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Harrington MP, Satherley RM, John M, O'Donnell N, Read R, Wakelin K, Jones CJ. Reliability and validity of a parent-reported screening tool for disordered eating in children and young people with type 1 diabetes. Diabet Med 2024; 41:e15256. [PMID: 37925592 DOI: 10.1111/dme.15256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/08/2023] [Accepted: 11/01/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND There is a high prevalence and complex overlap between type 1 diabetes (T1D) and disordered eating. However, screening for disordered eating in children and young people (CYP) with T1D is not routinely conducted, with reluctance reported by both professionals and parents. This study aimed to validate a parent-reported version of a validated disordered eating screening tool for CYP with T1D (the Diabetes Eating Problems Survey-Revised; DEPS-R). METHODS The existing DEPS-R was adapted for parental use. Eighty-nine parents of CYP with T1D aged 11-14 years completed the parent-reported DEPS-R and other questionnaires related to demographics, child eating behaviours and parental well-being. CYP of parents were invited to participate, with 51 CYP completing the validated CYP-reported DEPS-R for comparison. RESULTS The parent-reported DEPS-R demonstrated good internal consistency (Cronbach's α = 0.89). Moderate to good inter-rater reliability was found between the parent-reported DEPS-R and CYP-reported DEPS-R (ICC 0.746, 95% CI = 0.554-0.855, p < 0.001), indicating good convergent validity. Construct validity with hypothesised variables, including specific eating behaviours, diabetes-related distress, well-being, CYP BMI, gender and parental worry about CYP disordered eating, suggested validity of the measure. However, some hypothesised variables did not significantly correlate with the parent-reported DEPS-R as expected. CONCLUSIONS The parent-reported DEPS-R has demonstrated good reliability and validity, and it may provide clinical benefit by increasing screening and early detection of disordered eating in CYP with T1D. Whilst novel and providing stepped increase in our knowledge, these findings would benefit from further validation (e.g. in a larger sample and responsiveness).
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Affiliation(s)
- Megan P Harrington
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Rose-Marie Satherley
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Mary John
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, UK
| | - Nicola O'Donnell
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Rebecca Read
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Katherine Wakelin
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
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2
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Jones CJ, Read R, O'Donnell N, Wakelin K, John M, Skene SS, Stewart R, Hale L, Cooke D, Kanumakala S, Satherley RM. PRIORITY Trial: Results from a feasibility randomised controlled trial of a psychoeducational intervention for parents to prevent disordered eating in children and young people with type 1 diabetes. Diabet Med 2024; 41:e15263. [PMID: 38100228 DOI: 10.1111/dme.15263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 03/16/2024]
Abstract
AIMS Children and young people (CYP) with type 1 diabetes (T1D) are at increased risk of disordered eating. This study aimed to determine the feasibility and acceptability of a novel, theoretically informed, two-session psychoeducational intervention for parents to prevent disordered eating in CYP with T1D. METHODS Parents of CYP aged 11-14 years with T1D were randomly allocated to the intervention or wait-list control group. Self-reported measures including the Diabetes Eating Problem Survey-Revised (DEPS-R), Problem Areas in Diabetes Parent Revised (PAID-PR), Child Eating Behaviour Questionnaire subscales (CEBQ), Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), clinical outcomes (e.g. HbA1c, BMI, medication and healthcare utilisation) and process variables, were collected at baseline, 1-and 3-month assessments. Acceptability data were collected from intervention participants via questionnaire. RESULTS Eighty-nine parents were recruited, which exceeded recruitment targets, with high intervention engagement and acceptability (<80% across domains). A signal of efficacy was observed across outcome measures with moderate improvements in the CEBQ subscale satiety responsiveness (d = 0.55, 95% CI 0.01, 1.08) and child's BMI (d = -0.56, 95% CI -1.09, 0.00) at 3 months compared with controls. Trends in the anticipated direction were also observed with reductions in disordered eating (DEPS-R) and diabetes distress (PAID-PR) and improvements in wellbeing (WEMWBS). CONCLUSIONS This is the first study to have co-designed and evaluated a novel parenting intervention to prevent disordered eating in CYP with T1D. The intervention proved feasible and acceptable with encouraging effects. Preparatory work is required prior to definitive trial to ensure the most relevant primary outcome measure and ensure strategies for optimum outcome completion.
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Affiliation(s)
- Christina J Jones
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Rebecca Read
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Nicola O'Donnell
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Katherine Wakelin
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Mary John
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
- Sussex Partnership NHS Foundation Trust, Research and Development Department, Sussex Education Centre, Hove, UK
| | - Simon S Skene
- Surrey Clinical Trials Unit, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Rose Stewart
- Betsi Cadwaladr University Health Board, Wrexham, UK
| | - Lucy Hale
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Debbie Cooke
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Shankar Kanumakala
- Royal Alexandra Children's Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Rose-Marie Satherley
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
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3
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Demidova A, Drewitz KP, Kimkool P, Banjanin N, Barzylovich V, Botjes E, Capper I, Castor MAR, Comberiati P, Cook EE, Costa J, Chu DK, Epstein MM, Galvin AD, Giovannini M, Girard F, Golding MA, Greenhawt M, Ierodiakonou D, Jones CJ, Khaleva E, Knibb RC, Macit-Çelebi MS, Mack DP, Mafra I, Marchisotto MJ, Mijakoski D, Nekliudov N, Özdemir C, Patel N, Pazukhina E, Protudjer JLP, Rodríguez Del Rio P, Roomet J, Sammut P, Schoos AMM, Schopfer AF, Schultz F, Seylanova N, Skypala I, Sørensen M, Stoleski S, Stylianou E, Upton J, van de Veen W, Genuneit J, Boyle RJ, Apfelbacher C, Munblit D. Core Outcome Set for IgE-mediated food allergy clinical trials and observational studies of interventions: International Delphi consensus study 'COMFA'. Allergy 2024; 79:977-989. [PMID: 38433402 DOI: 10.1111/all.16023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND IgE-mediated food allergy (FA) is a global health concern with substantial individual and societal implications. While diverse intervention strategies have been researched, inconsistencies in reported outcomes limit evaluations of FA treatments. To streamline evaluations and promote consistent reporting, the Core Outcome Measures for Food Allergy (COMFA) initiative aimed to establish a Core Outcome Set (COS) for FA clinical trials and observational studies of interventions. METHODS The project involved a review of published clinical trials, trial protocols and qualitative literature. Outcomes found as a result of review were categorized and classified, informing a two-round online-modified Delphi process followed by hybrid consensus meeting to finalize the COS. RESULTS The literature review, taxonomy mapping and iterative discussions with diverse COMFA group yielded an initial list of 39 outcomes. The iterative online and in-person meetings reduced the list to 13 outcomes for voting in the formal Delphi process. One more outcome was added based on participant suggestions after the first Delphi round. A total of 778 participants from 52 countries participated, with 442 participating in both Delphi rounds. No outcome met a priori criteria for inclusion, and one was excluded as a result of the Delphi. Thirteen outcomes were brought to the hybrid consensus meeting as a result of Delphi and two outcomes, 'allergic symptoms' and 'quality of life' achieved consensus for inclusion as 'core' outcomes. CONCLUSION In addition to the mandatory reporting of adverse events for FA clinical trials or observational studies of interventions, allergic symptoms and quality of life should be measured as core outcomes. Future work by COMFA will define how best to measure these core outcomes.
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Affiliation(s)
| | - Karl Philipp Drewitz
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Parisut Kimkool
- Department of Pediatric Allergy, Imperial College Healthcare NHS Trust, London, UK
| | - Nikolina Banjanin
- Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladyslava Barzylovich
- Department of Pediatrics, National Medical University named after O.O. Bogomolets, Kyiv, Ukraine
| | - Erna Botjes
- Dutch Food Allergy SVA, Nijkerk, The Netherlands
| | | | - Mary Anne R Castor
- Division of Allergy and Immunology, Department of Pediatrics, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Emma E Cook
- Modern Japanese Studies Program, Graduate School of Media and Communication, Hokkaido University, Sapporo, Japan
| | - Joana Costa
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Derek K Chu
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Michelle M Epstein
- Experimental Allergy Laboratory, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Michael A Golding
- The Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Matthew Greenhawt
- Department of Pediatrics, Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Despo Ierodiakonou
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | | | - Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rebecca C Knibb
- School of Psychology, Aston Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | | | - Douglas P Mack
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Isabel Mafra
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | | | - Dragan Mijakoski
- Department for Allergic Diseases, Institute of Occupational Health of R.N. Macedonia, WHO Collaborating Center, Skopje, North Macedonia
- Department of Occupational Medicine, Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Nikita Nekliudov
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Cevdet Özdemir
- Department of Pediatric Basic Sciences, Institute of Child Health, Istanbul University, Istanbul, Turkey
| | - Nandinee Patel
- Department of Pediatric Allergy, Imperial College Healthcare NHS Trust, London, UK
| | | | - Jennifer L P Protudjer
- The Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Jelena Roomet
- Centre for Allergology and Immunology, East Tallinn Central Hospital, Tallinn, Estonia
| | - Patrick Sammut
- Department of Paediatrics, Mater Dei Hospital, Msida, Malta
| | - Ann-Marie Malby Schoos
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital-Herlev and Gentofte, Gentofte, Denmark
- Department of Pediatrics, Slagelse Sygehus, Slagelse, Denmark
| | | | - Fallon Schultz
- International FPIES Association (IFPIES), Point Pleasant Beach, New Jersey, USA
| | | | - Isabel Skypala
- Department of Inflammation and Repair, Imperial College London, London, UK
| | - Martin Sørensen
- Regional center for asthma, allergy and hypersensitivity, University Hospital of North Norway, Tromsø, Norway
| | - Sasho Stoleski
- Department for Allergic Diseases, Institute of Occupational Health of R.N. Macedonia, WHO Collaborating Center, Skopje, North Macedonia
- Department of Occupational Medicine, Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Eva Stylianou
- Department of Pulmonary Medicine, Regional Centre for Asthma, Allergy and Hypersensitivity, Oslo University Hospital, Oslo, Norway
| | - Julia Upton
- The Hospital for Sick Children, Divison of Immunology and Allergy, Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Robert J Boyle
- Department of Pediatric Allergy, Imperial College Healthcare NHS Trust, London, UK
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Daniel Munblit
- Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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4
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Knibb RC, Jones CJ, Herbert LJ, Screti C. Psychological support needs for children with food allergy and their families: A systematic review. Pediatr Allergy Immunol 2024; 35:e14108. [PMID: 38528707 DOI: 10.1111/pai.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 03/27/2024]
Abstract
This systematic review aimed to review the evidence for psychological support for children with food allergies and their families, identify effective psychological interventions, and highlight the support needs for this group. A systematic search was undertaken across six databases (up to October 2023). Articles were checked by three reviewers for inclusion. Study data were extracted, and quality was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was undertaken. A total of 11 papers were included (n = 838 participants). Intervention types were based on cognitive behavioral therapy (CBT; n = 7); psycho-education (n = 1); peer mentoring (n = 1); self-regulation theory (n = 1); and coping (n = 1). Two interventions were for children only, three were for children and parents and six for parents only. Cognitive behavioral therapy-based interventions with highly anxious parents or children or those facilitated by a psychologist showed significant improvements with moderate-to-large effect sizes. The one self-help CBT-based online program showed no effects. Other intervention types reported mainly trends in improvement due to small sample sizes. Most interventions were aimed at supporting children or parents in day-to-day management of food allergy, measuring outcomes such as quality of life, self-efficacy, anxiety, worry, and depression. One intervention was designed to assist with oral immunotherapy outcomes. The majority of the studies had small sample sizes and were feasibility or proof-of-concept studies. Available research evidence points to effectiveness of facilitated CBT-based interventions for those that have high food allergy-related anxiety, but as many studies have small sample sizes and few report effect sizes, no firm conclusions can yet be drawn. A stepped care approach is likely to be useful for this population. Research using large interventional designs, particularly for children and adolescents, are needed.
