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Munns LB, Preston C. The role of bodily experiences during pregnancy on mother and infant outcomes. J Neuropsychol 2024. [PMID: 38764291 DOI: 10.1111/jnp.12370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/11/2024] [Accepted: 04/15/2024] [Indexed: 05/21/2024]
Abstract
Pregnancy is a transformative time for women and their bodies, and therefore thoughts and feelings and about one's own body and internal bodily sensations may understandably change during this period. Body satisfaction and interoception have been found to influence factors such as antenatal attachment (AA) and maternal mental health. However, mixed results in the literature suggest complex relationships between the bodily experience during pregnancy and outcomes, necessitating a broader investigative approach. We aim to examine the relationship between the pregnancy bodily experience and multiple mother-infant outcomes. It is hypothesised that poor bodily experiences during pregnancy will have negative impacts on these outcomes. Cross-sectional online survey data was collected from individuals at various gestations throughout pregnancy as part of a larger longitudinal study (N = 253, mean age = 32). We analysed validated measures of pregnancy body satisfaction, interoceptive sensibility, AA and mood, as well as intentions to breastfeed. Linear regressions were used to confirm findings from previous literature and a network analysis allowed for a more exploratory approach to understanding the importance of the bodily experience during pregnancy. Multiple regressions found low body satisfaction predicts higher levels of anxiety, depression and AA. A network analysis revealed relationships between body satisfaction and interoception during pregnancy and mother-infant outcomes, including depression and AA. Our results highlight the far-reaching effects of poor bodily experiences during pregnancy on a variety of outcomes. Understanding the impact of the pregnant bodily experience can help identify at-risk individuals and inform interventions.
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Iluno AC, Tatterton MJ, Haith-Cooper M. Meta-synthesis of ethnic minority families' experiences of children's palliative care across developed countries. Palliat Support Care 2024:1-14. [PMID: 38654706 DOI: 10.1017/s1478951524000609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Meeting the needs of people accessing healthcare from ethnic minority (EM) groups is of great importance. An insight into their experience is needed to improve healthcare providers' ability to align their support with the perspectives and needs of families. This review provides insight into how families from EM backgrounds experience children's palliative care (CPC) by answering the question, "What are the experiences of EM families of children's palliative care across developed countries?" METHODS A systematic search of articles from 6 databases (Scopus, Medline, Web of Science, APA PsycINFO, CINAHL, and Global Health) with no limit to the date of publication. The search was conducted twice, first in June 2022 and again in December 2022. The extracted data were analyzed using thematic synthesis. RESULTS Eight studies explored the experiences of families of EM in different high-income countries. Four themes were identified: unmet needs leading to communication gaps, accessibility of hospital services and resources, the attitude of healthcare workers, and the need for survival as an immigrant. SIGNIFICANCE OF RESULTS Overall, the study shows EM families rely heavily on healthcare professionals' cultural competence in delivering palliative care for their children. There is an interplay between EM families' culture, spiritual ties, communication, and social needs from this review. Understanding how to bridge the communication gap and how families use their culture, faith, and spirituality to manage their pain, and grief and improve their quality of life would be extremely beneficial for healthcare practitioners in increasing their support to EM families accessing CPC.
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Affiliation(s)
- Adaobi C Iluno
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Michael J Tatterton
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Bluebell Wood Children's Hospice, Sheffield, United Kingdom
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Anbar R, Jones S, Chaturvedi N, Sudre C, Richards M, Sultan SR, Hughes AD. Associations of carotid atherosclerosis with cognitive function and brain health: Findings from a UK tri-ethnic cohort study (Southall and Brent Revisited). ATHEROSCLEROSIS PLUS 2024; 55:39-46. [PMID: 38371883 PMCID: PMC10874717 DOI: 10.1016/j.athplu.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/20/2024]
Abstract
Background Cognitive function has an important role in determining the quality of life of older adults. Cardiovascular disease (CVD) is common in older people and may compromise cognitive performance; however, the extent to which this is related to carotid atherosclerosis is unclear. Aim We investigated associations between carotid atherosclerosis and cognitive function and neuroimaging markers of brain health in a UK multi-ethnic community-based sample including older people of European, South Asian, and African-Caribbean ethnicity. Methods Carotid plaques and intima-media thickness (cIMT) were assessed using ultrasound in 985 people (mean age 73.2y, 56 % male). Associations of carotid atherosclerosis with cognitive function (memory, executive function, language and CSI-D, a global measure of cognitive state) and neuroimaging measures (total brain volume, hippocampal volume, white matter (WM) lesion volume and coalescence score) were analysed using regression analyses, with and without adjustment for potential confounders using two models: 1) adjustment for age, sex, and ethnicity; 2) model 1 plus education, physical activity category, body mass index, hypertension, diabetes, total and high density lipoprotein cholesterol, atrial fibrillation, smoking, previous CVD, alcohol consumption, and presence of chronic kidney disease. Results People with carotid plaque or higher cIMT had lower CSI-D score, poorer memory poorer executive function and higher WM lesion volume and coalescence. Language was poorer in people with plaque but was not correlated with cIMT. Associations with plaque were preserved after full adjustment (model 2) but relationships for cIMT were attenuated. Associations with other plaque characteristics were generally unconvincing after adjustment. Conclusions This multi-ethnic cohort study provides evidence that presence of carotid plaque, is associated with poorer cognitive function and brain health.
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Affiliation(s)
- Rayan Anbar
- MRC unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
- Department of Radiologic Sciences, Faculty of Applied Medical Sciences, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Siana Jones
- MRC unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
| | - Nish Chaturvedi
- MRC unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
| | - Carole Sudre
- MRC unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
| | - Marcus Richards
- MRC unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
| | - Salahaden R. Sultan
- Department of Radiologic Sciences, Faculty of Applied Medical Sciences, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Alun D. Hughes
- MRC unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
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Soley-Bori M, Ashworth M, McGreevy A, Wang Y, Durbaba S, Dodhia H, Fox-Rushby J. Disease patterns in high-cost individuals with multimorbidity: a retrospective cross-sectional study in primary care. Br J Gen Pract 2024; 74:BJGP.2023.0026. [PMID: 38325891 PMCID: PMC10877617 DOI: 10.3399/bjgp.2023.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 08/30/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND 'High-cost' individuals with multimorbidity account for a disproportionately large share of healthcare costs and are at most risk of poor quality of care and health outcomes. AIM To compare high-cost with lower-cost individuals with multimorbidity and assess whether these populations can be clustered based on similar disease patterns. DESIGN AND SETTING A cross-sectional study based on 2019/2020 electronic medical records from adults registered to primary care practices (n = 41) in a London borough. METHOD Multimorbidity is defined as having ≥2 long-term conditions (LTCs). Primary care costs reflected consultations, which were costed based on provider and consultation types. High cost was defined as the top 20% of individuals in the cost distribution. Descriptive analyses identified combinations of 32 LTCs and their contribution to costs. Latent class analysis explored clustering patterns. RESULTS Of 386 238 individuals, 101 498 (26%) had multimorbidity. The high-cost group (n = 20 304) incurred 53% of total costs and had 6833 unique disease combinations, about three times the diversity of the lower-cost group (n = 81 194). The trio of anxiety, chronic pain, and depression represented the highest share of costs (5%). High-cost individuals were best grouped into five clusters, but no cluster was dominated by a single LTC combination. In three of five clusters, mental health conditions were the most prevalent. CONCLUSION High-cost individuals with multimorbidity have extensive heterogeneity in LTCs, with no single LTC combination dominating their primary care costs. The frequent presence of mental health conditions in this population supports the need to enhance coordination of mental and physical health care to improve outcomes and reduce costs.
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Affiliation(s)
| | | | | | | | | | | | - Julia Fox-Rushby
- School of Life Course & Population Sciences, King's College London, London
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Mulvagh SL, Colella TJ, Gulati M, Crosier R, Allana S, Randhawa VK, Bruneau J, Pacheco C, Jaffer S, Cotie L, Mensour E, Clavel MA, Hill B, Kirkham AA, Foulds H, Liblik K, Van Damme A, Grace SL, Bouchard K, Tulloch H, Robert H, Pike A, Benham JL, Tegg N, Parast N, Adreak N, Boivin-Proulx LA, Parry M, Gomes Z, Sarfi H, Iwegim C, Van Spall HG, Nerenberg KA, Wright SP, Limbachia JA, Mullen KA, Norris CM. The Canadian Women's Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 9: Summary of Current Status, Challenges, Opportunities, and Recommendations. CJC Open 2024; 6:258-278. [PMID: 38487064 PMCID: PMC10935707 DOI: 10.1016/j.cjco.2023.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/03/2023] [Indexed: 03/17/2024] Open
Abstract
This final chapter of the Canadian Women's Heart Health Alliance "ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women" presents ATLAS highlights from the perspective of current status, challenges, and opportunities in cardiovascular care for women. We conclude with 12 specific recommendations for actionable next steps to further the existing progress that has been made in addressing these knowledge gaps by tackling the remaining outstanding disparities in women's cardiovascular care, with the goal to improve outcomes for women in Canada.
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Affiliation(s)
- Sharon L. Mulvagh
- Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Tracey J.F. Colella
- KITE-UHN-Toronto Rehabilitation, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Martha Gulati
- Barbra Streisand Women’s Heart Center, Cedars Sinai Heart Institute, Los Angeles, California, USA
| | - Rebecca Crosier
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | | | - Jill Bruneau
- Memorial University, St John's, Newfoundland and Labrador, Canada
| | - Christine Pacheco
- Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Shahin Jaffer
- Department of Medicine, Division of Community Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lisa Cotie
- KITE-UHN-Toronto Rehabilitation, Toronto, Ontario, Canada
| | - Emma Mensour
- University of Western Ontario, London, Ontario, Canada
| | | | - Braeden Hill
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Amy A. Kirkham
- KITE-UHN-Toronto Rehabilitation, Toronto, Ontario, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Heather Foulds
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Kiera Liblik
- Department of Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Andrea Van Damme
- University of Alberta Faculty of Graduate & Postdoctoral Studies, Edmonton, Alberta, Canada
| | - Sherry L. Grace
- York University and University Health Network, Toronto, Ontario, Canada
| | - Karen Bouchard
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Heather Tulloch
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Helen Robert
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - April Pike
- Memorial University, St John's, Newfoundland and Labrador, Canada
| | - Jamie L. Benham
- Departments of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nicole Tegg
- Faculties of Nursing, Medicine, and School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Nazli Parast
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Najah Adreak
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Zoya Gomes
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Hope Sarfi
- Canadian Women’s Heart Health Alliance, Ottawa, Ontario, Canada
| | - Chinelo Iwegim
- Fraser Health Authority, Surrey, British Columbia, Canada
| | - Harriette G.C. Van Spall
- Departments of Medicine and Health Research Methods, Evidence, and Impact, Research Institute of St Joe’s, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Kara A. Nerenberg
- Departments of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | | | - Colleen M. Norris
- Faculties of Nursing, Medicine, and School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Ahmed A, Smith M, Mandal S, Bushnik T. Who enrolls and why? Examining center-specific underlying patterns behind enrollment: a New York City-based traumatic brain injury model systems study. Brain Inj 2024; 38:19-25. [PMID: 38219046 DOI: 10.1080/02699052.2024.2304863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/09/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND To elucidate the sociodemographic and study factors involved in enrollment in the Traumatic Brain Injury Model System (TBIMS) database, this study examined the effect of a variety of variables on enrollment at a local TBIMS center. METHODS A sample of 654 individuals from the local TBIMS center was studied examining enrollment by age, gender, race, ethnicity, homelessness status at date of injury, history of homelessness, health insurance status, presence of social support, primary language, consenting in hospital or after discharge, and the need for an interpreter. Binary logistic regression was conducted to identify variables that predict center-based enrollment into TBIMS. RESULTS Results demonstrated that older age was associated with decreasing enrollment (OR = 0.99, p = 0.01), needing an interpreter made enrollment less likely (OR = 0.33, p < 0.01), being primarily Spanish speaking predicted enrollment (OR = 3.20, p = 0.02), Hispanic ethnicity predicted enrollment (OR = 7.31, p = 0.03), and approaching individuals in the hospital predicted enrollment (OR = 6.94, p < 0.01). Here, OR denotes the odds ratio estimate from a logistic regression model and P denotes the corresponding p-value. CONCLUSIONS These results can be useful in driving enrollment strategies at this center for other similar TBI research, and to contribute a representative TBI sample to the national database.
