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Adams SN. The Unmasking of Autism in South Africa and Nigeria. Neuropsychiatr Dis Treat 2024; 20:947-955. [PMID: 38737770 PMCID: PMC11088825 DOI: 10.2147/ndt.s461650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024] Open
Abstract
This review is of interest to researchers, policymakers, and healthcare professionals working in the field of autism in Africa. The review aims to describe autism in sub-Saharan Africa, focusing on South Africa and Nigeria regarding prevalence, incidence, identification, treatment, and attitudes towards autistic children. There are several challenges, such as lack of awareness, limited access to professional support and diagnostic tools, and cultural considerations in establishing the autism prevalence in the African region compared to other parts of the world. Additionally, South Africans and Nigerians exhibit diverse perspectives and attitudes that significantly influence the provision of treatment, including stigma and misconceptions held by healthcare professionals themselves. As a result, it is difficult to determine prevalence in South Africa and Nigeria. However, research has indicated that autism prevalence is rising globally, and in these contexts. Rising prevalence highlights the need to increase access to services, rehabilitation, and provide support to families of children with autism. Furthermore, research has emphasized the inequitable support and access available to families living in low-and high-income households and the need to provide contextually relevant and responsive interventions, education and training, research and policy in these countries.
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Affiliation(s)
- Skye Nandi Adams
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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Duale HA, Gele A. Exploring knowledge of autism, its causes and treatment among immigrant and nonimmigrant parents in Somalia\Somaliland. Child Adolesc Psychiatry Ment Health 2024; 18:22. [PMID: 38326911 PMCID: PMC10851585 DOI: 10.1186/s13034-024-00713-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The prevalence of autism spectrum disorders (ASDs) has increased over the recent years; however, little is known about the experience of parents of children with autism in Africa such as Somalia. The aim of this study is to understand the knowledge on autism of Somali parents of children with autism and their perceptions of causes and treatment of ASD. METHODS We conducted a qualitative study involving 22 parents of children with autism who lived in Mogadishu and Hargeisa; the two largest cities in Somalia. In-depth interviews were used to collect the data. Of the 22 participants, 9 were returned immigrants and 13 were local people (non-immigrants). Data were analysed using thematic analysis. RESULTS The data revealed that most of the parents hold the belief that their children's autism were caused by the measles vaccine. The findings demonstrated that parents sought diagnosis and treatment care from outside Somalia due to the lack of experience of health providers in the diagnosis and treatment of autism. The data also revealed a lack of knowledge about autism among the public with resultant stigma and discrimination against children with autism and their families. CONCLUSIONS Efforts to increase public knowledge on autism, its causes and treatments are of paramount importance, while a public health campaign designed to eliminate the stigma subjected to children with autism is necessary to improve the quality of life of children with autism and their caregivers. Finally, to counteract vaccine hesitancy, particularly in response to the measles vaccine, health policy makers should take steps to separate the cooccurrence of the onset of autism symptoms and the provision of the measles vaccine.
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Affiliation(s)
- Hodan A Duale
- Department of Maternal and Child Health, Somali Institute for Health Research (SIHR), Hargeisa, Somaliland.
| | - Abdi Gele
- Department of Maternal and Child Health, Somali Institute for Health Research (SIHR), Hargeisa, Somaliland.
- Department of Health Service Research, Norwegian Institute of Public Health, Skøyen, 222, 0213, Oslo, Norway.
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Casale LM, Gentles SJ, McLaughlin J, Schneider M. Service access experiences of immigrant and refugee caregivers of autistic children in Canada: A scoping review. PLoS One 2023; 18:e0293656. [PMID: 37943852 PMCID: PMC10635503 DOI: 10.1371/journal.pone.0293656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
Primary caregivers are the main mediators of care for children with an autism diagnosis in Canada, and the navigation process to gain access to autism-related services is known to be a major burden. These challenges to service access are compounded for newcomers to Canada, which include immigrants and refugees. The purpose of this scoping review is to describe the available research on Canadian newcomer caregiver experiences navigating and accessing autism-related services. After a systematic search and screening process, 28 studies were included. Data were extracted regarding the populations, study aims, and themes reported. Included studies characterized barriers and facilitators to service access and navigation specific to immigrants, while limited information was available for refugees. Based on the existing literature, the authors provide recommendations for possible research approaches, populations to include, and themes to examine in future research to promote health equity in Canadian autism service access.
