratamiento farmacológico , Administración Oral , Anticoagulantes/uso terapéutico , Anticoagulantes/administración & dosificación , Anticoagulantes/efectos adversos , Niño , PronósticoRESUMEN
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is currently the most common bariatric procedure performed in adolescents and young adults in the United States (USA), but there are limited data available on long-term postoperative weight outcomes in these patients. This single-institution US study follows longitudinal weight data in a diverse group of patients undergoing LSG at age 25 years or younger. METHODS: We retrospectively reviewed records of all patients 25 years or younger who underwent LSG at our institution between 2013 and 2020. All weight data documented in the medical record through January 2023 was included. We calculated weight change postoperatively as percent total weight loss (%TWL) relative to preoperative weight. RESULTS: One hundred forty-one patients underwent LSG, at a mean age of 23.1 years. Within this cohort, 56.1% identified as non-Hispanic Black or Hispanic, and 39.7% had private health insurance. The mean %TWL at weight nadir was 28.5% at a mean of 1.35 years postoperatively. The mean long-term %TWL (in patients with ≥ 4 years of follow-up) was 11.8% at a mean of 5.6 years postoperatively, with 43 of the 84 patients with long-term weight data (51%) within 10% of their preoperative weight at most recent follow-up. CONCLUSION: Adolescents and young adults undergoing LSG at our institution had weight nadir comparable to published results during the first 1 to 2 years postoperatively, but the majority developed significant weight recurrence over the ensuing years. Our findings highlight the need for adjuvant weight loss strategies to improve the durability of weight outcomes after LSG in this population.
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Gastrectomía , Laparoscopía , Obesidad Mórbida , Pérdida de Peso , Humanos , Femenino , Adulto Joven , Estudios Retrospectivos , Masculino , Adolescente , Gastrectomía/métodos , Obesidad Mórbida/cirugía , Resultado del Tratamiento , Estados Unidos/epidemiología , Adulto , Cirugía Bariátrica/estadística & datos numéricos , Cirugía Bariátrica/métodosRESUMEN
BACKGROUND: Hospitalized pediatric patients with behavioral health (BH) diagnoses awaiting transfer can exhibit behaviors that may lead to workplace violence such as aggression. Workplace violence can lead to discomfort in caring for these patients. Huddles can be used as a tool to identify potential for violence, to help address workplace violence, and improve clinician situational awareness. METHODS: Utilizing QI methodology, a BH specific huddle tool was created and implemented on an Acute Care floor that identified key components such as triggers and behavioral stability. Mixed methods were used to study the intervention including focus groups, surveys and measurement of agreement (surrogate for situational awareness). The aims of this quality improvement (QI) project were to 1) improve situational awareness by increasing agreement between team members 2) improve the overall comfort of the clinical team caring for BH patients by 10%. RESULTS: Agreement between clinicians on patient stability increased by 20%. Comfort in caring for BH patients increased by 4%. Providers reported the tool increased their understanding (89%) and communication (81%) regarding plan of care. APPLICATION TO PRACTICE: Standardized huddle tool can be utilized to increase situational awareness among team members caring for patients with behavioral health diagnoses and may help to address workplace violence.
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Mejoramiento de la Calidad , Humanos , Niño , Femenino , Masculino , Violencia Laboral/prevención & control , Violencia Laboral/psicología , Grupo de Atención al Paciente/organización & administración , Grupos FocalesRESUMEN
BACKGROUND: Bariatric surgery is one of the clinical pathways of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Masters Program, and laparoscopic adjustable gastric banding (LAGB) is one of the three anchoring bariatric procedures. To improve surgeon lifelong learning, the Masters Program seeks to identify sentinel articles of each of the 3 bariatric anchoring procedures. In this article, we present the top 10 articles on LAGB. METHODS: A systematic literature search of papers on LAGB was completed, and publications with the most citations and citation index were selected and shared with SAGES Metabolic and Bariatric Surgery Committee members for review. The individual committee members then ranked these papers, and the top 10 papers were chosen based on the composite ranking. RESULTS: The top 10 sentinel publications on LAGB contributed substantially to the body of literature related to the procedure, whether for surgical technique, novel information, or outcome analysis. A summary of each paper including expert appraisal and commentary is presented here. CONCLUSION: These seminal articles have had significant contribution to our understanding and appreciation of the LAGB procedure. Bariatric surgeons should use this resource to enhance their continual education and acquisition of specialized skills.