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Affiliation(s)
- Asim Ahmed
- Rusk Rehabilitation at NYU Langone Health, Department of Rehabilitation, New York, NY, United States
- New York Medical College, School of Medicine, Valhalla, NY, United States
| | - Michelle Smith
- Rusk Rehabilitation at NYU Langone Health, Department of Rehabilitation, New York, NY, United States
| | - Soutrik Mandal
- NYU Grossman School of Medicine Department of Population Health, New York, NY, United States
| | - Tamara Bushnik
- Rusk Rehabilitation at NYU Langone Health, Department of Rehabilitation, New York, NY, United States
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Victor CR, Gamble LD, Pentecost C, Quinn C, Charlwood C, Matthews FE, Clare L. Living well with dementia: An exploratory matched analysis of minority ethnic and white people with dementia and carers participating in the IDEAL programme. Int J Geriatr Psychiatry 2024; 39:e6048. [PMID: 38180319 PMCID: PMC10952883 DOI: 10.1002/gps.6048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/14/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES The increasing heterogeneity of the population of older people is reflected in an increasing number of people with dementia and carers drawn from minority ethnic groups. Data from the IDEAL study are used to compare indices of 'living well' among people with dementia and carers from ethnic minority groups with matched white peers. METHODS We used an exploratory cross-sectional case-control design to compare 'living well' for people with dementia and carers from minority ethnic and white groups. Measures for both groups were quality of life, life satisfaction, wellbeing, loneliness, and social isolation and, for carers, stress, relationship quality, role captivity and caring competence. RESULTS The sample of people with dementia consisted of 20 minority ethnic and 60 white participants and for carers 15 and 45 respectively. People with dementia from minority ethnic groups had poorer quality of life (-4.74, 95% CI: -7.98 to -1.50) and higher loneliness (1.72, 95% CI: 0.78-2.66) whilst minority ethnic carers had higher stress (8.17, 95% CI: 1.72-14.63) and role captivity (2.00, 95% CI: 0.43-3.57) and lower relationship quality (-9.86, 95% CI: -14.24 to -5.48) than their white peers. CONCLUSION Our exploratory study suggests that people with dementia from minority ethnic groups experience lower quality of life and carers experience higher stress and role captivity and lower relationship quality than their white peers. Confirmatory research with larger samples is required to facilitate analysis of the experiences of specific minority ethnic groups and examine the factors contributing to these disadvantages.
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Affiliation(s)
- Christina R. Victor
- Department of Health SciencesCollege of Health, Medicine and Life SciencesBrunel University LondonLondonUK
| | - Laura D. Gamble
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | | | - Catherine Quinn
- Centre for Applied Dementia StudiesFaculty of Health StudiesUniversity of BradfordBradfordUK
| | | | - Fiona E. Matthews
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Linda Clare
- University of Exeter Medical SchoolUniversity of Exeter, and NIHR Applied Research Collaboration South‐West PeninsulaExeterUK
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Bhui K, Cipriani A. Understanding and responding to the drivers of inequalities in mental health. BMJ MENTAL HEALTH 2023; 26:e300921. [PMID: 38114130 DOI: 10.1136/bmjment-2023-300921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023]
Affiliation(s)
- Kamaldeep Bhui
- Department of Psychiatry, University of Oxford, Oxford, UK
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Agbonmwandolor JO, Brand S. Evaluating ethnically diverse patients' perspectives of considering participation in renal clinical research. Nurse Res 2023; 31:38-44. [PMID: 37881871 DOI: 10.7748/nr.2023.e1904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Clinical trial cohorts do not often reflect target patient populations because minority ethnic groups are underrepresented in clinical trials. AIM To increase minority ethnic groups' opportunities to participate in clinical trials, by evaluating ethnically diverse patients' perspectives of considering participation in renal clinical research. DISCUSSION The authors gave patients participating in at least one research study the opportunity to take part in a structured survey. The survey explored preferences, barriers and opportunities that patients considered when deciding whether to take part in a clinical trial. The authors included participants from multiple ethnic groups so they could compare data for different ethnicities. CONCLUSION Participation was a positive experience for most patients, mostly because of the research team's flexibility and professionalism. Researchers' gender and ethnicity did not affect the participants' decision to participate. Cultural preferences were not obvious from the data as 80% of the participants were white. IMPLICATIONS FOR PRACTICE Patients preferred a face-to-face approach and the expertise of the research team affected participation more than any other characteristics did. However, respondents were already research-engaged and conducting a similar study with those who have declined to participate in research may show different results.
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Affiliation(s)
| | - Sarah Brand
- Renal and Transplant Unit, David Evans Medical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, England
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Westwood S. "It's the not being seen that is most tiresome": Older women, invisibility and social (in)justice. J Women Aging 2023; 35:557-572. [PMID: 37097812 DOI: 10.1080/08952841.2023.2197658] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/22/2023] [Accepted: 03/27/2023] [Indexed: 04/26/2023]
Abstract
Older women experience intersectional discrimination at the nexus of ageism and sexism. This is embodied, women's aging bodies being culturally devalued within youth-privileging cultures and the hyper-sexualization of younger, able-bodied, women. Older women often face the dilemma of attempting to mask the signs of aging or aging "authentically" but encountering heightened stigma, prejudice, and discrimination. Very old women in the fourth age who "fail" to age "successfully" are subject to extreme social exclusion. Many older women speak of experiencing a loss of visibility as they age, however how this occurs, and what it means, has not yet been analyzed in depth. This is an important issue, as recognition-cultural status and visibility-is essential for social justice. This article reports on findings taken from a U.K. survey on experiences of ageism and sexism completed by 158 heterosexual, lesbian, and bisexual women aged 50 to 89. Their perceived invisibility took five forms: (a) being under-seen/mis-seen in the media; (b) being mis-seen as objects of sexual undesirability; (c) being "ignored" in consumer, social, and public spaces; (d) being "grandmotherized," that is, seen only through the lens of (often incorrectly) presumed grandmotherhood; (e) being patronized and erroneously assumed to be incompetent. The findings are compared with Fraser's social justice model. The argument presented is that older women's experiences of nonrecognition and misrecognition are profound sources of social injustice. Both increased visibility and cultural worth are needed for older women to enjoy the benefits of social justice in later life.
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Leach E, Ndosi M, Jones GT, Ambler H, Park S, Lewis JS. Access to Chronic Pain Services for Adults from Minority Ethnic Groups in the United Kingdom (UK): a Scoping Review. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01803-2. [PMID: 37843777 DOI: 10.1007/s40615-023-01803-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Chronic pain services in the UK are required to provide services which meet the diverse needs of patients, but little is known about the access and use of these services by minority ethnic groups. OBJECTIVE To assess the available evidence regarding the ethnic profile of adults who access secondary and tertiary chronic pain services in the UK. METHODS A scoping review was conducted (August 2021-October 2021), comprising comprehensive literature searches using Embase, Medline and CINAHL databases and the grey literature. Studies were included if they reported on (i) access to chronic pain services in secondary and/or tertiary care in the UK, (ii) adults and (iii) stated the ethnicity of the involved participants. Studies were included if published between 2004 and 2021, as demographic data during this period would be broadly representative of the UK population, as per the 2021 UK census. A descriptive synthesis of the extracted data was performed. RESULTS The search yielded 124 records after duplicates were removed. Following title and abstract screening, 44 full texts were screened, ten of which were included in the review. CONCLUSIONS This is the first review to explore access to chronic pain services for adults from minority ethnic groups in the UK. Given the limited number of studies that met the inclusion criteria, the review highlights the need for routine collection of ethnicity data using consistent ethnic categories within UK chronic pain services and increased involvement of minority ethnic groups within chronic pain research. Findings should inform future research that aims to improve access to UK chronic pain services for adults from minority ethnic groups.
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Affiliation(s)
- Emily Leach
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Solent NHS Podiatry, Solent NHS Trust, Southampton, UK
| | - Mwidimi Ndosi
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Gareth T Jones
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Helen Ambler
- Bath National Pain Centre, Royal United Hospitals Bath NHS Trust, Bath, UK
| | - Sophie Park
- Bath National Pain Centre, Royal United Hospitals Bath NHS Trust, Bath, UK
| | - Jennifer S Lewis
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK.
- Bath National Pain Centre, Royal United Hospitals Bath NHS Trust, Bath, UK.
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Adan C. The importance of diversity in clinical research. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:898-901. [PMID: 37830855 DOI: 10.12968/bjon.2023.32.18.898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Clinical research is a fundamental part of the healthcare system and is critical to improving care, making it safe and effective. Research participants should be diverse as this reduces bias and helps to better understand illness and treatment and how it affects different groups of people. However, due to health inequalities and barriers to research participation, clinical research still lacks diversity. Data from the US Food and Drug Administration showed that 76% of research participants were White and the remaining 24% were from an ethnic minority. In the UK, only 5% of ethnic minorities have ever participated in clinical trials. Recently, with the COVID-19 vaccine trials, out of 270 000 participants, only 11 000 and 1200 participants were from Asian and Black backgrounds, respectively. The research participation of under-represented groups requires co-development with community members. This proactive approach helps establish trust and enhance recruitment strategies that build a positive legacy for under-represented groups.
