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Assche SBV, Ferraccioli F, Riccetti N, Gomez-Ramirez J, Ghio D, Stilianakis NI. Urban-rural disparities in COVID-19 hospitalisations and mortality: A population-based study on national surveillance data from Germany and Italy. PLoS One 2024; 19:e0301325. [PMID: 38696525 PMCID: PMC11065260 DOI: 10.1371/journal.pone.0301325] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/14/2024] [Indexed: 05/04/2024] Open
Abstract
PURPOSE Recent literature has highlighted the overlapping contribution of demographic characteristics and spatial factors to urban-rural disparities in SARS-CoV-2 transmission and outcomes. Yet the interplay between individual characteristics, hospitalisation, and spatial factors for urban-rural disparities in COVID-19 mortality have received limited attention. METHODS To fill this gap, we use national surveillance data collected by the European Centre for Disease Prevention and Control and we fit a generalized linear model to estimate the association between COVID-19 mortality and the individuals' age, sex, hospitalisation status, population density, share of the population over the age of 60, and pandemic wave across urban, intermediate and rural territories. FINDINGS We find that in what type of territory individuals live (urban-intermediate-rural) accounts for a significant difference in their probability of dying given SARS-COV-2 infection. Hospitalisation has a large and positive effect on the probability of dying given SARS-CoV-2 infection, but with a gradient across urban, intermediate and rural territories. For those living in rural areas, the risk of dying is lower than in urban areas but only if hospitalisation was not needed; while for those who were hospitalised in rural areas the risk of dying was higher than in urban areas. CONCLUSIONS Together with individuals' demographic characteristics (notably age), hospitalisation has the largest effect on urban-rural disparities in COVID-19 mortality net of other individual and regional characteristics, including population density and the share of the population over 60.
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Affiliation(s)
| | | | - Nicola Riccetti
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | | | - Daniela Ghio
- CERC in Migration and Integration, Toronto Metropolitan University, Toronto, Canada
| | - Nikolaos I. Stilianakis
- European Commission, Joint Research Centre (JRC), Ispra, Italy
- Department of Biometry and Epidemiology, University of Erlangen-Nuremberg, Erlangen, Germany
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Dobson A, Hornsey S, Ghio D, Latter S, Santer M, Muller I. 'Either something's wrong, or I'm a terrible parent': A systematic review of parent experiences of illness-related interpretations for unsettled babies. J Adv Nurs 2024. [PMID: 38528428 DOI: 10.1111/jan.16166] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/09/2024] [Accepted: 03/11/2024] [Indexed: 03/27/2024]
Abstract
AIMS To explore parents' experiences of unsettled babies and medical labels. DESIGN Qualitative systematic review, thematic synthesis and development of a conceptual model. REVIEW METHODS Systematic review and thematic synthesis of primary, qualitative research into parents' experiences of unsettled babies <12 months of age. 'Unsettled' was defined as perception of excessive crying with additional feature(s) such as vomiting, skin or stool problems. The Critical Appraisal Skills Programme (CASP) checklist was used to assess trustworthiness. DATA SOURCES Structured searches completed in CINAHL, Medline, Embase, PsychINFO and CochraneCT on 23 March 2022 and rerun on 14 April 2023. RESULTS Ten eligible studies were included across eight countries contributing data from 103 mothers and 24 fathers. Two analytical themes and eight descriptive themes were developed. Firstly, parents expressed fearing judgement, feeling guilty and out of control as a result of babies' unsettled symptoms and seeking strategies to construct an 'Identity as a "Good Parent"'. This desire for positive parenting identity underpinned the second analytical theme 'Searching for an explanation' which included seeking external (medical) causes for babies' unsettled behaviours. CONCLUSION Parents can become trapped in a cycle of 'searching for an explanation' for their baby's unsettled behaviours, experiencing considerable distress which is exacerbated by feelings of guilt and failure. IMPACT AND IMPLICATIONS FOR PATIENT CARE Insight gained from this review could inform interventions to support parents, reducing inaccurate medicalization. Health visiting teams supporting parents with unsettled baby behaviour could focus on supporting a positive parenting identity by managing expectations, normalizing the continuum of infant behaviours, reducing feelings of guilt or uncertainty and helping parents regain a feeling of control. REPORTING METHOD ENTREQ guidelines were adhered to in the reporting of this review. PATIENT OR PUBLIC CONTRIBUTION Parent input was crucial in the design phase; shaping the language used (e.g., 'unsettled babies') and in the analysis sense-checking findings.
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Affiliation(s)
- Amy Dobson
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Samantha Hornsey
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | - Susan Latter
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Miriam Santer
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Ingrid Muller
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
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Hornsey SJ, Dobson A, Ghio D, Henaghan-Sykes K, Adams S, Lovegrove E, Santer M, Muller I. Living with unsettled baby behaviours: Qualitative interview study exploring parental perceptions and experiences of help-seeking. J Adv Nurs 2024. [PMID: 38382897 DOI: 10.1111/jan.16070] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/20/2023] [Accepted: 01/10/2024] [Indexed: 02/23/2024]
Abstract
AIM To explore parents' perceptions/experiences of help-seeking for unsettled baby behaviours, including views and experiences of obtaining advice from primary healthcare professionals. DESIGN Semi-structured qualitative interviews. METHODS Recruitment occurred via social media, general practice and health visiting teams. Remote semi-structured interviews were conducted with parents of babies. Babies were under 12 months old at time of interview, and parents had perceived unsettled baby behaviours in their first 4 months of life. Interviews were transcribed and data analysed using reflexive thematic analysis. RESULTS Based on interviews with 25 mothers, four main themes were developed. 'The need for answers' highlighted parental uncertainty about what constitutes normal baby behaviour, leading to help-seeking from multiple sources. 'The importance of health professionals' and 'Experiencing health professional support' identified perceptions about limited access, communication, mixed advice and how these influenced parental perception/management of behaviours. 'Foundations to help-seeking' highlighted important roles of social support and online help for valued shared experiences, emotional and practical support. CONCLUSION Health professional access and advice are important to parents, despite the increasing role of online help and importance of social support. More support and improved access to reliable sources of information is needed for parents. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Findings will inform future research and clinical practice to address parental uncertainties. Qualitative research with front-line health professionals is necessary. IMPACT Findings can inform the development of resources to support professionals/families managing unsettled babies. REPORTING METHOD Standards for Reporting Qualitative Research. PUBLIC INVOLVEMENT A public contributor was involved throughout all stages of the research. Emerging findings were discussed at a parent group. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Addressing parental uncertainties is important; about what is normal, non-pharmacological approaches and when pharmacological intervention is required. A digital information/self-management intervention may be useful for parents/clinicians.
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Affiliation(s)
- Samantha J Hornsey
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Amy Dobson
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | | | | | | | | | - Miriam Santer
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Ingrid Muller
- Primary Care Research Centre, University of Southampton, Southampton, UK
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Ghio D, Brookes N, Preece S, Walsh N. From sceptic to believer: Acceptability of cognitive muscular therapy TM , a new intervention for knee osteoarthritis. Musculoskeletal Care 2023; 21:1639-1650. [PMID: 37971188 DOI: 10.1002/msc.1842] [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: 10/18/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Cognitive Muscular TherapyTM (CMT) is an integrated behavioural intervention developed for knee osteoarthritis. CMT teaches patients to reconceptualise the condition, integrates muscle biofeedback and aims to reduce muscle overactivity, both in response to pain and during daily activities. This nested qualitative study explored patient and physiotherapist perspectives and experiences of CMT. METHODS Five physiotherapists were trained to follow a well-defined protocol and then delivered CMT to at least two patients with knee osteoarthritis. Each patient received seven individual clinical sessions and was provided with access to online learning materials incorporating animated videos. Semi-structured interviews took place after delivery/completion of the intervention and data were analysed at the patient and physiotherapist level. RESULTS Five physiotherapists and five patients were interviewed. All described a process of changing beliefs throughout their engagement with CMT. A framework with three phases was developed to organise the data according to how osteoarthritis was conceptualised and how this changed throughout their interactions with CMT. Firstly, was an identification of pain beliefs to be challenged and recognition of how current beliefs can misalign with daily experiences. Secondly was a process of challenging and changing beliefs, validated through new experiences. Finally, there was an embedding of changed beliefs into self-management to continue with activities. CONCLUSION This study identified a range of psychological changes which occur during exposure to CMT. These changes enabled patients to reconceptualise their condition, develop a new understanding of their body, understand psychological processes, and make sense of their knee pain.
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Affiliation(s)
- Daniela Ghio
- Division of Psychology and Mental Health, Faculty of Biology, School of Health Sciences, Medicine, and Health, University of Manchester, Manchester, UK
| | - Nathan Brookes
- School of Health and Society, Health Sciences, University of Salford, Manchester, UK
| | - Stephen Preece
- School of Health and Society, Health Sciences, University of Salford, Manchester, UK
| | - Nicola Walsh
- Centre for Health and Clinical Research, University of the West of England, Bristol, UK
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Mountain DC, Ali SM, Ghio D, McDonagh JE, Cordingley L, Lee RR. Beliefs About Pain in Pediatric Inflammatory and Noninflammatory Chronic Musculoskeletal Conditions: A Scoping Review. J Pediatr Psychol 2023; 48:825-841. [PMID: 37738667 PMCID: PMC10588974 DOI: 10.1093/jpepsy/jsad046] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE The Common Sense Self-Regulatory Model posits that beliefs about pain influence coping behaviors and subsequent physical and mental health outcomes in children/young people with chronic musculoskeletal conditions. It was unclear how and what beliefs had been investigated in this population, and whether there were similarities and differences in beliefs held about pain by those experiencing inflammatory versus noninflammatory musculoskeletal conditions. This scoping review addressed this gap. METHODS A systematic search was conducted using four databases (MEDLINE, PsycINFO, Embase, and CINAHL) in November 2021. Primary studies exploring key stakeholders' (including children, parents, and/or healthcare professionals) beliefs about pain underlying pediatric chronic musculoskeletal conditions were synthesized. RESULTS Eighteen articles were identified. Cross-sectional designs were predominantly used to explore beliefs (n = 6). The majority used questionnaires to assess beliefs (n = 12). Beliefs common across musculoskeletal conditions were that children/young people felt their pain was not understood by others, and pain affected their physical functioning. Differences included children/young people and parents thinking they had some ability to control pain, and causal beliefs relating to underlying disease activity. These pain beliefs were more likely to be held in relation to inflammatory diagnoses. In contrast, children/young people and parents were more likely to view pain as uncontrollable, with more uncertainty regarding underlying causes, relating to noninflammatory diagnoses. CONCLUSIONS Methods used to explore pain beliefs were inconsistent. Studies identified similarities and differences which appear to be closely related to the underlying diagnosis. Findings justify further exploration to identify potentially modifiable targets to improve pain outcomes in this population.
