scholarly journals Patient race, ethnicity, and care in the emergency department: A scoping review

CJEM ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 245-253 ◽  
Author(s):  
Allison Owens ◽  
Brian R. Holroyd ◽  
Patrick McLane
Keyword(s):  
Emergency Department ◽  
Scoping Review ◽  
Race And Ethnicity ◽  
Research Question ◽  
The United States ◽  
Subjective Experiences ◽  
Patient Race ◽  
Abstract Screening ◽  
The Impact ◽  
Full Text Screening

ABSTRACTObjectivesHealth disparities between racial and ethnic groups have been documented in Canada, the United States, and Australia. Despite evidence that differences in emergency department (ED) care based on patient race and ethnicity exist, there are no comprehensive literature reviews in this area. The objective of this review is to provide an overview of the literature on the impact of patient ethnicity and race on the processes of ED care.MethodsA scoping review was conducted to capture the broad nature of the literature. A database search was conducted in MEDLINE/PubMed, EMBASE, CINAHL Plus, Social Sciences Citation Index, SCOPUS, and JSTOR. Five journals and reference lists of included articles were hand searched. Inclusion and exclusion criteria were defined iteratively to ensure literature captured was relevant to our research question. Data were extracted using predetermined variables, and additional extraction variables were added as familiarity with the literature developed.ResultsSearching yielded 1,157 citations, reduced to 153 following removal of duplicates, and title and abstract screening. After full-text screening, 83 articles were included. Included articles report that, in EDs, patient race and ethnicity impact analgesia, triage scores, wait times, treatments, diagnostic procedure utilization, rates of patients leaving without being seen, and patient subjective experiences. Authors of included studies propose a variety of possible causes for these disparities.ConclusionsFurther research on the existence of disparities in care within EDs is warranted to explore the causes behind observed disparities for particular health conditions and population groups in specific contexts.

scholarly journals P090: A scoping review on patient race, ethnicity, and care in the emergency department

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S96
Author(s):  
A. Owens ◽  
B. Holroyd ◽  
P. McLane
Keyword(s):  
United States ◽  
Emergency Department ◽  
Ethnic Groups ◽  
Scoping Review ◽  
Race And Ethnicity ◽  
Diagnostic Testing ◽  
The United States ◽  
Wait Times ◽  
Patient Race ◽  
The Impact

Introduction: Health disparities between racial and ethnic groups have been well documented in Canada, the United States, and Australia. Despite evidence that differences in emergency department (ED) care based on patient race and ethnicity exist, there is a lack of scientific reviews in this important area. The objective of this review is to provide an overview of the literature on the impact of patient race and ethnicity on ED care. Methods: A scoping review guided by the framework described by Arksey and O'Malley was undertaken. This approach was taken because it was best suited to the goal of providing an overview of all of the literature, given the broad nature of the topic. All studies with primary outcomes considering the impact of patient race and ethnicity on “throughput” factors in the ED as defined by Asplin et al., were considered. Outcomes considered included triage scores, wait times, analgesia, diagnostic testing, treatment, leaving without being seen, and patient experiences. Literature from Canada, the United States, Australia, and New Zealand was considered. A database search protocol was developed iteratively as familiarity with the literature developed. Inclusion and exclusion decisions were made using an established model. Results: The original search yielded 1157 citations, reduced to 453 after duplicate removal. 153 full texts were included for screening, of which 85 were included for final data extraction. Results indicate there is evidence that minority racial and ethnic groups experience disparities in triage scores, wait times, analgesia, treatment, diagnostic testing, leaving without being seen, and subjective experiences. Authors’ suggested explanations for these disparities can be placed in the following categories: (1) communication differences; (2) conscious or unconscious bias; (3) facility and resource factors in hospitals with higher minority presentation rates; and (4) differences in clinical presentations. Conclusion: This scoping review provides an overview of the literature on the impacts of race and ethnicity on ED care. As disparities have been shown to exist in numerous contexts, further research on the impact of race and ethnicity in ED care is warranted, especially in the Canadian literature. Such explorations could aid in the informing and creation of policy, and guide practice.

scholarly journals The Role of Targeted HIV Screening in the Emergency Department: A Scoping Review

2020 ◽  
Vol 18 ◽  
Author(s):  
Ornella Spagnolello ◽  
Bernadette Gallagher ◽  
Nazir Lone ◽  
Giancarlo Ceccarelli ◽  
Gabriella D’Ettorre ◽  
...  
Keyword(s):  
Emergency Department ◽  
Human Immunodeficiency Virus ◽  
Hiv Testing ◽  
Scoping Review ◽  
Significant Proportion ◽  
The United States ◽  
Hiv Prevalence ◽  
Hiv Screening ◽  
Immunodeficiency Virus ◽  
The Impact

