114 research outputs found
Tailoring immunisation programmes: Using behavioural insights to identify barriers and enablers to childhood immunisations in a Jewish community in London, UK.
: Due to regular vaccine preventable disease outbreaks and sub-optimal immunisation uptake in the London borough of Hackney, home to the largest Charedi Orthodox Jewish community in Europe, it was decided, in consultation with the community, to implement the WHO Tailoring Immunization Programmes approach (TIP). : The WHO Tailoring Immunization Programmes (TIP) approach was used. TIP provides a framework based on behavioural insights methodology to identify populations susceptible to vaccine preventable diseases, diagnose supply and demand side barriers and enablers to vaccination and recommend evidence-informed responses to improve vaccination coverage. : The results of the formative research and behavioural analysis challenged the assumption that a cultural or religious anti-vaccination sentiment existed within the community. Critical issues related to access to and convenience of immunisation services. Service providers in the area have challenges due to having to deliver immunisation services to the large numbers of children without additional resource. Where mothers were choosing to delay or refuse vaccinations their reasons were broadly similar to the wider population. The behavioural analysis identified potential categorisation of subgroups within the community enabling a more tailored approach to addressing concerns and meeting parents' needs. : The TIP approach was an effective way of investigating factors linked to sub-optimal immunisation within the Charedi community. The use of behavioural insights enabled the categorisation of subgroups so that more targeted interventions could be developed. The comprehensive stakeholder engagement which is a key pillar of the TIP approach ensured a deeper understanding of the barriers and enablers to vaccination as well as increasing the level of ownership in the community. TIP should be considered as a useful approach to identify main facilitators and barriers to vaccination in communities with suboptimal immunisation uptake.<br/
First measurement of kaonic helium-3 X-rays
The first observation of the kaonic 3He 3d - 2p transition was made using
slow K- mesons stopped in a gaseous 3He target. The kaonic atom X-rays were
detected with large-area silicon drift detectors using the timing information
of the K+K- pairs of phi-meson decays produced by the DAFNE e+e- collider. The
strong interaction shift of the kaonic 3He 2p state was determined to be -2+-2
(stat)+-4 (syst) eV.Comment: Accepted for publication in Phys. Lett.
Comorbidades fĂsicas e psicolĂłgicas antes e depois da cirurgia bariĂĄtrica : um estudo longitudinal
Introduction: Morbid obesity has multiple implications for
psychological and physical health. Bariatric surgery has been
selected as the treatment of choice for this chronic disease,
despite the controversial impact of the surgery on psychosocial
health. The objective of this study was to describe candidates
for bariatric surgery and analyze changes in weight, psychopathology,
personality, and health problems and complaints at
6- and 12- month follow-up assessments.
Methods: Thirty obese patients (20 women and 10 men) with a
mean age of 39.17±8.81 years were evaluated in different dimensions
before surgery and 6 and 12 months after the procedure.
Results: Six and 12 months after bariatric surgery, patients
reported significant weight loss and a significant reduction in
the number of health problems and complaints. The rates of
self-reported psychopathology were low before surgery, and
there were no statistically significant changes over time. The
conscientiousness, extraversion, and agreeableness dimensions
increased, but neuroticism and openness remained unchanged.
All changes had a medium effect size.
Conclusions: Our results suggest that patients experience
significant health improvements and some positive personality
changes after bariatric surgery. Even though these findings
underscore the role of bariatric surgery as a relevant treatment
for morbid obesity, more in-depth longitudinal studies
are needed to elucidate the evolution of patients after the
procedure.Introdução: A obesidade mórbida tem vårias implicaçÔes para
a saĂșde psicolĂłgica e fĂsica. A cirurgia bariĂĄtrica tem sido o
tratamento de escolha para essa doença crÎnica, apesar da
controvĂ©rsia sobre o impacto da cirurgia na saĂșde psicossocial.
O objetivo deste estudo foi descrever candidatos a cirurgia bariåtrica e analisar mudanças no peso, psicopatologia personalidade,
problemas e queixas de saĂșde desses pacientes em avaliaçÔes
realizadas 6 e 12 meses apĂłs a cirurgia.
MĂ©todos: Trinta pacientes obesos (20 mulheres e 10 homens)
com idade média de 39,17±8,81 anos foram avaliados em diferentes
dimensÔes antes da cirurgia e 6 e 12 meses após.
