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Barker C, Collet K, Gbesemete D, Piggin M, Watson D, Pristerà P, Lawerence W, Smith E, Bahrami-Hessari M, Johnson H, Baker K, Qavi A, McGrath C, Chiu C, Read RC, Ward H. Public attitudes to a human challenge study with SARS-CoV-2: a mixed-methods study. Wellcome Open Res 2022; 7:49. [PMID: 35321005 PMCID: PMC8921687 DOI: 10.12688/wellcomeopenres.17516.1] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Human challenge studies involve the deliberate exposure of healthy volunteers to an infectious micro-organism in a highly controlled and monitored way. They are used to understand infectious diseases and have contributed to the development of vaccines. In early 2020, the UK started exploring the feasibility of establishing a human challenge study with SARS-CoV-2. Given the significant public interest and the complexity of the potential risks and benefits, it is vital that public views are considered in the design and approval of any such study and that investigators and ethics boards remain accountable to the public. Methods: Mixed methods study comprising online surveys conducted with 2,441 UK adults and in-depth virtual focus groups with 57 UK adults during October 2020 to explore the public's attitudes to a human challenge study with SARS-CoV-2 taking place in the UK. Results: There was overall agreement across the surveys and focus groups that a human challenge study with SARS-CoV-2 should take place in the UK. Transparency of information, trust and the necessity to provide clear information on potential risks to study human challenge study participants were important. The perceived risks of taking part included the risk of developing long-term effects from COVID, impact on personal commitments and mental health implications of isolation. There were a number of practical realities to taking part that would influence a volunteer's ability to participate (e.g. Wi-Fi, access to exercise, outside space and work, family and pet commitments). Conclusions: The results identified practical considerations for teams designing human challenge studies. Recommendations were grouped: 1) messaging to potential study participants, 2) review of the protocol and organisation of the study, and 3) more broadly, making the study more inclusive and relevant. This study highlights the value of public consultation in research, particularly in fields attracting public interest and scrutiny .
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Affiliation(s)
- Caroline Barker
- NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.,NIHR Applied Research Collaboration Wessex, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK, UK
| | - Katharine Collet
- NIHR Imperial Biomedical Research Centre, Patient Experience Research Centre, Imperial College London, London, W2 1NY, UK
| | - Diane Gbesemete
- NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.,School of Clinical and Experimental Sciences, Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, S016 6YD, UK
| | - Maria Piggin
- NIHR Imperial Biomedical Research Centre, Patient Experience Research Centre, Imperial College London, London, W2 1NY, UK
| | - Daniella Watson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, S016 6YD, UK
| | - Philippa Pristerà
- NIHR Imperial Biomedical Research Centre, Patient Experience Research Centre, Imperial College London, London, W2 1NY, UK
| | - Wendy Lawerence
- NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.,Global Health Research Institute, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK
| | - Emma Smith
- National Heart and Lung Institute, Imperial College London, London, W2 1NY, UK
| | - Michael Bahrami-Hessari
- NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Halle Johnson
- NIHR Imperial Biomedical Research Centre, Patient Experience Research Centre, Imperial College London, London, W2 1NY, UK
| | - Katherine Baker
- NIHR Applied Research Collaboration Wessex, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK, UK
| | - Ambar Qavi
- NIHR Imperial Biomedical Research Centre, Patient Experience Research Centre, Imperial College London, London, W2 1NY, UK
| | - Carmel McGrath
- NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.,School of Clinical and Experimental Sciences, Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, S016 6YD, UK
| | - Christopher Chiu
- Department of Infectious Diseases, Imperial College London, London, W2 1NY, UK
| | - Robert C Read
- NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.,School of Clinical and Experimental Sciences, Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, S016 6YD, UK
| | - Helen Ward
- NIHR Imperial Biomedical Research Centre, Patient Experience Research Centre, Imperial College London, London, W2 1NY, UK
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Antonaccio CM, Pham P, Vinck P, Collet K, Brennan RT, Betancourt TS. Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study. BMC Public Health 2021; 21:2066. [PMID: 34763704 PMCID: PMC8581958 DOI: 10.1186/s12889-021-12146-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/26/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022] Open
Abstract
Background During the 2014–15 Ebola Virus Disease (EVD) epidemic, thousands of people in Sierra Leone were infected with the devastating virus and survived. Years after the epidemic was declared over, stigma toward EVD survivors and others affected by the virus is still a major concern, but little is known about the factors that influence stigma toward survivors. This study examines how key personal and ecological factors predicted EVD-related stigma at the height of the 2014–2015 epidemic in Sierra Leone, and the personal and ecological factors that shaped changes in stigma over time. Methods Using three waves of survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines factors associated with self-reported personal stigma toward Ebola survivors (11 items, α = 0.77) among 1008 adults (74.6% retention rate) from 63 census enumeration areas of the Western Rural and Western Urban districts of Sierra Leone. Participants were randomly sampled at the height of the EVD epidemic and followed up as the epidemic was waning and once the epidemic had been declared over by the WHO. Three-level mixed effects models were fit using Stata 16 SE to examine cross-sectional associations as well as predictors of longitudinal changes in stigma toward EVD survivors. Results At the height of the EVD epidemic, female sex, household wealth, post-traumatic stress, EVD-related fear and perceived infection risk are a few of the factors which predicted higher levels of stigma toward survivors. On average, stigma toward EVD survivors decreased significantly as the epidemic declined in Sierra Leone, but female sex, EVD fear, and risk perceptions predicted a slower rate of change. Conclusion This study identified key individual and psychosocial characteristics which may predict higher levels of stigma toward infectious disease survivors. Future studies should pursue a better understanding of how personal characteristics and perceptions, including psychosocial distress, fear, and perceived infection risk serve as pathways for stigma in communities affected by infectious disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12146-0.
