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Brisson J, Ravitsky V, Williams-Jones B. A Mixed-Methods Study Exploring Colombian Adolescents' Access to Sexual and Reproductive Health Services: The Need for a Relational Autonomy Approach. J Bioeth Inq 2024:10.1007/s11673-024-10356-w. [PMID: 38532187 DOI: 10.1007/s11673-024-10356-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/10/2024] [Indexed: 03/28/2024]
Abstract
This study's objective was to understand Colombian adolescents' experiences and preferences regarding access to sexual and reproductive health services (SRHS), either alone or accompanied. A mixed-method approach was used, involving a survey of 812 participants aged eleven to twenty-four years old and forty-five semi-structured interviews with participants aged fourteen to twenty-three. Previous research shows that adolescents prefer privacy when accessing SRHS and often do not want their parents involved. Such findings align with the longstanding tendency to frame the ethical principle of autonomy as based on independence in decision-making. However, the present study shows that such a conceptualization and application of autonomy does not adequately explain Colombian adolescent participants' preferences regarding access to SRHS. Participants shared a variety of preferences to access SRHS, with the majority of participants attaching great importance to having their parents involved, to varying degrees. What emerges is a more complex and non-homogenous conceptualization of autonomy that is not inherently grounded in independence from parental involvement in access to care. We thus argue that when developing policies involving adolescents, policymakers and health professionals should adopt a nuanced "relational autonomy" approach to better respect the myriad of preferences that Colombian (and other) adolescents may have regarding their access to SRHS.
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Affiliation(s)
- J Brisson
- Department of Social & Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada.
| | - V Ravitsky
- Department of Social & Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
| | - B Williams-Jones
- Department of Social & Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
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2
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Logie CH, Okumu M, Admassu Z, Perez-Brumer A, Ahmed R, Luna ML, MacKenzie F, Kortenaar JL, Berry I, Hakiza R, Katisi B, Musoke DK, Nakitende A, Batte S, Kyambadde P, Taing L, Giordana G, Mbuagbaw L. HIV Vulnerabilities Associated with Water Insecurity, Food Insecurity, and Other COVID-19 Impacts Among Urban Refugee Youth in Kampala, Uganda: Multi-method Findings. AIDS Behav 2024; 28:507-523. [PMID: 38048017 DOI: 10.1007/s10461-023-04240-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
Food insecurity (FI) and water insecurity (WI) are linked with HIV vulnerabilities, yet how these resource insecurities shape HIV prevention needs is understudied. We assessed associations between FI and WI and HIV vulnerabilities among urban refugee youth aged 16-24 in Kampala, Uganda through individual in-depth interviews (IDI) (n = 24), focus groups (n = 4), and a cross-sectional survey (n = 340) with refugee youth, and IDI with key informants (n = 15). Quantitative data was analysed via multivariable logistic and linear regression to assess associations between FI and WI with: reduced pandemic sexual and reproductive health (SRH) access; past 3-month transactional sex (TS); unplanned pandemic pregnancy; condom self-efficacy; and sexual relationship power (SRP). We applied thematic analytic approaches to qualitative data. Among survey participants, FI and WI were commonplace (65% and 47%, respectively) and significantly associated with: reduced SRH access (WI: adjusted odds ratio [aOR]: 1.92, 95% confidence interval [CI]: 1.19-3.08; FI: aOR: 2.31. 95%CI: 1.36-3.93), unplanned pregnancy (WI: aOR: 2.77, 95%CI: 1.24-6.17; FI: aOR: 2.62, 95%CI: 1.03-6.66), and TS (WI: aOR: 3.09, 95%CI: 1.22-7.89; FI: aOR: 3.51, 95%CI: 1.15-10.73). WI participants reported lower condom self-efficacy (adjusted β= -3.98, 95%CI: -5.41, -2.55) and lower SRP (adjusted β= -2.58, 95%CI= -4.79, -0.37). Thematic analyses revealed: (1) contexts of TS, including survival needs and pandemic impacts; (2) intersectional HIV vulnerabilities; (3) reduced HIV prevention/care access; and (4) water insecurity as a co-occurring socio-economic stressor. Multi-method findings reveal FI and WI are linked with HIV vulnerabilities, underscoring the need for HIV prevention to address co-occurring resource insecurities with refugee youth.
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Affiliation(s)
- Carmen H Logie
- Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada.
- United Nations University Institute for Water, Environment, and Health, Hamilton, ON, Canada.
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
- Centre for Gender & Sexual Health Equity, Vancouver, BC, Canada.
| | - Moses Okumu
- School of Social Work, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Zerihun Admassu
- Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | - Amaya Perez-Brumer
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rushdia Ahmed
- Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | - Marianne Lahai Luna
- Department of Geography and Planning, University of Toronto, Toronto, ON, Canada
| | - Frannie MacKenzie
- Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | - Jean-Luc Kortenaar
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Isha Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Robert Hakiza
- Young African Refugees for Integral Development (YARID), Kampala, Uganda
| | - Brenda Katisi
- Young African Refugees for Integral Development (YARID), Kampala, Uganda
| | | | | | - Shamilah Batte
- Organization for Gender Empowerment and Rights Advocacy (OGERA) Uganda, Kampala, Uganda
| | - Peter Kyambadde
- National AIDS Control Program, Ministry of Health, Kampala, Uganda
- Most At Risk Population Initiative Clinic, Mulago Hospital, Kampala, Uganda
| | - Lina Taing
- United Nations University Institute for Water, Environment, and Health, Hamilton, ON, Canada
| | - Gio Giordana
- World Food Programme East Africa, Nairobi, Kenya
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada
- Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
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3
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Dufour GK, Senn CY, Jeffrey NK. Self-Reports of Sexual Violence Outside of Survey Reference Periods: Implications for Measurement. J Interpers Violence 2023; 38:11475-11500. [PMID: 37431746 PMCID: PMC10515449 DOI: 10.1177/08862605231182383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Accurate measurement of sexual violence (SV) victimization is important for informing research, policy, and service provision. Measures such as the Sexual Experiences Survey (SES) that use behaviorally specific language and a specified reference period (e.g., since age 14, over the past 12 months) are considered best practice and have substantially improved SV estimates given that so few incidents are reported to police. However, to date, we know little about whether estimates are affected by respondents' reporting of incidents that occurred outside of the specified reference period (i.e., reference period errors). The current study explored the extent, nature, and impact on incidence estimates of reference period errors in two large, diverse samples of post-secondary students. Secondary analysis was conducted of data gathered using a follow-up date question after the Sexual Experiences Survey-Short Form Victimization. Between 8% and 68% of rape and attempted rape victims made reference period errors, with the highest proportion of errors occurring in the survey with the shortest reference period (1 month). These errors caused minor to moderate changes in time period-specific incidence estimates (i.e., excluding respondents with errors reduced estimates by up to 7%). Although including a date question does not guarantee that all time period-related errors will be identified, it can improve the accuracy of SV estimates, which is crucial for informing policy and prevention. Researchers measuring SV within specific reference periods should consider collecting dates of reported incidents as best practice.