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Affiliation(s)
- Danielle C Mountain
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University Hospital NHS Trust, Manchester Academic Health Science Centre, UK
- Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, UK
| | - Syed Mustafa Ali
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
- Division of Informatics, Imaging and Data Sciences, Centre for Health Informatics, Manchester Academic Health Sciences Centre, University of Manchester, UK
| | - Daniela Ghio
- Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, UK
| | - Janet E McDonagh
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University Hospital NHS Trust, Manchester Academic Health Science Centre, UK
| | - Lis Cordingley
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University Hospital NHS Trust, Manchester Academic Health Science Centre, UK
- Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, UK
| | - Rebecca R Lee
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University Hospital NHS Trust, Manchester Academic Health Science Centre, UK
- Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, UK
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Bignami-Van Assche S, Ghio D, Stilianakis NI. Demographic risk factors, healthcare utilization, and mortality during the first year of the Covid-19 pandemic in Austria, Germany, and Italy. Popul Stud (Camb) 2023:1-12. [PMID: 37338504 DOI: 10.1080/00324728.2023.2217789] [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: 06/21/2023]
Abstract
At the population level, there is limited empirical evidence on the characteristics of individuals who were hospitalized because of Covid-19, the role of hospitalization in mortality risk, and how both evolved over time. Through the analysis of surveillance data for 7 million people in Austria, Germany, and Italy, we investigate: (1) the demographic characteristics and outcomes of individuals hospitalized because of Covid-19; and (2) the role of demographic risk factors and healthcare utilization (as measured by hospitalization) for the individual probability of dying because of Covid-19, in both cases comparing the period February to June 2020 with July 2020 to February 2021. We find that the demographic profile of individuals who were hospitalized or died because of Covid-19 is the same in both periods, except for a younger age profile for hospitalizations in the second period. Mortality differentials across countries result from the interaction of demographic risk factors and hospitalization at the individual level.
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Muller I, Ghio D, Mobey J, Jones H, Hornsey S, Dobson A, Maund E, Santer M. Parental perceptions and experiences of infant crying: A systematic review and synthesis of qualitative research. J Adv Nurs 2023; 79:403-417. [PMID: 36373818 PMCID: PMC10100257 DOI: 10.1111/jan.15492] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 10/12/2022] [Accepted: 10/30/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Excessive infant crying is common and can have a huge impact on families and well-being. Systematically reviewing qualitative studies on infant crying can provide a greater understanding of parental perceptions and experiences. AIM This study sought to systematically review and thematically synthesize qualitative studies exploring parents/carers' views and experiences of infant crying. DESIGN A systematic review and synthesis of qualitative research. DATA SOURCES Electronic databases MEDLINE, EMBASE, PsycINFO and CINAHL were searched from the earliest date available to January 2022. We selected papers focussing on parents/carers' experiences, views, attitudes and beliefs about infant crying. We excluded papers focussing on health professionals' views and children older than 12 months. REVIEW METHODS Thematic synthesis was followed for the analysis of included studies and quality appraisal was conducted. RESULTS We synthesized 22 papers, reporting data from 376 participants in eight countries. Four analytical themes were developed: (1) Experiences and impact of crying; (2) parental management strategies; (3) the role of the health professional; (4) the role of infant feeding and maternal diet. Our findings suggest that infant crying has a substantial emotional impact on parents/carers that often impacts relationships. Parents/carers reported using a range of soothing techniques and coping strategies but were desperate to find effective treatment or cure. Support was often perceived as lacking. Excessive crying and beliefs about the role of maternal diet on breastmilk were reported to undermine parents' confidence in breastfeeding by making them feel their milk is insufficient or harmful, or through pressure from others to stop breastfeeding. CONCLUSION Parents/carers use a range of strategies to interpret and deal with the challenges of infant crying, but there is a need for more information and support. IMPACT Findings can be used to inform future research and interventions to support families experiencing excessive infant crying.
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Affiliation(s)
- Ingrid Muller
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Daniela Ghio
- Department of Psychology, University of Manchester, Manchester, UK
| | - Jasmine Mobey
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Hannah Jones
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Samantha Hornsey
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Amy Dobson
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Emma Maund
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Miriam Santer
- Primary Care Research Centre, University of Southampton, Southampton, UK
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Ghio D, Bratti M, Bignami S. Does speaking or writing Italian make differences? International Migration 2023. [DOI: 10.1111/imig.13098] [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] [Indexed: 02/01/2023]
Affiliation(s)
- Daniela Ghio
- Canada Excellence Research Chair in Migration and Integration (CERC) Canada Excellence Research Chair in Migration and Integration ‐ Chaire d’Excellence en Recherche du Canada sur les Migrations et L’Integration, Toronto Metropolitan University Toronto Canada
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Ghio D, Calam R, Lee RR, Cordingley L, Ulph F. "I just want to be normal": A qualitative investigation of adolescents' coping goals when dealing with pain related to arthritis and the underlying parent-adolescent personal models. Paediatr Neonatal Pain 2022; 4:96-109. [PMID: 36188161 PMCID: PMC9485820 DOI: 10.1002/pne2.12069] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/06/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022]
Abstract
The aim of the current study was to examine adolescents' goals when coping with pain and map these goals to the cognitive and emotional profiles of both adolescent and their parent. 17 adolescents (11-16 years) and their parents participated in a cohort study of Juvenile Idiopathic Arthritis (JIA); the adolescents, took part in a two-part interview (about their pain perceptions and about a recent pain experience) and the parents completed an open-ended qualitative survey. The three datasets were analysed following a qualitative framework approach. A coping framework was developed and cognitive and emotional profiles for both adolescent and parent were mapped back to the framework. The overall goal of adolescents was to preserve social identity, by either focusing on maintaining a "normal" lifestyle (sub-coping goal one) or managing the pain (sub-coping goal two). Across these two sub-coping goals, the adolescents held similar cognitive profiles (beliefs about timeline, consequences, control) but different emotional profiles such as feeling fine/happy compared with feeling angry and frustrated. Conversely, the parents' cognitive and emotional profiles were mapped back to the two groups and found that their beliefs were different across the two sub-coping goals but had similar emotional profiles across the two groups such as worry. Both the adolescents' emotional representations and parental cognitive profiles seem to be related to how the adolescent perceives a pain event, deals with the pain, and the overall coping goal of the adolescent. Findings are suggestive that parental pain beliefs influence the adolescents' pain representations and their coping goals but are also driven by adolescents' emotions. Further work on these potential pathways is needed. Family interventions should be designed, targeting coping goals taking into consideration the importance of emotions for adolescents and parental pain beliefs.
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Affiliation(s)
- Daniela Ghio
- Division of Psychology & Mental HealthSchool of Health SciencesFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
| | - Rachel Calam
- Division of Psychology & Mental HealthSchool of Health SciencesFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
| | - Rebecca Rachael Lee
- NIHR Manchester Biomedical Research CentreManchester Academic Health Science CentreManchester University NHS Foundation TrustManchesterUK
- Versus Arthritis Centre for Musculoskeletal ResearchUniversity of Manchester UniversityManchesterUK
| | - Lis Cordingley
- NIHR Manchester Biomedical Research CentreManchester Academic Health Science CentreManchester University NHS Foundation TrustManchesterUK
- Versus Arthritis Centre for Musculoskeletal ResearchUniversity of Manchester UniversityManchesterUK
| | - Fiona Ulph
- Division of Psychology & Mental HealthSchool of Health SciencesFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchesterUK
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Bignami-Van Assche S, Ghio D. Comparing COVID-19 fatality across countries: a synthetic demographic indicator. J Pop Research 2022; 39:513-525. [PMID: 36065463 PMCID: PMC9430010 DOI: 10.1007/s12546-022-09289-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 02/04/2022] [Accepted: 04/20/2022] [Indexed: 11/21/2022]
Abstract
Background The case fatality rate (CFR) is one of the most important measures for monitoring disease progression and evaluating appropriate policy health measures over the course of the COVID-19 pandemic. To remove biases arising from the age structure of COVID-19 cases in international comparisons of the CFR, existing studies have relied mainly on direct standardisation. Objective We propose and validate a synthetic indicator of COVID-19 fatality (SCFR) that improves its comparability across countries by adjusting for the age and sex structure of COVID-19 cases without relying on the arbitrary choice of a standard population. Results Contrary to what comparisons of the crude CFR suggest, differences in COVID-19 fatality across countries according to the proposed SCFR are not very stark. Importantly, once we adjust for the age structure of COVID-19 cases, the higher case fatality among men emerges as the main driver of international differences in COVID-19 CFR. Conclusions The SCFR is a simple indicator that is useful for monitoring the fatality of SARS-CoV-2 mutations and the efficacy of health policy measures for COVID-19, including vaccination. Contributions (1) A simple synthetic indicator of COVID-19 fatality that improves its comparability across countries by adjusting for the age and sex structure of COVID-19 cases; (2) Evidence that sex differences in COVID-19 fatality drive international differences in the overall CFR.
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Ghio D, Bratti M, Bignami S. Linguistic Barriers to Immigrants’ Labor Market Integration in Italy. International Migration Review 2022. [DOI: 10.1177/01979183221107923] [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: 11/17/2022]
Abstract
This article investigates whether and to what extent poor proficiency in Italian impairs immigrants’ labor market integration in Italy. Using individual-level survey data, we apply instrumental variables methods to leverage presumably exogenous variations in Italian proficiency induced by immigrants’ demo-linguistic characteristics (e.g., age at arrival, linguistic distance between mother tongue and destination language, speaking Italian during childhood) and their interplays. We find that, given the low-skill nature of Italy's immigrant labor market, poor proficiency in communication skills (speaking and understanding Italian) produces larger penalties for immigrants’ labor force participation and employment than does the lack of formal skills (reading and writing). In contrast, no effect is found on immigrants’ job characteristics like the type of contract and full-time or part-time work. Whereas female immigrants were more penalized than males by poor linguistic proficiency in labor force participation, immigrants in linguistic groups that were more likely to work with (for) co-nationals were less affected by linguistic barriers than other immigrant groups. Yet, when investigating perceived integration outcomes, immigrants working with (for) co-nationals fared worse on feeling at home, feeling accepted, and overall life satisfaction in Italy. As our analysis shows, linguistic enclaves in workplaces, while not always representing a hurdle to immigrants’ labor market success, can generate trade-offs for other non-labor market integration outcomes. These findings highlight that the development of linguistic skills should be prioritized in migration policy agendas, taking into account heterogeneity in immigrants’ demographic and linguistic profiles.