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Affiliation(s)
- Cara M Antonaccio
- Research Program on Children and Adversity, Boston College School of Social Work, Boston, MA, USA
| | - Phuong Pham
- Harvard Medical School and Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Patrick Vinck
- Harvard Medical School and Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Robert T Brennan
- Research Program on Children and Adversity, Boston College School of Social Work, Boston, MA, USA.,Women's Studies Research Center, Brandeis University, Waltham, MA, USA
| | - Theresa S Betancourt
- Research Program on Children and Adversity, Boston College School of Social Work, Boston, MA, USA.
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Hopwood H, Sevalie S, Herman MO, Harris D, Collet K, Bah AJ, Beynon F. The burden of mental disorder in Sierra Leone: a retrospective observational evaluation of programmatic data from the roll out of decentralised nurse-led mental health units. Int J Ment Health Syst 2021; 15:31. [PMID: 33832523 PMCID: PMC8033705 DOI: 10.1186/s13033-021-00455-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In sub-Saharan Africa the treatment gap for mental disorders is high. In 2009, 98.0% of people with mental illness in Sierra Leone were not receiving treatment, partly due to the absence of public psychiatric facilities outside the capital. In response, the Ministry of Health and Sanitation rolled out nurse-led mental health units (MHU) to every district. This study aims to retrospectively evaluate the uptake of these services by examining the pathways to care, diagnosis, management, and treatment gap, to provide insight into the functioning of these units and the potential burden of mental health disorders in Sierra Leone. METHODS We evaluated the roll out of MHU using summary data from all units between 1 st January 2015 and 1 st January 2017, to establish the burden of diagnoses among service users, pathways to care, treatments provided, and treatment gaps. Negative binomial regressions examine bivariate relationships between diagnoses, treatments, and medication inaccessibility with demographics (age and sex), location (Freetown vs the rest and Ebola endemic regions vs the rest) and year. RESULTS We collected data from 15 MHU covering 13 districts in 24 months. There were 2401 referrals. The largest age category was 25-34 (23.4%). The prominent diagnoses were epilepsy (43.5%, associated with children) and psychosis (17.5%, associated with males). Reported depression (8.6%) and suicide attempts (33 patients) were low. Ebola endemic regions reported higher rates of grief, trauma, and medically unexplained symptoms. In 24.7% of cases where medication was required, it was not accessible. CONCLUSIONS Nurse-led MHU can have a modest effect on the treatment gap in resource constrained environments such as Sierra Leone, particularly in epilepsy and psychosis.
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Affiliation(s)
- Helen Hopwood
- King's Sierra Leone Partnership, King's Global Health Partnerships, King's Centre for Global Health and Health Partnerships, School of Population and Environmental Sciences, King's College London, Freetown, Sierra Leone.
| | | | - Moshi Optat Herman
- Kings College London Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Dawn Harris
- King's Sierra Leone Partnership, King's Global Health Partnerships, King's Centre for Global Health and Health Partnerships, School of Population and Environmental Sciences, King's College London, Freetown, Sierra Leone
| | | | | | - Fenella Beynon
- King's Sierra Leone Partnership, King's Global Health Partnerships, King's Centre for Global Health and Health Partnerships, School of Population and Environmental Sciences, King's College London, Freetown, Sierra Leone
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Biffi R, Pittiruti M, Gillet JP, Fobe D, Hermanne JP, Pescio M, Gourlia A, Collet K, Battelli C, Cenciarelli S. Valved Central Venous Catheter Connected to Subcutaneous Port: A Multicenter Phase IV Study Based on a Cohort of 50 Oncology Patients. J Vasc Access 2018; 3:147-53. [PMID: 17639477 DOI: 10.1177/112972980200300403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose Since technical aspects and clinical features of central venous valved catheters are far from being completely understood, a multinational group of investigators has decided to assess a new distally-valved catheter connected to a port, in the clinical setting of oncology patients undergoing chemotherapy, in an attempt to verify its safety and viability, while also investigating its practical features. Methods Our project was structured as a phase IV multicenter study. Hospitalized adults (ages 18–80 years) who had solid tumors and were candidate for intravenous chemotherapy met the criteria to enter the study. One single type of port was used (made of titanium, plastic and silicone) connected to a silicone, distally valved catheter (as manufactured by B. Braun Aesculap). A case report form was provided for each treated case; all relevant data regarding implantation and follow-up were entered into the form, mailed to a coordinating center (G. Chevillon, B. Braun Medical, France) and stored in a software database for statistical analysis. Results 50 patients (from 6 participating centers) were included in this study. No major complications occurred at insertion. The most frequent clinical problem during follow-up was inability to draw blood samples (9% during the first chemotherapy cycle; 8% after the second cycle); blood obtained from the device was defined “unsuitable for hematology test” in 9% of the cases at first chemotherapy cycle and in 23% of the cases after the second cycle. No catheter obstruction occurred. Conclusion The distally valved catheter port tested in this study was reliable, safe and practical for long-term treatment of an oncology patients’ population undergoing chemotherapy. As most other reports and clinical trials dealing with other types of distally valved catheters pointed out, inability to draw viable blood samples (so called withdrawal occlusion) is a major concern in their clinical use. Mechanisms underlying this technical problem are still unclear.
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Affiliation(s)
- R Biffi
- Division of General Surgery, European Institute of Oncology, Milano - Italy
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