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Affiliation(s)
- Gena K. Dufour
- Department of Psychology, University of Windsor, ON, Canada
| | - Charlene Y. Senn
- Department of Psychology, University of Windsor, ON, Canada
- Women’s and Gender Studies Program, University of Windsor, ON, Canada
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Fafard St-Germain AA, Busby K, Urquia ML. Prevalence and sociodemographic correlates of marriage among adolescent mothers in Canada, 1989-2018. Can J Public Health 2023; 114:474-483. [PMID: 36562916 PMCID: PMC10156887 DOI: 10.17269/s41997-022-00728-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Female marriage before age 18 is a global health issue related to gender inequality, but it is understudied in Canada. This study examined marriage trends among mothers aged < 18 versus older mothers and the sociodemographic correlates of marriage among adolescent mothers aged < 18 and older adolescent mothers. METHODS Using the Canadian Vital Statistics - Birth Database, marriage prevalence was estimated by maternal age groups (< 18-year, 18-19-year, 20-24-year, and 25-49-year) between 1989-1990 and 2017-2018 (n = 10,399,250). Multivariable logistic regression was then used to examine the sociodemographic characteristics associated with marriage within adolescent maternal age group (< 18-year, 18-19-year, and 20-24-year) among births registered between 2000 and 2018. RESULTS From 1989-1990 to 2017-2018, marriage prevalence declined 80.5%, 60.2%, 47.3%, and 16.0% in the < 18-year, 18-19-year, 20-24-year, and 25-49-year groups, respectively. Within the < 18-year, 18-19-year, and 20-24-year adolescent maternal age groups, older maternal age, larger parental age gap, foreign-born parents, rurality, and earlier birth period were associated with higher adjusted odds of marriage. Higher maternal neighbourhood income was associated with marriage among births to mothers aged 18-19 and 20-24 years but not among those to mothers aged < 18 years. CONCLUSION Marriage prevalence declined among mothers of all ages, but the shifts away from marriage appear stronger among younger mothers. The sociodemographic correlates of marriage are generally similar among mothers below age 18 and slightly older adolescent mothers.
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Affiliation(s)
- Andrée-Anne Fafard St-Germain
- Manitoba Centre for Health Policy, Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
| | - Karen Busby
- Faculty of Law, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Marcelo L Urquia
- Manitoba Centre for Health Policy, Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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5
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Jacobson D, Grace D, Boddy J, Einstein G. Reproductive health care appointments: How the institutional organization of obstetric/gynecological work shapes the experiences of women with female genital cutting in Toronto, Canada. PLoS One 2023; 18:e0279867. [PMID: 36656810 PMCID: PMC9851502 DOI: 10.1371/journal.pone.0279867] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/15/2022] [Indexed: 01/20/2023] Open
Abstract
We investigated the social relations shaping the reproductive health care experiences of women with female genital cutting (FGC) in Toronto, Canada. Using Institutional Ethnography, we interviewed eight women with FGC and seven obstetrician/gynecologists (OB/GYN). We found a disjuncture between women's needs during appointments that extended beyond the reproductive body and range of care that doctors were able to provide. Women engaged in emotional healthwork during appointments by explaining FGC to doctors, reading doctors' body language, and getting through vulvar/vaginal examinations. Women reported that if they had emotional reactions during appointments, they were often referred to a mental health specialist, a referral on which they did not act. OB/GYNs described their specialty as "surgical"-training centered around treating reproductive abnormalities and not mental health issues. Therefore, the disjuncture between women's needs and OB/GYNs' institutional training highlights the difficulties inherent when bodies of "difference" encounter the reproductive health care system.
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Affiliation(s)
- Danielle Jacobson
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- * E-mail:
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Janice Boddy
- Department of Anthropology, University of Toronto, Toronto, Canada
| | - Gillian Einstein
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
- Department of Gender Studies, Linköping University, Linköping, Sweden
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Ford-Gilboe M, Varcoe C, Wuest J, Campbell J, Pajot M, Heslop L, Perrin N. Trajectories of Depression, Post-Traumatic Stress, and Chronic Pain Among Women Who Have Separated From an Abusive Partner: A Longitudinal Analysis. J Interpers Violence 2023; 38:NP1540-NP1568. [PMID: 35512192 PMCID: PMC9709554 DOI: 10.1177/08862605221090595] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This longitudinal study explored changes in women's health after separation from an abusive partner by characterizing the trajectories of their mental health (depression and post-traumatic stress disorder [PTSD]) and physical health (chronic pain) over a 4-year period. We examined how the severity of intimate partner violence (IPV) affected these trajectories, controlling for selected baseline factors using 5 waves of data collected from a community sample of 309 English-speaking, Canadian women. IPV severity was measured using the Index of Spouse Abuse where women were asked to consider the entire period of their partner relationship up to present at wave 1 and to rate their IPV experiences in the previous 12 months at waves 2-5. Mental health was measured using established self-report measures of depression (CESD) and PTSD (Davidson Trauma Scale), while chronic pain was measured using the Chronic Pain Grade Scale. Trajectories were estimated using MLM techniques with severity of IPV and selected co-variates (time since separation, age, financial strain) included. Our results show that women's health improved significantly over time, although significant levels of depression, PTSD symptoms and disabling chronic pain remained at the end of wave 5. Regardless of time since separation, more severe IPV was associated with higher levels of depression, PTSD, and disabling chronic pain, with IPV having a stronger effect on these health outcomes over time, suggesting cumulative effects of IPV on health. The results of this study contribute to quantifying the continuing mental and physical health burdens experienced by women after separation from an abusive partner. Increased attention to the long-term effects of violence on women's health beyond the crisis of leaving is critically needed to strengthen health and social services and better support women's recovery and healing.