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Affiliation(s)
- Lina Marie Casale
- Department of Health Studies, Faculty of Human and Social Sciences, Laurier Autism Research Consortium, Wilfrid Laurier University, Brantford, ON, Canada
| | - Stephen J. Gentles
- Department of Health Studies, Faculty of Human and Social Sciences, Wilfrid Laurier University, Brantford, ON, Canada
| | - Janet McLaughlin
- Department of Health Studies, Faculty of Human and Social Sciences, Co-Director, Laurier Autism Research Consortium, Wilfrid Laurier University, Brantford, Ontario, Canada
| | - Margaret Schneider
- Department of Kinesiology and Physical Education, Faculty of Science, Co-Director, Laurier Autism Research Consortium, Wilfrid Laurier University, Waterloo, Ontario, Canada
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Amirova A, Rakhymbayeva N, Zhanatkyzy A, Telisheva Z, Sandygulova A. Effects of Parental Involvement in Robot-Assisted Autism Therapy. J Autism Dev Disord 2023; 53:438-455. [PMID: 35088233 PMCID: PMC9889445 DOI: 10.1007/s10803-022-05429-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 02/04/2023]
Abstract
Parental involvement in traditional autism therapy is key to the effective treatment of children with ASD. Little is known about parental involvement in robot-assisted autism therapy (RAAT)-novel therapeutic support for children with ASD. Our study investigates the effect of parental presence on multiple-session RAAT conducted with 16 children with ASD. They interacted with the social robot in the presence or absence of their parents. We measured children's socio-behavioral outcomes and conducted semi-structured interviews with parents. Parents did not necessarily affect the children's outcomes during the interventions. However, children's autism-related symptoms resulted in different socio-behavioral outcomes between sessions with and without parents. Most parents have reported positive changes in their children's behaviors when interacting with the robot.
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Affiliation(s)
- Aida Amirova
- Graduate School of Education, Nazarbayev University, Kabanbay Batyr Avenue, 53, Nur-Sultan, 010000 Kazakhstan
| | - Nazerke Rakhymbayeva
- Department of Robotics and Mechatronics, School of Engineering and Digital Sciences, Nazarbayev University, Kabanbay Batyr Avenue, 53, Nur-Sultan, 010000 Kazakhstan
| | - Aida Zhanatkyzy
- Department of Robotics and Mechatronics, School of Engineering and Digital Sciences, Nazarbayev University, Kabanbay Batyr Avenue, 53, Nur-Sultan, 010000 Kazakhstan
| | - Zhansaule Telisheva
- Department of Robotics and Mechatronics, School of Engineering and Digital Sciences, Nazarbayev University, Kabanbay Batyr Avenue, 53, Nur-Sultan, 010000 Kazakhstan
| | - Anara Sandygulova
- Department of Robotics and Mechatronics, School of Engineering and Digital Sciences, Nazarbayev University, Kabanbay Batyr Avenue, 53, Nur-Sultan, 010000 Kazakhstan
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5
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Herzig van Wees S, Dini S. The silent shot: An analysis of the origin, sustenance and implications of the MMR vaccine - autism rumour in the Somali diaspora in Sweden and beyond. Glob Public Health 2023; 18:2257771. [PMID: 37750434 DOI: 10.1080/17441692.2023.2257771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/06/2023] [Indexed: 09/27/2023]
Abstract
This article traces the origin, sustenance and implications of a persistent rumour that is responsible for low measles mumps and rubella (MMR) vaccination uptake in the Somali diaspora in a number of countries across the globe. The rumour stipulates that the MMR vaccine - the silent shot - causes autism spectrum disorder (ASD). Although the association between MMR and ASD is non-causal, and various public health initiatives have promoted health information campaigns, the rumour continues to circulate in the Somali diaspora in many countries, including Sweden. This paper shows that there are valid reasons for this. The findings from this paper draw on a systematic scoping review and qualitative interview data from Sweden. The results show that the Somali community experiences higher than average rates of ASD compared to the general population. Moreover, ASD does not exist in the Somali language or their home country, is considered a Western disease that only affects Somali children in the diaspora, and is a highly stigmatised disease. Also, the Somali diaspora has had negative experiences with ASD diagnosis and care. The rumour has been sustained by the absence of an answer to their ASD fear and through active diaspora networks on social media. The network that surrounds the rumour has arguably further helped to create an epistemic community for a community whose concerns have been silenced.
