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McAteer J, Tamma PD. Diagnosing and Managing Urinary Tract Infections in Kidney Transplant Recipients. Infect Dis Clin North Am 2024; 38:361-380. [PMID: 38729666 PMCID: PMC11090456 DOI: 10.1016/j.idc.2024.03.008] [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] [Indexed: 05/12/2024]
Abstract
In the article, the authors review antibiotic treatment options for both acute uncomplicated UTI and complicated UTI. In addition, they review alternative regimens which are needed in the setting of drug-resistant pathogens including vancomycin-resistant Enterococcus, -extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E), carbapenem-resistant Enterobacterales, and carbapenem-resistant Pseudomonas, which are encountered with more frequency.
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Affiliation(s)
- John McAteer
- Division of Pediatric Nephrology, Johns Hopkins University School of Medicine; Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Pranita D Tamma
- Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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2
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Roznik K, Xue J, Stavrakis G, Johnston TS, Kalluri D, Ohsie R, Qin CX, McAteer J, Segev DL, Mogul D, Werbel WA, Karaba AH, Thompson EA, Cox AL. COVID-19 vaccination induces distinct T-cell responses in pediatric solid organ transplant recipients and immunocompetent children. NPJ Vaccines 2024; 9:73. [PMID: 38580714 PMCID: PMC10997632 DOI: 10.1038/s41541-024-00866-4] [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] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 03/19/2024] [Indexed: 04/07/2024] Open
Abstract
Immune responses to COVID-19 vaccination are attenuated in adult solid organ transplant recipients (SOTRs) and additional vaccine doses are recommended for this population. However, whether COVID-19 mRNA vaccine responses are limited in pediatric SOTRs (pSOTRs) compared to immunocompetent children is unknown. Due to SARS-CoV-2 evolution and mutations that evade neutralizing antibodies, T cells may provide important defense in SOTRs who mount poor humoral responses. Therefore, we assessed anti-SARS-CoV-2 IgG titers, surrogate neutralization, and spike (S)-specific T-cell responses to COVID-19 mRNA vaccines in pSOTRs and their healthy siblings (pHCs) before and after the bivalent vaccine dose. Despite immunosuppression, pSOTRs demonstrated humoral responses to both ancestral strain and Omicron subvariants following the primary ancestral strain monovalent mRNA COVID-19 series and multiple booster doses. These responses were not significantly different from those observed in pHCs and significantly higher six months after vaccination than responses in adult SOTRs two weeks post-vaccination. However, pSOTRs mounted limited S-specific CD8+ T-cell responses and qualitatively distinct CD4+ T-cell responses, primarily producing IL-2 and TNF with less IFN-γ production compared to pHCs. Bivalent vaccination enhanced humoral responses in some pSOTRs but did not shift the CD4+ T-cell responses toward increased IFN-γ production. Our findings indicate that S-specific CD4+ T cells in pSOTRs have distinct qualities with unknown protective capacity, yet vaccination produces cross-reactive antibodies not significantly different from responses in pHCs. Given altered T-cell responses, additional vaccine doses in pSOTRs to maintain high titer cross-reactive antibodies may be important in ensuring protection against SARS-CoV-2.
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Affiliation(s)
- Katerina Roznik
- Johns Hopkins Bloomberg School of Public Health, Department of Molecular Microbiology and Immunology, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - Jiashu Xue
- Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - Georgia Stavrakis
- Johns Hopkins Bloomberg School of Public Health, Department of Molecular Microbiology and Immunology, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - T Scott Johnston
- Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - Divya Kalluri
- Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, MD, USA
| | - Rivka Ohsie
- Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, MD, USA
| | - Caroline X Qin
- Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD, USA
| | - John McAteer
- Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD, USA
| | - Dorry L Segev
- Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, MD, USA
- NYU Grossman School of Medicine, Department of Surgery, New York, NY, USA
| | - Douglas Mogul
- Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD, USA
| | - William A Werbel
- Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - Andrew H Karaba
- Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - Elizabeth A Thompson
- Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - Andrea L Cox
- Johns Hopkins Bloomberg School of Public Health, Department of Molecular Microbiology and Immunology, Baltimore, MD, USA.
- Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA.
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McAteer J, Kalluri DD, Abedon RR, Qin CX, Auerbach SR, Charnaya O, Danziger-Isakov LA, Ebel NH, Feldman AG, Hsu EK, Mohammad S, Perito ER, Thomas AM, Chiang TPY, Garonzik-Wang JM, Segev DL, Werbel WA, Mogul DB. Omicron Infections in Vaccinated Pediatric Solid Organ Transplant Recipients. J Pediatric Infect Dis Soc 2024; 13:152-154. [PMID: 38035755 PMCID: PMC10896257 DOI: 10.1093/jpids/piad108] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Indexed: 12/02/2023]
Abstract
SARS-CoV-2 infection during the Omicron period was frequent amongst a cohort of vaccinated pediatric solid organ transplant recipients (pSOTRs) despite robust anti-receptor-binding domain (anti-RBD) antibody response, suggesting poor neutralizing capacity against Omicron subvariants. Breakthrough infections among pSOTRs were overall limited in severity.
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Affiliation(s)
- John McAteer
- Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Division of Nephrology, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Divya D Kalluri
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rivka R Abedon
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Caroline X Qin
- Division of Nephrology, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Scott R Auerbach
- Division of Cardiology, Department of Pediatrics, Children’s Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Olga Charnaya
- Division of Nephrology, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lara A Danziger-Isakov
- Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Noelle H Ebel
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lucile Packard Children’s Hospital Stanford, Stanford University School of Medicine, Palo Alto, California, USA
| | - Amy G Feldman
- Section of Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children’s Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Evelyn K Hsu
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - Saeed Mohammad
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, USA
| | - Emily R Perito
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California San Francisco Benioff Children’s Hospital, University of California San Francisco, San Francisco, California, USA
| | - Ashley M Thomas
- Section of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Teresa P Y Chiang
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Dorry L Segev
- Division of Transplant Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin, USA
| | - William A Werbel
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Douglas B Mogul
- Section of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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McAteer J, Kalluri DD, Abedon RR, Qin CX, Auerbach SR, Charnaya O, Danziger-Isakov LA, Ebel NH, Feldman AG, Hsu EK, Mohammad S, Perito ER, Thomas AM, Chiang TPY, Garonzik-Wang JM, Segev DL, Werbel WA, Mogul DB. Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients. Pediatr Transplant 2024; 28:e14671. [PMID: 38317335 PMCID: PMC11056938 DOI: 10.1111/petr.14671] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/09/2023] [Accepted: 11/17/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Adolescent solid organ transplant recipients (aSOTRs) who received three doses of the COVID-19 mRNA vaccine experience high seroconversion rates and antibody persistence for up to 3 months. Long-term antibody durability beyond this timeframe following three doses of the SARS-CoV-2 mRNA vaccine remains unknown. We describe antibody responses 6 months following the third vaccine dose (D3) of the BNT162b2 mRNA vaccination among aSOTRs. METHODS Participants in a multi-center, observational cohort who received the third dose of the vaccine were analyzed for antibodies to the SARS-CoV-2 spike protein receptor-binding domain (Roche Elecsys anti-SARS-CoV-2-S positive: ≥0.8, maximum: >2500 U/mL). Samples were collected at 1-, 3-, and 6-months post-D3. Participants were surveyed at each timepoint and at 12-months post-D3. RESULTS All 34 participants had positive anti-RBD antibody titers 6 months post-D3. Variations in titers occurred between 3 and 6 months post-D3, with 8/28 (29%) having decreased antibody levels at 6 months compared to 3 months and 2/28 (7%) reporting increased titers at 6 months. The remaining 18/28 (64%) had unchanged antibody titers compared to 3-month post-D3 levels. A total of 4/34 (12%) reported breakthrough infection within 6 months and 3/32 (9%) reported infection after 6-12 months following the third dose of the SARS-CoV-2 mRNA vaccine. CONCLUSIONS The results suggest that antibody durability persists up to 6 months following three doses of the SARS-CoV-2 mRNA in aSOTRs. Demography and transplant characteristics did not differ for those who experienced antibody weaning. Breakthrough infections did occur, reflecting immune-evasive nature of novel variants such as Omicron.
