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Ajiboye BO, Dada S, Fatoba HO, Lawal OE, Oyeniran OH, Adetuyi OY, Olatunde A, Taher M, Khotib J, Susanti D, Oyinloye BE. Dalbergiella welwitschia (Baker) Baker f. alkaloid-rich extracts attenuate liver damage in streptozotocin-induced diabetic rats. Biomed Pharmacother 2023; 168:115681. [PMID: 37837880 DOI: 10.1016/j.biopha.2023.115681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/16/2023] Open
Abstract
This experiment was conducted to evaluate the Dalbergiella welwitschia alkaloid-rich extracts on liver damage in streptozotocin-induced diabetic rats. Hence, to induce diabetes, 45 mg/kg body weight of streptozotocin was intraperitoneally injected into the Wistar rats. Subsequently, 5 % (w/v) of glucose water was given to the induced animals for 24 h. Thus, the animals (48) were grouped into five groups (n = 8), containing normal control (NC), diabetic control (DC), diabetic rats placed on low (50 mg/kg body weight) and high (100 mg/kg body weight) doses of D. welwitschi alkaloid-rich leaf extracts (i.e. DWL and DWH respectively), and diabetic rats administered 200 mg/kg body weight of metformin (MET). The animals were sacrificed on the 21st day of the experiment, blood and liver were harvested, and different liver damage biomarkers were evaluated. The results obtained demonstrated that diabetic rats administered DWL, DWH and MET significantly (p < 0.05) increased hepatic AST, ALT, albumin, SOD, CAT, GSH, and GPX levels when compared to DC with no significant (p > 0.05) different when compared with NC. Also, diabetic rats administered DWL, DWH and MET revealed a significant (p < 0.05) decrease in GGT and MDA levels, as well as, fragmented DNA and protein carbonyl levels when compared to DC with no significant (p > 0.05) different when compared with NC. In addition, histological examination revealed that diabetic rats placed on DWL, DWH and MET normalized the hepatocytes. Consequently, it can be inferred that alkaloid-rich extracts from D. welwitschi leaf could be helpful in improving liver damage associated with diabetes mellitus rats.
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Affiliation(s)
- B O Ajiboye
- Phytomedicine and Molecular Toxicology Research Laboratory, Department of Biochemistry, Federal University Oye-Ekiti, Ekiti State, Nigeria; Institute of Drug Research and Development, SE Bogoro Center, Afe Babalola University, Ado-Ekiti, Nigeria.
| | - S Dada
- Phytomedicine, Biochemical Toxicology and Biotechnology Research Laboratories, Department of Biochemistry, College of Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - H O Fatoba
- Phytomedicine and Molecular Toxicology Research Laboratory, Department of Biochemistry, Federal University Oye-Ekiti, Ekiti State, Nigeria
| | - O E Lawal
- Phytomedicine and Molecular Toxicology Research Laboratory, Department of Biochemistry, Federal University Oye-Ekiti, Ekiti State, Nigeria
| | - O H Oyeniran
- Functional Foods, Nutraceuticals, and Phytomedicine Unit, Department of Biochemistry, Federal University Oye-Ekiti, Ekiti State, Nigeria
| | - O Y Adetuyi
- Phytomedicine and Molecular Toxicology Research Laboratory, Department of Biochemistry, Federal University Oye-Ekiti, Ekiti State, Nigeria
| | - A Olatunde
- Phytomedicine and Natural Products Drug Discovery, Department of Medical Biochemistry, Abubakar Tafawa Balewa University, Bauchi, Bauchi State, Nigeria
| | - M Taher
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200 Kuantan, Pahang, Malaysia; Pharmaceutics and Translational Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200 Kuantan, Pahang, Malaysia
| | - J Khotib
- Department of Pharmacy Practice, Faculty of Pharmacy, Airlangga University, 60115 Surabaya, Indonesia.
| | - D Susanti
- Department of Chemistry, Kulliyyah of Science, International Islamic University Malaysia, 25200 Kuantan, Pahang, Malaysia
| | - B E Oyinloye
- Institute of Drug Research and Development, SE Bogoro Center, Afe Babalola University, Ado-Ekiti, Nigeria; Phytomedicine, Biochemical Toxicology and Biotechnology Research Laboratories, Department of Biochemistry, College of Sciences, Afe Babalola University, Ado-Ekiti, Nigeria; Biotechnology and Structural Biology (BSB) Group, Department of Biochemistry and Microbiology, University of Zululand, South Africa
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Dada S, Aivalli P, De Brún A, Barreix M, Chelwa N, Mutunga Z, Vwalika B, Gilmore B. Understanding communication in community engagement for maternal and newborn health programmes in low- and middle-income countries: a realist review. Health Policy Plan 2023; 38:1079-1098. [PMID: 37650702 PMCID: PMC10566325 DOI: 10.1093/heapol/czad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/20/2023] [Accepted: 08/29/2023] [Indexed: 09/01/2023] Open
Abstract
As community engagement (CE) is implemented for sustainable maternal and newborn health (MNH) programming, it is important to determine how these approaches work. Low- and middle-income countries (LMICs) have become a particular focus for MNH CE activities due to their high burden of maternal and neonatal deaths. MNH messaging and communication to engage communities are likely to differ by context, but how these approaches are actually developed and implemented within CE is not well understood. Understanding how communications in CE actually work is vital in the translation of learnings across programmes and to inform future projects. The purpose of this realist review is to describe how, why, to what extent and for whom communications in CE contribute to MNH programming in LMICs. After searching academic databases, grey literature and literature suggested by the expert advisory committee, documents were included if they described the CE communication processes/activities used for MNH programming in an LMIC. Relevant documents were assessed for richness (depth of insight) and rigor (trustworthiness and coherence of data/theories). Data were extracted as context-mechanism-outcome configurations (CMOCs) and synthesized into demi-regularities to contribute to theory refinement. After screening 416 records, 45 CMOCs were extracted from 11 documents. This informed five programme theories explaining that communications in CE for an MNH programme work when: communities are actively involved throughout the programme, the messaging and programme are acceptable, communication sources are trusted, the community has a reciprocal relationship with the programme and the community sees value in the programme. While these findings reflect what is often anecdotally known in CE or acknowledged in communications theory, they have implications for policy, practice and research by highlighting the importance of centring the community's needs and priorities throughout the stages of developing and implementing communications for CE in MNH.
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Affiliation(s)
- Sara Dada
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), University College Dublin, School of Nursing Midwifery and Health Systems , Belfield, Dublin 4, Ireland
- School of Nursing Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Praveenkumar Aivalli
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), University College Dublin, School of Nursing Midwifery and Health Systems , Belfield, Dublin 4, Ireland
- School of Nursing Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Aoife De Brún
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), University College Dublin, School of Nursing Midwifery and Health Systems , Belfield, Dublin 4, Ireland
- School of Nursing Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Maria Barreix
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211, Geneva 27, Switzerland
| | | | | | - Bellington Vwalika
- Department of Obstetrics and Gynaecology, University of Zambia School of Medicine, Lusaka, Zambia
| | - Brynne Gilmore
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), University College Dublin, School of Nursing Midwifery and Health Systems , Belfield, Dublin 4, Ireland
- School of Nursing Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
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Khorsand P, Dada S, Jung L, Law S, Patil P, Wangari MC, Omrani OE, Daalen KV. A planetary health perspective on menstruation: menstrual equity and climate action. Lancet Planet Health 2023; 7:e347-e349. [PMID: 37164506 DOI: 10.1016/s2542-5196(23)00081-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/02/2023] [Accepted: 03/31/2023] [Indexed: 05/12/2023]
Affiliation(s)
| | - Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Laura Jung
- Leipzig University Medical Center, Division of Infectious Diseases and Tropical Medicine, Leipzig, Germany
| | - Siufung Law
- Department of Women's, Gender and Sexuality Studies, Emory University, Atlanta, GA, USA
| | - Poorvaprabha Patil
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India; London School of Hygiene and Tropical Medicine, University of London, London, UK
| | | | - Omnia El Omrani
- Plastic, Reconstructive and Aesthetic Surgery Department, Ain Shams University Teaching Hospital, Cairo, Egypt
| | - Kim van Daalen
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Heart and Lung Research Institute, University of Cambridge, Cambridge, UK; Barcelona Supercomputing Center, Department of Earth Sciences, Barcelona, Spain
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Dada S, Dalkin S, Gilmore B, Hunter R, Mukumbang FC. Applying and reporting relevance, richness and rigour in realist evidence appraisals: Advancing key concepts in realist reviews. Res Synth Methods 2023; 14:504-514. [PMID: 36872619 DOI: 10.1002/jrsm.1630] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [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: 11/01/2022] [Revised: 02/08/2023] [Accepted: 02/26/2023] [Indexed: 03/07/2023]
Abstract
The realist review/synthesis has become an increasingly prominent methodological approach to evidence synthesis that can inform policy and practice. While there are publication standards and guidelines for the conduct of realist reviews, published reviews often provide minimal detail regarding how they have conducted some methodological steps. This includes selecting and appraising evidence sources, which are often considered for their 'relevance, richness and rigour.' In contrast to other review approaches, for example, narrative reviews and meta-analyses, the inclusion criteria and appraisal of evidence within realist reviews depend less on the study's methodological quality and more on its contribution to our understanding of generative causation, uncovered through the process of retroductive theorising. This research brief aims to discuss the current challenges and practices for appraising documents' relevance, richness and rigour and to provide pragmatic suggestions for how realist reviewers can put this into practice.
