Systematic Review Of International Evidence Research Articles

Impact of the COVID-19 pandemic on employment and inequalities: a systematic review of international evidence and critical appraisal of statistical methods.

To assess the impact of the COVID-19 pandemic on individual labour market outcomes and how these vary over time and between different groups of individuals. Searches were conducted using Medline, Scopus and EconLit. Grey literature searches used Google Scholar and Econpapers. Study quality was assessed using the risk of bias in non-randomised studies of exposure tool (ROBINS-E), accompanied by a directed acyclic graph (DAG) to identify relevant mediators, moderators and confounders. A total of 85 studies (77 peer-reviewed articles, 8 working papers) were included. The ROBINS-E showed that the overall risk of bias varied between studies from low (n = 14), moderate (n = 56) to serious (n = 15). Studies also varied in terms of outcome measures, study designs and the academic disciplines of researchers. Generally, studies using data collected before and during the pandemic showed large negative effects on employment, working hours and income. Studies that assessed moderators (e.g. by industry, occupation, age, gender, race and country of birth) indicated the pandemic has likely worsened pre-existing disparities in health and work. Generally, women, less educated, non-whites and young workers were affected the most, perhaps due to their jobs involving high levels of personal contact (e.g. hospitality, sales and entertainment) and being less amenable to remote working. The DAG highlighted methodological challenges in drawing robust inferences about COVID-19's impact on employment, including the lack of an unexposed control group. The COVID-19 health crisis caused unanticipated and unprecedented changes to employment opportunities around the world, with potential long-term health consequences. Further research should investigate the longer-term impact of COVID-19, with greater attention given to low- and middle-income countries. Our study provides guidance on the design and critical appraisal of future studies.

The impact of rail-based stations on passengers’ safety perceptions. A systematic review of international evidence

Feeling safe in public transport is essential for mobility, and fear of crime can be a larger problem for the individual than crime itself. The aim of the present paper is to systematically review the international evidence in rail-bound environments regarding (a) characteristics impacting safety perceptions and (b) behavioural consequences of unsafety, using the databases ScienceDirect, Scopus, PsycInfo, and Google Scholar. From a selection of 3226 publications, 52 were selected. The sample sizes range from 16 to 137 513 rail users or potential users. A social-ecological framework was adopted to categorize the findings in which place, social, individual, and temporal characteristics were identified along with short-term and long-term behavioural consequences of unsafety. Among the most important characteristics affecting passengers’ safety are lighting, surveillance, other persons’ behaviour, time of day, and one’s own gender. Future studies should further explore the complexity in interactions between characteristics connected to perceived safety.

The cost-effectiveness of physician assistants/associates: A systematic review of international evidence.

BackgroundThe global utilization of the physician assistant/associate (PA) is growing. Their increasing presence is in response to the rising demands of demographic changes, new developments in healthcare, and physician shortages. While PAs are present on four continents, the evidence of whether their employment contributes to more efficient healthcare has not been assessed in the aggregate. We undertook a systematic review of the literature on PA cost-effectiveness as compared to physicians. Cost-effectiveness was operationalized as quality, accessibility, and the cost of care.Methods and findingsLiterature to June 2021 was searched across five biomedical databases and filtered for eligibility. Publications that met the inclusion criteria were categorized by date, country, design, and results by three researchers independently. All studies were screened with the Risk of Bias in Non-randomised Studies—of Interventions (ROBIN-I) tool. The literature search produced 4,855 titles, and after applying criteria, 39 studies met inclusion (34 North America, 4 Europe, 1 Africa). Ten studies had a prospective design, and 29 were retrospective. Four studies were assessed as biased in results reporting. While most studies included a small number of PAs, five studies were national in origin and assessed the employment of a few hundred PAs and their care of thousands of patients. In 34 studies, the PA was employed as a substitute for traditional physician services, and in five studies, the PA was employed in a complementary role. The quality of care delivered by a PA was comparable to a physician’s care in 15 studies, and in 18 studies, the quality of care exceeded that of a physician. In total, 29 studies showed that both labor and resource costs were lower when the PA delivered the care than when the physician delivered the care.ConclusionsMost of the studies were of good methodological quality, and the results point in the same direction; PAs delivered the same or better care outcomes as physicians with the same or less cost of care. Sometimes this efficiency was due to their reduced labor cost and sometimes because they were more effective as producers of care and activity.

Do sugar taxes work?

Do sugar taxes work?