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Affiliation(s)
- John McAteer
- Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Division of Nephrology, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Divya D. Kalluri
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rivka R. Abedon
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Caroline X. Qin
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Scott R. Auerbach
- Division of Cardiology, Department of Pediatrics, Children’s Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Olga Charnaya
- Division of Nephrology, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lara A. Danziger-Isakov
- Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Noelle H. Ebel
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lucile Packard Children’s Hospital Stanford, Stanford University School of Medicine, Palo Alto, California, USA
| | - Amy G. Feldman
- Section of Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children’s Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Evelyn K. Hsu
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - Saeed Mohammad
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, USA
| | - Emily R. Perito
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California San Francisco Benioff Children’s Hospital, University of California San Francisco, San Francisco, California, USA
| | - Ashley M. Thomas
- Section of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Teresa P. Y. Chiang
- Department of Surgery, NYU Grossman School of Medicine, New York City, New York, USA
| | - Jacqueline M. Garonzik-Wang
- Division of Transplant Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin, USA
| | - Dorry L. Segev
- Department of Surgery, NYU Grossman School of Medicine, New York City, New York, USA
| | - William A. Werbel
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Douglas B. Mogul
- Section of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Jeffers L, Manner J, Jepson R, McAteer J. Healthcare professionals' perceptions and experiences of obesity and overweight and its management in primary care settings: a qualitative systematic review. Prim Health Care Res Dev 2024; 25:e5. [PMID: 38229563 PMCID: PMC11077507 DOI: 10.1017/s1463423623000683] [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] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 11/06/2023] [Accepted: 11/21/2023] [Indexed: 01/18/2024] Open
Abstract
AIM This qualitative systematic review aimed to synthesise existing qualitative research on HCPs' perceptions and experiences of obesity and its management in primary care settings. BACKGROUND Healthcare professionals (HCPs), particularly those in primary care, play a key role in policy implementation around weight management. Overweight and obese individuals are subject to weight stigma which has negative health consequences and reduces the likelihood of healthcare service usage. An understanding of HCPs' perceptions of obesity and weight management in primary care is necessary for the development and delivery of effective initiatives. METHODS A search strategy developed using the SPIDER framework was applied to Medline and CINAHL databases. Inclusion criteria were applied, and quality assessment was undertaken using the CASP framework. Fifteen papers meeting the inclusion criteria were analysed thematically. FINDINGS Four themes were identified: conflicting discourses surrounding obesity, medicalisation of obesity, organisational factors, and lack of patient knowledge and motivation. Conflicting discourses around obesity refers to the differing views of HCPs regarding what it means to have and treat obesity. Medicalisation of obesity considers whether obesity should be treated as a medical condition. Organisational factors were identified as knowledge, resources and time that affected HCPs' ability to provide care to overweight or obese. Finally, the review discovered that patients required their own knowledge and motivation to lose weight. This review has highlighted the need to provide safe, non-judgemental spaces for HCPs and patients to discuss weight and weight loss. This is essential to the therapeutic relationship and the provision of effective obesity management.
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Affiliation(s)
- Laura Jeffers
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Jillian Manner
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
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Lee JH, McAteer J, Tamma PD. Reply to Bulloch. Clin Infect Dis 2023; 77:497-498. [PMID: 37021686 PMCID: PMC11004946 DOI: 10.1093/cid/ciad207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 04/07/2023] Open
Affiliation(s)
- Jae Hyoung Lee
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John McAteer
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Pranita D Tamma
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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McAteer J, Lee JH, Cosgrove SE, Dzintars K, Fiawoo S, Heil EL, Kendall RE, Louie T, Malani AN, Nori P, Percival KM, Tamma PD. Defining the Optimal Duration of Therapy for Hospitalized Patients With Complicated Urinary Tract Infections and Associated Bacteremia. Clin Infect Dis 2023; 76:1604-1612. [PMID: 36633559 PMCID: PMC10411929 DOI: 10.1093/cid/ciad009] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 09/18/2022] [Revised: 11/18/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Limited data are available to guide effective antibiotic durations for hospitalized patients with complicated urinary tract infections (cUTIs). METHODS We conducted an observational study of patients ≥18 years at 24 US hospitals to identify the optimal treatment duration for patients with cUTI. To increase the likelihood patients experienced true infection, eligibility was limited to those with associated bacteremia. Propensity scores were generated for an inverse probability of treatment weighted analysis. The primary outcome was recurrent infection with the same species ≤30 days of completing therapy. RESULTS 1099 patients met eligibility criteria and received 7 (n = 265), 10 (n = 382), or 14 (n = 452) days of therapy. There was no difference in the odds of recurrent infection for patients receiving 10 days and those receiving 14 days of therapy (aOR: .99; 95% CI: .52-1.87). Increased odds of recurrence was observed in patients receiving 7 days versus 14 days of treatment (aOR: 2.54; 95% CI: 1.40-4.60). When limiting the 7-day versus 14-day analysis to the 627 patients who remained on intravenous beta-lactam therapy or were transitioned to highly bioavailable oral agents, differences in outcomes no longer persisted (aOR: .76; 95% CI: .38-1.52). Of 76 patients with recurrent infections, 2 (11%), 2 (10%), and 10 (36%) in the 7-, 10-, and 14-day groups, respectively, had drug-resistant infections (P = .10). CONCLUSIONS Seven days of antibiotics appears effective for hospitalized patients with cUTI when antibiotics with comparable intravenous and oral bioavailability are administered; 10 days may be needed for all other patients.
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Affiliation(s)
- John McAteer
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jae Hyoung Lee
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sara E Cosgrove
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kathryn Dzintars
- Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Suiyini Fiawoo
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Emily L Heil
- Department of Practice, Science, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Ronald E Kendall
- Department of Pharmacy, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Ted Louie
- Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Anurag N Malani
- Department of Medicine, Trinity Health St. Joseph Mercy, Ann Arbor, Michigan, USA
| | - Priya Nori
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kelly M Percival
- Department of Pharmaceutical Care, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - Pranita D Tamma
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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McNeill SG, McAteer J, Jepson R. Interactions Between Health Professionals and Lesbian, Gay and Bisexual Patients in Healthcare Settings: A Systematic Review. J Homosex 2023; 70:250-276. [PMID: 34292130 DOI: 10.1080/00918369.2021.1945338] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The ways in which health professionals (HPs) interact with individuals from sexual minorities can impact their perception of the health service and influence engagement. This systematic literature review aimed to identify and synthesize the qualitative literature exploring interactions between HPs and lesbian, gay and bisexual (LGB) patients in healthcare settings. A search strategy was developed and applied to CINAHL and Medline, inclusion criteria were then applied to results by two screeners with good agreement. Thematic analysis was carried out on papers meeting the inclusion criteria in three stages, beginning with coding the text line-by-line, developing descriptive themes and finally, analytical themes. Electronic searches identified 348 papers with 20 of these meeting the inclusion criteria. Thematic analysis found five themes; HPs' lack of knowledge regarding LGB specific issues, identification of sexual orientation, discomfort in interactions, LGB patients' experience of heteronormative attitudes and perceived judgment or other negative attitudes.
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Affiliation(s)
- Sarah G McNeill
- Centre for Public Health, Royal Victoria Hospital, Belfast, United Kingdom
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - John McAteer
- Grow Public Health Research and Consultancy, Edinburgh, Scotland, United Kingdom
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
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McAteer J, Earle B. Pleural effusion in an otherwise healthy infant. J Paediatr Child Health 2022. [PMID: 36468496 DOI: 10.1111/jpc.14594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 12/12/2022]
Affiliation(s)
- John McAteer
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
| | - Benjamin Earle
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
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Freeman MC, Lazzara A, Lennon T, McAteer J, Pease M, Sefcik R, Radovic-Stakic A, Milstone AM, Nowalk A, Trent M. Gonococcal Infection and Ventriculoperitoneal Shunts. Sex Transm Dis 2022; 49:838-840. [PMID: 35797550 PMCID: PMC9669122 DOI: 10.1097/olq.0000000000001671] [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] [Indexed: 11/25/2022]
Abstract
ABSTRACT Neisseria gonorrhoea e and Chlamydia trachomatis are pathogens commonly isolated in pelvic inflammatory disease. Neisseria gonorrhoea e may uncommonly spread outside the urogenital tract to cause complications. We present 2 cases of adolescents with ventriculoperitoneal shunt infection due to N. gonorrhoea e, requiring shunt externalization.
