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Oberg C. The Child Friendly Cities Initiative-Minneapolis Model. Matern Child Health J 2024; 28:990-997. [PMID: 38416333 DOI: 10.1007/s10995-024-03921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE The Child Friendly Cities Initiative (CFCI) is a UNICEF framework based on the UN Convention on the Rights of the Child (CRC). CFCI was launched globally in 1996 to protect children's rights throughout the world. There are child friendly cities in over 44 countries around the globe, but none presently in the United States. The purpose was to establish a Child Friendly City in the United States. DESCRIPTION Child friendly cities are a child-rights and equity-based approach designed to ensure all children in a community reach their full potential for optimal health, development, and well-being. The paper discusses the development of the guiding principles of the CFCI-Minneapolis Model as well as a community needs assessment. ASSESSMENT The assessment consisted of a digital survey of 60 questions on the SurveyMonkey platform. The sample included 173 Minneapolis youth 10-18 years of age and 85 parents with children less than five years of age. The participants were drawn from four of the 83 Minneapolis neighborhoods that had the highest concentration of children and youth, communities of color, and immigrant families that have historically been under resourced. CONCLUSION The results of the community assessment guided the development of four programmatic initiatives. These included child rights learning & awareness, emergency preparedness & planning, community safety, and youth participation in decision making. The paper concludes with the lesson learned to date in the implementation of the CFCI-Minneapolis Model. These include partnership, dedication, leadership, community engagement, coalition building, and celebrating success. CFCI-Minneapolis received full designation from UNICEF USA as a child friendly city in February 2024.
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Affiliation(s)
- Charles Oberg
- Division of Epidemiology and Community Health, Maternal and Child Health Program, School of Public Health, University of Minnesota, 1300 South 2nd Street, Minneapolis, MN, 55454, USA.
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Khalil GE, Khan M, Kim J. Social influence and advocacy pathways during a web-based program for adolescent smoking prevention. Addict Behav Rep 2024; 19:100529. [PMID: 38283066 PMCID: PMC10820259 DOI: 10.1016/j.abrep.2024.100529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/15/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024] Open
Abstract
Introduction Exposure to smokers has been identified as a predictor of adolescent tobacco use. Conversely, adolescents who tend to be advocates against smoking may become less likely to initiate smoking themselves. Several digital tobacco prevention programs have been developed to include social strategies. This study aimed to identify (1) whether programs can motivate adolescents to become advocates against smoking, and (2) if being an advocate against smoking and exposure to friends who smoke can predict smoking while controlling for a program's effect. Methods We conducted a non-prespecified secondary analysis using data from a randomized controlled trial (RCT) with 18-month follow-up. High schools were randomized to either receive ASPIRE or a tobacco education booklet. We conducted a cross-lagged linear path model to allow for reciprocal associations, estimating a two-time-points, three-variable panel model with logistic regression. Results Receiving ASPIRE was associated with a lower likelihood of smoking, but it did not predict becoming an advocate against smoking or changing adolescents' proportion of friends who smoke. After controlling for the effect of ASPIRE, the study shows that adolescents who were advocates against smoking had a decreased risk of smoking by follow-up, and smoking at baseline significantly predicted having a higher proportion of friends who smoke at follow-up. Discussion Being an advocate against smoking can be a key predictor of lower odds of smoking, even when controlling for an individual-based intervention. Future research can study the mechanisms and long-term effects of advocacy and incorporate social strategies that can leverage social networks for tobacco prevention.
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Affiliation(s)
- Georges E. Khalil
- University of Florida, Department of Health Outcomes and Biomedical Informatics, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Meerah Khan
- University of Florida, Department of Health Outcomes and Biomedical Informatics, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Jeanie Kim
- Loma Linda University, School of Medicine, 11175 Campus St, Loma Linda, CA 92350, United States
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Knod JL, Sathya C, Griggs CL, Henry MC, Froehlich M, Zallen G, Coakley BA, Masiakos PT, Gow KW, Naik-Mathuria B. Promoting Firearm Injury Prevention and Advocacy as Pediatric Surgeons: A Call to Action From the APSA/AAP Advocacy Committee. J Pediatr Surg 2024; 59:1135-1141. [PMID: 38160188 DOI: 10.1016/j.jpedsurg.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024]
Abstract
Firearm injuries have become the leading cause of death among American children. Here we review the scope of the problem, and the pivotal role pediatric surgeons have in preventing pediatric firearm injury. Specific methods for screening and counseling are reviewed, as well as how to overcome barriers. Community and hospital resources as well as organizational efforts are discussed. Finally, a path for surgeon advocacy is outlined as is a call to action for the pediatric surgeon, as we are uniquely poised to identify pediatric patients and deliver timely interventions to reduce the impact of firearm violence. LEVEL OF EVIDENCE: Level IV.
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Affiliation(s)
- J Leslie Knod
- Division of Pediatric Surgery, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, United States.
| | - Chethan Sathya
- Center for Gun Violence Prevention, Northwell Health, Division of Pediatric Surgery, Cohen Children's Medical Center, Zucker School of Medicine at Hofstra/Northwell, 1111 Marcus, Suite M15, New Hyde Park, NY 11042, United States
| | - Cornelia L Griggs
- Harvard Medical School, Division of Pediatric Surgery, Massachusetts General Hospital, 55 Fruit Street GRB-11, Boston MA 02114, United States
| | - Marion C Henry
- University of Chicago, 5839 S. Maryland Ave/MC 4062/Suite A-426, Chicago, IL 60637, United States
| | - Mary Froehlich
- Kirk Kerkorian School of Medicine at UNLV, Department of General Surgery, 4505 South Maryland Pkwy, Las Vegas, NV 89154, United States
| | - Garret Zallen
- PeaceHealth Medical Center Springfield Oregon and Shriner's Hospital, Portland, OR, United States
| | - Brian A Coakley
- The Icahn School of Medicine at Mount Sinai, Division of Pediatric Surgery, Department of Surgery, 5 East 98th Street, 15th Floor, New York, NY 10029, United States
| | - Peter T Masiakos
- Harvard Medical School, Division of Pediatric Surgery, Massachusetts General Hospital, 55 Fruit Street GRB-11, Boston MA 02114, United States
| | - Kenneth W Gow
- University of Washington and Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States
| | - Bindi Naik-Mathuria
- Division of Pediatric Surgery, University of Texas Medical Branch, 301 University Blvd, Research Building 6, Suite 3.220, Galveston, TX 77555, United States
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Resnick D, Anigo KM, Anjorin O, Deshpande S. Voice, access, and ownership: enabling environments for nutrition advocacy in India and Nigeria. Food Secur 2024; 16:637-658. [PMID: 38770157 PMCID: PMC11102356 DOI: 10.1007/s12571-024-01451-2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 04/05/2024] [Indexed: 05/22/2024]
Abstract
What constitutes an enabling environment for nutrition advocacy in low- and middle-income countries? While a sizeable body of scholarship considers the enabling environment for nutrition policy, we focus specifically on the necessary conditions for advocacy. We argue that three factors-voice, access, and ownership-provide a useful lens into the advocacy enabling environment. These are operationalized, respectively, as the space to articulate and frame policy positions, entry points to interact with policy decision makers, and the existence of committed decision makers rather than those responding to pressures from external actors. These three factors are explored vis-à-vis a comparative analysis of two federal democracies-India and Nigeria-that each have vibrant advocacy communities confronting persistent malnutrition. Drawing on more than 100 structured interviews with nutrition advocates, government actors, donors, and researchers in the two countries, we highlight the ways in which voice, access, and ownership interactively shape advocacy efforts. In doing so, we find that Nigeria has a less ideological approach to certain nutrition issues than in India but also perceived to be more beholden to external actors in defining its nutrition actions. Recent restrictions on freedom of speech and association shrunk the civic space in India but these were less problematic in Nigeria. In both countries, the multi-tiered, multi-party system offers many different points of access into the policy arena, with sometimes negative implications for coordination. Overall, the paper contributes more broadly to the literature on enabling environments by highlighting potential indicators to guide nutrition advocates in other settings.
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Affiliation(s)
- Danielle Resnick
- International Food Policy Research Institute, Washington, DC USA
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Small R, Nugent R, Webb D, Hutchinson B, Spencer G, Ngongo C, Chestnov R, Tarlton D. Advancing progress on tobacco control in low-income and middle-income countries through economic analysis. Tob Control 2024; 33:s3-s9. [PMID: 38697661 PMCID: PMC11103286 DOI: 10.1136/tc-2023-058335] [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: 08/15/2023] [Accepted: 01/29/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND More than 80% of the world's 1.3 billion tobacco users live in low-income and middle-income countries (LMICs), where progress to address tobacco and its harms has been slow. The perception that tobacco control detracts from economic priorities has impeded progress. The Secretariat of the WHO Framework Convention on Tobacco Control (FCTC) is leading the FCTC 2030 project, which includes technical assistance to LMICs to analyse the economic costs of tobacco use and the benefits of tobacco control. METHODS The Secretariat of the WHO FCTC, United Nations Development Programme and WHO supported 21 LMICs between 2017 and 2022 to complete national investment cases to guide country implementation of the WHO FCTC, with analytical support provided by RTI International. These country-level cases combine customised estimates of tobacco's economic impact with qualitative analysis of socio-political factors influencing tobacco control. This paper overviews the approach, observed tobacco control advancements and learnings from 21 countries: Armenia, Cabo Verde, Cambodia, Chad, Colombia, Costa Rica, El Salvador, Eswatini, Georgia, Ghana, Jordan, Laos, Madagascar, Myanmar, Nepal, Samoa, Sierra Leone, Sri Lanka, Suriname, Tunisia and Zambia. RESULTS Tobacco control advancements in line with investment case findings and recommendations have been observed in 17 of the 21 countries, and many have improved collaboration and policy coherence between health and economic stakeholders. CONCLUSIONS Tobacco control must be seen as more than a health concern. Tobacco control leads to economic benefits and contributes to sustainable development. National investment cases can support country ownership and leadership to advance tobacco control.
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Affiliation(s)
- Roy Small
- HIV, Health and Development Group, United Nations Development Programme, New York, New York, USA
| | - Rachel Nugent
- Department of Global Health, University of Washington, Seattle, Washington, USA
- RTI International, Research Triangle Park, North Carolina, USA
| | - Douglas Webb
- United Nations Development Programme, Tbilsi, Georgia
| | | | | | - Carrie Ngongo
- RTI International, Research Triangle Park, North Carolina, USA
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Nugent R, Hutchinson B, Mann N, Ngongo C, Spencer G, Grafton D, Small R. Evolving methodology of national tobacco control investment cases. Tob Control 2024; 33:s10-s16. [PMID: 38697658 PMCID: PMC11103330 DOI: 10.1136/tc-2023-058336] [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: 08/15/2023] [Accepted: 01/19/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND This article describes an investment case methodology for tobacco control that was applied in 36 countries between 2017 and 2022. METHODS The WHO Framework Convention on Tobacco Control (FCTC) investment cases compared two scenarios: a base case that calculated the tobacco-attributable mortality, morbidity and economic costs with status quo tobacco control, and an intervention scenario that described changes in those same outcomes from fully implementing and enforcing a variety of proven, evidence-based tobacco control policies and interventions. Health consequences included the tobacco-attributable share of mortality and morbidity from 38 diseases. The healthcare expenditures and the socioeconomic costs from the prevalence of those conditions were combined to calculate the total losses due to tobacco. The monetised benefits of improvements in health resulting from tobacco control implementation were compared with costs of expanding tobacco control to assess returns on investment in each country. An institutional and context analysis assessed the political and economic dimensions of tobacco control in each context. RESULTS We applied a rigorous yet flexible methodology in 36 countries over 5 years. The replicable model and framework may be used to inform development of tobacco control cases in countries worldwide. CONCLUSION Investment cases constitute a tool that development partners and advocates have demanded in even greater numbers. The economic argument for tobacco control provided by this set of country-contextualised analyses can be a strong tool for policy change.