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Affiliation(s)
- Daniela Ghio
- European Commission Joint Research Centre, Ispra, Italy
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12
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Sivyer K, Teasdale E, Greenwell K, Steele M, Ghio D, Ridd MJ, Roberts A, Chalmers JR, Lawton S, Langan SM, Cowdell F, Le Roux E, Wilczynska S, Williams HC, Thomas KS, Yardley L, Santer M, Muller I. Supporting families managing childhood eczema: developing and optimising eczema care online using qualitative research. Br J Gen Pract 2022; 72:e378-e389. [PMID: 35577586 PMCID: PMC9119812 DOI: 10.3399/bjgp.2021.0503] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 02/01/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Childhood eczema is often poorly controlled owing to underuse of emollients and topical corticosteroids (TCS). Parents/carers report practical and psychosocial barriers to managing their child's eczema, including child resistance. Online interventions could potentially support parents/carers; however, rigorous research developing such interventions has been limited. AIM To develop an online behavioural intervention to help parents/carers manage and co-manage their child's eczema. DESIGN AND SETTING Intervention development using a theory-, evidence-, and person-based approach (PBA) with qualitative research. METHOD A systematic review and qualitative synthesis of studies (n = 32) and interviews with parents/carers (n = 30) were used to identify barriers and facilitators to effective eczema management, and a prototype intervention was developed. Think-aloud interviews with parents/carers (n = 25) were then used to optimise the intervention to increase its acceptability and feasibility. RESULTS Qualitative research identified that parents/carers had concerns about using emollients and TCS, incomplete knowledge and skills around managing eczema, and reluctance to transitioning to co-managing eczema with their child. Think-aloud interviews highlighted that, while experienced parents/carers felt they knew how to manage eczema, some information about how to use treatments was still new. Techniques for addressing barriers included providing a rationale explaining how emollients and TCS work, demonstrating how to use treatments, and highlighting that the intervention provided new, up-to-date information. CONCLUSION Parents/carers need support in effectively managing and co-managing their child's eczema. The key output of this research is Eczema Care Online for Families, an online intervention for parents/carers of children with eczema, which is being evaluated in a randomised trial.
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Affiliation(s)
- Katy Sivyer
- Department of Psychology, University of Southampton, Southampton; lecturer, University of Portsmouth, Portsmouth
| | | | | | | | - Daniela Ghio
- University of Manchester, Manchester; research fellow, University of Southampton, Southampton
| | | | | | | | | | | | | | | | | | | | | | - Lucy Yardley
- University of Bristol, Bristol; professor of health psychology, University of Southampton, Southampton
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Epton T, Ghio D, Ballard LM, Allen SF, Kassianos AP, Hewitt R, Swainston K, Fynn WI, Rowland V, Westbrook J, Jenkinson E, Morrow A, McGeechan GJ, Stanescu S, Yousuf AA, Sharma N, Begum S, Karasouli E, Scanlan D, Shorter GW, Arden MA, Armitage CJ, O'Connor DB, Kamal A, McBride E, Swanson V, Hart J, Byrne-Davis L, Chater A, Drury J. Interventions to promote physical distancing behaviour during infectious disease pandemics or epidemics: A systematic review. Soc Sci Med 2022; 303:114946. [PMID: 35605431 PMCID: PMC8957361 DOI: 10.1016/j.socscimed.2022.114946] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Physical distancing, defined as keeping 1-2m apart when co-located, can prevent cases of droplet or aerosol transmitted infectious diseases such as SARS-CoV2. During the COVID-19 pandemic, distancing was a recommendation or a requirement in many countries. This systematic review aimed to determine which interventions and behavior change techniques (BCTs) are effective in promoting adherence to distancing and through which potential mechanisms of action (MOAs). METHODS Six databases were searched. The review included studies that were (a) conducted on humans, (b) reported physical distancing interventions, (c) included any comparator (e.g., pre-intervention versus post-intervention; randomized controlled trial), and (d) reported actual distancing or predictors of distancing behavior. Risk of bias was assessed using the Mixed Methods Appraisal Tool. BCTs and potential MoAs were identified in each intervention. RESULTS Six articles (with seven studies and 19 comparisons) indicated that distancing interventions could successfully change MoAs and behavior. Successful BCTs (MoAs) included feedback on behavior (e.g., motivation); information about health consequences, salience of health consequences (e.g., beliefs about consequences), demonstration (e.g., beliefs about capabilities), and restructuring the physical environment (e.g., environmental context and resources). The most promising interventions were proximity buzzers, directional systems, and posters with loss-framed messages that demonstrated the behaviors. CONCLUSIONS The evidence indicates several BCTs and potential MoAs that should be targeted in interventions and highlights gaps that should be the focus of future research.
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Affiliation(s)
- Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, UK,Corresponding author. Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Daniela Ghio
- Manchester Centre for Health Psychology, University of Manchester, UK
| | | | - Sarah F. Allen
- School of Social Sciences, Humanities and Law, Teesside University, UK
| | | | | | - Katherine Swainston
- Psychology, Centre for Applied Psychological Science, Teesside University, UK
| | | | | | | | - Elizabeth Jenkinson
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | | | - Sabina Stanescu
- School of Psychology, University of Southampton, Southampton, UK
| | | | - Nisha Sharma
- Department of Clinical Health Psychology, Royal National Orthopaedic Hospital, UK
| | - Suhana Begum
- Department of Psychology, City University of London, UK,Surrey County Council, UK
| | | | - Daniel Scanlan
- Research and Communication, Education Support, London, N5 1EW, UK
| | - Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, Queen's University Belfast, UK
| | - Madelynne A. Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, UK
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, UK,Manchester University NHS Foundation Trust, University of Manchester, UK,Manchester Academic Health Science Centre, University of Manchester, UK,NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK
| | | | - Atiya Kamal
- Department of Psychology, Birmingham City University, UK
| | - Emily McBride
- Department of Behavioural Science and Health, University College London, UK
| | | | - Jo Hart
- Manchester Centre for Health Psychology, University of Manchester, UK,Division of Medical Education, University of Manchester, UK
| | - Lucie Byrne-Davis
- Manchester Centre for Health Psychology, University of Manchester, UK,Division of Medical Education, University of Manchester, UK
| | | | - John Drury
- School of Psychology, University of Sussex, UK
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14
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Albasri R, Metcalfe P, Ghio D. P173 Using art workshops to facilitate research priority settings: identifying research questions with primary school children with juvenile idiopathic arthritis. Rheumatology (Oxford) 2022. [DOI: 10.1093/rheumatology/keac133.172] [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: 11/12/2022] Open
Abstract
Abstract
Background/Aims
Juvenile idiopathic arthritis (JIA) is an umbrella term of seven heterogeneous subtypes of childhood chronic inflammatory arthritis defined by joint swelling or limited movement due to joint pain or tenderness. Treatment plans vary but also involve managing and monitoring the symptoms of the disease. The most common symptom is pain; however, children also experience stiffness and fatigue alongside possible side effects from treatments such as methotrexate which include nausea, headaches and what is referred to as “methotrexate fog”. Research into these symptoms and side effects management can help support children and their parents and improve quality of life. One way to identify key research questions around these topics is through priority setting.
Methods
In collaboration with Children’s Chronic Arthritis Associations (CCAA) and Teapot Trust, an art therapy charity, we hosted multiple online workshops with children aged 6 to 11 and their caregivers. In these workshops we aimed to identify questions and priorities for this population. To establish children’s research priorities, art workshops for children with JIA were carried out facilitated by an art therapist. Art therapy techniques were utilised as it allows for creative ways to have conversations on symptoms of JIA and side effects from treatment. Children and their parent signed up through a specifically designed website. Materials were sent in advance and instructions were provided during the session by the art therapist and researchers (RA and DG) were there to take notes and facilitate discussion around research questions. Examples of activities include drawing a safe room followed by questions regarding what they would take with them and making themselves out of clay to gain a better understanding of how they view themselves and their symptoms. Specific probing questions were then explored to discuss what tools can be developed to address challenges they identified.
Results
The information was collated to list six research questions. Priorities were found to be around blood tests, taking medication, managing side effects and strategies used to deal with big emotions (e.g., anger, sadness, worry). Other challenges identified by the groups included managing others and school, and management of flare ups and the impact they have on sleep.
Conclusion
Children and parents are invited to take further part in voting on listing priorities and to provide feedback on the collated questions. Together this will establish next steps in research for managing treatment and symptoms in JIA based on what they perceive as a priority. This will allow for the research questions to be shaped by experiences and needs that have been identified by the population.
Disclosure
R. Albasri: Grants/research support; Financial statement: This study was supported by the NMAHPs Internship Versus Arthritis (Grant reference 22082), Affiliation: NMAHPs Internship Versus Arthritis, University of Salford. Other; Acknowledgements: Thank you to Emily Earle, Kirsty Edwards, Jane Voce and in general the CCAA and Teapot trust for this collaborative work. P. Metcalfe: None. D. Ghio: None.
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Affiliation(s)
- Renad Albasri
- Department of Psychology, University of Salford, Salford, UNITED KINGDOM
| | - Paige Metcalfe
- Department of Psychology, University of Salford, Salford, UNITED KINGDOM
| | - Daniela Ghio
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UNITED KINGDOM
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15
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Greenwell K, Ghio D, Sivyer K, Steele M, Teasdale E, Ridd MJ, Roberts A, Chalmers JR, Lawton S, Langan S, Cowdell F, Le Roux E, Wilczynska S, Jones H, Whittaker E, Williams HC, Thomas KS, Yardley L, Santer M, Muller I. Eczema Care Online: development and qualitative optimisation of an online behavioural intervention to support self-management in young people with eczema. BMJ Open 2022; 12:e056867. [PMID: 35443955 PMCID: PMC9021764 DOI: 10.1136/bmjopen-2021-056867] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To describe the development of Eczema Care Online (ECO), an online behaviour change intervention for young people with eczema (phase I); and explore and optimise the acceptability of ECO among this target group using think-aloud interviews (phase II). METHODS Theory-based, evidence-based and person-based approaches to intervention development were used. In phase I, a qualitative systematic review and qualitative interviews developed an in-depth understanding of the needs and challenges of young people with eczema. Guiding principles highlighted key intervention design objectives and features to address the needs of this target group to maximise user engagement. Behavioural analysis and logic modelling developed ECO's hypothesised programme theory. In phase II, qualitative think-aloud interviews were carried out with 28 young people with eczema and the intervention was optimised based on their feedback. RESULTS The final intervention aimed to reduce eczema severity by supporting treatment use (emollients, topical corticosteroids/topical calcineurin inhibitors), management of irritants/triggers, emotional management and reducing scratching. Generally, young people expressed positive views of intervention content and design in think-aloud interviews. Quotes and stories from other young people with eczema and ECO's focus on living with eczema (not just topical treatments) were valuable for normalising eczema. Young people believed ECO addressed knowledge gaps they had from childhood and the safety information about topical corticosteroids was reassuring. Negative feedback was used to modify ECO. CONCLUSIONS A prototype of the ECO intervention was developed using rigorous and complementary intervention development approaches. Subsequent think-aloud interviews helped optimise the intervention, demonstrated ECO is likely to be acceptable to this target group, and provided support for our guiding principles including key design objectives and features to consider when developing interventions for this population. A randomised controlled trial and process evaluation of the intervention is underway to assess effectiveness and explore user engagement with the intervention's behavioural goals.