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Affiliation(s)
| | - Alexandra Lazzara
- Department of Pediatrics, Johns Hopkins University School of Medicine
| | - Tyler Lennon
- Department of Pediatrics, Johns Hopkins University School of Medicine
| | - John McAteer
- Department of Pediatrics, Johns Hopkins University School of Medicine
| | - Matthew Pease
- Department of Neurosurgery, University of Pittsburgh School of Medicine
| | - Roberta Sefcik
- Department of Neurosurgery, University of Pittsburgh School of Medicine
| | | | - Aaron M. Milstone
- Department of Pediatrics, Johns Hopkins University School of Medicine
| | - Andrew Nowalk
- Department of Pediatrics, University of Pittsburgh School of Medicine
| | - Maria Trent
- Department of Pediatrics, Johns Hopkins University School of Medicine
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11
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Qin CX, Auerbach SR, Charnaya O, Danziger-Isakov LA, Ebel NH, Feldman AG, Hsu EK, McAteer J, Mohammad S, Perito ER, Thomas AM, Chiang TP, Garonzik-Wang JM, Segev DL, Mogul DB. Antibody response to three SARS-CoV-2 mRNA vaccines in adolescent solid organ transplant recipients. Am J Transplant 2022; 22:2481-2483. [PMID: 35510786 PMCID: PMC9348453 DOI: 10.1111/ajt.17085] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/08/2022] [Accepted: 05/02/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Caroline X. Qin
- Division of Gastroenterology, Hepatology, and Nutrition Department of Pediatrics Johns Hopkins Children’s Center Johns Hopkins University School of Medicine Baltimore, Maryland USA
- Department of Surgery The Johns Hopkins Hospital Johns Hopkins University School of Medicine Baltimore, Maryland USA
| | - Scott R. Auerbach
- Division of Cardiology Department of Pediatrics Children’s Hospital Colorado University of Colorado School of Medicine Aurora, Colorado USA
| | - Olga Charnaya
- Division of Nephrology Department of Pediatrics Johns Hopkins Children’s Center Johns Hopkins University School of Medicine Baltimore, Maryland USA
| | - Lara A. Danziger-Isakov
- Division of Infectious Diseases Department of Pediatrics Cincinnati Children’s Hospital Medical Center University of Cincinnati College of Medicine Cincinnati, Ohio USA
| | - Noelle H. Ebel
- Division of Gastroenterology, Hepatology and Nutrition Department of Pediatrics Lucile Packard Children’s Hospital Stanford Stanford University School of Medicine Palo Alto, California USA
| | - Amy G. Feldman
- Section of Gastroenterology, Hepatology and Nutrition Digestive Health Institute Children’s Hospital Colorado University of Colorado School of Medicine Aurora, Colorado USA
| | - Evelyn K. Hsu
- Division of Gastroenterology, Hepatology and Nutrition Department of Pediatrics Seattle Children’s Hospital University of Washington School of Medicine Seattle, Washington USA
| | - John McAteer
- Division of Nephrology Department of Pediatrics Johns Hopkins Children’s Center Johns Hopkins University School of Medicine Baltimore, Maryland USA
- Division of Infectious Diseases Department of Pediatrics Johns Hopkins Children’s Center Johns Hopkins University School of Medicine Baltimore, Maryland USA
| | - Saeed Mohammad
- Division of Gastroenterology, Hepatology and Nutrition Department of Pediatrics Ann & Robert H. Lurie Children’s Hospital of Chicago Northwestern University Feinberg School of Medicine Chicago, Illinois USA
| | - Emily R. Perito
- Division of Gastroenterology, Hepatology and Nutrition Department of Pediatrics University of California San Francisco Benioff Children’s Hospital University of California San Francisco School of Medicine San Francisco, California USA
| | - Ashley M. Thomas
- Division of Gastroenterology, Hepatology, and Nutrition Department of Pediatrics Johns Hopkins Children’s Center Johns Hopkins University School of Medicine Baltimore, Maryland USA
| | - Teresa P.Y. Chiang
- Department of Surgery The Johns Hopkins Hospital Johns Hopkins University School of Medicine Baltimore, Maryland USA
| | - Jacqueline M. Garonzik-Wang
- Department of Surgery University of Wisconsin Health University Hospital University of Wisconsin School of Medicine and Public Health Madison, Wisconsin USA
| | - Dorry L. Segev
- Department of Surgery The Johns Hopkins Hospital Johns Hopkins University School of Medicine Baltimore, Maryland USA
- Department of Surgery New York University Langone Health New York University Grossman School of Medicine New York, New York USA
| | - Douglas B. Mogul
- Division of Gastroenterology, Hepatology, and Nutrition Department of Pediatrics Johns Hopkins Children’s Center Johns Hopkins University School of Medicine Baltimore, Maryland USA
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12
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Qin CX, Auerbach SR, Charnaya O, Danziger-Isakov LA, Ebel NH, Feldman AG, Hsu EK, McAteer J, Mohammad S, Perito ER, Thomas AM, Chiang TP, Garonzik-Wang JM, Segev DL, Mogul DB. Antibody response to 2-dose SARS-CoV-2 mRNA vaccination in pediatric solid organ transplant recipients. Am J Transplant 2022; 22:669-672. [PMID: 34517430 PMCID: PMC8653193 DOI: 10.1111/ajt.16841] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/02/2021] [Accepted: 09/09/2021] [Indexed: 01/25/2023]
Affiliation(s)
- Caroline X. Qin
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,Correspondence Caroline X. Qin, Epidemiology Research Group in Organ Transplantation, Baltimore, MD, USA.
| | - Scott R. Auerbach
- Division of Cardiology, Department of Pediatrics, Children’s Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Olga Charnaya
- Division of Nephrology, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lara A. Danziger-Isakov
- Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Noelle H. Ebel
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lucile Packard Children’s Hospital Stanford, Stanford University School of Medicine, Palo Alto, California, USA
| | - Amy G. Feldman
- Section of Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children’s Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Evelyn K. Hsu
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - John McAteer
- Division of Nephrology, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Saeed Mohammad
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Emily R. Perito
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California San Francisco Benioff Children’s Hospital, University of California San Francisco, San Francisco, California, USA
| | - Ashley M. Thomas
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Teresa P.Y. Chiang
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jacqueline M. Garonzik-Wang
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dorry L. Segev
- Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Douglas B. Mogul
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins Children’s Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abstract
Since the COVID-19 pandemic first hit Wuhan, China, in December 2019, scientists have been racing to develop and test novel vaccines to protect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The speed of scientific discovery related to COVID-19 is unprecedented. With several vaccine candidates already being tested in clinical trials, we pose the question: what will the vaccine hesitant do in the face of this pandemic?
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Affiliation(s)
- John McAteer
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Inci Yildirim
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Epidemiology, Rollins School of Public Health, Atlanta, Georgia, USA
- Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia, USA
| | - Ann Chahroudi
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia, USA
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Laird Y, Manner J, Baldwin L, Hunter R, McAteer J, Rodgers S, Williamson C, Jepson R. Stakeholders' experiences of the public health research process: time to change the system? Health Res Policy Syst 2020; 18:83. [PMID: 32682426 PMCID: PMC7368787 DOI: 10.1186/s12961-020-00599-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 07/03/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The importance of engaging stakeholders in the research process is well recognised. Whilst engagement is important, guidelines and practices vary for how stakeholders should be involved in research and how to facilitate effective collaborative relationships. METHODS This study aimed to explore the perspectives and experiences of stakeholders involved in the policy and practice area of outdoor space and non-communicable disease prevention. Stakeholders interviewed included academics, practitioners, policy-makers, knowledge brokers and a funder. RESULTS The findings suggest that stakeholders had positive experiences when engaged meaningfully in the research process, where research projects were carefully planned and managed with attention to context and culture, and where the research team was effective, respectful and communicative. These factors help to facilitate the translation of research into policy and practice. However, multiple challenges of collaborative research were identified which related to structural and systemic challenges, building and maintaining relationships, use and collection of data and information, cultural perceptions of research and research generation, and getting evidence into action. Participants felt that changing the funding system, exploring more collaborative research methodologies, improved research translation, and more effective collaborative relationships at all stages of the research process could address some of these challenges. CONCLUSIONS The findings highlight that, whilst stakeholder engagement in research was considered important, structural, cultural and individual practices impacted how this worked in practice. Identifying and testing solutions to address these challenges could improve synergies between research, policy, and practice and lead to the production of impactful research that reduces wastage of public funding, improves implementation of findings and ultimately improves public health outcomes.
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Affiliation(s)
- Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Sydney, Australia.
| | - Jillian Manner
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Louise Baldwin
- School of Public Health and Social Work, Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation, Brisbane, Australia
| | - Ruth Hunter
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah Rodgers
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
| | - Chloë Williamson
- Physical Activity for Health Research Centre, Institute of Sport, Physical Education and Health Sciences, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, United Kingdom
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
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15
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McAteer J, Jernigan S, Mao C, Gonzalez MD, Watson RJ, Liverman R, Tobin-D Angelo M, Dishman M H, Shane A, Yildirim I. Cryptosporidiosis among solid organ transplant recipient attendees at a summer camp. Pediatr Transplant 2020; 24:e13649. [PMID: 31885132 DOI: 10.1111/petr.13649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 08/14/2019] [Revised: 11/13/2019] [Accepted: 12/09/2019] [Indexed: 11/29/2022]
Abstract
We report a cluster of pediatric cryptosporidiosis infections among solid organ transplant recipients at a summer camp in Georgia, USA. A retrospective cohort study was conducted to investigate the risk factors for infection. A total of 118 campers attended the camp during July 23-28, 2017. The overall attack rate among campers during the outbreak was 11% (13/118). Sanger-based amplicon sequencing of stool specimens from 7 (80%) campers identified Cryptosporidium hominis as the suspected etiologic agent. All infected campers were heart or kidney transplant recipients receiving immunosuppressive therapy. The median reported symptom duration was 12 days (range 6-18 days) and 9 (69.2%) were hospitalized for at least one night (median length of stay 5 days, range 2-16 days). There were no deaths or acute rejection events attributed to infection. The results of the epidemiologic and environmental investigation suggest a recreational pool as the presumed source, although there was no direct evidence to support this. Many long-term interventions were implemented, and there have been no further outbreaks at the camp in the following two years. This outbreak demonstrates that cryptosporidiosis may be associated with notable burden in pediatric transplant recipients, and illustrates the challenges associated with source identification and containment.
