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Carrillo I, Lopez-Pineda A, Pérez-Jover V, Guilabert M, Vicente MA, Fernández C, Gil-Guillen VF, Orozco-Bletrán D, Chilet-Rosell E, Luzon Oliver L, Astier-Peña MP, Tella S, Carratalá-Munuera C, Mira JJ. Epidemiological study on gender bias and low-value practices in primary care: a study protocol. BMJ Open 2023; 13:e070311. [PMID: 37160394 PMCID: PMC10174026 DOI: 10.1136/bmjopen-2022-070311] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
INTRODUCTION Evidence shows that gender has a substantial impact on health behaviours, access to and use of health systems and health system responses. This study aims to assess gender bias in patients subjected to low-value practices in the primary care setting and to develop recommendations for reducing adverse events that women experience for this reason. METHODS AND ANALYSIS A Delphi study will be performed to reach a consensus on the 'Do Not Do' recommendations with a possible gender bias. A retrospective cohort study in a random selection of medical records will then be carried out to identify the frequency of adverse events that occur when the selected 'Do Not Do' recommendations are ignored. Qualitative research techniques (consensus conference and nominal group) will be carried out to develop recommendations to address any gender bias detected, considering barriers and facilitators in clinical practice. ETHICS AND DISSEMINATION The study was approved by the ethics committee of San Juan de Alicante Hospital (San Juan de Alicante, Spain) Reference N. 21/061. We will disseminate the research findings via peer-reviewed articles, presentations at national and international scientific forums and webinars. TRIAL REGISTRATION NUMBER The study was registered at ClinicalTrials.gov (NCT05233852) on 10 February 2022.
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Affiliation(s)
- Irene Carrillo
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Adriana Lopez-Pineda
- Department of Clinical Medicine, Miguel Hernandez University of Elche, San Juan de Alicante, Spain
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, San Juan de Alicante, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), San Juan de Alicante, Spain
| | - Virtudes Pérez-Jover
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Mercedes Guilabert
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | | | - César Fernández
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Vicente F Gil-Guillen
- Department of Clinical Medicine, Miguel Hernandez University of Elche, San Juan de Alicante, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), San Juan de Alicante, Spain
| | - Domingo Orozco-Bletrán
- Department of Clinical Medicine, Miguel Hernandez University of Elche, San Juan de Alicante, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), San Juan de Alicante, Spain
| | - Elisa Chilet-Rosell
- Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Madrid, Spain
- Department of Public Health, Miguel Hernandez University of Elche, San Juan de Alicante, Spain
| | | | - Maria Pilar Astier-Peña
- Grupo de investigación IIS-Aragón H36_23D Feminización, Ética y Profesionalidad de las ciencias de la salud (FEPS), Tarragona, Spain
- Territorial Quality Unit. Management of Camp de Tarragona, Catalan Health Institute, Tarragona, Spain
| | - Susanna Tella
- Health & Wellbeing, LAB University of Applied Sciences-Lappeenrannan kampus, Lappeenranta, Finland
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Concepción Carratalá-Munuera
- Department of Clinical Medicine, Miguel Hernandez University of Elche, San Juan de Alicante, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), San Juan de Alicante, Spain
| | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, San Juan de Alicante, Spain
- Alicante-Sant Joan d'Alacant Health Department, San Juan de Alicante, Spain
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Abstract
Concentrations of 129I and values of the 129I/127I ration are reported in one sample of indigenous vegetation and in over forty additional individual thyroids of man, wild deer and beef cattle in Missouri. The results of this and other studies in our laboratory indicate the following order for successively lower values of 129I/127I ratios in the local environment: Rain, wild deer, commercial milk, beef cattle and human. The value of the 129I/127I ratio in the single vegetation sample is intermediate to the mean values in wild deer and commercial milk, but well within the range of values observed in both. These results are consistent with a geochemical cycle in which iodine that is enriched in 129I is transported via air into the central U.S. and then diluted with other iodine--especially mineral iodine that is added to the diets of domesticated animals--as the iodine deposited from air moves through the local ecosystem. Differences in the diets of beef and dairy cattle or differences in the biological life-times of iodine in thyroids and mammae, and hence the degree of equilibration with body iodine, may explain the lower value of the 129I/127I ratio in beef thyroids than in milk.
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