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Affiliation(s)
- Sara Dada
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Sonia Dalkin
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK.,Fuse (The Centre for Translational Research in Public Health), Northumbria University, Newcastle Upon Tyne, UK
| | - Brynne Gilmore
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rebecca Hunter
- Department of Nursing and Midwifery, University of Highlands and Islands, Inverness, UK
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Dada S, Cocoman O, Portela A, De Brún A, Bhattacharyya S, Tunçalp Ö, Jackson D, Gilmore B. What's in a name? Unpacking 'Community Blank' terminology in reproductive, maternal, newborn and child health: a scoping review. BMJ Glob Health 2023; 8:bmjgh-2022-009423. [PMID: 36750272 PMCID: PMC9906186 DOI: 10.1136/bmjgh-2022-009423] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 01/09/2023] [Indexed: 02/09/2023] Open
Abstract
INTRODUCTION Engaging the community as actors within reproductive, maternal, newborn and child health (RMNCH) programmes (referred to as 'community blank') has seen increased implementation in recent years. While evidence suggests these approaches are effective, terminology (such as 'community engagement,' 'community participation,' 'community mobilisation,' and 'social accountability') is often used interchangeably across published literature, contributing to a lack of conceptual clarity in practice. The purpose of this review was to describe and clarify varying uses of these terms in the literature by documenting what authors and implementers report they are doing when they use these terms. METHODS Seven academic databases (PubMed/MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Web of Science, Global Health), two grey literature databases (OAIster, OpenGrey) and relevant organisation websites were searched for documents that described 'community blank' terms in RMNCH interventions. Eligibility criteria included being published between 1975 and 1 October 2021 and reports or studies detailing the activities used in 'community blank.' RESULTS: A total of 9779 unique documents were retrieved and screened, with 173 included for analysis. Twenty-four distinct 'community blank' terms were used across the documents, falling into 11 broader terms. Use of these terms was distributed across time and all six WHO regions, with 'community mobilisation', 'community engagement' and 'community participation' being the most frequently used terms. While 48 unique activities were described, only 25 activities were mentioned more than twice and 19 of these were attributed to at least three different 'community blank' terms. CONCLUSION Across the literature, there is inconsistency in the usage of 'community blank' terms for RMNCH. There is an observed interchangeable use of terms and a lack of descriptions of these terms provided in the literature. There is a need for RMNCH researchers and practitioners to clarify the descriptions reported and improve the documentation of 'community blank' implementation. This can contribute to a better sharing of learning within and across communities and to bringing evidence-based practices to scale. Efforts to improve reporting can be supported with the use of standardised monitoring and evaluation processes and indicators. Therefore, it is recommended that future research endeavours clarify the operational definitions of 'community blank' and improve the documentation of its implementation.
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Affiliation(s)
- Sara Dada
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland .,UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Olive Cocoman
- London School of Hygiene & Tropical Medicine, London, UK
| | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Aoife De Brún
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland,UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | | | - Özge Tunçalp
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneve, Switzerland
| | - Debra Jackson
- London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK
| | - Brynne Gilmore
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland,UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Dada S, De Brún A, Banda EN, Bhattacharya S, Mutunga Z, Gilmore B. A realist review protocol on communications for community engagement in maternal and newborn health programmes in low- and middle-income countries. Syst Rev 2022; 11:201. [PMID: 36096841 PMCID: PMC9465973 DOI: 10.1186/s13643-022-02061-9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community engagement (CE) has been increasingly implemented across health interventions, including for maternal and newborn health (MNH). This may take various forms, from participatory women's groups and community health committees to public advocacy days. While research suggests a positive influence of CE on MNH outcomes, such as mortality or care-seeking behaviour, there is a need for further evidence on the processes of CE in different settings in order to inform the future development and implementation of CE across programmes. Communication is an integral component of CE serving as a link between the programme and community. The aim of the realist review described in this protocol is to understand how, why, to what extent, and for whom CE contributes to intended and unintended outcomes in MNH programming, focusing on the communication components of CE. METHODS Realist review methodology will be used to provide a causal understanding of what communication for CE interventions in MNH programming work, for whom, to what extent, why, and how. This will be done by developing and refining programme theories on communications for CE in MNH through a systematic review of the literature and engaging key experts for input and feedback. By extrapolating context-mechanism-outcome configurations, this review seeks to understand how certain contexts trigger or inhibit specific mechanisms and what outcomes this interaction generates when communication in CE interventions is used in MNH programming. DISCUSSION A realist philosophy is well-suited to address the aims of this study because of the complex nature of CE. The review findings will be used to inform a realist evaluation case study of CE for an MNH programme in order to ascertain transferable findings that can inform and guide engagement activities in various settings. Findings will also be shared with stakeholders and experts involved in the consultative processes of the review (through workshops or policy briefs) in order to ensure the relevance of these findings to policy and practice. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022293564.
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Affiliation(s)
- Sara Dada
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland. .,School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
| | - Aoife De Brún
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Esther Namwaba Banda
- Zambia Ministry of Health, Lusaka, Zambia.,Midwives Association of Zambia, Lusaka, Zambia
| | | | | | - Brynne Gilmore
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Buford A, Ashworth HC, Ezzeddine FL, Dada S, Nguyen E, Ebrahim S, Zhang A, Lebovic J, Hamvas L, Prokop LJ, Midani S, Chilazi M, Alahdab F. Systematic review of electronic health records to manage chronic conditions among displaced populations. BMJ Open 2022; 12:e056987. [PMID: 36285578 PMCID: PMC9453995 DOI: 10.1136/bmjopen-2021-056987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 08/15/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The objective of this study was to assess the impact of electronic health records (EHRs) on health outcomes and care of displaced people with chronic health conditions and determine barriers and facilitators to EHR implementation in displaced populations. DESIGN A systematic review protocol was developed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Systematic Reviews. DATA SOURCES MEDLINE, Embase, PsycINFO, CINAHL, Health Technology Assessment, Epub Ahead of Print, In-Process and Other Non-Indexed Citations, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews was searched from inception to 12 April 2021. ELIGIBILITY CRITERIA FOR SELECTED STUDIES Inclusion criteria were original research articles, case reports and descriptions of EHR implementation in populations of displaced people, refugees or asylum seekers with related chronic diseases. Grey literature, reviews and research articles unrelated to chronic diseases or the care of refugees or asylum populations were excluded. Studies were assessed for risk of bias using a modified Cochrane, Newcastle-Ottawa and Joanna Briggs Institute tools. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data from each study using Covidence. Due to heterogeneity across study design and specific outcomes, a meta-analysis was not possible. An inductive thematic analysis was conducted using NVivo V.12 (QSR International, Melbourne, Australia). An inductive analysis was used in order to uncover patterns and themes in the experiences, general outcomes and perceptions of EHR implementation. RESULTS A total of 32 studies across nine countries were included: 14 in refugee camps/settlements and 18 in asylum countries. Our analysis suggested that EHRs improve health outcomes for chronic diseases by increasing provider adherence to guidelines or treatment algorithms, monitoring of disease indicators, patient counselling and patient adherence. In asylum countries, EHRs resource allocation to direct clinical care and public health services, as well as screening efforts. EHR implementation was facilitated by their adaptability and ability to integrate into management systems. However, barriers to EHR development, deployment and data analysis were identified in refugee settings. CONCLUSION Our results suggest that well-designed and integrated EHRs can be a powerful tool to improve healthcare systems and chronic disease outcomes in refugee settings. However, attention should be paid to the common barriers and facilitating actions that we have identified such as utilising a user-centred design. By implementing adaptable EHR solutions, health systems can be strengthened, providers better supported and the health of refugees improved.
