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Dennis B, Deane A, Lauzier F, Zytaruk N, Hardie M, Hammond N, Finfer S, Arabi Y, Marshall J, Saunders L, Heels-Ansdell D, Myburgh J, Knowles S, Muscedere J, Ostermann M, Rajbhandari D, English S, Matic K, Venkatesh B, Al Fares A, Guyatt G, Alhazzani W, Mumtaz H, Poole A, Xie F, Thabane L, Hall R, Cook D. Protocol implementation during the COVID-19 pandemic: experiences from a randomized trial of stress ulcer prophylaxis. BMC Med Res Methodol 2024; 24:109. [PMID: 38704520 PMCID: PMC11069460 DOI: 10.1186/s12874-024-02233-2] [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: 06/13/2023] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, many intensive care units (ICUs) halted research to focus on COVID-19-specific studies. OBJECTIVE To describe the conduct of an international randomized trial of stress ulcer prophylaxis (Re-Evaluating the Inhibition of Stress Erosions in the ICU [REVISE]) during the pandemic, addressing enrolment patterns, center engagement, informed consent processes, data collection, a COVID-specific substudy, patient transfers, and data monitoring. METHODS REVISE is a randomized trial among mechanically ventilated patients, comparing pantoprazole 40 mg IV to placebo on the primary efficacy outcome of clinically important upper gastrointestinal bleeding and the primary safety outcome of 90-day mortality. We documented protocol implementation status from March 11th 2020-August 30th 2022. RESULTS The Steering Committee did not change the scientific protocol. From the first enrolment on July 9th 2019 to March 10th 2020 (8 months preceding the pandemic), 267 patients were enrolled in 18 centers. From March 11th 2020-August 30th 2022 (30 months thereafter), 41 new centers joined; 59 were participating by August 30th 2022 which enrolled 2961 patients. During a total of 1235 enrolment-months in the pandemic phase, enrolment paused for 106 (8.6%) months in aggregate (median 3 months, interquartile range 2;6). Protocol implementation involved a shift from the a priori consent model pre-pandemic (188, 58.8%) to the consent to continue model (1615, 54.1%, p < 0.01). In one new center, an opt-out model was approved. The informed consent rate increased slightly (80.7% to 85.0%, p = 0.05). Telephone consent encounters increased (16.6% to 68.2%, p < 0.001). Surge capacity necessitated intra-institutional transfers; receiving centers continued protocol implementation whenever possible. We developed a nested COVID-19 substudy. The Methods Centers continued central statistical monitoring of trial metrics. Site monitoring was initially remote, then in-person when restrictions lifted. CONCLUSION Protocol implementation adaptations during the pandemic included a shift in the consent model, a sustained high consent rate, and launch of a COVID-19 substudy. Recruitment increased as new centers joined, patient transfers were optimized, and monitoring methods were adapted.
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Affiliation(s)
- Brittany Dennis
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Adam Deane
- Department of Critical Care Or Medicine, Department of Critical Care Medicine, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - François Lauzier
- Departments of Anesthesiology, Medicine and Critical Care Medicine, Université Laval, Québec, Canada
| | - Nicole Zytaruk
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Critical Care, Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Miranda Hardie
- Critical Care Program, Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Naomi Hammond
- Critical Care Program, Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Simon Finfer
- Critical Care Program, Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Yaseen Arabi
- Intensive Care Department, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
| | - John Marshall
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada
| | - Lois Saunders
- Division of Critical Care, Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - John Myburgh
- Critical Care Program, Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- Intensive Care Unit, St. George Hospital, Sydney, Australia
| | - Serena Knowles
- Critical Care Program, Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - John Muscedere
- Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada
| | - Marlies Ostermann
- Department of Critical Care, King's College London, Thomas' Hospital, Guy's & St, London, UK
| | - Dorrilyn Rajbhandari
- Critical Care Program, Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Shane English
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Karlo Matic
- Division of Critical Care, Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Bala Venkatesh
- Critical Care Program, Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Abdulrahman Al Fares
- Departments of Anesthesia, Critical Care Medicine, and Pain Medicine, Al-Amiri Center for Respiratory and Cardiac Failure, Al-Amiri Hospital, Ministry of Health, Kuwait Extracorporeal Life Support Program, Ministry of Health, Kuwait City, Kuwait
| | - Gordon Guyatt
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Waleed Alhazzani
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Critical Care, Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Hassan Mumtaz
- Department of Critical Care, Maroof Hospital, Islamabad, Pakistan
| | - Alexis Poole
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Discipline of Acute Care Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Centre for Research Excellence in Translating Nutrition Science to Good Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Critical Care, Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Richard Hall
- Departments of Anesthesia, Critical Care and Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Deborah Cook
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
- Division of Critical Care, Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
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Chakraborty LS, Le Maitre CL, Chahine NO, Fields AJ, Gawri R, Giers MB, Smith LJ, Tang SY, Zehra U, Haglund L, Samartzis D, Martin JT. Impact of the COVID-19 pandemic on the productivity and career prospects of musculoskeletal researchers. J Orthop Res 2024. [PMID: 38678396 DOI: 10.1002/jor.25866] [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: 09/27/2023] [Revised: 03/27/2024] [Accepted: 04/15/2024] [Indexed: 04/30/2024]
Abstract
Academic researchers faced a multitude of challenges posed by the COVID-19 pandemic, including widespread shelter-in-place orders, workplace closures, and cessation of in-person meetings and laboratory activities. The extent to which these challenges impacted musculoskeletal researchers, specifically, is unknown. We developed an anonymous web-based survey to determine the pandemic's impact on research productivity and career prospects among musculoskeletal research trainees and faculty. There were 116 musculoskeletal (MSK) researchers with varying demographic backgrounds who completed the survey. Of respondents, 48.3% (n = 56) believed that musculoskeletal funding opportunities decreased because of COVID-19, with faculty members more likely to hold this belief compared to nonfaculty researchers (p = 0.008). Amongst MSK researchers, 88.8% (n = 103) reported research activity was limited by COVID-19, and 92.2% (n = 107) of researchers reported their research was not able to be refocused on COVID-19-related topics, with basic science researchers less likely to be able to refocus their research compared to clinical researchers (p = 0.030). Additionally, 47.4% (n = 55) reported a decrease in manuscript submissions since the onset of the pandemic. Amongst 51 trainee researchers, 62.8% (n = 32) reported a decrease in job satisfaction directly attributable to the COVID-19 pandemic. In summary, study findings indicated that MSK researchers struggled to overcome challenges imposed by the pandemic, reporting declines in funding opportunities, research productivity, and manuscript submission. Trainee researchers experienced significant disruptions to critical research activities and worsening job satisfaction. Our findings motivate future efforts to support trainees in developing their careers and target the recovery of MSK research from the pandemic stall.