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Affiliation(s)
- Carlito Adan
- Deputy Lead Nurse, Leonard Wolfson Experimental Neurology Centre, Clinical Research Facility, University College London Hospitals NHS Foundation Trust, London
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13
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Pinero de Plaza MA, Gebremichael L, Brown S, Wu CJ, Clark RA, McBride K, Hines S, Pearson O, Morey K. Health System Enablers and Barriers to Continuity of Care for First Nations Peoples Living with Chronic Disease. Int J Integr Care 2023; 23:17. [PMID: 38107834 PMCID: PMC10723014 DOI: 10.5334/ijic.7643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Failings in providing continuity of care following an acute event for a chronic disease contribute to care inequities for First Nations Peoples in Australia, Canada, and Aotearoa (New Zealand). Methods A rapid narrative review, including primary studies published in English from Medline, Embase, PsycINFO, and Cochrane Central, concerning chronic diseases (cancer, cardiovascular disease, chronic kidney disease, diabetes, and related complications), was conducted. Barriers and enablers to continuity of care for First Nations Peoples were explored considering an empirical lens from the World Health Organization framework on integrated person-centred health services. Results Barriers included a need for more community initiatives, health and social care networks, and coaching and peer support. Enabling strategies included care adapted to patients' cultural beliefs and behavioural, personal, and family influences; continued and trusting relationships among providers, patients, and caregivers; and provision of flexible, consistent, adaptable care along the continuum. Discussion The support and co-creation of care solutions must be a dialogical participatory process adapted to each community. Conclusions Health and social care should be harmonised with First Nations Peoples' cultural beliefs and family influences. Sustainable strategies require a co-design commitment for well-funded flexible care plans considering coaching and peer support across the lifespan.
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Affiliation(s)
- Maria Alejandra Pinero de Plaza
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, 5000, AU
- The Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence. Alice Springs, NT, 0871, AU
| | - Lemlem Gebremichael
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, 5000, AU
- The Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence. Alice Springs, NT, 0871, AU
| | | | - Chiung-Jung Wu
- School of Health, University of the Sunshine Coast, Petrie, QLD, 4502, AU
- Royal Brisbane & Women’s Hospital, QLD, 4029, AU
| | - Robyn A. Clark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, 5000, AU
- The Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence. Alice Springs, NT, 0871, AU
| | - Katharine McBride
- South Australian Aboriginal Chronic Disease Consortium, Adelaide, SA, 5001, AU
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, 5001, AU
- Telethon Kids Institute, Adelaide, SA, 5000, AU
- The John Curtin School of Medical Research, The Australian National University, Acton, ACT 2601, AU
| | - Sonia Hines
- The Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence. Alice Springs, NT, 0871, AU
- Flinders University, Rural and Remote Health, Alice Springs, Northern Territory, 0871, AU
| | - Odette Pearson
- South Australian Aboriginal Chronic Disease Consortium, Adelaide, SA, 5001, AU
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, 5001, AU
- Adelaide Medical School, The University of Adelaide, SA, 5000, AU
| | - Kim Morey
- South Australian Aboriginal Chronic Disease Consortium, Adelaide, SA, 5001, AU
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, 5001, AU
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Blanco Gutiérrez V, Hundley VA, Way S. The Experience of Women From Underrepresented Groups With Urinary Incontinence: A Systematic Review. J Transcult Nurs 2023; 34:288-300. [PMID: 37199465 PMCID: PMC10265309 DOI: 10.1177/10436596231172205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION Urinary incontinence (UI) in women is a global public health issue. However, there is a limited understanding of the experience of women from underrepresented groups suffering from UI. The purpose of this systematic review was to examine current evidence regarding the experience of women with UI from these groups. METHODOLOGY A systematic search was undertaken to retrieve research studies that answered the research question. Four qualitative research studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. RESULTS Four themes emerged from this review: the perceived origin of UI, the physical, psychological, and social impact of UI, the impact of culture and religion on UI, and vice versa, and the interaction of women with health services. DISCUSSION Social determinants of health, such as religion and culture, need to be considered by professionals providing care if women from underrepresented groups experiencing UI are to receive optimal care.
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Small SS, Lau E, McFarlane K, Archambault PM, Longstaff H, Hohl CM. Research recruitment and consent methods in a pandemic: a qualitative study of COVID-19 patients' perspectives. BMC Med Res Methodol 2023; 23:113. [PMID: 37170077 PMCID: PMC10173898 DOI: 10.1186/s12874-023-01933-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/25/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Virtual data collection methods and consent procedures adopted in response to the COVID-19 pandemic enabled continued research activities, but also introduced concerns about equity, inclusivity, representation, and privacy. Recent studies have explored these issues from institutional and researcher perspectives, but there is a need to explore patient perspectives and preferences. This study aims to explore COVID-19 patients' perspectives about research recruitment and consent for research studies about COVID-19. METHODS We conducted an exploratory qualitative focus group and interview study among British Columbian adults who self-identified as having had COVID-19. We recruited participants through personal contacts, social media, and REACH BC, an online platform that connects researchers and patients in British Columbia. We analyzed transcripts inductively and developed thematic summaries of each coding element. RESULTS Of the 22 individuals recruited, 16 attended a focus group or interview. We found that autonomy and the feasibility of participation, attitudes toward research about COVID-19, and privacy concerns are key factors that influence participants' willingness to participate in research. We also found that participants preferred remote and virtual approaches for contact, consent, and delivery of research on COVID-19. CONCLUSIONS Individuals who had COVID-19 are motivated to participate in research studies and value autonomy in their decision to participate, but researchers must be sensitive and considerate toward patient preferences and concerns, particularly as researchers adopt virtual recruitment and data collection methods. Such awareness may increase research participation and engagement.
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Affiliation(s)
- Serena S Small
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, 828 West 10th Ave, 7th Fl, Vancouver, BC, Canada
| | - Erica Lau
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, 828 West 10th Ave, 7th Fl, Vancouver, BC, Canada
| | | | - Patrick M Archambault
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada
- Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, QC, Canada
| | - Holly Longstaff
- Provincial Health Services Authority, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Corinne M Hohl
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
- Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, 828 West 10th Ave, 7th Fl, Vancouver, BC, Canada.
- Emergency Department, Vancouver General Hospital, Vancouver, BC, Canada.
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16
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Oliver BE, Nesbit RJ, McCloy R, Harvey K, Dodd HF. Adventurous play for a healthy childhood: Facilitators and barriers identified by parents in Britain. Soc Sci Med 2023; 323:115828. [PMID: 36931037 DOI: 10.1016/j.socscimed.2023.115828] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/22/2022] [Accepted: 03/03/2023] [Indexed: 03/08/2023]
Abstract
RATIONALE Adventurous play, where children take age-appropriate risks involving uncertainty, fear, and thrill, is positively associated with children's physical health, mental health, and development. There is growing concern that children's access to and engagement with adventurous play opportunities are declining in Westernised countries, which may have negative implications for children's health. OBJECTIVE The current study aimed to ascertain the facilitators of and barriers to children's adventurous play most identified by parents in Britain and to determine whether these differ across socio-demographic and geographic groups. METHODS This study analysed the responses of a nationally representative sample of 1919 parents who took part in the British Children's Play Survey. Two open-ended questions asked parents to identify what they perceive to be the facilitators of and barriers to their child's adventurous play. A quantitative coding scheme, developed using the qualitative framework identified by Oliver et al. (2022), was applied to parents' responses. RESULTS A diversity in the most identified facilitators and barriers was found, including concerns about the risk of injury from adventurous play and the safety of society, positive attitudes about the benefits of adventurous play, as well as factors related to child attributes. In general, these were consistently identified across different socio-demographic and geographic groups, although some differences were found in barriers. CONCLUSIONS The findings of this research support the identification of key targets for those working with parents to improve children's adventurous play opportunities and ultimately their physical and mental health. Future research should seek to design and tailor interventions by asking parents about the support they would value.
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Affiliation(s)
- Brooke E Oliver
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Rachel J Nesbit
- Children and Young People's Mental Health (ChYMe), College of Medicine and Health, University of Exeter, United Kingdom
| | - Rachel McCloy
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Kate Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Helen F Dodd
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom; Children and Young People's Mental Health (ChYMe), College of Medicine and Health, University of Exeter, United Kingdom.
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Chan J, Blane D, Choudhary P, Chowdhury TA, Goyal A, Hanif W, Jacca J, Mathur R, Misra S, Ocran N, Rutter MK, Studley R, Treweek S, Valabhji J, Khunti K. Addressing health inequalities in diabetes through research: Recommendations from Diabetes UK's 2022 health inequalities in diabetes workshop. Diabet Med 2023; 40:e15024. [PMID: 36508339 DOI: 10.1111/dme.15024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/05/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Abstract
AIMS To develop a position statement which identifies research priorities to address health inequalities in diabetes and provides recommendations to researchers and research funders on how best to conduct research in these areas. METHODS A two-day research workshop was conducted bringing together research experts in diabetes, research experts in health inequalities, healthcare professionals and people living with diabetes. RESULTS The following key areas were identified as needing increased focus: How can we improve patient and public involvement and engagement to make diabetes research more inclusive of and relevant to diverse communities? How can we improve research design so that the people who could benefit most are represented? How can we use theories from implementation science to facilitate the uptake of research findings into routine practice to reach the populations with highest need? How can we collate and evaluate local innovation projects and disseminate best practice around tackling health inequalities in diabetes? How can we best collect and use data to address health inequalities in diabetes, including the harnessing of real-world and routinely collected data? How could research funders allocate funds to best address health inequalities in diabetes? How do we ensure the research community is representative of the general population? CONCLUSIONS This position statement outlines recommendations to address the urgent need to tackle health inequalities in diabetes through research and calls on the diabetes research community to act upon these recommendations to ensure future research works to eliminate unfair and avoidable disparities in health.