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Affiliation(s)
- Anna Buford
- Medical School, University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - Henry Charles Ashworth
- Emergency Medicine, Alameda Health System, Oakland, California, USA
- Hikma Health, San Jose, California, USA
| | | | - Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Eliza Nguyen
- Obstetrics and Gynecology, Mayo Clinic, Rochester, New York State, USA
| | | | - Amy Zhang
- Hikma Health, San Jose, California, USA
| | - Jordan Lebovic
- Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York, USA
| | | | - Larry J Prokop
- Obstetrics and Gynecology, Mayo Clinic, Rochester, New York State, USA
| | - Sally Midani
- School of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Michael Chilazi
- Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Fares Alahdab
- Houston Methodist Academic Institute, Weill Cornell Medical College, Houston, Texas, USA
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Bandara S, Baral P, Joshi A, Muhia J, Rahman-Shepherd A, Adhikari P, Bayingana A, Bookholane H, Changyit-Levin Y, Dada S, Dutta R, Essar MY, Evaborhene NA, Krugman D, Kumar R, Manoj M, Mathewos K, Olson N, Osborne R, Romero-Alvarez D, Tun ZM, Wong BLH. Open Letter to G7 and G20 leaders: resolve global crises to secure our future. Nat Med 2022; 28:1974-1975. [PMID: 35970922 DOI: 10.1038/s41591-022-01944-7] [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: 11/09/2022]
Affiliation(s)
- Shashika Bandara
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
| | - Prativa Baral
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anshumi Joshi
- Trent/Fleming School of Nursing, Trent University, Ontario, Canada
| | - Joy Muhia
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Afifah Rahman-Shepherd
- Faculty of Health Systems and Behavioural Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Praju Adhikari
- Public and Global Health Program, Tampere University, Tampere, Finland
| | | | - Hloni Bookholane
- Division of Global Surgery, University of Cape Town, Cape Town, South Africa
| | - Yara Changyit-Levin
- Global Health Direct Matriculation Program, Johns Hopkins University, Baltimore, MD, USA
| | - Sara Dada
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rohini Dutta
- Programme for Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | | | | | - Daniel Krugman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ramya Kumar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Malvikha Manoj
- International Working Group for Health Systems Strengthening, New York, NY, USA
| | | | - Nehemiah Olson
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Rhiannon Osborne
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Daniel Romero-Alvarez
- One Health Research Group, Facultad de Medicina, Universidad de las Américas, Quito, Ecuador
| | - Zaw Myo Tun
- Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Brian Li Han Wong
- The International Digital Health & AI Research Collaborative (I-DAIR), Global Health Centre, Geneva Graduate Institute, Geneva, Switzerland
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van Daalen KR, Chowdhury M, Dada S, Khorsand P, El-Gamal S, Kaidarova G, Jung L, Othman R, O'Leary CA, Ashworth HC, Socha A, Olaniyan D, Azeezat FT, Abouhala S, Abdulkareem T, Dhatt R, Rajan D. Does global health governance walk the talk? Gender representation in World Health Assemblies, 1948-2021. BMJ Glob Health 2022; 7:bmjgh-2022-009312. [PMID: 35998979 PMCID: PMC9403126 DOI: 10.1136/bmjgh-2022-009312] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/20/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND While an estimated 70%-75% of the health workforce are women, this is not reflected in the leadership roles of most health organisations-including global decision-making bodies such as the World Health Assembly (WHA). METHODS We analysed gender representation in WHA delegations of Member States, Associate Members and Observers (country/territory), using data from 10 944 WHA delegations and 75 815 delegation members over 1948-2021. Delegates' information was extracted from WHO documentation. Likely gender was inferred based on prefixes, pronouns and other gendered language. A gender-to-name algorithm was used as a last resort (4.6%). Time series of 5-year rolling averages of the percentage of women across WHO region, income group and delegate roles are presented. We estimated (%) change ±SE of inferred women delegation members at the WHA per year, and estimated years±SE until gender parity from 2010 to 2019 across regions, income groups, delegate roles and countries. Correlations with these measures were assessed with countries' gender inequality index and two Worldwide Governance indicators. RESULTS While upwards trends could be observed in the percentage of women delegates over the past 74 years, men remained over-represented in most WHA delegations. Over 1948-2021, 82.9% of delegations were composed of a majority of men, and no WHA had more than 30% of women Chief Delegates (ranging from 0% to 30%). Wide variation in trends over time could be observed across different geographical regions, income groups and countries. Some countries may take over 100 years to reach gender parity in their WHA delegations, if current estimated trends continue. CONCLUSION Despite commitments to gender equality in leadership, women remain gravely under-represented in global health governance. An intersectional approach to representation in global health governance, which prioritises equity in participation beyond gender, can enable transformative policymaking that fosters transparent, accountable and just health systems.
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Affiliation(s)
- Kim Robin van Daalen
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
| | | | - Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | | | | | | | - Laura Jung
- Medical Faculty, Department for Infectious Diseases and Tropical Medicine, Leipzig University, Leipzig, Germany
| | | | | | - Henry Charles Ashworth
- Highland Hospital, Department of Emergency Medicine, Alameda Health System, Oakland, California, USA
| | - Anna Socha
- Systems for Health Research Group, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Dolapo Olaniyan
- Institute of Development Studies, University of Sussex, Brighton, UK
| | | | - Siwaar Abouhala
- Department of Community Health, Tufts University, Medford, Massachusetts, USA
| | | | - Roopa Dhatt
- Women in Global Health, Washington, District of Columbia, USA.,Medstar, Georgetown University Hospital, Washington, District of Columbia, USA
| | - Dheepa Rajan
- Department of Health System Governance and Financing, WHO, Geneve, Switzerland
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10
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van Daalen KR, Kallesøe SS, Davey F, Dada S, Jung L, Singh L, Issa R, Emilian CA, Kuhn I, Keygnaert I, Nilsson M. Extreme events and gender-based violence: a mixed-methods systematic review. Lancet Planet Health 2022; 6:e504-e523. [PMID: 35709808 PMCID: PMC10073035 DOI: 10.1016/s2542-5196(22)00088-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 05/03/2023]
Abstract
The intensity and frequency of extreme weather and climate events are expected to increase due to anthropogenic climate change. This systematic review explores extreme events and their effect on gender-based violence (GBV) experienced by women, girls, and sexual and gender minorities. We searched ten databases until February, 2022. Grey literature was searched using the websites of key organisations working on GBV and Google. Quantitative studies were described narratively, whereas qualitative studies underwent thematic analysis. We identified 26 381 manuscripts. 41 studies were included exploring several types of extreme events (ie, storms, floods, droughts, heatwaves, and wildfires) and GBV (eg, sexual violence and harassment, physical violence, witch killing, early or forced marriage, and emotional violence). Studies were predominantly cross-sectional. Although most qualitative studies were of reasonable quality, most quantitative studies were of poor quality. Only one study included sexual and gender minorities. Most studies showed an increase in one or several GBV forms during or after extreme events, often related to economic instability, food insecurity, mental stress, disrupted infrastructure, increased exposure to men, tradition, and exacerbated gender inequality. These findings could have important implications for sexual-transformative and gender-transformative interventions, policies, and implementation. High-quality evidence from large, ethnographically diverse cohorts is essential to explore the effects and driving factors of GBV during and after extreme events.
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Affiliation(s)
| | - Sarah Savić Kallesøe
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK; Centre for Infectious Disease Genomics and One Health, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Fiona Davey
- Health Equity Network, University of Cambridge, Cambridge, UK
| | - Sara Dada
- UCD Centre for Interdisciplinary Research, Education, and Innovation in Health Systems, School of Nursing, Midwifery, and Health Systems, University College Dublin, Dublin, Ireland
| | - Laura Jung
- Medical Faculty, Leipzig University, Leipzig, Germany
| | - Lucy Singh
- London School of Hygiene & Tropical Medicine, London, UK
| | - Rita Issa
- Institute for Global Health, University College London, London, UK
| | - Christina Alma Emilian
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Isla Kuhn
- Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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11
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Dada S, Tunçalp Ö, Portela A, Barreix M, Gilmore B. Community mobilization to strengthen support for appropriate and timely use of antenatal and postnatal care: A review of reviews. J Glob Health 2022; 11:04076. [PMID: 35003714 PMCID: PMC8710228 DOI: 10.7189/jogh.11.04076] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background Antenatal care (ANC) and postnatal care (PNC) are critical opportunities for women, babies and parents/families to receive quality care and support from health services. Community-based interventions may improve the accessibility, availability, and acceptance of this vital care. For example, community mobilization strategies have been used to involve and collaborate with women, families and communities to improve maternal and newborn health. Objective To synthesize existing reviews of evidence on community mobilization strategies that strengthen support for appropriate and timely use of ANC and PNC. Methods Six databases (MEDLINE, Embase, CINAHL, PsychINFO, Cochrane Library, PROSPERO) were searched for published reviews that describe community mobilization related strategies for ANC and/or PNC. Reviews were eligible for inclusion if they described any initiatives or strategies targeting the promotion of ANC and/or PNC uptake that included an element of community mobilization in a low- or middle-income country (LMIC), published after 2000. Included reviews were critically appraised according to the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Evidence Syntheses. This review of reviews was conducted following JBI guidelines for undertaking and reporting umbrella reviews. Results In total 23 papers, representing 22 reviews were included. While all 22 reviews contained some description of community mobilization and ANC/PNC, 13 presented more in-depth details on the community mobilization processes and relevant outcomes. Seventeen reviews focused on ANC, four considered both ANC and PNC, and only one focused on PNC. Overall, 16 reviews reported at least one positive association between community mobilization activities and ANC/PNC uptake, while five reviews presented primary studies with no statistically significant change in ANC uptake and one included a primary study with a decrease in use of antenatal facilities. The community mobilization activities described by the reviews ranged from informative, passive communication to more active, participatory approaches that included engaging individuals or consulting local leaders and community members to develop priorities and action plans. Conclusions While there is considerable momentum around incorporating community mobilization activities in maternal and newborn health programs, such as improving community support for the uptake of ANC and PNC, there is limited evidence on the processes used. Furthermore, the spectrum of terminology and variation in definitions should be harmonized to guide the implementation and evaluation efforts.
