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Dada D, Abu-Ba'are GR, Turner D, Mashoud IW, Owusu-Dampare F, Apreku A, Ni Z, Djiadeu P, Aidoo-Frimpong G, Zigah EY, Nyhan K, Nyblade L, Nelson LE. Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub-Saharan Africa. BMJ Open 2024; 14:e078794. [PMID: 38346887 PMCID: PMC10862343 DOI: 10.1136/bmjopen-2023-078794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES Sexual and gender minority (SGM) populations in sub-Saharan Africa (SSA) are disproportionately impacted by HIV and often face multiple HIV-related stigmas. Addressing these stigmas could reduce SGM HIV vulnerability but little is known about how the stigmas operate and intersect. Intersectional stigma offers a lens for understanding the experiences of stigmatised populations and refers to the synergistic negative health effects of various systems of oppression on individuals with multiple stigmatised identities, behaviours or conditions. This review aims to (1) assess how often and in what ways an intersectional lens is applied in HIV-related stigma research on SGM populations in SSA and (2) understand how intersectional stigma impacts HIV risk in these populations. DESIGN Scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. DATA SOURCES Public health and regional databases were searched in 2020 and 2022. ELIGIBILITY CRITERIA Articles in French and English on HIV-related stigma and HIV outcomes among men who have sex with men, women who have sex with women and/or transgender individuals in SSA. DATA EXTRACTION AND SYNTHESIS Articles were screened and extracted twice and categorised by use of an intersectional approach. Study designs and stigma types were described quantitatively and findings on intersectional stigma were thematically analysed. RESULTS Of 173 articles on HIV-related stigma among SGM in SSA included in this review, 21 articles (12%) applied an intersectional lens. The most common intersectional stigmas investigated were HIV and same-sex attraction/behaviour stigma and HIV, same-sex attraction/behaviour and gender non-conformity stigma. Intersectional stigma drivers, facilitators and manifestations were identified across individual, interpersonal, institutional and societal socioecological levels. Intersectional stigma impacts HIV vulnerability by reducing HIV prevention and treatment service uptake, worsening mental health and increasing exposure to HIV risk factors. CONCLUSION Intersectional approaches are gaining traction in stigma research among SGM in SSA. Future research should prioritise quantitative and mixed methods investigations, diverse populations and intervention evaluation.
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Affiliation(s)
- Debbie Dada
- School of Nursing, Yale University, New Haven, Connecticut, USA
- St Michael's Hospital Centre for Urban Health Solutions, Toronto, Ontario, Canada
| | - Gamji R Abu-Ba'are
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, Connecticut, USA
- Behavioral, Sexual, and Global Health Lab, University of Rochester, Rochester, New York, USA
| | | | | | | | | | - Zhao Ni
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Pascal Djiadeu
- St Michael's Hospital Centre for Urban Health Solutions, Toronto, Ontario, Canada
- School of Public Health, University of Toronto Dalla Lana, Toronto, Ontario, Canada
| | - Gloria Aidoo-Frimpong
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Edem Yaw Zigah
- Behavioral, Sexual, and Global Health Lab, University of Rochester, Rochester, New York, USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, USA
| | - Laura Nyblade
- Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - LaRon E Nelson
- School of Nursing, Yale University, New Haven, Connecticut, USA
- St Michael's Hospital Centre for Urban Health Solutions, Toronto, Ontario, Canada
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Wu HS, Gao F, Davis JE, Given CW. Effects of chronotype-tailored bright light intervention on post-treatment symptoms and quality of life in breast cancer survivors. Support Care Cancer 2023; 31:705. [PMID: 37975923 DOI: 10.1007/s00520-023-08157-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Bright light therapy holds promise for reducing common symptoms, e.g., fatigue, experienced by individuals with cancer. This study aimed to examine the effects of a chronotype-tailored bright light intervention on sleep disturbance, fatigue, depressive mood, cognitive dysfunction, and quality of life among post-treatment breast cancer survivors. METHODS In this two-group randomized controlled trial (NCT03304587), participants were randomized to receive 30-min daily bright blue-green light (12,000 lx) or dim red light (5 lx) either between 19:00 and 20:00 h or within 30 min of waking in the morning. Self-reported outcomes and in-lab overnight polysomnography sleep study were assessed before (pre-test) and after the 14-day light intervention (post-test). RESULTS The sample included 30 women 1-3 years post-completion of chemotherapy and/or radiation for stage I to III breast cancer (mean age = 52.5 ± 8.4 years). There were no significant between-group differences in any of the symptoms or quality of life (all p > 0.05). However, within each group, self-reported sleep disturbance, fatigue, depressive mood, cognitive dysfunction, and quality of life-related functioning showed significant improvements over time (all p < 0.05); the extent of improvement for fatigue and depressive mood was clinically relevant. Polysomnography sleep findings showed that a number of awakenings significantly decreased (p = 0.011) among participants who received bright light, while stage 2 sleep significantly increased (p = 0.015) among participants who received dim-red light. CONCLUSION The findings support using light therapy to manage post-treatment symptoms in breast cancer survivors. The unexpected symptom improvements among dim-red light controls remain unexplained and require further investigation. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03304587, October 19, 2017.