Domestic retrofit supply chain initiatives and business innovations: an international review

A systematic review of international evidence on housing retrofit supply chains was undertaken for the UK government: a Rapid Evidence Assessment (REA) summarised the most relevant research from outside the UK; key emerging themes were examined via analysis of 10 expert interviews with European and UK stakeholders, selected for the depth and breadth of their experience in developing retrofit business models. Market development requires concerted efforts from industry and policy, including the regulation of minimum standards. Conservatism in the industry means that opportunities for retrofit will be ignored in preference for the less risky, more familiar repair, maintenance and improvement (RMI) market. Successful retrofit involves customer engagement and after-care, which is outside customary practice. Financing mechanisms are important for firms’ cashflow and for customer acceptance. Skills governance needs to take account of national vocational education systems, and is more complex than simply providing a few new courses. Local partnerships are needed to mobilise and organise the supply chain, whether through local government involvement or new business models enshrining collaborative quality assurance. More formal quality assurance implies some consolidation of supply chains. All these elements must be integrated into a service package, whose overall purpose is to minimise the risks of retrofit for supply chains and customers. <em><strong>Policy relevance</strong></em> A functioning, large-scale energy-efficiency retrofit market needs to have some of the attributes of the existing RMI market, with energy performance grafted on. When compared with the ideal requirements for effective policy, existing policy support is inadequate, being too short-lived, too inconsistent and too easily sidelined by market realities. Retrofit requires high-quality outcomes achieved through integrated service, but construction industry business culture is focused on inputs (not outcomes) and the service is fragmented. Policy must help deliver a cultural shift, which no country has yet succeeded in bringing about. The task may be slow as it entails coordination and change across policy, education and vocational training, and industry practices.

Trends in health expectancies: a systematic review of international evidence

ObjectivesA clear understanding of whether increases in longevity are spent in good health is necessary to support ageing, health and care-related policy.DesignWe conducted a systematic review to update and summarise...

Does older adults' use of social care influence their healthcare utilisation? A systematic review of international evidence.

Improving our understanding of the complex relationship between health and social care utilisation is vital as populations age. This systematic review aimed to synthesise evidence on the relationship between older adults' use of social care and their healthcare utilisation. Ten databases were searched for international literature on social care (exposure), healthcare use (outcome) and older adults (population). Searches were carried out in October 2016, and updated May 2018. Studies were eligible if they were published after 2000 in a high income country, examined the relationship between use of social care and healthcare utilisation by older adults (aged ≥60years), and controlled for an indicator of need. Study quality and bias were rated using the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Study data were extracted and a narrative synthesis was conducted. Data were not suitable for quantitative synthesis. Thirteen studies were identified from 12,065 citations. Overall, the quality and volume of evidence was low. There was limited evidence to suggest that longer lengths of stay in care homes were associated with a lower risk of inpatient admissions. Residents of care homes with onsite nursing had fewer than expected admissions to hospital, compared to people in care homes without nursing, and adjusting for need. Evidence for other healthcare use outcomes was even more limited and heterogeneous, with notable gaps in primary care. We conclude that older adults' use of care homes may moderate inpatient admissions. In particular, the presence of registered nurses in care homes may reduce the need to transfer residents to hospital. However, further evidence is needed to add weight to this conclusion. Future research should build on this evidence and address gaps regarding the influence of community based social care on older adults' healthcare use. A greater focus on primary care outcomes is imperative.

On demand: Can demand response live up to expectations in managing electricity systems?

Residential demand response (meaning changes to electricity use at specific times) has been proposed as an important part of the low carbon energy system transition. Modelling studies suggest benefits may include deferral of distribution network reinforcement, reduced curtailment of wind generation, and avoided investment in reserve generation. To accurately assess the contribution of demand response such studies must be supported by realistic assumptions on consumer participation. A systematic review of international evidence on trials, surveys and programmes of residential demand response suggests that it is important that these assumptions about demand response are not overly optimistic. Customer participation in trials and existing programmes is often 10% or less of the target population, while responses of consumers in existing schemes have varied considerably for a complex set of reasons. Relatively little evidence was identified for engagement with more dynamic forms of demand response, making its wider applicability uncertain. The evidence suggests that the high levels of demand response modelled in some future energy system scenarios may be more than a little optimistic. There is good evidence on the potential of some of the least ‘smart’ options, such as static peak pricing and load control, which are well established and proven. More research and greater empirical evidence is needed to establish the potential role of more innovative and dynamic forms of demand response.

An International Educational Training Course for Conducting Systematic Reviews in Health Care: The Joanna Briggs Institute's Comprehensive Systematic Review Training Program.