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Affiliation(s)
| | - Samira Dini
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
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Outram SM, Brown J, Ackerman SL. The social value of genomic sequencing for disadvantaged families facing rare disease. Soc Sci Med 2022; 314:115465. [PMID: 36279794 DOI: 10.1016/j.socscimed.2022.115465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
This study explores parental expectations and value-making processes in respect to pediatric clinical genomic sequencing for socially disadvantaged families. Drawing on interviews and ethnographic observations with parents of children with undiagnosed physical and/or intellectual differences seeking to find whether these differences have a genetic etiology, we explore expectations and parental assessments of the value of genomic sequencing within the context of an ongoing research study. We demonstrate how the value of sequencing to parents goes well beyond finding diagnostic results or receiving prescriptive guidance as to the best care and treatment of their child; instead, value is co-created by parents, clinicians, and genetic counsellors throughout the enrollment and return of results process. Parents in our study found that clinicians and genetic counsellors repeatedly reenforce that parents need to lower their expectations and be prepared to wait for genetic science to provide more definitive answers. At the same time, parents experience that clinical teams validate parents for having made a good choice in their undertaking of genomic sequencing and, no matter the result, that they are not to blame for their child's symptoms. The experience of many parents (although not all) is that genomic science reduces or removes their sense of guilt for their child's condition, providing a platform that affirms them as "good parents." Moreover, rather than being voiceless and isolated, socially disadvantaged parents who enter into diagnostic sequencing find themselves in a familial-biosocial framework wherein they are co-partners in a socially and biologically authoritative vision of the future.
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Affiliation(s)
- S M Outram
- Program in Bioethics, Institute for Health & Aging, University of California, San Francisco, CA, USA.
| | - Jeh Brown
- Program in Bioethics, Institute for Health & Aging, University of California, San Francisco, CA, USA
| | - S L Ackerman
- Department of Social & Behavioral Sciences, University of California, San Francisco, CA, USA
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Maccaro A, Piaggio D, Vignigbé M, Stingl A, Pecchia L. COVID-19 preparedness and social dynamics in a Sub-Saharan Africa country, Benin. Health Promot Int 2022; 37:6674369. [PMID: 36000532 PMCID: PMC9400093 DOI: 10.1093/heapro/daac105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This project aims to assess and analyse the perception and impact of the COVID-19 pandemic in Benin. The applied research methodology was interdisciplinary and combined field studies that used ethnographic and social research methods with coding and data analysis, leading to theoretical dilemmas, which were analysed from the viewpoint of bioethical reflection. Furthermore, biomedical engineering approaches were used to assess the preparedness to COVID-19. Despite the preparedness to COVID-19 due to the promoted governmental measures, a peculiar management of the pandemic emerged. The latter, although noteworthy, did not overcome the typical challenges of medical locations in low-resource settings. This, together with the controversial spread of information and local beliefs, caused significant economic and social consequences, exceeding the benefits related to the containment of the virus. This research highlights how the emotion of fear, in this specific situation, was herald of dramatic consequences, rather than having a heuristic and empowering effect.