Background: Human immunodeficiency virus (HIV) infection continues to expand worldwide and a significant proportion of infection is still undiagnosed. Recent studies have addressed the impact and feasibility of ‘opt-out’ HIV screening in Emergency Departments (EDs) in urban settings at high HIV prevalence, whereas little is known about the yield of implementing ‘targeted’ HIV testing especially in low-prevalence areas. Objective: The present study undertakes a scoping review of research carried out on the implementation of targeted HIV screening in adult EDs to determine the impact, feasibility and acceptability of HIV testing in different HIV prevalence settings. Design: Online databases (EMBASE, MEDLINE) were used to identify papers published between 2000 to 2020. A threeconcept search was employed with HIV (HIV, Human immunodeficiency virus infection, HIV infections), targeted testing (Target, screening or testing) and emergency medicine (Emergency Service, emergency ward, A&E, accident and emergency or Emergency Department) (28th February 2020). Only full-text articles written in English, French, Spanish or Italian and using impact and/or feasibility and/or acceptability of the program as primary or secondary outcomes were analysed. Results: The search returned 416 articles. Of these, 12 met inclusion criteria and were included in the final review. Most of the included studies were carried out in the United States (n=8; 67%) and in areas of high HIV prevalence (n=11; 92%). Three (20%) were randomized control studies. While the rate of newly diagnosed HIV cases varied widely (0.03-2.2%), likely due to methodological heterogeneity between studies, the linkage of new HIV diagnosis was often high (80-100%) and median CD4+ cell count was always greater than 200 cells per microliter. Targeted HIV screening was found to be cost-effective (out of 2 studies) and well accepted by participants (out 2 studies). Conclusions: Targeted HIV screening at the ED can be impactful, feasible and well accepted, but often requires extra funding and staff. Most previous work has focused on areas of high disease prevalence.

scholarly journals Measuring Online Wellbeing: A Scoping Review of Subjective Wellbeing Measures

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhen Xin Ong ◽  
Liz Dowthwaite ◽  
Elvira Perez Vallejos ◽  
Mat Rawsthorne ◽  
Yunfei Long
Keyword(s):  
Scoping Review ◽  
English Language ◽  
Subjective Wellbeing ◽  
Subjective Evaluation ◽  
The Internet ◽  
Positive And Negative Affect ◽  
Common Features ◽  
Abstract Screening ◽  
The Impact ◽  
Full Text Screening

With the increasing importance of the internet to our everyday lives, questions are rightly being asked about how its' use affects our wellbeing. It is important to be able to effectively measure the effects of the online context, as it allows us to assess the impact of specific online contexts on wellbeing that may not apply to offline wellbeing. This paper describes a scoping review of English language, peer-reviewed articles published in MEDLINE, EMBASE, and PsychInfo between 1st January 2015 and 31st December 2019 to identify what measures are used to assess subjective wellbeing and in particular to identify any measures used in the online context. Two hundred forty studies were identified; 160 studies were removed by abstract screening, and 17 studies were removed by full-text screening, leaving 63 included studies. Fifty-six subjective wellbeing scales were identified with 18 excluded and 38 included for further analysis. Only one study was identified researching online wellbeing, and no specific online wellbeing scale was found. Therefore, common features of the existing scales, such as the number and type of questions, are compared to offer recommendations for building an online wellbeing scale. Such a scale is recommended to be between 3 and 20 questions, using mainly 5-point Likert or Likert-like scales to measure at least positive and negative affect, and ideally life satisfaction, and to use mainly subjective evaluation. Further research is needed to establish how these findings for the offline world effectively translate into an online measure of wellbeing.

scholarly journals The impact of adolescent peer influence via social media on eating behaviors: A global scoping review (Preprint)

2020 ◽  
Author(s):  
Alicia Chung ◽  
Dorice Vieira ◽  
Tiffany Donley ◽  
Nicholas Tan ◽  
Girardin Jean-Louis ◽  
...  
Keyword(s):  
Social Media ◽  
Peer Influence ◽  
Scoping Review ◽  
Fast Food ◽  
Eating Behaviors ◽  
Research Question ◽  
The United States ◽  
Subject Headings ◽  
Social Media Platforms ◽  
The Impact