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Affiliation(s)
- Jodie Chan
- Diabetes UK, Wells Lawrence House, London, UK
| | - David Blane
- General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Pratik Choudhary
- Department of Diabetes, School of Life Course Sciences, King's College London, London, UK
| | | | - Aaliya Goyal
- Black Country Integrated Care Board, Wolverhampton, UK
| | - Wasim Hanif
- University Hospital Birmingham, Birmingham, UK
| | - Joyce Jacca
- North Lewisham Primary Care Network, London, UK
| | - Rohini Mathur
- Centre for Primary Care, Wolfson Institute for Population Health, Queen Mary University of London, London, UK
| | - Shivani Misra
- Division of Metabolism, Digestion & Reproduction, Faculty of Medicine, Imperial College London, London, UK
- Department of Diabetes, Endocrinology & Metabolism, Imperial College Healthcare NHS Trust, London, UK
| | - Nana Ocran
- Diabetes Research Steering Group Member, London, UK
| | - Martin K Rutter
- Division of Endocrinology, Diabetes and Gastroenterology, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester, UK
- Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jonathan Valabhji
- Division of Metabolism, Digestion & Reproduction, Faculty of Medicine, Imperial College London, London, UK
- NHS England, London, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
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18
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Furtado JM, Fernandes AG, Silva JC, Del Pino S, Hommes C. Indigenous Eye Health in the Americas: The Burden of Vision Impairment and Ocular Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3820. [PMID: 36900846 PMCID: PMC10000964 DOI: 10.3390/ijerph20053820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/13/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
Review of the burden of vision impairment and blindness and ocular disease occurrence in Indigenous Peoples of the Americas. We systematically reviewed findings of the frequency of vision impairment and blindness and/or frequency of ocular findings in Indigenous groups. The database search yielded 2829 citations, of which 2747 were excluded. We screened the full texts of 82 records for relevance and excluded 16. The remaining 66 articles were examined thoroughly, and 25 presented sufficient data to be included. Another 7 articles derived from references were included, summing a total of 32 studies selected. When considering adults over 40 years old, the highest frequencies of vision impairment and blindness in Indigenous Peoples varied from 11.1% in high-income North America to 28.5% in tropical Latin America, whose rates are considerably higher than those in the general population. Most of the ocular diseases reported were preventable and/or treatable, so blindness prevention programs should focus on accessibility to eye examinations, cataract surgeries, control of infectious diseases, and spectacles distribution. Finally, we recommend actions in six areas of attention towards improving the eye health in Indigenous Peoples: access and integration of eye services with primary care; telemedicine; customized propaedeutics; education on eye health; and quality of data.
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Affiliation(s)
- João Marcello Furtado
- Pan American Health Organization, Washington, DC 20037, USA
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14015-010, Brazil
| | - Arthur Gustavo Fernandes
- Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, Sao Paulo 04023-062, Brazil
- Department of Anthropology and Archaeology, University of Calgary, Calgary, AB T2N 4N1, Canada
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Brown CL, Restall G, Diaz FAS, Anang P, Gerhold K, Pylypjuk H, Wittmeier K. Understand me: Youth with chronic pain on how knowledge gaps influence their pain experience. Can J Pain 2023; 7:2146489. [PMID: 36733474 PMCID: PMC9888456 DOI: 10.1080/24740527.2022.2146489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background There is a perceived lack of readily available resources to support self-management skills in youth living with chronic pain. The perspectives of youth regarding information gaps may improve the effectiveness of resources developed for them. Aim The aim of this study was to explore the perspectives of youth living with chronic pain on the interactions among their pain experiences, chronic pain resources and research. Methods Using an interpretive paradigm, we interviewed seven participants (age range 12-19 years) diagnosed with chronic pain. Two frameworks for meaningful engagement of citizens in research and policy informed the interview guide. Data were analyzed inductively using content analysis approaches to examine patterns and develop themes. Results The participants' perceptions were captured by the overarching theme of "understand me." Four subthemes elaborate on the relationship between the participants' experiences and how their lives could be enhanced through research and knowledge mobilization. In the subtheme "my unique pain experience," the participants help us understand them by chronicling the variation in presentation of their chronic pain. The subtheme "people don't know it's a thing" emphasizes that there is general misunderstanding of chronic pain by the public and in the participants' support systems. The first two subthemes influence the third, which describes how the pain "kind of stops you from living." The fourth subtheme, "knowledge offers hope," offers a solution to dismantling misunderstanding of youth living with chronic pain. Conclusion Future work needs to focus on embedding health literacy and knowledge mobilization into health and education structures to promote developmentally relevant self-management skills.
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Affiliation(s)
- Cara L. Brown
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada,CONTACT Cara L. Brown Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, R125, 771 McDermot Ave. Winnipeg, MBR3E 0T6, Canada
| | - Gayle Restall
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Francis Austin S. Diaz
- Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Polina Anang
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kerstin Gerhold
- Children’s Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada,Mississippi Center for Advanced Medicine, Mississippi, USA
| | - Heidi Pylypjuk
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristy Wittmeier
- Children’s Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada,Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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20
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Kaura AE. LGBTQ+ healthcare professionals and work related stress. BMJ 2023; 380:29. [PMID: 36631135 DOI: 10.1136/bmj.p29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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21
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Calia C, Chakrabarti A, Sarabwe E, Chiumento A. Maximising impactful, locally relevant global mental health research conducted in low and middle income country settings: ethical considerations. Wellcome Open Res 2023. [DOI: 10.12688/wellcomeopenres.18269.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: Achieving ethical and meaningful mental health research in diverse global settings requires approaches to research design, conduct, and dissemination that prioritise a contextualised approach to impact and local relevance. Method: Through three case studies presented at the 2021 Global Forum on Bioethics in Research meeting on the ethical issues arising in research with people with mental health conditions, we consider the nuances to achieving ethical and meaningful mental health research in three diverse settings. The case studies include research with refugees Rwanda and Uganda; a neurodevelopmental cohort study in a low resource setting in India, and research with Syrian refugees displaced across the Middle East. Results: Key considerations highlighted across the case studies include how mental health is understood and experienced in diverse contexts to ensure respectful engagement with communities, and to inform the selection of contextually-appropriate and feasible research methods and tools to achieve meaningful data collection. Related to this is a need to consider how communities understand and engage with research to avoid therapeutic misconception, exacerbating stigma, or creating undue inducement for research participation, whilst also ensuring meaningful benefit for research participation. Central to achieving these is the meaningful integration of the views and perspectives of local stakeholders to inform research design, conduct, and legacy. The case studies foreground the potential tensions between meeting local community needs through the implementation of an intervention, and attaining standards of scientific rigor in research design and methods; and between adherence to procedural ethical requirements such as ethical review and documenting informed consent, and ethical practice through attention to the needs of the local research team. Conclusions: We conclude that engagement with how to achieve local relevance and social, practice, and academic impact offer productive ways for researchers to promote ethical research that prioritises values of solidarity, inclusion, and mutual respect.
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22
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Howes S, Warwick P. Creating equitable and sustainable opportunities for nature immersion to support restoration from stress within mental health nursing: A critical interpretive synthesis. Int J Ment Health Nurs 2023; 32:673-686. [PMID: 36594459 DOI: 10.1111/inm.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 01/04/2023]
Abstract
In the face of global environmental changes threatening health, and despite increased calls for nurses to broker access to nature-based well-being interventions for people with mental health difficulties, there is a surprising absence of literature examining the nature-nursing relationship, inhibiting its inclusion within nursing curricula and practice. This critical interpretive synthesis supports the notion that nature immersion has the capacity to increase positive affect, reduce negative affect, provide restoration from everyday stress, promote meaning-making, enhance belonging, and foster an interest in caring for the natural world. Yet, critical examination of the literature reveals multiple social and environmental inequalities and unmasks latent anthropocentric, gendered, and colonialist thinking, which threatens the delivery of equitable and just sustainable practice. Recommendations are made for a transdisciplinary, systemic approach, which recognizes and responds to our shared humanity and vulnerability in pursuit of planetary health.
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Affiliation(s)
- Sarah Howes
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Paul Warwick
- Institute of Education, University of Plymouth, Plymouth, UK
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23
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Koffman J, Bajwah S, Davies JM, Hussain JA. Researching minoritised communities in palliative care: An agenda for change. Palliat Med 2022; 37:530-542. [PMID: 36271636 DOI: 10.1177/02692163221132091] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Palliative care access, experiences and outcomes of care disadvantage those from ethnically diverse, Indigenous, First nation and First people communities. Research into this field of inquiry raises unique theoretical, methodological, and moral issues. Without the critical reflection of methods of study and reporting of findings, researchers may inadvertently compromise their contribution to reducing injustices and perpetuating racism. AIM To examine key evidence of the place of minoritised communities in palliative care research to devise recommendations that improve the precision and rigour of research and reporting of findings. METHODS Narrative review of articles identified from PubMed, CINAHL and Google Scholar for 10 years augmented with supplementary searches. RESULTS We identified and appraised 109 relevant articles. Four main themes were identified (i) Lack of precision when working with a difference; (ii) 'black box epidemiology' and its presence in palliative care research; (iii) the inclusion of minoritised communities in palliative care research; and (iv) the potential to cause harm. All stymie opportunities to 'level up' health experiences and outcomes across the palliative care spectrum. CONCLUSIONS Based on the findings of this review palliative care research must reflect on and justify the classification of minoritised communities, explore and understand intersectionality, optimise data quality, decolonise research teams and methods, and focus on reducing inequities to level up end-of-life care experiences and outcomes. Palliative care research must be forthright in explicitly indentifying instances of structural and systemic racism in palliative care research and engaging in non-judgemental debate on changes required.
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Affiliation(s)
- Jonathan Koffman
- University of Hull, Hull York Medical School, Wolfson Palliative Care Research Centre, Hull, UK
| | - Sabrina Bajwah
- King's College London, Cicely Saunders Institute, London, UK
| | - Joanna M Davies
- King's College London, Cicely Saunders Institute, London, UK
| | - Jamilla Akhter Hussain
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, UK
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24
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Guevara AMM, White RMB, Johnson SL, Nair RL, Roche KM. School racial-ethnic discrimination, rule-breaking behaviors and the mediating role of trauma among Latinx adolescents: Considerations for school mental health practice. PSYCHOLOGY IN THE SCHOOLS 2022; 59:2005-2021. [PMID: 38188531 PMCID: PMC10768846 DOI: 10.1002/pits.22562] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 04/15/2021] [Indexed: 01/09/2024]
Abstract
Much of the literature linking adversity to trauma fails to account for racialized experiences, including racial-ethnic discrimination, which is a highly prevalent form of adversity for youth of color in the U.S. Adversity and trauma often result in students experiencing elevated rule-breaking behaviors, exacerbating existing racial-ethnic disparities in disproportionate school discipline. Drawing from race-based trauma theory, the present study explored trauma as a mediator of the longitudinal association between racial-ethnic discrimination from teachers, other adults, and students in schools and rule-breaking behaviors among Latinx youth. Data were from a longitudinal study of 547 Latinx students in a southeastern U.S. state. Across gender and nativity groups, school racial-ethnic discrimination and trauma positively predicted later rule-breaking behaviors. Additionally, for girls only, increased levels of trauma partially explained the association between school racial-ethnic discrimination and rule-breaking behaviors. The study highlights the importance of addressing school racial-ethnic discrimination and trauma in equitable school metal health systems. Indeed, efforts aimed at reducing disproportionate school discipline among Latinx students should focus on reducing their exposure to school racial-ethnic discrimination and increasing access to trauma-informed and restorative justice approaches.