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Affiliation(s)
- Alessia Maccaro
- School of Engineering, University of Warwick, Library Road, CV47AL Coventry, UK.,Institute of Advanced Studies, University of Warwick, Library Road, CV47AL Coventry, UK
| | - Davide Piaggio
- School of Engineering, University of Warwick, Library Road, CV47AL Coventry, UK
| | - Marius Vignigbé
- Département de Sociologie-Anthropologie, University of Abomey-Calavi, Abomey-Calavi, Benin
| | - Alexander Stingl
- Institute of Advanced Studies, University of Warwick, Library Road, CV47AL Coventry, UK
| | - Leandro Pecchia
- School of Engineering, University of Warwick, Library Road, CV47AL Coventry, UK.,School of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, Roma, Italy
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8
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Diemer MC, Gerstein ED, Regester A. Autism presentation in female and Black populations: Examining the roles of identity, theory, and systemic inequalities. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1931-1946. [PMID: 35899909 DOI: 10.1177/13623613221113501] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Although the prevalence of autism has been rising in recent years, disparities in diagnosis still remain. Female and Black populations in the United States are diagnosed later, are more likely to have an intellectual disability, and are excluded from research as well as services designed for autistic individuals. Autistic Black girls are effectively invisible in the current scientific literature. Intersectional theory, which looks at a person as a whole, examines models that are inclusive toward diverse gender, ability, and racial/ethnic backgrounds. This theory may be a useful approach to clinical and research work with autism so that practitioners may be most effective for the whole population of autistic people. The authors recommend research focusing on inclusion of autistic populations with intellectual disability and research studies that include evaluations as part of the procedure. Clinically, the authors recommend a focus on screening all young children for autism and improving provider knowledge in working with diverse autistic populations.
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Streuli S, Lewis T. Shifting Priorities and Neoliberal Ideologies in Refugee Health Intervention Design in the US. Med Anthropol 2022; 41:488-502. [PMID: 35394891 DOI: 10.1080/01459740.2022.2053965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We discuss the design of a technology-based vaccine education intervention for Somali refugees in the US. Originally conceived of as a culturally and linguistically appropriate project to be co-designed by refugees, funder demands for a "social enterprise" led to future iterations being developed for a "generic" audience. We explore epistemological negotiations and shifting priorities that shaped intervention design, highlighting how nonprofits engage neoliberal ideologies such as "social enterprise" and "design thinking" while attempting to meet community needs. We argue that social enterprises and design thinking can suffuse neoliberal ideologies into nonprofits to the detriment of community-engaged solutions.
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Affiliation(s)
- Samantha Streuli
- Department of Anthropology, University of California San Diego, La Jolla, California, USA
| | - Trinity Lewis
- Department of Anthropology, University of California San Diego, La Jolla, California, USA
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10
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Streuli S, Ibrahim N, Mohamed A, Sharma M, Esmailian M, Sezan I, Farrell C, Sawyer M, Meyer D, El-Maleh K, Thamman R, Marchetti A, Lincoln A, Courchesne E, Sahid A, Bhavnani SP. Development of a culturally and linguistically sensitive virtual reality educational platform to improve vaccine acceptance within a refugee population: the SHIFA community engagement-public health innovation programme. BMJ Open 2021; 11:e051184. [PMID: 34521673 PMCID: PMC8442061 DOI: 10.1136/bmjopen-2021-051184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To combat misinformation, engender trust and increase health literacy, we developed a culturally and linguistically appropriate virtual reality (VR) vaccination education platform using community-engaged approaches within a Somali refugee community. DESIGN Community-based participatory research (CBPR) methods including focus group discussions, interviews, and surveys were conducted with Somali community members and expert advisors to design the educational content. Co-design approaches with community input were employed in a phased approach to develop the VR storyline. PARTICIPANTS 60 adult Somali refugees and seven expert advisors who specialise in healthcare, autism research, technology development and community engagement. SETTING Somali refugees participated at the offices of a community-based organisation, Somali Family Service, in San Diego, California and online. Expert advisors responded to surveys virtually. RESULTS We find that a CBPR approach can be effectively used for the co-design of a VR educational programme. Additionally, cultural and linguistic sensitivities can be incorporated within a VR educational programme and are essential factors for effective community engagement. Finally, effective VR utilisation requires flexibility so that it can be used among community members with varying levels of health and technology literacy. CONCLUSION We describe using community co-design to create a culturally and linguistically sensitive VR experience promoting vaccination within a refugee community. Our approach to VR development incorporated community members at each step of the process. Our methodology is potentially applicable to other populations where cultural sensitivities and language are common health education barriers.
