Web-based psychological interventions for people living with and beyond cancer: A meta-review of what works and what doesn’t for maximising recruitment, engagement, and efficacy

Background: Despite high levels of psychological distress experienced by many patients with cancer, previous research has identified several barriers to accessing traditional face-to-face psychological support. In response, web-based psychosocial interventions have emerged as a promising alternative. Objective: This meta-review aimed to synthesise evidence on: (1) recruitment challenges and enablers; (2) factors that promote engagement and adherence to web-based intervention content; and (3) factors that promote the efficacy of web-based psychosocial interventions for cancer patients and survivors. Methods: We conducted a systematic search for previous reviews which have investigated the recruitment, engagement, and efficacy of online and app-based psychosocial interventions in adult cancer populations. We searched PubMed, CINAHL, PsycINFO, and the Cochrane Library database for relevant literature. Search terms focussed on a combination of topics pertaining to neoplasms and telemedicine. Two independent authors conducted abstract screening, full-text screening, and data extraction for each identified article. Results: Twenty articles met eligibility criteria. There was inconsistency in the reporting of uptake and engagement data; however, anxiety around technology and perceived time burden were identified as two key barriers. Online psychosocial oncology interventions demonstrated efficacy in reducing depression and stress but reported weak to mixed findings for distress, anxiety, quality of life, and wellbeing. While no factors consistently moderated intervention efficacy, preliminary evidence indicated that multi-component interventions and greater communication with a healthcare professional were preferred by participants and associated with superior effects. Conclusions: Several consistently cited barriers to intervention uptake and recruitment emerged, which we recommend future intervention studies address. Preliminary evidence also supports the superior efficacy of multi-component interventions and interventions which facilitate communication with a healthcare professional. However, a greater number of appropriately powered clinical trials, including randomised trials with head-to-head comparisons, are needed to enable more confident conclusions around which online psychosocial oncology interventions work best and for whom

“The Fruit of Consultation” – Co-production as a solution to the challenges of safeguarding children and young people in International Christian work, findings from an online survey.

Incidents of child abuse such as the Oxfam case in 2010 of sexual abuse of children by volunteers’ and cases of abuse in orphanages by high risk overseas volunteers have highlighted the need for the development of effective safeguarding in the international context. This is of equal importance for faith-based organisations (FBOs) who, like non-governmental organisations (NGOs) are obligated to create safe spaces for their beneficiaries. This paper reports the findings from an online survey conducted in 2019, which was completed by 72 participants, 39 were representatives from organisations based in the UK which support individuals to engage in International Christian Work (ICW), 33 were individuals who are or have been engaged in ICW in the last three years. The online survey collected qualitative data, which was analysed using reflexive thematic analysis whilst descriptive analytical techniques were employed on the quantitative data. The findings illustrate commitment to safeguarding children and young people in ICW but also the complexities, challenges, and tensions around this. The necessity to work collaboratively with local contexts and co-production was identified as key to developing effective safeguarding practice. These findings have implications beyond faith-based organisations to others working in the international context

Coronavirus Disease (COVID-19): The Mental Health, Resilience, and Communication Resources for the Short- and Long-term Challenges Faced by Healthcare Workers

The coronavirus disease pandemic has been an exceptional time for healthcare workers who have had to adapt to new ways of communicating with each other and delivering care to their patients. Maintaining healthcare workers’ well-being and mental health during increased COVID-19 workload pressure and change in practices is needed. It is essential to have a resilient workforce that can respond to the challenges presented by the pandemic. Healthcare workers at the frontline may be more susceptible to psychological stressors such as the availability of resources to protect themselves and their patients whilst balancing this with maintaining the health and well-being of family and friends. This research topic addresses the problems and issues researchers, policymakers, and educators face when formulating the best evidence and recommendations to support healthcare workers. There is a need to collate the best available practice and share knowledge from diverse contexts so healthcare workers can deliver the best care whilst they stay physically and mentally healthy

Baseline Behavioral Data and Behavioral Correlates of Disturbance for the Lake Oku Clawed Frog (Xenopus longipes)