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Affiliation(s)
- John McAteer
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Stephanie Jernigan
- Division of Nephrology, School of Medicine, Emory University, Atlanta, Georgia.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Chad Mao
- Children's Healthcare of Atlanta, Atlanta, Georgia.,Sibley sHeart Center Cardiology, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Mark D Gonzalez
- Department of Pathology and Laboratory Services, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Renee J Watson
- Quality and Patient Safety, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Rochelle Liverman
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Melissa Tobin-D Angelo
- Georgia Department of Public Health, Acute Disease Epidemiology Section, Atlanta, Georgia
| | - Hope Dishman M
- Georgia Department of Public Health, Acute Disease Epidemiology Section, Atlanta, Georgia
| | - Andi Shane
- Children's Healthcare of Atlanta, Atlanta, Georgia.,Division of Pediatric Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia
| | - Inci Yildirim
- Children's Healthcare of Atlanta, Atlanta, Georgia.,Division of Pediatric Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia.,Department of Epidemiology, Rollins School of Public Health, Emory University School of Medicine, Atlanta, Georgia
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16
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McAteer J, Earle B. Pleural effusion in an otherwise healthy infant. J Paediatr Child Health 2019; 55:1508-1509. [PMID: 31846150 DOI: 10.1111/jpc.1_14594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 11/27/2022]
Affiliation(s)
- John McAteer
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
| | - Benjamin Earle
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
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17
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McAteer J, Wang LA, Chan A, Raabe VN, Kamat P, Freeman A, Yildirim I. Chest Wall Swelling in a Child With Pneumonia. Clin Pediatr (Phila) 2019; 58:1462-1465. [PMID: 31165640 DOI: 10.1177/0009922819853004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Abstract
The study addresses the needs of Scottish kinship carers of teenage children who have been identified as being in need of extra support. It designs and tests an appropriate support programme, defined as CARE. The CARE intervention study reported here applied the Six Steps for Quality Intervention Development framework, a pragmatic, evidence-based framework. The Six Steps for Quality Intervention Development framework comprises six steps: the first three steps seek to reveal the concerns of the kinship carer group and to generate a theory of change; the remaining three steps generate a theory of action for the intervention, and subsequently for its implementation. There were three main benefits reported: first, the self-care techniques had a reportedly positive stress-reduction effect on kinship carers, and in their dealings with their teenager; second, kinship carers reported an increased self-awareness of their communication or 'connectedness' with their teenager; and third, there was a reported positive impact upon behaviour control as a result of the stress-reduction and improved connectedness. The development of the CARE intervention programme suggests that the Six Steps in Quality Intervention Development provides a useful methodological underpinning for intervention procedures which can be applied in a range of public health and social work settings.
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Affiliation(s)
- Jane EK Hartley
- Jane EK Hartley, Scottish Collaboration for
Public Health and Policy, University of Edinburgh, 20 West Richmond Street,
Edinburgh EH8 9DX, UK.
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19
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McAteer J, Di Ruggiero E, Fraser A, Frank JW. Bridging the academic and practice/policy gap in public health: perspectives from Scotland and Canada. J Public Health (Oxf) 2019; 41:632-637. [PMID: 30053047 PMCID: PMC6785667 DOI: 10.1093/pubmed/fdy127] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/06/2018] [Indexed: 11/14/2022] Open
Abstract
This article presents a critical commentary of specific organizational models and practices for bridging 'the gap' between public health research and policy and practice. The authors draw on personal experiences of such models in addition to the wider knowledge translation and exchange literature to reflect on their strengths and weaknesses as implemented in Scotland and Canada since the early 1990s.
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Affiliation(s)
- J McAteer
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh, UK
| | - E Di Ruggiero
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, Suite 408 Toronto, Ontario, Canada
| | - A Fraser
- Public Health Science, NHS Health Scotland, Gyle Square, 1 South Gyle Crescent, Edinburghx, UK
| | - J W Frank
- The Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, UK
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20
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Pringle J, McAteer J, Whitehead R, Scott E, Milne D, Jepson R. Developing a taxonomy to characterise trusted adult support in the lives of adolescents. J Adolesc 2019; 76:30-36. [PMID: 31442812 PMCID: PMC6838780 DOI: 10.1016/j.adolescence.2019.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 08/07/2019] [Accepted: 08/11/2019] [Indexed: 11/28/2022]
Abstract
Introduction A systematic review of trusted adult interventions for adolescents revealed that there was no common terminology, agreed explicit definition, or detail, regarding the personal qualities, functions and roles fulfilled by trusted adults that was used consistently across the papers. To provide clarity, we therefore aimed to produce a taxonomy of trusted adult input, using evidence drawn from our review. Methods Data from the review findings were used to compile the taxonomy, moving from the general to the more specific, in a four stage process. This involved: (1) compilation of elements described in individual papers, (2) grouping of elements derived from stage 1 into categories, (3) examination of context and nature of the relationship, (4) development of a categorisation of trusted adult input. Findings The resulting taxonomy encapsulates core essential qualities provided by people acting in trusted adult or mentoring roles, and gives details relating to what a young person might expect from individuals they put their trust in. The taxonomy consists of six categories relating to: delivery context, roles of trusted adults, nature of support, personal qualities, actions/functions, and impact. Conclusions The taxonomy describes key elements that define the trusted adult role, and has the potential to inform the development of policies and guidelines relating to support provision. It may be used as a framework for the reporting of trusted adult interventions within research, and act as a helpful guide if a young person is in doubt about the behaviour or qualities displayed by an adult in their environment.
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Affiliation(s)
- Jan Pringle
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 9 Hope Park Square, Edinburgh, EH8 9NW, UK.
| | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | | | | | | | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
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21
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Laird Y, Myers F, Reid G, McAteer J. Tobacco Control Policy in Scotland: A Qualitative Study of Expert Views on Successes, Challenges and Future Actions. Int J Environ Res Public Health 2019; 16:E2659. [PMID: 31349618 PMCID: PMC6696046 DOI: 10.3390/ijerph16152659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/20/2019] [Accepted: 07/23/2019] [Indexed: 11/16/2022]
Abstract
The Scottish Government launched a tobacco control strategy in 2013 with the ambition of making Scotland tobacco smoke-free by 2034. However, 17% of the adult population in Scotland smoke cigarettes. This study aimed to provide insight into why policies are successful or not and provide suggestions for future policy actions. Individual interviews with ten tobacco control experts were conducted and the results were analyzed using thematic analysis. Key successes included strong political leadership, mass media campaigns, legislation to address availability and marketing of cigarettes and tobacco products, and legislation to reduce second-hand smoke exposure. Challenges included implementing policy actions, monitoring and evaluation of tobacco control actions, addressing health inequalities in smoking prevalence, and external factors that influenced the success of policy actions. Key suggestions put forward for future policy actions included addressing the price and availability of tobacco products, maintaining strong political leadership on tobacco control, building on the success of the 'Take it Right Outside' mass media campaign with further mass media campaigns to tackle other aspects of tobacco control, and developing and testing methods of addressing inequalities in cigarette smoking prevalence. The findings of this study can inform future tobacco control policy in Scotland and have relevance for tobacco control policies in other countries.
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Affiliation(s)
- Yvonne Laird
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh EH1 2QL, UK.
| | - Fiona Myers
- Evidence for Action, NHS Health Scotland, Edinburgh EH12 9EB, UK
| | - Garth Reid
- Evidence for Action, NHS Health Scotland, Edinburgh EH12 9EB, UK
| | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh EH1 2QL, UK
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22
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Malden S, Jepson R, Laird Y, McAteer J. A theory based evaluation of an intervention to promote positive health behaviors and reduce social isolation in people experiencing homelessness. J Soc Distress Homeless 2019; 28:158-168. [PMID: 31708718 PMCID: PMC6817315 DOI: 10.1080/10530789.2019.1623365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 06/10/2023]
Abstract
Homelessness adversely affects an individual's ability to access healthcare, opportunities for social interaction and recreational activities such as physical activity. This study aimed to evaluate the impact of a community-based physical activity and peer support intervention on the health and wellbeing of homeless participants. This study employed semi-structured interviews to investigate the perceived impact of the Street Fit Scotland intervention on the health and wellbeing of 10 homeless adults. Interviews were audio recorded and transcribed verbatim. A thematic analysis was conducted. Participants reported that their health and wellbeing had improved since attending the intervention. This was attributed to improvements in self-esteem, social interaction and mental wellbeing. Participants generally felt that their physical activity had increased since attending Street Fit Scotland, and a number of individuals reported that they were making healthier choices with regards to health behaviors. A theory of change logic model was developed that demonstrated how each component of the intervention influences the observed and intended outcomes. Attendance of Street Fit Scotland had positive effects on participant's health and wellbeing, particularly concerning self-esteem, health behaviors, social interaction, and physical activity. More efforts should be made to evaluate small-scale interventions that are reaching vulnerable population groups.
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Affiliation(s)
- Stephen Malden
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Yvonne Laird
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
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23
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Inglis G, McHardy F, Sosu E, McAteer J, Biggs H. Health inequality implications from a qualitative study of experiences of poverty stigma in Scotland. Soc Sci Med 2019; 232:43-49. [PMID: 31054403 PMCID: PMC6597943 DOI: 10.1016/j.socscimed.2019.04.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 12/03/2018] [Revised: 03/15/2019] [Accepted: 04/21/2019] [Indexed: 11/28/2022]
Abstract
Rationale Individuals living in Scotland's most deprived communities experience a higher burden of morbidity and early mortality than those living in more affluent areas. Experiences of poverty-based stigma may be one psychosocial mechanism through which socioeconomic position influences health, although there is little available data on this issue from a Scottish perspective. Objective The aim of this study was to identify which aspects of poverty stigma are particularly salient to individuals with lived experience of poverty, and may therefore contribute to health inequalities. Methods Five focus groups were conducted with 39 individuals with experience of living on low incomes in Scotland in order to explore their experiences and perceptions of poverty stigma. Results Five main themes were identified, reflecting aspects of poverty stigma operating at various structural, public and individual levels: media representations of poverty; negative encounters with social security systems; perceived public attitudes regarding poverty in Scotland; lowered self-esteem and internalisation of negative attitudes, and; emotional responses to stigma. Conclusion These dimensions of stigma potentially influence public health and health inequalities in Scotland, although future research will be necessary to quantify these and estimate their relationships with health outcomes. Relatively little is currently known about poverty-based stigma in Scotland. People with experience of poverty discussed this issue in five focus groups. Participants' accounts reflected several forms of poverty stigma. Poverty stigma operates at various structural, social, and individual levels. Poverty stigma is a potentially important determinant of health inequalities.