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Affiliation(s)
- Rachel Nugent
- Department of Global Health, University of Washington, Seattle, Washington, USA
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Nathan Mann
- RTI International, Research Triangle Park, North Carolina, USA
| | - Carrie Ngongo
- RTI International, Research Triangle Park, North Carolina, USA
| | | | | | - Roy Small
- HIV, Health and Development Group, United Nations Development Programme, New York, New York, USA
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Mann N, Spencer G, Hutchinson B, Ngongo C, Tarlton D, Webb D, Grafton D, Nugent R. Interpreting results, impacts and implications from WHO FCTC tobacco control investment cases in 21 low-income and middle-income countries. Tob Control 2024; 33:s17-s26. [PMID: 38697659 PMCID: PMC11103323 DOI: 10.1136/tc-2023-058337] [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: 08/15/2023] [Accepted: 02/02/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Tobacco control investment cases analyse the health and socioeconomic costs of tobacco use and the benefits that can be achieved from implementing measures outlined in the WHO Framework Convention on Tobacco Control (WHO FCTC). They are intended to provide policy-makers and other stakeholders with country-level evidence that is relevant, useful and responsive to national priorities and policy context. METHODS This paper synthesises findings from investment cases conducted in Armenia, Cabo Verde, Cambodia, Chad, Colombia, Costa Rica, El Salvador, Eswatini, Georgia, Ghana, Jordan, Laos, Madagascar, Myanmar, Nepal, Samoa, Sierra Leone, Sri Lanka, Suriname, Tunisia and Zambia. We examine annual socioeconomic costs associated with tobacco use, focusing on smoking-related healthcare expenditures, the value of lives lost due to tobacco-related mortality and workplace productivity losses due to smoking. We explore potential benefits associated with WHO FCTC tobacco demand-reduction measures. RESULTS Tobacco use results in average annual socioeconomic losses of US$95 million, US$610 million and US$1.6 billion among the low-income (n=3), lower-middle-income (n=12) and upper-middle-income countries (n=6) included in this analysis, respectively. These losses are equal to 1.1%, 1.8% and 2.9% of average annual national gross domestic product, respectively. Implementation and enforcement of WHO FCTC tobacco demand-reduction measures would lead to reduced tobacco use, fewer tobacco-related deaths and reduced socioeconomic losses. CONCLUSIONS WHO FCTC tobacco control measures would provide a positive return on investment in every country analysed.
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Affiliation(s)
- Nathan Mann
- RTI International, Research Triangle Park, North Carolina, USA
| | | | | | - Carrie Ngongo
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Douglas Webb
- United Nations Development Programme, Amman, Jordan
| | | | - Rachel Nugent
- RTI International, Research Triangle Park, North Carolina, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
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Spencer G, Nugent R, Mann N, Hutchinson B, Ngongo C, Tarlton D, Small R, Webb D. Equity implications of tobacco taxation: results from WHO FCTC investment cases. Tob Control 2024; 33:s27-s33. [PMID: 38697660 PMCID: PMC11103284 DOI: 10.1136/tc-2023-058338] [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: 08/15/2023] [Accepted: 01/19/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Across time, geographies and country income levels, smoking prevalence is highest among people with lower incomes. Smoking causes further impoverishment of those on the lower end of the income spectrum through expenditure on tobacco and greater risk of ill health. METHODS This paper summarises the results of investment case equity analyses for 19 countries, presenting the effects of increased taxation on smoking prevalence, health and expenditures. We disaggregate the number of people who smoke, smoking-attributable mortality and cigarette expenditures using smoking prevalence data by income quintile. A uniform 30% increase in price was applied across countries. We estimated the effects of the price increase on smoking prevalence, mortality and cigarette expenditures. RESULTS In all but one country (Bhutan), a one-time 30% increase in price would reduce smoking prevalence by the largest percent among the poorest 20% of the population. All income groups in all countries would spend more on cigarettes with a 30% increase in price. However, the poorest 20% would pay an average of 12% of the additional money spent. CONCLUSIONS Our results confirm that health benefits from increases in price through taxation are pro-poor. Even in countries where smoking prevalence is higher among wealthier groups, increasing prices can still be pro-poor due to variable responsiveness to higher prices. The costs associated with higher smoking prevalence among the poor, together with often limited access to healthcare services and displaced spending on basic needs, result in health inequality and perpetuate the cycle of poverty.
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Affiliation(s)
| | - Rachel Nugent
- RTI International, Research Triangle Park, North Carolina, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Nathan Mann
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Carrie Ngongo
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Roy Small
- HIV, Health and Development Group, United Nations Development Programme, New York, New York, USA
| | - Douglas Webb
- United Nations Development Programme, Amman, Jordan
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Holland A, Etches S, Gander S. Drug decriminalization: The importance of policy change for the health and wellbeing of children and youth in Canada. Paediatr Child Health 2024; 29:87-89. [PMID: 38586481 PMCID: PMC10996576 DOI: 10.1093/pch/pxad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/09/2023] [Indexed: 04/09/2024] Open
Abstract
The criminalization of drug use and possession has demonstrable harms on the health of children and youth, with disproportionate effects on Black people, Indigenous people, people from other racially oppressed communities, and people living in poverty. Drug decriminalization, by separating personal possession and use of drugs from the criminal justice system, allows for a health-based approach to drug policy. Paediatricians are well-positioned to advocate for policies within a decriminalization framework to prioritize the physical and mental health of children and youth.
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Affiliation(s)
- Alyson Holland
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Selene Etches
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sarah Gander
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
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Jones HE, Manze M, Brakman A, Kwan A, Davies M, Romero D. Physician engagement in reproductive health advocacy: findings from a mixed methods evaluation of a leadership and advocacy program. BMC Med Educ 2024; 24:476. [PMID: 38689263 PMCID: PMC11061897 DOI: 10.1186/s12909-024-05410-5] [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: 01/23/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Medical curricula include advocacy competencies, but how much physicians engage in advocacy and what enables this engagement is not well characterized. The authors assessed facilitators and barriers to advocacy identified by physician alumni of a reproductive health advocacy training program. METHODS The authors present secondary results from a mixed methods program evaluation from 2018 to 2020, using alumni data from a cross-sectional survey (n = 231) and in-depth interviews (IDIs, n = 36). The survey measured engagement in policy, media, professional organization, and medical education advocacy and the value placed on the community fostered by the program (eight questions, Cronbach's alpha = 0.81). The authors estimated the association of community value score with advocacy engagement using multivariable Poisson regression to estimate prevalence ratios and analyzed IDI data inductively. RESULTS Over one third of alumni were highly engaged in legislative policy (n = 90, 39%), professional organizations (n = 98, 42%), or medical education (n = 89, 39%), with fewer highly active in media-based advocacy (n = 54, 23%) in the year prior to the survey. Survey and IDI data demonstrated that passion, sense of urgency, confidence in skills, and the program's emphasis on different forms of advocacy facilitated engagement in advocacy, while insufficient time, safety concerns, and sense of effort redundancies were barriers. The program community was also an important facilitator, especially for "out loud" efforts and for those working in environments perceived as hostile to abortion care (e.g., alumni in hostile environments with high community value scores were 1.8 times [95% CI 1.3, 2.6] as likely to report medium/high levels of media advocacy compared to those with low scores after adjusting for age, gender, and clinical specialty). CONCLUSION Physician advocacy training curricula should include both skills- and community-building and identify a full range of forms of advocacy. Community-building is especially important for physician advocacy for reproductive health services such as abortion care.
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Affiliation(s)
- Heidi E Jones
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), 55 W. 125th St #7th Floor, 10027, New York, NY, USA.
- City University of New York Institute of Implementation Science in Population Health (CUNY ISPH), New York, USA.
| | - Meredith Manze
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), 55 W. 125th St #7th Floor, 10027, New York, NY, USA
| | - Anita Brakman
- Physicians for Reproductive Health, Hartsdale, NY, USA
| | - Amy Kwan
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), 55 W. 125th St #7th Floor, 10027, New York, NY, USA
| | - MiQuel Davies
- Physicians for Reproductive Health, Hartsdale, NY, USA
| | - Diana Romero
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), 55 W. 125th St #7th Floor, 10027, New York, NY, USA
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Klitzman R, Bezborodko E, Chung WK, Appelbaum PS. Views of Genetic Testing for Autism Among Autism Self-Advocates: A Qualitative Study. AJOB Empir Bioeth 2024:1-18. [PMID: 38643392 DOI: 10.1080/23294515.2024.2336903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2024]
Abstract
BACKGROUND Autism self-advocates' views regarding genetic tests for autism are important, but critical questions about their perspectives arise. METHODS We interviewed 11 autism self-advocates, recruited through autism self-advocacy websites, for 1 h each. RESULTS Interviewees viewed genetic testing and its potential pros and cons through the lens of their own indiviudal perceived challenges, needs and struggles, especially concerning stigma and discrimination, lack of accommodations and misunderstandings from society about autism, their particular needs for services, and being blamed by others and by themselves for autistic traits. Their views of genetic testing tended not to be binary, but rather depended on how the genetic test results would be used. Interviewees perceived pros of genetic testing both in general and with regard to themselves (e.g., by providing "scientific proof" of autism as a diagnosis and possibly increasing availability of services). But they also perceived disadvantages and limitations of testing (e.g., possible eugenic applications). Participants distinguished between what they felt would be best for themselves and for the autistic community as a whole. When asked if they would undergo testing for themselves, if offered, interviewees added several considerations (e.g., undergoing testing because they support science in general). Interviewees were divided whether a genetic diagnosis would or should reduce self-blame, and several were wary of testing unless treatment, prevention or societal attitudes changed. Weighing these competing pros and cons could be difficult. CONCLUSIONS This study, the first to use in-depth qualitative interviews to assess views of autism self-advocates regarding genetic testing, highlights key complexities. Respondents felt that such testing is neither wholly good or bad in itself, but rather may be acceptable depending on how it is used, and should be employed in beneficial, not harmful ways. These findings have important implications for practice, education of multiple stakeholders, research, and policy.