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Affiliation(s)
- Samantha Streuli
- Department of Anthropology, University of California San Diego, La Jolla, California, USA
| | - Najla Ibrahim
- Department of Health and Wellness, Somali Family Service of San Diego, San Diego, CA, USA
| | - Alia Mohamed
- Department of Biology, San Diego State University, San Diego, CA, USA
| | - Manupriya Sharma
- Department of Physics and Engineering, Palomar College, San Marcos, California, USA
| | | | | | - Carrie Farrell
- School of Public Affairs, San Diego State University, San Diego, California, USA
| | - Mark Sawyer
- Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Dan Meyer
- Department of Cardiovascular & Thoracic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Ritu Thamman
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alex Marchetti
- Farmer School of Business, Miami University, Oxford, Ohio, USA
| | - Alan Lincoln
- Deparment of Clinical Psychology, Alliant International University-San Diego, San Diego, California, USA
| | - Eric Courchesne
- Department of Neurosciences, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Ahmed Sahid
- Somali Family Service of San Diego, San Diego, California, USA
| | - Sanjeev P Bhavnani
- Healthcare Innovation and Practice Transformation Laboratory, Scripps Clinic La Jolla-Genesee Executive Plaza, San Diego, California, USA
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11
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Tan CD. Defending 'snake oil': The preservation of contentious knowledge and practices. SOCIAL STUDIES OF SCIENCE 2021; 51:538-563. [PMID: 33618580 DOI: 10.1177/0306312721992543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
How does belief in controversial ideas persist? I study a community of parents and practitioners who contend that autism spectrum disorder is caused by harmful environmental exposures - notably, early childhood vaccinations - and that there are worthwhile alternative or experimental treatments. Despite objections from dominant experts, these actors maintain their disputed ideas. This study identifies a set of strategies that help maintain internal legitimacy. In particular, actors protect internal legitimacy through professional alignment and contrastive boundary work. Professional alignment mobilizes resemblances to conventional counterparts (i.e. mainstream doctors) to defend unorthodox practices. Meanwhile, contrastive boundary-work performances convey the defining values and strengths that actors associate with their knowledge community and concomitantly, the weaknesses they ascribe to competing groups. Through these activities, actors respond to perceived threats and construct a distinct group identity anchored in shared knowledge, ways of knowing and practice.
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12
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Li L. Deconstructing and Historicizing Access to Medicines: The Changing Priority of Pharmaceutical Governance in China. FRONTIERS IN SOCIOLOGY 2021; 5:537919. [PMID: 33869483 PMCID: PMC8022468 DOI: 10.3389/fsoc.2020.537919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
Securing access to medicines (ATM) is critical for improving public health outcomes. Existing research has long identified and analyzed various barriers that may impede ATM at the global, national, or local levels. However, it tends to adopt a normative perspective to prescribe what infrastructures, resources, and measures should be put in place to improve ATM. Little scholarship has explored how and why countries may prioritize certain dimensions of ATM over others in pharmaceutical governance within specific historical contexts. This article fills that gap by deconstructing and historicizing the concept of ATM. The author aims to make two arguments. First, tensions easily arise between different dimensions of ATM, and prioritizing certain dimensions in pharmaceutical policy may impede improvements in others (e.g., availability vs. affordability). Second, which dimension(s) of ATM might be prioritized in the state's pharmaceutical policy hinges upon social, economic, and political forces. To substantiate these arguments, the author draws on interview and archival evidence from China. Specifically, the author provides a historical account of how and why the priorities of pharmaceutical governance in China changed over time: 1) 1949-late 1970s: pursuing both drug availability and affordability through socialist planning; 2) early 1980s-2015: priority shifting from availability (before the mid-1990s) to affordability (after the mid-1990s); 3) 2015-present: striving for a rebalance between drug availability and affordability.