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Affiliation(s)
- Greig Inglis
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, UK.
| | | | | | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, UK.
| | - Hannah Biggs
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, UK.
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24
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McAteer J, Smith SE, Waris R. An Unusual Case of Bilateral Foot Swelling After an Online Gaming Overdose. Clin Pediatr (Phila) 2019; 58:257-259. [PMID: 30428710 DOI: 10.1177/0009922818812488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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25
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Pringle J, Whitehead R, Milne D, Scott E, McAteer J. The relationship between a trusted adult and adolescent outcomes: a protocol of a scoping review. Syst Rev 2018; 7:207. [PMID: 30474574 PMCID: PMC6260676 DOI: 10.1186/s13643-018-0873-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 11/05/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Although documentation of harm towards children and young people has existed for centuries, it was not until the 1960s that it became a specific focus for health professionals. Since that time, the importance of protective social networks has become better understood. The concept of trusted adults has come into sharper focus, with children being encouraged to develop networks of dependable adults to turn to for support in times of need. While many child protection processes highlight risks to younger children, there has been less emphasis on older children. The role of trusted adults may be particularly important during adolescence, due to burgeoning independence, developing sexuality, relationship formation, and associated vulnerabilities. While important choices relating to health and education are made during this period, there is little formal evidence relating to the impact of trusted adults on such outcomes. This review therefore aims to focus on the role and influence of trusted adults for adolescents. METHODS This study is a scoping review. A broad range of databases will be searched, including MEDLINE, ERIC, Education Abstracts, Web of Science, ASSIA, Sociological Abstracts, and PsycINFO. Predefined inclusion/exclusion criteria will be used, with a focus on outcomes relating to health and education. Two reviewers will blind screen papers independently at all screening stages, with conflicts being resolved by a third reviewer. Quantitative and qualitative studies, as well as unpublished (grey) literature/reports, will be included. We will use the World Health Organization's 'second decade' definition of adolescence. We aim to collate and map evidence in a broad overview and produce meta-analyses of homogenous data. Where this is not possible, a narrative summary will be produced. DISCUSSION There appears to be sparse knowledge regarding the role of trusted adults for adolescents. Potential benefits to health and wellbeing may impact on educational attainment, and vice versa. These areas are of particular relevance during the second decade, when decisions that affect future direction, achievement, and wellbeing are being made. The increased understanding of the role of trusted adults provided by this review may help to inform practice and policy and lead to potential benefits for the health and education of adolescents. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD 42017076739.
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Affiliation(s)
- Jan Pringle
- University of Edinburgh, 9 Hope Park Square, Edinburgh, EH8 9NW UK
| | | | - Dona Milne
- Public Health, NHS Lothian, Edinburgh, UK
| | | | - John McAteer
- University of Edinburgh, 9 Hope Park Square, Edinburgh, EH8 9NW UK
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Inglis G, Archibald D, Doi L, Laird Y, Malden S, Marryat L, McAteer J, Pringle J, Frank J. Credibility of subgroup analyses by socioeconomic status in public health intervention evaluations: An underappreciated problem? SSM Popul Health 2018; 6:245-251. [PMID: 30417067 PMCID: PMC6214868 DOI: 10.1016/j.ssmph.2018.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/27/2018] [Accepted: 09/30/2018] [Indexed: 01/12/2023] Open
Abstract
There is increasing interest amongst researchers and policy makers in identifying the effect of public health interventions on health inequalities by socioeconomic status (SES). This issue is typically addressed in evaluation studies through subgroup analyses, where researchers test whether the effect of an intervention differs according to the socioeconomic status of participants. The credibility of such analyses is therefore crucial when making judgements about how an intervention is likely to affect health inequalities, although this issue appears to be rarely considered within public health. The aim of this study was therefore to assess the credibility of subgroup analyses in published evaluations of public health interventions. An established set of 10 credibility criteria for subgroup analyses was applied to a purposively sampled set of 21 evaluation studies, the majority of which focussed on healthy eating interventions, which reported differential intervention effects by SES. While the majority of these studies were found to be otherwise of relatively high quality methodologically, only 8 of the 21 studies met at least 6 of the 10 credibility criteria for subgroup analysis. These findings suggest that the credibility of subgroup analyses conducted within evaluations of public health interventions' impact on health inequalities may be an underappreciated problem.
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Affiliation(s)
- Greig Inglis
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, EH8 9DX, United Kingdom
| | - Daryll Archibald
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, EH8 9DX, United Kingdom
| | - Lawrence Doi
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, EH8 9DX, United Kingdom
| | - Yvonne Laird
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, EH8 9DX, United Kingdom
| | - Stephen Malden
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, EH8 9DX, United Kingdom
| | - Louise Marryat
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, EH8 9DX, United Kingdom
| | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, EH8 9DX, United Kingdom
| | - Jan Pringle
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, EH8 9DX, United Kingdom
| | - John Frank
- Scottish Collaboration for Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, 20 West Richmond Street, EH8 9DX, United Kingdom
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Pringle J, Doi L, Jindal-Snape D, Jepson R, McAteer J. Adolescents and health-related behaviour: using a framework to develop interventions to support positive behaviours. Pilot Feasibility Stud 2018; 4:69. [PMID: 29619242 PMCID: PMC5879600 DOI: 10.1186/s40814-018-0259-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/07/2018] [Indexed: 11/24/2022] Open
Abstract
Background Experimentation is a natural part of adolescent maturation. In conjunction with increased exposure to behaviours such as alcohol or substance use, and the potentially intensified influence of peer groups, unhealthy behaviour patterns may develop as part of this experimentation. However, the adolescent years also provide considerable opportunity for behaviour to be shaped in positive ways that may improve immediate and longer term health outcomes. A systematic review carried out by the authors concluded that physiological changes during adolescence need to be considered when designing or implementing interventions, due to their influence on health behaviours. The aim of the study is to demonstrate how the six steps in quality intervention development (6SQuID) framework can be used, in conjunction with research or review findings, to inform the development of pilot or feasibility studies. Using the synthesised findings from our adolescent systematic review, we sought to illustrate how adolescent interventions might be designed to target specific health behaviours and augment positive adolescent health outcomes. Methods We applied the 6SQuID framework to the findings from a review of adolescent physiological influences on health behaviour. This involved following the process defined within 6SQuID and applying the sequential steps to build a proposed pilot study, based on the pre-defined findings of our systematic review. We used the Social Learning Theory to assist in identifying how and why change can be influenced, with and for adolescents. Results We devised a pilot study example, targeting teaching assistants, to illustrate how the detailed steps within the 6SQuID framework can assist the development and subsequent implementation of adolescent interventions that are likely to be effective. Conclusions This paper gives details of how the 6SQuID framework can be used for intervention development, using specific research findings, across a variety of adolescent health behaviours. This example provides details of how to operationalise 6SQuID in practical terms that are transferrable to other populations and situations. In this respect, we anticipate that this illustrative case may be of use in the design, development, and implementation of a wide variety of interventions.
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Affiliation(s)
- Jan Pringle
- 1Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond St, Edinburgh, EH8 9DX UK
| | - Lawrence Doi
- 1Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond St, Edinburgh, EH8 9DX UK
| | - Divya Jindal-Snape
- 2Education, Inclusion and Life Transitions, University of Dundee, Dundee, UK
| | - Ruth Jepson
- 1Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond St, Edinburgh, EH8 9DX UK
| | - John McAteer
- 1Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond St, Edinburgh, EH8 9DX UK
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Goodfellow A, Frank J, McAteer J, Rankin J. Improving preconception health and care: a situation analysis. BMC Health Serv Res 2017; 17:595. [PMID: 28835244 PMCID: PMC5569468 DOI: 10.1186/s12913-017-2544-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 08/15/2017] [Indexed: 11/24/2022] Open
Abstract
Background The purpose of this situation analysis was to explore the views of health and non-health professionals working with women of childbearing age on current and future delivery of preconception care in one National Health Service (NHS) Board area in Scotland. Methods The situation analysis was undertaken using a mixed methods approach. Six focus groups were conducted organised by profession – general practitioners (GPs), practice nurses, health visitors, family nurses, guidance teachers and youth workers. Existing evidence of effective preconception care interventions informed focus group guides. A survey was undertaken with community pharmacists which provided qualitative data for analysis. Focus group transcripts were analysed by two researchers using a thematic analysis approach. Results There was lack of awareness of preconception health and its importance amongst the target group. Levels of unplanned pregnancy hampered efforts to deliver interventions. Professional knowledge, capacity and consistency of practice were viewed as challenges, as was individual compliance with preconception care advice. Improvement requires multifaceted action, including ensuring the school curriculum adequately prepares adolescents for future parenthood, increasing awareness through communication and marketing, supporting professional knowledge and practice and capitalising on existing opportunities for preconception care, and ensuring services are equitable and targeted to need. Conclusions Delivery of preconception care needs to be improved both before and between pregnancies to improve outcomes for women and infants. Action is required at individual, organisational and community levels to ensure this important issue is at the forefront of preventative care and preventative spending.
