Weight discrimination linked to views on poverty

New academic study finds two issues are often connected in the minds of UK adults

Peer-Reviewed Publication

ANGLIA RUSKIN UNIVERSITY

A new study has discovered that people who believe individuals are to blame for living in poverty are more likely to oppose laws aimed at preventing weight discrimination – suggesting some UK adults think the two issues are connected.

Researchers from Anglia Ruskin University (ARU) canvassed almost 400 individuals in the UK aged between 18 and 77, split equally between men and women, and the results have been published in the journal Body Image.

Participants were asked to rate their agreement or disagreement with a series of statements assessing their perspective of poverty, such as the extent of their belief that people living in poverty are “personally deficient”, as well as assessing their views on the causes of obesity and prejudice towards people who are larger-bodied.

Researchers also recorded responses to 15 suggested policies and laws, such as “it should be illegal to fire a qualified employee because of their body weight”, or that “schools should have anti-bullying policies that protect students from being bullied about their weight”.

Among both women and men, the researchers found that a stronger belief that individuals are responsible for living in poverty was significantly associated with lower support for weight-related anti-discrimination policies and laws.

They also found that a stronger belief that individuals are responsible for living in poverty was associated with holding stigmatising or prejudicial views on weight, and greater prejudice toward larger-bodied individuals.

Lead author Viren Swami, Professor of Social Psychology at Anglia Ruskin University, said: “Beliefs about weight don’t occur in a vacuum. In this study, we wanted to find out how broader social and political understandings shape beliefs about weight-related discrimination.

“The results from our study suggest that attitudes toward poverty may be a barrier to bringing in anti-discrimination laws and policies towards protecting those who are larger-bodied. Any attempts to combat weight-related stigmatisation might also need to challenge assumptions and beliefs about the nature and meaning of poverty.

“Being larger-bodied is often conflated with living in poverty, and our study has shown that certain views on poverty might be connected with the stigmatisation, discrimination, and bias against larger-bodied individuals.

“Beliefs about poverty tend to originate in childhood and adolescence, and intervention efforts targeting young people may be particularly effective in shifting both attitudes about the poor and larger-bodied individuals.”

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JOURNAL

Body Image

DOI

10.1016/j.bodyim.2023.04.005 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Support for weight-related anti-discrimination laws and policies: Modelling the role of attitudes toward poverty alongside weight stigma, causal attributions about weight, and prejudice

Vast majority of tweets about obesity are negative, study finds

Only 8.25% of 25,000-plus tweets analysed contained positive sentiments

Reports and Proceedings

EUROPEAN ASSOCIATION FOR THE STUDY OF OBESITY

**Note: the release below is a special early release from the European Congress on Obesity (ECO, Dublin, 17-20 May). Please credit the conference if you use this story**

New research to be presented at next week’s European Congress on Obesity (ECO) in Dublin, Ireland (17-20 May), has found that tweets about obesity are predominantly negative.

The analysis, by researchers in Switzerland and the UK, also found that Twitter activity spiked around the time of significant political events.

These included comments about Donald Trump’s weight when he was US president and the launch of an obesity campaign in the UK by Boris Johnson.

“Obesity can lead to serious physical, mental, and social health problems and its prevalence is increasing worldwide among people of all age groups,” says researcher Dr Jorge Correia, of the Division of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, WHO Collaborating Centre, University Hospitals of Geneva, Geneva, Switzerland.

“Understanding the public’s attitudes to, and perceptions of, obesity is key to the formulation of effective health policies, prevention strategies, and treatment approaches.

“In this study, we have leveraged the wealth of information available on Twitter to explore the sentiments of the public, celebrities and other influential people and important organisations such as the World Health Organization and the Centers for Disease Control and Prevention (CDC).”

Open-source software (the Tweepy library in Python) was used to download obesity-related tweets from Twitter. Cutting-edge AI methods were then used to perform sentiment analysis and classify the tweets into positive, negative and neutral sentiments. Modelling techniques were used to identify the major topics being discussed.

25,580 tweets about obesity that were posted between December 2019 to December 2021 were extracted and analysed.

The sentiment analysis revealed a significantly higher percentage of tweets (72.97%) represented negative sentiments, followed by neutral (18.78%) and positive (8.25%).

Spikes in Twitter activity were associated with significant political events such as when the Speaker of the House of Representatives in the US, Nancy Pelosi, described the then president, Donald Trump, as “morbidly obese” (May 19, 2020).

A total of 1,003 tweets were posted on this topic over several days.  Around 94% of the tweets were negative in sentiment.

Dr Correia says: “The negative portrayal of obesity by influential politicians and celebrities in may increase stigma against people living with obesity, and also harm public health by spreading misinformation.”

The launch of an obesity strategy in the UK on July 27, 2020, by the then prime minister Boris Johnson, attracted a lot of criticism from the public. Around 73.9% of the tweets about the campaign during this spike held negative sentiments. 