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Affiliation(s)
- Ana Maria Meléndez Guevara
- T. Denny Sanford School of Social and Family Dynamics, Family and Human Development, Arizona State University, Tempe, Arizona, USA
| | - Rebecca M B White
- T. Denny Sanford School of Social and Family Dynamics, Family and Human Development, Arizona State University, Tempe, Arizona, USA
| | - Sarah Lindstrom Johnson
- T. Denny Sanford School of Social and Family Dynamics, Family and Human Development, Arizona State University, Tempe, Arizona, USA
| | - Rajni L Nair
- College of Integrative Science and Arts, Science, Mathematics and Social Sciences, Arizona State University, Tempe, Arizona, USA
| | - Kathleen M Roche
- Milken Institute School of Public Health, Prevention and Community Health, The George Washington University, Washington, USA
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Calia C, Chakrabarti A, Sarabwe E, Chiumento A. Maximising impactful and locally relevant mental health research: ethical considerations. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18269.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Achieving ethical and meaningful mental health research in diverse global settings requires approaches to research design, conduct, and dissemination that prioritise a contextualised approach to impact and local relevance. Method: Through three case studies presented at the 2021 Global Forum on Bioethics in Research meeting on the ethical issues arising in research with people with mental health conditions, we consider the nuances to achieving ethical and meaningful mental health research in three diverse settings. The case studies include research with refugees Rwanda and Uganda; a neurodevelopmental cohort study in a low resource setting in India, and research with Syrian refugees displaced across the Middle East. Results: Key considerations highlighted across the case studies include how mental health is understood and experienced in diverse contexts to ensure respectful engagement with communities, and to inform the selection of contextually-appropriate and feasible research methods and tools to achieve meaningful data collection. Related to this is a need to consider how communities understand and engage with research to avoid therapeutic misconception, exacerbating stigma, or creating undue inducement for research participation, whilst also ensuring meaningful benefit for research participation. Central to achieving these is the meaningful integration of the views and perspectives of local stakeholders to inform research design, conduct, and legacy. The case studies foreground the potential tensions between meeting local community needs through the implementation of an intervention, and attaining standards of scientific rigor in research design and methods; and between adherence to procedural ethical requirements such as ethical review and documenting informed consent, and ethical practice through attention to the needs of the local research team. Conclusions: We conclude that engagement with how to achieve local relevance and social, practice, and academic impact offer productive ways for researchers to promote ethical research that prioritises values of solidarity, inclusion, and mutual respect.
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26
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Lees JS, Hanlon P, Butterly EW, Wild SH, Mair FS, Taylor RS, Guthrie B, Gillies K, Dias S, Welton NJ, McAllister DA. Effect of age, sex, and morbidity count on trial attrition: meta-analysis of individual participant level data from phase 3/4 industry funded clinical trials. BMJ MEDICINE 2022; 1:e000217. [PMID: 36936559 PMCID: PMC9978693 DOI: 10.1136/bmjmed-2022-000217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/10/2022] [Indexed: 04/21/2023]
Abstract
Objectives To estimate the association between individual participant characteristics and attrition from randomised controlled trials. Design Meta-analysis of individual participant level data (IPD). Data sources Clinical trial repositories (Clinical Study Data Request and Yale University Open Data Access). Eligibility criteria for selecting studies Eligible phase 3 or 4 trials identified according to prespecified criteria (PROSPERO CRD42018048202). Main outcome measures Association between comorbidity count (identified using medical history or concomitant drug treatment data) and trial attrition (failure for any reason to complete the final trial visit), estimated in logistic regression models and adjusted for age and sex. Estimates were meta-analysed in bayesian linear models, with partial pooling across index conditions and drug classes. Results In 92 trials across 20 index conditions and 17 drug classes, the mean comorbidity count ranged from 0.3 to 2.7. Neither age nor sex was clearly associated with attrition (odds ratio 1.04, 95% credible interval 0.98 to 1.11; and 0.99, 0.93 to 1.05, respectively). However, comorbidity count was associated with trial attrition (odds ratio per additional comorbidity 1.11, 95% credible interval 1.07 to 1.14). No evidence of non-linearity (assessed via a second order polynomial) was seen in the association between comorbidity count and trial attrition, with minimal variation across drug classes and index conditions. At a trial level, an increase in participant comorbidity count has a minor impact on attrition: for a notional trial with high level of attrition in individuals without comorbidity, doubling the mean comorbidity count from 1 to 2 translates to an increase in trial attrition from 29% to 31%. Conclusions Increased comorbidity count, irrespective of age and sex, is associated with a modest increased odds of participant attrition. The benefit of increased generalisability of including participants with multimorbidity seems likely to outweigh the disadvantages of increased attrition.
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Affiliation(s)
| | | | - Elaine W Butterly
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | | | | | | | | | | | - Nicky J Welton
- Population Health Sciences, University of Bristol, Bristol, UK
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Clements-Cortés A, Yip JJY. The Impact of Systemic Language in Music Therapy and Western Healthcare Systems: A Canadian Perspective. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Exploring COVID-19 Vaccine Confidence with People from Black and Asian Backgrounds in England. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01372-w. [PMID: 35913541 PMCID: PMC9341420 DOI: 10.1007/s40615-022-01372-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 12/05/2022]
Abstract
Aims Little research has examined factors underlying COVID-19 vaccine hesitancy or refusal in Black and Asian individuals in England, among whom hesitancy tends to be higher than in the general population. This qualitative study aimed to gain an understanding of factors affecting hesitancy in Black and Asian individuals in England, to help address concerns about having the vaccine. Method Ninety-five participants (51 women, 42 men, 2 other; 58% were aged between 30 and 49) recruited via a market recruitment agency, local Healthwatch networks, and using a snowballing method, participated in four activities on an online engagement platform, sharing their attitudes towards the COVID-19 vaccine roll-out, and factors shaping their beliefs and concerns, over 5 weeks from April to March 2021. Results Inductive thematic analysis revealed five themes: (1) a variety of views on the COVID-19 vaccine, (2) targeted messaging for Black and Asian people as counterproductive, (3) confusion over the purpose of the vaccine roll-out, (4) hesitancy to take the vaccine, and (5) local networks as a trusted source of information. Conclusions Our findings suggest that respecting individuals’ agency, transparency of information provided, and the independence of the bodies providing this information are important. Instead of targeted messaging, local networks should be used in campaigns to increase COVID-19 vaccine uptake among Black and Asian individuals. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-022-01372-w.
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Bueser T, Skinner A, Bolton Saghdaoui L, Moorley C. Genomic research: The landscape for nursing. J Adv Nurs 2022; 78:e99-e100. [PMID: 35894114 DOI: 10.1111/jan.15396] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Tootie Bueser
- South East Genomic Medicine Service Alliance, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Amanda Skinner
- South West Genomic Medicine Service Alliance, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | | | - Calvin Moorley
- Department of Adult Nursing, Institute of Health and Social Care, London South Bank University, London, UK
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Kearney M, Bornstein M, Fall M, Nianogo R, Glik D, Massey P. Cross-sectional study of COVID-19 knowledge, beliefs and prevention behaviours among adults in Senegal. BMJ Open 2022; 12:e057914. [PMID: 35618332 PMCID: PMC9136694 DOI: 10.1136/bmjopen-2021-057914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The aim of the study was to explore COVID-19 beliefs and prevention behaviours in a francophone West African nation, Senegal. DESIGN This was a cross-sectional analysis of survey data collected via a multimodal observational study. PARTICIPANTS Senegalese adults aged 18 years or older (n=1452). PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measures were COVID-19 prevention behaviours. Secondary outcome measures included COVID-19 knowledge and beliefs. Univariate, bivariate and multivariate statistics were generated to describe the sample and explore potential correlations. SETTING Participants from Senegal were recruited online and telephonically between June and August 2020. RESULTS Mask wearing, hand washing and use of hand sanitiser were most frequently reported. Social distancing and staying at home were also reported although to a lower degree. Knowledge and perceived risk of COVID-19 were very high in general, but risk was a stronger and more influential predictor of COVID-19 prevention behaviours. Men, compared with women, had lower odds (adjusted OR (aOR)=0.59, 95% CI 0.46 to 0.75, p<0.001) of reporting prevention behaviours. Rural residents (vs urban; aOR=1.49, 95% CI 1.12 to 1.98, p=0.001) and participants with at least a high school education (vs less than high school education; aOR=1.33, 95% CI 1.01 to 1.76, p=0.006) were more likely to report COVID-19 prevention behaviours. CONCLUSIONS In Senegal, we observed high compliance with recommended COVID-19 prevention behaviours among our sample of respondents, in particular for masking and personal hygiene practice. We also identified a range of psychosocial and demographic predictors for COVID-19 prevention behaviours such as knowledge and perceived risk. Stakeholders and decision makers in Senegal and across Africa can use place-based evidence like ours to address COVID-19 risk factors and intervene effectively with policies and programming. Use of both phone and online surveys enhances representation and study generalisability and should be considered in future research with hard-to-reach populations.
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Affiliation(s)
- Matthew Kearney
- Department Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Marta Bornstein
- Department of Epidemiology, Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Marieme Fall
- The African Health and Education Network (NGO RAES), Dakar, Senegal
| | - Roch Nianogo
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Deborah Glik
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Philip Massey
- Department of Health, Human Performance and Recreation, University of Arkansas College of Education and Health Professions, Fayetteville, Arkansas, USA
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Hoverd EJ, Hawker-Bond G, Staniszewska S, Dale J. Factors influencing decisions about whether to participate in health research by people of diverse ethnic and cultural backgrounds: a realist review. BMJ Open 2022; 12:e058380. [PMID: 35589353 PMCID: PMC9121482 DOI: 10.1136/bmjopen-2021-058380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To develop and refine a programme theory that explains factors that influence decisions to take part in health research by people of diverse ethnic and cultural backgrounds. DESIGN Realist review following a sequence of five steps: (a) scoping search and identification of programme theory; (b) evidence searching; (c) critical appraisal and data extraction; (d) organisation of evidence and (e) refinement of programme theory. ELIGIBILITY CRITERIA Documents (including peer-reviewed articles, grey literature, websites, reports and conference papers) either full text, or a section of relevance to the overarching research question were included. DATA SOURCES EMBASE, Medline, Web of Science, Psych Info, Google and Google Scholar were searched iteratively between May and August 2020. Search strategy was refined for each database providing a broad enough review for building of programme theory. ANALYSIS Data from eligible documents was extracted to build understanding of the factors that influence decision-making. Data were mapped to create a data matrix according to context (C), mechanism (M), outcome (O), configurations (C) (CMOCs) for the process of informed consent, to aid interpretation and produce final programme theory. RESULTS 566 documents were screened and 71 included. Final programme theory was underpinned by CMOCs on processes influencing decisions to take part in research. Key findings indicate the type of infrastructure required, for example, resources, services and policies, to support inclusion in health research, with a greater need to increase the social presence of researchers within communities, improve cultural competency of individuals and organisations, reduce the complexity of participant information, and provide additional resources to support adaptive processes and shared decision making. CONCLUSION The review indicates the need for a more inclusive research infrastructure that facilitates diverse participation in health research through incorporating adaptive processes that support shared decision making within the informed consent process and in the conduct of research projects.