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Affiliation(s)
- Ashley Goodfellow
- Department of Public Health, NHS Lanarkshire, Bothwell, G71 8BB, Glasgow, Scotland.
| | - John Frank
- Scottish Collaboration of Public Health Research and Policy, Centre for Population Health Sciences, University of Edinburgh, EH48 9DX, Edinburgh, Scotland
| | - John McAteer
- Scottish Collaboration of Public Health Research and Policy, Centre for Population Health Sciences, University of Edinburgh, EH48 9DX, Edinburgh, Scotland
| | - Jean Rankin
- Maternal Child and Family Health, School of Health Nursing and Midwifery, University of the West of Scotland, Paisley, PA1 2BE, Scotland
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Stead M, Parkes T, Nicoll A, Wilson S, Burgess C, Eadie D, Fitzgerald N, McKell J, Reid G, Jepson R, McAteer J, Bauld L. Delivery of alcohol brief interventions in community-based youth work settings: exploring feasibility and acceptability in a qualitative study. BMC Public Health 2017; 17:357. [PMID: 28438195 PMCID: PMC5404319 DOI: 10.1186/s12889-017-4256-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 04/11/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Alcohol Brief Interventions (ABIs) are increasingly being delivered in community-based youth work settings. However, little attention has been paid to how they are being implemented in such settings, or to their feasibility and acceptability for practitioners or young people. The aim of this qualitative study was to explore the context, feasibility and acceptability of ABI delivery in youth work projects across Scotland. METHODS Individual, paired and group interviews were conducted with practitioners and young people in nine community projects that were either involved in the delivery of ABIs or were considering doing so in the near future. A thematic analysis approach was used to analyse data. RESULTS ABIs were delivered in a diverse range of youth work settings including the side of football pitches, on the streets as part of outreach activities, and in sexual health drop-in centres for young people. ABI delivery differed in a number of important ways from delivery in other health settings such as primary care, particularly in being largely opportunistic and flexible in nature. ABIs were adapted by staff in line with the ethos of their project and their own roles, and to avoid jeopardising their relationships with young people. Young people reacted positively to the idea of having conversations about alcohol with youth project workers, but confirmed practitioners' views about the importance of these conversations taking place in the context of an existing trusting relationship. CONCLUSION ABIs were feasible in a range of youth work settings with some adaptation. Acceptability to staff was strongly influenced by perceived benefits, and the extent to which ABIs fitted with their project's ethos. Young people were largely comfortable with such conversations. Future implementation efforts should be based on detailed consideration of current practice and contexts. Flexible models of delivery, where professional judgement can be exercised over defined but adaptable content, may be better appreciated by staff and encourage further development of ABI activity.
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Affiliation(s)
- Martine Stead
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA UK
| | - Tessa Parkes
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA UK
| | - Avril Nicoll
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA UK
| | - Sarah Wilson
- Faculty of Social Science, Colin Bell Building, University of Stirling, Stirling, FK9 4LA UK
| | - Cheryl Burgess
- Faculty of Social Science, Colin Bell Building, University of Stirling, Stirling, FK9 4LA UK
| | - Douglas Eadie
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA UK
| | - Niamh Fitzgerald
- Institute for Social Marketing, UK Centre for Tobacco and Alcohol Studies, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA UK
| | - Jennifer McKell
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA UK
| | | | - Ruth Jepson
- The Scottish Collaboration for Public Health Research (SCPHRP), 20 West Richmond Street, Edinburgh, EH8 9DX UK
| | - John McAteer
- The Scottish Collaboration for Public Health Research (SCPHRP), 20 West Richmond Street, Edinburgh, EH8 9DX UK
| | - Linda Bauld
- Institute for Social Marketing, UK Centre for Tobacco and Alcohol Studies, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA UK
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Pringle J, Mills KL, McAteer J, Jepson R, Hogg E, Anand N, Blakemore SJ. The physiology of adolescent sexual behaviour: A systematic review. Cogent Soc Sci 2017; 3:1368858. [PMID: 29201945 PMCID: PMC5692360 DOI: 10.1080/23311886.2017.1368858] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/15/2017] [Indexed: 06/07/2023]
Abstract
Objectives: To examine physiological influences of adolescent sexual behaviour, including associated psychosocial factors. Methods: Systematic review. Results: Thirteen studies met the inclusion criteria relating to adolescents, physiology and sexual behaviour. We excluded studies relating to abnormal development. Findings highlighted hormonal and gender differences. Females appear to be more influenced by psychosocial aspects, including the effects of peers, than males. Males may be more inclined to engage in unprotected sex with a greater number of partners. Early maturing adolescents are more likely to be sexually active at an early age. Conclusions: Hormonal, psychosocial context, and sexual preference need to be acknowledged in intervention development. Stage of readiness to receive information may differ according to gender and physiological maturity.
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Affiliation(s)
- Jan Pringle
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond St, EdinburghEH8 9DX, UK
| | | | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond St, EdinburghEH8 9DX, UK
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond St, EdinburghEH8 9DX, UK
| | - Emma Hogg
- Youth Health, NHS Health Scotland, Edinburgh, UK
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Pringle J, Mills K, McAteer J, Jepson R, Hogg E, Anand N, Blakemore SJ. A systematic review of adolescent physiological development and its relationship with health-related behaviour: a protocol. Syst Rev 2016; 5:3. [PMID: 26732773 PMCID: PMC4700763 DOI: 10.1186/s13643-015-0173-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/18/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND At any one time, there are one billion people worldwide who are in the second decade of their life, and 1.8 billion in the 10-24 age range. Whilst a great deal of focus has been placed on healthy early years development, the adolescent years are also a unique period of opportunity: exposure to health-influencing behaviours such as alcohol consumption or cigarette smoking, may serve to establish patterns that have significant health consequences in later life. Although there is often an emphasis on risk-taking and detrimental health behaviours during adolescence, these years also provide significant opportunities for behaviour to be shaped in positive ways that may improve longer term health outcomes. However, it is firstly important to understand the complex physiological changes that are taking place within the human body during this period and their relationship with health-related behaviour. Such knowledge can help to inform health policy and intervention development. AIM The aim of this study is to gain a comprehensive understanding of the relationship between physiological development and health-related behaviours in adolescence. METHODS The principles of an integrative review will be used. Such reviews are of use where research has emerged in different fields, to combine existing knowledge and produce a more extensive understanding. Studies from a range of different methodological approaches, published or unpublished, will be included. A range of databases and literature depositories will be searched using a pre-defined search strategy. The review will include studies that focus on adolescents (nominally, those aged 10-24 years). We will seek papers that focus on both physiological development and health behaviour, or papers focusing solely on physiological development if there are clear implications for health behaviour. Studies with a focus on participants with specific health conditions will be excluded. Two reviewers will independently screen potential studies for eligibility and quality; members of the project team will act as third reviewers in the case of uncertainty or discrepancy. Further analyses (e.g. meta-analysis, meta-synthesis, meta-summary) will be decided upon, and sub-set analyses carried out. Finally, an integrative summation will be produced, giving a critical analysis of the results and providing conclusions and recommendations.
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Affiliation(s)
- Jan Pringle
- Scottish Collaboration for Public Health Research & Policy (SCPHRP), University of Edinburgh, 20 West Richmond St, Edinburgh, EH8 9DX, UK.
| | - Kate Mills
- Scottish Collaboration for Public Health Research & Policy (SCPHRP), University of Edinburgh, 20 West Richmond St, Edinburgh, EH8 9DX, UK.
| | - John McAteer
- Scottish Collaboration for Public Health Research & Policy (SCPHRP), University of Edinburgh, 20 West Richmond St, Edinburgh, EH8 9DX, UK.
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research & Policy (SCPHRP), University of Edinburgh, 20 West Richmond St, Edinburgh, EH8 9DX, UK.
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Frank J, Bromley C, Doi L, Estrade M, Jepson R, McAteer J, Robertson T, Treanor M, Williams A. Seven key investments for health equity across the lifecourse: Scotland versus the rest of the UK. Soc Sci Med 2015. [PMID: 26225753 PMCID: PMC4539344 DOI: 10.1016/j.socscimed.2015.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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] [Indexed: 11/08/2022]
Abstract
While widespread lip service is given in the UK to the social determinants of health (SDoH), there are few published comparisons of how the UK's devolved jurisdictions ‘stack up’, in terms of implementing SDoH-based policies and programmes, to improve health equity over the life-course. Based on recent SDoH publications, seven key societal-level investments are suggested, across the life-course, for increasing health equity by socioeconomic position (SEP). We present hard-to-find comparable analyses of routinely collected data to gauge the relative extent to which these investments have been pursued and achieved expected goals in Scotland, as compared with England and Wales, in recent decades. Despite Scotland's longstanding explicit goal of reducing health inequalities, it has recently been doing slightly better than England and Wales on only one broad indicator of health-equity-related investments: childhood poverty. However, on the following indicators of other ‘best investments for health equity’, Scotland has not achieved demonstrably more equitable outcomes by SEP than the rest of the UK: infant mortality and teenage pregnancy rates; early childhood education implementation; standardised educational attainment after primary/secondary school; health care system access and performance; protection of the population from potentially hazardous patterns of food, drink and gambling use; unemployment. Although Scotland did not choose independence on September 18th, 2014, it could still (under the planned increased devolution of powers from Westminster) choose to increase investments in the underperforming categories of interventions for health equity listed above. However, such discussion is largely absent from the current post-referendum debate. Without further significant investments in such policies and programmes, Scotland is unlikely to achieve the ‘healthier, fairer society’ referred to in the current Scottish Government's official aspirations for the nation. We put forward seven societal-level investments for increasing health equity. We compare evidence for their effectiveness in Scotland versus the rest of the UK. There have been improvements in reducing childhood poverty in Scotland. No evidence for improvements versus the rest of the UK for other investments. We recommend policy debates should focus on pros/cons and costs of such investments.