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Affiliation(s)
- Rebecca C Knibb
- School of Psychology, College Health and Life Sciences, Aston University, Birmingham, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Linda J Herbert
- Division of Psychology & Behavorial Health, Children's National Hospital, Washington, District of Columbia, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Cassandra Screti
- School of Psychology, College Health and Life Sciences, Aston University, Birmingham, UK
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5
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Seylanova N, Chernyavskaya A, Degtyareva N, Mursalova A, Ajam A, Xiao L, Aktulaeva K, Roshchin P, Bobkova P, Aiyegbusi OL, Anbu AT, Apfelbacher C, Asadi-Pooya AA, Ashkenazi-Hoffnung L, Brackel C, Buonsenso D, de Groote W, Diaz JV, Dona D, Dunn Galvin A, Genuneit J, Goss H, Hughes SE, Jones CJ, Kuppalli K, Malone LA, McFarland S, Needham DM, Nekliudov N, Nicholson TR, Oliveira CR, Schiess N, Segal TY, Sigfrid L, Thorne C, Vijverberg S, Warner JO, Were WM, Williamson PR, Munblit D. Core outcome measurement set for research and clinical practice in post-COVID-19 condition (long COVID) in children and young people: an international Delphi consensus study "PC-COS Children". Eur Respir J 2024; 63:2301761. [PMID: 38359962 PMCID: PMC10938351 DOI: 10.1183/13993003.01761-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/04/2023] [Indexed: 02/17/2024]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic substantially impacted different age groups, with children and young people not exempted. Many have experienced enduring health consequences. Presently, there is no consensus on the health outcomes to assess in children and young people with post-COVID-19 condition. Furthermore, it is unclear which measurement instruments are appropriate for use in research and clinical management of children and young people with post-COVID-19. To address these unmet needs, we conducted a consensus study, aiming to develop a core outcome set (COS) and an associated core outcome measurement set (COMS) for evaluating post-COVID-19 condition in children and young people. Our methodology comprised of two phases. In phase 1 (to create a COS), we performed an extensive literature review and categorisation of outcomes, and prioritised those outcomes in a two-round online modified Delphi process followed by a consensus meeting. In phase 2 (to create the COMS), we performed another modified Delphi consensus process to evaluate measurement instruments for previously defined core outcomes from phase 1, followed by an online consensus workshop to finalise recommendations regarding the most appropriate instruments for each core outcome. In phase 1, 214 participants from 37 countries participated, with 154 (72%) contributing to both Delphi rounds. The subsequent online consensus meeting resulted in a final COS which encompassed seven critical outcomes: fatigue; post-exertion symptoms; work/occupational and study changes; as well as functional changes, symptoms, and conditions relating to cardiovascular, neuro-cognitive, gastrointestinal and physical outcomes. In phase 2, 11 international experts were involved in a modified Delphi process, selecting measurement instruments for a subsequent online consensus workshop where 30 voting participants discussed and independently scored the selected instruments. As a result of this consensus process, four instruments met a priori consensus criteria for inclusion: PedsQL multidimensional fatigue scale for "fatigue"; PedsQL gastrointestinal symptom scales for "gastrointestinal"; PedsQL cognitive functioning scale for "neurocognitive" and EQ-5D for "physical functioning". Despite proposing outcome measurement instruments for the remaining three core outcomes ("cardiovascular", "post-exertional malaise", "work/occupational and study changes"), a consensus was not achieved. Our international, consensus-based initiative presents a robust framework for evaluating post-COVID-19 condition in children and young people in research and clinical practice via a rigorously defined COS and associated COMS. It will aid in the uniform measurement and reporting of relevant health outcomes worldwide.
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Affiliation(s)
- Nina Seylanova
- Independent researcher, London, UK
- Authors contributed equally to the study; apart from the two joint first authors, who contributed equally, the primary study team members and the last author, authors are listed in alphabetical order
| | - Anastasia Chernyavskaya
- Department of Paediatrics and Paediatric Rheumatology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- National Medical Research Center for Children's Health, Moscow, Russia
- Authors contributed equally to the study; apart from the two joint first authors, who contributed equally, the primary study team members and the last author, authors are listed in alphabetical order
| | - Natalia Degtyareva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | - Ali Ajam
- University of Birmingham, Birmingham, UK
| | - Lin Xiao
- University of Birmingham, Birmingham, UK
| | | | | | | | | | | | | | - Ali Akbar Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Caroline Brackel
- Department of Paediatric Pulmonology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands
| | - Danilo Buonsenso
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Janet V Diaz
- Department for Women's and Children's Health, University of Padua, Padua, Italy
| | - Daniele Dona
- Department for Women's and Children's Health, University of Padua, Padua, Italy
| | | | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | | | - Sarah E Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Krutika Kuppalli
- Department for Women's and Children's Health, University of Padua, Padua, Italy
| | - Laura A Malone
- Kennedy Krieger Institute, Baltimore, MD, USA
- Departments of Neurology and Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| | - Sammie McFarland
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, USA
- Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nikita Nekliudov
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Timothy R Nicholson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carlos R Oliveira
- Yale University School of Medicine, Department of Pediatrics, Section of Infectious Diseases, New Haven, CT, USA
- Yale University School of Public Health, Department of Biostatistics, Division of Health Informatics, New Haven, CT, USA
- Yale New Haven Children's Hospital, New Haven, CT, USA
| | - Nicoline Schiess
- Brain Health Unit, Mental Health and Substance Use Department, World Health Organization, Geneva, Switzerland
| | - Terry Y Segal
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Louise Sigfrid
- ISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Claire Thorne
- Population, Policy and Practice Research and Teaching Dept, University College London GOS Institute of Child Health, London, UK
| | | | | | - Wilson Milton Were
- Department for Women's and Children's Health, University of Padua, Padua, Italy
| | - Paula R Williamson
- MRC-NIHR Trials Methodology Research Partnership, Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Daniel Munblit
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Division of Care in Long Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
- Research and Clinical Center for Neuropsychiatry, Moscow, Russia
- Authors contributed equally to the study; apart from the two joint first authors, who contributed equally, the primary study team members and the last author, authors are listed in alphabetical order
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6
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Protudjer JLP, Brough H, Jones CJ, Marchisotto MJ, Herbert LJ, Roleston C, Knibb RC. Patient-reported outcomes in food allergy: Speaking the same language to address some of the GAPS. Clin Exp Allergy 2024. [PMID: 38351856 DOI: 10.1111/cea.14463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/17/2024] [Accepted: 02/02/2024] [Indexed: 03/16/2024]
Affiliation(s)
- Jennifer L P Protudjer
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- The Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Department of Foods and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helen Brough
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Surrey, UK
| | | | - Linda J Herbert
- Divison of Psychology & Behavioral Health, Children's National Hospital, Washington, DC, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA
| | - Caity Roleston
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rebecca C Knibb
- Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
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Santos AF, Riggioni C, Agache I, Akdis CA, Akdis M, Alvarez-Perea A, Alvaro-Lozano M, Ballmer-Weber B, Barni S, Beyer K, Bindslev-Jensen C, Brough HA, Buyuktiryaki B, Chu D, Del Giacco S, Dunn-Galvin A, Eberlein B, Ebisawa M, Eigenmann P, Eiwegger T, Feeney M, Fernandez-Rivas M, Fisher HR, Fleischer DM, Giovannini M, Gray C, Hoffmann-Sommergruber K, Halken S, Hourihane JO, Jones CJ, Jutel M, Knol E, Konstantinou GN, Lack G, Lau S, Marques Mejias A, Marchisotto MJ, Meyer R, Mortz CG, Moya B, Muraro A, Nilsson C, Lopes de Oliveira LC, O'Mahony L, Papadopoulos NG, Perrett K, Peters RL, Podesta M, Poulsen LK, Roberts G, Sampson HA, Schwarze J, Smith P, Tham EH, Untersmayr E, Van Ree R, Venter C, Vickery BP, Vlieg-Boerstra B, Werfel T, Worm M, Du Toit G, Skypala I. EAACI guidelines on the diagnosis of IgE-mediated food allergy. Allergy 2023; 78:3057-3076. [PMID: 37815205 DOI: 10.1111/all.15902] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 10/11/2023]
Abstract
This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy-focused clinical history followed by tests to determine IgE sensitization, such as serum allergen-specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen-sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance.
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Affiliation(s)
- Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Carmen Riggioni
- Department of Allergy and Clinical Immunology, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
| | - Mubeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
| | - Alberto Alvarez-Perea
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Montserrat Alvaro-Lozano
- Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Barbara Ballmer-Weber
- Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Simona Barni
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Kirsten Beyer
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Helen A Brough
- Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Betul Buyuktiryaki
- Division of Pediatric Allergy, Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey
| | - Derek Chu
- McMaster University, Ontario, Hamilton, Canada
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
| | - Audrey Dunn-Galvin
- Paediatrics and Child Health, INFANT Centre, HRB-CRF, University College Cork, Cork, Ireland
- Paediatrics and Child Health, Royal College of Surgeons in Ireland, Children's Health Ireland, Dublin, Ireland
| | - Bernadette Eberlein
- Department of Dermatology and Allergy Biederstein, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Philippe Eigenmann
- Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Thomas Eiwegger
- Translational Medicine Program, Research Institute, Hospital for Sick Children, Ontario, Toronto, Canada
- Department of Immunology, Temerty Faculty of Medicine, University of Toronto, Ontario, Toronto, Canada
- Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
- Department of Pediatric and Adolescent Medicine, University Hospital St. Pölten, St.Pölten, Austria
| | - Mary Feeney
- Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
| | - Montserrat Fernandez-Rivas
- Allergy Department, Hospital Clinico San Carlos, Madrid, Spain
- Facultad de Medicina, IdISSC, ARADyAL, Universidad Complutense, Madrid, Spain
| | - Helen R Fisher
- Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
| | - David M Fleischer
- Children's Hospital Colorado, University of Colorado School of Medicine, Colorado, Aurora, USA
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Claudia Gray
- Red Cross Children's Hospital and Kidsallergy Centre, Cape Town, South Africa
- Department of Paediatrics, University of Cape Town, Cape Town, South Africa
| | - Karin Hoffmann-Sommergruber
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Susanne Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | | | - Christina J Jones
- Faculty of Medical Sciences, School of Psychology, University of Surrey, Surrey, UK
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, ALL-MED Medical Research Institute, Wroclaw, Poland
| | - Edward Knol
- Department of Dermatology/Allergology, Center of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - George N Konstantinou
- Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, Thessaloniki, Greece
| | - Gideon Lack
- Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Susanne Lau
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andreina Marques Mejias
- Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | | | - Rosan Meyer
- Department of Medicine, Imperial College, London, UK
- Department of Nutrition and Dietetics, Winchester University, Winchester, UK
- Department of Medicine, KU Leuven, Leuven, Belgium
| | - Charlotte G Mortz
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Beatriz Moya
- Department of Allergy, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Sanitaria, Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Antonella Muraro
- Food Allergy Referral Centre, Padua University Hospital, Padua, Italy
| | - Caroline Nilsson
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
- Sachs Children and Youth Hospital, South Hospital, Stockholm, Sweden
| | | | - Liam O'Mahony
- Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
- Lydia Becker Institute, University of Manchester, Manchester, UK
| | - Kirsten Perrett
- Department of Paediatrics, University of Melbourne, Victoria, Parkville, Australia
- Department of Allergy and Immunology, Royal Children's Hospital, Victoria, Parkville, Australia
- Population Allergy Research Group, Murdoch Children's Research Institute, Victoria, Parkville, Australia
| | - Rachel L Peters
- Department of Paediatrics, University of Melbourne, Victoria, Parkville, Australia
- Department of Allergy and Immunology, Royal Children's Hospital, Victoria, Parkville, Australia
- Population Allergy Research Group, Murdoch Children's Research Institute, Victoria, Parkville, Australia
| | - Marcia Podesta
- EFA - European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Lars K Poulsen
- Allergy Clinic, Copenhagen University Hospital at Herlev-Gentofte, Copenhagen, Denmark
| | - Graham Roberts
- Department of Paediatric Allergy and Respiratory Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, Southampton, UK
- David Hide Asthma and Allergy Centre, St Mary Hospital, Isle of Wight, UK
| | - Hugh A Sampson
- Division of Allergy and Immunology, Department of Pediatrics, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Jürgen Schwarze
- Child Life and Health, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Peter Smith
- Clinical Medicine, Griffith University, Queensland, Southport, Australia
- Queensland Allergy Services Private Practice, Queensland, Southport, Australia
| | - Elizabeth Huiwen Tham
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Ronald Van Ree
- Departments of Experimental Immunology and of Otorhinolaryngoloy, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Carina Venter
- Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado, Colorado, Aurora, USA
| | - Brian P Vickery
- Emory University School of Medicine and Children's Healthcare of Atlanta, Georgia, Atlanta, USA
| | - Berber Vlieg-Boerstra
- Department of Paediatrics, OLVG Hospital, Amsterdam, the Netherlands
- Rijnstate Allergy Centre, Rijnstate Hospital, Arnhem, The Netherlands
- Vlieg Dieticians, Private Practice for Dietary Management of Food Allergy, Arnhem, The Netherlands
| | - Thomas Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Margitta Worm
- Division of Allergy and immunology, Department of Dermatology, Venerology and Allergology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - George Du Toit
- Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Isabel Skypala
- Royal Brompton & Harefield Hospitals, Part of Guys & St Thomas NHS Foundation Trust, London, UK
- Department of Inflammation and Repair, Imperial College, London, UK
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Read RK, Mason OJ, Jones CJ. A randomised controlled trial (RCT) exploring the impact of a photography intervention on wellbeing and posttraumatic growth during the COVID-19 pandemic. Arts Health 2023; 15:275-291. [PMID: 35918101 DOI: 10.1080/17533015.2022.2107033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 07/22/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Emerging evidence points to rising levels of psychological distress resulting from the COVID-19 pandemic. There is a need for self-administered, low-cost, and accessible interventions that facilitate wellbeing and growth. METHODS This study used a randomised controlled trial (RCT) design to investigate the effects of a two-week positivity-oriented photography intervention on wellbeing and posttraumatic growth in comparison to a control group. Participants were adults between the ages of 21 and 80 living in the UK recruited between May and August 2020 (n = 109). RESULTS After adjusting for baseline wellbeing, both wellbeing and PTG were significantly higher in the intervention group compared to the control group following intervention completion, with this effect remaining similar at one-month follow-up. CONCLUSIONS The study offers preliminary evidence that a brief self-administered photography intervention could hold therapeutic value.
