Title Registration for a Systematic Review: Preventive Interventions to Reduce Youth Gang Violence in Low- and Middle-Income Countries: A Systematic Review

BACKGROUND Youth gang violence is a problem that is widespread throughout the developing world. Research suggests that over 85,000 people are members of gangs in El Salvador, Guatemala and Honduras (Seelke, 2013) and that gang activities – and particularly those of youth gangs – contribute significantly to the violent crime problem in low- and middle-income countries. The cost of violence in Latin America is estimated at approximately 14.2 per cent of GDP – almost three times the proportion of GDP reported in industrialised countries (Seelke, 2013). Gang violence makes up a significant proportion of this cost: the annual cost of violent crime in El Salvador is reported at US$ 1.7 billion, with gang violence accounting for 60 per cent (Seelke, 2013)..

Title Registration for a Systematic Review: Predictors of Youth Gang Membership in Low- and Middle-Income Countries: A Systematic Review

BACKGROUND Youth gangs are identified internationally with increased rates of delinquency and violent crime (Howell, 1997; Klein, 2002; White, 2002), including trafficking in arms, drugs and (increasingly) humans (Organisation of American States [OAS], 2007). Gang members are disproportionately involved with serious and violent offences compared to non-gang delinquent youth (Howell, 1998). This suggests that something about gang membership encourages violence over and above the correlation between having delinquent friends and a previous delinquent history (Battin, Hill, Abbott, Catalano, & Hawkins, 1998)..

The use of carer perspectives and expert consensus to define key components of a biopsychosocial support intervention for stroke carers

© 2019, © 2019 Taylor & Francis Group, LLC. Objective: To identify the key components of a biopsychosocial support intervention to improve mental wellbeing for informal stroke carers within the first year post-stroke based on the combined perspectives of experts in the field of psychological care after stroke and informal stroke carers themselves. Methods: After reviewing the existing literature a cross-sectional mixed-methods design was adopted comprising 1) focus groups with informal stroke carers about their psychological support needs, and 2) nominal group technique with academic and clinical stroke care experts to reach consensus on intervention priorities. Transcripts were thematically analyzed and combined with the ranked priorities from the nominal group to identify key components for intervention content. Results: Key themes for informal stroke carers were associated with: 1) changes in relationships, roles, and dynamics; 2) emotional impact and acceptance; 3) drawing on inner resources; 4) looking for information, solutions, and explanations; 5) support from others. The expert nominal group placed priority on eight ranked areas: 1) acknowledging “normal” emotions; 2) education about the effects of a stroke; 3) reactions to loss and adjustment; 4) recognizing signs and symptoms of not coping; 5) knowing how and when to access practical and emotional support; 6) strategies for taking care of own health; 7) dealing with difficult emotions; and 8) problem solving skills. Conclusions: Themes from the informal carer focus groups, and ranked priority areas will inform the development of a biopsychosocial support intervention for stroke carers to be tested in a feasibility randomized controlled trial

The emotional impact of screening for lung cancer

Lung cancer is the most commonly diagnosed cancer and the most common cause of cancer related death worldwide. Population-based lung cancer screening programmes have been initiated in the USA and could soon be implemented in other countries. The overarching purpose of this thesis was to explore the emotional impact of lung cancer screening. The research was conducted as part of a clinical trial that was investigating the effectiveness of a blood autoantibody test, EarlyCDT®-Lung, in identifying individuals at the risk of lung cancer. A systematic review was conducted that aimed to identify factors associated with the emotional impact of screening for lung cancer. Participants with indeterminate test results, current smokers and females were more likely to experience negative non-specific and specific emotional outcomes. In addition to highlighting several key factors associated with higher levels of emotional distress following screening, factors that warranted further research were also identified. Such factors included age, education level, marital status, ethnic origin, and perceived risk of developing lung cancer. Finally, important methodological and theoretical limitations in the literature were identified. One key methodological limitation was that no studies measured positive emotional outcomes. A longitudinal study was conducted exploring the impact of lung cancer screening on positive affect, negative affect, lung cancer worry and distress specific to screening for lung cancer. Participants from each of the EarlyCDT®-positive, EarlyCDT®-negative, and control groups completed questionnaires containing emotional outcome measures at pre-randomisation and then at one, three, six and 12 months post randomisation. Scores for each outcome measure were described by groups over time and multilevel regression modelling was used to compare scores over time within and between groups. Results were reassuring as screening was found to have no clinically important impact on positive affect, negative affect, frequency of lung cancer worry or impact of lung cancer worry on mood and ability to perform daily activities. Although screening specific distress in the EarlyCDT®-positive group was significantly higher than that of the EarlyCDT®-negative group, it did reduce over time. Statistically significant and clinically important increases in the proportion of participants reporting anxiety about the results of future tests/treatments were identified. As a result of this finding, a further study was carried out to identify factors that could influence an individual’s level of anxiety about the results of future tests/treatment. Participants more at risk of reporting anxiety about the results of future tests/treatment were younger participants, non-white participants, current smokers and participants who did not own or have a mortgage on their home. Psychological variables associated with increased anxiety were: higher general anxiety scores, higher depression scores, higher negative affect scores, participants who reported that they were upset when they thought about their risk of lung cancer, participants who were worried about getting lung cancer, and those who reported the highest impact of lung cancer worry on mood and ability to perform daily activities. The final chapter of this thesis presents the results of a randomised controlled trial embedded within the emotional outcomes study (described above), which evaluated the effect of timing of monetary incentives (£5 voucher sent with questionnaire vs. £5 voucher sent on receipt of questionnaire) on the following outcomes: study participation rates, questionnaire response rates over time, the number of reminders sent and the completeness of returned questionnaires over time. Previous research had found that monetary incentives were useful in increasing response rates in clinical trials. Results from this trial extended the evidence base by showing that the timing of monetary incentives makes no difference to the above outcomes. In each chapter the findings of this thesis are discussed in terms of their contribution to knowledge. Recommendations for future research and clinical practice are also made within each chapter