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Affiliation(s)
- John Frank
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, EH8 9DX, UK.
| | - Catherine Bromley
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, EH8 9DX, UK
| | - Larry Doi
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, EH8 9DX, UK
| | - Michelle Estrade
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, EH8 9DX, UK
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, EH8 9DX, UK
| | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, EH8 9DX, UK
| | - Tony Robertson
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, EH8 9DX, UK
| | - Morag Treanor
- School of Social and Political Sciences, University of Edinburgh, EH8 9LD, UK
| | - Andrew Williams
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, EH8 9DX, UK
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Stone S, Fuller C, Michie S, McAteer J, Charlett A. What Is the Optimal Period for Measuring Hand Hygiene Compliance: Are Longer Periods Better than 20-Minute Periods? Infect Control Hosp Epidemiol 2015; 33:1174-6. [DOI: 10.1086/668017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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McAteer J, Stone S, Fuller C, Michie S. Using psychological theory to understand the challenges facing staff delivering a ward-led intervention to increase hand hygiene behavior: a qualitative study. Am J Infect Control 2014; 42:495-9. [PMID: 24656784 DOI: 10.1016/j.ajic.2013.12.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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: 07/23/2013] [Revised: 12/26/2013] [Accepted: 12/30/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Feedback Intervention Trial was a national trial of an intervention to increase hand hygiene behavior in English and Welsh hospitals. It significantly improved behavior, the effect increasing with fidelity to intervention, but the intervention proved more difficult to implement than anticipated. This study aimed to identify the barriers to and facilitators of implementation as experienced by those who delivered the intervention. METHODS Semistructured interviews were conducted with 17 intervention ward coordinators implementing the intervention. Interview questions were based on the Theoretical Domains Framework. Text relating to each domain was scored according to whether it indicated low or high likelihood of implementation, and thematic analysis conducted. RESULTS The lowest scoring domains were "environmental context and resources," "beliefs about capabilities," "social influences," and "emotion." Lack of time and understaffing, perceived negativity from other staff members, and stress were identified as challenges to implementation. The highest scoring domains were "behavioral regulation," "motivation," "skills," "knowledge," and "professional role." Ward coordinators reported that they had the skills, understanding, and motivation to implement the intervention and spoke of consistency of tasks with existing roles. CONCLUSION Implementation might be improved by giving designated time for intervention tasks and ensuring that the ward coordinator role is allocated to staff for whom tasks are commensurate with existing professional roles.
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Affiliation(s)
- John McAteer
- Scottish Collaboration for Public Health Research and Policy, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK; Department of Psychology, University College London, London, UK.
| | - Sheldon Stone
- Royal Free Campus, University College London Medical School, London, UK
| | - Christopher Fuller
- Centre for Infectious Disease Epidemiology, University College London, London, UK
| | - Susan Michie
- Department of Psychology, University College London, London, UK
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Fuller C, Besser S, Savage J, McAteer J, Stone S, Michie S. Application of a theoretical framework for behavior change to hospital workers' real-time explanations for noncompliance with hand hygiene guidelines. Am J Infect Control 2014; 42:106-10. [PMID: 24355490 DOI: 10.1016/j.ajic.2013.07.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/23/2013] [Accepted: 07/23/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Insufficient use of behavioral theory to understand health care workers' (HCWs) hand hygiene compliance may result in suboptimal design of hand hygiene interventions and limit effectiveness. Previous studies examined HCWs' intended, rather than directly observed, compliance and/or focused on just 1 behavioral model. This study examined HCWs' explanations of noncompliance in "real time" (immediately after observation), using a behavioral theory framework, to inform future intervention design. METHODS HCWs were directly observed and asked to explain episodes of noncompliance in "real-time." Explanations were recorded, coded into 12 behavioral domains, using the Theory Domains Framework, and subdivided into themes. RESULTS Over two-thirds of 207 recorded explanations were explained by 2 domains. These were "Memory/Attention/Decision Making" (87, 44%), subdivided into 3 themes (memory, loss of concentration, and distraction by interruptions), and "Knowledge" (55, 26%), with 2 themes relating to specific hand hygiene indications. No other domain accounted for more than 18 (9%) explanations. CONCLUSION An explanation of HCW's "real-time" explanations for noncompliance identified "Memory/Attention/Decision Making" and "Knowledge" as the 2 behavioral domains commonly linked to noncompliance. This suggests that hand hygiene interventions should target both automatic associative learning processes and conscious decision making, in addition to ensuring good knowledge. A theoretical framework to investigate HCW's "real-time" explanations of noncompliance provides a coherent way to design hand hygiene interventions.
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Parkes T, Stead M, Eadie D, Nicoll A, McKell J, Bauld L, Wilson S, Burgess C, Reid G, McAteer J, Jepson R. Alcohol brief interventions in youth and social work settings in Scotland. Addict Sci Clin Pract 2013. [PMCID: PMC3766038 DOI: 10.1186/1940-0640-8-s1-a52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
This study sought to extract underlying beliefs towards measles, mumps and rubella (MMR) vaccination from UK parents' views towards potential motivational and organisational interventions to boost MMR vaccination. Thematic analysis of transcripts of five focus groups identified five underlying psychological themes: parents' information needs, distrust of government sources, trust of other parents, attentional biases towards risk information and problems of achieving "balance" in MMR information provision. These are likely to represent important psychological barriers to or facilitators of the effectiveness of MMR promotion interventions.
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Affiliation(s)
- Benjamin Gardner
- Centre for Outcomes Research and Effectiveness, University College London, UK.
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Fuller C, Besser S, Cookson BD, Fragaszy E, Gardiner J, McAteer J, Michie S, Savage J, Stone SP. Technical note: Assessment of blinding of hand hygiene observers in randomized controlled trials of hand hygiene interventions. Am J Infect Control 2010; 38:332-4. [PMID: 20189686 DOI: 10.1016/j.ajic.2009.10.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 10/13/2009] [Accepted: 10/16/2009] [Indexed: 10/19/2022]
Abstract
Trials evaluating interventions to improve health care workers' hand hygiene compliance use directly observed compliance as a primary outcome measure. Observers should be blinded to the intervention and the effectiveness of blinding assessed to prevent systematic bias. The literature has not addressed this issue, and this study describes a robust and pragmatic method for assessing the adequacy of blinding in hand hygiene intervention trials.
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Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol 2010; 28:690-701. [PMID: 19916637 DOI: 10.1037/a0016136] [Citation(s) in RCA: 1369] [Impact Index Per Article: 97.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Meta-analyses of behavior change (BC) interventions typically find large heterogeneity in effectiveness and small effects. This study aimed to assess the effectiveness of active BC interventions designed to promote physical activity and healthy eating and investigate whether theoretically specified BC techniques improve outcome. DESIGN Interventions, evaluated in experimental or quasi-experimental studies, using behavioral and/or cognitive techniques to increase physical activity and healthy eating in adults, were systematically reviewed. Intervention content was reliably classified into 26 BC techniques and the effects of individual techniques, and of a theoretically derived combination of self-regulation techniques, were assessed using meta-regression. MAIN OUTCOME MEASURES Valid outcomes of physical activity and healthy eating. RESULTS The 122 evaluations (N = 44,747) produced an overall pooled effect size of 0.31 (95% confidence interval = 0.26 to 0.36, I(2) = 69%). The technique, "self-monitoring," explained the greatest amount of among-study heterogeneity (13%). Interventions that combined self-monitoring with at least one other technique derived from control theory were significantly more effective than the other interventions (0.42 vs. 0.26). CONCLUSION Classifying interventions according to component techniques and theoretically derived technique combinations and conducting meta-regression enabled identification of effective components of interventions designed to increase physical activity and healthy eating.
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Affiliation(s)
- Susan Michie
- Centre for Outcomes Research and Effectiveness, University College London, UK.
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Gardner B, Whittington C, McAteer J, Eccles MP, Michie S. Using theory to synthesise evidence from behaviour change interventions: the example of audit and feedback. Soc Sci Med 2010; 70:1618-25. [PMID: 20207464 DOI: 10.1016/j.socscimed.2010.01.039] [Citation(s) in RCA: 161] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2009] [Revised: 12/02/2009] [Accepted: 01/28/2010] [Indexed: 11/19/2022]
Abstract
Evidence syntheses are used to inform health care policy and practice. Behaviour change theories offer frameworks for categorising and evaluating interventions and identifying likely mechanisms through which effects are achieved. Yet systematic reviews rarely explicitly classify intervention components using theory, which may result in evidence syntheses and health care practice recommendations that are less than optimal. This paper outlines a method for applying theory to evidence syntheses of behaviour change interventions. We illustrate this method with an analysis of 'audit and feedback' interventions, based on data from a Cochrane review. Our analysis is based on Control Theory, which suggests that behaviour change is most likely if feedback is accompanied by comparison with a behavioural target and by action plans, and we coded interventions for these three techniques. Multivariate meta-regression was performed on 85 comparisons from 61 studies. However, few interventions incorporated targets or action plans, and so meta-regression models were likely to be underfitted due to insufficient power. The utility of our approach could not be tested via our analysis because of the limited nature of the audit and feedback interventions. However, we show that conceptualising and categorising interventions using behaviour change theory can reveal the theoretical coherence of interventions and so point towards improvements in intervention design, evaluation and synthesis. The results demonstrate that a theory-based approach to evidence synthesis is feasible, and can prove beneficial in understanding intervention design, even where there is insufficient empirical evidence to reliably synthesise effects of specific intervention components.