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Affiliation(s)
- Lauren S Chakraborty
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Christine L Le Maitre
- Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Nadeen O Chahine
- Department of Orthopedic Surgery, Columbia University, New York, New York, USA
| | - Aaron J Fields
- Department of Orthopaedic Surgery, University of California in San Francisco, San Francisco, California, USA
| | - Rahul Gawri
- Division of Orthopaedic Surgery, Department of Surgery, McGill University, Montréal, Quebec, Canada
| | - Morgan B Giers
- School of Chemical, Biological & Environmental Engineering, Oregon State University, Corvallis, Oregon, USA
| | - Lachlan J Smith
- Departments of Orthopaedic Surgery and Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Simon Y Tang
- Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, USA
| | - Uruj Zehra
- Department of Anatomy, University of Health Sciences, Lahore, Pakistan
| | - Lisbet Haglund
- Division of Orthopaedic Surgery, Department of Surgery, McGill University, Montréal, Quebec, Canada
| | - Dino Samartzis
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - John T Martin
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
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Hsieh E, Dey D, Grainger R, Li M, Machado PM, Ugarte-Gil MF, Yazdany J. Global Perspective on the Impact of the COVID-19 Pandemic on Rheumatology and Health Equity. Arthritis Care Res (Hoboken) 2024; 76:22-31. [PMID: 37277949 DOI: 10.1002/acr.25169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Abstract
Although the public health emergency associated with the COVID-19 pandemic has ended, challenges remain, especially for individuals with rheumatic diseases. We aimed to assess the historical and ongoing effects of COVID-19 on individuals with rheumatic diseases and rheumatology practices globally, with specific attention to vulnerable communities and lessons learned. We reviewed literature from several countries and regions, including Africa, Australia and New Zealand, China, Europe, Latin America, and the US. In this review, we summarize literature that not only examines the impact of the pandemic on individuals with rheumatic diseases, but also research that reports the lasting changes to rheumatology patient care and practice, and health service use. Across countries, challenges faced by individuals with rheumatic diseases during the pandemic included disruptions in health care and medication supply shortages. These challenges were associated with worse disease and mental health outcomes in some studies, particularly among those who had social vulnerabilities defined by socioeconomic, race, or rurality. Moreover, rheumatology practice was impacted in all regions, with the uptake of telemedicine and changes in health care utilization. While many regions developed rapid guidelines to disseminate scientific information, misinformation and disinformation remained widespread. Finally, vaccine uptake among individuals with rheumatic diseases has been uneven across the world. As the acute phase of the pandemic wanes, ongoing efforts are needed to improve health care access, stabilize rheumatology drug supplies, improve public health communication, and implement evidence-based vaccination practices to reduce COVID-19 morbidity and mortality among individuals with rheumatic diseases.
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Affiliation(s)
- Evelyn Hsieh
- Yale School of Medicine, New Haven, Connecticut, and VA Connecticut Healthcare System, West Haven, Connecticut
| | - Dzifa Dey
- Korle-bu Teaching Hospital and the University of Ghana Medical School, Accra, Ghana
| | | | - Mengtao Li
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Pedro M Machado
- University College London, NIHR University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, Northwick Park Hospital, and London North West University Healthcare NHS Trust, London, UK
| | - Manuel F Ugarte-Gil
- Universidad Científica del Sur and Hospital Nacional Guillermo Almenara Irigoyen - EsSalud, Lima, Perú
| | - Jinoos Yazdany
- San Francisco General Hospital and University of California, San Francisco
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Karcher H, Schoenberger M, Rayban T, Kelly C, Heaney A, Mackay A. Impact of COVID-19 measures on exacerbation rates and healthcare visits in US asthma patients. Allergy Asthma Proc 2023; 44:422-428. [PMID: 37919845 PMCID: PMC10629374 DOI: 10.2500/aap.2023.44.230061] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Objective: To compare exacerbation rates and healthcare resource utilization (HCRU) in real-world patients in the United States who had moderate-to-severe asthma on medium- or high-dose inhaled corticosteroid/long-acting β₂-agonist therapy at different stages before and after the pandemic. Methods: This noninterventional, retrospective study described demographics, exacerbations, HCRU, and medication use in patients from a US-wide healthcare claims database in 4 consecutive years anchored around March 15, 2020 (start date of the first emergency health measures against coronavirus disease 2019 [COVID-19], or the first lockdown, in the United States, termed "restriction onset" hereafter). Four cohorts of patients potentially eligible for moderate-to-severe asthma clinical trials at the beginning (index) of each of four 1-year periods (March 15, 2018, 2019, 2020, 2021, respectively) were built. Exacerbations, healthcare visits, and asthma medication use were counted in the 1-year period after the index for each cohort. Results: The prevalence of patients with one or more exacerbation per year decreased by 10.00% in the first year after the restriction onset compared with the year before and attenuated over time to 6.37% in the second year. The proportion of inpatient, emergency department, and physician's office visits remained stable over the time periods evaluated for all patients and those patients who experienced one or more exacerbations. Asthma treatment of patients who experienced one or more exacerbations also remained stable over the 4 years. Conclusion: The effect of COVID-19 public health measures on asthma exacerbation rates might have affected clinical trials being run during this period and should be considered in their analysis. Asthma clinical trials run under pandemic hygiene restrictions should consider lower exacerbation frequency in their study design, while treatment and healthcare visits seem unchanged.