BACKGROUND The impact of social media among adolescent peer groups can be a powerful change agent. OBJECTIVE Our scoping review aimed to elucidate the ways in which social media use among adolescent peers influences eating behaviors. METHODS A scoping review of the literature from inception to 2019 was performed using PubMed/Medline, Embase, Food Science & Technology Abstracts (FSTA), INSPEC, Cumulative Index to Nursing & Allied Health (CINAHL), PsycINFO, ERIC, Google Scholar and Web of Science databases. The review was conducted in three steps: 1) identification of the research question and clarification of criteria using the PICO framework, 2) selection of the literature using PRISMA guidelines, and 3) charting and summarizing information from selected articles. PubMed’s Medical subject headings (MeSH) and Embase’s Emtree subject headings were reviewed along with specific keywords to construct a comprehensive search strategy. Subject headings and keywords were based on adolescent age groups, social media platforms, and eating behaviors. After screening 1382 peer-reviewed articles, 32 articles were assessed for eligibility. Participant age, gender, study location, social media channel(s) utilized, user volume and content themes related to findings were extracted. RESULTS Six articles fit the final inclusion criteria. A final sample of 1,225 adolescents (ages 10-19) from the United States, England, Sweden, Norway, Denmark, Portugal, Brazil and Australia were included in controlled studies. Instagram and Facebook were among the most popular social media platforms that influenced healthful eating behaviors (i.e., fruit and vegetable intake) as well as unhealthful eating behaviors related to fast food advertising. Online forums and blogs served as accessible channels for eating disorder relapse prevention among youth. Social media influence converged around four central themes: 1. Visual appeal, 2. Content dissemination, 3. Socialized digital connections and 4. Adolescent “marketer” influencers. CONCLUSIONS Adolescent peer influence in social media environments spans the spectrum of healthy eating (non-pathological) to eating disorders (pathological). Strategic network-driven approaches should be considered for engaging adolescents in promotion of positive dietary behaviors.

Cognitive Impairment and Length of Stay in Acute Care Hospitals: A Scoping Review of the Literature

2021 ◽  
pp. 1-19
Author(s):  
Jonathan Plante ◽  
Karine Latulippe ◽  
Edeltraut Kröger ◽  
Dominique Giroux ◽  
Martine Marcotte ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Length Of Stay ◽  
Acute Care ◽  
Scoping Review ◽  
Research Question ◽  
Positive Association ◽  
Well Being ◽  
Future Research ◽  
Care Hospital ◽  
The Impact

Abstract Older persons experiencing a longer length of stay (LOS) or delayed discharge (DD) may see a decline in their health and well-being, generating significant costs. This review aimed to identify evidence on the impact of cognitive impairment (CI) on acute care hospital LOS/DD. A scoping review of studies examining the association between CI and LOS/DD was performed. We searched six databases; two reviewers independently screened references until November 2019. A narrative synthesis was used to answer the research question; 58 studies were included of which 33 found a positive association between CI and LOS or DD, 8 studies had mixed results, 3 found an inverse relationship, and 14 showed an indirect link between CI-related syndromes and LOS/DD. Thus, cognitive impairment seemed to be frequently associated with increased LOS/DD. Future research should consider CI together with other risks for LOS/DD and also focus on explaining the association between the two.

scholarly journals Emergency Department Visit Rates for Motor Vehicle Crashes by Selected Characteristics in the United States, 2017-2018

2021 ◽  
Author(s):  
Danielle Davis ◽  
Christopher Cairns
Keyword(s):  
United States ◽  
Emergency Department ◽  
Emergency Department Visit ◽  
Race And Ethnicity ◽  
Motor Vehicle ◽  
The United States ◽  
Motor Vehicle Crashes ◽  
Insurance Status ◽  
Vehicle Crashes ◽  
Health Insurance Status

This report presents emergency department visit rates for motor vehicle crashes by age, race and ethnicity, health insurance status, and region.

Racial and Ethnic Differences in Response to Anticoagulation: A Review of the Literature

2019 ◽  
pp. 089719001989414 ◽  
Author(s):  
Caitlin M. Gibson ◽  
Wei C. Yuet
Keyword(s):  
Racial Differences ◽  
Race And Ethnicity ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Ethnic Disparities ◽  
The United States ◽  
End Points ◽  
Medline Search ◽  
Drug Concentrations ◽  
The Impact

Introduction: Anticoagulants are among the most frequently prescribed medications in the United States. Racial and ethnic disparities in incidence and outcomes of thrombotic disorders are well-documented, but differences in response to anticoagulation are incompletely understood. Objective: The objective of this review is to describe the impact of race and ethnicity on surrogate and clinical end points related to anticoagulation and discuss racial or ethnic considerations for prescribing anticoagulants. Methods: A PubMed and MEDLINE search of clinical trials published between 1950 and May 2018 was conducted using search terms related to anticoagulation, specific anticoagulant drugs, race, and ethnicity. References of identified studies were also reviewed. English-language human studies on safety or efficacy of anticoagulants reporting data for different races or ethnicities were eligible for inclusion. Results: Seventeen relevant studies were identified. The majority of major trials reviewed for inclusion either did not include representative populations or did not report on the racial breakdown of participants. Racial differences in pharmacokinetics, dosing requirements, drug response, and/or safety end points were identified for unfractionated heparin, enoxaparin, argatroban, warfarin, rivaroxaban, and edoxaban. Conclusions: Race appears to influence drug concentrations, dosing, or safety for some but not all direct oral anticoagulants. This information should be considered when selecting anticoagulant therapy for nonwhite individuals.