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Affiliation(s)
- Marilyn Ford-Gilboe
- Arthur Labatt Family School of
Nursing, Western
University London, ON, Canada
| | - Colleen Varcoe
- School of Nursing,
University
of British Columbia, Vancouver, BC,
Canada
| | - Judith Wuest
- Faculty of Nursing,
University
of New Brunswick, Fredericton, NB,
Canada
| | | | - Michelle Pajot
- Arthur Labatt Family School of
Nursing, Western
University London, ON, Canada
| | - Lisa Heslop
- Arthur Labatt Family School of
Nursing, Western
University London, ON, Canada
| | - Nancy Perrin
- Johns Hopkins University School of
Nursing, Baltimore, MA, USA
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Jacobson D, Grace D, Boddy J, Einstein G. How Canadian Law Shapes the Health Care Experiences of Women with Female Genital Mutilation/Cutting/Circumcision and Their Providers: A Disjuncture Between Expectation and Actuality. Arch Sex Behav 2023; 52:107-119. [PMID: 36169778 PMCID: PMC9859896 DOI: 10.1007/s10508-022-02349-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 05/06/2023]
Abstract
This study explored how the reproductive health care experiences of women with female genital mutilation/cutting/circumcision (FGC) were shaped. We used Institutional Ethnography, a sociological approach which allows for the study of social relations and the coordination of health care. From qualitatively interviewing eight women with FGC, we learned that they felt excluded within the Canadian health care system because they were unable to access reconstructive surgery, which was not covered by Ontario's universal health coverage (Ontario Health Insurance Plan). We then talked with seven obstetricians/gynecologists (OB/GYNs) and learned that while it was legal to perform certain genital (e.g., female genital cosmetic surgery) and reproductive (e.g., elective caesarean section) surgeries commonly requested by Western-born women, it was not legal for them to perform other genital surgeries often requested by immigrant populations (e.g., reinfibulation), nor were these covered by OHIP (e.g., clitoral reconstructive surgery). From participants' comparison of clitoral reconstructive surgery and reinfibulation to female genital cosmetic and gender confirming surgeries, it became clear that the law and policies within the health care system favored surgeries elected by Western adults over those wished for by women with FGC. We found that the law had an impact on the choices that OB/GYNs and the women they treated could make, shaping their respective experiences. This created ethical dilemmas for OB/GYNs and a sense of exclusion from the health care system for women with FGC.
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Affiliation(s)
- Danielle Jacobson
- Dalla Lana School of Public Health, University of Toronto, 155 College Street (Room 500), Toronto, ON, M5T 3M7, Canada.
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, 155 College Street (Room 500), Toronto, ON, M5T 3M7, Canada
| | - Janice Boddy
- Department of Anthropology, University of Toronto, Toronto, ON, Canada
| | - Gillian Einstein
- Dalla Lana School of Public Health, University of Toronto, 155 College Street (Room 500), Toronto, ON, M5T 3M7, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Department of Gender Studies, Linköping University, Linköping, Sweden
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Baumbusch J, Cooke HA, Seetharaman K, Khan A, Khan KB. Exploring the Impacts of COVID-19 Public Health Measures on Community-Dwelling People Living With Dementia and Their Family Caregivers: A Longitudinal, Qualitative Study. J Fam Nurs 2022; 28:183-194. [PMID: 35674313 PMCID: PMC9280696 DOI: 10.1177/10748407221100284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Since the onset of the COVID-19 pandemic, community-dwelling people living with dementia and their family caregivers have experienced many challenges. The unanticipated consequences of public health measures have impacted these families in a myriad of ways. In this interpretive policy analysis, which used a longitudinal, qualitative methodology, we purposively recruited 12 families in British Columbia, Canada, to explore the impacts of pandemic public health measures over time. Semi-structured interviews were conducted every 3 months and participants completed diary entries. Twenty-eight interviews and 34 diary entries were thematically analyzed. The findings explore ways that families adopted and adapted to public health measures, loss of supports, both formal and informal, and the subsequent consequences for their mental and physical well-being. Within the ongoing context of the pandemic, as well as potential future wide-spread emergencies, it is imperative that programs and supports are restarted and maintained to avoid further harm to these families.
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Affiliation(s)
| | | | | | - Aneesa Khan
- The University of British Columbia, Vancouver, Canada
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Deom Tardif A, Gogovor A, Guay-Bélanger S, Audet D, Parent N, Gaudreau A, Remy-Lamarche D, Vigneault L, Ngueta G, Bilodeau A, Légaré F. Integration of sex and gender in a continuing professional development course on diabetes and depression: a mixed methods feasibility study. BMJ Open 2022; 12:e050890. [PMID: 35459660 PMCID: PMC9036429 DOI: 10.1136/bmjopen-2021-050890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Assess the feasibility and impact of a continuous professional development (CPD) course on type 2 diabetes and depression on health professionals' intention to include sex and gender considerations in patient care. DESIGN AND SETTING In collaboration with CPD organisations and patient-partners, we conducted a mixed-methods feasibility controlled trial with postintervention measures in three Canadian provinces. PARTICIPANTS Of 178 eligible health professionals, 127 completed questionnaires and 67 participated in semistructured group discussions. INTERVENTION AND COMPARATOR An interactive 1 hour CPD course, codesigned with patient-partners, on diabetes and depression that included sex and gender considerations (innovation) was compared with a similar course that did not include them (comparator). OUTCOMES Feasibility of recruitment and retention of CPD organisations and patient-partners throughout the study; adherence to planned activities; health professionals' intention to include sex and gender considerations in patient care as measured by the CPD-Reaction questionnaire; and barriers and facilitators using the Theoretical Domains Framework. RESULTS All recruited CPD organisations and patient-partners remained engaged throughout the study. All planned CPD courses occurred. Overall, 71% of eligible health professionals participated (63% under 44 years old; 79.5% women; 67.7% practising in French; 66.9% practising in Quebec; 78.8% in urban practice). After training, mean intention scores for the innovation (n=49) and control groups (n=78) were 5.65±0.19 and 5.19±0.15, respectively. Mean difference was -0.47 (CI -0.95 to 0.01; p=0.06). Adjusted for age, gender and practice settings, mean difference was -0.57 (CI -1.09 to -0.05; p=0.03). We identified eight theoretical domains related to barriers and six related to facilitators for providing sex-adapted and gender-adapted diabetes and depression care. CONCLUSIONS CPD training on diabetes and depression that includes sex and gender considerations is feasible and, compared with CPD training that does not, may prompt health professionals to modify their care. Addressing identified barriers and facilitators could increase intention. TRIAL REGISTRATION NUMBER NCT03928132 with ClinicalTrials.gov; Post-results.