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Affiliation(s)
- Rebecca K Read
- School of Psychology, University of Surrey, Guildford, UK
| | - Oliver J Mason
- School of Psychology, University of Surrey, Guildford, UK
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Nyikavaranda P, Pantelic M, Jones CJ, Paudyal P, Tunks A, Llewellyn CD. Barriers and facilitators to seeking and accessing mental health support in primary care and the community among female migrants in Europe: a "feminisms" systematic review. Int J Equity Health 2023; 22:196. [PMID: 37752502 PMCID: PMC10523615 DOI: 10.1186/s12939-023-01990-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/14/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Recent years have seen record levels of migration to Europe. Female migrants are at heightened risk of developing mental health disorders, yet they face barriers to accessing mental health services in their host countries. This systematic review aims to summarise the barriers and facilitators to accessing mental health support for female migrants in Europe. METHODS The review follows PRISMA guidelines, and the protocol was pre-published on PROSPERO. Six electronic databases were searched: CINAHL, Global Health Database, Medline, PsycARTICLES, PsycINFO and Web of Science. Thematic analysis was undertaken on the identified studies. A feminist quality appraisal tool was applied. RESULTS Eight qualitative, six quantitative and five mixed methods studies were identified. Barriers included a lack of information, stigma, religious and cultural practices and beliefs, and a lack of consideration of gender-specific needs within the health system. Gender-sensitive services, supportive general practitioners and religious leaders facilitated access. CONCLUSIONS The design of mental health research, services, policies, and commissioning of support for migrants must consider female migrant needs. Mental health support services must be culturally aware and gender sensitive. REGISTRATION The review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO, registration number CRD42021235571.
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Affiliation(s)
- Patrick Nyikavaranda
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK.
| | - Marija Pantelic
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, Surrey, UK
| | - Priyamvada Paudyal
- Institute for Global Health and Wellbeing School of Medicine, Keele University, Keele, Staffordshire, ST5 5GB, UK
| | - Alice Tunks
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
| | - Carrie D Llewellyn
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
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Zinser J, O’Donnell N, Hale L, Jones CJ. Multi-family therapy for eating disorders across the lifespan: A systematic review and meta-analysis. Eur Eat Disord Rev 2022; 30:723-745. [PMID: 35730146 PMCID: PMC9796154 DOI: 10.1002/erv.2919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/30/2022] [Accepted: 04/21/2022] [Indexed: 01/01/2023]
Abstract
Eating disorders (EDs) have an estimated prevalence rate of 1%-5% across Europe. Effective adjunct interventions are needed to support the 20%-40% of families whose recovery requires additional support to first line approaches. This systematic review and meta-analysis aimed to establish whether multi-family therapy (MFT) improves the physical and psychological health of patients and family members. Searches were conducted in PsycINFO, MEDLINE, PubMed, EMBASE, CINAHL, and the Cochrane Library in March 2021. 15 studies (850 patients) met the inclusion criteria. Meta-analysis demonstrated MFT resulted in significant benefits in weight gain, ED symptoms, patients' and parents' depression symptoms, and parents' negative experiences of caregiving. However, significant improvements were only evident when comparisons were drawn before and after the intervention; these dissipated when MFT was compared to another intervention. There was no evidence MFT improves family functioning, positive aspects of caregiving, nor patient and parental anxiety. Intervention completion rates ranged from 86% to 100% indicating a high level of acceptability. Studies varied with regard to intervention length and structure, follow-up period, and outcome measures utilised; most were rated as moderate or weak in methodological quality. More rigorous and large scale randomised controlled trials are needed to fully assess the effectiveness of MFT.
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Affiliation(s)
| | | | - Lucy Hale
- School of PsychologyUniversity of SurreyGuildfordUK
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11
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Jones CJ, Paudyal P, West RM, Mansur AH, Jay N, Makwana N, Baker S, Krishna MT. Burden of allergic disease among ethnic minority groups in high-income countries. Clin Exp Allergy 2022; 52:604-615. [PMID: 35306712 PMCID: PMC9324921 DOI: 10.1111/cea.14131] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 12/19/2022]
Abstract
The COVID‐19 pandemic raised acute awareness regarding inequities and inequalities and poor clinical outcomes amongst ethnic minority groups. Studies carried out in North America, the UK and Australia have shown a relatively high burden of asthma and allergies amongst ethnic minority groups. The precise reasons underpinning the high disease burden are not well understood, but it is likely that this involves complex gene–environment interaction, behavioural and cultural elements. Poor clinical outcomes have been related to multiple factors including access to health care, engagement with healthcare professionals and concordance with advice which are affected by deprivation, literacy, cultural norms and health beliefs. It is unclear at present if allergic conditions are intrinsically more severe amongst patients from ethnic minority groups. Most evidence shaping our understanding of disease pathogenesis and clinical management is biased towards data generated from white population resident in high‐income countries. In conjunction with standards of care, it is prudent that a multi‐pronged approach towards provision of composite, culturally tailored, supportive interventions targeting demographic variables at the individual level is needed, but this requires further research and validation. In this narrative review, we provide an overview of epidemiology, sensitization patterns, poor clinical outcomes and possible factors underpinning these observations and highlight priority areas for research.
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Affiliation(s)
- Christina J Jones
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK
| | - Priyamvada Paudyal
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, Brighton, UK
| | - Robert M West
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Adel H Mansur
- Birmingham Regional Severe Asthma Service, University Hospitals Birmingham NHS Foundation Trust, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Nicola Jay
- Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Nick Makwana
- Department of Child Health, Sandwell and West Birmingham Hospitals, Birmingham, UK
| | | | - Mamidipudi T Krishna
- Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
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Jones CJ, O'Donnell N, John M, Cooke D, Stewart R, Hale L, Skene SS, Kanumakala S, Harrington M, Satherley RM. PaRent InterventiOn to pRevent dIsordered eating in children with TYpe 1 diabetes (PRIORITY): Study protocol for a feasibility randomised controlled trial. Diabet Med 2022; 39:e14738. [PMID: 34741779 DOI: 10.1111/dme.14738] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
AIMS Increasing evidence suggests that children and young people with type 1 diabetes (T1D) are at greater risk of disordered eating compared to children without T1D. Disordered eating in T1D has been linked to impaired wellbeing, increased health service use and early mortality. To address this problem, we will co-develop a psycho-education intervention for parents of children and young people with T1D, informed by the Information Motivation Behavioural Skills model. METHODS The objective of this study is to assess the feasibility and acceptability of the intervention compared to a waitlist control group using a feasibility randomised controlled trial (RCT) design. We aim to recruit 70 parents of children and young people with T1D (11-14 years), 35 in each arm. Those assigned to the intervention will be invited to participate in two workshops of 2 h each. Parents will be asked to complete outcome measures regarding eating habits, diabetes management, as well as a questionnaire based on the Information Motivation Behavioural Skills model which provides a theoretical foundation for the intervention. These will be completed at baseline, 1- and 3-month post-intervention. Children and young people will be asked to complete questionnaires on their eating behaviours at the same time intervals. Parents randomised to receive the intervention will be invited to take part in interviews to feedback on the intervention and research protocol acceptability. CONCLUSION It is anticipated that the psycho-education intervention aimed at parents will help prevent the development of disordered eating in children and young people with T1D and improve parental wellbeing. The results of this feasibility trial will determine whether this intervention approach is acceptable to families living with T1D, and whether a definitive RCT of intervention effectiveness is justified. Qualitative findings will be used to refine the intervention and study protocols. TRIAL REGISTRATION This protocol has been registered with ClinicalTrials.gov [Identifier: NCT04741568].
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Affiliation(s)
| | | | - Mary John
- School of Psychology, University of Surrey, Guildford, UK
- Sussex Partnership NHS Foundation Trust, Research and Development Department, Sussex Education Centre, Hove, UK
| | - Debbie Cooke
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Rose Stewart
- Betsi Cadwaladr University Health Board, Wrexham, Wales, UK
| | - Lucy Hale
- School of Psychology, University of Surrey, Guildford, UK
| | - Simon S Skene
- Surrey Clinical Trials Unit, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Shankar Kanumakala
- Royal Alexandra Children's Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
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O’Donnell NR, Satherley RM, John M, Cooke D, Hale LS, Stewart R, Jones CJ. Development and Theoretical Underpinnings of the PRIORITY Intervention: A Parenting Intervention to Prevent Disordered Eating in Children and Young People With Type 1 Diabetes. Front Clin Diabetes Healthc 2022; 3:822233. [PMID: 36992722 PMCID: PMC10012129 DOI: 10.3389/fcdhc.2022.822233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022]
Abstract
Children and young people (CYP) with type 1 diabetes (T1D) are twice as likely to develop disordered eating (T1DE) and clinical eating disorders than those without. This has significant implications for physical and mental health, with some eating disorders associated with repeated diabetic ketoacidosis and higher HbA1c levels, both of which are life threatening. There is currently limited psychological support for CYP and families with T1D but increasingly, policy and practice are suggesting disordered eating in T1D may be effectively prevented through psychological intervention. We describe the development and theoretical underpinnings of a preventative psychological intervention for parents of CYP aged 11-14, with T1D. The intervention was informed by psychological theory, notably the Information Motivation Behaviour Skills model and Behaviour Change Technique Taxonomy. The intervention was co-developed with an expert advisory group of clinicians, and families with T1D. The manualised intervention includes two online group workshops, and supplementary online materials. The intervention continues to evolve, and feasibility findings will inform how best to align the intervention with routine care in NHS diabetes teams. Early detection and intervention are crucial in preventing T1DE, and it is hoped that the current intervention can contribute to improving the psychological and physical wellbeing of young people and families managing T1D.
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Affiliation(s)
| | | | - Mary John
- School of Psychology, University of Surrey, Guildford, United Kingdom
- Research and Development Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Brighton & Hove, United Kingdom
| | - Debbie Cooke
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Lucy S. Hale
- School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Rose Stewart
- Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham, United Kingdom
| | - Christina J. Jones
- School of Psychology, University of Surrey, Guildford, United Kingdom
- *Correspondence: Christina J. Jones,
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Sugunasingha N, Jones FW, du Toit G, Jones CJ. Evaluating an online self-help intervention for parents of children with food allergies. Pediatr Allergy Immunol 2022; 33:e13731. [PMID: 35212055 PMCID: PMC9306710 DOI: 10.1111/pai.13731] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/12/2021] [Accepted: 01/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parents of children with food allergies (CwFA) experience reduced quality of life (QoL) and may have reduced access to in-person interventions in the COVID-19 pandemic. This trial developed and evaluated an online, self-help, information provision website, aimed at improving QoL in parents of CwFA. METHODS In a single-blinded, randomised controlled trial (RCT), participants were randomised to either receive access to the website or a waiting-list control. At baseline, post-intervention (week 4) and follow-up (week 8), measures of parental food allergy-related QoL, depression, anxiety, stress, intolerance of uncertainty (IU) and self-efficacy were obtained. RESULTS A total of 205 participants were randomised; 97% were females, 91% white and 78% educated ≥ degree level, with a mean age of 38.95 years (SD = 6.89). 44.9% (n = 92) were retained at follow-up. The arms did not significantly differ on any outcome at any time point. For a sub-group of participants above the clinical cut-off for depression at baseline, the intervention may have improved QoL. Participants reported the website content as useful and accessible, but accessed it infrequently. In baseline data, IU and self-efficacy were significantly associated with QoL. CONCLUSION While the COVID-19 pandemic has encouraged greater provision of online interventions, our RCT suggests this particular website is not suitable for this population in general, although future research could examine its efficacy for depressed parents of CwFA, to increase confidence that the sub-group finding was not a Type 1 error. The baseline data suggest IU and self-efficacy remain potential proximal targets for intervention.