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Affiliation(s)
- Helene Karcher
- From the Global Medical Affairs, Novartis Pharma AG, Basel, Switzerland
| | | | - Tejaswini Rayban
- Real World Evidence, Novartis Healthcare Private Limited, Hyderabad, India; and
| | | | | | - Alexander Mackay
- From the Global Medical Affairs, Novartis Pharma AG, Basel, Switzerland
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Wong KHTW, Lau WCY, Man KKC, Bilbow A, Ip P, Wei L. Effectiveness of Facebook Groups and Pages on Participant Recruitment Into a Randomized Controlled Trial During the COVID-19 Pandemic: Descriptive Study. J Med Internet Res 2023; 25:e46190. [PMID: 37847536 PMCID: PMC10618879 DOI: 10.2196/46190] [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: 02/01/2023] [Revised: 07/25/2023] [Accepted: 09/22/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND In response to the unprecedented challenges posed by the COVID-19 pandemic, conventional recruitment approaches were halted, causing the suspension of numerous clinical trials. Previously, Facebook (Meta Platforms, Inc) has emerged as a promising tool for augmenting participant recruitment. While previous research has explored the use of Facebook for surveys and qualitative studies, its potential for recruiting participants into randomized controlled trials (RCTs) remains underexplored. OBJECTIVE This study aimed to comprehensively examine the effectiveness of using Facebook groups and pages to facilitate participant recruitment during the COVID-19 pandemic for an RCT on the effectiveness of a remote parenting program, 1-2-3 Magic, in families who have children with attention-deficit/hyperactivity disorder (ADHD) in the United Kingdom. METHODS We disseminated 5 Facebook posts with an attached digital flyer across 4 prominent ADHD UK support groups and pages run by the National Attention Deficit Disorder Information and Support Services, reaching an audience of around 16,000 individuals over 2 months (January 7 to March 4, 2022). Eligibility criteria mandated participants to be parents or caregivers of a child with diagnosed ADHD aged 12 years or younger, be residing in the United Kingdom, have access to stable internet, and have a device with the Zoom (Zoom Video Communications) app. Participants were required to have never attended 1-2-3 Magic training previously. Prospective participants expressed their interest through Microsoft Forms (Microsoft Corporation). The trial aimed to recruit 84 parents. It is important to note that the term "parent" or "caregiver" in the RCT and in this study within a trial refers to anybody who has legal responsibility for the child. RESULTS Overall, 478 individuals registered their interest through Microsoft Forms within the stipulated 2-month window. After the eligibility check, 135 participants were contacted for a baseline meeting through Zoom. The first 84 participants who attended a baseline meeting and returned a completed consent form were enrolled. Subsequently, another 16 participants were added, resulting in a final sample of 100 participants. This recruitment strategy incurred negligible expenses and demanded minimal human resources. The approach yielded favorable outcomes by efficiently attracting eligible participants in a condensed time frame, transcending geographical barriers throughout the United Kingdom, which would have been tedious to achieve through traditional recruitment methods. CONCLUSIONS Our experience demonstrated that digital flyers posted in the targeted Facebook groups were a cost-effective and quick method for recruiting for an RCT, which opened during the COVID-19 pandemic when lockdown restrictions were in place in the United Kingdom. Trialists should consider this low-cost recruitment intervention for trials going forward, and in the case of a global pandemic, this novel recruitment method enabled the trial to continue where many have failed. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN) 15281572; https://www.isrctn.com/ISRCTN15281572.
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Affiliation(s)
- Kirstie H T W Wong
- Research Department of Practice and Policy, University College London, London, United Kingdom
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Wallis C Y Lau
- Research Department of Practice and Policy, University College London, London, United Kingdom
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China (Hong Kong)
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong, China (Hong Kong)
| | - Kenneth K C Man
- Research Department of Practice and Policy, University College London, London, United Kingdom
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China (Hong Kong)
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong, China (Hong Kong)
| | - Andrea Bilbow
- National Attention Deficit Disorder Information and Support Services, London, United Kingdom
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Li Wei
- Research Department of Practice and Policy, University College London, London, United Kingdom
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Mahady L, White J, Rafee S, Yap SM, O'Riordan S, Hutchinson M, Gough P, O'Keeffe F. Social cognition in cervical dystonia. Clin Park Relat Disord 2023; 9:100217. [PMID: 37711968 PMCID: PMC10497798 DOI: 10.1016/j.prdoa.2023.100217] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/19/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023] Open
Abstract
Background Whilst traditionally considered a movement disorder, it is now generally accepted that cervical dystonia (CD) presents with additional non-motor symptoms which significantly impact quality of life. Our study primarily aimed to explore social cognition and levels of psychological distress in individuals with CD, in comparison to age- and sex-matched healthy controls. Methods 20 participants with CD attending a specialist movement disorders clinic were recruited. 20 age and sex matched neurologically healthy controls were recruited in parallel. Participants completed the Hospital Anxiety and Depression Scale, and two novel social cognition tasks: The Cambridge Mindreading Face-Voice Battery (CAFMB) and the Edinburgh Social Cognition Test (ESCoT). Results Participants with CD exhibited poorer complex emotion recognition abilities for visual and auditory stimuli, compared to controls on the CAFMB task. Participants with CD did not differ significantly from controls on performance on cognitive or affective Theory of Mind tasks, or interpersonal or intrapersonal understanding of social norms, as measured by the ESCoT. The proportion of depressive symptoms was significantly higher for participants with CD than controls. 40% of participants with CD reported clinically elevated depressive symptoms, and 60% reported clinically elevated anxiety. Poorer understanding of emotional facial expressions was associated with higher levels of depression in the CD group. Conclusions Significant between-group differences between participants with CD and controls suggests socio-cognitive dysfunction is an important aspect of the non-motor syndrome of CD. Findings highlight the need for assessment of and intervention for both social cognitive difficulties and psychological distress in individuals with CD.