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Rodgers CC. Continuous electronic fetal monitoring during prolonged labor may be a risk factor for having a child diagnosed with autism spectrum disorder. Med Hypotheses 2020; 145:110339. [PMID: 33126162 DOI: 10.1016/j.mehy.2020.110339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/23/2020] [Accepted: 10/05/2020] [Indexed: 11/16/2022]
Abstract
In just 50 years the prevalence of autism spectrum disorder has vaulted from extremely rare to common in every community. During this time, a large body of scientific literature has been amassed regarding what environmental, genetic, maternal, or obstetric factors may be at work. The hypothesis presented here identifies two developments in today's childbirth experience that, in combination, may provide the key: 1) a significant increase in the mean duration of labor and 2) the adoption of continuous electronic fetal monitoring utilizing Doppler ultrasound as the standard of care even in low-risk pregnancies. Together, these two factors have created an unprecedented fetal environment that has the potential to affect neuronal migration and cause non-inherited genetic disruptions. This paper will briefly describe the nature and history of contributing factors, why there may be a link between evolving maternal characteristics, obstetric trends and the increase in autism, as well as the means by which the hypothesis can be tested.
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González-Agüero M, Vargas I, Campos S, Farías Cancino A, Quezada Quezada C, Urrutia Egaña M. What makes a health movement successful? Health inequalities and the insulin pump in Chile. CRITICAL PUBLIC HEALTH 2020. [DOI: 10.1080/09581596.2020.1808190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Ivonne Vargas
- School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Solange Campos
- School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile
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15
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de Leeuw A, Happé F, Hoekstra RA. A Conceptual Framework for Understanding the Cultural and Contextual Factors on Autism Across the Globe. Autism Res 2020; 13:1029-1050. [PMID: 32083402 PMCID: PMC7614360 DOI: 10.1002/aur.2276] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 01/02/2020] [Accepted: 01/24/2020] [Indexed: 12/14/2022]
Abstract
Autism research is heavily skewed toward western high-income countries. Culturally appropriate screening and diagnostic instruments for autism are lacking in most low- and middle-income settings where the majority of the global autism population lives. To date, a clear overview of the possible cultural and contextual factors that may affect the process of identifying and diagnosing individuals with autism spectrum disorders (ASD) is missing. This study aims to outline these factors by proposing a conceptual framework. A multidisciplinary review approach was applied to inform the development of the conceptual framework, combining a systematic review of the relevant autism research literature with a wider literature search spanning key texts in global mental health, cultural psychiatry, cross-cultural psychology, and intellectual disability research. The resulting conceptual framework considers the identification, help-seeking, and diagnostic process at four interrelated levels: (a) the expression; (b) recognition; (c) interpretation; and (d) reporting of autism symptoms, and describes the cultural and contextual factors associated with each of these levels, including cultural norms of typical and atypical behavior, culture-specific approaches to parenting, mental health literacy, cultural beliefs, attitudes and stigma, as well as the affordability, availability, accessibility, and acceptability of services. This framework, mapping out the cultural and contextual factors that can affect the identification, help-seeking, and diagnosis of ASD may function as a springboard for the development of culturally appropriate autism screening and diagnostic instruments, and inform future cross-cultural autism research directions. The framework also has relevance for clinicians and policy makers aiming to improve support for underserved autism populations worldwide. Autism Res 2020, 13: 1029-1050. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The vast majority of autism research is conducted in western high-income settings. We therefore know relatively little of how culture and context can affect the identification, help-seeking, and diagnosis of autism across the globe. This study synthesizes what is known from the autism research literature and a broader literature and maps out how culture and context may affect (a) the expression, (b) recognition, (c) interpretation, and (d) reporting of autism symptoms.