Resultados: Aos 6 e 12 meses apĂłs a cirurgia bariĂĄtrica, os
pacientes relataram significativa perda de peso e significativa
redução no nĂșmero de problemas e queixas de saĂșde. As taxas
de psicopatologia autorrelatada foram baixas antes da cirurgia e
não sofreram mudanças significativas com o tempo. As dimensÔes
conscienciosidade, extroversĂŁo e agradabilidade aumentaram,
mas o neuroticismo e a abertura permaneceram inalteradas.
Todas as mudanças apresentaram um tamanho de efeito médio.
ConclusÔes: Os nossos resultados sugerem que os pacientes
experimentam melhoras significativas em saĂșde e algumas mudanças
positivas de personalidade apĂłs a cirurgia bariĂĄtrica.
Embora esses achados reforcem o papel da cirurgia bariĂĄtrica
como um tratamento relevante para a obesidade mĂłrbida, mais
estudos longitudinais e aprofundados sĂŁo necessĂĄrios para elucidar
a evolução dos pacientes após a realização do procedimento.(undefined
Measurements of the strong-interaction widths of the kaonic 3He and 4He 2p levels
The kaonic 3He and 4He X-rays emitted in the 3d-2p transitions were measured
in the SIDDHARTA experiment. The widths of the kaonic 3He and 4He 2p states
were determined to be Gamma_2p(3He) = 6 \pm 6 (stat.) \pm 7 (syst.) eV, and
Gamma_2p(4He) = 14 \pm 8 (stat.) \pm 5 (syst.) eV, respectively. Both results
are consistent with the theoretical predictions. The width of kaonic 4He is
much smaller than the value of 55 \pm 34 eV determined by the experiments
performed in the 70's and 80's, while the width of kaonic 3He was determined
for the first time.Comment: Accepted in Phys. Lett.
Catch-up growth follows an abnormal pattern in experimental renal insufficiency and growth hormone treatment normalizes it
The primary goal of this study was to determine if the ability to undergo catch-up growth following a transient injury is preserved in an experimental model of moderate chronic renal failure (CRF) and the effect of growth hormone (GH) administration on such phenomenon. Young rats were subtotally nephrectomized (days 0 and 4) (Nx). From days 11 to 13, food intake was restricted in subgroups of Nx and control (C) rats (NxR and CR). After refeeding, subgroups of NxR and CR rats received GH from days 14 to 20 (NxRGH and CRGH). Rats were killed on days 14 (C, CR, Nx, NxR), 17 and 21 (C, CR, CRGH, Nx, NxR, NxRGH), and 36 (C, CR, Nx, NxR). Longitudinal growth rate was measured by osseous front advance in the proximal tibiae. With refeeding, growth rate of CR, NxR, and NXrGH rats became significantly greater than that of C, indicating catch-up growth. This occurred later and with lower growth rate in NxR than in CR rats, whereas the characteristics of catch-up growth in CR and NxRGH animals were similar. Changes in growth rate were associated with modifications in the morphology and proliferative activity of growth cartilage. We conclude that catch-up growth occurs in renal insufficiency but follows a different pattern from that observed with normal renal function. GH treatment normalizes the pattern of catch-up growth in CRF. Changes in growth velocity are associated to modifications in the structure and dynamics of growth cartilage
Volunteer Bias in Recruitment, Retention, and Blood Sample Donation in a Randomised Controlled Trial Involving Mothers and Their Children at Six Months and Two Years: A Longitudinal Analysis
BACKGROUND: The vulnerability of clinical trials to volunteer bias is under-reported. Volunteer bias is systematic error due to differences between those who choose to participate in studies and those who do not. METHODS AND RESULTS: This paper extends the applications of the concept of volunteer bias by using data from a trial of probiotic supplementation for childhood atopy in healthy dyads to explore 1) differences between a) trial participants and aggregated data from publicly available databases b) participants and non-participants as the trial progressed 2) impact on trial findings of weighting data according to deprivation (Townsend) fifths in the sample and target populations. 1) a) Recruits (nâ=â454) were less deprived than the target population, matched for area of residence and delivery dates (nâ=â6,893) (mean [SD] deprivation scores 0.09[4.21] and 0.79[4.08], tâ=â3.44, dfâ=â511, p<0.001). b) i) As the trial progressed, representation of the most deprived decreased. These participants and smokers were less likely to be retained at 6 months (nâ=â430[95%]) (OR 0.29,0.13-0.67 and 0.20,0.09-0.46), and 2 years (nâ=â380[84%]) (aOR 0.68,0.50-0.93 and 0.55,0.28-1.09), and consent to infant blood sample donation (nâ=â220[48%]) (aOR 0.72,0.57-0.92 and 0.43,0.22-0.83). ii) Mothers interested in probiotics or research or reporting infants' adverse events or rashes were more likely to attend research clinics and consent to skin-prick testing. Mothers participating to help children were more likely to consent to infant blood sample donation. 2) In one trial outcome, atopic eczema, the intervention had a positive effect only in the over-represented, least deprived group. Here, data weighting attenuated risk reduction from 6.9%(0.9-13.1%) to 4.6%(-1.4-+10.5%), and OR from 0.40(0.18-0.91) to 0.56(0.26-1.21). Other findings were unchanged. CONCLUSIONS: Potential for volunteer bias intensified during the trial, due to non-participation of the most deprived and smokers. However, these were not the only predictors of non-participation. Data weighting quantified volunteer bias and modified one important trial outcome. TRIAL REGISTRATION: This randomised, double blind, parallel group, placebo controlled trial is registered with the International Standard Randomised Controlled Trials Register, Number (ISRCTN) 26287422. Registered title: Probiotics in the prevention of atopy in infants and children