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Affiliation(s)
| | - George Hawker-Bond
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| | | | - Jeremy Dale
- Warwick Medical School, University of Warwick, Coventry, UK
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Baiden D, Evans M. Recruitment Strategies to Engage Newcomer Mothers of African Descent in Maternal Mental Health Research in Canada. J Transcult Nurs 2022; 33:467-474. [PMID: 35466798 PMCID: PMC9240378 DOI: 10.1177/10436596221090268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Newcomer mothers of African descent are at risk for maternal mental
stress because of inadequate social support, newcomer status,
and stress of motherhood. Limited participation of newcomer
African mothers in mental health research contributes to a
knowledge gap in this area further impacting culturally
competent health services. This article reports recruitment
strategies to better engage African newcomer women in maternal
mental health research. Methods: In-depth discussion of recruitment strategies, used in a
qualitative descriptive study conducted with Black African
newcomer mothers in Canada. Results: Ten African newcomer mothers were successfully recruited using
recruitment strategies such as engagement with religious
organizations, snowballing, and the use of social media. Discussion: Cultural beliefs on motherhood, resilience, and mental illness may
account for hesitancy to engage in maternal mental health
research. Recruitment strategies could help overcome the
challenges and potentially diversify maternal mental health
research in Canada through the engagement of African newcomer
mothers.
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Land J, Hackett J, Sidhu G, Heinrich M, McCourt O, Yong KL, Fisher A, Beeken RJ. Myeloma patients’ experiences of a supervised physical activity programme: a qualitative study. Support Care Cancer 2022; 30:6273-6286. [PMID: 35467117 PMCID: PMC9035778 DOI: 10.1007/s00520-022-07062-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/11/2022] [Indexed: 10/31/2022]
Abstract
Abstract
Purpose
The Myeloma: Advancing Survival Cancer Outcomes Trial (MASCOT) tested the impact of a supervised exercise programme on fatigue, clinical, and patient-reported outcomes in multiple myeloma [MM] patients. The current study explored MM patients’ experiences of the programme to guide future interventions.
Methods
Purposive sampling was used to recruit stable MM patients participating in MASCOT. Semi-structured, face-to-face interviews were conducted, transcribed verbatim, and analysed using thematic analysis.
Results
Six themes were identified. Key drivers for participation in MASCOT were “Altruism and extended cancer care”; participants wanted to give something back and assist in improving post-treatment care for MM patients, especially as after treatment “Barriers to being physically active” were a fear of damage and lack of health professional guidance. “Influences fostering change within the intervention” included physiotherapy supervision and tailored exercises, which gave participants confidence to push themselves in a safe environment and broke down misconceptions about their body. “Social support”, from both family and peers in the programme, promoted motivation and adherence. Participants expressed concerns about “Maintaining things going forward” but had identified mechanisms to aid continuation. “Physical and mental benefits” of the programme were highlighted; participants were able to do things they couldn’t before and described feeling free from the constraints of MM.
Conclusions
A post-treatment exercise intervention for MM patients was a positive experience, which enhanced participants’ physical and psychological wellbeing. Tailored gym and home-based exercises, a specialist cancer physiotherapist, and sustained support were perceived to be important for success.
Implications for cancer survivors
Exercise support for MM patients, ideally with physiotherapist supervision, should be incorporated into survivorship care to qualitatively improve patients’ quality of life, self-efficacy, and mental wellbeing.
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Mew L, Heaslip V, Immins T, Wainwright TW. A Patient and Public Involvement Study to Explore the Need for Further Research into the Experience of Younger Patients Undergoing Total Hip Arthroplasty. J Patient Exp 2022; 9:23743735221083166. [PMID: 35274035 PMCID: PMC8902004 DOI: 10.1177/23743735221083166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Total Hip Arthroplasty (THA) is one of the most commonly performed operations in orthopaedics. It is an operation usually performed in older patients, however the need for THA in younger patients is increasing. There is a lack of literature examining whether current recovery pathways address the specific needs of younger patients. Public and Patient Involvement (PPI) is a core aspect of good research practice and is recommended throughout the research process, including the formulation and refinement of pertinent research questions. Therefore, the explicit aim of this PPI study was to collect qualitative data from patients on the feasibility and requirement for further research into the experience of younger hip arthroplasty patients. Methods: Qualitative data was collected via an online questionnaire that was advertised on social media, requesting the input of anybody who had experienced a lower limb musculoskeletal injury or condition before the age of 50. The survey asked the respondents to describe their experiences and reflect on their priorities and goals throughout their recovery. Results: There were 71 respondents, of which 90% were female, with an average age of 43. Qualitative responses identified many concerns that were issues that could be translated across all patient ages. However, other priorities were raised that are not always recognised as important when measuring successful outcomes after a THA. Furthermore, many respondents described not feeling listened to by clinicians or treatment options not being sufficiently addressed and explored. Multiple respondents reported being told they were too young to have anything serious or that nothing could be done until they were older. Conclusions: The responses to the survey indicate that current care pathways are not fulfilling the needs and priorities in younger patients. Further research is required to explore these priorities and goals in more depth in order to understand how healthcare professionals can address them.
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Affiliation(s)
- L. Mew
- Milton Keynes University Hospital, Standing Way, Milton Keynes, MK6 5LD
- Louise Mew, Research and Development, Academic Centre, Milton Keynes University Hospital, Standing Way, Milton Keynes, MK6 5LD.
| | - V. Heaslip
- Department of Nursing Science, Faculty of Health and Social Sciences, Bournemouth University, UK
- Department of Social Work, Stavanger University, Norway
| | - T. Immins
- Orthopaedic Research Institute, Bournemouth University, UK
| | - T. W. Wainwright
- Orthopaedic Research Institute, Bournemouth University, UK
- Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust
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Dementia care-sharing and migration: An intersectional exploration of family carers' experiences. J Aging Stud 2022; 60:100996. [DOI: 10.1016/j.jaging.2021.100996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/20/2022]
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Rogers CC, Pope S, Whitfield F, Cohn WF, Valdez RS. The lived experience during the peri-diagnostic period of breast cancer: A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:547-585. [PMID: 34210570 DOI: 10.1016/j.pec.2021.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/13/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The aim of this scoping review is to provide an overview of the existing research that investigates the lived experience during the peri-diagnostic period of breast cancer. METHODS Nine databases were searched for relevant literature between January 2007 and April 2019. Data were extracted and categorized using deductive and inductive approaches. RESULTS A majority of the 66 studies included used qualitative methods to retrospectively explore the treatment decision making process of female breast cancer patients. Patients experienced uncertainty, emotional distress, and a need for more information from providers and relied on social support and family guidance during this period. CONCLUSIONS The results of this review show that the burdens experienced during the peri-diagnostic period parallel those in later periods of cancer care. However, these burdens are prompted by different circumstances. More research is needed to explore the lived experience during this period through the use of mixed-methods and by recruiting a diverse sample with regards to role in the breast cancer experience, age, gender, race, and ethnicity. PRACTICE IMPLICATIONS Interventions positioned at earlier points in the breast cancer experience should provide informational support, which could be delivered through shared decision making models. Additional support could be facilitated by patient navigation programs and health information technology.
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Affiliation(s)
- Courtney C Rogers
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States; Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Shannon Pope
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Francesca Whitfield
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Wendy F Cohn
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Rupa S Valdez
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States; Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States.
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Beer K, Gentgall M, Templeton N, Whitehouse C, Straiton N. Who's included? The role of the Clinical Research Nurse in enabling research participation for under-represented and under-served groups. J Res Nurs 2022; 27:143-154. [PMID: 35392191 PMCID: PMC8980581 DOI: 10.1177/17449871221077076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background There is a global call for more inclusive clinical research that is representative of all populations, particularly those historically under-represented or under-served. A lack of broad representation results in disproportionate health outcomes and limits the applicability and translation of research findings. Aim Identify and describe barriers to participation across the research lifecycle and consider the role of the Clinical Research Nurse (CRN) in promoting inclusivity, including for Aboriginal and Torres Strait Islander Peoples within Australia. Discussion Review of recent literature and best practice identified barriers to research participation across the research process; at system, participant and practitioner levels. This discussion paper explores the role of the CRN; acting as enablers, facilitators and navigators, to mitigate participation barriers. Conclusion With their comprehensive understanding of the research process, clinical care pathways, reflective practices and participant-centred approaches, CRNs are uniquely positioned to advocate for greater equity in access to clinical research and to motivate stakeholders across the research enterprise to embed inclusive approaches in the design, conduct and dissemination of research. Implications for Practice An in-depth understanding of the research process, self, and cultural norms of the populations they serve is essential for CRNs to effectively advocate for equity in access to research.
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Affiliation(s)
- Kelly Beer
- Kelly Beer, Perron Institute for Neurological and Translational Science; Murdoch University, Building 390, Discovery Way, Murdoch, WA 6150, Australia.
| | - Melanie Gentgall
- Clinical Research Nurse, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | | | - Claire Whitehouse
- Senior Nurse for Nursing, Midwifery and Allied Health Professions Research, The James Paget University Hospitals NHS Foundation Trust, Norfolk, UK
| | - Nicola Straiton
- Registered Nurse, Faculty of Medicine and Health, University of Sydney, NSW, Australia
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Mekhail KT, Burström B, Marttila A, Wångdahl J, Lindberg L. Psychometric qualities of the HLS-EU-Q16 instrument for parental health literacy in Swedish multicultural settings. BMC Public Health 2022; 22:293. [PMID: 35151303 PMCID: PMC8841050 DOI: 10.1186/s12889-021-12346-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background Health literacy (HL) is important for individuals in terms of knowledge and competence to make decisions about healthcare, health promotion and disease prevention. Migrants generally demonstrate lower HL levels compared to the majority populations. HL interventions among migrants are rarely studied. Thus, there is a need to find useful HL measurements for multicultural settings. The importance of understanding parents’ HL is related to their key role in providing and promoting the health of their children. This study aimed to add knowledge about the psychometric properties of the HLS-EU-Q16 instrument (Swedish version) among parents in Swedish multicultural settings. Methods A cross sectional design was used. Totally 193 first-time parents (N = 193) were recruited through two child healthcare centres in Stockholm. Parents were interviewed when their infants were < 2 months old using structured questionnaires including HLS-EU-Q16. For psychometric evaluation of HLS-EU-Q16 instrument, exploratory factor analyses (EFA) were used to test internal consistency (N = 164). HL levels in sub-groups were explored with Kruskal-Wallis/Chi2 tests. Participants’ comments on HLS-EU-Q16 questionnaire were viewed to explore how the questions were perceived by the target population. Results One factor solution of EFA explained 37.3% of the total variance in HLS-EU-Q16. Statistically significant differences in HL levels were found in relation to migration including language difficulties and level of education of the study population and access to support in line with previous research. Challenges related to understanding HLS-EU-Q16 questionnaire were found among participants with migrant background. Conclusions The Swedish version of HLS-EU-Q16 could be used together with other instruments for measuring overall HL in multicultural settings. HLS-EU-Q16 appears to discriminate between different levels of HL in relation to migrant background and shorter education and limited access to support. However, other measures of HL which should be adapted to use in multicultural settings, need to be explored in further studies of parental HL and its relationship to child health in multicultural settings. Trial registration The study was retrospectively registered (18 February 2020) in the ISRCTN registry (ISRCTN10336603). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12346-8.