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Affiliation(s)
- Robert Klitzman
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - Wendy K Chung
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul S Appelbaum
- Department of Law Ethics and Psychiatry, NYP Columbia University Irving Medical, New York Presbyterian Hospital, New York, NY, USA
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Wagner GJ, Bogart LM, Matovu JKB, Okoboi S, Gwokyalya V, Klein DJ, Ninsiima S, Green HD. Characteristics of Received HIV Prevention Advocacy from Persons Living with HIV in Uganda, and Associations with HIV Testing and Condom Use Among Social Network Members. AIDS Behav 2024:10.1007/s10461-024-04347-6. [PMID: 38642213 DOI: 10.1007/s10461-024-04347-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
Receiving peer advocacy has been shown to result in increased HIV protective behaviors, but little research has gone beyond assessment of the mere presence of advocacy to examine aspects of advocacy driving these effects. With baseline data from a controlled trial of an advocacy training intervention, we studied characteristics of HIV prevention advocacy received among 599 social network members of persons living with HIV in Uganda and the association of these characteristics with the social network members' recent HIV testing (past six months) and consistent condom use, as well as perceived influence of advocacy on these behaviors. Participants reported on receipt of advocacy specific to HIV testing and condom use, as well as on measures of advocacy content, tone of delivery, support for autonomous regulation, and perceived influence on behavior. Receiving HIV testing advocacy and condom use advocacy were associated with recent HIV testing [65.2% vs. 51.4%; OR (95% CI) = 1.77 (1.11-2.84)], and consistent condom use with main sex partner [19.3% vs. 10.0%; OR (95% CI) = 2.16 (1.12-4.13)], respectively, compared to not receiving advocacy. Among those who received condom advocacy, perceived influence of the advocacy was positively correlated with consistent condom use, regardless of type of sex partner; support of autonomous regulation was a correlate of consistent condom use with casual sex partners, while judgmental advocacy was a correlate of consistent condom use with serodiscordant main partners. Among those who received testing advocacy, HIV testing in the past 6 months was positively correlated with receipt of direct support for getting tested. In multiple regression analysis, perceived influence of both HIV testing and condom use advocacy were positively correlated with advocacy that included access information and support of autonomous regulation; confrontational advocacy and judgmental advocacy were independent positive correlates of perceived influence of testing and condom use advocacy, respectively. These findings support associations that suggest potential benefits of peer advocacy from PLWH on HIV testing and condom use among their social network members, and indicate that advocacy content, tone of delivery, and support of autonomous regulation advocacy may play an important role in the success of advocacy.
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Affiliation(s)
- Glenn J Wagner
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA.
| | - Laura M Bogart
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | | | - Stephen Okoboi
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - David J Klein
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
| | - Susan Ninsiima
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Harold D Green
- University of Indiana Bloomington School of Public Health, Bloomington, IN, USA
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13
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Assunta M, Chamberlain P. Ensuring a safe, tobacco free future for the young: protecting children from tobacco industry interference. Tob Control 2024; 33:281-282. [PMID: 38641358 DOI: 10.1136/tc-2024-058698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Affiliation(s)
- Mary Assunta
- Southeast Asia Tobacco Control Alliance, Bangkok, Thailand
- Advocacy at Global Center for Good Governance in Tobacco Control, Bangkok, Thailand
| | - Phil Chamberlain
- Tobacco Control Research Group at the University of Bath, Bath, UK
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Müller A, Hebben F, Dillen K, Dunkl V, Goereci Y, Voltz R, Löcherbach P, Warnke C, Golla H. "So at least now I know how to deal with things myself, what I can do if it gets really bad again"-experiences with a long-term cross-sectoral advocacy care and case management for severe multiple sclerosis: a qualitative study. BMC Health Serv Res 2024; 24:453. [PMID: 38600493 PMCID: PMC11007872 DOI: 10.1186/s12913-024-10851-1] [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: 11/23/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Persons with severe Multiple Sclerosis (PwsMS) face complex needs and daily limitations that make it challenging to receive optimal care. The implementation and coordination of health care, social services, and support in financial affairs can be particularly time consuming and burdensome for both PwsMS and caregivers. Care and case management (CCM) helps ensure optimal individual care as well as care at a higher-level. The goal of the current qualitative study was to determine the experiences of PwsMS, caregivers and health care specialists (HCSs) with the CCM. METHODS In the current qualitative sub study, as part of a larger trial, in-depth semi-structured interviews with PwsMS, caregivers and HCSs who had been in contact with the CCM were conducted between 02/2022 and 01/2023. Data was transcribed, pseudonymized, tested for saturation and analyzed using structuring content analysis according to Kuckartz. Sociodemographic and interview characteristics were analyzed descriptively. RESULTS Thirteen PwsMS, 12 caregivers and 10 HCSs completed interviews. Main categories of CCM functions were derived deductively: (1) gatekeeper function, (2) broker function, (3) advocacy function, (4) outlook on CCM in standard care. Subcategories were then derived inductively from the interview material. 852 segments were coded. Participants appreciated the CCM as a continuous and objective contact person, a person of trust (92 codes), a competent source of information and advice (on MS) (68 codes) and comprehensive cross-insurance support (128 codes), relieving and supporting PwsMS, their caregivers and HCSs (67 codes). CONCLUSIONS Through the cross-sectoral continuous support in health-related, social, financial and everyday bureaucratic matters, the CCM provides comprehensive and overriding support and relief for PwsMS, caregivers and HCSs. This intervention bears the potential to be fine-tuned and applied to similar complex patient groups. TRIAL REGISTRATION The study was approved by the Ethics Committee of the University of Cologne (#20-1436), registered at the German Register for Clinical Studies (DRKS00022771) and in accordance with the Declaration of Helsinki.
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Affiliation(s)
- Anne Müller
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
| | - Fabian Hebben
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Kim Dillen
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Veronika Dunkl
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Yasemin Goereci
- Department of Neurology, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), University of Cologne, Cologne, Germany
- Center for Health Services Research, University of Cologne, Cologne, Germany
| | - Peter Löcherbach
- German Society of Care and Case Management E.V. (DGCC), Münster, Germany
| | - Clemens Warnke
- Department of Neurology, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Heidrun Golla
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
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15
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Bala A, Pierce J, Pierce K, Song S. Advocacy and Policy: A Focus on Migrant Youth. Child Adolesc Psychiatr Clin N Am 2024; 33:163-180. [PMID: 38395503 DOI: 10.1016/j.chc.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Mental health challenges experienced by migrant children are shaped by multiple factors within the health care system and society at large. It is essential for health care providers to recognize the profound impact of these influences on child well-being. By actively engaging in advocacy and policy initiatives, health care providers can address structural barriers, social inequalities, and stigma that perpetuate mental health disparities. Through their advocacy efforts, providers can contribute to creating an inclusive society that upholds children's rights and ensures equitable access to mental health support and services.
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Affiliation(s)
- Abishek Bala
- Central Michigan University, 1000 Houghton Avenue, Saginaw, MI 48602, USA.
| | - Jessica Pierce
- University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5277, USA
| | - Karen Pierce
- Northwestern University Department of Psychiatry, 2634 N Dayton ST, Chicago, Il 60614, USA
| | - Suzan Song
- Boston Children's Hospital, 1 Brookline Place, Suite 552, Boston, MA 02445, USA
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16
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Abstract
Health policy and quality improvement initiatives exist symbiotically. Quality projects can be spurred by policy decisions, such as the creation of financial incentives for high-value care. Then, advocacy can streamline high-value care, offering opportunities for quality improvement scholars to create projects consistent with evidenced-based care. Thirdly, as pediatrics and neonatology reconcile with value-based payment structures, successful quality initiatives may serve as demonstration projects, illustrating to policy-makers how best to allocate and incentivize resources that optimize newborn health. And finally, quality improvement (QI) can provide an essential link between broad reaching advocacy principles and boots-on-the-ground local or regional efforts to implement good ideas in ways that work practically in particular environments. In this paper, we provide examples of how national legislation elevated the importance of QI, by penalizing hospitals for low quality care. Using Medicaid coverage of pasteurized human donor milk as an example, we discuss how advocacy improved cost-effectiveness of treatments used as tools for quality projects related to reduction of necrotizing enterocolitis and improved growth. We discuss how the future of QI work will assist in informing the agenda as neonatology transitions to value-based care. Finally, we consider how important local and regional QI work is in bringing good ideas to the bedside and the community.
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Affiliation(s)
- Shetal Shah
- Division of Neonatology, Department of Pediatrics, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA, 100 Woods Road, C-2225A, Valhalla, NY 10595, USA.
| | - Lily Lou
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Illinois School of Medicine, 840 S. Wood Street (M/C 856), Suite 1252, Chicago, IL 60612, USA
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17
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Noel NL, Abrams J, Mudafort ER, Babu A, Forbes E, Hill L, Hill CC, Valbrun TG, Osian N, Wise LA, Kuohung W. Study protocol for the implementation of Centering Patients with Fibroids, a novel group education and empowerment program for patients with symptomatic uterine fibroids. Reprod Health 2024; 21:41. [PMID: 38561795 PMCID: PMC10983732 DOI: 10.1186/s12978-024-01777-2] [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: 03/02/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Black women and people with uteri have utilized collectivistic and relational practices to improve health outcomes in the face of medical racism and discrimination for decades. However, there remains a need for interventions to improve outcomes of uterine fibroids, a condition that disproportionately impacts Black people with uteri. Leveraging personalized approaches alongside evidence that demonstrates the positive impact of social and peer support on health outcomes, we adapted from CenteringPregnancy, an evidence based group prenatal care intervention, for the education and empowerment of patients with uterine fibroids. METHODS The present report provides an overview of the study design and planned implementation of CPWF in cohorts at Boston Medical Center and Emory University / Grady Memorial Hospital. After receiving training from the Centering Healthcare Institute (CHI), we adapted the 10-session CenteringPregnancy curriculum to an 8-session hybrid group intervention called Centering Patients with Fibroids (CPWF). The study began in 2022 with planned recruitment of six cohorts of 10-12 participants at each institution. We will conduct a mixed methods evaluation of the program using validated survey tools and qualitative methods, including focus groups and 1:1 interviews. DISCUSSION To date, we have successfully recruited 4 cohorts at Boston Medical Center and are actively implementing BMC Cohort 5 and the first cohort at Emory University / Grady Memorial Hospital. Evaluation of the program is forthcoming.
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Affiliation(s)
- Nyia L Noel
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA.
| | - Jasmine Abrams
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Estefania Rivera Mudafort
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA
| | - Anagha Babu
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Emma Forbes
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA
| | | | - Cherie C Hill
- Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Nkem Osian
- The White Dress Project, Atlanta, GA, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Wendy Kuohung
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA
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18
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Kang JM, Bentan M, Coelho DH. Awareness campaigns for cochlear implants: Are we making an impact? Cochlear Implants Int 2024:1-6. [PMID: 38561981 DOI: 10.1080/14670100.2024.2334550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This study aimed to determine if the major public awareness campaign for cochlear implants 'International Cochlear Implant Day' influenced national and international public interest as measured by internet search activity. METHODS Weekly search volume data in the United States, Canada, Australia, Germany, United Kingdom, Brazil, India, Japan, and a 'Worldwide' group for the search topic 'cochlear implant' was collected from Google Trends over a 5-year period (2017-2021). The 'Campaign' window was defined as 1 week before, the week of, and 2 weeks after International Cochlear Implant Day (February 25th). 'Non-Campaign' weeks were considered any data outside the 'Campaign' window. RESULTS Of the studied regions, the United States, United Kingdom, Australia, India, and 'Global' demonstrated a significant increase in internet search activity between 2017 and 2021. Although some individual years showed significant increases during the 'Campaign' period for Canada, Germany, Brazil, and Japan, none showed statistically significant increases over the 5-year period studied. CONCLUSION Public awareness campaigns are recognized crucial elements to delivering effective healthcare, but their success varies worldwide. While data from Google Trends suggests that cochlear implant awareness campaigns can translate into increased internet searches, greater efforts can be made in select countries to improve public interest.