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Affiliation(s)
- Laura Mahady
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Jessica White
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Shameer Rafee
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Siew-Mei Yap
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Sean O'Riordan
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Michael Hutchinson
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
- School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Patricia Gough
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Fiadhnait O'Keeffe
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
- Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Suslow A, Giehl C, Hergesell J, Vollmar HC, Otte IC. Conducting Qualitative Research under Pandemic Restrictions - Considerations, Challenges, and Benefits: A Methodological Field Report. Gesundheitswesen 2023; 85:S189-S196. [PMID: 37751755 DOI: 10.1055/a-2129-6311] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
BACKGROUND The Covid-19 pandemic has a significant impact on professionals working in the medical area, with very high workload and tightened safety restrictions for physicians, nurses, caregivers, and patients. One of the main target participants in health services research are medical professionals. Their experiences contribute immensely to any research project aiming to improve delivery and quality of care. Furthermore, their input gives significantly greater insights into the handling of the pandemic and into what future improvements should be considered. In our research project ADAPTIVE (Impact of Digital Technologies in Palliative Care) we evaluate with qualitative research methods the impact of a web-based software on communication, teamwork, and lasting transformations in accountability in multidisciplinary teams (e. g., medication and independent decisions). In this paper, we discuss the challenges and benefits of conducting a qualitative research project under pandemic conditions by illustrating the progress of ADAPTIVE. METHODS ADAPTIVE started in March 2020 and ended in August 2021. For data collection, we interviewed 26 participants about using a web-based program to facilitate the exchange of patient information in multidisciplinary teams in outpatient palliative care in Germany (mainly physicians and nurses). However, due to emerging hygiene regulations, corona-related restrictions, and the ongoing workload of medical professionals, the recruiting and interviewing process were challenging. Hence, we had to modify the original study design of two face-to-face interviews per participant and a focus group discussion into one telephone interview. The focus groups were cancelled. RESULTS We discussed several adjustments to the data collection. However, the privacy policies of different clinics, participants' lack of experience with video calls, and a potential poor internet connectivity eliminated the option of digital video interviewing. Therefore, we interviewed 21 participants by telephone and only five face-to-face. Further, the focus group discussions initially planned had to be dropped since a simultaneous gathering of the participants was not possible due to several reasons. Nonetheless, we obtained many insights into the usage of digital support systems in palliative care by conducting 26 interviews, allowing us to complete the research project. DISCUSSION Telephone interviews come with limitations. Firstly, it may be difficult for participants to establish a trusting relationship with the interviewer. Secondly, non-verbal communication is lost during a telephone interview. However, expanding the survey methodology to include telephone interviews gave us the option of allowing us to expand the recruitment nationwide and overcome issues successfully. CONCLUSIONS Recruitment and data collection showed to be more time-consuming under pandemic circumstances, and further survey methods such as focus groups were nearly impossible. However, a qualitative research design offers greater flexibility when adapting study designs.
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Affiliation(s)
- Anastasia Suslow
- Abteilung für Allgemeinmedizin (AM RUB), Ruhr-Universität Bochum, Bochum, Germany
| | - Chantal Giehl
- Abteilung für Allgemeinmedizin (AM RUB), Ruhr-Universität Bochum, Bochum, Germany
| | - Jannis Hergesell
- Forschungsnetzwerk Alterssicherung, Deutsche Rentenversicherung Bund, Berlin, Germany
| | | | - Ina Carola Otte
- Abteilung für Allgemeinmedizin (AM RUB), Ruhr-Universität Bochum, Bochum, Germany
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Naz S, Haider KA, Jaffar A, Khan U, Azam I, Siddiqui AR, Iqbal R. Feasibility of a peer-supported, WhatsApp-assisted, lifestyle modification intervention for weight reduction among adults in an urban slum of Karachi, Pakistan: a mixed-methods, single-group, pretest-post-test, quasi-experimental study. BMJ Open 2023; 13:e070913. [PMID: 37527890 PMCID: PMC10394542 DOI: 10.1136/bmjopen-2022-070913] [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: 12/08/2022] [Accepted: 07/24/2023] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVES This pilot study assessed whether a peer-supported, WhatsApp-assisted lifestyle modification intervention for weight reduction is feasible to execute a definitive trial. DESIGN A mixed-methods, single group, pretest and post-test, quasi-experimental study. SETTING Azam Basti, an urban slum in Karachi, Pakistan. PARTICIPANTS Fifty participants (males and females aged 20-60) with a body mass index of >23 kg/m2, along with their nominated peers from the same family. INTERVENTION Using motivational interviewing techniques, a trained nutritionist delivered the lifestyle modification intervention to the participants and peers for 3 days after the baseline assessment and then once monthly for 1 year. The intervention was delivered in groups using WhatsApp voice calls. The education sessions mainly focused on dietary modifications, physical activity advice and peer-support assignments to achieve a 5% wt loss from the participant's initial body weight. OUTCOMES The feasibility measures included screening, recruitment, retention and monthly interview response rates. At 1 year, in-depth interviews (IDIs) with participants and peers were conducted to explore the facilitators, barriers, acceptability and experiences of the intervention. Changes in weight, calorie intake/day and calorie expenditure/day were also assessed. RESULTS The recruitment and retention rates were 32% (n=50/156) and 78% (n=39/50), respectively, while the response rate for monthly interviews ranged between 66% (n=33) and 94% (n=47). The mean weight loss at 1 year was 2.2 kg, and the reduction in mean calorie intake was 386 kcal/day. There were no changes in the mean calorie expenditure. During the IDIs, participants and peers reported intervention via WhatsApp and peer support as convenient, flexible and supportive. CONCLUSIONS The quantitative and qualitative findings of the current pilot study support the scale-up of this work with minor modifications to the screening method as well as close monitoring and motivational interviewing to improve adherence in terms of physical activity. TRIAL REGISTRATION NUMBER NCT05928338.
