Context: Medical-legal partnerships (MLPs) are innovative, promising models that integrate legal service providers and medical professionals to prevent, detect, and address legal, social, and economic needs arising from social inequities that may negatively impact health. The COVID-19 pandemic impacted health care systems across the United States. MLP workflows and legal services were also interrupted by COVID-19 infection prevention and control measures such as no-visitor policies, social distancing, and the cancellation of non-emergent or routine health care services.
Objective: We sought to describe the impact of COVID-19 on legal services provided by an MLP by exploring case types and services provided prior to the COVID-19 pandemic and during the pandemic.
Design: This is an examination of MLP services provided at a Midwestern academic medical center comparing data from three years prior to the pandemic (2017-2019) to three years during the pandemic (2020-2022).
Setting: The MLP is a collaboration between the University of Nebraska Medical Center/Nebraska Medicine (an academic medical center) and Legal Aid of Nebraska and Iowa Legal Aid (legal service providers).
Participants: Case data was drawn from individuals who were MLP patient-clients between 2017 and 2022.
Main Outcome Measures: The main outcome measures were the number of cases and categories and types of legal services provided by the MLP.
Results: Consistent across time, we found that on average 494 cases were closed each year. Consumer/finance cases decreased significantly from pre-COVID-19 to during the pandemic, while family cases increased significantly during the pandemic. Cases related to income maintenance increased across time.
Conclusions: Through the COVID-19 pandemic experience and understanding the case mix, MLPs and health care champions can be better prepared to understand some of the challenges that may occur and changes that may be necessary to better serve patient-clients during a public health emergency.
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Alzheimers Dement
December 2024
Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA.
Background: Participant dropout from study treatment in a clinical trial can leave a trial underpowered, produce bias in statistical analysis, and limit interpretability of study results. Retaining participants in clinical trials for the full study duration is therefore as important as participant recruitment. This analysis aims to identify the baseline characteristics of participants who discontinued during the blinded phase of one of the first and largest preclinical AD trial completed to date, the Anti-Amyloid treatment in Asymptomatic AD (A4) Study.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of California, Irvine, Irvine, CA, USA.
Background: Recruitment challenges in people with and without Down syndrome (DS) can delay research progress and risk sample bias. This study identified and quantified differences in research attitudes across populations of research enrollment decision-makers for individuals with and without DS.
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Alzheimers Dement
December 2024
Singapore General Hospital, Singapore, Singapore, Singapore.
Background: With the advent of new media, more people - possibly including caregivers of persons with dementia - are turning to social media platforms to share their thoughts and emotions related to personal life experiences. This may potentially serve as an opportunity to leverage on social media to gain insights into the key issues faced by dementia caregivers. We examined salient concerns of dementia caregivers through Twitter posts, aiming to shed light on how to better support and engage such caregivers.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of Pittsburgh, Pittsburgh, PA, USA.
Background: The COVID-19 pandemic had a major impact on healthcare, contributing to a mass exodus of the workforce. This poses a concern for Alzheimer's disease and related dementias (ADRD) care, which benefits from consistent care routine and staff that know the resident. Therefore, it is important to understand nursing home staff perspectives on maintaining high staff morale, which impacts recruitment, retention, and care quality.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Tulane University, New Orleans, LA, USA.
Background: Vascular dementia (VaD), the second most common cause of dementia, is characterized by cognitive decline due to reduced cerebral blood flow and blood-brain barrier disruption. Current evidence demonstrates that not only are VaD patients at higher risk of severe COVID-19 illness and mortality, but also that pre-existing cognitive dysfunction/dementia is associated with increased COVID-19 incidence. Conversely, SARS-CoV-2 infection alone worsens dementia-related mild cognitive impairment (MCI) and increases risk of cognitive decline, supported by similar fMRI findings demonstrating hypoperfusion.
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