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Affiliation(s)
- Joshua M Kang
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Mihai Bentan
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Daniel H Coelho
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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19
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Huminuik K. The five connections: A human rights framework for psychologists. Int J Psychol 2024; 59:218-224. [PMID: 37041089 DOI: 10.1002/ijop.12908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 03/03/2023] [Indexed: 04/13/2023]
Abstract
This article provides a brief introduction to human rights, describes why human rights are intrinsic to psychology, and introduces the "Five Connections Framework," which was adopted by the American Psychological Association in 2021. This framework articulates five distinct relationships between human rights and psychology: (a) Psychologists possess rights by virtue of being human, as well as specific rights essential to their profession and discipline; (b) Psychologists apply their knowledge and methods to the greater realisation of human rights; (c) Psychologists respect human rights and oppose the misuse of psychological science; (d) Psychologists ensure access to the benefits of psychological science and practice; and, (e) Psychologists advocate for human rights. Each of the five connections is described, highlighting implications for psychological research, practice, training and advocacy, with suggestions for how these connections can guide and inspire individual psychologists and psychological associations worldwide.
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Affiliation(s)
- Kirby Huminuik
- University of British Columbia, Vancouver, British Columbia, Canada
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20
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Lee K, Kronick R, Miconi D, Rousseau C. Moving Forward in Mental Health Care for Refugee, Asylum-Seeking, and Undocumented Children: Social Determinants, Phased Approach to Care, and Advocacy. Child Adolesc Psychiatr Clin N Am 2024; 33:237-250. [PMID: 38395508 DOI: 10.1016/j.chc.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Given the current political and climate crisis, the number of forcedly displaced individuals continues to rise, posing new challenges to host societies aiming to support and respond to the needs of those fleeing war or persecution. In this article, we turn our attention to current and historical sociopolitical contexts influencing the mental health of forcedly displaced children (ie, refugee, asylum-seeking, and undocumented) during their resettlement in high-income countries, proposing timely ways to respond to evolving needs and recommendations to redress ubiquitous structural inequities that act as barriers to education and care for the children, youth, and families seeking sanctuary.
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Affiliation(s)
- Keven Lee
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada; Lady Davis Institute, 3755 Côte Ste-Catherine Road, Montreal, Quebec.
| | - Rachel Kronick
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada; Lady Davis Institute, 3755 Côte Ste-Catherine Road, Montreal, Quebec
| | - Diana Miconi
- Department of Educational Psychology and Adult Education, Université de Montréal, 90 Vincent D'Indy Avenue, Outremont, Montréal, QC, Canada
| | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada
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21
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Walker SJ, Shrestha LB, Lloyd AR, Dawson O, Sheehan Y, Sheehan J, Maduka NBC, Cabezas J, Akiyama MJ, Kronfli N. Barriers and advocacy needs for hepatitis C services in prisons: Informing the prisons hepatitis C advocacy toolkit. Int J Drug Policy 2024; 126:104386. [PMID: 38492433 PMCID: PMC11106844 DOI: 10.1016/j.drugpo.2024.104386] [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: 12/21/2023] [Revised: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Carceral settings are a key focus of the 2030 WHO global hepatitis C virus (HCV) elimination goals. Despite this, access to HCV testing and treatment services in prisons remains low globally, limiting opportunities to achieve these goals. Advocacy efforts are needed to address service inequities and mobilise support for enhanced HCV programs in prisons globally. INHSU Prisons, a special interest group of the International Network on Health and Hepatitis in Substance Users (INHSU) is developing a Prisons HCV Advocacy Toolkit to address this need. Here we present findings of a mixed study to inform the development of the Toolkit. METHODS The aim of this study was to inform the development of the Toolkit, including understanding barriers for scaling up prison-based HCV services globally and advocacy needs to address these. An online survey (n = 181) and in-depth interviews (n = 25) were conducted with key stakeholders from countries of different economic status globally. Quantitative data were statistically analysed using R Studio and qualitative data were analysed thematically. The data sets were merged using a convergent design. RESULTS Key barriers for enhanced prison-based HCV services included lack of political will and action, lack of prison-based healthcare resources, and poor awareness about HCV and the importance of prison-based HCV services. These findings underscore how advocacy efforts are needed to motivate policymakers to prioritise HCV healthcare in prisons and ensure funds are available for services (including diagnostic tools and treatment, healthcare teams to implement services, and systems to measure their success). Advocacy resources to raise the awareness of policy makers, people working in the prison sector, and incarcerated populations were also identified as key to increasing HCV service uptake. CONCLUSION The Toolkit has the potential to support advocacy efforts for reaching HCV elimination targets. By understanding the advocacy needs of potential Toolkit end-users, the findings can inform its development and increase its accessibility, acceptability, and uptake for a globally diverse audience.
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Affiliation(s)
- Shelley J Walker
- National Drug Research Institute, Curtin University, Perth, Australia; Burnet Institute, Melbourne, Australia; Public Health and Preventative Medicine, Monash University, Melbourne, Australia.
| | - Lok B Shrestha
- The Kirby Institute, University of New South Wales (UNSW), Sydney, Australia; School of Biomedical Sciences, University of New South Wales (UNSW), Sydney, Australia
| | - Andrew R Lloyd
- The Kirby Institute, University of New South Wales (UNSW), Sydney, Australia
| | - Olivia Dawson
- The International Network on Health and Hepatitis in Substance Users (INHSU)
| | - Yumi Sheehan
- The Kirby Institute, University of New South Wales (UNSW), Sydney, Australia
| | | | | | - Joaquin Cabezas
- Gastroenterology and Hepatology Department, University Hospital Marques de Valdecilla, Santander, Spain; Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Santander, Spain
| | - Matthew J Akiyama
- Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Centre, New York, USA
| | - Nadine Kronfli
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Québec, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
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22
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Hallowell R, Saluja S, Lewis L, Novak DA, Valentine W, Batch E, Clayton Johnson MA, Bluthenthal RN, Cousineau MR, Ben-Ari R. Advocacy for Health Justice: An Innovative Pilot Course for MD and Master of Public Policy Students. Teach Learn Med 2024; 36:198-210. [PMID: 36519450 DOI: 10.1080/10401334.2022.2155169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/15/2022] [Indexed: 06/17/2023]
Abstract
Problem: U.S. medical schools are searching for ways to address issues of health justice in undergraduate medical education. Physicians have not typically received training in how to be effective advocates for systemic change and individuals in policy fields are not usually equipped to understand the complex issues of health science and their intersection with the health system and society. To address this gap, medical school faculty partnered with school of public policy faculty on a collaborative learning model that engaged MD and Master of Public Policy students together to strengthen their collective knowledge of the healthcare landscape, and to build skills to work for health justice. Intervention: We hypothesized that pairing medical students with public policy students to learn about the intersections of health justice and advocacy could enhance the efficacy of each group and provide a new model of collaboration between medical and policy professionals. The students collaborated on a health justice advocacy project through which they provided consultation to an established community organization. Context: The 8-week course took place in the spring of 2021 in Los Angeles, California. Due to Covid-19 the course was taught online and included asynchronous learning modules and live Zoom sessions. The project also served as a pilot for the post-clerkship phase of a new longitudinal health justice curriculum for MD students that launched in August 2021. Impact: Analysis of student work products, course evaluations, partner interviews, and student focus groups showed that students valued learning through their interdisciplinary collaborative work which gave them new perspectives on health justice issues. The community partners indicated that the students consultative work products were useful for their initiatives, and that they found working with MD and MPP students to be a valuable way to think about how to build stronger and more inclusive coalitions to advocate for health justice. This project has the potential for national impact as it aligns with the Association of American Medical Colleges' renewed focus on the responsibility of academic medicine to partner with communities for health justice. The project also contributed to the national conversation on how to align health systems science education with the aims of health justice through our participation in the American Medical Association Accelerating Change in Medical Education Consortium. Lessons Learned: Leveraging faculty relationships with community partners was crucial for developing meaningful projects for students. Cultivating and expanding community partner networks is necessary to sustain and scale up this type of intervention. Centering the needs of communities and supporting their on-going work for health justice is essential for becoming an effective advocate. Learning communities that bring interdisciplinary students, healthcare providers, policy professionals, and community partners together to learn from one another can create key opportunities for ameliorating health inequities.
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Affiliation(s)
- Ronan Hallowell
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Sonali Saluja
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - LaVonna Lewis
- Sol Price School of Public Policy, University of Southern California, Los Angeles, California, USA
| | - Daniel A Novak
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | | | - Eric Batch
- American Heart Association, Los Angeles, California, USA
| | | | - Ricky N Bluthenthal
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Michael R Cousineau
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Ron Ben-Ari
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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23
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da Costa C, Benn CS, Nyirenda T, Mpabalwani E, Grewal HMS, Ahmed R, Kapata N, Nyasulu PS, Maeurer M, Hui DS, Goletti D, Zumla A. Perspectives on development and advancement of new tuberculosis vaccines. Int J Infect Dis 2024; 141S:106987. [PMID: 38417616 DOI: 10.1016/j.ijid.2024.106987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/17/2024] [Accepted: 02/23/2024] [Indexed: 03/01/2024] Open
Abstract
Tuberculosis (TB) remains a leading cause of death worldwide and is estimated to have caused 1.3 million deaths worldwide in 2022. Approximately one quarter of the world's population are infected with Mycobacterium tuberculosis, of whom up to 10% will progress to developing active TB disease. Achieving the World Health Organization End TB Strategy targets of a 95% reduction in TB mortality and a 90% reduction in TB incidence worldwide by 2035 remains a daunting task. The continuing spread of multidrug-resistant TB adds another obstacle to achieving global TB control. Larger funding pledges coupled with technological advances have recently enabled the enhancement of TB vaccine development efforts. These are yielding a pipeline of over 17 products currently in different stages of clinical trials. Emerging promising phase I and II trial results and advancement to phase III trials have necessitated "vaccine preparedness" in parallel so that a smooth transition from any positive clinical trial result to phase IV evaluation and implementation into policy and practice can follow. Promotion of a human rights-based approach, which recognizes and upholds the fundamental rights of all affected by the disease, is essential to ensure universal access to quality TB vaccines, regardless of their background or personal circumstances.
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Affiliation(s)
- Christopher da Costa
- Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Boston, MA, USA; Coalition for Epidemic Preparedness Innovations, Research and Development Division, Washington, DC, USA.
| | - Christine S Benn
- Bandim Health Project, University of Southern Denmark, Department of Clinical Research and Danish Institute for Advanced Study, Odense, Denmark
| | - Thomas Nyirenda
- European Developing Countries Clinical Trials partnership (EDCTP) Africa Office, Cape Town, South Africa
| | - Evans Mpabalwani
- University Teaching Hospital, University of Zambia School of Medicine, Department of Paediatrics and Child Health, Lusaka, Zambia
| | - Harleen M S Grewal
- University of Bergen, Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, Bergen, Norway
| | - Rizwan Ahmed
- Department of Respiratory Medicine, Royal Bolton Hospital, and University of Bolton, Farnworth, Bolton, UK
| | - Nathan Kapata
- Zambia National Public Health Institute, Ministry of Health, Lusaka, Zambia
| | - Peter S Nyasulu
- Stellenbosch University, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Markus Maeurer
- Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal; Johannes Gutenberg University, I Medizinische Klinik, Mainz, Germany
| | - David S Hui
- The Chinese University of Hong Kong, Department of Medicine and Therapeutics and S. H. Ho Research Center for Infectious Diseases, Hong Kong, China
| | - Delia Goletti
- National Institute for Infectious Diseases L. Spallanzani-Istituto di Ricovero e Cura a Carattere Scientifico, Translational Research Unit, Department of Epidemiology and Preclinical Research, Rome, Italy
| | - Alimuddin Zumla
- University College London, Center for Clinical Microbiology, Division of Infection and Immunity, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
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24
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Schukow C, Johnson C, Martinez S, Mckinley K, Campbell K, Ahmed A. The impact of Pathology Outreach Program (POP) on United States and Canadian high school students. Acad Pathol 2024; 11:100112. [PMID: 38590794 PMCID: PMC10999372 DOI: 10.1016/j.acpath.2024.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/01/2024] [Accepted: 01/28/2024] [Indexed: 04/10/2024] Open
Abstract
Given recent trends in National Resident Matching Program (NRMP) data, there exists a looming deficit of practicing pathologists. As such, the Pathology Outreach Program (POP) was established in 2018 in the United States, and in 2022 in Canada, to educate high school students about pathology and laboratory medicine to help curb this projected shortage. We present survey data gathered from several educational sessions hosted at high schools in the United States (U.S.) and Canada over a 5-year period comparing participants' perceptions and awareness of pathology both before and after each session. Using this data, we wish to highlight the positive impact of POP on increasing students' awareness and appreciation for careers in pathology or laboratory medicine. This data will also highlight the additional work that must be done to further boost public knowledge of laboratory medicine's contributions to patient care. We hope this project will lay the foundation for further improvements to laboratory visibility and inspire additional outreach efforts to mitigate a future workforce shortage.