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Affiliation(s)
- Sabahat Naz
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan
| | - Kaniz Amna Haider
- Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Ali Jaffar
- Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Umber Khan
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan
| | - Iqbal Azam
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan
| | - Amna Rehana Siddiqui
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan
| | - Romaina Iqbal
- Department of Community Health Sciences and Medicine, The Aga Khan University, Karachi, Pakistan
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9
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Seguin-Fowler RA, Demment M, Folta SC, Graham M, Hanson K, Maddock JE, Patterson MS. Recruiting experiences of NIH-funded principal investigators for community-based health behavior interventions during the COVID-19 pandemic. Contemp Clin Trials 2023; 131:107271. [PMID: 37354992 PMCID: PMC10286519 DOI: 10.1016/j.cct.2023.107271] [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: 02/10/2023] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 06/26/2023]
Abstract
Successful recruitment into randomized trials and interventions is essential to advance scientific knowledge to improve health. This rapid assessment study explored how the COVID-19 pandemic affected participant recruitment overall, identified how it exacerbated existing challenges to recruit hard-to-reach populations, and described how NIH-funded Principal Investigators (PIs) responded to COVID-era recruitment challenges. A cross-sectional survey of NIH-funded PIs conducting interventions and trials related to health behaviors was conducted in 2022. The survey was completed by 52 PIs, most of whom were highly experienced in this type of research. Eighteen PIs reported it was very difficult to recruit participants now (39.1%) compared to before COVID-19 when only one did (2.2%). PIs reported changing recruitment and data collection methods (29.4%), increasing staff dedicated to recruitment (29.4%), and increasing participant compensation (23.5%). Recruitment methods shifted from in-person activities to social media and other electronic communications. Barriers to recruitment included reluctance to participate in research, COVID-19 protocols and precautions, overwhelmed community partners, staff burnout and turnover, and limited access to technology for some populations that were already hard to reach. Facilitators to recruitment consisted of increased access and ability to use remote technologies, use of social media, strong community ties, and wanting to be part of something positive. PIs perceived recruitment as much more difficult after the onset of COVID-19, though research teams were able to pivot to more online and remote options. These tools may have a lasting impact in modernizing recruitment, data collection, and intervention techniques in future trials.
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Affiliation(s)
- Rebecca A Seguin-Fowler
- Institute for Advancing Health through Agriculture (IHA), Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University System, 1500 Research Parkway, Centeq Building B, College Station, TX 77845, United States of America.
| | - Margaret Demment
- Texas A&M AgriLife Research and Extension Center, 17360 Coit Rd, Dallas, TX 75252, United States of America.
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, United States of America.
| | - Meredith Graham
- Texas A&M AgriLife Research and Extension Center, 17360 Coit Rd, Dallas, TX 75252, United States of America.
| | - Karla Hanson
- Department of Public & Ecosystem Health, Cornell University, Ithaca, NY 4853, United States of America.
| | - Jay E Maddock
- Department of Environmental and Occupational Health, Texas A&M University, College Station, TX 77843, United States of America.
| | - Megan S Patterson
- Department of Health Behavior, Texas A&M University, 1266 TAMU, College Station, TX 77843, United States of America.
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Najm A, Alunno A, Machado PM. COVID - How will it continue to change our lives? Joint Bone Spine 2023; 90:105572. [PMID: 37028643 PMCID: PMC10126740 DOI: 10.1016/j.jbspin.2023.105572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/26/2023] [Accepted: 03/29/2023] [Indexed: 04/08/2023]
Affiliation(s)
- Aurélie Najm
- Institute of Infection and Immunity, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Alessia Alunno
- Department of Life, Health and Environmental Sciences, Internal Medicine and Nephrology Division, University of L'Aquila, L'Aquila, Italy
| | - Pedro M Machado
- Department of Rheumatology, London North West University Healthcare NHS Trust, London, United Kingdom; Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, United Kingdom; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre (BRC), University College London Hospitals (UCLH) NHS Foundation Trust, London, United Kingdom.
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Lepage S, Conway A, Goodson N, Wicks P, Flight L, Devane D. Online randomised trials with children: A scoping review. PLoS One 2023; 18:e0280965. [PMID: 37228143 DOI: 10.1371/journal.pone.0280965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Paediatric trials must contend with many challenges that adult trials face but often bring additional obstacles. Decentralised trials, where some or all trial methods occur away from a centralised location, are a promising strategy to help meet these challenges. This scoping review aims to (a) identify what methods and tools have been used to create and conduct entirely online-decentralised trials with children and (b) determine the gaps in the knowledge in this field. This review will describe the methods used in these trials to identify their facilitators and the gaps in the knowledge. METHODS The methods were informed by guidance from the Joanna Briggs Institute and the PRISMA extension for scoping reviews. We systematically searched MEDLINE, CENTRAL, CINAHL, and Embase databases, trial registries, pre-print servers, and the internet. We included randomised and quasi-randomised trials conducted entirely online with participants under 18 published in English. A risk of bias assessment was completed for all included studies. RESULTS Twenty-one trials met our inclusion criteria. The average age of participants was 14.6 years. Social media was the most common method of online recruitment. Most trials employed an external host website to store and protect their data. Duration of trials ranged from single-session interventions up to ten weeks. Fourteen trials compensated participants. Eight trials involved children in their trial design process; none reported compensation for this. Most trials had a low risk of bias in "random sequence generation", "selective reporting", and "other". Most trials had a high risk of bias in "blinding participants and personnel", "blinding of outcome assessment", and "incomplete outcome data". "Allocation concealment" was unclear in most studies. CONCLUSIONS There was a lack of transparent reporting of the recruitment, randomisation, and retention methods used in many of the trials included in this review. Patient and public involvement (PPI) was not common, and the compensation of PPI partners was not reported in any study. Consent methods and protection against fraudulent entries to trials were creative and thoroughly discussed by some trials and not addressed by others. More work and thorough reporting of how these trials are conducted is needed to increase their reproducibility and quality. ETHICS AND DISSEMINATION Ethical approval was not necessary since all data sources used are publicly available.
