Systematic review of healthcare interventions for reducing gender-based violence impact on the mental health of women with disabilities.

PURPOSE: Women with disabilities are more exposed to violence. The health sector has a key role in all three levels of prevention of violence against women. The objective of this paper was to review the interventions for preventing gender-based violence and reducing its impact on the mental health of women with any form of disability. METHOD: Relevant studies were identified through conducting searches in PubMed, Scopus, CINAHL, PsyInfo, Social Services Abstracts, and PILOTS. Two reviewers analyzed and selected studies. A qualitative synthesis was made. RESULTS: 3149 references were obtained, among which eight articles describing nine interventions from the USA and the UK. Most were intended for women with mental/intellectual disability and assessed intimate partner or sexual violence. Only one study showed high methodological quality. They were found to be particularly effective as regards improvement of the skills acquired by participants, but the results as regards improved mental health are not consistent. CONCLUSION: Our review shows very little evidence of effective interventions. Further studies are required with higher internal validity and female sample groups with diverse disabilities. CLINICAL RELEVANCE: Gender-based violence is a highly prevalent problem for women with disabilities, and in addition to being a public health challenge is a violation of human rights. Health care systems and policymakers should take a key role in all three levels of prevention of violence against women with disabilities. Interventions with longer follow-up times are required. It is also important for interventions to be designed in consultation with people with disabilities.

Scoping review of the methodology of large health surveys conducted in Spain early on in the COVID-19 pandemic.

Background: The use of health surveys has been key in the scientific community to promptly communicate results about the health impact of COVID-19. But what information was collected, where, when and how, and who was the study population? Objective: To describe the methodological characteristics used in large health surveys conducted in Spain early on in the COVID-19 pandemic. Methods: Scoping review. Inclusion criteria: observational studies published between January 2020 and December 2021, with sample sizes of over 2,000 persons resident in Spain. Databases consulted: PubMed, CINAHL, Literatura Latinoamericana y del Caribe en CC de la Salud, Scopus, PsycINFO, Embase, Sociological Abstracts, Dialnet and Web of Science Core Collection. We analyzed the characteristics of the literature references, methodologies and information gathered in the surveys selected. Fifty five studies were included. Results: Sixty percentage of the studies included had mental health as their main topic and 75% were conducted on the general adult population. Thirteen percentage had a longitudinal design, 93% used the internet to gather information and the same percentage used non-probability sampling. Thirty percentage made some type of sampling correction to reduce coverage or non-response biases, but not selection biases. Sixty seven percentage did not state the availability of their data. Conclusions: Consistent with the extensive use of non-probability sampling without any bias correction in the extraordinary setting created by COVID-19, quality population frameworks are required so that probability and representative samples can be extracted quickly to promptly address other health crises, as well as to reduce potential coverage, non-response and particularly selection biases by utilizing reweighting techniques. The low data accessibility despite the huge opportunity that COVID-19 provided for Open Science-based research is striking.

The patient, diagnostic, and treatment intervals in adult patients with cancer from high- and lower-income countries: A systematic review and meta-analysis.

BACKGROUND: Longer time intervals to diagnosis and treatment are associated with worse survival for various types of cancer. The patient, diagnostic, and treatment intervals are considered core indicators for early diagnosis and treatment. This review estimated the median duration of these intervals for various types of cancer and compared it across high- and lower-income countries. METHODS AND FINDINGS: We conducted a systematic review with meta-analysis (prospectively registered protocol CRD42020200752). Three databases (MEDLINE, Embase, and Web of Science) and information sources including grey literature (Google Scholar, OpenGrey, EThOS, ProQuest Dissertations & Theses) were searched. Eligible articles were published during 2009 to 2022 and reported the duration of the following intervals in adult patients diagnosed with primary symptomatic cancer: patient interval (from the onset of symptoms to first presentation to a healthcare professional), diagnostic interval (from first presentation to diagnosis), and treatment interval (from diagnosis to treatment start). Interval duration was recorded in days and study medians were combined in a pooled estimate with 95% confidence intervals (CIs). The methodological quality of studies was assessed using the Aarhus checklist. A total of 410 articles representing 68 countries and reporting on 5,537,594 patients were included. The majority of articles reported data from high-income countries (n = 294, 72%), with 116 (28%) reporting data from lower-income countries. Pooled meta-analytic estimates were possible for 38 types of cancer. The majority of studies were conducted on patients with breast, lung, colorectal, and head and neck cancer. In studies from high-income countries, pooled median patient intervals generally did not exceed a month for most cancers. However, in studies from lower-income countries, patient intervals were consistently 1.5 to 4 times longer for almost all cancer sites. The majority of data on the diagnostic and treatment intervals came from high-income countries. Across both high- and lower-income countries, the longest diagnostic intervals were observed for hematological (71 days [95% CI 52 to 85], e.g., myelomas (83 days [47 to 145])), genitourinary (58 days [50 to 77], e.g., prostate (85 days [57 to 112])), and digestive/gastrointestinal (57 days [45 to 67], e.g., colorectal (63 days [48 to 78])) cancers. Similarly, the longest treatment intervals were observed for genitourinary (57 days [45 to 66], e.g., prostate (75 days [61 to 87])) and gynecological (46 days [38 to 54], e.g., cervical (69 days [45 to 108]) cancers. In studies from high-income countries, the implementation of cancer-directed policies was associated with shorter patient and diagnostic intervals for several cancers. This review included a large number of studies conducted worldwide but is limited by survivor bias and the inherent complexity and many possible biases in the measurement of time points and intervals in the cancer treatment pathway. In addition, the subintervals that compose the diagnostic interval (e.g., primary care interval, referral to diagnosis interval) were not considered. CONCLUSIONS: These results identify the cancers where diagnosis and treatment initiation may take the longest and reveal the extent of global disparities in early diagnosis and treatment. Efforts should be made to reduce help-seeking times for cancer symptoms in lower-income countries. Estimates for the diagnostic and treatment intervals came mostly from high-income countries that have powerful health information systems in place to record such information.

El bibliotecario como coautor de revisiones y síntesis de evidencia / Librarian as co-author of reviews and evidence synthesis

No disponible

Interventions to promote the use of advance directives: an overview of systematic reviews.

OBJECTIVE: To identify, appraise and synthesise the results of systematic reviews of the literature (SRLs) that examines the effectiveness of interventions to increase advance directive (AD) completion rate. METHODS: Narrative review of the literature-an overview of SRLs focused on interventions to improve patients' AD completion rate. RESULTS: Seven SRLs were located. A wide range of interventions was identified in order to determine their influence on the AD completion rate. CONCLUSION: The most effective method of increasing the use of ADs is the combination of informative material and repeated conversations over clinical visits. The use of passive informative material in isolation does not significantly increase AD completion rates. However, when interactive informative interventions are employed, the AD completion rate increases and the majority of the studies identify multiple sessions as the most effective method for direct interaction between patients and health care professionals. PRACTICE IMPLICATIONS: The progressive ageing of the population and the provision of quality care during the process of ageing and dying, have given rise to the Governments' interest in developing moral autonomy and regulating tools as ADs. In order to put legislation into practice it is necessary to set up successful interventions to expand ADs use.