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Affiliation(s)
- Casey Schukow
- Department of Pathology, Corewell Health, Royal Oak, MI, USA
| | - Curtiss Johnson
- Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA
| | | | | | - Katelynn Campbell
- Department of Pathology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Aadil Ahmed
- Department of Pathology and Laboratory Medicine, Loyola Stritch School of Medicine, Maywood, IL, USA
- Dermatopathology Section, Illinois Dermatology Institute, Park Ridge, IL, USA
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Wagner GJ, Bogart LM, Matovu JKB, Okoboi S, Gwokyalya V, Ninsiima S, McBain RK, Storholm ED, Malika N, Green HD. Correlates of HIV Prevention Advocacy by Persons Living with HIV in Kampala, Uganda: A Cross-sectional Evaluation of a Conceptual Model. Int J Behav Med 2024:10.1007/s12529-024-10277-3. [PMID: 38519810 DOI: 10.1007/s12529-024-10277-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND HIV prevention advocacy empowers persons living with HIV (PLWH) to act as advocates and encourage members of their social networks to engage in protective behaviors such as HIV testing, condom use, and antiretroviral therapy (ART) adherence. We examined correlates of HIV prevention advocacy among PLWH in Uganda. METHOD A cross-sectional analysis was conducted with baseline data from 210 PLWH (70% female; mean age = 40 years) who enrolled in a trial of an HIV prevention advocacy training program in Kampala, Uganda. The baseline survey, which was completed prior to receipt of the intervention, included multiple measures of HIV prevention advocacy (general and specific to named social network members), as well as internalized HIV stigma, HIV disclosure, HIV knowledge, positive living (condom use; ART adherence), and self-efficacy for HIV prevention advocacy. RESULTS Consistent with our hypotheses, HIV disclosure, HIV knowledge, consistent condom use, and HIV prevention advocacy self-efficacy were all positively correlated with at least one measure of HIV prevention advocacy, after controlling for the other constructs in multiple regression analysis. Internalized HIV stigma was positively correlated with advocacy in bivariate analysis only. CONCLUSION These findings identify which characteristics of PLWH are associated with acting as change agents for others in their social network to engage in HIV protective behaviors.
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Affiliation(s)
- Glenn J Wagner
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA.
| | - Laura M Bogart
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
| | | | - Stephen Okoboi
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Susan Ninsiima
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ryan K McBain
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
| | | | - Nipher Malika
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
| | - Harold D Green
- University of Indiana Bloomington School of Public Health, Bloomington, IN, USA
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Gendall P, Hoek J. Regulating flavours and flavour delivery technologies: an analysis of menthol cigarettes and RYO tobacco in Aotearoa New Zealand. Tob Control 2024; 33:e122-e124. [PMID: 36882318 DOI: 10.1136/tc-2022-057823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/23/2023] [Indexed: 03/09/2023]
Abstract
INTRODUCTION Menthol facilitates smoking initiation among young people, enhances nicotine's addictiveness and fosters the false belief that menthol products are safer. As a result, several countries have banned use of menthol as a characterising flavour. Aotearoa New Zealand (NZ) could disallow menthol-flavoured cigarettes as part of its endgame legislation; however, little is known about the NZ menthol market. METHODS To examine the NZ menthol market, we analysed tobacco company returns to the Ministry of Health from 2010 to 2021. We calculated the market share of menthol cigarettes as a percentage of total cigarettes released for sale, estimated capsule cigarettes' market share as a percentage of total cigarette released for sale and menthol released for sale, and calculated menthol roll-your-own (RYO) tobacco released for sale as a percentage of total RYO released. RESULTS Menthol brands accounted for a relatively small but nonetheless sizeable proportion of NZ's tobacco market and in 2021 constituted 13% of NZ's factory made cigarette market and 7% of the RYO market, representing 161 million cigarettes and 25 tonnes of RYO. The introduction of capsule technologies using menthol flavours corresponded with a rise in menthol sales among factory made cigarettes. CONCLUSIONS Capsule technologies using menthol flavours work synergistically to enhance the appeal of smoking and appear likely to encourage experimentation among non-smoking young people. Comprehensive policy that regulates menthol flavours and innovations used to deliver flavour sensations will support tobacco endgame goals in NZ and could inform policy in other countries.
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Affiliation(s)
| | - Janet Hoek
- University of Otago, Wellington, New Zealand
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Masiakos PT, Jatana KR, DelMonte M, Stanford A, Aldrink JH. Day to Day Advocacy by Pediatric Health Care Providers. J Pediatr Surg 2024:S0022-3468(24)00178-7. [PMID: 38580545 DOI: 10.1016/j.jpedsurg.2024.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 04/07/2024]
Abstract
This manuscript highlights the impressive advocacy work that members of the American Academy of Pediatrics have achieved and serves to inspire pediatric health care providers of all specialties to pursue such efforts beyond the acute physical need of the child. This article represents one of the Symposia presented at the 2023 American Academy of Pediatrics Section on Surgery.
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Affiliation(s)
- Peter T Masiakos
- Division of Pediatric Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kris R Jatana
- Department of Otolaryngology - Head and Neck Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Mark DelMonte
- Chief Executive Officer, Executive Vice President of the American Academy of Pediatrics, Washington, D.C, USA
| | - Ala Stanford
- Founder, Black Doctors Consortium and Center for Health Equity, Philadelphia, PA, USA
| | - Jennifer H Aldrink
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
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Mannava SV, Brar A, Patwardhan U, Godfrey J, Berdan E, Gow K, Knod JL. Bridging the Knowledge Gap: A Toolkit on Reproductive Rights for Pediatric Surgeons in the Post-Dobbs Era. J Pediatr Surg 2024:S0022-3468(24)00181-7. [PMID: 38589273 DOI: 10.1016/j.jpedsurg.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The ripple effect of the Supreme Court ruling in Dobbs v. Jackson Women's Health Organization has impacted physicians and patients across numerous medical specialties. In pediatric surgery, the patient population ranges from fetus to the pregnant patient. There is a gap in the knowledge of pediatric surgeons regarding abortion laws and access. This project aims to bridge the gap by creating access to reliable resources which may be used to optimize patient care and support physicians. METHODS We collaborated with the Reproductive Health Coalition, co-founded by the American Medical Women's Association and Doctors for America, to curate a list of resources beneficial to pediatric surgeons. RESULTS We created a web-based toolkit with the purpose of providing easily accessible and reliable information on reproductive rights in the United States. We identified up-to-date resources on state-by-state abortion laws, legal resources, patient-centered information on obtaining abortion care, and resources for physicians interested in getting involved in advocacy. CONCLUSION Pediatric surgery rests at a critical juncture with respect to reproductive rights in the United States. Our toolkit enables users to understand the current climate and identify next steps to advocate for patients and physicians amidst a formidable legal environment. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
- Sindhu V Mannava
- Indiana University School of Medicine, Department of Surgery, Indianapolis, IN, USA
| | - Amanpreet Brar
- University of Michigan, Department of Surgery, Ann Arbor, MI, USA
| | - Utsav Patwardhan
- Rady Children's Hospital San Diego, Division of Pediatric Surgery, San Diego, CA, USA
| | - Jodi Godfrey
- American Medical Women's Association, West Orange, NJ, USA
| | - Elizabeth Berdan
- Mary Bridge Children's Hospital, Department of General and Thoracic Surgery, Tacoma, WA, USA
| | - Kenneth Gow
- University of Washington School of Medicine, Division of Pediatric General and Thoracic Surgery, Seattle, WA, USA
| | - J Leslie Knod
- University of Connecticut School of Medicine, Department of Surgery and Pediatrics, 282 Washington Street, Hartford, CT 06106, USA.
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Mitchell LK, Chopp D. Medical-Legal Partnerships Reinvigorate Systems Lawyering Using an Upstream Approach. J Law Med Ethics 2024; 51:810-816. [PMID: 38477281 PMCID: PMC10937177 DOI: 10.1017/jme.2023.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
The upstream framework presented in public health and medicine considers health problems from a preventive perspective, seeking to understand and address the root causes of poor health. Medical-legal partnerships (MLPs) have demonstrated the value of this upstream framework in the practice of law and engage in upstream lawyering by utilizing systemic advocacy to address root causes of injustices and health inequities. This article explores upstreaming and its use by MLPs in reframing legal practice.
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Affiliation(s)
| | - Debra Chopp
- UNIVERSITY OF MICHIGAN LAW SCHOOL, ANN ARBOR, MI, USA
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Puschel K, Thompson B, Rioseco A, Leon A, Goic C, Fuentes I, Vescovi Z. Cancer advocacy in residency education: From principles to competencies. J Cancer Policy 2024; 40:100470. [PMID: 38479645 DOI: 10.1016/j.jcpo.2024.100470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/05/2024] [Accepted: 03/10/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION The global cancer burden is increasing. Current global evidence indicates there will be a 47% rise of cancer cases for the period 2020-2040. The cancer rate differential also is evident within countries and regions. Efforts have been used to reduce the health disparities; however, the inequity prevails. One potential way to help reduce the disparity is through advocacy by physicians. METHODS Two recent systematic review articles on advocacy among physicians note that physicians are unlikely to be taught advocacy in medical education, and also note there are no advocacy competencies or skill sets that are either taught or valued in medical education. We explore literature and develop a model to understand the components of advocacy in medical education, specifically in resident training. We follow the model's main components by examining principles of advocacy, relevant domains of advocacy, and competencies and values for advocacy education. RESULTS Four ethical principles of advocacy education are identified: beneficence, non-maleficence, autonomy, and justice. These principles must be applied in meaningful, culturally sensitive, respectful, and promotion of the well-being ways. Three domains are identified: the practice domain (provider-patient interaction), the community domain (provider-community collaboration), and the health policy domain (the larger social environment). Advocacy occurs differently within each domain. Finally, competencies in the form of knowledge, skills, and values are described. We present a table noting where each competency occurs (by domain) as well as the value of each knowledge and skill. POLICY SUMMARY The significance of including advocacy instruction in medical education requires a change in the current medical education field. Besides valuing the concept of including advocacy, principles, domains, and competencies of inclusion are critical. In summary, we encourage the inclusion of advocacy education in resident medical programs so physicians become competent medical providers at diverse levels of society.