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Affiliation(s)
- Simone Lepage
- Health Research Board-Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Aislinn Conway
- Evidence Synthesis Ireland, University of Galway, Galway, Ireland
| | - Noah Goodson
- Data & Analytics, Thread Research, Tustin, California, United States of America
| | - Paul Wicks
- Wicks Digital Health, Lichfield, Staffordshire, United Kingdom
| | - Laura Flight
- National Institute for Health and Care Excellence, Piccadilly Plaza, Manchester, United Kingdom
| | - Declan Devane
- Health Research Board-Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
- Evidence Synthesis Ireland, University of Galway, Galway, Ireland
- Cochrane Ireland, University of Galway, Galway, Ireland
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Mangwani J, Hau M, Thomson L. Research priorities in foot and ankle conditions: results of a UK priority setting partnership with the James Lind Alliance. BMJ Open 2023; 13:e070641. [PMID: 37192795 DOI: 10.1136/bmjopen-2022-070641] [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] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVE To ascertain the priorities of research in surgical interventions and aftercare in foot and ankle conditions in adults, from inclusive viewpoints of patients, carers, allied professionals and clinicians, as a collaboration with James Lind Alliance (JLA) Priority Setting Partnership. Setting A UK-based national study organised through British Orthopaedic Foot and Ankle Society (BOFAS). DESIGN A cross-section of both medical and allied professionals, with patient involvement, submitted their 'top priorities' pertaining to foot and ankle pathology, using both paper and web-based formats, which were synthesised into the primary priorities. Following this, workshop-based reviews were used to determine the top 10 priorities. PARTICIPANTS Adult patients, carers, allied professionals and clinicians who have experienced or managed foot and ankle conditions in the UK. METHODS A transparent and well-established process developed by JLA was carried out by a steering group of 16 members. A broad survey was designed and disseminated to the public via clinics, BOFAS meetings and website, JLA platforms and electronic media to establish potential research priority questions. Surveys were analysed and initial questions were categorised and cross-referenced with the literature. Those questions that were out of scope and sufficiently answered by research were excluded. The unanswered questions were ranked by the public via a second survey. The top 10 questions were finalised via an extensive workshop. RESULTS 472 questions from 198 responders were received from the primary survey. 71% (140) from healthcare professionals, 24% (48) from patients and carers and 5% (10) from other responders. 142 questions were out of scope, leaving 330 questions. These were summarised into 60 indicative questions. Reviewing against current literature, 56 questions were left. From the secondary survey, there were 291 respondents: 79% (230) healthcare professionals and 12% (61) patients and carers. After the secondary survey, the top 16 questions were brought to the final workshop to finalise the top 10 research questions. The top 10 questions were: What are the best outcome measures (ways of assessing the effect of the treatment) after foot and ankle surgery? What treatment is the best for Achilles tendon pain? What is the best treatment (including surgery) for tibialis posterior dysfunction (tendon on the inner side of the ankle), leading to a successful long-term outcome? Should physiotherapy be provided following foot and ankle surgery and is there an optimal amount needed to restore function after foot and ankle surgery? At what stage should a patient with ankle instability (ie, an ankle that keeps giving way) be considered for surgical treatment? How effective are steroid injections in improving pain from arthritis in the foot and ankle? What is the best surgery for bone and cartilage defects in the talus? What is better, ankle fusion or ankle replacements? What is the success of surgical lengthening of the calf muscle in improving forefoot pain? What is the best time to start weight bearing after ankle fusion/replacement surgery? CONCLUSION Top 10 themes included outcomes following interventions, for example, range of movement, reduction in pain, rehabilitation, which included physiotherapy to optimise post intervention outcomes, rehabilitation and condition-specific treatments. These questions will aid to guide national research into foot and ankle surgery. It will also help national funding bodies to prioritise areas of research interest to improve patient care.
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Affiliation(s)
- Jitendra Mangwani
- Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Melinda Hau
- Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Lauren Thomson
- Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK
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Lalji R, Hofstetter L, Kongsted A, von Wyl V, Puhan MA, Hincapié CA. The Swiss chiropractic practice-based research network: a population-based cross-sectional study to inform future musculoskeletal research. Sci Rep 2023; 13:5655. [PMID: 37024506 PMCID: PMC10078089 DOI: 10.1038/s41598-023-32437-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023] Open
Abstract
The Swiss chiropractic practice-based research network (PBRN) is a nationwide project developed in collaboration with patients, clinicians, and academic stakeholders to advance musculoskeletal epidemiologic research. The aim of this study was to describe the clinician population recruited and representativeness of this PBRN to inform future collaboration. A population-based cross-sectional study was performed. PBRN clinician characteristics were described and factors related to motivation (operationalised as VAS score ≥ 70) to participate in a subsequent patient cohort pilot study were assessed. Among 326 eligible chiropractors, 152 enrolled in the PBRN (47% participation). The PBRN was representative of the larger Swiss chiropractic population with regards to age, language, and geographic distribution. Of those enrolled, 39% were motivated to participate in a nested patient cohort pilot study. Motivation was associated with age 40 years or older versus 39 years or younger (OR 2.3, 95% CI 1.0-5.2), and with a moderate clinic size (OR 2.4, 95% CI 1.1-5.7) or large clinic size (OR 2.8, 95% CI 1.0-7.8) versus solo practice. The Swiss chiropractic PBRN has enrolled almost half of all Swiss chiropractors and has potential to facilitate collaborative practice-based research to improve musculoskeletal health care quality.Trial registration: Swiss chiropractic PBRN (ClinicalTrials.gov identifier: NCT05046249); Swiss chiropractic cohort (Swiss ChiCo) pilot study (ClinicalTrials.gov identifier: NCT05116020).
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Affiliation(s)
- Rahim Lalji
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Léonie Hofstetter
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Chiropractic Knowledge Hub, Odense, Denmark
| | - Viktor von Wyl
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Cesar A Hincapié
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.
- University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
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14
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Quiñones MM, Silva C, Ross C, Sörensen S, Serrano R, Van Orden K, Heffner K. Recruiting Socially Disconnected Latinos Caring for a Person with Alzheimer's Disease and Related Dementias During the COVID-19 Pandemic: Lessons Learned. Clin Gerontol 2023:1-14. [PMID: 37005703 PMCID: PMC10542654 DOI: 10.1080/07317115.2023.2197895] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
OBJECTIVES The purpose of this article is to present conceptual and methodological challenges to recruitment strategies in enrolling socially disconnected middle-aged and older Latino caregivers of a loved one with Alzheimer's disease and related dementias (ADRD). METHODS Middle-aged and older Latino ADRD caregivers were recruited into two early stage, intervention development studies during the COVID-19 pandemic via online or in-person methods. Recruitment criteria included Latino ADRD caregivers over the age of 40 reporting elevated loneliness on the UCLA 3-item Loneliness Scale (LS) during screening. RESULTS Middle-aged, Latino caregivers were recruited predominantly from online methods whereas older caregivers were mostly recruited from in-person methods. We report challenges identifying socially disconnected Latino caregivers using the UCLA 3-item LS. CONCLUSIONS Our findings support previously reported disparities in recruitment by age and language and suggest further methodological considerations to assess social disconnection among Latino caregivers. We discuss recommendations to overcome these challenges in future research. CLINICAL IMPLICATIONS Socially disconnected Latino ADRD caregivers have an elevated risk for poor mental health outcomes. Successful recruitment of this population in clinical research will ensure the development of targeted and culturally sensitive interventions to improve the mental health and overall well-being of this marginalized group.