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Gastroplastia , Humanos , Gastroplastia/métodos , Laparoscopía/métodos , Laparoscopía/educación , Cirugía Bariátrica/métodos , Cirugía Bariátrica/educación , Obesidad Mórbida/cirugía , Educación de Postgrado en Medicina/métodosRESUMEN
INTRODUCTION: The incidence, treatment, and outcomes of necrotizing soft tissue infections (NSTIs) and associated racial disparities have been described in adults, but research in the pediatric population is limited. The purpose of this study is to provide a nationally representative characterization of pediatric NSTI and determine the presence of any racial disparities. METHODS: The National Inpatient Sample was analyzed from 2016 through 2020. Patients aged less than 20 y with a diagnosis of necrotizing fasciitis, Fournier's gangrene, or gas gangrene (based on International Classification of Diseases, Tenth Revision, Clinical Modification codes) were included for analysis. RESULTS: A total of 355 patients were identified. Black and Hispanic patients accounted for the most admissions in 2016 and 2018, respectively (P = 0.024). Compared to White patients, more Black patients were insured by Medicaid (P = 0.037) and were in the first zip code-based income quartile (P = 0.005). The leading infection overall was necrotizing fasciitis and most patients (81.7%) underwent a surgical procedure by the first calendar day after admission. Although the proportion of Black patients undergoing subcutaneous tissue and fascia excisions was more than that of White patients (P = 0.005), there were no significant differences by race in the time to first procedure, the total number of procedures, or number of postoperative complications. Our amputation and mortality rates were low and unreportable, but there were no differences by race. CONCLUSIONS: NSTI is rare in the pediatric population and mortality is low. Black patients are disproportionately diagnosed, but these disparities do not extend to disease treatment or outcomes.
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Fascitis Necrotizante , Gangrena de Fournier , Infecciones de los Tejidos Blandos , Masculino , Adulto , Estados Unidos , Humanos , Niño , Infecciones de los Tejidos Blandos/cirugía , Fascitis Necrotizante/epidemiología , Estudios Transversales , Pacientes Internos , Gangrena de Fournier/cirugía , Estudios RetrospectivosRESUMEN
BACKGROUND: Rapid adoption of sleeve gastrectomy (SG) in the last decade aptly reflects the desire of patients and surgeons for alternatives to RYGB and DS. While SG provides good outcomes, other options that address specific patient needs are warranted. Recently approved by ASMBS, SADI, and OAGB have garnered increasing interest due to their single anastomosis technique. METHODS: Using the Metabolic and Bariatric Surgery Quality Improvement Program database, we examined laparoscopic and robotic cases from 2018 to 2021 to understand the percentage of primary bariatric surgery cases that are SADI and OAGB. We used coarsened exact matching to match patients who underwent SADI or OAGB to patients who underwent Roux-en-Y gastric bypass (RYGB). We examined outcomes of matched patients using logistic regression. RESULTS: Of the 667,979 patients that underwent bariatric-metabolic surgery, 1326 (0.2%) underwent SADI, and 2541 (0.4%) underwent OAGB. SADI was not identified in the database until 2020. In 2020, there were 487 SADI procedures compared to 839 in 2021. From 2018 to 2021, OAGBs went from 149 to 940. Compared with RYGB, SADI was associated with higher rates of anastomotic or staple line leak (OR 2.21 (95% CI 1.08-4.53)) and sepsis (OR 3.62 (95% CI 1.62-8.12)). Compared with RYGB, OAGB was associated with lower rates of gastrointestinal bleeding (OR 0.29 (95% CI 0.12-0.71)) and bowel obstruction (OR 0.10 (95% CI 0.02-0.39)). Of note, there were no differences between these procedures and RYGB for 30-day mortality. CONCLUSION: More SADIs and OAGBs are being performed. However, there were higher complication rates associated with the SADI procedure. Further studies will be needed to better understand the key drivers for these outcomes.