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Affiliation(s)
- Alèxe Deom Tardif
- VITAM Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Amédé Gogovor
- VITAM Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Sabrina Guay-Bélanger
- VITAM Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
| | - Denis Audet
- University Family Medicine Group Saint-François-d'Assise, Quebec, Quebec, Canada
| | - Nicole Parent
- Direction de la formation professionnelle, Médecins francophones du Canada, Montreal, Quebec, Canada
| | - André Gaudreau
- Patient Partner, Université Laval, Quebec, Quebec, Canada
| | | | - Luc Vigneault
- VITAM Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
- Patient Partner, CAP Rétablissement, Quebec, Quebec, Canada
| | - Gérard Ngueta
- VITAM Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
| | - André Bilodeau
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - France Légaré
- VITAM Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec, Quebec, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
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10
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Jaradat D, Ford-Gilboe M, Berman H, Wong C. Structural and construct validity of the Quality of Life Scale among Canadian women with histories of intimate partner violence. Womens Health (Lond) 2022; 18:17455057221125574. [PMID: 36165206 PMCID: PMC9520177 DOI: 10.1177/17455057221125574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 08/21/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To evaluate the structural and construct validity, and internal consistency of the Quality of Life Scale among Canadian women with histories of intimate partner violence. METHODS Consistent with COSMIN Guidelines, a secondary analysis was conducted using data from a community sample of 250 adult (over 18 years) Canadian women with histories of partner violence and who participated in Wave 5 of the longitudinal Women's Health Effects Study. Data were collected 4 years after baseline using structured interviews that included the Quality of Life Scale and two mental symptom scales (Center for Epidemiological Depression Scale and Davidson Trauma Scale) used to assess construct validity of the Quality of Life Scale. RESULTS Confirmatory factor analysis in MPLUS 8 with maximum likelihood estimation supported the hypothesized unidimensional structure of the 9-item Quality of Life Scale based on acceptable fit indices. Internal consistency, estimated using Cronbach's alpha and composite reliability, were .91 and .92, respectively, with item-total correlations ranging from .46 to .84. Inter-item correlation coefficients (range = .30-.79), suggesting that all items contribute to the total score. As hypothesized, the quality of life total score was negatively related to the total scores on both the Center for Epidemiologic Studies-Depression (r = -.739) and Davidson Trauma Scale (r = -.537), providing evidence of construct validity of the Quality of Life Scale. CONCLUSION The Quality of Life Scale is a brief, reliable, valid, unidimensional self-report measure appropriate for use with women who have experienced partner violence. By addressing an important measurement gap, results of this study have potential to advance research on women's quality of life in the context of partner violence, including improving the evaluation of a growing body of advocacy and health interventions designed to support women's healing and well-being.
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Affiliation(s)
- Diana Jaradat
- Department of Community and Mental Health Nursing, Jordan University of Science & Technology, Irbid, Jordan
| | - Marilyn Ford-Gilboe
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Helene Berman
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Carol Wong
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
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Fletcher-Hildebrand S, Alimezelli H, Carr T, Lawson K, Ali A, Groot G. Understanding the impact of a residential housing programme for people living with HIV/AIDS: a realist evaluation protocol. BMJ Open 2021; 11:e044522. [PMID: 33820789 PMCID: PMC8030488 DOI: 10.1136/bmjopen-2020-044522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Housing instability and homelessness are significant barriers to medical treatment for people living with HIV/AIDS. For these individuals, lack of stable housing and stigma is associated with insufficient access to care, poor adherence to medication and higher cost burdens to the healthcare system. This protocol reports on the efforts to evaluate Sanctum V.1.0, a hospice and transitional care home for adults with HIV/AIDS in Saskatoon, Saskatchewan, Canada. The current project was developed out of a need to identify how Sanctum V.1.0 produces varying programme outcomes to assist in endeavours to replicate the programme in other geographic locations. METHODS AND ANALYSIS A realist evaluation will be conducted to explore how and why Sanctum V.1.0 is successful or unsuccessful, in which circumstances and for whom. Rather than explore the degree to which a programme is effective, realist evaluations seek to uncover mechanisms that explain processual links between programme inputs and outcomes. The completed first phase of the project involved the development of an initial realist programme theory. Phases 2 and 3 will consist of methods to test, refine and validate the initial theory using various data sources. ETHICS AND DISSEMINATION Ethics approval was obtained from the institutional review board at the University of Saskatchewan on 2 July 2020. Results will be disseminated according to stakeholders' desires.
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Affiliation(s)
| | - Hubert Alimezelli
- Community Health and Epidemiology, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Tracey Carr
- Community Health and Epidemiology, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Karen Lawson
- Psychology, University of Saskatchewan College of Arts and Science, Saskatoon, Saskatchewan, Canada
| | - Anum Ali
- Community Health and Epidemiology, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Gary Groot
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Scheim A, Kacholia V, Logie C, Chakrapani V, Ranade K, Gupta S. Health of transgender men in low-income and middle-income countries: a scoping review. BMJ Glob Health 2020; 5:e003471. [PMID: 33239337 PMCID: PMC7689587 DOI: 10.1136/bmjgh-2020-003471] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/03/2020] [Accepted: 10/21/2020] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Despite the rapid growth of research on transgender (trans) health globally, the extent of research on trans men and other transmasculine persons assigned the female sex at birth remains unclear. We, therefore, conducted a scoping review on trans men's health in low-income and middle-income countries (LMICs). METHODS The review included peer-reviewed articles and conference abstracts, and grey literature published from 1 January 1999 to 5 July 2019 in English, French, Hindi or Spanish and reporting original quantitative and/or qualitative data on the health of trans men or transmasculine persons living in LMIC. Studies were excluded if they did not disaggregate data for trans men or if they only described surgical techniques or laboratory values. RESULTS We included 53 studies (42 peer-reviewed and 11 grey literature) from 19 LMIC. Most were conducted in higher-middle-income countries (n=12) and in Latin America (n=16, 30.2%), the Middle East (n=14, 26.4%) or Sub-Saharan Africa (n=12, 22.6%) and published in 2014 or later (n=44, 83.0%). Approximately half of studies used quantitative methods (52.8%, n=28), of which 64.3% (n=18) had fewer than 50 participants and 14.2% (n=4) had over 150. Across study designs, social determinants of health and gender-affirming care were the most commonly represented domains (49.1% and 47.1% of studies respectively), with common themes including gender-based violence, coercion and discrimination as well as unprescribed hormone use. Other domains represented included mental health (32.1%), sexual and reproductive health (24.5%), general healthcare access (18.9%), physical health (9.4%) and substance use (9.4%). CONCLUSION Greater inclusion and disaggregation of trans men and transmasculine persons in global health research is needed to support sex- and gender-based analyses of trans health. Community-based research approaches and theoretically driven research may help to increase the relevance and rigour of such research. Funders should invest in research on trans men's health in LMIC.
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Affiliation(s)
- Ayden Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Vibhuti Kacholia
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Carmen Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Venkatesan Chakrapani
- The Humsafar Trust, Mumbai, Maharashtra, India
- Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, Tamil Nadu, India
| | - Ketki Ranade
- School of Social Work, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Shaman Gupta
- TWEET Foundation (Transgender Welfare Equity and Empowerment Trust), New Delhi, India
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Hébert M, Amédée LM, Blais M, Gauthier-Duchesne A. Child Sexual Abuse among a Representative Sample of Quebec High School Students: Prevalence and Association with Mental Health Problems and Health-Risk Behaviors. Can J Psychiatry 2019; 64:846-854. [PMID: 31299163 PMCID: PMC6935828 DOI: 10.1177/0706743719861387] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The objective of this study was to estimate the prevalence of child sexual abuse in a representative sample of Quebec high school youths and document its associations with mental health problems and health-risk behaviors. METHOD Data were drawn from the Quebec Youths' Romantic Relationships Survey, which involved a one-stage stratified cluster sampling of 34 Quebec high schools from Grades 10 to 12. A total of 8,194 youths (mean age = 15.35) were recruited. The survey assessed child sexual abuse, mental health problems (psychological distress, post-traumatic stress symptoms, suicidality), health services utilization, and health-risk behaviors (alcohol, drug, and cannabis use). Gender-stratified multivariate analyses were used to assess associations between child sexual abuse and mental health problems and health-risk behaviors while controlling for confounding demographic variables and other forms of child maltreatment experienced in childhood. RESULTS A total of 14.9% of girls and 3.9% of boys reported having experienced child sexual abuse. Child sexual abuse was independently associated with an increased risk of psychological distress, greater health services utilization, and increased health-risk behaviors, after controlling for other forms of childhood maltreatment experienced. CONCLUSIONS Child sexual abuse is prevalent among youths in Quebec and is associated with an increased risk of a host of negative consequences. Continued efforts in the development of early detection strategies as well as prevention and intervention programs are warranted.
