4 results
Development of a multi-component intervention to promote participation of Black and Latinx individuals in biomedical research
- Maria I. Danila, Jeroan J. Allison, Karin Valentine Goins, Germán Chiriboga, Melissa Fischer, Melissa Puliafico, Amy S. Mudano, Elizabeth J. Rahn, Jeanne Merchant, Colleen E. Lawrence, Leah Dunkel, Tiffany Israel, Bruce Barton, Fred Jenoure, Tiffany Alexander, Danny Cruz, Marva Douglas, Jacqueline Sims, Al Richmond, Erik D. Roberson, Carol Chambless, Paul A. Harris, Kenneth G. Saag, Stephenie C. Lemon
-
- Journal:
- Journal of Clinical and Translational Science / Volume 5 / Issue 1 / 2021
- Published online by Cambridge University Press:
- 14 June 2021, e134
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Introduction:
Barriers to research participation by racial and ethnic minority group members are multi-factorial, stem from historical social injustices and occur at participant, research team, and research process levels. The informed consent procedure is a key component of the research process and represents an opportunity to address these barriers. This manuscript describes the development of the Strengthening Translational Research in Diverse Enrollment (STRIDE) intervention, which aims to improve research participation by individuals from underrepresented groups.
Methods:We used a community-engaged approach to develop an integrated, culturally, and literacy-sensitive, multi-component intervention that addresses barriers to research participation during the informed consent process. This approach involved having Community Investigators participate in intervention development activities and using community engagement studios and other methods to get feedback from community members on intervention components.
Results:The STRIDE intervention has three components: a simulation-based training program directed toward clinical study research assistants that emphasizes cultural competency and communication skills for assisting in the informed consent process, an electronic consent (eConsent) framework designed to improve health-related research material comprehension and relevance, and a “storytelling” intervention in which prior research participants from diverse backgrounds share their experiences delivered via video vignettes during the consent process.
Conclusions:The community engaged development approach resulted in a multi-component intervention that addresses known barriers to research participation and can be integrated into the consent process of research studies. Results of an ongoing study will determine its effectiveness at increasing diversity among research participants.
Reduction in the occurrence of distressing involuntary memories following propranolol or hydrocortisone in healthy women
- Sunjeev K. Kamboj, An Tong Gong, ZhiHui Sim, Adrihani A. Rashid, Ami Baba, Georges Iskandar, Ravi K. Das, H. Valerie Curran
-
- Journal:
- Psychological Medicine / Volume 50 / Issue 7 / May 2020
- Published online by Cambridge University Press:
- 14 May 2019, pp. 1148-1155
-
- Article
- Export citation
-
Background
Pharmacological treatments targeting the neuroendocrine stress response may hold special promise in secondary prevention of posttraumatic stress disorder (PTSD). However, findings from clinical trials have been inconsistent and the efficacy of specific drugs, their temporal window of efficacy, effective doses and the characteristics of likely treatment responders remain unclear.
MethodUsing an experimental human model of distressing involuntary memory formation, we compare the effects of two drugs that have theoretical or empirical support as secondary preventive agents in PTSD. Eighty-eight healthy women (average age: 23.5 years) received oral propranolol (80 mg), hydrocortisone (30 mg), or matched placebo immediately after viewing a ‘trauma film’. They then completed daily, time-stamped intrusion diaries for 1 week, at the end of which, voluntary memory was tested.
ResultsWhile neither drug affected voluntary memory for the trauma narrative, propranolol treatment was associated with 42% fewer, and hydrocortisone with 55% fewer intrusions across the week, relative to placebo. Additionally, propranolol reduced general trauma-like symptoms, and post-drug cortisol levels were negatively correlated with intrusion frequency in the hydrocortisone group.
ConclusionsOverall, this study shows substantial reductions in intrusive memories and preserved voluntary narrative-declarative memory following either propranolol or hydrocortisone in an experimental model of psychological trauma. As such, despite some inconsistencies in clinical trials, our findings support continued investigation of propranolol and hydrocortisone as secondary preventive agents for re-experiencing symptoms of PTSD. The findings also suggest that it is critical for future research to identify the conditions governing the preventive efficacy of these drugs in PTSD.