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Affiliation(s)
- Benjamin Gardner
- Centre for Outcomes Research and Effectiveness, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
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Gardner B, Davidson R, McAteer J, Michie S. A method for studying decision-making by guideline development groups. Implement Sci 2009; 4:48. [PMID: 19656366 PMCID: PMC2731071 DOI: 10.1186/1748-5908-4-48] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Accepted: 08/05/2009] [Indexed: 11/22/2022] Open
Abstract
Background Multidisciplinary guideline development groups (GDGs) have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR) study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making. Methods A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis. Results Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE) acute physical health GDG. Conclusion This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making groups.
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Affiliation(s)
- Benjamin Gardner
- Centre for Outcomes Research and Effectiveness, Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
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Florez JC, Jablonski KA, McAteer J, Sandhu MS, Wareham NJ, Barroso I, Franks PW, Altshuler D, Knowler WC. Testing of diabetes-associated WFS1 polymorphisms in the Diabetes Prevention Program. Diabetologia 2008; 51:451-7. [PMID: 18060660 PMCID: PMC2483955 DOI: 10.1007/s00125-007-0891-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2007] [Accepted: 10/30/2007] [Indexed: 11/25/2022]
Abstract
AIMS/HYPOTHESIS Wolfram syndrome (diabetes insipidus, diabetes mellitus, optic atrophy and deafness) is caused by mutations in the WFS1 gene. Recently, single nucleotide polymorphisms (SNPs) in WFS1 have been reproducibly associated with type 2 diabetes. We therefore examined the effects of these variants on diabetes incidence and response to interventions in the Diabetes Prevention Program (DPP), in which a lifestyle intervention or metformin treatment was compared with placebo. METHODS We genotyped the WFS1 SNPs rs10010131, rs752854 and rs734312 (H611R) in 3,548 DPP participants and performed Cox regression analysis using genotype, intervention and their interactions as predictors of diabetes incidence. We also evaluated the effect of these SNPs on insulin resistance and beta cell function at 1 year. RESULTS Although none of the three SNPs was associated with diabetes incidence in the overall cohort, white homozygotes for the previously reported protective alleles appeared less likely to develop diabetes in the lifestyle arm. Examination of the publicly available Diabetes Genetics Initiative genome-wide association dataset revealed that rs10012946, which is in strong linkage disequilibrium with the three WFS1 SNPs (r(2)=0.88-1.0), was associated with type 2 diabetes (allelic odds ratio 0.85, 95% CI 0.75-0.97, p=0.026). In the DPP, we noted a trend towards increased insulin secretion in carriers of the protective variants, although for most SNPs this was seen as compensatory for the diminished insulin sensitivity. CONCLUSIONS/INTERPRETATION The previously reported protective effect of select WFS1 alleles may be magnified by a lifestyle intervention. These variants appear to confer an improvement in beta cell function.
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Affiliation(s)
- J C Florez
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA.
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McAteer J, Stone S, Fuller C, Charlett A, Cookson B, Slade R, Michie S, the NOSEC/FIT group. Development of an observational measure of healthcare worker hand-hygiene behaviour: the hand-hygiene observation tool (HHOT). J Hosp Infect 2008; 68:222-9. [DOI: 10.1016/j.jhin.2007.12.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Stone S, Slade R, Fuller C, Charlett A, Cookson B, Teare L, Jeanes A, Cooper B, Roberts J, Duckworth G, Hayward A, McAteer J, Michie S. Early communication: Does a national campaign to improve hand hygiene in the NHS work? Initial English and Welsh experience from the NOSEC study (National Observational Study to Evaluate the CleanYourHandsCampaign). J Hosp Infect 2007; 66:293-6. [PMID: 17582651 DOI: 10.1016/j.jhin.2007.04.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Accepted: 04/19/2007] [Indexed: 11/15/2022]
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Stone S, Slade R, Fuller C, McAteer J, Cookson B, Teare L, Jeanes A, Cooper B, Roberts J, Duckworth G, Hayward A, Charlett A, Michie S. Cleanyourhands Campaign: a critique of the critique. J Hosp Infect 2007; 66:288-9; author reply 289-90. [PMID: 17573154 DOI: 10.1016/j.jhin.2007.03.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Accepted: 03/30/2007] [Indexed: 11/16/2022]
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McAteer J, Stone S, Roberts J, Michie S, Fuller C, Slade R, Charlett A, Cookson B, Cooper B, Duckworth G, Hayward A, Jeane A, Teare L. Use of performance feedback to increase healthcare worker hand-hygiene behaviour. J Hosp Infect 2007; 66:291-2; author reply 292-3. [PMID: 17548128 DOI: 10.1016/j.jhin.2007.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Accepted: 04/02/2007] [Indexed: 11/30/2022]
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McAteer J, Stone S, Fuller C, Michie S. P10.09 Development of an Intervention to Increase UK NHS Healthcare Worker Hand-hygiene Behaviour Using Psychological Theory. J Hosp Infect 2006. [DOI: 10.1016/s0195-6701(06)60175-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dominguez JH, Song B, Liu-Chen S, Qulali M, Howard R, Lee CH, McAteer J. Studies of renal injury. II. Activation of the glucose transporter 1 (GLUT1) gene and glycolysis in LLC-PK1 cells under Ca2+ stress. J Clin Invest 1996; 98:395-404. [PMID: 8755650 PMCID: PMC507443 DOI: 10.1172/jci118805] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Injury to the renal proximal tubule is common and may be followed by either recovery or cell death. The survival of injured cells is supported by a transient change in cellular metabolism that maintains life even when oxygen tension is reduced. This adaptive process involves the activation of the gene encoding the glucose transporter GLUT1, which is essential to maintain the high rates of glucose influx demanded by glycolysis. We hypothesized that after cell injury increases of cell Ca2+ (Ca2+i) initiate the flow of information that culminates with the upregulation of the stress response gene GLUT1. We found that elevations of Ca2+i caused by the calcium ionophore A23187 activated the expression of the GLUT1 gene in LLC-PK1 cells. The stimulatory effect of Ca2+i on GLUT1 gene expression was, at least in part, transcriptional and resulted in higher levels of GLUT1 mRNA, cognate protein, cellular hexose transport activity, glucose consumption, and lactate production. This response was vital to the renal cells, as its interruption severely increased Ca2+-induced cytotoxicity and cell mortality. We propose that increases of Ca2+i initiate stress responses, represented in part by activation of the GLUT1 gene, and that disruption to the flow of information originating from Ca2+-induced stress, or to the coordinated expression of the stress response, prevents cell recovery after injury and may be an important cause of permanent renal cell injury and cell death.
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Affiliation(s)
- J H Dominguez
- Department of Medicine, Indiana University Medical Center, Indiana 46202, USA
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Grantham JJ, Uchic M, Cragoe EJ, Kornhaus J, Grantham JA, Donoso V, Mangoo-Karim R, Evan A, McAteer J. Chemical modification of cell proliferation and fluid secretion in renal cysts. Kidney Int 1989; 35:1379-89. [PMID: 2770116 DOI: 10.1038/ki.1989.137] [Citation(s) in RCA: 66] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We used an in vitro model, MDCK cyst, to determine the extent to which pharmacologic compounds known to inhibit plasma membrane solute transport mechanisms could alter the enlargement of renal epithelial cysts. Solitary MDCK cells cultured within collagen gel undergo clonal growth to form true epithelial cysts in which a single layer of polarized cells (apex toward lumen) encloses a fluid-filled cavity. Repeated observations by light microscopy were used to quantitate the rate of cyst growth in diameter, and demonstrated that cyst enlargement involved an increase in cell number (proliferation) and a net increase in intracystic volume (fluid secretion). Intracyst pressure was greater than the interstitium (6.7 mm H2O +/- 3.1 SD), indicating that fluid entry was secondary to net solute accumulation. Amiloride and seven amiloride analogs that inhibited to different degrees conductive Na+ transport, Na+-dependent H+ transport and Na+-dependent Ca++ transport reversibly decreased the rate of cyst enlargement. The effectiveness of these agents to retard cyst enlargement correlated with their relative potencies to inhibit Na+-dependent Ca++ transport. Morphologic examination indicated that amiloride and amiloride analogs decreased cell proliferation and fluid secretion to the same degree. Ouabain and vanadate (Na+K,ATPase inhibitors), and L-645,695 (Na+-dependent Cl-/HCO3- inhibitor) potently slowed cyst expansion. In contrast to amiloride and amiloride analogs, these agents caused an unusual degree of cellular stratification within the cyst walls, a finding consistent with the notion that fluid secretion was inhibited to a greater extent then cellular proliferation. We conclude that chemical inhibitors of primary and secondary active solute transport can diminish or halt the enlargement of epithelial cysts in vitro by decreasing the rate of cellular proliferation and/or net fluid secretion.
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Affiliation(s)
- J J Grantham
- Department of Medicine, University of Kansas School of Medicine, Kansas City
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