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Affiliation(s)
- Martine Hébert
- Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | | | - Martin Blais
- Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
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Abstract
OBJECTIVES Comorbidity in traumatic brain injury (TBI) has been recognised to alter the clinical course of patients and influence short-term and long-term outcomes. We synthesised the evidence on the effects of different comorbid conditions on early and late mortality post-TBI in order to (1) examine the relationship between comorbid condition(s) and all-cause mortality in TBI and (2) determine the influence of sociodemographic and clinical characteristics of patients with a TBI at baseline on all-cause mortality. DESIGN Systematic review. DATA SOURCES Medline, Central, Embase, PsycINFO and bibliographies of identified articles were searched from May 1997 to January 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Included studies met the following criteria: (1) focused on comorbidity as it related to our outcome of interest in adults (ie, ≥18 years of age) diagnosed with a TBI; (2) comorbidity was detected by any means excluding self-report; (3) reported the proportion of participants without comorbidity and (4) followed participants for any period of time. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted the data and assessed risk of bias using the Quality in Prognosis Studies tool. Data were synthesised through tabulation and qualitative description. RESULTS A total of 27 cohort studies were included. Among the wide range of individual comorbid conditions studied, only low blood pressure was a consistent predictors of post-TBI mortality. Other consistent predictors were traditional sociodemographic risk factors. Higher comorbidity scale, scores and the number of comorbid conditions were not consistently associated with post-TBI mortality. CONCLUSIONS Given the high number of comorbid conditions that were examined by the single studies, research is required to further substantiate the evidence and address conflicting findings. Finally, an enhanced set of comorbidity measures that are suited for the TBI population will allow for better risk stratification to guide TBI management and treatment. PROSPERO REGISTRATION NUMBER CRD42017070033.
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Affiliation(s)
- Chen Xiong
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Sara Hanafy
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Vincy Chan
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Zheng Jing Hu
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mitchell Sutton
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
| | - Michael Escobar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Tatyana Mollayeva
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
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Dharma C, Scheim AI, Bauer GR. Exploratory Factor Analysis of Two Sexual Health Scales for Transgender People: Trans-Specific Condom/Barrier Negotiation Self-Efficacy (T-Barrier) and Trans-Specific Sexual Body Image Worries (T-Worries). Arch Sex Behav 2019; 48:1563-1572. [PMID: 31172396 DOI: 10.1007/s10508-018-1383-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/14/2018] [Accepted: 12/15/2018] [Indexed: 05/28/2023]
Abstract
Few sexual health measures have been validated for transgender (trans) populations. Condom/barrier self-efficacy and sexual body image worries are interrelated constructs that may contribute to enhanced and poor sexual health, respectively. We report on the development and initial validation of trans-specific scales designed to measure these constructs. Trans people in Ontario, Canada, who had ever had sex completed these scales as a part of a larger Trans PULSE survey (n = 323). Using exploratory factor analysis, a one-factor solution fit the 8-item Condom/Barrier Negotiation Self-Efficacy Scale (T-Barrier). Two factors were identified for the 7-item Sexual Body Image Worries Scale (T-Worries): "general body image worries" and "trans-related image worries," while two items were recommended for deletion. The scales demonstrated convergent validity with measures such as self-esteem, sexual anxiety, sexual satisfaction, sexual fear, and experiences of transphobia. Further evaluation to confirm these structures within an independent trans sample would be valuable. We recommend the use of these scales for studies of sexual health within trans populations, to enhance our ability to better understand and promote sexual health within trans communities.
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Affiliation(s)
- Christoffer Dharma
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 5C1, Canada
| | - Ayden I Scheim
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 5C1, Canada
| | - Greta R Bauer
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 5C1, Canada.
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Hankivsky O, Springer KW, Hunting G. Beyond sex and gender difference in funding and reporting of health research. Res Integr Peer Rev 2018; 3:6. [PMID: 30167330 PMCID: PMC6112145 DOI: 10.1186/s41073-018-0050-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [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: 01/18/2018] [Accepted: 07/30/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Understanding sex and gender in health research can improve the quality of scholarship and enhance health outcomes. Funding agencies and academic journals are two key gatekeepers of knowledge production and dissemination, including whether and how sex/gender is incorporated into health research. Though attention has been paid to key issues and practices in accounting for sex/gender in health funding agencies and academic journals, to date, there has been no systematic analysis documenting whether and how agencies and journals require attention to sex/gender, what conceptual explanations and practical guidance are given for such inclusion, and whether existing practices reflect the reality that sex/gender cannot be separated from other axes of inequality. METHODS Our research systematically examines official statements about sex/gender inclusion from 45 national-level funding agencies that fund health research across 36 countries (covering the regions of the EU and associated countries, North America, and Australia) and from ten top-ranking general health (the top five in "science" and the top five in "social science") and ten sex- and/or gender-related health journals. We explore the extent to which agencies and journals require inclusion of sex/gender considerations and to what extent existing strategies reflect state of the art understandings of sex/gender, including intersectional perspectives. RESULTS The research highlights the following: (a) there is no consistency in whether sex/gender are mentioned in funding and publishing guidelines; (b) there is wide variation in how sex/gender are conceptualized and how researchers are asked to address the inclusion/exclusion of sex/gender in research; (c) funding agencies tend to prioritize male/female equality in research teams and funding outcomes over considerations of sex/gender in research content and knowledge production; and (d) with very few exceptions, agency and journal criteria fail to recognize the complexity of sex/gender, including the intersection of sex/gender with other key factors that shape health. CONCLUSIONS The conceptualization and integration of sex/gender needs to better capture the interacting and complex factors that shape health-an imperative that can be informed by an intersectional approach. This can strengthen current efforts to advance scientific excellence in the production and reporting of research. We provide recommendations and supporting questions to strengthen consideration of sex/gender in policies and practices of health journals and funding agencies.