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Cirugía Bariátrica , Derivación Gástrica , Obesidad Mórbida , Humanos , Derivación Gástrica/métodos , Obesidad Mórbida/cirugía , Mejoramiento de la Calidad , Gastrectomía/métodos , América del Norte/epidemiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Background: Many educational disciplines, especially in health professions, are required by accrediting bodies to introduce or include health informatics (HI); however, faculty (academics) teaching this content may not be well prepared. Objective: The aim of this project was to explore how a doctoral physical therapy (DPT) program could more accurately represent compliance with HI accreditation requirements by identifying hidden instances of relevant content within the curriculum. Method: This exploratory, mixed methods, action research study utilised document review, questionnaires and interviews in the collection of quantitative and qualitative data to enable assessment of knowledge about HI, to determine if HI content was already incorporated in current courses, and, whether the content was accurately reflected in course student learning objectives (SLOs). Change in faculty understanding of HI as a result of this study was also assessed. Results: Of 16 DPT faculty, 13 participated in the pre-interview questionnaire; 8 (50%) representing 22/39 courses participated in the full study. Most were unfamiliar with HI and had unrecognised HI already incorporated in their courses leading to several SLO revisions and additions. Interview and post-interview questionnaire results documented significant increases in HI understanding among faculty. Conclusion: Physical therapy and HIM collaboration was successful in identifying HI content hiding in plain sight. Results revealed multiple instances of unrecognised HI content across the DPT curriculum. Revised and newly added SLOs, with others likely to follow due to this study, will assist faculty with future reaccreditation and in preparing graduates to more fully utilise HI in today's digital healthcare environments.
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Gestión de la Información en Salud , Informática Médica , Humanos , Docentes , Atención a la Salud , EstudiantesRESUMEN
BACKGROUND: The incidence and impact of hypoalbuminemia in bariatric surgery patients is poorly characterized. We describe its distribution in laparoscopic sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) patients undergoing primary or revision surgeries and assess its impact on postoperative complications. METHODS: The Metabolic and Bariatric Surgery Quality Improvement Program Database (2015 to 2021) was analyzed. Hypoalbuminemia was defined as Severe (< 3 g/dL), Moderate (3 ≤ 3.5 g/dL), Mild (3.5 ≤ 4 g/dL), or Normal (≥ 4 g/dL). Multivariable logistic regression was performed to calculate odds ratios of postoperative complications compared to those with Normal albumin after controlling for procedure, age, gender, race, body mass index, functional status, American Society of Anesthesia class, and operative length. RESULTS: A total of 817,310 patients undergoing Primary surgery and 69,938 patients undergoing Revision/Conversion ("Revision") surgery were analyzed. The prevalence of hypoalbuminemia was as follows (Primary, Revision): Severe, 0.3%, 0.6%; Moderate, 5.2%, 6.5%; Mild, 28.3%, 31.4%; Normal, 66.2%, 61.4%. Primary and Revision patients with hypoalbuminemia had a significantly higher prevalence (p < 0.01) of several co-morbidities, including hypertension and insulin-dependent diabetes. Any degree of hypoalbuminemia increased the odds ratio of several complications in Primary and Revision patients, including readmission, intervention, and reoperation. In Primary patients, all levels of hypoalbuminemia also increased the odds ratio of unplanned intubation, intensive care unit admission, and venous thromboembolism requiring therapy. CONCLUSION: Over 30% of patients present with hypoalbuminemia. Even mild hypoalbuminemia was associated with an increased rate of several complications including readmission, intervention, and reoperation. Ensuring nutritional optimization, especially prior to revision surgery, may improve outcomes in this challenging population.
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Cirugía Bariátrica , Derivación Gástrica , Hipoalbuminemia , Obesidad Mórbida , Humanos , Hipoalbuminemia/epidemiología , Hipoalbuminemia/etiología , Obesidad Mórbida/cirugía , Cirugía Bariátrica/efectos adversos , Cirugía Bariátrica/métodos , Complicaciones Posoperatorias/etiología , Derivación Gástrica/métodos , Gastrectomía/efectos adversos , Gastrectomía/métodos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVES: Children in immigrant families comprise â¼25% of US children and live in families with high levels of poverty and food insecurity. Studies suggest a decline in public benefit enrollment among children in immigrant families. We aimed to explore perspectives on barriers and facilitators in accessing care among immigrant caregivers of hospitalized children. METHODS: With a general qualitative descriptive design, we developed a semistructured interview guide using an iterative process informed by literature and content expertise. Using purposive sampling, we recruited immigrant caregivers of hospitalized children in March 2020 and conducted interviews in English or Spanish. Interviews were recorded, transcribed, and translated to English. Three authors coded transcripts using Dedoose and identified themes via thematic analysis. RESULTS: Analysis of 12 caregiver interviews revealed barriers and facilitators in accessing healthcare and public benefit use. Barriers included healthcare system barriers, immigration-related fear, and racism and discrimination. Within healthcare system barriers, subthemes included language barriers, cost, complexity of resource application, and lack of guidance on available benefits. Within immigration-related fear, subthemes included fear of familial separation, fear of deportation, fear that benefit use affects immigration status, and provider distrust. Healthcare system facilitators of resource use included recruiting diverse workforces, utilizing language interpretation, guidance on benefit enrollment, legal services, and mental health services. Participants also recommended hospital partnership with trusted information sources, including media stations and low-cost clinics. CONCLUSIONS: Immigrant caregivers of hospitalized children identified barriers and facilitators in access to care. Further research is needed to assess the efficacy of caregiver-suggested interventions.
