Background Homeless populations (HPs) have difficulties obtaining necessary medical care, and primary health care service outreach (PHSO) might be useful to bridge this gap. Objective Using the Centre for Evidence-Based Management Critically Appraised Topics framework, to provide systematic evidence of the usefulness of PHSO interventions for HPs. Methods A systematic search was conducted in 4 electronic databases: PubMed, Web of Science, CINAHL, and Cochrane (publication dates between January 1980 and November 2020). In total, 2,872 articles were identified. Primary research about PHSO for HPs in high-income countries were included. Data were extracted from eligible studies, summarized, and collated into a narrative account. Results Twenty-four studies that described and evaluated PHSO interventions for adults experiencing homelessness were selected in the final synthesis. Most studies had a nonrandomized design. PHSO was found to successfully address some barriers to health care access for HPs through flexible appointments in convenient locations, fostering an understanding relationship between doctor and patients, and provision of additional basic necessities and referrals. Outreach was provided for a range of health care concerns, and several solutions to engage more HPs in primary care, improve continuity of care and to decrease the running costs were identified. Outreach also helped to implement preventative measures and reduced emergency service admissions. Conclusion Our review adds to the evidence that PHSO likely improves health care access for HPs. Further studies over longer time periods, involving collaborations with experts with lived experience of homelessness, and utilizing randomized study designs are needed to test outreach efficacy.
Learning analytics can be used in conjunction with learner dispositions to identify at-risk students and provide personalized guidance on how to improve. Participants in the current study were students (n=192) studying a first year anatomy and physiology course. A two-step cluster analysis was performed using learning analytics data from the learning management system and self-regulated learning behavior from meta-learning assessment tasks. Three clusters of students were identified – high, medium and low self-regulated learners. High self-regulated learners were engaged with the meta-learning tasks, reported the most self-regulated learning strategies and used new strategies during semester. They also had the highest academic achievement. Compared to low self-regulated leaners, medium self-regulated learners were more engaged in the meta-learning tasks and used more learning strategies during semester, including new strategies; however, both medium and low self-regulated learners had similar levels of academic achievement. It is possible that the medium self-regulated learners represent students who were attempting to improve their learning, but had not yet found strategies that were right for them. Future evaluation of academic performance may determine whether the attempts to improve learning by medium self-regulated learners distinguishes them from low self-regulated learners in the later years of their study.
Learning anatomy and physiology at university can be challenging, as students need to understand both the language of the discipline and complex topics, such as system integration. Yet learning strategies are rarely taught at university, making it difficult for students to adopt new strategies, if their approach to learning has not been effective or efficient. This study evaluated the use of small-group peer discussion boards as an avenue for sharing learning strategies between students in a first-year anatomy and physiology course. The majority of students (91%) identified strategies from the discussion board worth trying before they completed the midsemester exam. The most frequently reported type of strategy was transforming records. By the end of semester, 76% of students had adopted at least one new strategy; however, these students performed significantly worse on the exam compared with students who did not adopt new strategies. The students who adopted new strategies learned about them from peers (33%), the discussion board (32%), or through self-discovery (32%). The majority of students (83%) found the discussion boards to be useful as a source of new learning strategies and for insight into how others learn. Although the discussion boards provided an avenue for students to learn about new strategies from each other, further guidance from instructors may be required to help students evaluate the effectiveness of these learning strategies.
Objective Workers from various industries use personal protective equipment (PPE) including masks, respirators, and hearing protection to reduce their exposures to workplace hazards. Many studies have evaluated the physiological impacts of PPE use, but few have assessed the psychological impacts. The aim of the present study was to carry out a scoping review to compile existing evidence and determine the extent of knowledge on workplace mask, respirator or hearing protection use as a psychosocial hazard (stressor) that could result in a stress response and potentially lead to psychological injury. Methods The scoping review followed recognized methods and was conducted using Ovid Emcare, PubMed, Sage Journals, ScienceDirect, Scopus, SpringerLink, Google Scholar and preprint databases (OSF Preprints and medRxiv). Articles on the stressors associated with the use of masks, respirators, and hearing protection were included. The extracted data included author(s) name, year of publication, title of article, study design, population data, stressors assessed, and key findings. Results We retrieved 650 articles after removal of duplicates, of which 26 were deemed eligible for inclusion for review. Identified factors associated with PPE use that could potentially create a stress response were identified: communication impacts, physical impacts, psychological illness symptoms, cognitive impacts, and perceived PPE-related impacts. Evidence for respirators suggest that there may be psychological injury associated with their use. However, hearing protection appears to have a protective effect in reducing psychological symptoms such as anxiety, depression, and aggression. Conclusions Mask or respirator use may lead to an increase in work-related stress. Whereas hearing protection may have protective effects against psychological symptoms and improves speech intelligibility. More research is needed to better understand potential psychosocial impacts of mask, respirator and/or hearing protection use.
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