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Ahmed A, Vandrevala T, Hendy J, Kelly C, Ala A. An examination of how to engage migrants in the research process: building trust through an 'insider' perspective. ETHNICITY & HEALTH 2022; 27:463-482. [PMID: 31722534 DOI: 10.1080/13557858.2019.1685651] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
Introduction: Ensuring all members of society can equally participate in research and the provision of services is a challenging goal. Increased migration has been mirrored by media narratives of social threat, leaving many migrants feeling differentiated and distrustful of mainstream society.Objectives: We explore how migrant and ethnic minority populations can be given the opportunity to participate in the research process. In this work, we iteratively and jointly developed a range of engagement strategies that adopt an 'insider' approach; seeking to eliminate feelings of differentiation and 'otherness' by establishing mutual trust.Design: Recruitment activities were carried out with 8 focus groups of first-generation South Asian migrants (the largest ethnic minority group in England). Our analysis was grounded in the broad principles of action research with reflective evaluation of our recruitment process using field observations and relevant focus group data; asking whether we tackled barriers to engagement.Results: Our findings show that 'otherness' can be reduced by establishing a trustworthy researcher-community relationship, but also that this relationship is complex, and needs to acknowledge residual mistrust. Alongside, researchers need to enable opportunities for empowered interaction, with flexible strategies to negotiate potential power divides.Conclusions: We can successfully create opportunities for engagement but there is no 'one size fits all'. Engagement requires tailored approaches that embrace flexibility, and position both engagement and non-engagement as positive and empowered choices.
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Affiliation(s)
- Ayesha Ahmed
- Brunel Business School, Brunel University London, London, UK
| | - T Vandrevala
- Department of Psychology, School of Social and Behavioural Sciences, Kingston University, Kingston-Upon-Thames, UK
| | - J Hendy
- Brunel Business School, Brunel University London, London, UK
| | - C Kelly
- Department of Gastroenterology and Hepatology, The Royal Surrey County Hospital NHS Foundation Trust Guildford, Guildford, UK
| | - A Ala
- Department of Gastroenterology and Hepatology, The Royal Surrey County Hospital NHS Foundation Trust Guildford, Guildford, UK
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- Institute of Liver Studies, King's College Hospital London, London, UK
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Bothongo PL, Jitlal M, Parry E, Waters S, Foote IF, Watson CJ, Cuzick J, Giovannoni G, Dobson R, Noyce AJ, Mukadam N, Bestwick JP, Marshall CR. Dementia risk in a diverse population: A single-region nested case-control study in the East End of London. THE LANCET REGIONAL HEALTH. EUROPE 2022; 15:100321. [PMID: 35558994 PMCID: PMC9088197 DOI: 10.1016/j.lanepe.2022.100321] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Umaefulam V, Kleissen T, Barnabe C. The representation of Indigenous peoples in chronic disease clinical trials in Australia, Canada, New Zealand, and the United States. Clin Trials 2022; 19:22-32. [PMID: 34991361 PMCID: PMC8847750 DOI: 10.1177/17407745211069153] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Indigenous peoples are overrepresented with chronic health conditions and experience suboptimal outcomes compared with non-Indigenous peoples. Genetic variations influence therapeutic responses, thus there are potential risks and harm when extrapolating evidence from the general population to Indigenous peoples. Indigenous population-specific clinical studies, and inclusion of Indigenous peoples in general population clinical trials, are perceived to be rare. Our study (1) identified and characterized Indigenous population-specific chronic disease trials and (2) identified the representation of Indigenous peoples in general population chronic disease trials conducted in Australia, Canada, New Zealand, and the United States. METHODS For Objective 1, publicly available clinical trial registries were searched from May 2010 to May 2020 using Indigenous population-specific terms and included for data extraction if in pre-specified chronic disease. For identified trials, we extracted Indigenous population group identity and characteristics, type of intervention, and funding type. For Objective 2, a random selection of 10% of registered clinical trials was performed and the proportion of Indigenous population participants enrolled extracted. RESULTS In total, 170 Indigenous population-specific chronic disease trials were identified. The clinical trials were predominantly behavioral interventions (n = 95). Among general population studies, 830 studies were randomly selected. When race was reported in studies (n = 526), Indigenous individuals were enrolled in 172 studies and constituted 5.6% of the total population enrolled in those studies. CONCLUSION Clinical trials addressing chronic disease conditions in Indigenous populations are limited. It is crucial to ensure adequate representation of Indigenous peoples in clinical trials to ensure trial data are applicable to their clinical care.
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Affiliation(s)
- Valerie Umaefulam
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tessa Kleissen
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Cheryl Barnabe
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Gallacher D, Kimani P, Stallard N. Biased Survival Predictions When Appraising Health Technologies in Heterogeneous Populations. PHARMACOECONOMICS 2022; 40:109-120. [PMID: 34580839 PMCID: PMC8738626 DOI: 10.1007/s40273-021-01082-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/22/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Time-to-event data from clinical trials are routinely extrapolated using parametric models to estimate the cost effectiveness of novel therapies, but how this approach performs in the presence of heterogeneous populations remains unknown. METHODS We performed a simulation study of seven scenarios with varying exponential distributions modelling treatment and prognostic effects across subgroup and complement populations, with follow-up typical of clinical trials used to appraise the cost effectiveness of therapies by agencies such as the UK National Institute for Health and Care Excellence (NICE). We compared established and emerging methods of estimating population life-years (LYs) using parametric models. We also proved analytically that an exponential model fitted to censored heterogeneous survival times sampled from two distinct exponential distributions will produce a biased estimate of the hazard rate and LYs. RESULTS LYs are underestimated by the methods in the presence of heterogeneity, resulting in either under- or overestimation of the incremental benefit. In scenarios where the overestimation of benefit is likely, which is of interest to the healthcare provider, the method of taking the average LYs from all plausible models has the least bias. LY estimates from complete Kaplan-Meier curves have high variation, suggesting mature data may not be a reliable solution. We explore the effect of increasing trial sample size and accounting for detected treatment-subgroup interactions. CONCLUSIONS The bias associated with heterogeneous populations suggests that NICE may need to be more cautious when appraising therapies and to consider model averaging or the separate modelling of subgroups when heterogeneity is suspected or detected.
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Affiliation(s)
| | - Peter Kimani
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Nigel Stallard
- Warwick Medical School, University of Warwick, Coventry, UK
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Translating best practice into real practice: Methods, results and lessons from a project to translate an English sexual health survey into four Asian languages. PLoS One 2021; 16:e0261074. [PMID: 34919577 PMCID: PMC8682877 DOI: 10.1371/journal.pone.0261074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 11/23/2021] [Indexed: 11/24/2022] Open
Abstract
Background Migrants are underrepresented in population health surveys. Offering translated survey instruments has been shown to increase migrant representation. While ‘team translation’ represents current best practice, there are relatively few published examples describing how it has been implemented. The purpose of this paper is to document the process, results and lessons from a project to translate an English-language sexual health and blood-borne virus survey into Khmer, Karen, Vietnamese and Traditional Chinese. Methods The approach to translation was based on the TRAPD (Translation, Review, Adjudication, Pretesting, and Documentation) model. The English-language survey was sent to two accredited, independent translators. At least one bilingual person was chosen to review and compare the translations and preferred translations were selected through consensus. Agreed translations were pretested with small samples of individuals fluent in the survey language and further revisions made. Results Of the 51 survey questions, only nine resulted in identical independent translations in at least one language. Material differences between the translations related to: (1) the translation of technical terms and medical terminology (e.g. HIV); (2) variations in dialect; and (3) differences in cultural understandings of survey concepts (e.g. committed relationships). Conclusion Survey translation is time-consuming and costly and, as a result, deviations from TRAPD ‘best practice’ occurred. It is not possible to determine whether closer adherence to TRAPD ‘best practice’ would have improved the quality of the resulting translations. However, our study does demonstrate that even adaptations of the TRAPD method can identify issues that may not have been apparent had non-team-based or single-round translation approaches been adopted. Given the dearth of clear empirical evidence about the most accurate and feasible method of undertaking translations, we encourage future researchers to follow our example of making translation data publicly available to enhance transparency and enable critical appraisal.
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Vereenooghe L. Participation of People With Disabilities in Web-Based Research. ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1027/2151-2604/a000472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Leen Vereenooghe
- Department of Psychology, Faculty of Psychology and Sports Science, Bielefeld University, Germany
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Byrne T, Patel P, Shrotri M, Beale S, Michie S, Butt J, Hawkins N, Hardelid P, Rodger A, Aryee A, Braithwaite I, Fong WLE, Fragaszy E, Geismar C, Kovar J, Navaratnam AMD, Nguyen V, Hayward A, Aldridge RW. Trends, patterns and psychological influences on COVID-19 vaccination intention: Findings from a large prospective community cohort study in England and Wales (Virus Watch). Vaccine 2021; 39:7108-7116. [PMID: 34728095 PMCID: PMC8498741 DOI: 10.1016/j.vaccine.2021.09.066] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Vaccination intention is key to the success of any vaccination programme, alongside vaccine availability and access. Public intention to take a COVID-19 vaccine is high in England and Wales compared to other countries, but vaccination rate disparities between ethnic, social and age groups has led to concern. METHODS Online survey of prospective household community cohort study participants across England and Wales (Virus Watch). Vaccination intention was measured by individual participant responses to 'Would you accept a COVID-19 vaccine if offered?', collected in December 2020 and February 2021. Responses to a 13-item questionnaire collected in January 2021 were analysed using factor analysis to investigate psychological influences on vaccination intention. RESULTS Survey response rate was 56% (20,785/36,998) in December 2020 and 53% (20,590/38,727) in February 2021, with 14,880 adults reporting across both time points. In December 2020, 1,469 (10%) participants responded 'No' or 'Unsure'. Of these people, 1,266 (86%) changed their mind and responded 'Yes' or 'Already had a COVID-19 vaccine' by February 2021. Vaccination intention increased across all ethnic groups and levels of social deprivation. Age was most strongly associated with vaccination intention, with 16-24-year-olds more likely to respond "Unsure" or "No" versus "Yes" than 65-74-year-olds in December 2020 (OR: 4.63, 95 %CI: 3.42, 6.27 & OR 7.17 95 %CI: 4.26, 12.07 respectively) and February 2021 (OR: 27.92 95 %CI: 13.79, 56.51 & OR 17.16 95 %CI: 4.12, 71.55). The association between ethnicity and vaccination intention weakened, but did not disappear, over time. Both vaccine- and illness-related psychological factors were shown to influence vaccination intention. CONCLUSIONS Four in five adults (86%) who were reluctant or intending to refuse a COVID-19 vaccine in December 2020 had changed their mind in February 2021 and planned to accept, or had already accepted, a vaccine.