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Emigrantes e Inmigrantes , Accesibilidad a los Servicios de Salud , Humanos , Niño , Investigación Cualitativa , CuidadoresRESUMEN
BACKGROUND: The Nursing Science Precision Health (NSPH) Model has the potential to guide research on the development, testing, and targeting of interventions. PURPOSE: This scoping review examines the relationship between physical activity (PA) and cancer-related fatigue (CRF) within the context of the NSPH Model. METHODS: The Joanna Briggs Institute scoping review methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guided this review. We included randomized controlled trials in people with cancer that investigated PA interventions and measured change in CRF as an outcome. DISCUSSION: A total of 181 studies met the eligibility criteria. Over 20 different instruments were used to measure CRF. The most common PA interventions were strength training (48%), walking (36%), cycling (26%), and yoga (15%). A limited number of studies reported phenotypic characteristics (32/181, 17%) or biomarkers (31/181, 17%) associated with CRF. CONCLUSION: This scoping review identified the body of existing research exploring CRF and PA from a precision health perspective.
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Neoplasias , Medicina de Precisión , Humanos , Ejercicio Físico , Fatiga/etiología , Fatiga/prevención & control , Neoplasias/complicaciones , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
As costs of higher education continue to rise, textbook pur¬chase is an area in which students have control over spending. The purposes of this project were to: 1) describe textbook use among current students and recent graduates in one physical therapist program, and 2) determine how this information might be utilized in addressing faculty textbook decisions in entry-level education. Electronic surveys were sent to 83 students and 229 graduates of a Doctor of Physical Therapy program in Texas. Ten faculty completed an 8-question paper survey about factors considered in requiring a textbook. Data analyses included descriptive statistics, ANOVA, and chi-square test for independence. Thirty-two students, 28 graduates, and 7 faculty responded. A total of 23 textbooks were required during the curriculum. Only 6 of 23 required texts were reported as "useful" by students. Graduates identified 3 texts as "useful" during early clinical practice. Six faculty required textbooks for classes; 4 indicated texts were "necessary" for student success. Students purchased a small percentage of required textbooks and maintained a high level of success. Results indicate that faculty are providing the required content. Faculty should carefully consider their instructional delivery when making decisions about if required textbooks are truly required for success.
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Fisioterapeutas , Humanos , Estudiantes , Curriculum , Docentes , Encuestas y CuestionariosRESUMEN
Background: The role of multidisciplinary clinics for psychosocial care is increasingly recognized for those living with inherited cardiac conditions (ICC). In Canada, access to healthcare providers differ between clinics. Little is known about the relationship between access to specialty care and a patient's ability to cope with, and manage their condition. Methods: We leveraged the Hearts in Rhythm Organization (HiRO) to conduct a cross-sectional, community-based survey of individuals with ICC and their family members. We aimed to describe access to services, and explore the relationships between participants' characteristics, cardiac history and self-reported health status and self-efficacy (GSE: General Self-Efficacy Scale) and empowerment (GCOS-24: Genetic Counseling Outcome Scale). Results: We collected 235 responses from Canadian participants in 10 provinces and territories. Overall, 63% of participants reported involvement of a genetic counsellor in their care. Access to genetic testing was associated with greater empowerment [mean GCOS-24: 121.14 (SD = 20.53) vs. 105.68 (SD = 21.69); p = 0.004]. Uncertain genetic test results were associated with lower perceived self-efficacy (mean GSE: uncertain = 28.85 vs. positive = 33.16, negative = 34.13; p = 0.01). Low global mental health scores correlated with both lower perceived self-efficacy and empowerment scores, with only 11% of affected participants reporting involvement of psychology services in their care. Conclusion: Differences in resource accessibility, clinical history and self-reported health status impact the perceived self-efficacy and empowerment of patients with ICC. Future research evaluating interventions to improve patient outcomes is recommended.