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Affiliation(s)
- Olena Hankivsky
- School of Public Policy, Institute for Intersectionality Research and Policy, Simon Fraser University, Harbour Centre Campus, Room 3274, 505 West Hastings Street, Vancouver, BC V68 5K3 Canada
| | - Kristen W. Springer
- Department of Sociology, Faculty Affiliate, Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, 26 Nichol Avenue, New Brunswick, NJ 08901 USA
| | - Gemma Hunting
- Institute for Intersectionality Research and Policy, Simon Fraser University, Harbour Centre Campus, Room 3274, 505 West Hastings Street, Vancouver, BC V68 5K3 Canada
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Xiong C, Biscardi M, Nalder E, Colantonio A. Sex and gender differences in caregiving burden experienced by family caregivers of persons with dementia: a systematic review protocol. BMJ Open 2018; 8:e022779. [PMID: 30104318 PMCID: PMC6091900 DOI: 10.1136/bmjopen-2018-022779] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/09/2018] [Accepted: 07/06/2018] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION While much is known about caregiving burden and its consequences on both caregivers and care recipients, reports on the sex and gender differences that may be present among family caregivers of persons with dementia (PWD) are lacking. Attention to and a synthesis of these sex and gender distinctions have direct implications on the planning and development of health services for this population. The current protocol outlines a strategy for a systematic review of the current evidence to identify and synthesise sex and gender distinctions in caregiving burden experienced by family caregivers of PWD. METHODS AND ANALYSIS A comprehensive search strategy for studies that examine the sex and gender differences in caregiving impacts and experiences has been developed in collaboration with an information specialist at a university. All peer-reviewed English language studies on adult family caregivers of PWD, published from January 2007 to September 2017, found through Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature and bibliographies of identified articles, will be considered eligible. Study quality will be assessed using the Critical Appraisal Skills Programme checklists. ETHICS AND DISSEMINATION As the first systematic review of its kind that focus on sex and gender differences in caregiving burden, findings will be relevant for healthcare practitioners and researchers who can better prescribe and develop interventions and technologies to better address the specific challenges and burden experienced by male and female family caregivers of PWD. Moreover, given that more than half of family caregivers are females; these sex and gender differences will also be pertinent to policy-makers when evaluating and planning of our healthcare systems to better meet the needs of this population. TRIAL REGISTRATION NUMBER CRD42018070032.
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Affiliation(s)
- Chen Xiong
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Aquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Melissa Biscardi
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Aquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Emily Nalder
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Aquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Miner SA, Robins S, Zhu YJ, Keeren K, Gu V, Read SC, Zelkowitz P. Evidence for the use of complementary and alternative medicines during fertility treatment: a scoping review. BMC Complement Altern Med 2018; 18:158. [PMID: 29764413 PMCID: PMC5952848 DOI: 10.1186/s12906-018-2224-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/30/2018] [Indexed: 03/26/2024]
Abstract
BACKGROUND Complementary and alternative medicines (CAM) are sometimes used by individuals who desire to improve the outcomes of their fertility treatment and/or mental health during fertility treatment. However, there is little comprehensive information available that analyzes various CAM methods across treatment outcomes and includes information that is published in languages other than English. METHOD This scoping review examines the evidence for 12 different CAM methods used to improve female and male fertility outcomes as well as their association with improving mental health outcomes during fertility treatment. Using predefined key words, online medical databases were searched for articles (n = 270). After exclusion criteria were applied, 148 articles were analyzed in terms of their level of evidence and the potential for methodological and author bias. RESULTS Surveying the literature on a range of techniques, this scoping review finds a lack of high quality evidence that complementary and alternative medicine (CAM) improves fertility or mental health outcomes for men or women. Acupuncture has the highest level of evidence for its use in improving male and female fertility outcomes although this evidence is inconclusive. CONCLUSION Overall, the quality of the evidence across CAM methods was poor not only because of the use of research designs that do not yield conclusive results, but also because results were contradictory. There is a need for more research using strong methods such as randomized controlled trials to determine the effectiveness of CAM in relation to fertility treatment, and to help physicians and patients make evidence-based decisions about CAM use during fertility treatment.
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Affiliation(s)
- Skye A. Miner
- Department of Sociology, McGill University, Room 712, Leacock Building, 855 Sherbrooke Street West, Montreal, QC H3A 2T7 Canada
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
| | - Stephanie Robins
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
| | - Yu Jia Zhu
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
- Department of Dentistry, McGill University, 2001 McGill College Ave, Montreal, QC H3A 1G1 Canada
| | - Kathelijne Keeren
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
| | - Vivian Gu
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
- Department of Medicine, University of British Columbia Medical School, 2275 Laurel Street, 10th Floor, British Columbia, BC V5Z 1M9 Canada
| | - Suzanne C. Read
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
- Lady Davis Institute, 3755 Chemin de la Cote-Ste-Catherine, Montreal, QC H3T 1E2 Canada
- Department of Psychiatry, McGill University, Ludmer Research and Training Building, 1033 Pine Ave. West., Montreal, QC H3A 1A1 Canada
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Snow ME, Tweedie K, Pederson A. Heard and valued: the development of a model to meaningfully engage marginalized populations in health services planning. BMC Health Serv Res 2018; 18:181. [PMID: 29544486 PMCID: PMC5856315 DOI: 10.1186/s12913-018-2969-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 02/27/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Recently, patient engagement has been identified as a promising strategy for supporting healthcare planning. However, the context and structure of universalistic, "one-size-fits-all" approaches often used for patient engagement may not enable diverse patients to participate in decision-making about programs intended to meet their needs. Specifically, standard patient engagement approaches are gender-blind and might not facilitate the engagement of those marginalized by, for example, substance use, low income, experiences of violence, homelessness, and/or mental health challenges-highly gendered health and social experiences. The project's purpose was to develop a heuristic model to assist planners to engage patients who are not traditionally included in healthcare planning. METHODS Using a qualitative research approach, we reviewed literature and conducted interviews with patients and healthcare planners regarding engaging marginalized populations in health services planning. From these inputs, we created a model and planning manual to assist healthcare planners to engage marginalized patients in health services planning, which we piloted in two clinical programs undergoing health services design. The findings from the pilots were used to refine the model. RESULTS The analysis of the interviews and literature identified power and gender as barriers to participation, and generated suggestions to support diverse populations both to attend patient engagement events and to participate meaningfully. Engaging marginalized populations cannot be reduced to a single defined process, but instead needs to be understood as an iterative process of fitting engagement methods to a particular situation. Underlying this process are principles for meaningfully engaging marginalized people in healthcare planning. CONCLUSION A one-size-fits-all approach to patient engagement is not appropriate given patients' diverse barriers to meaningful participation in healthcare planning. Instead, planners need a repertoire of skills and strategies to align the purpose of engagement with the capacities and needs of patient participants. Just as services need to meet diverse patients' needs, so too must patient engagement experiences.