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Affiliation(s)
- Kate Greenwell
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Daniela Ghio
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Katy Sivyer
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Department of Psychology, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Mary Steele
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Emma Teasdale
- School of Primary Care, Population Health and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Matthew J Ridd
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Amanda Roberts
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Joanne R Chalmers
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sandra Lawton
- Department of Dermatology, Rotherham NHS Foundation Trust, Rotherham, UK
| | - Sinead Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Fiona Cowdell
- Faculty of Health Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - Emma Le Roux
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Sylvia Wilczynska
- School of Primary Care, Population Health and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Hannah Jones
- Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - H C Williams
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Kim Suzanne Thomas
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Centre for Academic Primary Care, School of Psychological Science, University of Bristol, Bristol, UK
| | - Miriam Santer
- School of Primary Care, Population Health and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ingrid Muller
- School of Primary Care, Population Health and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
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16
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Krusche A, Wilde L, Ghio D, Morrissey C, Froom A, Chick D. Developing public transport messaging to provide crowding information during COVID-19: Application of the COM-B model and behaviour change wheel. Transp Res Interdiscip Perspect 2022; 13:100564. [PMID: 35224474 PMCID: PMC8860671 DOI: 10.1016/j.trip.2022.100564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/27/2022] [Accepted: 02/06/2022] [Indexed: 05/20/2023]
Abstract
The COVID-19 outbreak meant that using public transport was potentially unsafe for risk of catching and transmitting the virus. UK anxiety is high with lockdowns preventing a normal way of life for over a year. A lack of ability to travel freely causes numerous declines in quality of life including social isolation and poor physical and mental health. People need crowding information to choose safer travel options and subdue coronavirus. To provide effective guidance, it is essential to empirically formulate messaging to create clarity and trust which can be acted upon in confidence. Behaviour Change Techniques incorporating the Behaviour Change Wheel and COM-B model have been utilised in vast areas of public health intervention development and messaging. There is consensus that public transport information needs to be clearer and more accessible but BCTs have not been utilised in the development of public transport advice. This paper outlines the development of crowding messaging for public transport on a platform available to UK travellers. Barriers and facilitators were explored; related behaviours, intervention functions and behaviour change techniques were mapped. Specific message phrasing was developed utilising the mapped functions and advice from the literature. With the COVID-19 outbreak, having accessible and effective messaging for safely using public transport is a continuation of the work recently conducted examining the best ways to present public health information. It is important to be transparent when developing messaging and interventions accessible to the public and this work forms a basis for continued exploration and development in this area.
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Affiliation(s)
- Adele Krusche
- Zipabout Limited, 1 Chapel Court, Holly Walk, Leamington Spa CV32 4YS, UK
| | - Laura Wilde
- Zipabout Limited, 1 Chapel Court, Holly Walk, Leamington Spa CV32 4YS, UK
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Daniela Ghio
- School of Health and Society, L818 Allerton Building, University of Salford, Manchester M6 6PU, UK
| | - Cora Morrissey
- Zipabout Limited, 1 Chapel Court, Holly Walk, Leamington Spa CV32 4YS, UK
| | - Alex Froom
- Zipabout Limited, 1 Chapel Court, Holly Walk, Leamington Spa CV32 4YS, UK
| | - Daniel Chick
- Zipabout Limited, 1 Chapel Court, Holly Walk, Leamington Spa CV32 4YS, UK
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17
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Payne L, Ghio D, Grey E, Slodkowska-Barabasz J, Harris P, Sutcliffe M, Green S, Roberts HC, Childs C, Robinson S, Gudgin B, Holloway P, Kelly J, Wallis K, Dean O, Aveyard P, Gill P, Stroud M, Little P, Yardley L, Morrison L. Optimising an intervention to support home-living older adults at risk of malnutrition: a qualitative study. BMC Fam Pract 2021; 22:219. [PMID: 34758733 PMCID: PMC8580738 DOI: 10.1186/s12875-021-01572-z] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022]
Abstract
Background In the UK, about 14% of community-dwelling adults aged 65 and over are estimated to be at risk of malnutrition. Screening older adults in primary care and treating those at risk may help to reduce malnutrition risk, reduce the resulting need for healthcare use and improve quality of life. Interventions are needed to raise older adults’ risk awareness, offer relevant and meaningful strategies to address risk and support general practices to deliver treatment and support. Methods Using the Person-based Approach and input from Patient and Public Involvement representatives, we developed the ‘Eat well, feel well, stay well’ intervention. The intervention was optimised using qualitative data from think aloud and semi-structured process evaluation interviews with 23 and 18 older adults respectively. Positive and negative comments were extracted to inform rapid iterative modifications to support engagement with the intervention. Data were then analysed thematically and final adjustments made, to optimise the meaningfulness of the intervention for the target population. Results Participants’ comments were generally positive. This paper focuses predominantly on participants’ negative reactions, to illustrate the changes needed to ensure that intervention materials were optimally relevant and meaningful to older adults. Key factors that undermined engagement included: resistance to the recommended nutritional intake among those with reduced appetite or eating difficulties, particularly frequent eating and high energy options; reluctance to gain weight; and a perception that advice did not align with participants’ specific personal preferences and eating difficulties. We addressed these issues by adjusting the communication of eating goals to be more closely aligned with older adults’ beliefs about good nutrition, and acceptable and feasible eating patterns. We also adjusted the suggested tips and strategies to fit better with older adults’ everyday activities, values and beliefs. Conclusions Using iterative qualitative methods facilitated the identification of key behavioural and contextual elements that supported engagement, and issues that undermined older adults’ engagement with intervention content. This informed crucial revisions to the intervention content that enabled us to maximise the meaningfulness, relevance and feasibility of the key messages and suggested strategies to address malnutrition risk, and therefore optimise engagement with the intervention and the behavioural advice it provided. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01572-z.
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Affiliation(s)
- Liz Payne
- School of Psychology, University of Southampton, Southampton, UK.
| | - Daniela Ghio
- Primary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | | | - Philine Harris
- School of Psychology, University of Southampton, Southampton, UK
| | - Michelle Sutcliffe
- Dietetics Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sue Green
- Department for Nursing Science, Bournemouth University, Poole, UK
| | - Helen C Roberts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Caroline Childs
- Human Development and Health, University of Southampton, Southampton, UK
| | - Sian Robinson
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Bernard Gudgin
- Public and Patient Involvement, University of Southampton, Southampton, UK
| | - Pam Holloway
- Public and Patient Involvement, University of Southampton, Southampton, UK
| | - Jo Kelly
- Primary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Kathy Wallis
- Wessex Academic Health Science Network, Southampton, UK
| | - Oliver Dean
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Paramjit Gill
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Mike Stroud
- Clinical Nutrition, University of Southampton, Southampton, UK
| | - Paul Little
- Primary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Lucy Yardley
- School of Psychology, University of Southampton, Southampton, UK.,School of Psychological Science, University of Bristol, Bristol, UK
| | - Leanne Morrison
- School of Psychology, University of Southampton, Southampton, UK.,Primary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK
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18
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Ghio D, Lawes-Wickwar S, Tang MY, Epton T, Howlett N, Jenkinson E, Stanescu S, Westbrook J, Kassianos AP, Watson D, Sutherland L, Stanulewicz N, Guest E, Scanlan D, Carr N, Chater A, Hotham S, Thorneloe R, Armitage CJ, Arden M, Hart J, Byrne-Davis L, Keyworth C. What influences people's responses to public health messages for managing risks and preventing infectious diseases? A rapid systematic review of the evidence and recommendations. BMJ Open 2021; 11:e048750. [PMID: 34764167 PMCID: PMC8587350 DOI: 10.1136/bmjopen-2021-048750] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Individual behaviour changes, such as hand hygiene and physical distancing, are required on a population scale to reduce transmission of infectious diseases such as COVID-19. However, little is known about effective methods of communicating risk reducing information, and how populations might respond. OBJECTIVE To synthesise evidence relating to what (1) characterises effective public health messages for managing risk and preventing infectious disease and (2) influences people's responses to messages. DESIGN A rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704. DATA SOURCES Electronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020. STUDY SELECTION All study designs that (1) evaluated public health messaging interventions targeted at adults and (2) concerned a communicable disease spread via primary route of transmission of respiratory and/or touch were included. Outcomes included preventative behaviours, perceptions/awareness and intentions. Non-English language papers were excluded. SYNTHESIS Due to high heterogeneity studies were synthesised narratively focusing on determinants of intentions in the absence of measured adherence/preventative behaviours. Themes were developed independently by two researchers and discussed within team to reach consensus. Recommendations were translated from narrative synthesis to provide evidence-based methods in providing effective messaging. RESULTS Sixty-eight eligible papers were identified. Characteristics of effective messaging include delivery by credible sources, community engagement, increasing awareness/knowledge, mapping to stage of epidemic/pandemic. To influence intent effectively, public health messages need to be acceptable, increase understanding/perceptions of health threat and perceived susceptibility. DISCUSSION There are four key recommendations: (1) engage communities in development of messaging, (2) address uncertainty immediately and with transparency, (3) focus on unifying messages from sources and (4) frame messages aimed at increasing understanding, social responsibility and personal control. Embedding principles of behavioural science into public health messaging is an important step towards more effective health-risk communication during epidemics/pandemics.