Protocol for a systematic review: community-oriented policing's impact on interpersonal violent crime in developing countries

BACKGROUND FOR THE REVIEW\ud \ud Violence is a global public health problem with complex causes at the individual, family, community and societal levels (World Health Organization [WHO], 2002a). Violence can be divided into three broad categories according to the perpetrator of the violent act: interpersonal violence; self-directed violence; and collective violence (WHO, 2002b). This review will focus specifically on the category of interpersonal violence. Worldwide, the direct impact of interpersonal violence is estimated at 1400 deaths per day (WHO, 2002b) and the economic cost is estimated to be between $95 billion and$163 billion per year (Geneva Declaration Secretariat, cited in Willman & Makisaka, 2010). For victims, mortality, physical and psychological damage, disability, and social problems are immediate and long-lasting outcomes of violence (WHO, 2002a)..

Protocol: Predictors of youth gang membership in low- and middle-income countries: a systematic review

BACKGROUND The Problem There is evidence of gang violence in low- and middle-income countries in Africa and Asia, and the prevalence of gangs is particularly well documented throughout Central and South America (Decker & Pyrooz, 2010; Gatti et al., 2011). Official estimates of gang membership in Central America estimate approximately 69,000 members, while academic estimates believe this figure to be closer to 200,000 (UNODC, 2007). Some estimates are as high as 500,000 gang members in the region including South America and the Caribbean, and gangs have been identified as “the primary threat to regional stability and security” (Muggah & Aguirre, 2013). While reporting and recording issues make it difficult to estimate rates of gang violence, the homicide rate in Colombia, Brazil, El Salvador and Guatemala are substantially higher than those of European and North American countries (Decker & Pyrooz, 2010; UNODC, 2007). Gangs are also active in South Africa, with an estimate of 100,000 members in Western Cape alone (Reckson & Becker, cited in Decker & Pyrooz, 2010); however, to date, there is limited research examining gangs in Africa and Asia..

Decision-making about HPV vaccination in parents of boys and girls:A population-based survey in England and Wales

BACKGROUND School-based HPV vaccination in the UK will soon be extended to boys. Based on other countries’ experience, uptake may initially be lower in boys than girls. We assessed HPV vaccine attitudes and decision-making in parents of boys and girls, to explore sex differences and inform public health messages. METHODS We carried out a cross-sectional population-based survey using home-based interviews in spring 2019. Participants were adults in England and Wales, with a child in school years 5–7 (aged 9–12 and eligible for HPV vaccination within 3 years). Measures included awareness of HPV and the vaccine, demographic factors, previous vaccine refusal and (after exposure to brief information) whether participants would allow their child to have the HPV vaccine (decided to vaccinate; decided not to vaccinate; undecided). We also assessed vaccine attitudes. Data were weighted to adjust for non-response. Multinomial logistic regression was used to explore predictors of deciding to (or not to) vaccinate compared with being undecided. RESULTS Among 1049 parents (weighted n = 1156), 55% were aware of HPV and the girls’ vaccination programme, but only 23% had heard of plans to vaccinate boys. After information exposure, 62% said they would vaccinate their child, 10% would not, and 28% were undecided. Parents of girls were more willing to vaccinate than parents of boys (adjusted odds ratio: 1.80 (1.32–2.45)). Positive attitudes and HPV/vaccine awareness were significantly independently associated with deciding to vaccinate. Previous vaccine refusal for a child was the strongest predictor of not wanting the HPV vaccine. CONCLUSIONS Our findings suggest a need for public health campaigns to raise awareness of plans to extend HPV vaccination to boys. Reassuringly only 10% of all parents were unwilling to vaccinate and our data suggest further information, including about safety and efficacy, may be important in supporting undecided parents to make the decision to vaccinate

Factors influencing the decision to attend screening for cancer in the UK: a meta-ethnography of qualitative research

Background: This review aimed to better understand experiences of being invited to cancer screening and associated decision-making. Methods: Qualitative evidence explaining UK cancer screening attendance decisions was systematically identified. Data were extracted and meta-ethnography used to identify shared themes, synthesise findings and generate higher level interpretations. Results: Thirty four studies met inclusion criteria. They related to uptake of breast, cervical, colorectal, prostate, ovarian and lung cancer screening. Three primary themes emerged from the synthesis. Relationships with the health service shaped decisions, influenced by trust, compliance with power, resistance to control or surveillance, and perceived failures to meet cultural, religious and language needs. Fear of cancer screening was both a motivator and barrier in different ways and to varying degrees. Strategies to negotiate moderate fear levels were evident. Experiences of risk included the creation of alternative personal risk discourses and the use of screening as a coping strategy, influenced by disease beliefs and feelings of health and wellness. Conclusions: The findings highlight the importance of the provider-patient relationship in screening uptake and enrich our understanding of how fear and risk are experienced and negotiated. This knowledge can help promote uptake and improve the effectiveness of cancer screening