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Affiliation(s)
- Anne de Leeuw
- Amsterdam University Medical Centre, location VUmc, Amsterdam, The Netherlands
| | - Francesca Happé
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Rosa A Hoekstra
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
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Papoudi D, Jørgensen CR, Guldberg K, Meadan H. Perceptions, Experiences, and Needs of Parents of Culturally and Linguistically Diverse Children with Autism: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00210-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AbstractA scoping review of studies carried out in the UK and the USA was conducted to explore the perceptions, experiences, and needs of culturally and linguistically diverse families of children with autism. Overall, 32 articles met the inclusion criteria, 25 studies were conducted in the USA and 7 studies in the UK. Four themes emerged including (a) knowledge and beliefs about autism and their impact on the family; (b) autism and family life; (c) family experiences of accessing services and support, and parents’ needs; and (d) multilanguage. Findings highlighted that family perceptions of autism are influenced by an often-reported lack of knowledge; experiences include social stigma as well as difficulties in having access to services. Needs indicate the development of culturally sensitive interventions, information in multiple languages, and parent–professional collaboration. Implications for research, policy, and practice are included.
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Alsharaydeh EA, Alqudah M, Lee RLT, Chan SWC. Challenges, Coping, and Resilience Among Immigrant Parents Caring for a Child With a Disability: An Integrative Review. J Nurs Scholarsh 2019; 51:670-679. [DOI: 10.1111/jnu.12522] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Ethar A. Alsharaydeh
- PhD candidate, Faculty of Health and Medicine, School of Nursing and Midwifery University of Newcastle Callaghan NSW Australia
| | - Muhammad Alqudah
- Lecturer school of Nursing and Midwifery, Faculty of Health and Medicine University of Newcastle Callaghan NSW Australia
| | - Regina Lai Tong Lee
- Professor, School of Nursing and Midwifery, Faculty of Health and Medicine University of Newcastle Callaghan NSW Australia
| | - Sally Wai-Chi Chan
- Pro Vice-Chancellor, University of Newcastle Singapore campus University of Newcastle Callaghan NSW Australia
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18
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Sritharan B, Koola MM. Barriers faced by immigrant families of children with autism: A program to address the challenges. Asian J Psychiatr 2019; 39:53-57. [PMID: 30572272 DOI: 10.1016/j.ajp.2018.11.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 11/16/2018] [Accepted: 11/24/2018] [Indexed: 10/27/2022]
Abstract
Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder characterized by social, communication, and behavioral deficits. Fortunately, early intervention has proved to be of significant benefit in the lives of children with ASD. However, timely access to health services and support requires equitable access, which is often a challenge for immigrant families. Barriers to equal access and support for immigrant families of children with ASD include cultural beliefs about child development and ASD, delayed diagnosis, access to services, and negative perceptions of services. There is a shortage of studies that explore how to increase understanding and collaboration among the immigrant population and health care practitioners to address these barriers. The barriers can indeed be appropriately addressed with structured programs and cultural models. The objectives of this article are to shed light on how barriers impact outcomes of immigrant children with ASD and to describe a culturally sensitive program model to address the barriers and provide awareness, education, and interventions for these immigrant families. The South Asian Autism Awareness Center in Toronto, Canada is presented as an example of such a model.
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Affiliation(s)
| | - Maju Mathew Koola
- Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington DC, USA.
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19
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Hussein AM, Pellicano E, Crane L. Understanding and awareness of autism among Somali parents living in the United Kingdom. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:1408-1418. [PMID: 30486651 DOI: 10.1177/1362361318813996] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Using vignettes and interviews, this study examined understanding and awareness of autism, and (a)typical development more broadly, among 32 Somali parents living in the United Kingdom. Results demonstrated that parents of both autistic (n = 16) and non-autistic (n = 16) children were just as likely to identify vignettes of typically developing children, yet parents of autistic children appeared more astute to signs of atypical development. Across the whole sample, parents commonly identified and labelled vignettes of autistic children, but experienced more difficulty labelling vignettes that described children with other forms of atypical development, sometimes mislabeling these children as autistic. This suggests that there is a need for greater support in recognising and identifying different types of atypical development in the Somali community (to mitigate the risk that the term 'autism' may take on its own meaning within the Somali community, becoming a euphemism for a range of developmental conditions). Analysis of interview data identified key sociocultural factors that either helped or hindered the inclusion of families with autistic children within the community, including the Somali community's: (1) perceptions of disability, (2) beliefs about the causes of autism in the Western world and (3) strong reliance on religious beliefs in understanding and accepting an autism diagnosis.
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