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Affiliation(s)
- Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Özge Tunçalp
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - María Barreix
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Brynne Gilmore
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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12
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Dada S, van Daalen KR, Barrios-Ruiz A, Wu KT, Desjardins A, Bryce-Alberti M, Castro-Varela A, Khorsand P, Santamarta Zamorano A, Jung L, Malolos G, Li J, Vervoort D, Hamilton NC, Patil P, El Omrani O, Wangari MC, Sibanda T, Buggy C, Mogo ERI. Challenging the "old boys club" in academia: Gender and geographic representation in editorial boards of journals publishing in environmental sciences and public health. PLOS Glob Public Health 2022; 2:e0000541. [PMID: 36962476 PMCID: PMC10021803 DOI: 10.1371/journal.pgph.0000541] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 05/05/2022] [Indexed: 11/19/2022]
Abstract
In light of global environmental crises and the need for sustainable development, the fields of public health and environmental sciences have become increasingly interrelated. Both fields require interdisciplinary thinking and global solutions, which is largely directed by scientific progress documented in peer-reviewed journals. Journal editors play a critical role in coordinating and shaping what is accepted as scientific knowledge. Previous research has demonstrated a lack of diversity in the gender and geographic representation of editors across scientific disciplines. This study aimed to explore the diversity of journal editorial boards publishing in environmental science and public health. The Clarivate Journal Citation Reports database was used to identify journals classified as Public, Environmental, and Occupational (PEO) Health, Environmental Studies, or Environmental Sciences. Current EB members were identified from each journal's publicly available website between 1 March and 31 May 2021. Individuals' names, editorial board roles, institutional affiliations, geographic locations (city, country), and inferred gender were collected. Binomial 95% confidence intervals were calculated for the proportions of interest. Pearson correlations with false discovery rate adjustment were used to assess the correlation between journal-based indicators and editorial board characteristics. Linear regression and logistic regression models were fitted to further assess the relationship between gender presence, low- and middle-income country (LMIC) presence and several journal and editor-based indicators. After identifying 628 unique journals and excluding discontinued or unavailable journals, 615 journal editorial boards were included. In-depth analysis was conducted on 591 journals with complete gender and geographic data for their 27,772 editors. Overall, the majority of editors were men (65.9%), followed by women (32.9%) and non-binary/other gender minorities (0.05%). 75.5% journal editorial boards (n = 446) were composed of a majority of men (>55% men), whilst only 13.2% (n = 78) demonstrated gender parity (between 45-55% women/gender minorities). Journals categorized as PEO Health had the most gender diversity. Furthermore, 84% of editors (n = 23,280) were based in high-income countries and only 2.5% of journals (n = 15) demonstrated economic parity in their editorial boards (between 45-55% editors from LMICs). Geographically, the majority of editors' institutions were based in the United Nations (UN) Western Europe and Other region (76.9%), with 35.2% of editors (n = 9,761) coming solely from the United States and 8.6% (n = 2,373) solely from the United Kingdom. None of the editors-in-chief and only 27 editors in total were women based in low-income countries. Through the examination of journal editorial boards, this study exposes the glaring lack of diversity in editorial boards in environmental science and public health, explores the power dynamics affecting the creation and dissemination of knowledge, and proposes concrete actions to remedy these structural inequities in order to inform more equitable, just and impactful knowledge creation.
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Affiliation(s)
- Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Kim Robin van Daalen
- Department of Public Health and Primary Care, Cardiovascular Epidemiology Unit, Cambridge University, Cambridge, United Kingdom
| | - Alanna Barrios-Ruiz
- Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, México
| | - Kai-Ti Wu
- Leibniz Institute for Freshwater Ecology and Inland Fisheries, Berlin, Germany
- Faculty of Mathematics and Natural Science, Department of Geography, Humboldt University of Berlin, Berlin, Germany
| | - Aidan Desjardins
- Department of Microbiology, School of Genetics and Microbiology, Moyne Institute of Preventive Medicine, Trinity College Dublin, Dublin, Ireland
| | | | | | - Parnian Khorsand
- Women in Global Health, Washington, District of Columbia, United States of America
| | | | - Laura Jung
- Leipzig University, Medical Faculty, Leipzig, Germany
| | - Grace Malolos
- College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Jiaqi Li
- University of Cambridge, School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Dominique Vervoort
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Nikita Charles Hamilton
- NCH Strategy Group, Nassau, The Bahamas
- The Department of Environmental Planning and Protection (DEPP), Nassau, Bahamas
| | - Poorvaprabha Patil
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | | | - Telma Sibanda
- Zimbabwe Red Cross Society, Harare, Gokwe South and North, Zimbabwe
| | - Conor Buggy
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Ebele R I Mogo
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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13
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van Daalen KR, Dada S, James R, Ashworth HC, Khorsand P, Lim J, Mooney C, Khankan Y, Essar MY, Kuhn I, Juillard H, Blanchet K. Impact of conditional and unconditional cash transfers on health outcomes and use of health services in humanitarian settings: a mixed-methods systematic review. BMJ Glob Health 2022; 7:e007902. [PMID: 35078813 PMCID: PMC8796230 DOI: 10.1136/bmjgh-2021-007902] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/03/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Cash transfers, payments provided by formal or informal institutions to recipients, are increasingly used in emergencies. While increasing autonomy and being supportive of local economies, cash transfers are a cost-effective method in some settings to cover basic needs and extend benefits of limited humanitarian aid budgets. Yet, the extent to which cash transfers impact health in humanitarian settings remains largely unexplored. This systematic review evaluates the evidence on the effect of cash transfers on health outcomes and health service utilisation in humanitarian contexts. METHODS Studies eligible for inclusion were peer reviewed (quantitative,qualitative and mixed-methods). Nine databases (PubMed, EMBAS, Medline, CINAHL, Global Health, Scopus, Web of Science Core Collection, SciELO and LiLACS) were searched without language and without a lower bound time restriction through 24 February 2021. The search was updated to include articles published through 8 December 2021. Data were extracted using a piloted extraction tool and quality was assessed using The Joanna Briggs Critical Appraisal Tool. Due to heterogeneity in study designs and outcomes, results were synthesised narratively and no meta-analysis was performed. RESULTS 30 673 records were identified. After removing duplicates, 17 715 were double screened by abstract and title, and 201 in full text. Twenty-three articles from 16 countries were included reporting on nutrition outcomes, psychosocial and mental health, general/subjective health and well-being, acute illness (eg, diarrhoea, respiratory infection), diabetes control (eg, blood glucose self-monitoring, haemoglobin A1C levels) and gender-based violence. Nineteen studies reported some positive impacts on various health outcomes and use of health services, 11 reported no statistically significant impact on outcomes assessed and 4 reported potential negative impacts on health outcomes. DISCUSSION Although there is evidence to suggest a positive relationship between cash transfers and health outcomes in humanitarian settings, high-quality empirical evidence, that is methodologically robust, investigates a range of humanitarian settings and is conducted over longer time periods is needed. This should consider factors influencing programme implementation and the differential impact of cash transfers designed to improve health versus multipurpose cash transfers. PROSPERO REGISTRATION NUMBER CRD42021237275.
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Affiliation(s)
- Kim Robin van Daalen
- Cardiovascular Epidemiology Unit, Department of Public Health & Primary Care, Cambridge University, Cambridge, UK
| | - Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rosemary James
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, Stoke-on-Trent, UK
| | | | | | - Jiewon Lim
- School of Medicine, NUI Galway, Galway, Ireland
| | - Ciaran Mooney
- Northern Ireland Medical and Dental Training Agency, Belfast, Antrim, UK
| | - Yasmeen Khankan
- Department of Biology, Siena Heights University, Adrian, Michigan, USA
| | | | - Isla Kuhn
- Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Helene Juillard
- Geneva Centre of Humanitarian Studies, University of Geneva, Geneva, Geneva, Switzerland
| | - Karl Blanchet
- Global Health Development, University of Geneva Faculty of Medicine, Geneve, Switzerland
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14
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van Daalen KR, Dada S, Issa R, Chowdhury M, Jung L, Singh L, Stokes D, Orcutt M, Singh NS. A Scoping Review to Assess Sexual and Reproductive Health Outcomes, Challenges and Recommendations in the Context of Climate Migration. Front Glob Womens Health 2021; 2:757153. [PMID: 34816251 PMCID: PMC8594026 DOI: 10.3389/fgwh.2021.757153] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: As growing numbers of people may be forced to migrate due to climate change and variability, it is important to consider the disparate impacts on health for vulnerable populations, including sexual and reproductive health (SRH). This scoping review aims to explore the relationship between climate migration and SRH. Methods: We searched PubMed/MEDLINE, CINAHL Plus, EMBASE, Web of Science, Scopus, Global Health and Google for peer-reviewed and gray literature published before 2nd July 2021 in English that reported on SRH in the context of climate migration. Data were extracted using a piloted extraction tool and findings are reported in a narrative synthesis. Results: We screened 1,607 documents. Ten full-text publications were included for analysis: five peer-reviewed articles and five gray literature documents. Reported SRH outcomes focused on maternal health, access to family planning and antiretroviral therapy, sexual and gender-based violence, transactional sex, and early/forced marriage. Recommendations to improve SRH in the context of climate migration called for gender-transformative health systems, education and behavior change programmes, and the involvement of local women in policy planning and programme implementation. Discussion: While the disparate impacts of climate change and migration are well-established, primary data on the scope of impact due to climate migration is limited. The SRH outcomes reported in the literature focus on a relatively narrow range of SRH domains, emphasizing women and girls, over men. Achieving holistic and equitable SRH in the context of climate migration requires engaging all genders across the range of SRH outcomes and migration contexts. This review highlights the need for further empirical evidence on the effect of climate migration on SRH, with research that is context-specific and engages communities in order to reflect the heterogeneity of outcomes and impact in the climate-migration-SRH nexus.