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Affiliation(s)
- Daniela Ghio
- Department of Psychology, Faculty of Health and Society, University of Salford, Manchester, UK
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Sadie Lawes-Wickwar
- Department of Primary Care and Population Health, University College London, London, UK
| | - Mei Yee Tang
- Behavioural Science Policy Research Unit, Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Neil Howlett
- Department of Psychology, Sports, and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK
| | - Elizabeth Jenkinson
- Department of Health and Social Sciences, University of West England, Bristol, UK
| | - Sabina Stanescu
- School of Psychology, University of Southampton, Southampton, UK
| | | | - Angelos P Kassianos
- Department of Applied Health Research, University College London, London, UK
| | - Daniella Watson
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lisa Sutherland
- Behavioural Insight for Public Affairs, Ipsos Mori, Edinburgh & London, UK
| | - Natalia Stanulewicz
- Faculty of Health and Life Sciences, School of Applied Social Sciences, De Montfort University, Leicester, UK
| | - Ella Guest
- Centre for Appearance Research,Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Daniel Scanlan
- Department of Communication, Policy, and Research, Education Support, London, UK
| | - Natalie Carr
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
- Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Angel Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedfordshire, UK
| | - Sarah Hotham
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Rachael Thorneloe
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester; and NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Madelynne Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - Jo Hart
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Lucie Byrne-Davis
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Christopher Keyworth
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
- School of Psychology, University of Leeds, Leeds, UK
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19
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Bignami-Van Assche S, Boujija Y, Ghio D, Stilianakis NI. Beware of regional heterogeneity when assessing the role of schools in the SARS-CoV-2 second wave in Italy. Lancet Reg Health Eur 2021; 7:100174. [PMID: 34557849 PMCID: PMC8454866 DOI: 10.1016/j.lanepe.2021.100174] [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] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/11/2021] [Accepted: 06/28/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Simona Bignami-Van Assche
- Département de démographie, Université de Montréal, 3150 rue Jean Brillant, Montréal, Québec H3C 3J3, Canada
| | - Yacine Boujija
- Département de démographie, Université de Montréal, 3150 rue Jean Brillant, Montréal, Québec H3C 3J3, Canada
| | - Daniela Ghio
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Nikolaos I Stilianakis
- European Commission, Joint Research Centre (JRC), Ispra, Italy.,Department of Biometry and Epidemiology, University of Erlangen-Nuremberg, Erlangen, Germany
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20
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Ghio D, Acosta E, Fisman D, Noymer A, Stilianakis NI, Assche SBV. Population Health and COVID-19 in Canada: a Demographic Comparative Perspective. Can Stud Popul 2021; 48:131-137. [PMID: 34566247 PMCID: PMC8455230 DOI: 10.1007/s42650-021-00057-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Daniela Ghio
- European Commission Joint Research Center, Ispra, Italy
| | - Enrique Acosta
- Max Plank Institute for Demographic Research, Rostock, Germany
| | - David Fisman
- Della Lana School of Public Health - University of Toronto, Toronto, Canada
| | | | - Nikolaos I. Stilianakis
- European Commission Joint Research Center, Ispra, Italy
- Department of Biometry and Epidemiology, University of Erlangen-Nuremberg, Erlangen, Germany
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21
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Goujon A, Natale F, Ghio D, Conte A. Demographic and territorial characteristics of COVID-19 cases and excess mortality in the European Union during the first wave. J Popul Res (Canberra) 2021; 39:533-556. [PMID: 34093083 PMCID: PMC8164406 DOI: 10.1007/s12546-021-09263-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2021] [Indexed: 01/01/2023]
Abstract
This article explores for a large number of countries in the European Union (plus the United Kingdom) the main demographic differentials in positive tested COVID-19 cases and excess mortality during the first wave in 2020, accounting for differences at territorial level, where population density and size play a main role in the diffusion and effects of the disease in terms of morbidity and mortality. This knowledge complements and refines the epidemiological information about the spread and impact of the virus. For this analysis, we rely on the descriptive exploration of (1) data from The European Surveillance System (TESSy) database developed at the European Centre for Disease Prevention and Control (ECDC) on the number of cases and fatality rates and (2) of weekly mortality data collected by Eurostat. The analysis at territorial level studies the changes in R0-the basic reproduction number-and median excess mortality, across territories with different levels of urbanization. The unique findings of this study encompassing most European Union Member States confirm and define the demographic and territorial differential impacts in terms of infections and fatalities during the first wave of the pandemic in 2020. The information is important for stakeholders at European Union, national and sub-national levels in charge of designing containment measures for COVID-19 and adaptation policies for the future by anticipating the rebound for certain segments of the population with differential medical and economic needs.
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Affiliation(s)
- Anne Goujon
- European Commission Joint Research Centre, Ispra, Italy
| | | | - Daniela Ghio
- European Commission Joint Research Centre, Ispra, Italy
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22
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Al-Abbadey M, Fong MMW, Wilde LJ, Ingham R, Ghio D. Mobile health apps: An exploration of user-generated reviews in Google Play Store on a physical activity application. Digit Health 2021; 7:20552076211014988. [PMID: 34017609 PMCID: PMC8114246 DOI: 10.1177/20552076211014988] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/12/2021] [Indexed: 11/26/2022] Open
Abstract
Objective This study aimed to evaluate reviews that have been posted publicly on the app ‘MapMyRun’ to investigate which features were associated with usage of the app. A secondary aim was to determine whether MapMyRun consisted of specific behaviour change techniques that would have increased the likelihood of users being engaged with the app. Methods Reviews posted on MapMyRun by users between 1st May 2017- 30th April 2018 were extracted, coded and analysed using content analysis. Results Eleven behaviour change techniques were identified among the features of MapMyRun. A total of 3,253 reviews met the inclusion/exclusion criteria, and 12 codes were developed. The codes were grouped into 8 subthemes within 2 main themes: ‘Effort’ and ‘Self-monitoring’. Consistent with previous literature, ‘Goal-Setting’ and ‘Self-Monitoring of Behaviour’ were two techniques included in MapMyRun. Social features of MapMyRun facilitated competition among users, their family, and friends. Conclusions This was the first qualitative review to assess a single mobile health physical activity app and analyse it from the perspectives of the users. Creators of future mobile health apps should focus on user friendliness and the use of social features, as both may increase the chances of users’ continued use with the app.
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Affiliation(s)
| | - Megan M-W Fong
- Department of Psychology, University of Southampton, Southampton, UK
| | - Laura J Wilde
- Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Roger Ingham
- Department of Psychology, University of Southampton, Southampton, UK
| | - Daniela Ghio
- Primary Care, Population Sciences, and Medical Education, University of Southampton, Southampton, UK
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23
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Teasdale E, Sivyer K, Muller I, Ghio D, Roberts A, Lawton S, Santer M. Children's Views and Experiences of Treatment Adherence and Parent/Child Co-Management in Eczema: A Qualitative Study. Children (Basel) 2021; 8:children8020158. [PMID: 33672514 PMCID: PMC7923777 DOI: 10.3390/children8020158] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/16/2021] [Accepted: 02/16/2021] [Indexed: 11/16/2022]
Abstract
Eczema affects one in five children and can have a substantial impact on quality of life. This qualitative study aimed to explore children's views and experiences of eczema and what may affect treatment adherence from their perspective. We conducted semi-structured, face-to-face interviews with children with eczema aged 6-12 years from March to July 2018. Interviews were transcribed verbatim and analysed using inductive thematic analysis. We found that children do not typically view eczema as a long-term condition, and topical treatments (predominately emollients) were seen to provide effective symptom relief. Uncertainty around co-managing at home was expressed as children typically felt that parental reminders and assistance with applying different types of topical treatments were still needed. For some children, eczema can be difficult to manage at school due to a lack of convenient access and appropriate spaces to apply creams and psychosocial consequences such as attracting unwanted attention from peers and feeling self-conscious. Treatment adherence could be supported by reinforcing that eczema is a long-term episodic condition, providing clear information about regular emollient use, practical advice such as setting reminders to support co-management at home, and working with schools to facilitate topical treatment use when necessary.
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Affiliation(s)
- Emma Teasdale
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK; (I.M.); or (D.G.); (M.S.)
- Correspondence: ; Tel.: +44-2380-591753
| | - Katy Sivyer
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton SO17 1BJ, UK; or
- Department of Psychology, University of Portsmouth, Portsmouth PO1 2UP, UK
| | - Ingrid Muller
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK; (I.M.); or (D.G.); (M.S.)
| | - Daniela Ghio
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK; (I.M.); or (D.G.); (M.S.)
- School of Health and Society, Allerton Building, University of Salford, Manchester M6 6PU, UK
| | - Amanda Roberts
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham NG7 2RD, UK;
| | - Sandra Lawton
- Department of Dermatology, Rotherham NHS Foundation Trust, Rotherham, S60 2UD, UK;
| | - Miriam Santer
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK; (I.M.); or (D.G.); (M.S.)
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24
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Lawes-Wickwar S, Ghio D, Tang MY, Keyworth C, Stanescu S, Westbrook J, Jenkinson E, Kassianos AP, Scanlan D, Garnett N, Laidlaw L, Howlett N, Carr N, Stanulewicz N, Guest E, Watson D, Sutherland L, Byrne-Davis L, Chater A, Hart J, Armitage CJ, Shorter GW, Swanson V, Epton T. A Rapid Systematic Review of Public Responses to Health Messages Encouraging Vaccination against Infectious Diseases in a Pandemic or Epidemic. Vaccines (Basel) 2021; 9:72. [PMID: 33498395 PMCID: PMC7909419 DOI: 10.3390/vaccines9020072] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 12/18/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 01/08/2023] Open
Abstract
Public health teams need to understand how the public responds to vaccination messages in a pandemic or epidemic to inform successful campaigns encouraging the uptake of new vaccines as they become available. A rapid systematic review was performed by searching PsycINFO, MEDLINE, healthevidence.org, OSF Preprints and PsyArXiv Preprints in May 2020 for studies including at least one health message promoting vaccine uptake of airborne-, droplet- and fomite-spread viruses. Included studies were assessed for quality using the Mixed Methods Appraisal Tool (MMAT) or the Assessment of Multiple Systematic Reviews (AMSTAR), and for patient and public involvement (PPI) in the research. Thirty-five articles were included. Most reported messages for seasonal influenza (n = 11; 31%) or H1N1 (n = 11; 31%). Evidence from moderate to high quality studies for improving vaccine uptake included providing information about virus risks and vaccination safety, as well as addressing vaccine misunderstandings, offering vaccination reminders, including vaccination clinic details, and delivering mixed media campaigns across hospitals or communities. Behavioural influences (beliefs and intentions) were improved when: shorter, risk-reducing or relative risk framing messages were used; the benefits of vaccination to society were emphasised; and beliefs about capability and concerns among target populations (e.g., vaccine safety) were addressed. Clear, credible, messages in a language target groups can understand were associated with higher acceptability. Two studies (6%) described PPI in the research process. Future campaigns should consider the beliefs and information needs of target populations in their design, including ensuring that vaccine eligibility and availability is clear, and messages are accessible. More high quality research is needed to demonstrate the effects of messaging interventions on actual vaccine uptake.
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Affiliation(s)
- Sadie Lawes-Wickwar
- Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
| | - Daniela Ghio
- Department of Psychology, Faculty of Health and Society, University of Salford, Manchester M6 6PU, UK;
| | - Mei Yee Tang
- Behavioural Science Policy Research Unit, Population Health Sciences, Newcastle University, Newcastle upon Tyne NE2 4AX, UK;
| | - Chris Keyworth
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
| | - Sabina Stanescu
- School of Psychology, University of Southampton, Southampton SO17 1BJ, UK;
| | | | - Elizabeth Jenkinson
- Department of Health and Social Sciences, University of West England, Bristol BS16 1QY, UK; (E.J.); (N.G.); (E.G.)
| | - Angelos P. Kassianos
- Department of Applied Health Research, University College London, London WC1E 6BT, UK;
| | - Daniel Scanlan
- Department of Communication, Policy, and Research, Education Support, London N5 1EW, UK;
| | - Natalie Garnett
- Department of Health and Social Sciences, University of West England, Bristol BS16 1QY, UK; (E.J.); (N.G.); (E.G.)
| | - Lynn Laidlaw
- Public Contributor, Health Psychology Exchange Patient and Public Involvement (PPI) Group, UK;
| | - Neil Howlett
- Department of Psychology, Sports, and Geography, School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hertfordshire AL10 9AB, UK;
| | - Natalie Carr
- Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Manchester M15 6BH, UK;
| | - Natalia Stanulewicz
- Faculty of Health and Life Sciences, School of Applied Social Sciences, De Montfort University, Leicester LE1 9BH, UK;
| | - Ella Guest
- Department of Health and Social Sciences, University of West England, Bristol BS16 1QY, UK; (E.J.); (N.G.); (E.G.)