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Affiliation(s)
- Maria M Quiñones
- Elaine C. Hubbard Center for Nursing Research on Aging School of Nursing, University of Rochester Medical Center, New York, USA
| | - Caroline Silva
- Department of Psychiatry, University of Rochester Medical Center, New York, USA
| | - Carmona Ross
- Warner School of Education and Human Development, University of Rochester, New York, USA
| | - Silvia Sörensen
- Warner School of Education and Human Development, University of Rochester, New York, USA
| | | | - Kimberly Van Orden
- Department of Psychiatry, University of Rochester Medical Center, New York, USA
| | - Kathi Heffner
- Elaine C. Hubbard Center for Nursing Research on Aging School of Nursing, University of Rochester Medical Center, New York, USA
- Department of Psychiatry, University of Rochester Medical Center, New York, USA
- Division of Geriatrics & Aging Department of Medicine, University of Rochester Medical Center, New York, USA
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Claus LK, Jarvis SS. Building Trust: Strategies for Recruiting Underrepresented Populations in Research during the COVID-19 Pandemic. Int J Transl Med Res Public Health 2023; 7:e446. [PMID: 37786836 PMCID: PMC10545306 DOI: 10.21106/ijtmrph.446] [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] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
The COVID-19 pandemic disproportionately affected racial and ethnic populations within the United States, creating a distinct set of circumstances that exacerbated barriers to research participation for underrepresented communities. This article aims to provide a rationale that validates the impact of the COVID-19 pandemic on these groups and suggests strategies for participant recruitment while sharing lessons learned from our own laboratory. By understanding the barriers that limit the recruitment of intended populations, researchers can implement culturally sensitive strategies and work towards a more inclusive body of literature with improved participation from underrepresented racial and ethnic populations.
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Affiliation(s)
- Leah K. Claus
- Department of Biological Sciences, Northern Arizona University, 617 S Beaver, Flagstaff, AZ, 86011, USA
| | - Sara S. Jarvis
- Department of Biological Sciences, Northern Arizona University, 617 S Beaver, Flagstaff, AZ, 86011, USA
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Swartz MC, Robertson MC, Christopherson U, Wells SJ, Lewis ZH, Bai J, Swartz MD, Silva HC, Martinez E, Lyons EJ. Assessing the Suitability of a Virtual 'Pink Warrior' for Older Breast Cancer Survivors during COVID-19: A Pilot Study. Life (Basel) 2023; 13:574. [PMID: 36836931 PMCID: PMC9965453 DOI: 10.3390/life13020574] [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: 01/14/2023] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
The COVID-19 pandemic impacted the conduct of in-person physical activity (PA) interventions among older survivors of BC, who need such interventions to stay active and prevent functional decline. We tested the feasibility of virtually delivering an exergame-based PA intervention to older BC survivors. We enrolled 20 female BC survivors ≥55 years and randomly assigned them to two groups. The intervention group (Pink Warrior 2) received 12 weekly virtual exergame sessions with behavioral coaching, survivorship navigation support, and a Fitbit for self-monitoring. The control group received 12 weekly phone-based survivorship discussion sessions and wore a Mi Band 3. Feasibility was evaluated by rates of recruitment (≥0.92 participants/center/month), retention (≥80%), and group attendance (≥10 sessions), percentage of completed virtual assessments, and number of technology-related issues and adverse events. Intervention acceptability was measured by participants' ratings on a scale of 1 (strongly disagree) to 5 (strongly agree). The recruitment rate was 1.93. The retention and attendance rates were 90% and 88% (≥10 sessions), respectively. Ninety-six percent completed virtual assessments without an adverse event. Acceptability was high (≥4). The intervention met benchmarks for feasibility. Additional research is needed to further understand the impact of virtually delivered PA interventions on older BC survivors.
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Affiliation(s)
- Maria C. Swartz
- Department of Pediatrics Research, Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael C. Robertson
- Department of Nutrition, Metabolism & Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX 77550, USA
| | - Ursela Christopherson
- Department of Nutrition, Metabolism & Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX 77550, USA
| | - Stephanie J. Wells
- Department of Pediatrics Research, Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Zakkoyya H. Lewis
- Department of Kinesiology & Health Promotion, California State Polytechnic University, Pomona, CA 91768, USA
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA
| | - Michael D. Swartz
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health, Houston, TX 77030, USA
| | - H. Colleen Silva
- Department of Surgery, The University of Texas Medical Branch, Galveston, TX 77550, USA
| | - Eloisa Martinez
- Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX 77550, USA
| | - Elizabeth J. Lyons
- Department of Nutrition, Metabolism & Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX 77550, USA
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Mossack S, Inoyatov I, Fonseca P, Du C, Lee E, Ruan H, Kim J. A Randomized Controlled Trial Comparing Telemedicine Versus In-Person Office Visits for the Follow-Up of Overactive Bladder. Female Pelvic Med Reconstr Surg 2022; 28:819-24. [PMID: 35830578 DOI: 10.1097/SPV.0000000000001231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
IMPORTANCE Overactive bladder is a condition that may be ideally suited for the use of telemedicine because initial treatment options are behavioral modification and pharmacotherapy. OBJECTIVE We sought to evaluate if there was an overall difference in patient follow-up rates between telemedicine and in-person visits. STUDY DESIGN New patients presenting with overactive bladder from July 2020 to March 2021 were randomized into telemedicine and in-person visits groups. A prospective database was maintained to compare follow-up rates, satisfaction rates, and time commitment. RESULTS Forty-eight patients were randomized, 23 to the telemedicine group and 25 to the in-person visits group. There was no significant difference in follow-up rates between the telemedicine and in-person follow-up groups at 30 days (39% vs 28%, P = 0.41), 60-days (65% vs 56% P = 0.51) or 90 days (78% vs 60%, P = 0.17). There was no significant difference in satisfaction rates between the 2 groups. There was a significant difference between the average telemedicine visit time and in-person visit time (12.1 ± 6.9 minutes vs 22.8 ± 17.1 minutes; P = 0.02). For in-person visits, the average travel time was 49 minutes (interquartile range, 10-90 minutes) and average miles traveled was 22.1 miles (interquartile range, 10-70 miles). CONCLUSIONS There was no significant difference in follow-up or satisfaction rates between telemedicine and in-person visits. Telemedicine visits took half the length of time compared with in-person visits. On average, patients in the telemedicine group saved approximately 1 hour per follow-up visit. Telemedicine visits save both the health care provider and patient significant amounts of time without sacrificing patient satisfaction and follow-up rates.