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Affiliation(s)
- Klaus Puschel
- Department of Family and Community Medicine, School of Medicine, Universidad Católica de Chile, Chile; Centro de Prevención y Control de Cáncer (CECAN), FONDAP Chile, Chile.
| | - Beti Thompson
- Public Health Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Andrea Rioseco
- Department of Family and Community Medicine, School of Medicine, Universidad Católica de Chile, Chile; Centro de Prevención y Control de Cáncer (CECAN), FONDAP Chile, Chile
| | - Augusto Leon
- Centro de Prevención y Control de Cáncer (CECAN), FONDAP Chile, Chile; Department of Surgical Oncology, School of Medicine, Universidad Católica de Chile, Chile
| | - Carolina Goic
- Centro de Prevención y Control de Cáncer (CECAN), FONDAP Chile, Chile
| | - Isabella Fuentes
- Centro de Prevención y Control de Cáncer (CECAN), FONDAP Chile, Chile
| | - Zdenka Vescovi
- Centro de Prevención y Control de Cáncer (CECAN), FONDAP Chile, Chile
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Jin MX, Kidwai AZ, Wu MJ, Frageau J, Tan K, Keir G, Amoateng EJ, Feigin K. Radiology advocacy: Promoting collaboration between trainees and professional societies. Curr Probl Diagn Radiol 2024:S0363-0188(24)00052-5. [PMID: 38508976 DOI: 10.1067/j.cpradiol.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024]
Abstract
From mammographic screening guidelines to resident work hour regulations, public policy affects every aspect of the practice of radiology and ultimately determines how radiological care is delivered to patients. Shaping public policy through advocacy is therefore critical to ensure patient access to equitable, high-quality radiological care. In advocacy, individual practicing radiologists and radiology trainees can increase the scope of their influence by collaborating with professional radiology societies. When radiology trainees participate in organized radiology advocacy, they learn about regulatory and legislative issues that will affect their careers, and they learn how to effect policy change. Radiology societies in turn benefit from trainee involvement, as engaging trainees early in their careers leads to more robust future participation and leadership. To encourage trainee involvement, radiology societies can engage individual residency programs and medical student radiology interest groups, invest in trainee-focused events, and maximize the number of positions of responsibility open to trainees. To circumvent the barriers to participation that many trainees face, radiology societies can make meeting proceedings free and available through virtual mediums. Through active collaboration, trainees and professional societies can help assure a bright future for radiologists and patients in need of radiological care.
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Affiliation(s)
- Michael X Jin
- Department of Radiology, Stony Brook University, 101 Nicolls Rd Level 4, Stony Brook, NY 11794, United States
| | - Ali Z Kidwai
- Department of Radiology, Stony Brook University, 101 Nicolls Rd Level 4, Stony Brook, NY 11794, United States.
| | - Matthew J Wu
- Department of Radiology, Stony Brook University, 101 Nicolls Rd Level 4, Stony Brook, NY 11794, United States
| | - James Frageau
- Department of Radiology, Stony Brook University, 101 Nicolls Rd Level 4, Stony Brook, NY 11794, United States
| | - Kevin Tan
- Department of Radiology, Stony Brook University, 101 Nicolls Rd Level 4, Stony Brook, NY 11794, United States
| | - Graham Keir
- Department of Radiology, Northwell Health System, Manhasset, NY 11030, United States
| | - Emmanuel Jnr Amoateng
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, United States
| | - Kimberly Feigin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
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Menashe SJ, Zavaletta V, McCoy MN, Wright JN. Advocacy in gender affirming care. Pediatr Radiol 2024:10.1007/s00247-024-05885-w. [PMID: 38436706 DOI: 10.1007/s00247-024-05885-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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/05/2024]
Abstract
Healthcare advocacy is the duty and privilege of all healthcare providers, but especially for those who care for children. Intersex and gender diverse youth face significant barriers across many aspects of life, with access to competent gender affirming healthcare chief among them. Understanding the importance of both institutional and individual efforts in healthcare advocacy is paramount to improving healthcare access and outcomes for this population.
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Affiliation(s)
- Sarah J Menashe
- Department of Radiology, Seattle Children's Hospital, University of Washington, MA.7.220, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA.
| | - Vaz Zavaletta
- Department of Pediatric Radiology, Children's Hospital Chicago, University of Colorado Hospital, Aurora, CO, USA
| | | | - Jason N Wright
- Department of Radiology, Seattle Children's Hospital, University of Washington, MA.7.220, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA
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Eatman JA, Hill CC, Davenport-Nicholson AR. Delivering Diversity and Inducing Inclusion: Evidence-Based Perspectives on Charting a Future of Equity in Obstetrics and Gynecology Residency Programs. Obstet Gynecol Clin North Am 2024; 51:143-155. [PMID: 38267124 DOI: 10.1016/j.ogc.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
An active implementation of principles encompassed by the terms diversity, equity, and inclusion (DEI) is critical to the success of obstetrics and gynecology (OB/GYN) residency programs. The patients served by our specialty come from a vast array of backgrounds, identities, and experiences. Preparing OB/GYN providers for the reality of this practice requires commitment to DEI principles in training programs nationwide through evidence-based policies and practices while empowering the next generation to chart the path forward to equity.
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Affiliation(s)
- Jasmin A Eatman
- Emory University School of Medicine, Emory University, Atlanta, GA, USA; Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Cherie C Hill
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Emory Women's Care, 550 Peachtree St NE, Atlanta, GA 30308, USA
| | - Agena R Davenport-Nicholson
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Emory Women's Care, 550 Peachtree St NE, Atlanta, GA 30308, USA
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Mottes T, Menon S, Conroy A, Jetton J, Dolan K, Arikan AA, Basu RK, Goldstein SL, Symons JM, Alobaidi R, Askenazi DJ, Bagshaw SM, Barhight M, Barreto E, Bayrakci B, Ray ONB, Bjornstad E, Brophy P, Charlton J, Chanchlani R, Conroy AL, Deep A, Devarajan P, Fuhrman D, Gist KM, Gorga SM, Greenberg JH, Hasson D, Heydari E, Iyengar A, Krawczeski C, Meigs L, Morgan C, Morgan J, Neumayr T, Ricci Z, Selewski DT, Soranno D, Stanski N, Starr M, Sutherland SM, Symons J, Tavares M, Vega M, Zappitelli M, Ronco C, Mehta RL, Kellum J, Ostermann M. Pediatric AKI in the real world: changing outcomes through education and advocacy-a report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference. Pediatr Nephrol 2024; 39:1005-1014. [PMID: 37934273 PMCID: PMC10817828 DOI: 10.1007/s00467-023-06180-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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Acute kidney injury (AKI) is independently associated with increased morbidity and mortality across the life course, yet care for AKI remains mostly supportive. Raising awareness of this life-threatening clinical syndrome through education and advocacy efforts is the key to improving patient outcomes. Here, we describe the unique roles education and advocacy play in the care of children with AKI, discuss the importance of customizing educational outreach efforts to individual groups and contexts, and highlight the opportunities created through innovations and partnerships to optimize lifelong health outcomes. METHODS During the 26th Acute Disease Quality Initiative (ADQI) consensus conference, a multidisciplinary group of experts discussed the evidence and used a modified Delphi process to achieve consensus on recommendations on AKI research, education, practice, and advocacy in children. RESULTS The consensus statements developed in response to three critical questions about the role of education and advocacy in pediatric AKI care are presented here along with a summary of available evidence and recommendations for both clinical care and research. CONCLUSIONS These consensus statements emphasize that high-quality care for patients with AKI begins in the community with education and awareness campaigns to identify those at risk for AKI. Education is the key across all healthcare and non-healthcare settings to enhance early diagnosis and develop mitigation strategies, thereby improving outcomes for children with AKI. Strong advocacy efforts are essential for implementing these programs and building critical collaborations across all stakeholders and settings.
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Affiliation(s)
- Theresa Mottes
- Division of Nephrology, Robert Lurie Children's Hospital of Chicago, Ann &, Chicago, IL, USA.
| | - Shina Menon
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Andrea Conroy
- Department of Pediatrics, Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jennifer Jetton
- Section of Pediatric Nephrology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kristin Dolan
- Section of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Ayse Akcan Arikan
- Section of Critical Care Medicine and Section of Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Rajit K Basu
- Division of Critical Care Medicine, Department of Pediatrics, Robert Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Ann &, Chicago, IL, USA
| | - Stuart L Goldstein
- Division of Pediatric Nephrology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jordan M Symons
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
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Searl J, Genoa K, Fritz A, Kearney A, Pandian V, Brenner MJ, Doyle P. Perceptions and practices of people with a total laryngectomy during COVID-19 pandemic: A mixed methods analysis. Am J Otolaryngol 2024; 45:104126. [PMID: 38039911 PMCID: PMC10939873 DOI: 10.1016/j.amjoto.2023.104126] [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: 09/01/2023] [Accepted: 11/19/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE People with a total laryngectomy (PTL) confront safety threats related to altered airway anatomy and risk of adverse events is amplified during healthcare crises, as exemplified by COVID-19 pandemic. Understanding these challenges, how they are navigated by PTL, and what resources can be deployed to alleviate risk can improve interprofessional care by speech-language pathologists (SLPs), otolaryngologists, and other professionals. MATERIALS AND METHODS An online survey was disseminated to PTL in the United States during the COVID-19 pandemic, querying participants about safety concerns and sources of information accessed to address care. Descriptive statistics and Chi-square were used to analyze information sources consumed by tracheoesophageal, esophageal, and electrolaryngeal speakers. Content analysis was completed to identify themes and quantify responses by subtheme. RESULTS Among 173 respondent PTL, tracheoesophageal speakers preferentially sought otolaryngologist input, whereas esophageal and electrolaryngeal speakers more often chose SLPs (p < .01). Overall, tracheoesophageal speakers had more SLP or otolaryngologist contact. Many PTL reported stringent handwashing, neck cleaning, and hygienic risk mitigation strategies. Six themes emerged in content analysis involving risk of infection/transmission, heightened vigilance, changes to alaryngeal communication, modified tracheostoma coverage, diagnostic testing, and risk from comorbid conditions. Limited provider contact suggested pandemic barriers to healthcare access. CONCLUSIONS PTL have a range of laryngectomy-specific needs and concerns, and type of alaryngeal communication was associated with source of information sought. Collaborations among healthcare professionals need to be optimized to improve patient navigation and overall access to specialized care.
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Affiliation(s)
- Jeff Searl
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA.
| | - Kathryn Genoa
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA.
| | - Alyssa Fritz
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA.
| | - Ann Kearney
- Division of Laryngology, Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.
| | - Vinciya Pandian
- Center for Immersive Learning and Digital Innovation, Johns Hopkins School of Nursing, Baltimore, MD, USA.; Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, USA; Global Tracheostomy Collaborative, Raleigh, NC, USA.
| | - Michael J Brenner
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA; Global Tracheostomy Collaborative, Raleigh, NC, USA.
| | - Philip Doyle
- Division of Laryngology, Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.