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Affiliation(s)
- Naomi Sugunasingha
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, UK
| | - Fergal W Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, UK
| | - George du Toit
- Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
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15
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Midtbo K, Jones CJ, Kapasa M, Vwalika B, Rabe H. Barriers to implementation of placental transfusion of babies at birth in Zambia. Afr J Reprod Health 2022; 26:58-67. [PMID: 37584997 DOI: 10.29063/ajrh2022/v26i2.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Delayed cord clamping (DCC) and umbilical cord milking (CM) have many benefits. However, a previous study done in Zambia showed that it was not a common practice among midwives. This study investigated possible barriers to DCC and CM, at the University Teaching Hospital in Lusaka. This was a qualitative study. A convenience sample was chosen, and snowball sampling was used. The midwives were interviewed using semi-structured interviews. Burnard's method of thematic content analysis was used. Through 14 interviews it became clear that the midwives were aware of DCC and used it whenever possible. The participants reported that the main barriers were the high workload and a variation in knowledge. A lack of facilities, such as heaters and resuscitation equipment in the delivery room also led to earlier cord clamping. The midwives were motivated to continue improving the routines. They expressed a need for more training as well as equipment and resources to facilitate DCC.
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Affiliation(s)
- K Midtbo
- Brighton and Sussex Medical School, University of Sussex, UK
| | - C J Jones
- School of Psychology, University of Surrey, UK
| | - M Kapasa
- University Teaching Hospital, Lusaka, Zambia
| | - B Vwalika
- University of Zambia Medical School, Lusaka, Zambia
| | - H Rabe
- Brighton and Sussex Medical School, University of Sussex, UK
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16
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Wiehn E, Ricci C, Alvarez‐Perea A, Perkin MR, Jones CJ, Akdis C, Bousquet J, Eigenmann P, Grattan C, Apfelbacher CJ, Genuneit J. Adherence to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist in articles published in EAACI Journals: A bibliographic study. Allergy 2021; 76:3581-3588. [PMID: 34022062 DOI: 10.1111/all.14951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 01/09/2023]
Abstract
Research data derived from observational studies are accumulating quickly in the field of allergy and immunology and a large amount of observational studies are published every year. The aim of the present study was to evaluate the adherence to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist by papers published in the three European Academy of Allergy and Clinical Immunology journals, during the period 2009-2018. To this end, we conducted a bibliographic study of up to eight randomly selected papers per year per Journal. Our literature search resulted in 223 papers. Amongst those, 80, 80 and 63 records were from Paediatric Allergy and Immunology, Allergy and Clinical and Translational Allergy, respectively; the latter was published only from 2011 on. Prospective, case control and cross-sectional designs were described in 88, 43 and 92 papers, respectively. Full reporting of all STROBE items was present in 47.4%, 45.6% and 41.2% for the cohort, cross-sectional and case-control studies, respectively. Generally, no time trend in adherence of reporting STROBE items was observed, apart from reporting funding, which increased from 60% in 2009/2010 to more than 90% in 2018. We identified a cluster of STROBE items with low proportions of full reporting constituted by the items on reporting study design in the title and methods, variables types along with their measurement/assessment, bias and confounding, study size, and grouping of variables. It appears that the STROBE checklist is a suitable tool in observational allergy epidemiology. However, adherence to the STROBE checklist appeared suboptimal.
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Affiliation(s)
- Elena Wiehn
- Institute of Epidemiology and Medical Biometry Ulm University Ulm Germany
| | - Cristian Ricci
- Pediatric Epidemiology Department of Pediatrics Medical Faculty, Leipzig University Leipzig Germany
| | | | - Michael R. Perkin
- Population Health Research Institute St George's University of London London UK
| | - Christina J. Jones
- Faculty of Health & Medical Sciences School of Psychology University of Surrey Guildford UK
| | - Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research University of Zurich Davos Switzerland
| | | | | | - Clive Grattan
- St John's Institute of DermatologyGuy's Hospital London UK
| | - Christian J. Apfelbacher
- Institute of Epidemiology and Preventive Medicine University of Regensburg Regensburg Germany
- Institute of Social Medicine and Health Systems Research Otto von Guericke University Magdeburg Magdeburg Germany
| | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry Ulm University Ulm Germany
- Pediatric Epidemiology Department of Pediatrics Medical Faculty, Leipzig University Leipzig Germany
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17
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Jones CJ, Mabbitt J, Kissling E, Gilchrist K, Scanlon T, Thomas G, Wooler E, McFarlane R, Mukhopadhyay S. Measuring the proportion of and reasons for asthma-related school absence in England. Clin Exp Allergy 2021; 50:752-755. [PMID: 32080928 DOI: 10.1111/cea.13589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 02/12/2020] [Accepted: 02/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Christina J Jones
- Faculty of Health & Medical Sciences, School of Psychology, University of Surrey, Guildford, UK
| | | | | | | | - Thomas Scanlon
- Department of Public Health & Primary Care, Brighton & Sussex Medical School, Brighton, UK
| | | | - Edwina Wooler
- Brighton & Sussex University Hospitals NHS Trust, Brighton, UK
| | - Renske McFarlane
- Academic Department of Paediatrics, Brighton & Sussex Medical School, Royal Alexandra Children's Hospital, Brighton, UK
| | - Somnath Mukhopadhyay
- Brighton & Sussex University Hospitals NHS Trust, Brighton, UK.,Academic Department of Paediatrics, Brighton & Sussex Medical School, Royal Alexandra Children's Hospital, Brighton, UK
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18
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Abstract
Difficulties associated with Autism Spectrum Disorders can cause considerable impact on personal, familial, social, educational and occupational functioning. Living with a child who has an Autism Spectrum Disorder can therefore pose a challenge to family members, including typically developing siblings. However, it is only in recent years that the experience of typically developing siblings has become a focal point. A systematic review using keywords across six databases was undertaken to summarise qualitative studies that focused on the experience of being a sibling of a child with an Autism Spectrum Disorder. Fifteen studies met inclusion criteria and a thematic synthesis was completed. The synthesis found that having a sibling who has an Autism Spectrum Disorder can impact typically developing sibling's self-identity and personal development in a number of ways. Similarly, interactions with the sibling who has Autism Spectrum Disorders and with other individuals can evoke a myriad of experiences that can both benefit and challenge typically developing siblings. The ability of typically developing siblings to cope with adverse experiences needs to remain a focus. This synthesis concludes that further research is needed to identify which methods are the most effective in supporting typically developing siblings of children with Autism Spectrum Disorders.
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Affiliation(s)
- Lucy Watson
- University of Surrey, Guildford, UK.,Surrey and Borders Partnership NHS Foundation Trust, UK.,The Howard Partnership Trust, Surrey, UK
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19
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Vreeken-Ross SC, Cartwright-Hatton S, Harris SA, Hanna P, Jones CJ. Feasibility of an online CBT group intervention for parents of children with food allergy. Clin Exp Allergy 2021; 52:171-175. [PMID: 34143528 DOI: 10.1111/cea.13970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Stefanie C Vreeken-Ross
- Faculty of Health & Medical Sciences, School of Psychology, University of Surrey, Guildford, UK
| | | | - Sally A Harris
- Royal Alexandra Children's Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Paul Hanna
- Faculty of Health & Medical Sciences, School of Psychology, University of Surrey, Guildford, UK
| | - Christina J Jones
- Faculty of Health & Medical Sciences, School of Psychology, University of Surrey, Guildford, UK
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20
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Soares P, Fidler K, Felton J, Jones CJ, Tavendale R, Hövels A, Bremner S, Palmer CNA, Mukhopadhyay S. An FCER2 polymorphism is associated with increased oral leukotriene receptor antagonists and allergic rhinitis prescribing. Clin Exp Allergy 2021; 51:1089-1092. [PMID: 34050993 DOI: 10.1111/cea.13958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 12/30/2022]
Affiliation(s)
- Patricia Soares
- Academic Department of Paediatrics, Brighton & Sussex Medical School, Royal Alexandra Children's Hospital, Brighton, UK
| | - Katy Fidler
- Academic Department of Paediatrics, Brighton & Sussex Medical School, Royal Alexandra Children's Hospital, Brighton, UK
| | | | | | - Roger Tavendale
- Division of Population and Health Genomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Anke Hövels
- Department of Pharmaceutical Sciences, Science Faculty, Utrecht University, Utrecht, The Netherlands
| | - Stephen Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Colin N A Palmer
- Division of Population and Health Genomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Somnath Mukhopadhyay
- Academic Department of Paediatrics, Brighton & Sussex Medical School, Royal Alexandra Children's Hospital, Brighton, UK
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21
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Simpson S, Hanna P, Jones CJ. A systematic review of parents’ experiences of raising a child with type 1 diabetes. Br J Diabetes 2021. [DOI: 10.15277/bjd.2021.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background: There are currently 1.1 million young people estimated to have type 1 diabetes (T1D) across the world. A diagnosis of T1D impacts not only the children’s lives but also those of the parents.Aim: To understand the experiences of parents raising a child with T1D.Methods: For inclusion, studies had to report qualitative data on parents' experiences of raising a child with a diagnosis of T1D. Parents included mothers, fathers or any other primary caregivers. Eleven databases were systematically searched for relevant articles. Studies were quality assessed and study characteristics extracted. The data were thematically synthesised.Results: Thirty-two studies met the inclusion criteria. Thematic synthesis yielded two analytical themes: ‘adjusting to a new reality’ and ‘navigating appropriate T1D support’. The five descriptive themes that contributed to these were ‘distressing diagnostic experience’, ‘change of life routine’, ‘enablers and barriers to support from others’, ‘reconstruction of family dynamics’ and ‘psychological impact over time’.Conclusions: Difficulties parents encounter in support received from school and healthcare professionals are highlighted. Parents’ mental health needs should be attended to throughout T1D clinic appointments. Future research should explore fathers' experiences, as well as characteristics (such as employment status, education, relationship status and underlying mental health issues) which may affect parental experience, given the paucity of existing evidence.
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22
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Nadarzynski T, Frost M, Miller D, Wheldon CW, Wiernik BM, Zou H, Richardson D, Marlow LAV, Smith H, Jones CJ, Llewellyn C. Vaccine acceptability, uptake and completion amongst men who have sex with men: A systematic review, meta-analysis and theoretical framework. Vaccine 2021; 39:3565-3581. [PMID: 34034949 DOI: 10.1016/j.vaccine.2021.05.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/16/2021] [Accepted: 05/04/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Due to an increased risk of sexually transmitted infections (STIs), gay, bisexual and other men who have sex with men (MSM) have been recommended to receive vaccinations against human papillomavirus, meningitis C and hepatitis A/B. This review aimed to compare the rates of vaccine acceptability, uptake and completion, and to identify determinants of vaccine outcomes specific to MSM to inform a theoretical framework. METHODS In January 2020 four databases were explored to identify vaccination behaviours and associated factors among MSM. A narrative systematic review and meta-analysis were performed. Data were synthesised for theoretical modelling. RESULTS Seventy-eight studies, mostly from the USA, were included. The average vaccine acceptability was 63% (median = 72%, range: 30%-97%), vaccine uptake 45% (median = 42%, range: 5%-100%) and vaccine completion 47% (median = 45%, range: 12%-89%). Six categories of factors associated with vaccination acceptability, uptake and completion were conceptualised: Individual (e.g., demographic and psychosocial); Interpersonal (e.g., peer education); Healthcare provider (e.g., vaccine recommendation); Organisational and practice setting (e.g., routine collection of patient sexual orientation information that is integrated into a clinical decision support system); Community environment (e.g., targeted health promotion campaigns); and National, state and local policy environment (e.g., public health guidelines targeting MSM). CONCLUSION Despite overall high levels of acceptability, uptake and completion rates were below targets predicted by cost-effectiveness modelling across all recommended vaccines. These parameters may need to be adjusted for more precise estimations of cost-effectiveness. Addressing the multiple levels of determinants, as outlined in our theoretical framework, will help guide interventions to increase vaccine completion among MSM.
