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Medical-legal partnership (MLP) is an intervention embedding legal professionals within a clinical setting to address patients’ health harming legal needs (HHLN). While much of the literature focuses on the role of the lawyer in the partnership, less is understood about the role of the clinician. Data were collected about MLP medical champions from workshop attendees at an MLP conference held by the Solomon Center at Yale Law School, a leader in health law. From the 107 concepts collected at the workshop, 40 mechanisms by which the medical champion can best serve an MLP were identified and ranked by expert MLP champions, using a Delphi method. Medical champions’ relations with the legal team and with direct patient care were of high priority, in contrast with their role in larger scale advocacy. The findings from this study provide evidence that medical champions are a cornerstone of MLPs as they understand clinical workflows, are aware of patient population needs, and can support the multi-disciplinary MLP team to address HHLN. By gaining a deeper understanding of the potential responsibilities and actionable steps that a medical champion can undertake, it is possible to mitigate the challenges faced by MLPs and enhance their implementation and longevity.
Dissemination and implementation (D&I) scientists are key members of collaborative, interdisciplinary clinical and translational research teams. Yet, early career D&I researchers (ECRs) have few guidelines for cultivating productive research collaborations. We developed recommendations for ECRs in D&I when serving as collaborators or co-investigators.
Methods:
We employed a consensus-building approach: (1) group discussions to identify 3 areas of interest: “Marketing yourself” (describing your value to non-D&I collaborators), “Collaboration considerations” (contributions during proposal development), and “Responsibilities following project initiation” (defining your role throughout projects); (2) first survey and focus groups to iteratively rank/refine sub-domains within each area; (3) second survey and expert input on clarity/content of sub-domains; and (4) iterative development of key recommendations.
Results:
Forty-four D&I researchers completed the first survey, 12 of whom attended one of three focus groups. Twenty-nine D&I researchers completed the second survey (n = 29) and 10 experts provided input. We identified 25 recommendations. Findings suggest unique collaboration strengths (e.g, partnership-building) and challenges (e.g., unclear link to career milestones) for ECR D&I researchers, and underscore the value of ongoing training and mentorship for ECRs and the need to intersect collaborative D&I efforts with health equity principles.
Conclusions:
Research collaborations are essential in clinical and translational research. We identified recommendations for D&I ECRs to be productive research collaborators, including training and support needs for the field. Findings suggest an opportunity to examine research collaboration needs among early career D&I scientists, and provide guidance on how to successfully provide mentorship and integrate health equity principles into collaborative research.
Our objective was to assess how, and to what extent, a systems-level perspective is considered in decision-making processes for health interventions by illustrating how studies define the boundaries of the system in their analyses and by defining the decision-making context in which a systems-level perspective is undertaken.
Method
We conducted a scoping review following the Joanna Briggs Institute methodology. MEDLINE, EMBASE, Cochrane Library, and EconLit were searched and key search concepts included decision making, system, and integration. Studies were classified according to an interpretation of the “system” of analysis used in each study based on a four-level model of the health system (patient, care team, organization, and/or policy environment) and using categories (based on intervention type and system impacts considered) to describe the decision-making context.
Results
A total of 2,664 articles were identified and 29 were included for analysis. Most studies (16/29; 55%) considered multiple levels of the health system (i.e., patient, care team, organization, environment) in their analysis and assessed multiple classes of interventions versus a single class of intervention (e.g., pharmaceuticals, screening programs). Approximately half (15/29; 52%) of the studies assessed the influence of policy options on the system as a whole, and the other half assessed the impact of interventions on other phases of the disease pathway or life trajectory (14/29; 48%).
Conclusions
We found that systems thinking is not common in areas where health technology assessments (HTAs) are typically conducted. Against this background, our study demonstrates the need for future conceptualizations and interpretations of systems thinking in HTA.