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Affiliation(s)
- M. Elizabeth Snow
- Centre for Health Evaluation & Outcome Sciences (CHÉOS), University of British Columbia, St. Paul’s Hospital, 588 - 1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada
| | - Katherine Tweedie
- University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4 Canada
| | - Ann Pederson
- BC Women’s Hospital + Health Centre, E305 - 4500 Oak Street, Vancouver, BC V6H 3N1 Canada
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McTavish JR, Kimber M, Devries K, Colombini M, MacGregor JCD, Wathen CN, Agarwal A, MacMillan HL. Mandated reporters' experiences with reporting child maltreatment: a meta-synthesis of qualitative studies. BMJ Open 2017; 7:e013942. [PMID: 29042370 PMCID: PMC5652515 DOI: 10.1136/bmjopen-2016-013942] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated reporters' (MRs) experiences with reporting. DESIGN As no studies assessing the effectiveness of mandatory reporting were retrieved from our systematic search, we conducted a meta-synthesis of retrieved qualitative research. Searches in Medline (Ovid), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, Education Resources Information Center, Criminal Justice Abstracts and Cochrane Library yielded over 6000 citations, which were deduplicated and then screened by two independent reviewers. English-language, primary qualitative studies that investigated MRs' experiences with reporting of child maltreatment were included. Critical appraisal involved a modified checklist from the Critical Appraisal Skills Programme and qualitative meta-synthesis was used to combine results from the primary studies. SETTING All healthcare and social-service settings implicated by mandatory reporting laws were included. Included studies crossed nine high-income countries (USA, Australia, Sweden, Taiwan, Canada, Norway, Finland, Israel and Cyprus) and three middle-income countries (South Africa, Brazil and El Salvador). PARTICIPANTS The studies represent the views of 1088 MRs. OUTCOMES Factors that influence MRs' decision to report and MRs' views towards and experiences with mandatory reporting of child maltreatment. RESULTS Forty-four articles reporting 42 studies were included. Findings indicate that MRs struggle to identify and respond to less overt forms of child maltreatment. While some articles (14%) described positive experiences MRs had with the reporting process, negative experiences were reported in 73% of articles and included accounts of harm to therapeutic relationships and child death following removal from their family of origin. CONCLUSIONS The findings of this meta-synthesis suggest that there are many potentially harmful experiences associated with mandatory reporting and that research on the effectiveness of this process is urgently needed.
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Affiliation(s)
- Jill R McTavish
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Karen Devries
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Manuela Colombini
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - C Nadine Wathen
- Faculty of Information and Media Studies, Western University, London, Ontario, Canada
| | - Arnav Agarwal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Davidov DM, Davis SM, Zhu M, Afifi TO, Kimber M, Goldstein AL, Pitre N, Gurka KK, Stocks C. Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States. PLoS One 2017; 12:e0184222. [PMID: 28886119 PMCID: PMC5590902 DOI: 10.1371/journal.pone.0184222] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/21/2017] [Indexed: 11/23/2022] Open
Abstract
The highly rural region of Appalachia faces considerable socioeconomic disadvantage and health disparities that are recognized risk factors for intimate partner violence (IPV). The objective of this study was to estimate the rate of IPV-related hospitalizations in Appalachia and the non-Appalachian United States for 2007–2011 and compare hospitalizations in each region by clinical and sociodemographic factors. Data on IPV-related hospitalizations were extracted from the State Inpatient Databases, which are part of the Healthcare Cost and Utilization Project. Hospitalization day, year, in-hospital mortality, length of stay, average and total hospital charges, sex, age, payer, urban-rural location, income, diagnoses and procedures were compared between Appalachian and non-Appalachian counties. Poisson regression models were constructed to test differences in the rate of IPV-related hospitalizations between both regions. From 2007–2011, there were 7,385 hospitalizations related to IPV, with one-third (2,645) occurring in Appalachia. After adjusting for age and rurality, Appalachian counties had a 22% higher hospitalization rate than non-Appalachian counties (ARR = 1.22, 95% CI: 1.14–1.31). Appalachian residents may be at increased risk for IPV and associated conditions. Exploring disparities in healthcare utilization and costs associated with IPV in Appalachia is critical for the development of programs to effectively target the needs of this population.
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Affiliation(s)
- Danielle M. Davidov
- Department of Emergency Medicine and Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, United States of America
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, United States of America
- * E-mail:
| | - Stephen M. Davis
- Department of Emergency Medicine and Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, United States of America
| | - Motao Zhu
- Department of Epidemiology, West Virginia University, Morgantown, West Virginia, United States of America
| | - Tracie O. Afifi
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Abby L. Goldstein
- Department of Applied Psychology and Human Development, OISE, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Pitre
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kelly K. Gurka
- Department of Epidemiology, West Virginia University, Morgantown, West Virginia, United States of America
| | - Carol Stocks
- Agency for Healthcare Research and Quality, Rockville, Maryland, United States of America
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Welch V, Doull M, Yoganathan M, Jull J, Boscoe M, Coen SE, Marshall Z, Pardo JP, Pederson A, Petkovic J, Puil L, Quinlan L, Shea B, Rader T, Runnels V, Tudiver S. Reporting of sex and gender in randomized controlled trials in Canada: a cross-sectional methods study. Res Integr Peer Rev 2017; 2:15. [PMID: 29451565 PMCID: PMC5803639 DOI: 10.1186/s41073-017-0039-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 03/29/2017] [Accepted: 06/26/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Accurate reporting on sex and gender in health research is integral to ensuring that health interventions are safe and effective. In Canada and internationally, governments, research organizations, journal editors, and health agencies have called for more inclusive research, provision of sex-disaggregated data, and the integration of sex and gender analysis throughout the research process. Sex and gender analysis is generally defined as an approach for considering how and why different subpopulations (e.g., of diverse genders, ages, and social locations) may experience health conditions and interventions in different or similar ways.The objective of this study was to assess the extent and nature of reporting about sex and/or gender, including whether sex and gender analysis (SGA) was carried out in a sample of Canadian randomized controlled trials (RCTs) with human participants. METHODS We searched MEDLINE from 01 January 2013 to 23 July 2014 using a validated filter for identification of RCTs, combined with terms related to Canada. Two reviewers screened the search results to identify the first 100 RCTs that were either identified in the trial publication as funded by a Canadian organization or which had a first or last author based in Canada. Data were independently extracted by two people from 10% of the RCTs during an initial training period; once agreement was reached on this sample, the remainder of the data extraction was completed by one person and verified by a second. RESULTS The search yielded 1433 records. We screened 256 records to identify 100 RCTs which met our eligibility criteria. The median sample size of the RCTs was 107 participants (range 12-6085). While 98% of studies described the demographic composition of their participants by sex, only 6% conducted a subgroup analysis across sex and 4% reported sex-disaggregated data. No article defined "sex" and/or "gender." No publication carried out a comprehensive sex and gender analysis. CONCLUSIONS Findings highlight poor uptake of sex and gender considerations in the Canadian RCT context and underscore the need for better articulated guidance on sex and gender analysis to improve reporting of evidence, inform policy development, and guide future research.