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Affiliation(s)
| | - Miles Frost
- The University of Southampton, Southampton, United Kingdom
| | - Danny Miller
- The University of Westminster, London, United Kingdom
| | | | | | - Huachun Zou
- Sun Yat-sen University, School of Public Health, Shenzhen, China
| | - Daniel Richardson
- Brighton & Sussex University Hospitals NHS Trust, Brighton; Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom
| | - Laura A V Marlow
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Helen Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | | | - Carrie Llewellyn
- Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom
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23
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Vreeken-Ross SC, Smith HE, Jones CJ. A review of freely available online support for food allergy-related emotional well-being. Clin Exp Allergy 2021; 51:942-946. [PMID: 33763914 DOI: 10.1111/cea.13868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/26/2022]
Affiliation(s)
| | - Helen E Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Christina J Jones
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK
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24
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Schofield R, Dibb B, Coles-Gale R, Jones CJ. The experience of relatives using intensive care diaries: A systematic review and qualitative synthesis. Int J Nurs Stud 2021; 119:103927. [PMID: 33905992 DOI: 10.1016/j.ijnurstu.2021.103927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/04/2021] [Accepted: 03/10/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Intensive care patient diaries written by staff and/or relatives are widely used in intensive care units (ICUs) across the world. Although the original aim of the diaries was to support patients in their recovery from ICU, a more recent focus of the literature has been the potential benefit of the diaries to the relatives of patients. Meta-analyzes of quantitative studies looking at the impact on the psychological wellbeing of relatives have not consistently found an effect of the diaries, even though qualitative studies suggest that relatives find the diaries to be a useful coping strategy. OBJECTIVES To evaluate and synthesise qualitative studies looking at the experience of relatives writing in ICU diaries. DESIGN A systematic review and qualitative synthesis. DATA SOURCES A structured search using CINAHL, MEDLINE, PsycInfo, Cochrane Central Register of Controlled Trials (CENTRAL), PTSDHubs and Published International Literature Web of Science Conference Proceedings Citation Index - Science and Social Science and Humanities was conducted. REVIEW METHODS All studies published at any time that included qualitative data (including mixed methods studies) about the perceptions of relatives using ICU patient diaries were included. Themes and narrative statements were extracted from included articles and synthesised. Articles were quality assessed using the Critical Appraisal Skills Programme (CASP) qualitative checklist and Mixed Methods Appraisal Tool (MMAT). RESULTS Sixteen studies were included in the review, thirteen qualitative and three mixed methods articles. The themes identified were: 1. Coping (subthemes: 1.1. Emotion-Focused Coping and 1.2. Problem-Focused Coping) 2. Connection (subthemes: 2.1 Method of Communication and 2.2 Developing and maintaining relationships) 3. Developing a Narrative (subthemes 3.1 Understanding 3.2 Shaping the story 3.3 Remembering). CONCLUSIONS Relatives use the diaries in a variety of ways including as a means of coping, a way of staying connected, as a tool to understand and develop a narrative about the experience. These findings link the use of ICU diaries with literature on written emotional exposure, post-traumatic growth and meaning making. The relationship between a relative's use of the ICU diary, coping strategies and/or post-traumatic growth could be a focus for future quantitative trials. PROSPERO protocol number CRD42020165869.
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Affiliation(s)
- Rachel Schofield
- University of Surrey, Stag Hill, University Campus, Guildford GU2 7XH, UK.
| | - Bridget Dibb
- University of Surrey, Stag Hill, University Campus, Guildford GU2 7XH, UK
| | - Rebecca Coles-Gale
- East Sussex Healthcare NHS Trust, St. Anne's House, 729 The Ridge, St. Leonards-on-Sea, East Sussex TN37 7PT, UK
| | - Christina J Jones
- University of Surrey, Stag Hill, University Campus, Guildford GU2 7XH, UK
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25
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Ruffles T, Jones CJ, Palmer C, Turner S, Grigg J, Tavendale R, Hogarth F, Rauchhaus P, Pilvinyte K, Hannah R, Smith H, Littleford R, Lipworth B, Mukhopadhyay S. Asthma prescribing according to Arg16Gly beta-2 genotype: a randomised trial in adolescents. Eur Respir J 2021; 58:13993003.04107-2020. [PMID: 33479111 DOI: 10.1183/13993003.04107-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/01/2021] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The A allele of rs1042713 (Arg16 amino acid) in the beta-2 (β2) adrenoreceptor is associated with poor response to long-acting β2-agonist (LABA) in young people with asthma. Our aim was to assess whether the prescribing of second line controller with LABA or a leukotriene receptor antagonist (LTRA) according to Arg16Gly genotype would result in improvements in pediatric asthma-related quality of life questionnaire (PAQLQ). METHODS We performed a pragmatic randomised controlled trial (RCT) via a primary care clinical research network covering England and Scotland. We enrolled participants aged 12-18 years with asthma taking inhaled corticosteroids. A total of 241 participants (mean (sd) age 14.7 years (1.91)) were randomised (1:1) to receive personalised care (genotype directed prescribing) or standard guideline care. Following 4-week run-in participants were followed for 12-months. The primary outcome measure was change in PAQLQ. Asthma control, asthma exacerbation frequency and healthcare utilisation were secondary outcomes. RESULTS Genotype directed prescribing resulted in an improvement in PAQLQ compared to standard care 0.16, (95%CI 0.00-0.31; p=0.049), although this improvement was below the pre-determined clinical threshold of 0.25. The AA genotype was associated with a larger improvement in PAQLQ with personalised versus standard care 0.42, (95%CI 0.02-0.81; p=0.041). CONCLUSION This is the first RCT demonstrating that genotype driven asthma prescribing is associated with a significant improvement in a clinical outcome compared to standard care. Adolescents with the AA homozygous genotype benefited most. The potential role of such β2-adrenoceptor genotype directed therapy in younger and more severe childhood asthma warrants further exploration.
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Affiliation(s)
- Tom Ruffles
- Academic Department of Paediatrics, Royal Alexandra Children's Hospital, Brighton & Sussex Medical School, Brighton, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK
| | - Colin Palmer
- Division of Population and Health Genomics, University of Dundee, Ninewells Hospital & Medical School University of Dundee, Dundee, UK
| | - Steve Turner
- Child Health, University of Aberdeen, Aberdeen, UK
| | - Jonathan Grigg
- Blizard Institute, Queen Mary University of London, London, UK
| | - Roger Tavendale
- Division of Population and Health Genomics, University of Dundee, Ninewells Hospital & Medical School University of Dundee, Dundee, UK
| | - Fiona Hogarth
- Tayside Clinical Trials Unit, University of Dundee, Dundee, UK
| | - Petra Rauchhaus
- Tayside Medical Science Centre TASC, University of Dundee, Dundee, UK
| | | | - Romanie Hannah
- Academic Department of Paediatrics, Royal Alexandra Children's Hospital, Brighton & Sussex Medical School, Brighton, UK
| | - Helen Smith
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK.,Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Roberta Littleford
- Center for Clinical Research, University of Queensland, Brisbane, Australia
| | - Brian Lipworth
- Scottish Centre for Respiratory Research, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Somnath Mukhopadhyay
- Academic Department of Paediatrics, Royal Alexandra Children's Hospital, Brighton & Sussex Medical School, Brighton, UK.,Division of Population and Health Genomics, University of Dundee, Ninewells Hospital & Medical School University of Dundee, Dundee, UK
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Phillips C, O'Sullivan M, Schulkind J, Jones CJ, Verma S. Authors' reply to letter: In support of community-based hepatitis C treatment with triage of people at risk of cirrhosis to specialist care. J Viral Hepat 2021; 28:219-220. [PMID: 32852073 DOI: 10.1111/jvh.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 12/09/2022]
Affiliation(s)
- Clare Phillips
- Department of Gastroenterology and Hepatology, Brighton and Sussex University Hospital NHS Trust, Brighton, UK
| | - Margaret O'Sullivan
- Department of Gastroenterology and Hepatology, Brighton and Sussex University Hospital NHS Trust, Brighton, UK
| | - Jasmine Schulkind
- Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UK
| | | | - Sumita Verma
- Department of Gastroenterology and Hepatology, Brighton and Sussex University Hospital NHS Trust, Brighton, UK.,Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UK
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Abstract
Much of the research exploring the experiences of family caregivers of people with dementia has focussed on spouses and adult children. It is hypothesised that other family members at different life stages and with different family roles may experience and perceive the caregiving role differently. The objective of the current review was to explore the experiences of grandchildren who provide care to a grandparent with dementia. A systematic search of four databases identified 12 studies which met the inclusion criteria. An assessment of quality was completed for each of the included studies. Grandchildren described dementia-related changes, changes to their role and relationship with their grandparent, multiple impacts of caregiving, influences of other family relationships on caregiving and positive aspects of caregiving. Many of the included studies met most of the quality criteria for the respective methodological design; however, there was some variation in quality and sample across included studies. The review indicates that assessments and interventions to incorporate grandchildren and the wider family system may help to support family carers to continue to provide care for grandparents with dementia. The research and clinical implications and limitations of the review are also considered.
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Affiliation(s)
- Sophie Venters
- Department of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Christina J Jones
- Department of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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28
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Law GC, Bülbül A, Jones CJ, Smith H. 'The mean mummy way' - experiences of parents instilling eye drops to their young children as described in online forums and blogs. BMC Pediatr 2020; 20:514. [PMID: 33167925 PMCID: PMC7653738 DOI: 10.1186/s12887-020-02410-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/30/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adults often have difficulty instilling eye drops in their own eyes, but little has been documented about the difficulties experienced by parents when administering eye drops to their young children, where the challenges of instillation are accentuated by their inability to cooperate. This qualitative study explores parents' experiences of administering eye drops to their children as described in online forum discussions and blog posts. METHODS This was an exploratory study using qualitative methods. We thematically analysed the written exchanges between parents participating in online forum discussions and blog posts about the administration of eye drops to their young children. RESULTS We found 64 forum discussion threads and 4 blog posts, representing 464 unique contributors expressing their experiences of eye drop administration to young children. Three major themes were identified - administration challenges, administration methods and role of health care professionals. Besides describing their children's distress, parents discussed their own discomfort and anxiety when administering eye drops. Parents used a variety of techniques to facilitate adherence with medication, including restraining the child, role-play, reassurance, distraction, or reward. The ideas exchanged about eye drop administration occasionally included reiteration of professional advice, but were dominated by parents' own ideas/suggestions; interestingly health care professionals were considered diagnosticians and prescribers, rather than sources of practical advice on administration. CONCLUSIONS Parents struggling to deliver eye drops to their young children may seek advice on how to administer treatment from parental on-line discussion forums. The distress experienced by the young child and their parents is a powerful reminder to clinicians that procedures common and routine in health care may be challenging to parents. The advice given to parents needs to go beyond the instillation of the eye drops, and include advice on child restraint, distraction techniques and allaying distress. Forewarned of the potential difficulties and provided with coping strategies parents can employ when the child resists, could alleviate their own and their child's distress.
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Affiliation(s)
- Gloria C. Law
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232 Singapore
| | | | | | - Helen Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232 Singapore
- Brighton and Sussex Medical School, Brighton, UK
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Sugunasingha N, Jones FW, Jones CJ. Interventions for caregivers of children with food allergy: A systematic review. Pediatr Allergy Immunol 2020; 31:805-812. [PMID: 32311157 DOI: 10.1111/pai.13255] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/10/2020] [Accepted: 04/06/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Studies have identified that food allergy (FA) in children is related to poorer caregiver quality of life (QoL). However, it is unclear which interventions are most effective at improving outcomes for caregivers of children with FA. This review aimed to identify and determine the efficacy, acceptability and quality of interventions for caregivers of children with FA. METHODS A systematic search of four databases was conducted to identify studies evaluating any intervention that targeted well-being and support of caregivers of children with FA. Studies were not excluded based on design and were rated for quality using the Mixed Methods Appraisal Tool (MMAT) and the Cochrane risk of bias tool for randomized controlled trials (RCTs). RESULTS Fifteen studies met the inclusion criteria: eight studies used a pre-test/post-test design, four studies used a post-test design, two studies used an RCT design, and one study used a case-control design. Seven studies were educational interventions, five were psychological interventions, and three involved peer/professional support. All interventions had high participant acceptability; some evidence for cognitive behavioural interventions in supporting mothers was observed. Educational interventions tended to be associated with improvements in FA knowledge. With the exception of three studies, most studies were assessed as poor or moderate in terms of quality. CONCLUSION There is a paucity of high-quality research evaluating interventions to improve outcomes in parents of children with FA. Limited evidence suggests that cognitive behavioural interventions could benefit some mothers, but this has not been tested in other populations. Future research should use methodologically sound designs with validated outcome measures.