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Affiliation(s)
- Kim Robin van Daalen
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Cambridge University, Cambridge, United Kingdom
| | - Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rita Issa
- Institute for Global Health, University College London, London, United Kingdom
| | | | - Laura Jung
- Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Lucy Singh
- EGA Institute for Women's Health, University College London, London, United Kingdom
| | | | - Miriam Orcutt
- Institute for Global Health, University College London, London, United Kingdom
| | - Neha S. Singh
- Health in Humanitarian Crises Centre, London School of Tropical Hygiene and Medicine, London, United Kingdom
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15
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Kummervold PE, Martin S, Dada S, Kilich E, Denny C, Paterson P, Larson HJ. Categorizing Vaccine Confidence With a Transformer-Based Machine Learning Model: Analysis of Nuances of Vaccine Sentiment in Twitter Discourse. JMIR Med Inform 2021; 9:e29584. [PMID: 34623312 PMCID: PMC8538052 DOI: 10.2196/29584] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 04/13/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background Social media has become an established platform for individuals to discuss and debate various subjects, including vaccination. With growing conversations on the web and less than desired maternal vaccination uptake rates, these conversations could provide useful insights to inform future interventions. However, owing to the volume of web-based posts, manual annotation and analysis are difficult and time consuming. Automated processes for this type of analysis, such as natural language processing, have faced challenges in extracting complex stances such as attitudes toward vaccination from large amounts of text. Objective The aim of this study is to build upon recent advances in transposer-based machine learning methods and test whether transformer-based machine learning could be used as a tool to assess the stance expressed in social media posts toward vaccination during pregnancy. Methods A total of 16,604 tweets posted between November 1, 2018, and April 30, 2019, were selected using keyword searches related to maternal vaccination. After excluding irrelevant tweets, the remaining tweets were coded by 3 individual researchers into the categories Promotional, Discouraging, Ambiguous, and Neutral or No Stance. After creating a final data set of 2722 unique tweets, multiple machine learning techniques were trained on a part of this data set and then tested and compared with the human annotators. Results We found the accuracy of the machine learning techniques to be 81.8% (F score=0.78) compared with the agreed score among the 3 annotators. For comparison, the accuracies of the individual annotators compared with the final score were 83.3%, 77.9%, and 77.5%. Conclusions This study demonstrates that we are able to achieve close to the same accuracy in categorizing tweets using our machine learning models as could be expected from a single human coder. The potential to use this automated process, which is reliable and accurate, could free valuable time and resources for conducting this analysis, in addition to informing potentially effective and necessary interventions.
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Affiliation(s)
- Per E Kummervold
- Vaccine Research Department, FISABIO-Public Health, Valencia, Spain
| | - Sam Martin
- Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Oxford, United Kingdom.,Rapid Research Evaluation and Appraisal Lab, Departament of Targeted Intervention, University College London, London, United Kingdom.,Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.,Ethox Centre, Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, United Kingdom
| | - Sara Dada
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.,UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Eliz Kilich
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Chermain Denny
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pauline Paterson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit, London, United Kingdom
| | - Heidi J Larson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit, London, United Kingdom.,Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, United States.,Chatham House Centre on Global Health Security, The Royal Institute of International Affairs, London, United Kingdom
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16
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Dada S, Ashworth H, Sobitschka A, Raguveer V, Sharma R, Hamilton RL, Burke T. Experiences with implementation of continuous positive airway pressure for neonates and infants in low-resource settings: A scoping review. PLoS One 2021; 16:e0252718. [PMID: 34115776 PMCID: PMC8195417 DOI: 10.1371/journal.pone.0252718] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/21/2021] [Indexed: 11/24/2022] Open
Abstract
Background Continuous positive airway pressure (CPAP) is the gold standard of care in providing non-invasive positive pressure support to neonates in respiratory distress in high-resource settings. While safety has been demonstrated in low-resource settings, there is a lack of knowledge on the barriers and facilitators to proper implementation. Objective To identify and describe the barriers, facilitators, and priorities for future implementation of CPAP for neonates and infants in low-resource settings. Methods A systematic search (database inception to March 6, 2020) was performed on MEDLINE, Embase, Web of Science, CINAHL, Global Health, and the WHO Global Index Medicus using PRISMA-ScR guidelines. Original research articles pertaining to implementation of CPAP devices in low-resource settings, provider or parent perspectives and experiences with CPAP, cost-benefit analyses, and cost-effectiveness studies were included. Inductive content analysis was conducted. Findings 1385 article were screened and 54 studies across 19 countries met inclusion criteria. Six major themes emerged: device attributes, patient experiences, parent experiences, provider experiences, barriers, and facilitators. Nasal trauma was the most commonly reported complication. Barriers included unreliable electricity and lack of bioengineering support. Facilitators included training, mentorship and empowerment of healthcare providers. Device design, supply chain infrastructure, and training models were imperative to the adoption and sustainability of CPAP. Conclusion Sustainable implementation of CPAP in low resource settings requires easy-to-use devices, ready access to consumables, and holistic, user-driven training. Further research is necessary on standardizing metrics, interventions that support optimal provider performance, and conditions needed for successful long-term health system integration.
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Affiliation(s)
- Sara Dada
- Vayu Global Health Foundation Boston, Boston, Massachusetts, United States of America
- * E-mail:
| | - Henry Ashworth
- Vayu Global Health Foundation Boston, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Alina Sobitschka
- Vayu Global Health Foundation Boston, Boston, Massachusetts, United States of America
- University of Göttingen, Göttingen, Germany
| | - Vanitha Raguveer
- Vayu Global Health Foundation Boston, Boston, Massachusetts, United States of America
- University of Illinois College of Medicine, Chicago, Illinois, United States of America
| | - Rupam Sharma
- Vayu Global Health Foundation Boston, Boston, Massachusetts, United States of America
- University of California Los Angeles Kern Medical Center, Bakersfield, California, United States of America
| | - Rebecca L. Hamilton
- Massachusetts General Hospital, Department of Anesthesiology, Boston, Massachusetts, United States of America
- Karolinska Institute, Department of Cell and Molecular Biology, Solna, Sweden
| | - Thomas Burke
- Vayu Global Health Foundation Boston, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Massachusetts General Hospital, Global Health Innovation Lab, Department of Emergency Medicine, Boston, Massachusetts, United States of America
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
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17
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Achour B, Nsibi S, Chalbaoui A, Bouslema E, Dada S, Bensayed N, Regaieg H, Kmira Z, Zaier M, Ben Y, Khélif A. Anémie hémolytique auto-immune du sujet âgé de plus de 75 ans : étude rétrospective de 24 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.106] [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: 11/27/2022]
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18
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Karafillakis E, Martin S, Simas C, Olsson K, Takacs J, Dada S, Larson HJ. Methods for Social Media Monitoring Related to Vaccination: Systematic Scoping Review. JMIR Public Health Surveill 2021; 7:e17149. [PMID: 33555267 PMCID: PMC7899807 DOI: 10.2196/17149] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [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: 11/21/2019] [Revised: 11/05/2020] [Accepted: 12/17/2020] [Indexed: 01/26/2023] Open
Abstract
Background Social media has changed the communication landscape, exposing individuals to an ever-growing amount of information while also allowing them to create and share content. Although vaccine skepticism is not new, social media has amplified public concerns and facilitated their spread globally. Multiple studies have been conducted to monitor vaccination discussions on social media. However, there is currently insufficient evidence on the best methods to perform social media monitoring. Objective The aim of this study was to identify the methods most commonly used for monitoring vaccination-related topics on different social media platforms, along with their effectiveness and limitations. Methods A systematic scoping review was conducted by applying a comprehensive search strategy to multiple databases in December 2018. The articles’ titles, abstracts, and full texts were screened by two reviewers using inclusion and exclusion criteria. After data extraction, a descriptive analysis was performed to summarize the methods used to monitor and analyze social media, including data extraction tools; ethical considerations; search strategies; periods monitored; geolocalization of content; and sentiments, content, and reach analyses. Results This review identified 86 articles on social media monitoring of vaccination, most of which were published after 2015. Although 35 out of the 86 studies used manual browser search tools to collect data from social media, this was time-consuming and only allowed for the analysis of small samples compared to social media application program interfaces or automated monitoring tools. Although simple search strategies were considered less precise, only 10 out of the 86 studies used comprehensive lists of keywords (eg, with hashtags or words related to specific events or concerns). Partly due to privacy settings, geolocalization of data was extremely difficult to obtain, limiting the possibility of performing country-specific analyses. Finally, 20 out of the 86 studies performed trend or content analyses, whereas most of the studies (70%, 60/86) analyzed sentiments toward vaccination. Automated sentiment analyses, performed using leverage, supervised machine learning, or automated software, were fast and provided strong and accurate results. Most studies focused on negative (n=33) and positive (n=31) sentiments toward vaccination, and may have failed to capture the nuances and complexity of emotions around vaccination. Finally, 49 out of the 86 studies determined the reach of social media posts by looking at numbers of followers and engagement (eg, retweets, shares, likes). Conclusions Social media monitoring still constitutes a new means to research and understand public sentiments around vaccination. A wide range of methods are currently used by researchers. Future research should focus on evaluating these methods to offer more evidence and support the development of social media monitoring as a valuable research design.