| | - Daniella Watson
- Global Health Research Institute, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
| | | | - Lucie Byrne-Davis
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
- Division of Medical Education, University of Manchester, Manchester M13 9PT, UK
| | - Angel Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, Bedfordshire MK41 9EA, UK;
| | - Jo Hart
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
- Division of Medical Education, University of Manchester, Manchester M13 9PT, UK
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
- Manchester Academic Health Science Centre, Health Innovation Manchester, Manchester M13 9NQ, UK
| | - Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, Queen’s University Belfast, Belfast BT7 1NN, UK;
| | - Vivien Swanson
- Department of Psychology, University of Stirling, Stirling FK9 4LA, UK;
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
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Abstract
OBJECTIVES To explore young people's experiences of eczema self-management and interacting with health professionals. DESIGN Secondary qualitative data analysis of data sets from two semistructured interview studies. Data were analysed using inductive thematic analysis. SETTING Participants were recruited from the UK primary care, dermatology departments and a community-based sample (eg, patient representative groups, social media). PARTICIPANTS Data included 28 interviews with young people with eczema aged 13-25 years (mean age=19.5 years; 20 female). RESULTS Although topical treatments were generally perceived as effective, young people expressed doubts about their long-term effectiveness, and concerns around the safety and an over-reliance on topical corticosteroids. Participants welcomed the opportunity to take an active role in their eczema management, but new roles and responsibilities also came with initial apprehension and challenges, including communicating their treatment concerns and preferences with health professionals, feeling unprepared for transition to an adult clinic and obtaining treatments. Decisions regarding whether to engage in behaviours that would exacerbate their eczema (eg, irritants/triggers, scratching) were influenced by young people's beliefs regarding negative consequences of these behaviours, and perceived control over the behaviour and its negative consequences. CONCLUSIONS Behavioural change interventions must address the treatment concerns of young people and equip them with the knowledge, skills and confidence to take an active role in their own eczema management.
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Affiliation(s)
- Kate Greenwell
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Daniela Ghio
- Primary Care, Population Science and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
- Psychology, School of Health and Society, University of Salford, Manchester, UK
| | - Ingrid Muller
- Primary Care, Population Science and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Amanda Roberts
- Centre of Evidence-Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Abigail McNiven
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Sandra Lawton
- Dermatology Department, The Rotherham NHS Foundation Trust, Rotherham, UK
| | - Miriam Santer
- Primary Care, Population Science and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
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26
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Ghio D, Greenwell K, Muller I, Roberts A, McNiven A, Santer M. Psychosocial needs of adolescents and young adults with eczema: A secondary analysis of qualitative data to inform a behaviour change intervention. Br J Health Psychol 2020; 26:214-231. [PMID: 32844574 DOI: 10.1111/bjhp.12467] [Citation(s) in RCA: 13] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/22/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES This study aimed to explore adolescents and young adults' experiences of symptoms related to their eczema in order to determine their psychosocial needs. DESIGN A secondary qualitative analysis of two data sources collected through semi-structured interviews for two different projects, SKINS project and Eczema Care Online project. METHODS In total, there were 28 transcripts with adolescents and young adults with eczema having a mean age of 19.5 years available to analyse. Interview data were collected from face-to-face interviews that were recorded and transcribed. Inductive thematic analysis explored data about symptoms and organized according to psychosocial needs. RESULTS Adolescents and young adults with eczema experience both visible symptoms (such as flaky, dry, and inflamed skin) and invisible symptoms (such as itch, pain, exhaustion, and mental distress) that elicit different psychosocial needs. These psychosocial needs are to (i) be understood; (ii) be perceived as normal; and (iii) receive emotional support. Interviewees described a struggle between wanting their peers and family to understand but take their eczema seriously whilst not wanting to stand out and instead to be perceived as 'normal', which they would define as being perceived as other adolescents. This has implications on behaviours, such as seeking support, avoiding going out, hiding their skin, as well as emotional implications, such as social isolation and feeling anxious and low. CONCLUSIONS Having a better understanding of young people's experiences and psychosocial needs will provide a framework on how best to support adolescents and young adults when managing symptoms related to eczema. Statement of contribution What is already known on this subject? Eczema has a high impact on children and is considered a burden by children and adults with eczema. However, it is unclear what impact eczema has on adolescents and young adults. Adolescents and young adults with chronic conditions are known to be vulnerable to negative psychosocial outcomes but psychosocial needs and how to best support this age group with eczema are unknown What does this add? Three psychosocial needs were developed from evaluating the impact of visible and invisible symptoms of eczema: The need to feel understood (mostly reflective of invisible symptoms such as itch and pain and visible symptoms such as scratching). The need to be perceived as 'normal': visible symptoms such as flaky, inflamed skin make them stand out in comparison with their peers and a need emerged to blend in. The need for emotional support: adolescents and young adults searched for this from their health care providers, from shared experiences and from online resources. Adolescents and young adults with eczema appear to feel ambivalent about wishing the impact of the condition to be acknowledged whilst wishing the condition to be invisible to others. This ambivalence had further impact on feeling self-conscious, seeking support, and dealing with unsolicited advice.
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Affiliation(s)
- Daniela Ghio
- Primary Care and Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, UK
| | - Kate Greenwell
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK
| | - Ingrid Muller
- Primary Care and Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, UK
| | - Amanda Roberts
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, UK
| | - Abigail McNiven
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK
| | - Miriam Santer
- Primary Care and Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, UK
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27
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Payne L, Harris P, Ghio D, Slodkowska-Barabasz J, Sutcliffe M, Kelly J, Stroud M, Little P, Yardley L, Morrison L. Beliefs about inevitable decline among home-living older adults at risk of malnutrition: a qualitative study. J Hum Nutr Diet 2020; 33:841-851. [PMID: 32840942 DOI: 10.1111/jhn.12807] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Approximately 14% of free-living adults aged ≥65 years are at risk of malnutrition. Malnutrition screen and treat interventions in primary care are few, show mixed results, and the advice given is not always accepted and followed. We need to better understand the experiences and contexts of older adults when aiming to develop interventions that are engaging, optimally persuasive and relevant. METHODS Using the Person-based Approach, we carried out 23 semi-structured interviews with purposively selected adults ≥65 years with chronic health or social conditions associated with malnutrition risk. Thematic analysis informed the development of key principles to guide planned intervention development. RESULTS We found that individuals' beliefs about an inevitable decline in appetite and eating in older age compound the many and varied physical and physiological barriers that they experience. Also, we found that expectations of decline in appetite and physical ability may encourage resignation, reduce self-efficacy to overcome barriers, and reduce motivation to address weight loss and/or recognise it as an issue that needs to be addressed. Fear of loss of independence may also reduce the likelihood of asking general practitioners for advice. CONCLUSIONS The key findings identified include a sense of resignation, multiple different barriers to eating and a need for independence, each underpinned by the expectation of a decline in older adulthood. Interventions need to address misperceptions about the inevitability of decline, highlight how and why diet recommendations are somewhat different from recommendations for the general population, and suggest easy ways to increase food intake that address common barriers.
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Affiliation(s)
- L Payne
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - P Harris
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - D Ghio
- School of Primary Care, Population Sciences and Medical Education, Aldermoor Health Centre, University of Southampton, Southampton, UK
| | - J Slodkowska-Barabasz
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - M Sutcliffe
- Dietetics Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J Kelly
- School of Primary Care, Population Sciences and Medical Education, Aldermoor Health Centre, University of Southampton, Southampton, UK
| | - M Stroud
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - P Little
- School of Primary Care, Population Sciences and Medical Education, Aldermoor Health Centre, University of Southampton, Southampton, UK
| | - L Yardley
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK.,School of Psychological Science, University of Bristol, Bristol, UK
| | - L Morrison
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK.,School of Primary Care, Population Sciences and Medical Education, Aldermoor Health Centre, University of Southampton, Southampton, UK
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28
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Teasdale E, Muller I, Sivyer K, Ghio D, Greenwell K, Wilczynska S, Roberts A, Ridd M, Francis N, Yardley L, Thomas K, Santer M. Views and experiences of managing eczema: systematic review and thematic synthesis of qualitative studies*. Br J Dermatol 2020; 184:627-637. [DOI: 10.1111/bjd.19299] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Affiliation(s)
- E. Teasdale
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
| | - I. Muller
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
| | - K. Sivyer
- Centre for Clinical and Community Applications of Health Psychology University of Southampton Southampton UK
| | - D. Ghio
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
| | - K. Greenwell
- Centre for Clinical and Community Applications of Health Psychology University of Southampton Southampton UK
| | - S. Wilczynska
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
| | - A. Roberts
- Patient and Public Contributor Nottingham UK
| | - M.J. Ridd
- Department of Population Health SciencesUniversity of Bristol BristolUK
| | - N. Francis
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
| | - L. Yardley
- Centre for Clinical and Community Applications of Health Psychology University of Southampton Southampton UK
- School of Experimental Psychology University of Bristol Bristol UK
| | - K.S. Thomas
- Centre for Evidence Based Dermatology University of Nottingham Nottingham UK
| | - M. Santer
- Department of Primary Care, Population Science and Medical Education Faculty of MedicineUniversity of Southampton SouthamptonUK
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29
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Ghio D, Muller I, Greenwell K, Roberts A, McNiven A, Langan S, Santer M. How young people adapt to living with eczema. Br J Dermatol 2020. [DOI: 10.1111/bjd.18649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Ghio D, Muller I, Greenwell K, Roberts A, McNiven A, Langan S, Santer M. 年轻人如何适应与湿疹共存. Br J Dermatol 2020. [DOI: 10.1111/bjd.18666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee RR, Muckian CG, Damaraju S, Ghio D, Thomson W, Cordingley L. P08 Beliefs about pain in juvenile idiopathic arthritis are significantly associated with higher reported pain and more negative affect in children and young people. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez415.004] [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: 11/14/2022] Open
Abstract
Abstract
Background
Persistent, unpredictable pain is one of the most burdensome features of juvenile idiopathic arthritis (JIA) which is a relapsing-remitting inflammatory musculoskeletal condition presenting in children and young people under 16 years. Recent research into perceptions of illness in young people has found that conceptualisations of long-term disease are mainly about the most salient features and symptoms, not of the illness as a whole. Particularly in young people with JIA, perceptions of pain are central to the individuals’ beliefs about the chronic condition. In paediatric pain research in general, the study of pain beliefs has mainly focused on pain catastrophising. Associations between other potentially important pain beliefs and pain outcomes (e.g. reporting pain or well-being) have not been explored to date. The aim of this study was to explore a wide range of pain perceptions in young people with JIA and to investigate whether these pain beliefs were associated with pain severity or well-being.
Methods
Cross-sectional data from the largest UK cohort study of children with JIA were analysed (the Childhood Arthritis Prospective Study- CAPS). Participants aged over 11 years completed ‘The Pain Perceptions Questionnaire for Young People (PPQ–YP)’ which assesses pain beliefs corresponding to the Common Sense-Self Regulatory framework first proposed by Leventhal and colleagues in the 1980s. Self-reported pain severity scores were captured using a Visual Analogue Scale (VAS). Emotional well-being was assessed using the Positive and Negative Affect Scale (PANAS). Associations were explored using Spearman’s Rank Correlation.