Non-governmental organizations (NGOs) are one of the important players during a pandemic, including the Islamic Medical Association of Malaysia (IMAM) Response and Relief Team (IMARET). During the coronavirus disease (COVID-19) pandemic, IMARET played a key role in assisting health relief efforts in Malaysia. We are sharing this experience as a medical NGO’s response to the pandemic. This report presents data from the March 18 to June 10, 2020, retrieved from IMARET’s database with approval from the Executive Committee and the IMARET COVID-19 Task Force. We report that IMARET’s task force consists of 30 people, mostly medical doctors. Supplies distributed included personal protective equipment with other medical equipment, such as portable ultrasounds and ventilators. IMARET engaged with 33 collaborators and 92 partners and funders. There were 135 volunteers with the majority being medical volunteers. IMARET raised more than RM $3 million (US $740 000) garnering support from over 40 000 donors in 85 days. In conclusion, NGOs play a significant role that effectively enhance and complement the consolidated works by the authorities and public in the effort to overcome COVID-19 challenges.
La pandémie de la COVID-19 et l’état d’urgence publique qui en a découlé ont eu des répercussions significatives sur les personnes âgées au Canada et à travers le monde. Il est impératif que le domaine de la gérontologie réponde efficacement à cette situation. Dans la présente déclaration, les membres du conseil d’administration de l’Association canadienne de gérontologie/Canadian Association on Gerontology (ACG/CAG) et ceux du comité de rédaction de La Revue canadienne du vieillissement/Canadian Journal on Aging (RCV/CJA) reconnaissent la contribution des membres de l’ACG/CAG et des lecteurs de la RCV/CJA. Les auteurs exposent les voies complexes par lesquelles la COVID-19 affecte les personnes âgées, allant du niveau individuel au niveau populationnel. Ils préconisent une approche impliquant des équipes collaboratives pluridisciplinaires, regroupant divers champs de compétences, et différentes perspectives et méthodes d’évaluation de l’impact de la COVID-19.
Mixed home care, in which informal and professional actors work closely together, contributes significantly to ensuring home care up to old age. In this context, collaboration applications can considerably enhance the interactions among caregivers. However, although much research is conducted on need and requirement analyses of such applications, little is known about their introduction and use in care models. The purpose of this contribution is to identify studies that evaluate collaboration applications for mixed home care and compare their outcomes.
Methods
To identify literature on mixed home care collaboration applications (mHCA) and their evaluation, a systematic literature review was conducted in five bibliographic databases covering the years 2008 through 2019. The results were supplemented by a search in the meta-database Google Scholar. The evaluation approaches of the studies were analyzed and results compared by using the NASSS framework. Finally, a context concretized model was derived which summarizes interrelations.
Results
Twelve qualitative studies evaluating eleven applications could be identified. They report on increased competency in self-management, psychological relatedness, involvement, and understanding. However, most studies conclude that large scale platform tests are still needed to prove significant changes in care processes, communication, or organization.
Conclusion
Among other things, their implementation is rather difficult due to the specifics of the target group. To enable a more targeted and successful implementation, it might be helpful to classify care networks beforehand and assess their communication behavior and needs. To prove the added value of mHCAs standardized assessment tools should be used.
The COVID-19 pandemic and subsequent state of public emergency have significantly affected older adults in Canada and worldwide. It is imperative that the gerontological response be efficient and effective. In this statement, the board members of the Canadian Association on Gerontology/L’Association canadienne de gérontologie (CAG/ACG) and the Canadian Journal on Aging/La revue canadienne du vieillissement (CJA/RCV) acknowledge the contributions of CAG/ACG members and CJA/RCV readers. We also profile the complex ways that COVID-19 is affecting older adults, from individual to population levels, and advocate for the adoption of multidisciplinary collaborative teams to bring together different perspectives, areas of expertise, and methods of evaluation in the COVID-19 response.
An international joint task group co-led by the International Network of Agencies for Health Technology Assessment (INAHTA) and Health Technology Assessment International (HTAi) has developed a new and internationally accepted definition of HTA.
Methods
The task group, consisting of representatives of leading HTA networks, societies and global organizations, developed guiding principles for the process and followed an established consultation plan with the broader HTA community to develop the definition.
Results
The consensus achieved by the international joint task group brings the collective weight of the participating networks, societies, and organizations behind the new definition.
Conclusion
The new definition of HTA is an historic achievement and it is offered to the current and emerging HTA world as a cornerstone reference for today and into the future.
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