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Ibrahim AM. Nurses' ethical responsibilities: Whistleblowing and advocacy in patient safety. Nurs Ethics 2024:9697330241235306. [PMID: 38415609 DOI: 10.1177/09697330241235306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND In the dynamic landscape of healthcare, nurses play a crucial role as ethical stewards, responsible for whistleblowing, nurse advocacy, and patient safety. Their duties involve ensuring patient well-being through ethical practices and advocacy initiatives. AIM This study investigates the ethical responsibilities of nurses regarding whistleblowing and advocacy in reporting concerns about patient safety. RESEARCH DESIGN A cross-sectional study utilized cluster and simple random sampling to gather a representative sample of actively practicing registered nurses. Data collection involved a demographic form, Nurse Whistleblowing Intentions Scale, Nursing Advocacy Scale, and Clinical Decision-Making Scale. PARTICIPANTS AND RESEARCH CONTEXT The study utilizing a robust sample size determination formula for reliable findings included 96 diverse nurses, predominantly females. Engaged actively in direct patient care across various outpatients clinics. The recruitment process specifically sought individuals with expertise in safety protocols and reporting, contributing to a nuanced understanding of the study's focus. ETHICAL CONSIDERATIONS Ethical approval was obtained from the ethics committee of the university and the hospitals involved. Written consent was obtained from the participants. A thorough ethical review was conducted to guarantee participant protection and adherence to ethical principles. RESULTS Surveyed nurses demonstrated positive whistleblowing (Overall Mean Score: 3.58), high advocacy (Overall Mean Score: 12.2), and nuanced ethical decision-making for patient safety (Overall Mean Score: 15.78). Demographic factors, such as nationality and ethical training, significantly impacted whistleblowing intentions, while age, gender, and ethical training correlated with nursing advocacy behavior. Associations with experience and qualification emerged in ethical decision-making. CONCLUSION The gained insights foster targeted interventions, improving ethical practices, advocacy, and informed decision-making in nursing. This study explores the intricate link between demographics and ethical considerations among surveyed nurses, acting as a catalyst for ongoing initiatives to strengthen the ethical foundation in healthcare sector.
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Braun K. Looking back to look forward-the history of VAD laws in Australia and future law reform in the Australian territories. Med Law Rev 2024; 32:42-60. [PMID: 37695300 PMCID: PMC10896628 DOI: 10.1093/medlaw/fwad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Taking one's own life or attempting to do so has long been decriminalised in Australia. Aiding, counselling, or inciting another person to kill him or herself, however, remains a criminal offence. Yet, all six Australian States have now introduced laws allowing assistance in dying under certain circumstances. This article traces the recent history of Voluntary Assisted Dying (VAD) laws in Australia. It examines the introduction of the world's first assisted dying legislation in the Northern Territory in 1995 followed by the Federal Government's 1997 deprivation of the Territories' power to legislate on assisted dying invalidating said law. It further considers the fifty-seven failed Bills attempting to achieve law reform in this context in Australian jurisdictions between 1993 and 2017 with a view to identifying what factors may have contributed to the continuing lack of success. This article then outlines the rapid introduction of VAD laws in all six Australian States decriminalising VAD over the span of only 5 years. It ponders what may have changed to bring about this law reform. This article closes by contemplating potential future law reform in the Australian Territories, which have been reinstated with jurisdiction to legislate on VAD in December 2022.
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Affiliation(s)
- Kerstin Braun
- School of Law and Justice, University of Southern Queensland, Toowoomba, Australia
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Tsagkaris C, Arranz B, Yared W, Medeiros R, Martín-Moreno JM. How can youth involvement in public health conferences promote a tobacco-free generation? Lessons from the ECToH 2023's Youth Committee. Tob Control 2024:tc-2023-058439. [PMID: 38378212 DOI: 10.1136/tc-2023-058439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/23/2024] [Indexed: 02/22/2024]
Abstract
Young health advocates have the legitimate aspiration to be masters of their future and are increasingly contributing to public health research and practice worldwide, yet their potential to contribute to the documentation and communication of outputs from public health conferences has not been fully realised. This short communication highlights the Youth Committee of the 2023 European Conference on Tobacco or Health as an example of youth involvement in a major public health conference focused on tobacco control. The authors explore the benefits, practicalities and challenges of incorporating young professionals into conference workflow, including creativity, networking and engagement with broader public health challenges within their communities. This article emphasises the active participation of Youth Committees in public health fora as a model for future conferences and underscores a commitment to achieving a tobacco-free generation.
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Affiliation(s)
| | - Beatriz Arranz
- Association of European Cancer Leagues, Brussels, Belgium
- AECC Spanish Association Against Cancer, Madrid, Spain
| | - Wendy Yared
- Association of European Cancer Leagues, Brussels, Belgium
| | - Rui Medeiros
- Association of European Cancer Leagues, Brussels, Belgium
- Research Center of IPO Porto, Porto, Portugal
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Hefler M. Progress, setbacks and changing perception of the possible: reflections on Aotearoa/New Zealand's changed political landscape and tobacco policy plans. Tob Control 2024; 33:141-142. [PMID: 38378208 DOI: 10.1136/tc-2024-058630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
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Shahriar MH, Hasan MM, Alam MS, Matthes BK, Gilmore AB, Zubair ABM. Tobacco industry interference to undermine the development and implementation of graphic health warnings in Bangladesh. Tob Control 2024:tobaccocontrol-2022-057538. [PMID: 37185882 DOI: 10.1136/tc-2022-057538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 03/29/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND In Bangladesh, the 2013 Amendment of the Tobacco Control Act made graphic health warnings (GHWs) on the upper 50% of all tobacco packs obligatory. However, at the time of writing (May 2022), GHWs are still being printed on the lower 50% of packs. This paper seeks to explore how the tobacco industry undermined the development and implementation of GHWs in Bangladesh, a country known for a high level of tobacco industry interference (TII) that has rarely been examined in the peer-reviewed literature. METHODS Analysis of print and electronic media articles and documents. RESULTS Cigarette companies actively opposed GHWs, while bidi companies did not. The primary strategy used to influence the formulation and delay the implementation of GHWs was direct lobbying by the Bangladesh Cigarette Manufacturers' Association and British American Tobacco Bangladesh. Their arguments stressed the economic benefits of tobacco to Bangladesh and sought to create confusion about the impact of GHWs, for example, claiming that GHWs would obscure tax banderols, thus threatening revenue collection. They also claimed technical barriers to implementation-that new machinery would be needed-leading to delays. Tensions between government bodies were identified, one of which (National Board of Revenue)-seemingly close to cigarette companies and representing their arguments-sought to influence others to adopt industry-preferred positions. Finally, although tobacco control advocates were partially successful in counteracting TII, one self-proclaimed tobacco control group, whose nature remains unclear, threatened the otherwise united approach. CONCLUSIONS The strategies cigarette companies used closely resemble key techniques from the well-evidenced tobacco industry playbook. The study underlines the importance of continuing monitoring and investigations into industry conduct and suspicious actors. Prioritising the implementation of WHO Framework Convention on Tobacco Control Article 5.3 is crucial for advancing tobacco control, particularly in places like Bangladesh, where close government-industry links exist.
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Affiliation(s)
| | | | | | | | | | - A B M Zubair
- PROGGA: Knowledge for Progress, Dhaka, Bangladesh
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Liptak K, Liptak L, Rozsa NK, Hermann P, Tarnoki AD, Tarnoki DL, Vegh D. Oral Health Knowledge and Habits of Hungarian Monozygotic and Dizygotic Twins: A Pilot Study. Int Dent J 2024; 74:66-70. [PMID: 37482503 PMCID: PMC10829344 DOI: 10.1016/j.identj.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
OBJECTIVE The aim of this research was to collate and analyse the data on the oral health knowledge and the related habits of a Hungarian cohort of monozygotic (MZ) and dizygotic (DZ) twins using the newly developed World Health Organisation Oral Health Questionnaire for Adults (Annex 7). METHOD A total of 15 sets of MZ twins and 14 sets of DZ twins (58 individuals) aged between 18 and 71 years were enrolled in the study. Each participant had to fill out a web-based questionnaire which comprised 23 questions (Google Forms). The data were collated and the oral health/hygiene habits of MZ and DZ twins were compared. RESULTS No significant differences were detected between MZ and DZ twins with regards to their daily tooth-cleaning habits or the tooth-cleaning products used by the 2 groups. For instance, when asked how often they clean their teeth, 80% of MZ twins and 71% of DZ twins responded similarly. Further, both groups provided similar responses when questioned about the use of fluoride toothpaste, frequency of dental visits, and dental counselling received as well as a number of other parameters such as snacking of sweets and fear of visiting dentists. CONCLUSIONS Our pilot analysis of the questionnaire responses from MZ and DZ twins in Hungary did not indicate any significant differences in their oral care habits in general. Further studies with a large cohort are required to confirm or refute our findings.
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Affiliation(s)
- Klaudia Liptak
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Laura Liptak
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University, Budapest, Hungary
| | - Noemi Katinka Rozsa
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University, Budapest, Hungary
| | - Peter Hermann
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | | | | | - Daniel Vegh
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary.
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Thiery JP, Sheng G, Shu X, Runyan R. How studies in developmental epithelial-mesenchymal transition and mesenchymal-epithelial transition inspired new research paradigms in biomedicine. Development 2024; 151:dev200128. [PMID: 38300897 DOI: 10.1242/dev.200128] [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] [Indexed: 02/03/2024]
Abstract
Epithelial-mesenchymal transition (EMT) and its reverse mechanism, mesenchymal-epithelial transition (MET), are evolutionarily conserved mechanisms initially identified in studies of early metazoan development. EMT may even have been established in choanoflagellates, the closest unicellular relative of Metazoa. These crucial morphological transitions operate during body plan formation and subsequently in organogenesis. These findings have prompted an increasing number of investigators in biomedicine to assess the importance of such mechanisms that drive epithelial cell plasticity in multiple diseases associated with congenital disabilities and fibrosis, and, most importantly, in the progression of carcinoma. EMT and MET also play crucial roles in regenerative medicine, notably by contributing epigenetic changes in somatic cells to initiate reprogramming into stem cells and their subsequent differentiation into distinct lineages.
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Affiliation(s)
| | - Guojun Sheng
- International Research Center for Medical Sciences, Kumamoto University, Kumamoto 860-0811, Japan
| | - Xiaodong Shu
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China
| | - Raymond Runyan
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ 85721, USA
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Banu T. Revising Destiny - Surgical Care in Birth Defects. J Pediatr Surg 2024; 59:177-181. [PMID: 37953161 DOI: 10.1016/j.jpedsurg.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/06/2023] [Indexed: 11/14/2023]
Abstract
Birth Defects are accountable for the substantial surgical burden of disease worldwide. It can bring upon death, chronic illness, disability [physical or mental or both], financial burden, social stigma, abandonment, feticide and Infanticide. Availing timely and safe surgery can minimize the potential fatalities and sufferings caused by birth defects. Yet surgery is not treated as essential for the management of birth defects, especially in lower middle-income countries. It causes potentially correctable conditions to exacerbate, which can lead to death or lifelong disabilities. Surgical care cannot only correct birth defects but also can avert potential Disability Adjusted Life Years (DALYs) and financial burden. Furthermore, surgical correction facilitates social inclusion. Such transformation can be equated to "Revising Destiny". A "whole of society" approach focused on surgical care is instrumental for addressing the health, financial, and social implications of birth defects. LEVEL OF EVIDENCE V: Expert Opinion.
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Affiliation(s)
- Tahmina Banu
- Chittagong Research Institute for Children Surgery (CRICS), Panchlaish, Chittagong 4203, Bangladesh.