âEveryday borderingâ in England, Sweden and Bulgaria: Social work decision-making processes when working with migrant family members
The global movement of people is a growing feature of contemporary life, and it is essential that professionals providing support services know how to best engage with migrant families. However, despite globalisation and the related processes of de-bordering, borders continue to remain significant and, in contemporary life, the ways in which immigration is controlled and surveilledâbureaucratically and symbolicallyâare multiple. The paper draws on data gathered in the immediate period following the so called 2015 European âmigration crisisâ and examines whether and in what ways social workers in three European countriesâBulgaria, Sweden and Englandâenact bordering in their work with migrant family members. We apply the concept of âeveryday borderingâ to the data set: whilst borders are traditionally physical and at the boundary between nation states, bordering practices increasingly permeate everyday life in bureaucratic and symbolic forms. Overall, the data show that everyday bordering affects social work practice in three ways: by social workers being required to engage in bordering as an everyday practice; by producing conditions that require social workers to negotiate borders; and in revealing aspects of symbolic everyday bordering. Our analyses shows that âeveryday borderingâ practices are present in social work decision-making processes in each country, but the forms they take vary across contexts. Analysis also indicates that, in each country, social workers recognise the ways in which immigration control can impact on the families with whom they work but that they can also inadvertently contribute to the âotheringâ of migrant populations
Identifying the participant characteristics that predict recruitment and retention of participants to randomised controlled trials involving children : a systematic review
Background
Randomised controlled trials (RCTs) are recommended as the âgold standardâ in evaluating health care interventions. The conduct of RCTs is often impacted by difficulties surrounding recruitment and retention of participants in both adult and child populations. Factors influencing recruitment and retention of children to RCTs can be more complex than in adults. There is little synthesised evidence of what influences participation in research involving parents and children.
Aim
To identify predictors of recruitment and retention in RCTs involving children.
Methods
A systematic review of RCTs was conducted to synthesise the available evidence. An electronic search strategy was applied to four databases and restricted to English language publications. Quantitative studies reporting participant predictors of recruitment and retention in RCTs involving children aged 0â12 were identified. Data was extracted and synthesised narratively. Quality assessment of articles was conducted using a structured tool developed from two existing quality evaluation checklists.
Results
Twenty-eight studies were included in the review. Of the 154 participant factors reported, 66 were found to be significant predictors of recruitment and retention in at least one study. These were classified as parent, child, family and neighbourhood characteristics. Parent characteristics (e.g. ethnicity, age, education, socioeconomic status (SES)) were the most commonly reported predictors of participation for both recruitment and retention. Being young, less educated, of an ethnic minority and having low SES appear to be barriers to participation in RCTs although there was little agreement between studies. When analysed according to setting and severity of the childâs illness there appeared to be little variation between groups. The quality of the studies varied. Articles adhered well to reporting guidelines around provision of a scientific rationale for the study and background information as well as displaying good internal consistency of results. However, few studies discussed the external validity of the results or provided recommendations for future research.
Conclusion
Parent characteristics may predict participation of children and their families to RCTs; however, there was a lack of consensus. Whilst sociodemographic variables may be useful in identifying which groups are least likely to participate they do not provide insight into the processes and barriers to participation for children and families. Further studies that explore variables that can be influenced are warranted. Reporting of studies in this field need greater clarity as well as agreed definitions of what is meant by retention
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