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Affiliation(s)
- Thomas Byrne
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK.
| | - Parth Patel
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK.
| | - Madhumita Shrotri
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK
| | - Sarah Beale
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Jabeer Butt
- Race Equality Foundation, 27 Greenwood Pl, London NW5 1LB, UK
| | | | - Pia Hardelid
- Department of Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK
| | - Alison Rodger
- Institute for Global Health, University College London, 30 Guilford St, London WC1N 1EH, UK; Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Anna Aryee
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK
| | - Isobel Braithwaite
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK
| | - Wing Lam Erica Fong
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK
| | - Ellen Fragaszy
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Cyril Geismar
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Jana Kovar
- Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Annalan M D Navaratnam
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Vincent Nguyen
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Robert W Aldridge
- Centre for Public Health Data Science, Institute of Health Informatics, University College, 222 Euston Rd, London NW1 2DA, UK.
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Barriers and facilitators to implementing a cancer risk assessment tool (QCancer) in primary care: a qualitative study. Prim Health Care Res Dev 2021; 22:e51. [PMID: 34615569 PMCID: PMC8527274 DOI: 10.1017/s1463423621000281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: We aimed to explore service users’ and primary care practitioners’ perspectives on the barriers and facilitators to implementing a cancer risk assessment tool (RAT), QCancer, in general practice consultations. Background: Cancer RATs, including QCancer, are designed to estimate the chances of previously undiagnosed cancer in symptomatic individuals. Little is known about the barriers and facilitators to implementing cancer RATs in primary care consultations. Methods: We used a qualitative design, conducting semi-structured individual interviews and focus groups with a convenience sample of service users and primary care practitioners. Findings: In all, 36 participants (19 service users, 17 practitioners) living in Lincolnshire, were included in the interviews and focus groups. Before asking for their views, participants were introduced to QCancer and shown an example of how it estimated cancer risk. Participants identified barriers to implementing the tool namely: additional consultation time; unnecessary worry; potential for over-referral; practitioner scepticism; need for training on use of the tool; need for evidence of effectiveness; and need to integrate the tool in general practice systems. Participants also identified facilitators to implementing the tool as: supporting decision-making; modifying health behaviours; improving speed of referral; and personalising care. Conclusions: The barriers and facilitators identified should be considered when seeking to implement QCancer in primary care. In addition, further evidence is needed that the use of this tool improves diagnosis rates without an unacceptable increase in harm from unnecessary investigation.
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Mulrine S, Blell M, Murtagh M. Beyond trust: Amplifying unheard voices on concerns about harm resulting from health data-sharing. MEDICINE ACCESS @ POINT OF CARE 2021; 5:23992026211048421. [PMID: 36204496 PMCID: PMC9413596 DOI: 10.1177/23992026211048421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background: The point of care in many health systems is increasingly a point of health data generation, data which may be shared and used in a variety of ways by a range of different actors. Aim: We set out to gather data about the perspectives on health data-sharing of people living in North East England who have been underrepresented within other public engagement activities and who are marginalized in society. Methods: Multi-site ethnographic fieldwork was carried out in the Teesside region of England over a 6-month period in 2019 as part of a large-scale health data innovation program called Connected Health Cities. Organizations working with marginalized groups were contacted to recruit staff, volunteers, and beneficiaries for participation in qualitative research. The data gathered were analyzed thematically and vignettes constructed to illustrate findings. Results: Previous encounters with health and social care professionals and the broader socio-political contexts of people’s lives shape the perspectives of people from marginalized groups about sharing of data from their health records. While many would welcome improved care, the risks to people with socially produced vulnerabilities must be appreciated by those advocating systems that share data for personalized medicine or other forms of data-driven care. Conclusion: Forms of innovation in medicine which rely on greater data-sharing may present risks to groups and individuals with existing vulnerabilities, and advocates of these innovations should address the lack of trustworthiness of those receiving data before asking that people trust new systems to provide health benefits.
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Affiliation(s)
- Stephanie Mulrine
- Department of Social Work, Education & Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Mwenza Blell
- School of Geography, Politics, and Sociology, Newcastle University, Newcastle upon Tyne, UK
| | - Madeleine Murtagh
- School of Social & Political Sciences, University of Glasgow, Glasgow, UK
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Fernandes AG, Alves M, Nascimento RAE, Valdrighi NY, de Almeida RC, Nakano CT. Visual impairment and blindness in the Xingu Indigenous Park - Brazil. Int J Equity Health 2021; 20:197. [PMID: 34461895 PMCID: PMC8404365 DOI: 10.1186/s12939-021-01536-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/16/2021] [Indexed: 12/05/2022] Open
Abstract
Background Most estimates of visual impairment and blindness worldwide do not include data from specific minority groups as indigenous populations. We aimed to evaluate frequencies and causes of visual impairment and blindness in a large population sample from the Xingu Indigenous Park. Methods Cross-sectional study performed at Xingu Indigenous Park, Brazil, from 2016 to 2017. Residents from 16 selected villages were invited to participate and underwent a detailed ocular examination, including uncorrected (UVA) and best-corrected visual acuity (BCVA). The main cause of UVA < 20/32 per eye was determined. Results A total of 2,099 individuals were evaluated. Overall, the frequency of visual impairment and blindness was 10.00% (95% CI: 8.72–11.29%) when considering UVA, decreasing to 7.15% (95% CI: 6.04–8.25%) when considering BCVA. For each increasing year on age, the risk of being in the visually impaired or blind category increased by 9% (p < 0.001). Cataracts (39.1%) and uncorrected refractive errors (29.1%) were the most frequent causes of visual impairment and blindness in this population. The main causes among those aged 45 years and more were cataracts (54.5%) while refractive errors were the main cause in adults aged 18 to 45 years (50.0%) and children up to 18 years old (37.1%). Conclusions A higher frequency of visual impairment and blindness was observed in the indigenous population when compared to worldwide estimates with most of the causes being preventable and/or treatable. Blindness prevention programs should focus on accessibility to eye exam, cataract surgeries and eyeglass distribution.
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Affiliation(s)
- Arthur Gustavo Fernandes
- Associação Médicos da Floresta, Sao Paulo, Brazil. .,Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo - Paulista Medical School, Sao Paulo, Brazil.
| | - Monica Alves
- Associação Médicos da Floresta, Sao Paulo, Brazil.,Department of Ophthalmology and Otorhinolaryngology, University of Campinas, Campinas, Brazil
| | - Roberta Andrade E Nascimento
- Associação Médicos da Floresta, Sao Paulo, Brazil.,Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo - Paulista Medical School, Sao Paulo, Brazil
| | - Natalia Yumi Valdrighi
- Associação Médicos da Floresta, Sao Paulo, Brazil.,Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo - Paulista Medical School, Sao Paulo, Brazil
| | - Rafael Cunha de Almeida
- Associação Médicos da Floresta, Sao Paulo, Brazil.,Department of Ophthalmology, ABC Medical School, Santo Andre, Brazil
| | - Celso Takashi Nakano
- Associação Médicos da Floresta, Sao Paulo, Brazil.,Department of Ophthalmology, University of Sao Paulo, Sao Paulo, Brazil
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Bedtime Routine Characteristics and Activities in Families with Young Children in the North of England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178983. [PMID: 34501576 PMCID: PMC8431293 DOI: 10.3390/ijerph18178983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 11/18/2022]
Abstract
Bedtime routines have been shown to have significant associations with health, wellbeing and development outcomes for children and parents. Despite the importance of bedtime routines, most research has been carried out in the United States, with little information on bedtime routine characteristics and activities for families in other countries such as the United Kingdom and England in particular. Additionally, little is known about the possible effects of weekends vs. weekdays on the quality of bedtime routines. Finally, traditional, retrospective approaches have been most used in capturing data on bedtime routines, limiting our understanding of a dynamic and complex behaviour. The aim of this study was to explore bedtime routine characteristics and activities in families in the North of England with a real-time, dynamic data collection approach and to examine possible effects of weekend nights on the quality of bedtime routines. In total, 185 parents with children ages 3 to 7 years old provided data around their bedtime routine activities using an automated text-survey assessment over a 7-night period. Information on socio-economic and demographic characteristics were also gathered during recruitment. A small majority of parents managed to achieve all crucial elements of an optimal bedtime routine every night, with 53% reporting brushing their children’s teeth every night, 25% reading to their children every night and 30% consistently putting their children to bed at the same time each night. Results showed significant differences between weekend (especially Saturday) and weekday routines (F(1, 100) = 97.584, p < 0.001), with an additional effect for parental employment (F(1, 175) = 7.151, p < 0.05). Results highlight variability in bedtime routine activities and characteristics between families. Many families undertook, in a consistent manner, activities that are closely aligned with good practices and recommendations on what constitutes an optimal bedtime routine, while others struggled. Routines remained relatively stable during weekdays but showed signs of change over the weekend. Additional studies on mechanisms and elements affecting the formation, development and maintenance of bedtime routines are needed alongside studies on supporting and assisting families to achieve optimal routines.
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Stynes H, Lane C, Pearson B, Wright T, Ranieri V, Masic U, Kennedy E. Gender identity development in children and young people: A systematic review of longitudinal studies. Clin Child Psychol Psychiatry 2021; 26:706-719. [PMID: 33827265 DOI: 10.1177/13591045211002620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Children are presenting in greater numbers to gender clinics around the world. Prospective longitudinal research is important to better understand outcomes and trajectories for these children. This systematic review aims to identify, describe and critically evaluate longitudinal studies in the field. METHOD Five electronic databases were systematically searched from January 2000 to February 2020. Peer-reviewed articles assessing gender identity and psychosocial outcomes for children and young people (<18 years) with gender diverse identification were included. RESULTS Nine articles from seven longitudinal studies were identified. The majority were assessed as being of moderate quality. Four studies were undertaken in the Netherlands, two in North America and one in the UK. The majority of studies had small samples, with only two studies including more than 100 participants and attrition was moderate to high, due to participants lost to follow-up. Outcomes of interest focused predominantly on gender identity over time and emotional and behavioural functioning. CONCLUSIONS Larger scale and higher quality longitudinal research on gender identity development in children is needed. Some externally funded longitudinal studies are currently in progress internationally. Findings from these studies will enhance understanding of outcomes over time in relation to gender identity development in children and young people.
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Affiliation(s)
- Hannah Stynes
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Chloe Lane
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Beth Pearson
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Talen Wright
- Division of Psychiatry, University College London, UK
| | - Veronica Ranieri
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Una Masic
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Eilis Kennedy
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, UK
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