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Affiliation(s)
- Horng-Shiuann Wu
- Michigan State University College of Nursing, C347 Bott Building, 1355 Bogue Street, East Lansing, MI, 48824, USA.
| | - Feng Gao
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Jean E Davis
- University of South Carolina College of Nursing, Columbia, SC, USA
| | - Charles W Given
- Michigan State University College of Nursing, C347 Bott Building, 1355 Bogue Street, East Lansing, MI, 48824, USA
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Britt KC, Cacchione PZ, Naylor MD. Faith-based organizations can support dementia caregivers in a post-pandemic world. Res Nurs Health 2023; 46:282-284. [PMID: 37042730 PMCID: PMC10187066 DOI: 10.1002/nur.22309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 04/13/2023]
Affiliation(s)
- Katherine Carroll Britt
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Luci Baines Johnson and Ian J. Turpin Center for Gerontological Nursing, University of Texas at Austin School of Nursing, Austin, Texas, USA
| | - Pamela Z Cacchione
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Penn Presbyterian Medical Center, Penn Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mary D Naylor
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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Sefcik JS, Ersek M, Cacchione PZ. Nursing home residents with advanced dementia and persistent vocalisations: Observations of surrounding context. Int J Older People Nurs 2020; 15:e12322. [PMID: 32383798 PMCID: PMC7648731 DOI: 10.1111/opn.12322] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 03/05/2020] [Accepted: 04/14/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Persistent vocalisations are commonly exhibited by persons with dementia and are often characterised as agitation or aggression. There has been little focus on persistent vocalisations independent from other behavioural and psychological symptoms of dementia making it difficult to differentiate information about the context that surrounds the person with dementia, including the circumstances and events that precede and accompany the expression. Therefore, the aim of this study was to describe the context surrounding persistent vocalisations expressed by older adults residing in nursing homes (NH) with advanced dementia. DESIGN AND METHODS The need-driven dementia-compromised behaviour model informed this qualitative descriptive study. This naturalistic qualitative observational study involved direct observations of nine older adults diagnosed with dementia residing in four NHs and included informal interviews with formal caregivers. Field notes were taken and analysed using conventional content analysis. RESULTS Variability of exhibited persistent vocalisations was both observed by the investigator and explained by NH staff. Two themes emerged from the field notes; Routine of Staying in Room was identified for participants considered 'disruptive' to others, and Providing Care Without Communicating triggered persistent vocalisations. IMPLICATIONS The findings provide insight into the lack of therapeutic interactions between NH staff and persons with advanced dementia and persistent vocalisations residing in NHs. Ongoing, mandatory, evidence-based training on person-centred interventions and dementia care communication for all NH staff globally could have a significant impact on the delivery of holistic quality care for persons with dementia and persistent vocalisations.
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Affiliation(s)
- Justine S. Sefcik
- Drexel University College of Nursing and Health Professions, Philadelphia, PA, USA
| | - Mary Ersek
- Department of Veterans Affairs, Philadelphia, PA, USA
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Pamela Z. Cacchione
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Penn Presbyterian Medical Center, Philadelphia, PA, USA
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