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Stankute I, Kazlauskiene M, Blouin JL, Schwitzgebel VM, Verkauskiene R. Co-segregation analysis and functional trial in vivo of candidate genes for monogenic diabetes. BMJ Open Diabetes Res Care 2022; 10:10/6/e003038. [PMID: 36585034 PMCID: PMC9809257 DOI: 10.1136/bmjdrc-2022-003038] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The aim of this study was to perform familial co-segregation analysis and functional trial in vivo during mixed meal tolerance test (MMTT) of novel variants in diabetes candidate genes. RESEARCH DESIGN AND METHODS It is a continuation of the project "Genetic diabetes in Lithuania" with the cohort of 1209 patients with diabetes. Prior screening for autoimmune markers confirmed type 1 diabetes (T1D) diagnosis in 88.1% (n=1065) of patients, and targeted next-generation sequencing identified 3.5% (n=42) pathogenic variants in MODY genes. Subsequently, 102 patients were classified as having diabetes of unknown etiology. 12/102 were found to have novel variants in potential diabetes genes (RFX2, RREB1, SLC5A1 (3 patients with variants in this gene), GCKR, MC4R, CASP10, TMPRSS6, HGFAC, DACH1, ZBED3). Co-segregation analysis and MMTT were carried out in order to study beta-cell function in subjects with specific variants. RESULTS MMTT analysis showed that probands with variants in MC4R, CASP10, TMPRSS6, HGFAC, and SLC5A1 (c.1415T>C) had sufficient residual beta-cell function with stimulated C-peptide (CP) >200 pmol/L. Seven individuals with variants in RFX2, RREB1, GCKR, DACH1, ZBED3 and SLC5A1 (c.1415T>C, and c.932A>T) presented with complete beta-cell failure. No statistical differences were found between patients with sufficient CP production and those with complete beta-cell failure when comparing age at the onset and duration of diabetes. Nineteen family members were included in co-segregation analysis; no diabetes cases were reported among them. Only in patient with the variant c.1894G>A in RFX2 gene, none of the family members were affected by proband's variant. CONCLUSIONS Functional beta-cell study in vivo allowed to select five most probable genes for monogenic diabetes. Familial co-segregation analysis showed that novel variant in RFX2 gene could be a possible cause of diabetes. Future functional analysis in vitro is necessary to support or rule out the genetic background as a cause of diabetes.
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Affiliation(s)
- Ingrida Stankute
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mintaute Kazlauskiene
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jean-Louis Blouin
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland
- Department of Diagnostics, University Hospitals of Geneva, Geneva, Switzerland
| | - Valerie M Schwitzgebel
- Pediatric Endocrine and Diabetes Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
- Diabetes Center of the Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Rasa Verkauskiene
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Davidson AR, Morgan M, Ball L, Reidlinger DP. Patient advocates' views of patient roles in interprofessional collaborative practice in primary care: A constructivist grounded theory study. Health Soc Care Community 2022; 30:e5775-e5785. [PMID: 36134601 PMCID: PMC10087047 DOI: 10.1111/hsc.14009] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/22/2022] [Accepted: 08/20/2022] [Indexed: 06/16/2023]
Abstract
Interprofessional collaborative practice has been shown to be an appropriate model of care for chronic disease management in primary care. However, how patients play a role in this model is relatively unknown. The aim of this constructivist grounded theory focus group study was to explore the perceptions of patient advocates regarding the role of patients in interprofessional collaborative practice for chronic conditions in primary care. Primary data were collected from patient advocates, from public and private Australian organisations and who represent patients with chronic disease in primary care, through focus groups in July-August 2020. Videoconference focus groups were recorded, transcribed verbatim and inductively, thematically analysed using the five-step approach by Charmaz: (1) initial line-by-line coding, (2) focused coding, (3) memo writing, (4) categorisation and (5) theme and sub-theme development. Three focus groups comprising 17 patient advocates with diverse cultural and professional backgrounds participated. Two themes and five sub-themes relating to interprofessional collaborative practice teams were constructed from the data. In theme 1, patients 'shifted across the spectrum of roles' from 'relinquishing control to the team', 'joining the team' to 'disengaging from the team'. The second theme was the need for 'juggling roles' by 'integrating patient role with life roles', and 'learning about the patient role'. The diversity and variability of patient roles as described by patient advocates highlight the challenges of working with people with chronic conditions. The diverse patient roles described by advocates are an important finding that may better inform communication between patients and health professionals when managing chronic conditions. From the health professional perspective, identification of the role of a patient may be challenging. Therefore, future research should explore the development of a tool to assist both patients and health professionals to identify patient roles as they move across the spectrum, with the support of policy makers. This tool should aim to identify and promote patient engagement in interprofessional collaborative practice in primary care settings.
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Affiliation(s)
| | - Mark Morgan
- Faculty of Health Sciences and MedicineBond UniversityGold CoastQueenslandAustralia
| | - Lauren Ball
- Menzies Health Institute QueenslandGriffith UniversityGold CoastQueenslandAustralia
- The University of QueenslandBrisbaneQueenslandAustralia
| | - Dianne P. Reidlinger
- Faculty of Health Sciences and MedicineBond UniversityGold CoastQueenslandAustralia
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