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Affiliation(s)
- Naomi Sugunasingha
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, UK
| | - Fergal W Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, UK
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Hazell CM, Hayward M, Lobban F, Pandey A, Pinfold V, Smith HE, Jones CJ. Demographic predictors of wellbeing in Carers of people with psychosis: secondary analysis of trial data. BMC Psychiatry 2020; 20:269. [PMID: 32487127 PMCID: PMC7265638 DOI: 10.1186/s12888-020-02691-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/21/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Carers of people with psychosis are at a greater risk of physical and mental health problems compared to the general population. Yet, not all carers will experience a decline in health. This predicament has provided the rationale for research studies exploring what factors predict poor wellbeing in carers of people with psychosis. Our study builds on previous research by testing the predictive value of demographic variables on carer wellbeing within a single regression model. METHODS To achieve this aim, we conducted secondary analysis on two trial data sets that were merged and recoded for the purposes of this study. RESULTS Contrary to our hypotheses, only carer gender and age predicted carer wellbeing; with lower levels of carer wellbeing being associated with being female or younger (aged under 50). However, the final regression model explained only 11% of the total variance. CONCLUSIONS Suggestions for future research are discussed in light of the limitations inherent in secondary analysis studies. Further research is needed where sample sizes are sufficient to explore the interactive and additive impact of other predictor variables.
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Affiliation(s)
- Cassie M. Hazell
- grid.12896.340000 0000 9046 8598School of Social Sciences, University of Westminster, London, W1W 6UW UK ,grid.414601.60000 0000 8853 076XResearch and Development Department, Sussex Education Centre, Brighton and Sussex Medical School, Nevill Avenue, Hove, BN3 7HZ UK ,grid.12082.390000 0004 1936 7590University of Sussex, Brighton, UK
| | - Mark Hayward
- grid.12082.390000 0004 1936 7590University of Sussex, Brighton, UK ,grid.451317.50000 0004 0489 3918Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ UK
| | - Fiona Lobban
- grid.9835.70000 0000 8190 6402Health & Medicine, Lancaster University, Furness Building, Lancaster, LA1 4YX UK
| | - Aparajita Pandey
- grid.451317.50000 0004 0489 3918Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ UK
| | - Vanessa Pinfold
- grid.490917.2The McPin Foundation, 32-36 Loman Street, London, SE1 0EH UK
| | - Helen E. Smith
- grid.414601.60000 0000 8853 076XResearch and Development Department, Sussex Education Centre, Brighton and Sussex Medical School, Nevill Avenue, Hove, BN3 7HZ UK ,grid.59025.3b0000 0001 2224 0361Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232 Singapore
| | - Christina J. Jones
- grid.414601.60000 0000 8853 076XResearch and Development Department, Sussex Education Centre, Brighton and Sussex Medical School, Nevill Avenue, Hove, BN3 7HZ UK ,grid.5475.30000 0004 0407 4824School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH UK
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Phillips C, Schulkind J, O'Sullivan M, Edelman N, Smith HE, Verma S, Jones CJ. Improving access to care for people who inject drugs: Qualitative evaluation of project ITTREAT-An integrated community hepatitis C service. J Viral Hepat 2020; 27:176-187. [PMID: 31566851 DOI: 10.1111/jvh.13214] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/08/2019] [Accepted: 08/31/2019] [Indexed: 12/11/2022]
Abstract
Achieving hepatitis C virus (HCV) elimination by 2030 requires an increased linkage to care for people who inject drugs (PWID). Project ITTREAT was established to mitigate barriers to HCV care by providing an integrated service within a local drug and alcohol treatment centre. This study aimed to explore the experiences of clients and staff involved in Project ITTREAT and assess the facilitators and barriers to a community-based HCV service. Between October 2014 and April 2016, drug and alcohol treatment attendees were interviewed using one-to-one semi-structured interviews. Drug and alcohol treatment staff took part in focus groups. All data were recorded, transcribed verbatim and analysed using thematic content analysis. Fifteen drug and alcohol treatment attendees with current/previous HCV infection were interviewed, and 15 staff members contributed across two focus groups. Drug and alcohol treatment staff and attendees reported that Project ITTREAT facilitated access to HCV care by mitigating previous negative hospital-based experiences. Other key facilitators were positive narratives around HCV care, and drug and alcohol treatment attendees being well engaged in their drug/alcohol recovery. Barriers included a lack of stability in drug and alcohol treatment attendees, negative discourse around testing/treatment and stigma associated with attending the drug and alcohol treatment to access HCV treatment in some who had successfully achieved drug rehabilitation. Our findings indicate the positive impact of an integrated and personalized community-based service delivered by a dedicated hepatitis nurse. This played a crucial role in reducing barriers to HCV care for PWID. Our work also highlights areas for future investment including non-DAT-based community services and increasing awareness of new treatments amongst this cohort.
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Affiliation(s)
- Clare Phillips
- Department of Gastroenterology and Hepatology, Brighton and Sussex University Hospital NHS Trust, Brighton, UK
| | - Jasmine Schulkind
- Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UK
| | - Margaret O'Sullivan
- Department of Gastroenterology and Hepatology, Brighton and Sussex University Hospital NHS Trust, Brighton, UK
| | - Natalie Edelman
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, Brighton, UK
| | - Helen E Smith
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, Brighton, UK.,Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Sumita Verma
- Department of Gastroenterology and Hepatology, Brighton and Sussex University Hospital NHS Trust, Brighton, UK.,Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UK
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Hazell CM, Jones CJ, Pandey A, Smith HE. Barriers to recruiting and retaining psychosis carers: a case study on the lessons learned from the Caring for Caregivers (C4C) trial. BMC Res Notes 2019; 12:810. [PMID: 31847874 PMCID: PMC6918613 DOI: 10.1186/s13104-019-4832-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/28/2019] [Indexed: 11/22/2022] Open
Abstract
Objective Carers play an important role within the UK mental health system. Those carers who support persons with psychosis can experience a reduction in their own physical and mental health. As part of the Caring for Caregivers (C4C) trial, we piloted a writing intervention (Positive Written Disclosure) that has been shown to improve wellbeing in other populations. Although we reached our recruitment target, we encountered several barriers that made recruitment slower than anticipated. This paper synthesises the process data collected during the C4C trial that relates to the barriers to recruiting and retaining psychosis carers. Results We encountered four main carer-specific barriers to the recruitment and retention of participants in our study. These were: (1) poor relationship with mental health clinicians, (2) conflicting with the care recipient’s (CR) needs, (3) lack of spare time, and (4) lack of services for mental health carers. The interventions to assist carers need to be informed by robust evidence and this requires trials that reach their recruitment targets. By sharing our practical experiences other researchers and clinicians can modify their practices to minimise recruitment difficulties and delay. Trial registration ISRCTN79116352. Retrospectively registered (before the final participant was recruited) on 23rd January 2017
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Affiliation(s)
- Cassie M Hazell
- School of Social Sciences, University of Westminster, London, W1W 6UW, UK
| | | | - Aparajita Pandey
- Sussex Partnership NHS Foundation Trust, Research and Development, Hove, BN3 7HZ, UK
| | - Helen E Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore. .,Division of Public Health and Primary Care, Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PH, UK.
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Law GC, Jones CJ, Bülbül A, Smith HE. "At a loss of what to do": a qualitative analysis of parents' online discussion forums about their administration of asthma inhalers to their young children. J Asthma 2019; 57:914-923. [PMID: 31215826 DOI: 10.1080/02770903.2019.1615941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The difficulties adults have using inhaler devices is well documented but much less is known about how parents administer inhaler devices to young children and the difficulties experienced. The purpose of this article is to explore the underlying concepts and practical issues that parents encounter in administering inhaled asthma medications to their young children.Methods: This is a qualitative study using applied thematic analysis on parental written discourses from asynchronous online discussion forums on the topic of administration and use of asthma inhaler devices to young children.Results: "At a loss of what to do" summarizes the experiences parents described when administering inhaler devices to their young children. Parents describe the problems, the situations, the emotions, the decisions, and the confusion they face. They struggle with their child's resistance and the associated conflict, describing their own and their child's distress. Results highlight the coping strategies used in administration, how parents decide whether to use coercive measures or not, their help-seeking endeavors, together with the assurance they give to themselves and others after administration.Conclusion: The online discussions highlight parents' distress, lack of preparedness, and understanding of administering inhaler devices to young children. While the prevalence of the problem cannot be estimated from our data, it illustrates a need for some healthcare professionals to review their own knowledge and skills in administration of inhaled medication to younger patients, and their provision of patient and family centered care.
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Affiliation(s)
- Gloria C Law
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | | | - Helen E Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Brighton and Sussex Medical School, Brighton, UK
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Jones CJ, Goetz MP, Ingle JN, Hawse JR. Abstract P5-04-05: Glucocorticoid receptor activation inhibits proliferation of endoxifen resistant breast cancer cells and resensitizes cells to hormonal therapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-04-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Despite the prevalent treatment options for ERα-positive breast cancer patients, and their initial efficacy for many women, ERα-positive disease still accounts for more breast cancer related deaths than any other subtype. Relapse in these patients is largely due to the development of resistance to anti-estrogen therapies such as tamoxifen. While tamoxifen and its resistance mechanisms have been extensively studied from both the bench and the bedside, relatively little is known about its active metabolite endoxifen. Our group has provided evidence that endoxifen is the most potent and clinically relevant metabolite of tamoxifen, suggesting that its characterization may be crucial to understanding tamoxifen resistance.
Methods: We have developed novel endoxifen resistant MCF7 and T47D cell lines through chronic exposure to endoxifen during a period of 12-24 months. Using these models and their respective controls, we compared global gene expression profiles of endoxifen resistant cells to tamoxifen resistant cells and found marked differences between the two models. Additionally, we subjected treatment naïve cells to a genome-wide, CRISPR-mediated knockout screen to identify genes, and their associated pathways, that are likely involved in mediating endoxifen resistance.
Results: Analysis of CRISPR guide RNAs enriched or depleted in response to chronic endoxifen treatment revealed that disruption of genes regulated by dexamethasone (Dex), a potent glucocorticoid receptor (GR) agonist, enhanced cells' ability to survive and proliferate in the presence of endoxifen. These data suggest that GR activation may inhibit endoxifen resistance, and that treatment of resistant cells with Dex may restore endoxifen efficacy. Indeed, Dex treatment significantly inhibited the proliferation rates of endoxifen resistant cells by 50-60% with little to no inhibitory effects in endoxifen sensitive models. Further, Dex was shown to synergize with endoxifen in resistant cells to further suppress cell proliferation, implying that Dex treatment could be utilized as an effective therapy for endocrine resistant disease. Conditioned media harvested from cells chronically exposed to Dex also resulted in substantial inhibition of endoxifen resistant cell proliferation rates. To explore potential mechanisms of these effects, we performed RNA-seq on both treatment-naïve and endoxifen resistant cells following Dex treatment. Out of 246 genes significantly regulated by Dex in endoxifen resistant cells, we identified 61 genes that were not differentially regulated in treatment naïve cells. These genes may provide insights into the mechanisms of GR activity specific to endoxifen resistant cells.
Conclusions: To our knowledge, we have developed the first models of endoxifen resistance and have demonstrated that global transcriptomic changes that occur during this process are substantially different than those observed in tamoxifen resistant models. We have shown that activation of GR signaling elicits significant growth-inhibitory effects specifically in the setting of endoxifen resistance. These data identify the GR pathway as a potential novel therapeutic target for the treatment of endocrine resistant breast cancer.
Citation Format: Jones CJ, Goetz MP, Ingle JN, Hawse JR. Glucocorticoid receptor activation inhibits proliferation of endoxifen resistant breast cancer cells and resensitizes cells to hormonal therapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-04-05.
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Brooks H, Llewellyn CD, Nadarzynski T, Pelloso FC, De Souza Guilherme F, Pollard A, Jones CJ. Sexual orientation disclosure in health care: a systematic review. Br J Gen Pract 2018; 68:e187-e196. [PMID: 29378698 PMCID: PMC5819984 DOI: 10.3399/bjgp18x694841] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/10/2017] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Significant health disparities between sexual minority individuals (that is, lesbian, gay, bisexual, or transgender [LGBT]) and heterosexual individuals have been demonstrated. AIM To understand the barriers and facilitators to sexual orientation (SO) disclosure experienced by LGBT adults in healthcare settings. DESIGN AND SETTING Mixed methods systematic review, including qualitative, quantitative, and mixed methods papers following PRISMA guidelines. METHOD Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT) and a qualitative synthesis was performed. Studies were included if their participants were aged ≥18 years who either identified as LGBT, had a same-sex sexual relationship, or were attracted to a member of the same sex. RESULTS The review included 31 studies representing 2442 participants. Four overarching themes were identified as barriers or facilitators to SO disclosure: the moment of disclosure, the expected outcome of disclosure, the healthcare professional, and the environment or setting of disclosure. The most prominent themes were the perceived relevance of SO to care, the communication skills and language used by healthcare professionals, and the fear of poor treatment or reaction to disclosure. CONCLUSION The facilitators and barriers to SO disclosure by LGBT individuals are widespread but most were modifiable and could therefore be targeted to improve healthcare professionals' awareness of their patients' SO. Healthcare professionals should be aware of the broad range of factors that influence SO disclosure and the potential disadvantageous effects of non-disclosure on care. The environment in which patients are seen should be welcoming of different SOs as well as ensuring that healthcare professionals' communication skills, both verbal and non-verbal, are accepting and inclusive.