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Affiliation(s)
- Emilie Karafillakis
- London School of Hygiene & Tropical Medicine, Vaccine Confidence Project, London, United Kingdom
| | - Sam Martin
- London School of Hygiene & Tropical Medicine, Vaccine Confidence Project, London, United Kingdom
| | - Clarissa Simas
- London School of Hygiene & Tropical Medicine, Vaccine Confidence Project, London, United Kingdom
| | - Kate Olsson
- European Centre for Disease Prevention and Control, Stockhom, Sweden
| | - Judit Takacs
- European Centre for Disease Prevention and Control, Stockhom, Sweden.,Centre for Social Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Sara Dada
- London School of Hygiene & Tropical Medicine, Vaccine Confidence Project, London, United Kingdom
| | - Heidi Jane Larson
- London School of Hygiene & Tropical Medicine, Vaccine Confidence Project, London, United Kingdom.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
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19
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Dada S, Ashworth HC, Bewa MJ, Dhatt R. Words matter: political and gender analysis of speeches made by heads of government during the COVID-19 pandemic. BMJ Glob Health 2021; 6:e003910. [PMID: 33514593 PMCID: PMC7849321 DOI: 10.1136/bmjgh-2020-003910] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/26/2020] [Accepted: 12/03/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has put a spotlight on political leadership around the world. Differences in how leaders address the pandemic through public messages have practical implications for building trust and an effective response within a country. METHODS We analysed the speeches made by 20 heads of government around the world (Bangladesh, Belgium, Bolivia, Brazil, Dominican Republic, Finland, France, Germany, India, Indonesia, New Zealand, Niger, Norway, Russia, South Africa, Scotland, Sint Maarten, United Kingdom, United States and Taiwan) to highlight the differences between men and women leaders in discussing COVID-19. We used an inductive analytical approach, coding speeches for specific themes based on language and content. FINDINGS Five primary themes emerged across a total of 122 speeches on COVID-19, made by heads of government: economics and financial relief, social welfare and vulnerable populations, nationalism, responsibility and paternalism, and emotional appeals. While all leaders described the economic impact of the pandemic, women spoke more frequently about the impact on the individual scale. Women leaders were also more often found describing a wider range of social welfare services, including: mental health, substance abuse and domestic violence. Both men and women from lower-resource settings described detailed financial relief and social welfare support that would impact the majority of their populations. While 17 of the 20 leaders used war metaphors to describe COVID-19 and the response, men largely used these with greater volume and frequency. CONCLUSION While this analysis does not attempt to answer whether men or women are more effective leaders in responding to the COVID-19 pandemic, it does provide insight into the rhetorical tools and types of language used by different leaders during a national and international crisis. This analysis provides additional evidence on the differences in political leaders' messages and priorities to inspire citizens' adhesion to the social contract in the adoption of response and recovery measures. However, it does not consider the influence of contexts, such as the public audience, on leaders' strategic communication approaches.
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Affiliation(s)
- Sara Dada
- Vayu Global Health Foundation, Boston, Massachusetts, USA
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
- Women in Global Health, Washington, District of Columbia, USA
| | - Henry Charles Ashworth
- Vayu Global Health Foundation, Boston, Massachusetts, USA
- Women in Global Health, Washington, District of Columbia, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Marlene Joannie Bewa
- Women in Global Health, Washington, District of Columbia, USA
- Department of Community and Family Health, University of South Florida, Tampa, Florida, USA
| | - Roopa Dhatt
- Women in Global Health, Washington, District of Columbia, USA
- Division of General Internal Medicine, Department of Medicine, Georgetown University School of Medicine, Washington, District of Columbia, USA
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, USA
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20
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Hammami A, Dabbabi H, Dada S, Ben Brahim M, Kechida M, Ouali S. Hughes-Stovin: A rare entity and challenging therapeutic management. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.150] [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: 10/22/2022]
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21
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Ide N, Allen G, Ashworth HC, Dada S. Critical Breaths in Transit: A Review of Non-invasive Ventilation (NIV) for Neonatal and Pediatric Patients During Transportation. Front Pediatr 2021; 9:667404. [PMID: 34055699 PMCID: PMC8155575 DOI: 10.3389/fped.2021.667404] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/15/2021] [Indexed: 12/24/2022] Open
Abstract
Respiratory illnesses are a leading cause of death for children worldwide, with the majority of these cases occurring from preterm birth complications or acute respiratory infections. Appropriate respiratory intervention must be provided quickly to lower the chances of death or permanent harm. As a result, respiratory support given in prehospital and interfacility transport can substantially improve health outcomes for these patients, particularly in areas where transportation time to appropriate facilities is lengthy. Existing literature supports the use of non-invasive ventilation (NIV), such as nasal or bilevel continuous positive airway pressure, as a safe form of respiratory support for children under 18 years old in certain transportation settings. This mini review summarizes the literature on pediatric NIV in transport and highlights significant gaps that future researchers should address. In particular, we identify the need to: solidify clinical guidelines for the selection of eligible pediatric patients for transport on NIV; explore the range of factors influencing successful NIV implementation during transportation; and apply appropriate best practices in low and middle income countries.
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Affiliation(s)
- Nellie Ide
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, United States
| | - Grace Allen
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, United States
| | | | - Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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22
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van Daalen KR, Bajnoczki C, Chowdhury M, Dada S, Khorsand P, Socha A, Lal A, Jung L, Alqodmani L, Torres I, Ouedraogo S, Mahmud AJ, Dhatt R, Phelan A, Rajan D. Symptoms of a broken system: the gender gaps in COVID-19 decision-making. BMJ Glob Health 2020; 5:bmjgh-2020-003549. [PMID: 33004348 PMCID: PMC7533958 DOI: 10.1136/bmjgh-2020-003549] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Kim Robin van Daalen
- Cardiovascular Epidemiology Unit, Cambridge University, Cambridge, UK .,Women in Global Health, Washington, District of Columbia, USA
| | - Csongor Bajnoczki
- UHC2030 Alliance, Health Systems Governance Collaborative, World Health Organization, Geneva, Switzerland
| | | | - Sara Dada
- Women in Global Health, Washington, District of Columbia, USA.,Vayu Global Health Foundation, Boston, Massachusetts, USA
| | | | - Anna Socha
- UHC2030 Alliance, Health Systems Governance Collaborative, World Health Organization, Geneva, Switzerland
| | - Arush Lal
- Women in Global Health, Washington, District of Columbia, USA
| | - Laura Jung
- Women in Global Health, Washington, District of Columbia, USA.,Leipzig University, Leipzig, Germany
| | - Lujain Alqodmani
- Education and Agriculture Together (EAT) Foundation, Oslo, Norway
| | | | - Samiratou Ouedraogo
- McGill University, Montreal, Quebec, Canada.,Institut National de Santé Publique du Québec (INSPQ), Montreal, Quebec, Canada
| | - Amina Jama Mahmud
- Women in Global Health, Garowe, Somalia.,Department of Women's and Children's Health, Uppsala University Department of International Maternal and Child Health, Uppsala, Sweden
| | - Roopa Dhatt
- Women in Global Health, Washington, District of Columbia, USA
| | - Alexandra Phelan
- Center for Global Health Science & Security, Georgetown University, Washington, District of Columbia, USA
| | - Dheepa Rajan
- UHC2030 Alliance, Health Systems Governance Collaborative, World Health Organization, Geneva, Switzerland
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23
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Martin S, Kilich E, Dada S, Kummervold PE, Denny C, Paterson P, Larson HJ. "Vaccines for pregnant women…?! Absurd" - Mapping maternal vaccination discourse and stance on social media over six months. Vaccine 2020; 38:6627-6637. [PMID: 32788136 DOI: 10.1016/j.vaccine.2020.07.072] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 02/25/2020] [Revised: 07/24/2020] [Accepted: 07/31/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To understand the predominant topics of discussion, stance and associated language used on social media platforms relating to maternal vaccines in 15 countries over a six-month period. BACKGROUND In 2019, the World Health Organisation prioritised vaccine hesitancy as a top ten global health threat and recognized the role of viral misinformation on social media as propagating vaccine hesitancy. Maternal vaccination offers the potential to improve maternal and child health, and to reduce the risk of severe morbidity and mortality in pregnancy. Understanding the topics of discussion, stance and language used around maternal vaccines on social media can inform public health bodies on how to combat vaccine misinformation and vaccine hesitancy. METHODS Social media data was extracted (Twitter, forums, blogs and comments) for six months from 15 countries (Australia, Brazil, Canada, France, Germany, India, Italy, Korea, Mexico, Panama, South Africa, Spain, United Kingdom and United States). We used stance, discourse and topic analysis to provide insight into the most frequent and weighted keywords, hashtags and themes of conversation within and across countries. RESULTS We exported a total of 19,192 social media posts in 16 languages obtained between 1st November 2018 and 30th April 2019. After screening all posts, 16,000 were included in analyses, while excluding retweets, 2,722 were annotated for sentiment. Main topics of discussion were the safety of the maternal influenza and pertussis vaccines. Discouraging posts were most common in Italy (44.9%), and the USA (30.8%). CONCLUSION The content and stance of maternal vaccination posts from November 2018 to April 2019 differed across countries, however specific topics of discussion were not limited to geographical location. These discussions included the promotion of vaccination, involvement of pregnant women in vaccine research, and the trust and transparency of institutions. Future research should examine the relationship between stance (promotional, neutral, ambiguous, discouraging) online and maternal vaccination uptake in the respective regions.