Results
223 participants (64% female) completed the PPQ-YP. 38.2% of participants had a diagnosis of oligoarthritis, 29.6% had polyarthritis and equal proportions of participants had systemic, psoriatic or enthesitis related JIA (7.3%). Higher reported pain severity was significantly correlated with stronger beliefs about the greater impact of pain on life (rho=0.494, p < 0.001), pain unpredictability (rho=0.369, p < 0.001) and pain persistence (rho=0.278,p<0.001). Higher pain controllability beliefs (that pain was controllable) were significantly associated with lower self-reported pain severity (rho=-0.526, p < 0.001). Stronger beliefs about the impact of pain on life (rho=0.425,p=0.001) and pain coherence (poorer understanding about own pain: rho=-0.295,p=0.021) were significantly associated with more negative mood.
Conclusion
Pain beliefs (particularly about consequences, unpredictability, persistence and understanding) are linked to levels of pain severity and well-being in children with JIA. Adding to the evidence base on the link between pain catastrophising and illness outcomes, this research enhances our understanding of long-term illness and pain perceptions in young people through the implication of a wider range of pain beliefs and cognitions on illness outcomes. The PPQ-YP identified salient pain beliefs which should be considered in the design of potential interventions to improve pain outcomes in this group. Future research should aim to explore whether these perceptions can predict other important illness outcomes.
Conflicts of Interest
The authors declare no conflicts of interest.
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Affiliation(s)
- Rebecca Rachael Lee
- National Institute for Health Research, Manchester Musculoskeletal Biomedical Research Centre, Manchester, United Kingdom
- Centre for Epidemiology, Versus Arthritis, Manchester, United Kingdom
| | - Caitlin Grace Muckian
- National Institute for Health Research, Manchester Musculoskeletal Biomedical Research Centre, Manchester, United Kingdom
- Centre for Epidemiology, Versus Arthritis, Manchester, United Kingdom
| | - Sandeep Damaraju
- National Institute for Health Research, Manchester Musculoskeletal Biomedical Research Centre, Manchester, United Kingdom
- Centre for Epidemiology, Versus Arthritis, Manchester, United Kingdom
| | - Daniela Ghio
- Life Sciences, Faculty of Medicine, Southampton, United Kingdom
| | - Wendy Thomson
- National Institute for Health Research, Manchester Musculoskeletal Biomedical Research Centre, Manchester, United Kingdom
- Centre for Genetics and Genomics, Versus Arthritis, Manchester, United Kingdom
| | - Lis Cordingley
- Centre for Musculoskeletal Research, Manchester, United Kingdom
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Ghio D, Muller I, Greenwell K, Roberts A, McNiven A, Langan SM, Santer M. 'It's like the bad guy in a movie who just doesn't die': a qualitative exploration of young people's adaptation to eczema and implications for self-care. Br J Dermatol 2019; 182:112-118. [PMID: 31021418 PMCID: PMC6972719 DOI: 10.1111/bjd.18046] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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] [Accepted: 04/23/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Eczema is a common childhood inflammatory skin condition, affecting more than one in five children. A popular perception is that children 'outgrow eczema', although epidemiological studies have shown that, for many, eczema follows a lifelong episodic course. OBJECTIVES To explore the perceptions of young people about the nature of their eczema and how these perceptions relate to their self-care and adapting to living with eczema. METHODS This is a secondary inductive thematic analysis of interviews conducted for Healthtalk.org. In total 23 interviews with young people with eczema were included. Of the 23 participants, 17 were female and six male, ranging from 17 to 25 years old. RESULTS Participants generally experienced eczema as an episodic long-term condition and reported a mismatch between information received about eczema and their experiences. The experience of eczema as long term and episodic had implications for self-care, challenging the process of identifying triggers of eczema flare-ups and evaluating the success of treatment regimens. Participants' experiences of eczema over time also had implications for adaptation and finding a balance between accepting eczema as long term and hoping it would go away. This linked to a gradual shift in treatment expectations from 'cure' to 'control' of eczema. CONCLUSIONS For young people who continue to experience eczema beyond childhood, a greater focus on self-care for a long-term condition may be helpful. Greater awareness of the impact of early messages around 'growing out of' eczema and provision of high-quality information may help patients to manage expectations and support adaptation to treatment regimens. What's already known about this topic? There is a common perception that people 'grow out of' eczema, but for many people eczema follows a lifelong episodic course. Qualitative work has shown that parents can find that being told their child will grow out of eczema is dismissive, and that they have difficulty with messages about 'control not cure' of eczema. It is unclear how young people perceive their eczema and the implications of this perception for their adaptation and self-care. What does this study add? The message that many people 'grow out of' eczema has a potentially detrimental effect for young people where the condition persists. This has implications for young people's perceptions of their eczema, their learning to self-care and how they adapt to living with eczema and eczema treatments. What are the clinical implications of this work? Clinicians need to promote awareness among young people that eczema is a long-term episodic condition in order to engage them with effective self-care. Young people transitioning to self-care need evidence-based information that is specific and relatable to them.
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Affiliation(s)
- D Ghio
- Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, U.K
| | - I Muller
- Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, U.K
| | - K Greenwell
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Social and Human Sciences, University of Southampton, Southampton, U.K
| | - A Roberts
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, U.K
| | - A McNiven
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, U.K
| | - S M Langan
- Faculty of Epidemiology & Population Health, London School of Hygiene and Tropical Medicine, London, U.K.,Health Data Research U.K., London, U.K
| | - M Santer
- Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, U.K
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Harris PS, Payne L, Morrison L, Green SM, Ghio D, Hallett C, Parsons EL, Aveyard P, Roberts HC, Sutcliffe M, Robinson S, Slodkowska-Barabasz J, Little PS, Stroud MA, Yardley L. Barriers and facilitators to screening and treating malnutrition in older adults living in the community: a mixed-methods synthesis. BMC Fam Pract 2019; 20:100. [PMID: 31307402 PMCID: PMC6631945 DOI: 10.1186/s12875-019-0983-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 06/18/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Malnutrition (specifically undernutrition) in older, community-dwelling adults reduces well-being and predisposes to disease. Implementation of screen-and-treat policies could help to systematically detect and treat at-risk and malnourished patients. We aimed to identify barriers and facilitators to implementing malnutrition screen and treat policies in primary/community care, which barriers have been addressed and which facilitators have been successfully incorporated in existing interventions. METHOD A data-base search was conducted using MEDLINE, Embase, PsycINFO, DARE, CINAHL, Cochrane Central and Cochrane Database of Systematic Reviews from 2012 to June 2016 to identify relevant qualitative and quantitative literature from primary/community care. Studies were included if participants were older, community-dwelling adults (65+) or healthcare professionals who would screen and treat such patients. Barriers and facilitators were extracted and mapped onto intervention features to determine whether these had addressed barriers. RESULTS Of a total of 2182 studies identified, 21 were included (6 qualitative, 12 quantitative and 3 mixed; 14 studies targeting patients and 7 targeting healthcare professionals). Facilitators addressing a wide range of barriers were identified, yet few interventions addressed psychosocial barriers to screen-and-treat policies for patients, such as loneliness and reluctance to be screened, or healthcare professionals' reservations about prescribing oral nutritional supplements. CONCLUSION The studies reviewed identified several barriers and facilitators and addressed some of these in intervention design, although a prominent gap appeared to be psychosocial barriers. No single included study addressed all barriers or made use of all facilitators, although this appears to be possible. Interventions aiming to implement screen-and-treat approaches to malnutrition in primary care should consider barriers that both patients and healthcare professionals may face. REVIEW REGISTRATIONS PROSPERO: CRD42017071398 . The review protocol was registered retrospectively.
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Affiliation(s)
- Philine S Harris
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP), University of Southampton, Building 44, Highfield Campus, Southampton, SO17 1BJ, UK
| | - Liz Payne
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP), University of Southampton, Building 44, Highfield Campus, Southampton, SO17 1BJ, UK.
| | - Leanne Morrison
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP), University of Southampton, Building 44, Highfield Campus, Southampton, SO17 1BJ, UK.,Primary Care and Population Sciences, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Sue M Green
- Bournemouth University, Bournemouth House B236, 19 Christchurch Road, Bournemouth, BH1 3LH, UK
| | - Daniela Ghio
- Primary Care and Population Sciences, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Claire Hallett
- Friarsgate Surgery, Stockbridge Road, Winchester, SO22 6EL, UK
| | - Emma L Parsons
- Wessex Academic Health Science Network and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - Helen C Roberts
- Academic Geriatric Medicine, Level E Centre Block, Mailpoint 807, University Hospital Southampton, Southampton, SO16 6YD, UK
| | - Michelle Sutcliffe
- Community Dietetic Department, Southampton NHS Treatment Centre, Royal South Hampshire Hospital, Brintons Terrace, Southampton, SO14 0YG, UK
| | - Siân Robinson
- AGE Research Group, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Joanna Slodkowska-Barabasz
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP), University of Southampton, Building 44, Highfield Campus, Southampton, SO17 1BJ, UK
| | - Paul S Little
- Primary Care and Population Sciences, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Michael A Stroud
- Gastroenterology and Clinical Nutrition, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP), University of Southampton, Building 44, Highfield Campus, Southampton, SO17 1BJ, UK.,Centre for Academic Primary Care and School of Psychological Science, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
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Lee RR, Rashid A, Ghio D, Thomson W, Cordingley L. "Seeing Pain Differently": A Qualitative Investigation Into the Differences and Similarities of Pain and Rheumatology Specialists' Interpretation of Multidimensional Mobile Health Pain Data From Children and Young People With Juvenile Idiopathic Arthritis. JMIR Mhealth Uhealth 2019; 7:e12952. [PMID: 31267979 PMCID: PMC6632104 DOI: 10.2196/12952] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/19/2018] [Revised: 02/28/2019] [Accepted: 03/03/2019] [Indexed: 11/22/2022] Open
Abstract
Background In contrast to the use of traditional unidimensional paper-based scales, a mobile health (mHealth) assessment of pain in children and young people (CYP) with juvenile idiopathic arthritis (JIA) enables comprehensive and complex multidimensional pain data to be captured remotely by individuals. However, how professionals use multidimensional pain data to interpret and synthesize pain reports gathered using mHealth tools is not yet known. Objective The aim of this study was to explore the salience and prioritization of different mHealth pain features as interpreted by key stakeholders involved in research and management of pain in CYP with JIA. Methods Pain and rheumatology specialists were purposively recruited via professional organizations. Face-to-face focus groups were conducted for each specialist group. Participants were asked to rank order 9 static vignette scenarios created from real patient mHealth multidimensional pain data. These data had been collected by a researcher in a separate study using My Pain Tracker, a valid and acceptable mHealth iPad pain communication tool that collects information about intensity, severity, location, emotion, and pictorial pain qualities. In the focus groups, specialists discussed their decision-making processes behind each rank order in the focus groups. The total group rank ordering of vignette scenarios was calculated. Qualitative data from discussions were analyzed using latent thematic analysis. Results A total of 9 pain specialists took part in 1 focus group and 10 rheumatology specialists in another. In pain specialists, the consensus for the highest pain experience (44%) was poorer than their ranking of the lowest pain experiences (55%). Conversely, in rheumatology specialists, the consensus for the highest pain experience (70%) was stronger than their ranking of the lowest pain experience (50%). Pain intensity was a high priority for pain specialists, but rheumatology specialists gave high priority to intensity and severity taken together. Pain spread was highly prioritized, with the number of pain locations (particular areas or joints) being a high priority for both groups; radiating pain was a high priority for pain specialists only. Pain emotion was challenging for both groups and was only perceived to be a high priority when specialists had additional confirmatory evidence (such as information about pain interference or clinical observations) to validate the pain emotion report. Pain qualities such as particular word descriptors, use of the color red, and fire symbols were seen to be high priority by both groups in interpretation of CYP pain reports. Conclusions Pain interpretation is complex. Findings from this study of specialists’ decision-making processes indicate which aspects of pain are prioritized and weighted more heavily than others by those interpreting mHealth data. Findings are useful for developing electronic graphical summaries which assist specialists in interpreting patient-reported mHealth pain data more efficiently in clinical and research settings.