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Affiliation(s)
| | | | - Tom Nadarzynski
- Department of Psychology, University of Southampton, Southampton, UK
| | | | | | | | - Christina J Jones
- Department of Clinical Medicine, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
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Abstract
In unpremedicated patients presenting for general anaesthesia for electroconvulsive therapy (ECT), the use of atropine combined with methohexitone as an intravenous induction agent was found to produce a significantly greater increase in heart rate than glycopyrrolate in similar combination. There was no difference in the antisialogogue effect of the two drugs at the doses used, and both drugs provided similar protection against the effects of suxamethonium and ECT on heart rate.
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Hazell CM, Jones CJ, Hayward M, Bremner SA, O'Connor DB, Pinfold V, Smith HE. Caring for Caregivers (C4C): study protocol for a pilot feasibility randomised control trial of Positive Written Disclosure for older adult caregivers of people with psychosis. Pilot Feasibility Stud 2017; 3:63. [PMID: 29201390 PMCID: PMC5697360 DOI: 10.1186/s40814-017-0206-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 10/31/2017] [Indexed: 12/02/2022] Open
Abstract
Background The caregivers of people who experience psychosis are themselves at risk of developing physical and mental health problems. This risk is increased for older adult caregivers who also have to manage the lifestyle and health changes associated with ageing. As a consequence, older adult caregivers are in particular need of support; we propose a Written Emotional Disclosure (WED) intervention, called Positive Written Disclosure (PWD). Methods/design This is a pilot randomised controlled trial of PWD compared to a neutral writing control and a no writing condition. We aim to recruit 60 participants, 20 in each arm. This study will utilise a mixed-methods approach and collect quantitative (questionnaires) and qualitative (interviews) data. Quantitative data will be collected at baseline and 1, 3, and 6 months post baseline. Participants who complete a writing task (PWD or neutral writing control) will be invited to complete an exit interview to discuss their experiences of the intervention and study. The study is supported by a patient and public involvement group. Discussion The results of this trial will determine whether a definitive trial is justified. If so, the quantitative and qualitative findings will be used to refine the intervention and study protocols. Trial registration ISRCTN, ISRCTN79116352. Registered on 23 January 2017 Electronic supplementary material The online version of this article (10.1186/s40814-017-0206-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cassie M Hazell
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, BN1 9PH UK
| | - Christina J Jones
- Department of Clinical Medicine, Royal Alexandra Children's Hospital, University of Sussex, Eastern Road, Brighton, BN2 5BE UK
| | - Mark Hayward
- Sussex Partnership NHS Foundation Trust, Research and Development Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ UK
| | - Stephen A Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, BN1 9PH UK
| | | | - Vanessa Pinfold
- The McPin Foundation, 32-36 Loman Street, London, SE1 0EH UK
| | - Helen E Smith
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, BN1 9PH UK.,Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Novena Campus, 11 Mandalay Road, Singapore, 308232 Singapore
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Mercer RD, Jones CJ, Smith HE. Reviewing the Content and Design of Anaphylaxis Management Plans Published in English. The Journal of Allergy and Clinical Immunology: In Practice 2017; 5:1288-1294.e4. [DOI: 10.1016/j.jaip.2017.06.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/27/2017] [Accepted: 06/28/2017] [Indexed: 10/19/2022]
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Smith H, Bulbul A, Jones CJ. Can Online Discussion Sites Generate Quality Data for Research Purposes? Front Public Health 2017; 5:156. [PMID: 28730148 PMCID: PMC5499632 DOI: 10.3389/fpubh.2017.00156] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/19/2017] [Indexed: 12/02/2022] Open
Affiliation(s)
- Helen Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Alpaslan Bulbul
- Brighton and Sussex Medical School, Brighton, United Kingdom
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Lyver POB, Aldridge SP, Gormley AM, Gaw S, Webb S, Buxton RT, Jones CJ. Elevated mercury concentrations in the feathers of grey-faced petrels (Pterodroma gouldi) in New Zealand. Mar Pollut Bull 2017; 119:195-203. [PMID: 28372818 DOI: 10.1016/j.marpolbul.2017.03.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 03/19/2017] [Accepted: 03/25/2017] [Indexed: 06/07/2023]
Abstract
Our objective was to measure the concentrations of Hg, As, Cd, Co, Cr, Cu, Pb, Sb, V and Zn in the body feathers of grey-faced petrel (Pterodroma gouldi), fluttering shearwater (Puffinus gavia), little shearwater (Puffinus assimilis) and common diving petrel (Pelecanoides urinatrix) from breeding colonies in New Zealand between 2006 and 2013. The mean Hg concentration (36.48ppm; SD=9.59) in grey-faced petrel feathers was approximately 8.5 to 14 times that detected in the other three species sampled. We detected no trend or differences in Hg concentrations in grey-faced petrels over the 8years of this study, but Hg concentrations varied between breeding colonies although there was no strong relationship with latitude. The elevated Hg concentrations detected in grey-faced petrels could pose a risk to the breeding performance of grey-faced petrels and the customary harvest of chicks by Māori (New Zealand's indigenous peoples).
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Affiliation(s)
- P O' B Lyver
- Landcare Research, PO Box 69040, Lincoln 7640, New Zealand; University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Department of Fish, Wildlife and Conservation Biology, Colorado State University,1474 Campus Delivery, Fort Collins, CO 80523, USA.
| | - S P Aldridge
- Landcare Research, PO Box 69040, Lincoln 7640, New Zealand; University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Department of Fish, Wildlife and Conservation Biology, Colorado State University,1474 Campus Delivery, Fort Collins, CO 80523, USA
| | - A M Gormley
- Landcare Research, PO Box 69040, Lincoln 7640, New Zealand; University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Department of Fish, Wildlife and Conservation Biology, Colorado State University,1474 Campus Delivery, Fort Collins, CO 80523, USA
| | - S Gaw
- Landcare Research, PO Box 69040, Lincoln 7640, New Zealand; University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Department of Fish, Wildlife and Conservation Biology, Colorado State University,1474 Campus Delivery, Fort Collins, CO 80523, USA
| | - S Webb
- Landcare Research, PO Box 69040, Lincoln 7640, New Zealand; University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Department of Fish, Wildlife and Conservation Biology, Colorado State University,1474 Campus Delivery, Fort Collins, CO 80523, USA
| | - R T Buxton
- Landcare Research, PO Box 69040, Lincoln 7640, New Zealand; University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Department of Fish, Wildlife and Conservation Biology, Colorado State University,1474 Campus Delivery, Fort Collins, CO 80523, USA
| | - C J Jones
- Landcare Research, PO Box 69040, Lincoln 7640, New Zealand; University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Department of Fish, Wildlife and Conservation Biology, Colorado State University,1474 Campus Delivery, Fort Collins, CO 80523, USA
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Abstract
OBJECTIVES It is not known which of the many asthma-specific quality of life (QoL) questionnaires best capture the lived experience of people with asthma. The objective of this study was to explore patients' views of three commonly used asthma-specific QoL questionnaires. DESIGN Qualitative study using semistructured interviews. SETTING Primary and secondary care in Brighton and Hove, UK. PARTICIPANTS 30 adult people with a physician-diagnosis of asthma who were asked to complete the Juniper Asthma Quality of Life Questionnaire (AQLQ-J), the Sydney Asthma Quality of Life Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ) to elicit their views on the content validity of these. RESULTS Thematic content analysis revealed a lack of congruence between the concerns of people with asthma and the questionnaire content in terms of missing (eg, allergies) and irrelevant (eg, smoky restaurants) content. The AQLQ-J was perceived as a 'narrow', 'medical' questionnaire focused on symptoms, the environment and functional ability. In contrast, the LWAQ and the AQLQ-S were perceived to be 'non-medical'. The LWAQ was described as a 'test' and as a wide-ranging, embracing and holistic questionnaire. Its strong emotional focus was irritating to some. The AQLQ-S was described as a simple, quick and easy questionnaire, although there was a perception that it was lacking in depth. CONCLUSIONS Patient interviews highlighted strengths and shortcomings in the content validity of these three asthma-specific questionnaires. For patients, the AQLQ-S content seemed to be the most pertinent in its adequacy of coverage of medical, social and emotional aspects of health-related QoL in asthma.
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Affiliation(s)
- Christian J Apfelbacher
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
- Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Christina J Jones
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Anthony Frew
- Department of Respiratory Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Helen Smith
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
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Jones CJ, Hayward M, Brown A, Clark E, Bird D, Harwood G, Scott C, Hillemann A, Smith HE. Feasibility and Participant Experiences of a Written Emotional Disclosure Intervention for Parental Caregivers of People with Psychosis. Stress Health 2016. [PMID: 26223511 DOI: 10.1002/smi.2644] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Caregivers are at increased risk of poor health but often cannot engage with health care because of practical constraints. Writing therapies such as written emotional disclosure (WED) might represent an accessible therapy for this population. This study aimed to determine whether WED is a suitable therapy for caregivers of people with psychosis. Data were collected from a feasibility trial comparing WED with a neutral writing task. Twenty four participants completed writing tasks; the content was analysed using the Linguistic Inquiry Word Count (LIWC) programme. Twenty one participants provided feedback about the writing task, and data were analysed using Burnard's thematic content analysis. WED was feasible to implement in caregivers of people with psychosis. All participants ascribed benefit to writing tasks, the majority describing a cathartic effect, enjoying time to oneself or distraction from caregiving. Quantitative comparison indicated differences in emotional content between intervention and control writing. However, qualitative analysis showed that control participants found it challenging to write neutrally, the majority citing the care-recipient in their writing. Community-based WED is a feasible therapy for caregivers of people with psychosis. The need for refinement of the control writing task for use in caregivers is discussed. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Christina J Jones
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, Brighton, BN1 9PH, UK
| | - Mark Hayward
- Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Millview Hospital Site, Nevill Avenue, Hove, BN3 7HZ, UK.,School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Abigail Brown
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, Brighton, BN1 9PH, UK
| | - Elizabeth Clark
- School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Daniel Bird
- School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Gina Harwood
- School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Crystyn Scott
- School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Angela Hillemann
- School of Psychology, Pevensey Building, University of Sussex, Falmer Brighton, BN1 9QH, UK
| | - Helen E Smith
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, Village Way, Falmer, Brighton, BN1 9PH, UK
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43
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Brown CE, Jones CJ, Stuttaford L, Robertson A, Rashid RS, Smith HE. A qualitative study of the allergy testing experiences, views and preferences of adult patients. Clin Transl Allergy 2016; 6:34. [PMID: 27583128 PMCID: PMC5006618 DOI: 10.1186/s13601-016-0125-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/12/2016] [Indexed: 11/25/2022] Open
Abstract
Background Patients can be tested for IgE sensitivities with in vivo or in vitro testing, but patients’ experiences of different allergy test modalities have not been studied. The objective of this study was to investigate adult patients’ experiences, views and preferences for allergy testing, exploring skin prick testing and allergen-specific IgE testing. Methods A qualitative study of adults attending out-patients for investigation of a suspected allergy. A purposive, convenience sample identified participants and semi-structured interviews were conducted, face to face or by telephone. Interviews were recorded and transcribed verbatim. Thematic content analysis was used to explore patients’ experiences. Results 23 patients were interviewed. The characteristics of skin prick tests particularly valued were the immediacy and visibility of results, which enabled testing and interpretation to be achieved within a single clinic appointment. In vitro testing offered patients simplicity and procedural speed, necessitating only a single puncture site, and was perceived to be a superior test as it was conducted in a laboratory. Conclusions The patient preferred method of allergy testing was skin prick testing rather than in vitro allergen specific IgE testing. However, most patients were accepting of either testing modality because their desire to confirm or exclude an allergic trigger overrode any perceived disadvantages of the test method. Trial registration Not applicable as study descriptive and qualitative.