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44
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Sansweet S, Rolling C, Ebisawa M, Wang J, Gupta R, Davis CM. Reaching Communities Through Food Allergy Advocacy, Research, and Education: A Comprehensive Analysis. J Allergy Clin Immunol Pract 2024; 12:310-315. [PMID: 38151118 DOI: 10.1016/j.jaip.2023.12.026] [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: 10/25/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 12/29/2023]
Abstract
This article explores the multifaceted approach of food allergy (FA) advocacy, research, and education to address the diverse challenges associated with FA, such as disparities in socioeconomic status, food security, quality of life, and the overall burden of the disease. Advocacy initiatives are instrumental in driving policy changes, raising public awareness, and directing substantial research funding, with a focus on reducing disparities. They have influenced allergen labeling regulations and improved access to epinephrine, emphasizing the importance of school-based management plans, especially in underserved communities. Research in FA informs medical practices and offers them hope for improved treatments. Recent breakthroughs in peanut allergy prevention and oral immunotherapy trials exemplify the potential for advancements while highlighting the need to address disparities in health care access. Education is a critical tool for prevention, raising awareness, and reducing the risk of allergic reactions. Efforts should be tailored to reach marginalized communities, particularly in schools where education on FA management is essential. Collaborating directly with communities is imperative to ensure inclusivity and address disparities. Barriers such as mistrust, language and cultural differences, and lack of diversity among researchers must be overcome to encourage diverse participation in research studies. This article concludes by emphasizing the significance of a comprehensive approach to FA research that prioritizes equity and inclusivity. The call to action highlights the need for global initiatives to reshape the landscape of FA care and address disparities in health care access and outcomes.
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Affiliation(s)
- Samantha Sansweet
- Center for Food Allergy and Asthma Research, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Corwin Rolling
- Center for Food Allergy and Asthma Research, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Julie Wang
- Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ruchi Gupta
- Center for Food Allergy and Asthma Research, Feinberg School of Medicine, Northwestern University, Chicago, Ill; Department of Pediatrics and Medicine at Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital, Chicago, Ill
| | - Carla M Davis
- Division of Immunology, Allergy, and Retrovirology, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital Food Allergy Program, Texas Children's Hospital, Houston, Texas.
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Gupta K. Impact of Climate Change, Environmental Toxins and Pollution on the AOFOG region: What can OBGYNs do? J Obstet Gynaecol India 2024; 74:22-26. [PMID: 38434121 PMCID: PMC10901753 DOI: 10.1007/s13224-024-01958-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/13/2024] [Indexed: 03/05/2024] Open
Abstract
Climate change is occurring rapidly, and this crisis should now be recognized as a "global emergency". It is one of the major global health threats brought about by global warming, resulting from human activity due in large part to increasing levels of greenhouse gases. The ongoing climate crisis poses significant risks to women, pregnant mothers, unborn fetuses and offspring, who were exposed in-utero to climate stressors, especially those in marginalized communities where effects are magnified. A focus on education, research, and advocacy in responding to changing health consequences and global awareness are key to educating our professional healthcare providers, patients, the lay public, key personnel in the government and other leaders, and by making the changes necessary to address this crisis. Building on the pillars that FIGO has identified (advocacy, research interpretation, capacity building, and education), and following the footsteps of the FIGO Committee on "Climate Change and Toxic Environmental Exposures", the baby steps yet focussed efforts taken by AOFOG through its recently formed "Climate Change & Pollution Working Group" will be highlighted in this review article. After all, investing in the health of women is investing in the health of current and future generations, and we, as healthcare providers along with health professional organizations should be in the forefront of environmental health advocacy to save the present generation and future generations through engagement as public opinion leaders.
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Affiliation(s)
- Krishnendu Gupta
- Department of Obstetrics and Gynaecology, Vivekananda Institute of Medical College (VIMS), Kolkata, West Bengal India
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46
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Woodcock A, Carter G, Baayd J, Turok DK. The US Supreme Court Dobbs decision's impact on the future plans of 2023 residency graduates at the University of Utah. Contraception 2024; 130:110328. [PMID: 37977429 DOI: 10.1016/j.contraception.2023.110328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES This study aimed to understand how the Dobbs decision impacted graduating resident physicians in Utah and to understand residents' perspectives on abortion access. STUDY DESIGN We invited all 2023 graduating residents at the University of Utah, from all specialties, to participate in this survey. We analyzed univariate relationships between respondent demographics and change of career plans post-Dobbs. We also performed a thematic analysis of free text responses. RESULTS We received responses from 85 residents (55% of all graduating residents from the University of Utah) representing 19 specialties. Six (7%) residents changed their practice location due to the Dobbs decision. Most residents supported and wanted to advocate for legal abortion. In a thematic analysis, many graduating residents do not want to live in an abortion-restrictive state. CONCLUSIONS The Dobbs decision impacts physicians across all specialties, not just obstetrician/gynecologists. IMPLICATIONS Future research into the impact of the Dobbs decision should include physicians of all specialties.
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Affiliation(s)
- Alexandra Woodcock
- University of Utah School of Medicine, Department of Obstetrics and Gynecology, Salt Lake City, UT, United States.
| | - Gentry Carter
- University of Utah School of Medicine, Department of Obstetrics and Gynecology, Salt Lake City, UT, United States
| | - Jami Baayd
- University of Utah School of Medicine, Department of Obstetrics and Gynecology, Salt Lake City, UT, United States
| | - David K Turok
- University of Utah School of Medicine, Department of Obstetrics and Gynecology, Salt Lake City, UT, United States
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Casey E, Linehan C. The physician's role in reducing health disparities for persons with epilepsy and intellectual disability: "it's not just epilepsy…you really have to take a deeper dive.". Epilepsy Behav 2024; 151:109646. [PMID: 38271851 DOI: 10.1016/j.yebeh.2024.109646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 01/27/2024]
Abstract
Epilepsy affects approximately 25 % of people with intellectual disability (ID). Despite this high prevalence, evidence of health disparity exists in healthcare access and health outcomes for this population. Patients with ID experience additional challenges in accessing appropriate epilepsy care, and are at greater risk of experiencing inappropriate prescribing, polypharmacy and misdiagnosis compared with the general population. The expectations, attitudes and actions of physicians are key in addressing health inequalities, particularly those which disproportionately impact a specific group of patients, such as patients with ID and epilepsy. This qualitative study aimed to explore the views of specialist physicians as to why they believe this patient group are at a disadvantage when it comes to accessing appropriate epilepsy care, and how physicians can intervene to ensure that patients with ID are given equal access to suitable epilepsy care, and equal opportunity to achieve the best possible treatment outcomes. Semi-structured interviews were carried out with six physicians, located in six countries, who specialise in the care of persons with ID who have epilepsy. Interviews sought views on prognostic expectations, experiences of disparities in epilepsy care, and suggestions for advocacy interventions. Interviews were analysed using reflexive thematic analysis. Three core themes and nine subthemes were identified. Core themes included (1) 'Nervousness in care and treatment,' which reflected participants' descriptions of a nervousness by colleagues when treating epilepsy in patients with ID. (2) 'Taking a deeper dive' captured the harmful effects of accepting "common dogma," as well as the issue of a lack of clarity around treatment pathways for patients with epilepsy and ID. (3) 'Teach me' illustrated the importance of shared expertise, reflective practice and continued research and advocacy. Findings reflected participants' recommendations to address disparities in epilepsy care for patients with ID. These recommendations highlighted education and training, taking time to learn how to communicate in different ways, and regular reflection on personal assumptions and biases as important contributors to addressing inequalities in epilepsy care for patients with ID. It is hoped that findings will prompt those providing epilepsy care to reflect on their own practice and identify ways in which they might intervene to minimise inadvertent harm and reduce health disparities in epilepsy care for patients with ID.
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Affiliation(s)
- Emma Casey
- University College Dublin, UCD School of Psychology, Dublin, Ireland.
| | - Christine Linehan
- University College Dublin, UCD School of Psychology, Dublin, Ireland; UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland
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Vijayvergiya DH, Christiansen-Lindquist L. Fusing stillbirth parent advocacy and epidemiology to address the US stillbirth crisis. Semin Perinatol 2024; 48:151874. [PMID: 38238215 DOI: 10.1016/j.semperi.2023.151874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
This narrative describes how a stillbirth advocate and an epidemiologist have worked together to advocate for federal legislation to address stillbirth in the United States. It alternates between each of their perspectives to illustrate how they have leveraged their complementary skills and experiences with the hope that fewer families will experience the tragedy of stillbirth.
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Lerma K, Arey W, Chatillon A, White K. Reasons for participation in abortion research in restrictive settings. Contraception 2024; 130:110324. [PMID: 37926363 DOI: 10.1016/j.contraception.2023.110324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES Following the implementation of a restrictive abortion law in Texas (Senate Bill 8), we conducted in-depth interviews with pregnant people about their experiences seeking abortion care. In this analysis, we explore participants' motivations for taking part in a research study. STUDY DESIGN Between October 2021 and August 2022, we conducted 120 in-depth interviews with Texans (aged ≥15 years) who, after considering abortion, had a facility-based abortion, self-managed their abortion, experienced miscarriage or ectopic pregnancy, or continued their pregnancy. We asked all interviewees, "Why did you decide to participate in the interview?" For analysis, we used inductive and deductive coding approaches to explore motivations for and concerns about participation. RESULTS Most commonly, interviewees appreciated the opportunity to share their stories, frequently describing how their experiences highlight the nuance of abortion decision-making and challenge stigmatized views about abortion. Some described an emotional benefit of participating, as they had no one else to whom to disclose their experience without judgment. Many hoped to help others by participating, saying that access to other people's stories would have helped them feel less isolated. Relatedly, many viewed their participation as an opportunity to speak out against restrictive policies that caused them harm, hardship, and distress. Interviewees seldom cited the monetary incentive alone as motivation for participation. A few expressed concerns about participating out of fear of legal repercussions for others involved in their abortion process (e.g., ride-share driver). These themes were consistent across pregnancy outcomes. CONCLUSIONS Research volunteers are motivated to participate for altruistic and self-benefiting reasons. IMPLICATIONS This study provides insights into what people seeking abortion consider when deciding to participate in qualitative research. Research ethics committees evaluating and researchers conducting abortion research should weigh these motivations, perceived benefits, and concerns. Policies that enhance protections for participant data are needed to support knowledge generation from abortion research.
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Affiliation(s)
- Klaira Lerma
- Texas Policy Evaluation Project, Population Research Center, The University of Texas at Austin, Austin, Texas, USA.
| | - Whitney Arey
- Texas Policy Evaluation Project, Population Research Center, The University of Texas at Austin, Austin, Texas, USA
| | - Anna Chatillon
- Texas Policy Evaluation Project, Population Research Center, The University of Texas at Austin, Austin, Texas, USA
| | - Kari White
- Texas Policy Evaluation Project, Population Research Center, The University of Texas at Austin, Austin, Texas, USA; Department of Sociology, The University of Texas at Austin, Austin, Texas, USA; Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA
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Naunheim KS, Platz JJ. Integrating Advocacy into Your Practice. Thorac Surg Clin 2024; 34:77-84. [PMID: 37953055 DOI: 10.1016/j.thorsurg.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
In the last 60 years, health care has evolved due to many trends including the introduction of third-party payers, a progressively aging society, advancing technology, emerging recognition of social issues of race/gender/poverty, the relative decline in the physician workforce, rising health care costs, ongoing consolidation of health care entities, and the corporatization of health care delivery. This has led to problems in health care delivery with respect to cost, quality, and access. Many medical leaders feel it is now the duty of the physician to go beyond the classic patient-doctor clinical responsibility and work to advocate for their patients and society regarding economic, financial, educational, and social issues.
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Affiliation(s)
- Keith S Naunheim
- St Louis University School of Medicine, 1008 South Spring Avenue, St Louis, MO 63104, USA.
| | - Joseph J Platz
- St Louis University School of Medicine, 1008 South Spring Avenue, St Louis, MO 63104, USA
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