Task shifting to clinical officer-led echocardiography screening for detecting rheumatic heart disease in Malawi, Africa
- Amy Sims Sanyahumbi, Craig A. Sable, Melissa Karlsten, Mina C. Hosseinipour, Peter N. Kazembe, Charles G. Minard, Daniel J. Penny
-
- Journal:
- Cardiology in the Young / Volume 27 / Issue 6 / August 2017
- Published online by Cambridge University Press:
- 19 December 2016, pp. 1133-1139
-
- Article
- Export citation
-
Background
Echocardiographic screening for rheumatic heart disease in asymptomatic children may result in early diagnosis and prevent progression. Physician-led screening is not feasible in Malawi. Task shifting to mid-level providers such as clinical officers may enable more widespread screening.
HypothesisWith short-course training, clinical officers can accurately screen for rheumatic heart disease using focussed echocardiography.
MethodsA total of eight clinical officers completed three half-days of didactics and 2 days of hands-on echocardiography training. Clinical officers were evaluated by performing screening echocardiograms on 20 children with known rheumatic heart disease status. They indicated whether children should be referred for follow-up. Referral was indicated if mitral regurgitation measured more than 1.5 cm or there was any measurable aortic regurgitation. The κ statistic was calculated to measure referral agreement with a paediatric cardiologist. Sensitivity and specificity were estimated using a generalised linear mixed model, and were calculated on the basis of World Heart Federation diagnostic criteria.
ResultsThe mean κ statistic comparing clinical officer referrals with the paediatric cardiologist was 0.72 (95% confidence interval: 0.62, 0.82). The κ value ranged from a minimum of 0.57 to a maximum of 0.90. For rheumatic heart disease diagnosis, sensitivity was 0.91 (95% confidence interval: 0.86, 0.95) and specificity was 0.65 (95% confidence interval: 0.57, 0.72).
ConclusionThere was substantial agreement between clinical officers and paediatric cardiologists on whether to refer. Clinical officers had a high sensitivity in detecting rheumatic heart disease. With short-course training, clinical officer-led echo screening for rheumatic heart disease is a viable alternative to physician-led screening in resource-limited settings.
9 - Sapphic Shadows: Sworn Sisterhoods and Cyber Lesbian Communities in Hong Kong
-
- By SIM Amy
- Edited by Khun Eng Kuah-Pearce
-
- Book:
- Chinese Women and the Cyberspace
- Published by:
- Amsterdam University Press
- Published online:
- 26 January 2021
- Print publication:
- 21 May 2008, pp 181-202
-
- Chapter
- Export citation
-
Summary
Introduction: Background
Rich's (1980) conception of ‘compulsory heterosexuality’ to explain the existence of female homosexuality as resistance to heterosexuality has been criticized for its ignorance of the range of female sexuality and the inability to imagine women's same-sex desires as anything but resistance to heterosexuality (Blackwood & Wieringa 1999). However, Rich's central thesis remains unchallenged that many societies are characterized by systems of compulsory heterosexuality, symptomatic of patriarchy.
Rich's (1980) continuity approach located all women on a lesbian continuum with respect to their practices that resist compulsory heterosexuality and dependence on men, defining lesbianism cross-culturally and trans-historically as forms of ‘women-loving women’ (Radicalesbians 1973; Cook 1977; Sahli 1979; Faderman 1981). Discontinuous approaches focusing on lesbianism as geographically rooted and historically developed do not recognize commonalities in universal structures of male domination and reject notions of lesbianism as resistance to patriarchy. Like postmodern feminism, discontinuous approaches are concerned with the divisions among lesbians on issues of race, ethnicity, class, etc. (Ferguson 1990). This chapter examines some of these concerns among Chinese women to find support for Rich's (1980) thesis.
The political agendas of lesbians and feminists in Europe and North America have not always been coterminous. The connection between female homosexuality and feminism came about in the development of lesbian feminist theory during the 1970s, where ‘feminism is the complaint, lesbianism the solution’ (Johnston 1973), and where ‘feminism is the theory, lesbianism the practice’ (Ti-Grace Atkinson cited in Echols 1989: 238). Political lesbianism was strongly advocated as revolutionary action – e.g. Radicalesbians (1973: 240) proclaimed that ‘a lesbian is the rage of all women condensed to the point of explosion’, advocating lesbianism as a significant form of resistance to patriarchy and identifying lesbians as, first and foremost, feminist.
Political lesbianism in the West has been influential in shaping the aspirations of young lesbians in Hong Kong as they access feminist/lesbian theories through institutes of higher learning. This chapter employs a dialectical historical approach in examining two diachronic groups in the interlocution of local socio-cultural dynamics in Southern China, and of historical developments in urban modernity. Sworn sisterhoods emerged in the mid nineteenth century in Guangdong Province while its modern-day counterparts are represented by self-identified lesbians in Hong Kong.