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Gastroparesis is a gastric motility disorder characterized by delayed gastric emptying. It is a rare disease and difficult to treat effectively; management is a dilemma for gastroenterologists and surgeons alike. We conducted a systematic review of the literature to evaluate current diagnostic tools as well as treatment options. We describe key elements in the pathophysiology of the disease, in addition to current evidence on treatment alternatives, including nutritional considerations, medical and surgical options, and related outcomes.
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Gastroparesia , Cirujanos , Humanos , Gastroparesia/diagnóstico , Gastroparesia/etiología , Gastroparesia/cirugía , Vaciamiento GástricoRESUMEN
OBJECTIVE: Children with tracheostomies have complex medical issues that require long-term technology dependence and continuous medical care at home. Parents of tracheostomy-dependent children often assume the majority of their child's home care leading to a shift in family dynamics and a decrease in caregiver quality of life. This systematic review sought to identify instruments to measure caregiver psychosocial outcomes after their child's tracheostomy and report on the findings. DATA SOURCES: A systematic review was performed using Medline, CINAHL, and EMBASE. REVIEW METHODS: Studies that evaluated psychosocial outcomes in caregivers of tracheostomy-dependent children were included. RESULTS: We screened a total of 1286 nonduplicate records to include a total of 12 studies assessing the psychosocial outcomes of parents of tracheostomy-dependent children. Fourteen instruments were identified. Caregivers reported lower quality of life when compared to other chronic caregiver groups. They experienced high degrees of stress, struggled to cope individually and as a family unit, and experienced decision regret and conflict. CONCLUSION: Findings from this review suggest a significant impact on caregiver psychosocial well-being, but few quantitative studies investigated this dynamic with measures validated in this caregiver population. This review demonstrates the need for longitudinal studies using validated tools to assess the long-term impacts and outcomes of caregivers of the tracheostomy-dependent child.
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Cuidadores , Calidad de Vida , Niño , Humanos , Traqueostomía , Padres/psicología , EmocionesRESUMEN
BACKGROUND: Young adults experiencing homelessness (YAEH) experience more stressors compared to housed peers, yet little is known about the impact of the COVID-19 pandemic on these youth. The purpose of this qualitative study was to explore how YAEH perceived the pandemic's impact on their well-being and coping. METHODS: YAEH were recruited from those participating in an HIV prevention study. Semi-structured interviews were conducted and analysis was guided by Lazarus and Folkman's transactional theory of stress and coping. RESULTS: Four major themes were identified from interviews with 40 youth: (1) ongoing harms, (2) COVID-19 as a stressor, (3) mental health impacts, and (4) coping strategies. Participants described unmet basic needs, emotions of frustration and anxiety, and several coping strategies including substance use. CONCLUSION: Many YAEH reported experiencing continued challenges that were compounded by the stressors related to the COVID-19 pandemic. Special considerations are needed to address pandemic-related exacerbations of mental health symptoms and substance use among YAEH.
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COVID-19 , Personas con Mala Vivienda , Trastornos Relacionados con Sustancias , Adolescente , Humanos , Adulto Joven , COVID-19/epidemiología , Pandemias , Vivienda , Adaptación Psicológica , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
BACKGROUND: A systematic review (SR) synthesizes evidence in a reproducible way and informs evidence-based decision-making. SRs are time-intensive, particularly with respect to staying organized, maintaining records, and managing different phases of the process. Although there are numerous methodological guides to lead researchers in the approach to SRs to minimize bias and enhance rigor, there is less focus on technological approaches that can make the SR process easier for researchers. AIM: To guide researchers through the currently available technological applications that can assist with the SR process and synthesis of scientific literature. METHODOLOGY: Key ways that technological applications can facilitate the SR process are examined. RESULTS: Specific applications are discussed and stratified by their support of one or multiple phases of the systematic review process. Key features, strengths, and limitations are provided for technological applications that support the SR process. LINKING EVIDENCE TO ACTION: This paper guides researchers in different ways technology can support SRs. Through use of these applications, the researcher can complete SRs in a timely manner and manage the process effectively.