The 25,580 tweets included in the analysis covered 243 topics. These included childhood obesity, COVID-19 vaccination, racism and high obesity rates among minorities, smoking, illicit substance use and alcohol consumption among people with obesity, environmental risk factors for obesity (such as unavailability of green spaces), polycystic ovary syndrome and surgical treatments.

The largest number of tweets related to the issue of COVID-19 vaccination for people with obesity, followed by Nancy Pelosi’s comments on Donald Trump.

The third largest group of tweets wasn’t made up of tweets from the public but of tweets from research teams about their work on obesity. Racism towards Black people was the fourth most tweeted topic.

In addition, negative tweets often talked about increased hospitalisations and death due to COVID-19 among people with obesity and about how people living with obesity are responsible for their weight.

The researchers say that their results emphasise the need to view obesity through a holistic lens.

Dr Correia explains: “We need investments in various aspects of healthcare for obesity in order to achieve better health outcomes for the population. This includes improving health information regarding obesity, promoting awareness and reducing stigma, as well as development of effective interventions.

“Campaigns should be run on platforms like Twitter to improve the information about obesity available to the public. This could be done with partnerships between the social media platforms, public and third sector organisations.”

Dr Jorge Correia, Division of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, Unit of Therapeutic Patient Education, WHO Collaborating Centre, University Hospitals of Geneva, Geneva, Switzerland. E) jorgecesar.correia@hcuge.ch

Alternative contact: Tony Kirby in the ECO Media Centre. T) +44 7834 385827 E) tony@tonykirby.com

Notes to editors:

The authors declare no conflicts of interest.

This press release is based on abstract PO2.126 at the European Congress on Obesity (ECO). The material has been peer reviewed by the congress selection committee. There is no full paper at this stage.

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ARTICLE PUBLICATION DATE

11-May-2023

Research pinpoints the time of year and hour when people have the strongest suicidal thoughts

Peer-Reviewed Publication

UNIVERSITY OF NOTTINGHAM

New research has identified the month when people have the strongest suicidal thoughts, and that these thoughts occur a few months before the peak of suicide behaviours in spring/early summer. It also showed the daily peak in suicidal thought is between 4-5 am.   

Most people assume suicide rates will be highest in winter, yet spring/early summer is when suicidal behaviours peak and this finding has baffled researchers since first identified. 

Research from the University of Nottingham’s School of Psychology, led in collaboration with the University of Amsterdam and Harvard University, has study has examined the seasonal paths of suicidal thoughts and identified when suicidal thoughts peak during the year and also what time of day these thoughts are the worst. The findings have been published in Nature Translational Psychiatry.

Over a period of six years, responses were collected from over 10,000 people in the UK, US and Canada who completed questionnaires and tasks about their moods and thoughts and ideations around suicide and self-harm using the Project Implicit Health Database (PIH).

The researchers, Brian O’Shea and René Freichel, show that suicidal thoughts are, in fact, highest in winter (December), and they developed a conceptual model for why suicidal behaviour takes a few months to reach a ‘tipping point’. They also found that the hours of 4am-6am are when people are likely the most vulnerable to taking their own lives. Additionally, they found a general increase in negative self-harm cognitions across the six-year period of the study.

Dr Brian O’Shea from the University of Nottingham led the study and explains: “It is well documented that winter is the time when people with mental health problems may struggle with worsening mood and depression, indeed Seasonal Affective Disorder is a recognised issue related to the change in season that affects many people’s mental health. So, it may come as a surprise that spring, a time when you would assume people’s mood lifts, is actually the time of year when people are most at risk of taking their own lives. The reasons for this are complex, but our research shows that suicidal thoughts and mood are the worst in December and the best in June. Between these two points, there is a heightened risk of suicidal behaviour, and we feel this is occurring because the gradual improvements in their mood and energy may enable them to plan and engage in a suicide attempt. The relative comparison between the self and others’ mood improving at a perceived greater rate are complementary possibilities that need further testing.”   

Online tasks were created to examine the temporal dynamics of explicit and implicit self-harm cognitions, with explicit cognition examined via direct questions about mood, suicide and self-harm using a standard 1-5 scale. Implicit cognition was explored with a reaction time task where people were required to sort words relating to the self in real-time with death and life words.

The respondents in the sample were from three groups: (1) past suicide attempters; (2) suicide ideation and/or non-suicidal self-injury; (3) no previous self-harm, suicidal thoughts, or behaviours). The researchers found a general increase of negative self-harm cognitions across the six years and seasonality effects for mood and desire to die, particularly among those who previously made a suicide attempt.

The findings show a latency between the peak of explicit and implicit suicide cognition in winter and the peak in suicide attempts and suicide deaths in spring.  Explicit suicide cognition which peaks in December preceded implicit self-harm associations, which peaks in February. Both these peaks precede the peak of suicide behaviour in spring/early summer. Similar lagged effects were observed in a 24-hour period, with explicit suicidal cognition and mood peaking at 4-5 am and implicit cognition lagging this peak. 