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Affiliation(s)
- Sam Martin
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Eliz Kilich
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Sara Dada
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Chermain Denny
- Faculty of Science, Vrije University, Amsterdam, Netherlands
| | - Pauline Paterson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Heidi J Larson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
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24
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Kilich E, Dada S, Francis MR, Tazare J, Chico RM, Paterson P, Larson HJ. Factors that influence vaccination decision-making among pregnant women: A systematic review and meta-analysis. PLoS One 2020; 15:e0234827. [PMID: 32645112 PMCID: PMC7347125 DOI: 10.1371/journal.pone.0234827] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/02/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The most important factor influencing maternal vaccination uptake is healthcare professional (HCP) recommendation. However, where data are available, one-third of pregnant women remain unvaccinated despite receiving a recommendation. Therefore, it is essential to understand the significance of other factors and distinguish between vaccines administered routinely and during outbreaks. This is the first systematic review and meta-analysis (PROSPERO: CRD 42019118299) to examine the strength of the relationships between identified factors and maternal vaccination uptake. METHODS We searched MEDLINE, Embase Classic & Embase, PsycINFO, CINAHL Plus, Web of Science, IBSS, LILACS, AfricaWideInfo, IMEMR, and Global Health databases for studies reporting factors that influence maternal vaccination. We used random-effects models to calculate pooled odds ratios (OR) of being vaccinated by vaccine type. FINDINGS We screened 17,236 articles and identified 120 studies from 30 countries for inclusion. Of these, 49 studies were eligible for meta-analysis. The odds of receiving a pertussis or influenza vaccination were ten to twelve-times higher among pregnant women who received a recommendation from HCPs. During the 2009 influenza pandemic an HCP recommendation increased the odds of antenatal H1N1 vaccine uptake six times (OR 6.76, 95% CI 3.12-14.64, I2 = 92.00%). Believing there was potential for vaccine-induced harm had a negative influence on seasonal (OR 0.22, 95% CI 0.11-0.44 I2 = 84.00%) and pandemic influenza vaccine uptake (OR 0.16, 95% CI 0.09-0.29, I2 = 89.48%), reducing the odds of being vaccinated five-fold. Combined with our qualitative analysis the relationship between the belief in substantial disease risk and maternal seasonal and pandemic influenza vaccination uptake was limited. CONCLUSIONS The effect of an HCP recommendation during an outbreak, whilst still powerful, may be muted by other factors. This requires further research, particularly when vaccines are novel. Public health campaigns which centre on the protectiveness and safety of a maternal vaccine rather than disease threat alone may prove beneficial.
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Affiliation(s)
- Eliz Kilich
- Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - Sara Dada
- Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - Mark R. Francis
- Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - John Tazare
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - R. Matthew Chico
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - Pauline Paterson
- Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - Heidi J. Larson
- Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
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25
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Dada S, McKay G, Mateus A, Lees S. Lessons learned from engaging communities for Ebola vaccine trials in Sierra Leone: reciprocity, relatability, relationships and respect (the four R's). BMC Public Health 2019; 19:1665. [PMID: 31829223 PMCID: PMC6907283 DOI: 10.1186/s12889-019-7978-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Building trust and engaging the community are important for biomedical trials. This was core to the set up and delivery of the EBOVAC-Salone and PREVAC Ebola vaccine trials in Sierra Leone during and following the 2014-2016 West African Ebola epidemic. Local community liaison teams (CLT) engaged with the community through public meetings, radio chat shows, and other activities, while a social science team (SST) assessed community members' and participants' perceptions and regularly updated the clinical team to adapt procedures to improve the acceptability and compliance of the trial. The objective of this study was to examine the community engagement (CE) program in these trials and to identify potential barriers and facilitators. METHODS Fifteen CLT and SST members participated in in-depth interviews and 23 community members attended three focus groups to discuss the Ebola vaccine trials and their experiences and perspectives of the CE activities. RESULTS A key aim of the CE program was to build trust between the community and the trial. Four main principles (the "four R's") evolved from the discussions with team members and the community that influenced this trust: reciprocity, relatability, relationships and respect. The CLT and SST ensured reciprocal communication between the trial team and the community. The CLT delivered key messages from the trial, whilst the SST completed ethnographic research in the field to uncover rumors and perceptions of the trial in the community. These ethnographic findings were shared with the CLT and addressed in targeted messaging to the community. Both the CLT and SST approached the communities in an egalitarian manner, by dressing modestly, speaking local dialects, and using relatable examples. Appreciation and understanding of the importance of interpersonal relationships and respect for the people, their customs, and traditions also played a large role in the CE program. CONCLUSION These findings provide an in-depth understanding of how interdisciplinary community liaison and social science teams can work with a clinical team to strengthen trust. The four R's suggest the ways in which trust relations are central to CE and confidence in vaccine trials, and could offer an approach to CE in vaccine trials.
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Affiliation(s)
- Sara Dada
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
- The Royal Veterinary College, Royal College Street, London, NW1 0TU UK
| | - Gillian McKay
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Ana Mateus
- The Royal Veterinary College, Royal College Street, London, NW1 0TU UK
| | - Shelley Lees
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
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26
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Dada S, Lees S, Mateus A, McKay G. The four R's: a community engagement framework for disease preparedness research in Sierra Leone. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.320] [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: 11/30/2022] Open
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27
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Huus K, Dada S, Bornman J, Lygnegård F. The awareness of primary caregivers in South Africa of the human rights of their children with intellectual disabilities. Child Care Health Dev 2016; 42:863-870. [PMID: 27357624 DOI: 10.1111/cch.12358] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 04/29/2016] [Accepted: 05/02/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Besides the right to freedom, human rights can be seen as a basic requirement also for the maintenance of human dignity and the opportunity to thrive - particularly in the case of children with disabilities. It is imperative to explore primary caregivers' awareness of the human rights of their children with intellectual disabilities in view of the role they may play in either facilitating or restricting these rights. This paper explores the awareness of 219 primary caregivers of the human rights of their children with intellectual disabilities. METHOD A descriptive survey design was used with a custom-designed questionnaire that employed a deductive content analysis based on the articles of the United Nations Convention on the Rights of a Child. Comparisons were drawn between the awareness of primary caregivers from urban and those from rural areas. RESULTS The majority (85.5%) of participants agreed that their child with intellectual disability had rights. Three broad kinds of right were mentioned (in descending order): provision rights, protection rights and participation rights. Participants from both urban and rural areas mentioned education (a provision right) most frequently. However, participants from urban areas were more aware of the different rights that existed than were their counterparts from rural areas. CONCLUSION Primary caregivers in both rural and urban areas are aware of the rights of their children with disabilities, although there are significant differences between them.