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Affiliation(s)
- Rebecca Rachael Lee
- NIHR Manchester Musculoskeletal Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.,Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Amir Rashid
- NIHR Manchester Musculoskeletal Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.,Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Daniela Ghio
- Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Wendy Thomson
- Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Lis Cordingley
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Ghio D, Blangiardo GC. Exploring the link between irregular migration and asylum: the case of Italy. Genus 2019. [DOI: 10.1186/s41118-019-0060-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lazzari C, Ceresoli G, Bearz A, Ferreri A, Mandalá M, Cordio S, Aprile G, Ghio D, Da Passano CF, Gregorc V. PS02.07 Telemedicine: A New Era for the Treatment of Patients with Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ghio D, Thomson W, Calam R, Ulph F, Baildam EM, Hyrich K, Cordingley L. The prioritization of symptom beliefs over illness beliefs: The development and validation of the Pain Perception Questionnaire for Young People. Br J Health Psychol 2017; 23:68-87. [PMID: 28990337 PMCID: PMC5765490 DOI: 10.1111/bjhp.12275] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 12/09/2016] [Revised: 08/28/2017] [Indexed: 11/30/2022]
Abstract
Objectives To investigate the suitability of the revised Illness Perception Questionnaire (IPQ‐R) for use with adolescents with a long‐term pain condition and to validate a new questionnaire for use with this age group. Design A three‐phase mixed‐methods study. Methods Phase 1 comprised in‐depth qualitative analyses of audio‐recorded cognitive interviews with 20 adolescents with juvenile idiopathic arthritis who were answering IPQ‐R items. Transcripts were coded using framework analysis. A content analysis of their intended responses to individual items was also conducted. In Phase 2, a new questionnaire was developed and its linguistic and face validity were assessed with 18 adolescents without long‐term conditions. In Phase 3, the construct validity of the new questionnaire was assessed with 240 adolescents with juvenile idiopathic arthritis. A subset of 43 adolescents completed the questionnaire a second time to assess test–retest reliability. All participants were aged 11–16 years. Results Participants described both conceptual and response format difficulties when answering IPQ‐R items. In response, the Pain Perception Questionnaire for Young People (PPQ‐YP) was designed which incorporated significant modifications to both wording and response formats when compared with the IPQ‐R. A principal component analysis of the PPQ‐YP identified ten constructs in the new questionnaire. Emotional representations were separated into two constructs, responsive and anticipatory emotions. The PPQ‐YP showed high test–retest reliability. Conclusions Symptom beliefs appear to be more salient to adolescents with a long‐term pain condition than beliefs about the illness as a whole. A new questionnaire to assess pain beliefs of adolescents was designed. Further validation work may be needed to assess its suitability for use with other pain conditions. Statement of contribution What is already known on this subject? Versions of the adult Revised Illness Perception Questionnaire (IPQ‐R) have been adapted for adolescents and children by changing item wording; however, research to assess the degree to which the underlying IPQ‐R constructs are relevant to adolescents with a long‐term condition had not been performed.
What the present study adds? In adolescents, beliefs about symptoms of their condition are more salient than beliefs about the illness as a whole. Question response formats for children and young people need to take account of age‐specific abilities. A new questionnaire has been designed for adolescents with pain. It is theoretically congruent with the CS‐SRM.
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Affiliation(s)
- Daniela Ghio
- Division of Musculoskeletal and Dermatological Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Wendy Thomson
- Division of Musculoskeletal and Dermatological Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.,NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, UK.,Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Rachel Calam
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Fiona Ulph
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
| | | | - Kimme Hyrich
- Division of Musculoskeletal and Dermatological Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.,NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, UK.,Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Lis Cordingley
- Division of Musculoskeletal and Dermatological Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.,NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, UK
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Tapping P, Rashid A, Thomson W, Ghio D, Cordingley L, Calam R, Jimmieson P, Chieng A. OP0157-HPR “This Feeling!”: Can a New Ipad App Help Children with Juvenile Idiopathic Arthritis Communicate their Pain Experiences? Feasibility, Usability and Acceptability. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ghio D, Calam R, L. Hyrich K, Thomson W, Cordingley L. 268. Validating a Pain Perception Questionnaire for Young People with Juvenile Arthritis. Rheumatology (Oxford) 2015. [DOI: 10.1093/rheumatology/kev090.033] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Daniela Ghio
- NIHR Manchester Musculoskeletal Biomedical Research, 2School of Psychological Sciences and 3Arthritis Research UK, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Rachel Calam
- NIHR Manchester Musculoskeletal Biomedical Research, 2School of Psychological Sciences and 3Arthritis Research UK, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Kimme L. Hyrich
- NIHR Manchester Musculoskeletal Biomedical Research, 2School of Psychological Sciences and 3Arthritis Research UK, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Wendy Thomson
- NIHR Manchester Musculoskeletal Biomedical Research, 2School of Psychological Sciences and 3Arthritis Research UK, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Lis Cordingley
- NIHR Manchester Musculoskeletal Biomedical Research, 2School of Psychological Sciences and 3Arthritis Research UK, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
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Bordignon C, Vago L, Oliveira G, Noviello M, Soldati C, Ghio D, Brigida I, Aiuti A, Lupo-Stanghellini MT, Peccatori J, Lambiase A, Bondanza A, Del Maschio A, Ciceri F, Bonini C. Mechanism of thymic renewal after infusion of suicide gene-modified donor T cells after hematopoietic stem cell transplantation (HSCT) in adult patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bordignon C, Vago L, Oliveira G, Ghio D, Lupo Stanghellini M, Peccatori J, Bondanza A, Lambiase A, Ciceri F, Bonini C. Thymic renewal and antileukemic effect in adults after haploidentical transplantation and suicide gene therapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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42
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Gregorc V, Hidalgo M, Spreafico A, Cusatis G, Ludovini V, Ingersoll RG, Marsh S, Steinberg SM, Viganò MG, Ghio D, Villa E, Sparreboom A, Baker SD. Germline polymorphisms in EGFR and survival in patients with lung cancer receiving gefitinib. Clin Pharmacol Ther 2007; 83:477-84. [PMID: 17713473 DOI: 10.1038/sj.clpt.6100320] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The purpose of this study was to evaluate associations between germline epidermal growth factor receptor (EGFR) variants involved in transcriptional regulation and overall survival in white patients with non-small-cell lung cancer (NSCLC) treated with the EGFR tyrosine kinase inhibitor, gefitinib. Of 175 consecutive patients treated with oral gefitinib (250 mg/day), 170 (median age: 67 years; 72% men) were evaluable for genotyping and survival. Fifty-five patients (33%) had stable disease and 17 (10%) had an objective response. The most common of four haplotypes was G-C (EGFR*1) at the EGFR -216G>T and -191C>A loci (frequency, 0.45). After adjusting for performance status, previous platinum-containing chemotherapy and occurrence of skin rash or diarrhea during the first treatment cycle in patients with performance status 0 or 1 (N=139), the absence of EGFR*1 was associated with significantly better survival (hazard ratio: 0.54; 95% confidence interval: 0.32-0.91; P=0.015). The results may help identify patients with NSCLC who can benefit from gefitinib treatment.
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Affiliation(s)
- V Gregorc
- Department of Oncology, Scientific Institute University Hospital San Raffaele, Milan, Italy
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Castrucci M, Ghio D, Salvioni M, Angeli E, Venturini M, Del Maschio A. [Embolization of iatrogenic renal vascular lesions with coaxial catheters and microcoils]. Radiol Med 1997; 93:576-81. [PMID: 9280941] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION We report our experience with the superselective embolization of iatrogenic vascular injuries. We used new coaxial catheters and new microcoils to assess their technical features and efficacy. MATERIALS AND METHODS Diagnostic angiography by catheterization of the main renal artery was performed in 7 patients with suspected renal vascular injury to detect injury presence and site. After super-selective catheterization of the feeding arteries with a coaxial catheter (Tracker 18), we performed embolization with platinum microcoils inserted using a coil pusher. The procedure efficacy was assessed at angiography and by comparing serum hemoglobin and hematocrit levels before and after embolization; posttreatment renal function was also studied. RESULTS Selective embolization permitted complete occlusion of the arteries feeding the vascular injury in all patients, preserving as much parenchyma as possible. Hemoglobin and hematocrit levels were improved or unchanged after the maneuver (average hemoglobin level before embolization: 9.01 mg/dl versus 9.95 mg/dl after embolization; average hematocrit level before embolization: 27.3% versus 30.06% after embolization). We had no difficulty during microcoil insertion and the coaxial catheter was always stable. CONCLUSION Superselective embolization of iatrogenic vascular injuries is an effective and definitive treatment. We recommend it in the patients with renal bleeding due to iatrogenic vascular injury after percutaneous diagnostic or therapeutic procedures.
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Castrucci M, Camalori M, Angeli E, Salvioni M, Venturini M, Ghio D, Ongari B, Spina GP, Del Maschio A. [Recanalization of 2 suprahepatic veins with metal stents via a percutaneous transhepatic approach in a case of the Budd-Chiari syndrome]. Radiol Med 1996; 91:148-52. [PMID: 8614724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M Castrucci
- Servizio di Radiologia Diagnostica, Istituto Scientifico, H San Raffaele, Milano
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Castrucci M, Salvioni M, Angeli E, Venturini M, Ghio D, Del Maschio A. [A case of intrahepatic portosystemic shunt via the femoral vein. Technical considerations and usefulness of preliminary imaging by MR and echo-color Doppler]. Radiol Med 1994; 88:151-6. [PMID: 8066246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- M Castrucci
- Istituto Scientifico, Ospedale San Raffaele Milano
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