A Scoping Review on the Long-Term Outcomes in Persons with Adult-Acquired Burn Injuries

2019 ◽  
Vol 41 (3) ◽  
pp. 472-502
Author(s):  
Stephanie R Cimino ◽  
Jorge N Rios ◽  
Matthew Godleski ◽  
Sander L Hitzig
Keyword(s):  
Community Participation ◽  
Scoping Review ◽  
The United States ◽  
Community Dwelling ◽  
Burn Injuries ◽  
Computer Assisted ◽  
Long Term Outcomes ◽  
Burn Survivors ◽  
The Impact

Abstract Adult-acquired burn injuries are a life-altering event that can lead to debilitating functional or psychological impairments. With advancements in health care resulting in decreased mortality rates, survivors of burn injuries can expect to live longer. This warrants a shift in focus to better understand what happens to adults once they are discharged from the hospital into the community. Therefore, the purpose of this scoping review was to map the literature regarding the long-term outcomes of community-dwelling adult-acquired burn survivors. A computer-assisted literature search was conducted on literature from January 1, 2000 to August 31, 2018 utilizing four large databases (MEDLINE, EMBASE, CINHAL, and PsycINFO). Articles were included if they had a minimum of five individuals with a burn injury as a result of an accidental injury who were at least 18 years of age at the time of injury. Fifty-four articles were found suitable for inclusion in this review. The majority of studies were conducted in the United States and were longitudinal in design. Four themes were apparent from the articles: postburn complications, psychosocial outcomes, quality of life, and community participation. Data are lacking with respect to outcomes more than 5 years postburn as well as qualitative research. Furthermore, more literature is needed to understand the impact of postburn complications, coping strategies, and posttraumatic growth as well as barriers to community participation. Overall, there is an emerging body of literature that describes the long-term outcomes of adult-acquired burn survivors up to 5 years postburn.

The Impact of Broadband Access on Social and Economic Integration: Results from the RefugeeMobile Pilot

2019 ◽  
Author(s):  
William N Evans ◽  
Brendan Perry ◽  
Rachel Factor
Keyword(s):  
United States ◽  
Research Question ◽  
Risk Groups ◽  
The United States ◽  
Control Group ◽  
Broadband Access ◽  
Office Visits ◽  
Group Members ◽  
One Year ◽  
The Impact

Abstract The Internet is a ubiquitous feature of everyday life and an important research question is whether improving broadband access for at-risk groups such as refugees enhances social and economic outcomes. The article reports the results of the RefugeeMobile pilot where a sample of refugees to the United States were randomly assigned a smartphone (n = 82) with eight months of free service and pre-loaded apps designed to help them adjust to life in the United States, or not (n = 74). At a one-year follow-up, results indicate that assignment to treatment generates statistically significant increases in smartphone ownership and Internet access, and some measures of social integration. Results for employment and earnings were positive but statistically insignificant. Treatment-group members had fewer interactions with their case worker, a smaller fraction of in-office visits and hence a larger fraction of interactions by phone than control-group members, suggesting the pilot may have increased programme efficiency.

Exploring How Trauma Is Addressed in Sexual Education Interventions for Youth: A Scoping Review

2020 ◽  
Vol 47 (6) ◽  
pp. 880-893
Author(s):  
Lisa S. Panisch ◽  
Monica Faulkner ◽  
Sofia B. Fernandez ◽  
Nicole M. Fava
Keyword(s):  
Sexual Health ◽  
Scoping Review ◽  
The United States ◽  
Health Interventions ◽  
Traumatic Experiences ◽  
Sexually Transmitted ◽  
Trauma Informed ◽  
Education Interventions ◽  
Intervention Content ◽  
The Impact

Traumatic experiences are common among adolescents and can negatively affect learning and increase the risk of early pregnancy, parenthood, and sexually transmitted infections. Little is known about how current sexual health interventions address trauma. A scoping review was conducted to gain insight into how trauma is addressed in adolescent sexual health interventions. Peer-reviewed studies from the United States published between 2008 and 2018 describing a sexual health intervention for youth were considered. Studies were analyzed to determine if and how trauma was addressed in the interventions. Out of 169 articles initially screened, 29 met inclusion criteria and 23% ( n = 6) addressed trauma. Four interventions addressed trauma in the intervention content, while two studies evaluated trauma in outcome measures. Educators can broaden this reach by developing trauma-informed content that is compatible with existing curricula. Ongoing study is recommended to evaluate the impact of trauma-informed content on the sexual knowledge, attitudes, and behaviors of youth.

Sign in / Sign up

Export Citation Format

Share Document