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Affiliation(s)
- K Huus
- School of Health Sciences, CHILD Research Group, Jönköping, Sweden.
| | - S Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - J Bornman
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - F Lygnegård
- School of Health Sciences, CHILD Research Group, Jönköping, Sweden
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28
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Bastable K, Dada S, Uys CJE. The Effect of a Non-Powered, Self-Initiated Mobility Program on the Engagement of Young Children with Severe Mobility Limitations in the South African Context. Phys Occup Ther Pediatr 2016; 36:272-91. [PMID: 26861153 DOI: 10.3109/01942638.2015.1126879] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To determine the effect of a non-powered, self-initiated mobility program on the engagement of young children with severe mobility limitations, in the South African context. METHODS A multiple-probe-across-participant design was used. Four children (aged 2-6 years) with severe mobility limitations underwent an intervention that targeted non-powered, self-initiated mobility. The intervention comprised eight sessions over a 2-week period. Engagement was measured during each baseline, intervention and postintervention session using the Individual Child Engagement Record-Revised (ICER-R). The data were presented graphically and analyzed using statistical procedures appropriate for single-subject designs. RESULTS Participants demonstrated an improvement in engagement during the time in which non-powered, self-initiated mobility program was introduced. A reciprocal deterioration in nonengagement was also demonstrated. The results of the study are discussed in terms of various intrinsic and extrinsic factors. CONCLUSIONS The use of a non-powered, self-initiated mobility program may be effective in improving engagement in some young children with severe mobility limitations.
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Affiliation(s)
- K Bastable
- a Centre for Augmentative and Alternative Communication , University of Pretoria , South Africa
| | - S Dada
- a Centre for Augmentative and Alternative Communication , University of Pretoria , South Africa
| | - C J E Uys
- a Centre for Augmentative and Alternative Communication , University of Pretoria , South Africa
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29
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Schlebusch L, Samuels AE, Dada S. South African families raising children with autism spectrum disorders: relationship between family routines, cognitive appraisal and family quality of life. J Intellect Disabil Res 2016; 60:412-423. [PMID: 27120985 DOI: 10.1111/jir.12292] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 03/17/2016] [Accepted: 03/18/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND The purpose of this study was to investigate the relationship between family routines, cognitive appraisal of the impact of autism spectrum disorders (ASD) on the family and family quality of life (FQOL) in families raising children with ASD in South Africa. METHODS A sample of 180 families of young children with ASD who were receiving disability-related services in the Gauteng province of South Africa completed a self-administered survey. Structural equation modelling was used to examine the direct relationship between the regularity of family routines and FQOL, and the mediating effect of cognitive appraisal on this relationship. RESULTS The results suggested a direct, positive relationship between the regularity of family routines and families' satisfaction with their FQOL. Furthermore, cognitive appraisal of the impact of ASD on the family mediated this relationship in a partial manner. CONCLUSION A higher frequency of regular family routines was strongly associated with a higher satisfaction level of FQOL. Also, cognitive appraisal of the impact of ASD acted as a mechanism through which the regularity of family routines influenced FQOL. We discuss the research and clinical implications of these findings.
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Affiliation(s)
- L Schlebusch
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, Gauteng, South Africa
| | - A E Samuels
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, Gauteng, South Africa
- CHILD,School of Education and Communication, Jönköping University, Jönköping, Sweden
| | - S Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, Gauteng, South Africa
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30
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Plüddemann A, Dada S, Parry CDH, Kader R, Parker JS, Temmingh H, Van Heerden S, De Clercq C, Lewis I. Monitoring the prevalence of methamphetamine-related presentations at psychiatric hospitals in Cape Town, South Africa. ACTA ACUST UNITED AC 2013; 16:45-9. [DOI: 10.4314/ajpsy.v16i1.8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 03/26/2012] [Indexed: 11/17/2022]
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31
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Dada S, Ben Abdallah O, Miniaoui I, Rezgui A, Karmeni M, Ben Fredj Ismail F, Laouani Kechrid C. Étude de l’atteinte péricardique au cours du lupus érythémateux systémique. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.065] [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: 10/26/2022]
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Abstract
BACKGROUND Activity-based intervention has been defined as a child-directed, transactional approach that uses logically occurring antecedents and consequences to develop functional and generative skills by embedding intervention of children's individual goals and objectives in routine, planned or child-initiated activities. In this approach, clear goals and objectives that are functional and embedded in a play activities or routines are developed. The teacher mediates the child's environment to facilitate learning with the child directing the teacher on the pace, duration spent on the objective. Learning and development in this framework occur through both a carefully planned environment and adult facilitation. Progress made by a child using this approach focuses on observational data that describe if the child is able to respond in functional and generative ways. While activity-based interventions are usually provided for a group of children, progress is measured by describing individual children's responses. Individual variations in the children's progress, despite exposure to the same interventions are an area that is seldom discussed. This article aims to explore the niche concept and its application to explaining this variation between individuals. METHODS Four children participated in this single-subject, multiple-probe study across four participants. A 3-week long activity-based aided language stimulation programme was developed. The effect of the programme was determined by describing the individual participants understanding of the 24 targeted vocabulary items. RESULTS The results of the activity-based language programme are presented and the variability among the participants is discussed using the niche concept. The role of the niche concept in individual development is described and the implications thereof are discussed. CONCLUSIONS Finally, activity-based intervention research is placed in a systems perspective and possible outcome measures of this intervention are discussed from a multidimensional ecological perspective.
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Affiliation(s)
- S Dada
- Centre for Augmentative and Alternative Communication, Communication Pathology Building, Main Campus, University of Pretoria, Pretoria, Gauteng, South Africa
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Kirkl J, Garrett R, Dada S, Corvera C. Open surgical clipping of murine bile duct is more efficient than a laparoscopic approach. J Surg Res 2006. [DOI: 10.1016/j.jss.2005.11.411] [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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Farhat F, Saab M, Dada S, Ghaddar A, Balhas A, Ghorayeb G. [Thrombolytic treatment of obstructions of mechanical valve prostheses. Apropos of 4 cases and analysis of the literature]. J Med Liban 1999; 47:354-9. [PMID: 10758710] [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: 02/16/2023]
Abstract
The obstruction of the mechanical valve prothesis (OMVP) is a serious complication. The treatment of this complication was classically surgical. Recently, the thrombolytic treatment was introduced as an alternative approach for patients with high perioperative risk and for those in whom the mechanism of the obstruction is a recently formed thrombus. The authors report four cases of OMVP treated by a thrombolytic agent (Streptokinase, SK, Streptase). Immediate success was obtained in all theses four cases. One late recurrence with fatal issue was noted. All four prostheses were Saint Jude medical (SJM), three in mitral and one in aortic position respectively. The details of the clinical presentation (acute or progressive dyspnea) as well as the contribution of the echocardiography to the diagnosis were presented. The evolution of this therapeutic approach and the international recommendations were reviewed.
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Affiliation(s)
- F Farhat
- Service de cardiologie, Hôpital général Sahel, Beyrouth
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35
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Abstract
Waldenstrom macroglobulinemia is a plasma cell dyscrasia that rarely presents with gastrointestinal involvement. We report a case of gastric involvement of Waldenstrom macroglobulinemia detected by CT.
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Affiliation(s)
- H M Qutub
- Department of Radiology, University of Illinois College of Medicine at Chicago, 1740 W. Taylor Street, Chicago, IL 60612, USA
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Lauribe P, Benchimol D, Dartigues JF, Dada S, Benchimol H, Drouillet F, Bonnet J, Bricaud H. Biological risk factors for sudden death in patients with coronary artery disease and without heart failure. Int J Cardiol 1992; 34:307-18. [PMID: 1563856 DOI: 10.1016/0167-5273(92)90029-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In a study of biological risk factors for sudden death in patients with coronary artery disease, 320 patients were, prospectively, recruited and followed-up over two years. None of the patients had heart failure or recent myocardial infarction. The following variables were recorded: previous acute myocardial infarction, hypertension, smoking habits, ventricular arrhythmia; the angiographic variables included: left ventricular ejection fraction, Jenkins' and mean atherosclerotic scores; lipid profile: cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoproteins Al and B; hemostatic profile: fibrinogen, fibrinopeptide A, antithrombin III, factor VIII antigen, factor VIII coagulant, protein C, plasminogen, alpha 2-antiplasmin, euglobulin clot lysis time and tissue plasminogen activator before and after venous occlusion, tissue plasminogen activator inhibitor, platelet factor 4, beta-thromboglobulin. During the follow-up period, 12 of the patients died suddenly. In these patients, ejection fraction was lower: 49 +/- 16% versus 61 +/- 14% for the other patients (P less than 0.02), fibrinogen higher: 3.9 +/- 0.8 g/l versus 3.5 +/- 0.8 for the living patients (P less than 0.05) and protein C lower: 89 +/- 39% versus 111 +/- 39% (P = 0.06) for the other patients. In multivariate analysis: lower ejection fraction (P less than 0.008), older age (P less than 0.03) and lower protein C (P less than 0.01) were correlated with sudden death. Among the patients with coronary artery disease, the raised fibrinogen and the decreased protein C appeared to be risk factors for sudden cardiac death. These alterations reflected a prothrombotic state which might increase the ischemic risk, due to an acute thrombosis, leading to the fatal ventricular arrhythmia. Determination of these hemostatic variables might be a useful adjunct for assessment of the vital prognosis of patients with coronary artery disease, especially the risk of sudden death in addition to other known clinical, electrocardiographic, hemodynamic risk factors. This would also guide both the instigation of complementary investigations and appropriate therapy in such high risk group of patients.
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Affiliation(s)
- P Lauribe
- Service de Cardiologie, Hôpital Nord, Marseille, France
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