Animal behavior and welfare science can form the basis of zoo animal management. However, even basic behavioral data are lacking for the majority of amphibian species, and species-specific research is required to inform management. Our goal was to develop the first ethogram for the critically endangered frog Xenopus longipes through observation of a captive population of 24 frogs. The ethogram was applied to produce a diurnal activity budget and to measure the behavioral impact of a routine health check where frogs were restrained. In the activity budget, frogs spent the vast majority of time swimming, resting in small amounts of time devoted to feeding, foraging, breathing, and (in males) amplexus. Using linear mixed models, we found no effect of time of day or sex on baseline behavior, other than for breathing, which had a greater duration in females. Linear mixed models indicated significant effects of the health check on duration of swimming, resting, foraging, feeding, and breathing behaviors for all frogs. This indicates a welfare trade-off associated with veterinary monitoring and highlights the importance of non-invasive monitoring where possible, as well as providing candidates for behavioral monitoring of acute stress. This investigation has provided the first behavioral data for this species which can be applied to future research regarding husbandry and management practices

Did school characteristics affect the uptake of meningococcal quadrivalent vaccine in Greater Manchester, United Kingdom?

Objectives The objective of this study was to assess if school characteristics were associated with the uptake of the meningococcal ACWY (MenACWY) vaccine in Greater Manchester in 2017/18. Study design This is an ecological cross-sectional study. Methods We analysed data on all 129 schools in seven local authorities in Greater Manchester from the Department for Education and from local child health information systems to determine whether school characteristics, including school type and Ofsted effectiveness score, were associated with vaccine uptake. Schools with no eligible pupils were excluded. We undertook single-variable and multivariable analysis and considered key interactions. Results The overall uptake rate was 80.7%, with a median uptake per school of 80.6% (interquartile range, 69.0%–87.4%). Lower vaccination rates were associated with lower overall effectiveness scores (odds ratio [OR]: 3.54, 95% confidence interval [CI]: 3.00–4.19) and lower numbers of pupils eligible for vaccination (OR: 1.39, 95% CI: 1.28–1.51). Schools with a lower percentage of pupils for whom English is a second language and high deprivation were associated with lower uptake (OR: 1.58, 95% CI: 1.41–1.78). In addition, community schools (the schools with the most local authority oversight) had lower vaccination rates than other categories of schools. Conclusions In this study, uptake rates of the MenACWY vaccine were associated with all five school characteristics considered. Effectiveness scores for schools had the largest association with vaccine uptake, with poorer schools having lower uptake. These characteristics should be used by vaccination providers to prioritise their interventions to increase immunisation rates

Translating from egg- to antigen-based indicators for Schistosoma mansoni elimination targets: A Bayesian latent class analysis study

This Document is Protected by copyright and was first published by Frontiers. All rights reserved. it is reproduced with permission.Schistosomiasis is a parasitic disease affecting over 240-million people. World Health Organization (WHO) targets for Schistosoma mansoni elimination are based on Kato-Katz egg counts, without translation to the widely used, urine-based, point-of-care circulating cathodic antigen diagnostic (POC-CCA). We aimed to standardize POC-CCA score interpretation and translate them to Kato-Katz-based standards, broadening diagnostic utility in progress towards elimination. A Bayesian latent-class model was fit to data from 210 school-aged-children over four timepoints pre- to six-months-post-treatment. We used 1) Kato-Katz and established POC-CCA scoring (Negative, Trace, +, ++ and +++), and 2) Kato-Katz and G-Scores (a new, alternative POC-CCA scoring (G1 to G10)). We established the functional relationship between Kato-Katz counts and POC-CCA scores, and the score-associated probability of true infection. This was combined with measures of sensitivity, specificity, and the area under the curve to determine the optimal POC-CCA scoring system and positivity threshold. A simulation parametrized with model estimates established antigen-based elimination targets. True infection was associated with POC-CCA scores of ≥ + or ≥G3. POC-CCA scores cannot predict Kato-Katz counts because low infection intensities saturate the POC-CCA cassettes. Post-treatment POC-CCA sensitivity/specificity fluctuations indicate a changing relationship between egg excretion and antigen levels (living worms). Elimination targets can be identified by the POC-CCA score distribution in a population. A population with ≤2% ++/+++, or ≤0.5% G7 and above, indicates achieving current WHO Kato-Katz-based elimination targets. Population-level POC-CCA scores can be used to access WHO elimination targets prior to treatment. Caution should be exercised on an individual level and following treatment, as POC-CCAs lack resolution to discern between WHO Kato-Katz-based moderate- and high-intensity-infection categories, with limited use in certain settings and evaluations