The cornerstone of evidence-based health care is the systematic review of international evidence. Systematic reviews follow a rigorous, standardized approach in their conduct and reporting, and as such, education and training are essential prior to commencement. This study reports on the evolution of the Joanna Briggs Institute Comprehensive Systematic Review Training Program (JBICSRTP) as an exemplar approach for teaching systematic review methods. The Joanna Briggs Institute (JBI) is an international research and development center at the University of Adelaide, South Australia. Its mission is to promote and facilitate evidence-based best practice globally, largely through the provision of education and training. JBI was one of the first to consider all forms of evidence in systematic reviews, and as such, implementation of standardized training was essential. Since 1999, JBI has offered a systematic review training program. The JBICSRTP is now delivered face to face over 5days, with an optional online component; the content aligns to that proposed in the Sicily statement. Over the last 3years, JBI and its Collaboration have trained over 3,300 people from over 30 countries. A "train-the-trainer" (TtT) style program was established to cope with demand, and to date, hundreds of trainers have been licensed across the globe to deliver the JBICSRTP. Providing standardized training materials, ensuring open and ongoing communication, and adopting a TtT style program while still allowing for local adaptability are strategies that have led to the establishment of a highly skilled global training network and ensured the success and longevity of the JBICSRTP.

Referral interventions from primary to specialist care: a systematic review of international evidence.

Demand management defines any method used to monitor, direct, or regulate patient referrals. Strategies have been developed to manage the referral of patients to secondary care, with interventions that target primary care, specialist services, or infrastructure. To review the international evidence on interventions to manage referral from primary to specialist care. Systematic review. Iterative, systematic searches of published and unpublished sources public health, health management, management, and grey literature databases from health care and other industries were undertaken to identify recent, relevant studies. A narrative synthesis of the data was completed to structure the evidence into groups of similar interventions. The searches generated 8327 unique results, of which 140 studies were included. Interventions were grouped into four intervention categories: GP education (n = 50); process change (n = 49); system change (n = 38); and patient-focused (n = 3). It is clear that there is no 'magic bullet' to managing demand for secondary care services: although some groups of interventions may have greater potential for development, given the existing evidence that they can be effective in specific contexts. To tackle demand management of primary care services, the focus cannot be on primary care alone; a whole-systems approach is needed because the introduction of interventions in primary care is often just the starting point of the referral process. In addition, more research is needed to develop and evaluate interventions that acknowledge the role of the patient in the referral decision.

Systematic review of international evidence on the effectiveness and costs of paediatric home care for children and young people who are ill

Promoting 'care closer to home' for ill children is a policy and practice objective internationally. Progress towards this goal is hampered by a perceived lack of evidence on effectiveness and costs. The aim of the work reported here was to establish the strength of current international evidence on the effectiveness and costs of paediatric home care by updating and extending an earlier systematic review. A systematic review following Centre for Reviews and Dissemination guidelines involved updating electronic searches, and extending them to cover paediatric home care for short-term acute conditions. Twenty-one databases were searched from 1990 to April 2007. Hand searching was also carried out. Pairs of team members, guided by an algorithm, selected randomized controlled trials (RCTs), other comparative studies and studies including health economics data. A third reviewer resolved any disagreements. The quality of RCTs was assessed, but a 'best-evidence' approach was taken overall. Data were extracted into specifically designed spreadsheets and a second team member checked all data. Narrative synthesis was used throughout. This paper reports findings from RCTs and studies with health economics data. In total, 16 570 publications were identified after de-duplication. Eleven new RCTs (reported in 17 papers) and 20 papers with health economics data were included and reviewed. Evidence on costs and effectiveness of paediatric home care has not grown substantially since the previous review, but this updated review adds weight to the conclusion that it can deliver equivalent clinical outcomes for children and not impose a greater burden on families. Indeed, in some cases, there is evidence of reduced burden and costs for families compared with hospital care. There is also growing evidence, albeit based on weaker evidence, that paediatric home care may reduce costs for health services, particularly for children with complex and long-term needs.

International food advertising, pester power and its effects

The increasing importance of children as consumers has focused attention on ‘pester power’: children’s influence over adult purchasing through requests and demands for certain products. Many concerns are expressed about pester power, including that it increases parent-child conflict. In the contested area of food marketing, an additional and particularly potent criticism of pester power is that it can undermine parents’ attempts to feed their children a healthy diet. Results from a systematic review of international evidence find that food advertising does cause ‘pestering’ by children and results in parents buying less healthy products that are associated with obesity. This undermines industry arguments that pester power is just a legitimate way for children to express their growing autonomy as consumers. Policy implications for marketers and government are discussed.