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Affiliation(s)
- Clare E Brown
- Division of Primary Care and Public Health Medicine, Brighton and Sussex Medical School, Room 319, Mayfield House, Village Way, Brighton, BN1 9PH UK
| | - Christina J Jones
- Division of Primary Care and Public Health Medicine, Brighton and Sussex Medical School, Room 319, Mayfield House, Village Way, Brighton, BN1 9PH UK
| | - Laura Stuttaford
- Division of Primary Care and Public Health Medicine, Brighton and Sussex Medical School, Room 319, Mayfield House, Village Way, Brighton, BN1 9PH UK
| | - Annalee Robertson
- Division of Primary Care and Public Health Medicine, Brighton and Sussex Medical School, Room 319, Mayfield House, Village Way, Brighton, BN1 9PH UK
| | - Rabia S Rashid
- Department of Respiratory Medicine, Royal Sussex County Hospital, Brighton, UK
| | - Helen E Smith
- Division of Primary Care and Public Health Medicine, Brighton and Sussex Medical School, Room 319, Mayfield House, Village Way, Brighton, BN1 9PH UK
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El Turki A, Smith H, Llewellyn C, Jones CJ. A systematic review of patients', parents' and healthcare professionals' adrenaline auto-injector administration techniques. Emerg Med J 2016; 34:403-416. [DOI: 10.1136/emermed-2016-205742] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 05/30/2016] [Accepted: 07/07/2016] [Indexed: 11/03/2022]
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45
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Jones CJ, Smith HE, Llewellyn CD. A systematic review of the effectiveness of interventions using the Common Sense Self-Regulatory Model to improve adherence behaviours. J Health Psychol 2016; 21:2709-2724. [PMID: 25957228 DOI: 10.1177/1359105315583372] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This systematic review assessed the effectiveness of the Common Sense Self-Regulatory Model in the design of interventions to improve adherence behaviours. Of nine eligible studies, six reported improvements in adherence behaviours and three showed moderate to large effects on return to work and lifestyle recommendations. Four studies stated how Common Sense Self-Regulatory Model constructs were addressed in the intervention and five measured illness perceptions as outcomes. Evidence was found for targeting cure/control perceptions in studies aimed at improving adherence behaviours. Future studies need to measure illness perceptions pre- and post-intervention to enable mediational analyses to assess the effect of Common Sense Self-Regulatory Model interventions on improving health outcomes.
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46
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Ragazzola F, Foster LC, Jones CJ, Scott TB, Fietzke J, Kilburn MR, Schmidt DN. Impact of high CO2 on the geochemistry of the coralline algae Lithothamnion glaciale. Sci Rep 2016; 6:20572. [PMID: 26853562 PMCID: PMC4744931 DOI: 10.1038/srep20572] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 01/06/2016] [Indexed: 12/04/2022] Open
Abstract
Coralline algae are a significant component of the benthic ecosystem. Their ability to withstand physical stresses in high energy environments relies on their skeletal structure which is composed of high Mg-calcite. High Mg-calcite is, however, the most soluble form of calcium carbonate and therefore potentially vulnerable to the change in carbonate chemistry resulting from the absorption of anthropogenic CO2 by the ocean. We examine the geochemistry of the cold water coralline alga Lithothamnion glaciale grown under predicted future (year 2050) high pCO2 (589 μatm) using Electron microprobe and NanoSIMS analysis. In the natural and control material, higher Mg calcite forms clear concentric bands around the algal cells. As expected, summer growth has a higher Mg content compared to the winter growth. In contrast, under elevated CO2 no banding of Mg is recognisable and overall Mg concentrations are lower. This reduction in Mg in the carbonate undermines the accuracy of the Mg/Ca ratio as proxy for past temperatures in time intervals with significantly different carbonate chemistry. Fundamentally, the loss of Mg in the calcite may reduce elasticity thereby changing the structural properties, which may affect the ability of L. glaciale to efficiently function as a habitat former in the future ocean.
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Affiliation(s)
- F Ragazzola
- School of Earth Sciences, University of Bristol, Wills Memorial Building, Bristol BS8 1RJ, UK
| | - L C Foster
- School of Earth Sciences, University of Bristol, Wills Memorial Building, Bristol BS8 1RJ, UK
| | - C J Jones
- Interface Analysis Centre, School of Physics, Tyndall Avenue, Bristol BS8 1TL, UK
| | - T B Scott
- Interface Analysis Centre, School of Physics, Tyndall Avenue, Bristol BS8 1TL, UK
| | - J Fietzke
- GEOMAR
- Helmholtz Centre for Ocean Research Kiel, Wischhofstrße 1-3, 24148 Kiel, Germany
| | - M R Kilburn
- Centre for Microscopy, Characterisation and Analysis, University of Western Australia, Australia
| | - D N Schmidt
- School of Earth Sciences, University of Bristol, Wills Memorial Building, Bristol BS8 1RJ, UK
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47
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Fanzo JC, Graziose MM, Kraemer K, Gillespie S, Johnston JL, de Pee S, Monterrosa E, Badham J, Bloem MW, Dangour AD, Deckelbaum R, Dobermann A, Fracassi P, Hossain SMM, Ingram J, Jerling JC, Jones CJ, Jap SI, Kiess L, Marshall Q, Martin K, Narayan A, Amuyunzu-Nayamongo M, Pepping F, West KP. Educating and training a workforce for nutrition in a post-2015 world. Adv Nutr 2015; 6:639-47. [PMID: 26567189 PMCID: PMC4642431 DOI: 10.3945/an.115.010041] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nearly all countries in the world today are burdened with malnutrition, manifesting as undernutrition, micronutrient deficiencies, and/or overweight and obesity. Despite some progress, efforts to alleviate malnutrition are hampered by a shortage in number, skills, and geographic coverage, of a workforce for nutrition. Here, we report the findings of the Castel Gandolfo workshop, a convening of experts from diverse fields in March 2014 to consider how to develop the capacity of a global cadre of nutrition professionals for the post-2015 development era. Workshop participants identified several requirements for developing a workforce for nutrition, including an ability to work as part of a multisectoral team; communication, advocacy, and leadership skills to engage decision makers; and a set of technical skills to address future challenges for nutrition. Other opportunities were highlighted that could immediately contribute to capacity development, including the creation of a consortium to link global North and South universities, online training modules for middle managers, and practical, hands-on experiences for frontline nutrition workers. Institutional and organizational support is needed to enable workshop recommendations on education and training to be effectively implemented and sustained. The findings from the Castel Gandolfo workshop can contribute to the delivery of successful nutrition-relevant actions in the face of mounting external pressures and informing and attaining the forthcoming Sustainable Development Goals.
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Affiliation(s)
- Jessica C Fanzo
- School of Advanced International Studies and the Berman Institute of Bioethics, Johns Hopkins University, Washington, DC;
| | | | - Klaus Kraemer
- Sight and Life, Basel, Switzerland;,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Jessica L Johnston
- United Nations Special Envoy Office for the Millennium Development Goals, New York, NY
| | - Saskia de Pee
- United Nations World Food Programme, Rome, Italy;,Tufts University, Boston, MA
| | | | | | - Martin W Bloem
- United Nations World Food Programme, Rome, Italy;,Johns Hopkins University, Baltimore, MD
| | - Alan D Dangour
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | | | - SM Moazzem Hossain
- Mailman School of Public Health, Columbia University, New York, NY;,United Nations Children’s Fund, New York, NY
| | - John Ingram
- Environmental Change Institute, University of Oxford, Oxford, United Kingdom
| | | | - CJ Jones
- independent consultant, Nairobi, Kenya
| | | | - Lynnda Kiess
- United Nations World Food Programme, Rome, Italy
| | | | - Keith Martin
- Consortium of Universities for Global Health, Washington, DC
| | - Anuradha Narayan
- USAID Strengthening Partnerships, Results and Innovations in Nutrition Globally (SPRING), Arlington, VA
| | | | - Fré Pepping
- Wageningen University, Wageningen, Netherlands
| | - Keith P West
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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49
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Jones CJ, Llewellyn CD, Frew AJ, Du Toit G, Mukhopadhyay S, Smith H. Factors associated with good adherence to self-care behaviours amongst adolescents with food allergy. Pediatr Allergy Immunol 2015; 26:111-8. [PMID: 25586900 DOI: 10.1111/pai.12333] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Our understanding of factors which affect adherence to health sustaining self-care behaviours in adolescents with food allergy is limited. This study used the Health Belief Model to explore the relationship between food allergic adolescents' health beliefs, demographic, structural and social psychological factors with adherence to self-care behaviours, including allergen avoidance and carrying emergency medication. METHODS A cross-sectional study of 188 13- to 19- olds identified from hospital prescribed auto-injectable epinephrine for food allergy. Data were collected on demographics, structural factors, social psychological factors, health beliefs and current adherence behaviour using a postal questionnaire. RESULTS Full adherence was reported by 16% of participants. Multivariate analysis indicated that adherence was more likely to be reported if the adolescents belonged to a support group (OR = 2.54, (1.04, 6.20) 95% CI), had an anaphylaxis management plan (OR = 3.22, (1.18, 8.81) 95% CI), perceived their food allergy to be more severe (OR = 1.24, (1.01, 1.52) 95% CI) and perceived fewer barriers to disease management (OR = 0.87, (0.79, 0.96) 95% CI). CONCLUSIONS Membership of a patient support group and having an anaphylaxis management plan were associated with good adherence to self-care behaviours in adolescents with food allergy. Our results suggest that interventions to improve provision and utilisation of management plans, address adolescents' perceptions of the severity of anaphylaxis and reduce barriers to disease management may facilitate good adherence behaviours than focussing on knowledge-based interventions.
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Affiliation(s)
- Christina J Jones
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
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50
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Rubinstein M, Westenbroek RE, Yu FH, Jones CJ, Scheuer T, Catterall WA. Genetic background modulates impaired excitability of inhibitory neurons in a mouse model of Dravet syndrome. Neurobiol Dis 2014; 73:106-17. [PMID: 25281316 DOI: 10.1016/j.nbd.2014.09.017] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/04/2014] [Accepted: 09/24/2014] [Indexed: 01/23/2023] Open
Abstract
Dominant loss-of-function mutations in voltage-gated sodium channel NaV1.1 cause Dravet Syndrome, an intractable childhood-onset epilepsy. NaV1.1(+/-) Dravet Syndrome mice in C57BL/6 genetic background exhibit severe seizures, cognitive and social impairments, and premature death. Here we show that Dravet Syndrome mice in pure 129/SvJ genetic background have many fewer seizures and much less premature death than in pure C57BL/6 background. These mice also have a higher threshold for thermally induced seizures, fewer myoclonic seizures, and no cognitive impairment, similar to patients with Genetic Epilepsy with Febrile Seizures Plus. Consistent with this mild phenotype, mutation of NaV1.1 channels has much less physiological effect on neuronal excitability in 129/SvJ mice. In hippocampal slices, the excitability of CA1 Stratum Oriens interneurons is selectively impaired, while the excitability of CA1 pyramidal cells is unaffected. NaV1.1 haploinsufficiency results in increased rheobase and threshold for action potential firing and impaired ability to sustain high-frequency firing. Moreover, deletion of NaV1.1 markedly reduces the amplification and integration of synaptic events, further contributing to reduced excitability of interneurons. Excitability is less impaired in inhibitory neurons of Dravet Syndrome mice in 129/SvJ genetic background. Because specific deletion of NaV1.1 in forebrain GABAergic interneuons is sufficient to cause the symptoms of Dravet Syndrome in mice, our results support the conclusion that the milder phenotype in 129/SvJ mice is caused by lesser impairment of sodium channel function and electrical excitability in their forebrain interneurons. This mild impairment of excitability of interneurons leads to a milder disease phenotype in 129/SvJ mice, similar to Genetic Epilepsy with Febrile Seizures Plus in humans.
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Affiliation(s)
- Moran Rubinstein
- Department of Pharmacology, University of Washington, Seattle, WA 98195-7280, USA
| | - Ruth E Westenbroek
- Department of Pharmacology, University of Washington, Seattle, WA 98195-7280, USA
| | - Frank H Yu
- Department of Pharmacology, University of Washington, Seattle, WA 98195-7280, USA
| | - Christina J Jones
- Department of Pharmacology, University of Washington, Seattle, WA 98195-7280, USA
| | - Todd Scheuer
- Department of Pharmacology, University of Washington, Seattle, WA 98195-7280, USA
| | - William A Catterall
- Department of Pharmacology, University of Washington, Seattle, WA 98195-7280, USA.
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