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Affiliation(s)
- V. Welch
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
- University of Ottawa, Ontario, Canada
| | - M. Doull
- School of Nursing, University of British Columbia, T223-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - M. Yoganathan
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
| | - J. Jull
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario Canada
| | - M. Boscoe
- Research Sex/gender, Health Equity, Primary Care Consultant, 906 Bowron Court, North Vancouver, BC V7H 2S7 Canada
| | - S. E. Coen
- Department of Geography and Planning, Queen’s University, Mackintosh-Corry Hall, Kingston, Ontario K7L 3 N6 Canada
| | - Z. Marshall
- Renison University College, University of Waterloo, 240 Westmount Road North, Waterloo, Ontario N2L 3G4 Canada
| | - J. Pardo Pardo
- Cochrane Musculoskeletal, University of Ottawa, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, ON K1H 8L6 Canada
| | - A. Pederson
- B.C. Women’s Hospital + Health Centre, E305, 4500 Oak Street, Vancouver, BC V6H 3E1 Canada
| | - J. Petkovic
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
- University of Ottawa, Ontario, Canada
| | - L. Puil
- Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia, 2176 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
| | - L. Quinlan
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
| | - B. Shea
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
- University of Ottawa, Ontario, Canada
| | - T. Rader
- Canadian Agency for Drugs and Technology in Health, 865 Carling Ave, Ottawa, Ontario Canada
| | - V. Runnels
- Globalization and Health Equity Research Unit, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 850 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3 Canada
| | - S. Tudiver
- Gender and Health Consultant, 161 Northwestern Avenue, Ottawa, Ontario K1Y 0 M1 Canada
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23
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Barha CK, Salvante KG, Hanna CW, Wilson SL, Robinson WP, Altman RM, Nepomnaschy PA. Child mortality, hypothalamic-pituitary-adrenal axis activity and cellular aging in mothers. PLoS One 2017; 12:e0177869. [PMID: 28542264 PMCID: PMC5444612 DOI: 10.1371/journal.pone.0177869] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 07/11/2016] [Accepted: 04/25/2017] [Indexed: 12/11/2022] Open
Abstract
Psychological challenges, including traumatic events, have been hypothesized to increase the age-related pace of biological aging. Here we test the hypothesis that psychological challenges can affect the pace of telomere attrition, a marker of cellular aging, using data from an ongoing longitudinal-cohort study of Kaqchikel Mayan women living in a population with a high frequency of child mortality, a traumatic life event. Specifically, we evaluate the associations between child mortality, maternal telomere length and the mothers’ hypothalamic-pituitary-adrenal axis (HPAA), or stress axis, activity. Child mortality data were collected in 2000 and 2013. HPAA activity was assessed by quantifying cortisol levels in first morning urinary specimens collected every other day for seven weeks in 2013. Telomere length (TL) was quantified using qPCR in 55 women from buccal specimens collected in 2013. Results: Shorter TL with increasing age was only observed in women who experienced child mortality (p = 0.015). Women with higher average basal cortisol (p = 0.007) and greater within-individual variation (standard deviation) in basal cortisol (p = 0.053) presented shorter TL. Non-parametric bootstrapping to estimate mediation effects suggests that HPAA activity mediates the effect of child mortality on TL. Our results are, thus, consistent with the hypothesis that traumatic events can influence cellular aging and that HPAA activity may play a mediatory role. Future large-scale longitudinal studies are necessary to confirm our results and further explore the role of the HPAA in cellular aging, as well as to advance our understanding of the underlying mechanisms involved.
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Affiliation(s)
- Cindy K. Barha
- Maternal and Child Health Laboratory, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Katrina G. Salvante
- Maternal and Child Health Laboratory, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Human Evolutionary Studies Program, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Courtney W. Hanna
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
- Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Samantha L. Wilson
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
- Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Wendy P. Robinson
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
- Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Rachel M. Altman
- Statistics and Actuarial Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Pablo A. Nepomnaschy
- Maternal and Child Health Laboratory, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Human Evolutionary Studies Program, Simon Fraser University, Burnaby, British Columbia, Canada
- Child and Family Research Institute, Vancouver, British Columbia, Canada
- * E-mail:
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Abstract
OBJECTIVES To assess the effects of costs on access to medicines in 11 developed countries offering different levels of prescription drug coverage for their populations. DESIGN Cross-sectional study of data from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults. SETTING Telephone survey conducted in 11 high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK and the USA. PARTICIPANTS 22 532 adults aged 55 and older and living in the community in studied countries. PRIMARY OUTCOME MEASURE Self-reported cost-related non-adherence (CRNA) in the form of either not filling a prescription or skipping doses within the last 12 months because of out-of-pocket costs. RESULTS Estimated prevalence of CRNA among all older adults varied from <3% in the France, Norway, Sweden, Switzerland and the UK to 16.8% in the USA. Canada had the second highest national prevalence of CRNA (8.3%), followed by Australia (6.8%). Older adults in the USA were approximately six times more likely to report CRNA than older adults in the UK (adjusted OR=6.09; 95% CI 3.60 to 10.20). Older adults in Australia and Canada were also statistically significantly more likely to report CRNA than older adults in the UK. Across most countries, the prevalence of CRNA was higher among lower income residents and lower among residents over age 65. CONCLUSIONS Observed differences in national prevalence of CRNA appear to follow lines of availability of prescription drug coverage and the extent of direct patient charges for prescriptions under available drug plans.
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Affiliation(s)
- Steven G Morgan
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Augustine Lee
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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25
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McIsaac KE, Farrell MacDonald S, Chong N, Moser A, Moineddin R, Colantonio A, Nathens A, Matheson FI. Creating a Powerful Platform to Explore Health in a Correctional Population: A Record Linkage Study. PLoS One 2016; 11:e0161173. [PMID: 27532612 PMCID: PMC4988706 DOI: 10.1371/journal.pone.0161173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 08/01/2016] [Indexed: 11/18/2022] Open
Abstract
We used record linkage to create a data repository of health information of persons who were federally incarcerated in Ontario and Canada. We obtained records from 56,867 adults who were federally incarcerated between January 1, 1998 and December 31, 2011 from the Correctional Service of Canada; 15,248 records belonged to individuals residing in Ontario, Canada. We linked these records to the Registered Persons Database (RPDB) which contained records from 18,116,996 individuals eligible for health care in Ontario. Out of 56,867 OMS records, 22,844 (40.2%) were linked to the RPDB. Looking only at those incarcerated in Ontario, 98%, (14 953 of 15248) records were linked to RPDB. Most records of persons in Ontario-based facilities were linked deterministically. Linkage rates were lower for women, minority groups, and substance users. In conclusion, record linkage enabled the creation of a valuable data repository: there are no electronic medical records for correctional populations in Canada, making it more difficult to profile their health.
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Affiliation(s)
- Kathryn E. McIsaac
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada
| | | | - Nelson Chong
- Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Andrea Moser
- Correctional Service Canada, Ottawa, Ontario, Canada
| | - Rahim Moineddin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Avery Nathens
- Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Flora I. Matheson
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Ontario, Canada
- * E-mail:
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