Interaction between metabolic genetic risk score and dietary fatty acid intake on central obesity in a Ghanaian population

Obesity is a multifactorial condition arising from the interaction between genetic and lifestyle factors. We aimed to assess the impact of lifestyle and genetic factors on obesity-related traits in 302 healthy Ghanaian adults. Dietary intake and physical activity were assessed using a 3 day repeated 24 h dietary recall and global physical activity questionnaire, respectively. Twelve single nucleotide polymorphisms (SNPs) were used to construct 4-SNP, 8-SNP and 12-SNP genetic risk scores (GRSs). The 4-SNP GRS showed significant interactions with dietary fat intakes on waist circumference (WC) (Total fat, Pinteraction = 0.01; saturated fatty acids (SFA), Pinteraction = 0.02; polyunsaturated fatty acids (PUFA), Pinteraction = 0.01 and monounsaturated fatty acids (MUFA), Pinteraction = 0.01). Among individuals with higher intakes of total fat (>47 g/d), SFA (>14 g/d), PUFA (>16 g/d) and MUFA (>16 g/d), individuals with ≥3 risk alleles had a significantly higher WC compared to those with <3 risk alleles. This is the first study of its kind in this population, suggesting that a higher consumption of dietary fatty acid may have the potential to increase the genetic susceptibility of becoming centrally obese. These results support the general dietary recommendations to decrease the intakes of total fat and SFA, to reduce the risk of obesity, particularly in individuals with a higher genetic predisposition to central obesity

Reassessing the health impacts of trade and investment agreements: a systematic review of quantitative studies, 2016–20

To ensure a high level of health protection, governments must ensure that health and trade policy objectives are aligned. We conducted a systematic review of the health impacts of trade policies, including trade and investment agreements (TIAs), to provide a timely overview of this field. We systematically reviewed studies evaluating the health impacts of trade policies published between Jan 19, 2016, and July 10, 2020. Included studies were quantitative studies evaluating the impact of TIAs and trade policies on health determinants or outcomes. We evaluated methodological quality and performed a narrative synthesis. 21 of 28 067 articles identified via searches met our criteria. Methodologically strong studies found reduced child mortality, deteriorating worker health, rising supplies of sugar, ultra-processed food, tobacco, and alcohol supplies, and increased drug overdoses following trade reforms, compared with the time periods before trade reform. However, associations varied substantially across contexts and socioeconomic characteristics. Our findings show that trade policies, including TIAs, have diverse effects on health and health determinants. These effects vary substantially across contexts and socioeconomic groups. Governments seeking to adopt healthy trade policies should consider these updated findings to ensure that opportunities for health improvement are leveraged and widely shared, while harms are avoided, especially among vulnerable groups

Moving 'out' to be 'in': the suburbanization of London Jewry, 1900-1939

This article has been accepted for publication and will appear in a revised form, subsequent to peer review and/or editorial input by Cambridge University Press, in Urban History published by Cambridge University Press. Copyright 2022.Between 1900 and 1939, Jewish Londoners departed the East End for the suburbs. Relocation, however, was not always the result of individual agency. Many Jews became the object of institutional strategies to coerce and persuade them to disperse away from inner-city areas. Simultaneous to this was the emergence of a dominant pro-suburban rhetoric within and beyond Jewish cultural circles, which aimed to raise aspirations towards middle-class lifestyles. This striking suburban ‘urge’ amongst London Jewry, managed by the community's elite institutions and leaders, was far more than a phenomenon running parallel to wider British society. As this article argues, it was a decisive response to an insidious culture of intolerance and antisemitism