Dr O’Shea adds: “This study is the first to look at temporal trends around mood and self-harm thoughts on such a large scale and really pinpoints times when intervention could be most beneficial.”

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JOURNAL

Translational Psychiatry

DOI

10.1038/s41398-023-02434-1 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Suicidality and mood: the impact of trends, seasons, day of the week, and time of day on explicit and implicit cognitions among an online community sample

ARTICLE PUBLICATION DATE

12-May-2023

98% of TikTok videos promote vaping, putting teens at risk: Study

Peer-Reviewed Publication

CURTIN UNIVERSITY

New Curtin University research has found TikTok’s policies on the promotion of vaping are frequently violated, putting the social media platform’s predominantly young users at potential risk of e-cigarette exposure and use.

Lead researcher Professor Jonine Jancey, from the Curtin School of Population Health said the findings highlighted the dangers of relying on social media platforms to develop and enforce their own policies around content.

“Our study explored how e-cigarettes are promoted on TikTok, to assess the effectiveness of the platform’s own ‘drugs, controlled substances, alcohol and tobacco policy’,” Professor Jancey said.

“The sheer amount of potentially harmful content being fed to young people on TikTok shows self-regulation is failing.

“Of the 264 videos related to e-cigarettes that we studied and which had a total of 2.5 million views, 97.7 per cent portrayed them positively, and these posts received 98.7 per cent of the total views and 98.2 per cent of the total likes. These used humour, music, shared vaping tricks and referred to a ‘vaping community’, supporting the normalisation of these products.

“Sixty-nine of the posts (26.1 per cent) we reviewed violated TikTok’s content policy by promoting these products for purchase. This included videos containing details on how and where to purchase e-cigarette products, links to online retailers and other social media accounts for purchasing products and offers such as ‘buy three, get one free’ and giveaways.”

Professor Jancey said federal regulations should be tightened to ensure penalties are enforced for both content creators and social media platforms that breach policies or Government advertising laws.

“It seems there are no major consequences for those who do not follow TikTok guidelines and violate content policy. Social media platforms can decide the consequences for breaches of their policies, but they have a clear financial incentive not to punish people who breach their policies,” Professor Jancey said.

“Government regulations that captures e-cigarette advertising, promotion and sponsorship, including on social media must be enforced. These should include requiring social media platforms to report on how they are ensuring these regulations are upheld.”

Co-author and Professor of Internet Studies Tama Leaver from Curtin’s School of Media, Creative Arts and Social Inquiry said because the videos are typically made by young people for young people, they are particularly powerful.

“This is essentially a form of peer-to-peer promotion where young people see their friends or celebrities portraying vaping in a positive way,” Professor Leaver said.

"In addition, some vaping content is posted by influencers who may actually be paid by the e-cigarette industry to promote their products, although this is not disclosed and young people watching these videos may not even know they are being advertised to.”

Published in International Journal of Environmental Research and Public Health, the research is titled ‘Promotion of e-cigarettes on TikTok and regulatory considerations’ and is available online here.

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JOURNAL

International Journal of Environmental Research and Public Health

DOI

10.3390/ijerph20105761 

METHOD OF RESEARCH

Content analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Promotion of e-cigarettes on TikTok and regulatory considerations

ARTICLE PUBLICATION DATE

9-May-2023

Substantial racial inequalities despite frequent health care contact found in treatment for opioid use disorder

Peer-Reviewed Publication

HARVARD T.H. CHAN SCHOOL OF PUBLIC HEALTH

Key points:

• In a national study of Medicare beneficiaries with disability and active opioid use disorder (OUD) symptoms, White patients received and filled prescriptions for medications to treat OUD up to 80% more frequently than Black patients and up to 25% more frequently than Hispanic patients in the six months following a high-risk OUD-related event such as an overdose or infection

• Across racial groups, patients visited health care providers a similar number of times in the six months post OUD event—indicating that disparities in treatment do not stem from disparities in seeking care

Boston, MA—In the wake of an opioid-related event such as an overdose, infection, or detox admission, White patients received medication for opioid use disorder (OUD) up to 80% more frequently than Black patients and up to 25% more frequently than Hispanic patients, according to a new study led by researchers at Harvard T.H. Chan School of Public Health. Across racial groups, patients made a similar number of visits to health care providers in the six months following such an event—indicating that disparities in treatment are not explained by low contact with care.

“Opioid overdoses are rising faster in the Black population than in any other racial group: In 2021, they surpassed overdose rates in the White population for the first time in decades. And rates of overdose in the Hispanic population have recently risen by 40%,” said lead author Michael Barnett, associate professor of health policy and management. “We need to understand barriers to obtaining life-saving addiction treatment for minority populations to address this huge demographic shift and public health crisis.”

The study will be published in the May 11, 2023 edition of the New England Journal of Medicine.

While racial disparities in addiction treatment have been identified by previous studies, little of this research examined the full range of medications for OUD or accounted for non-recommended medications like opioid analgesics and benzodiazepines, both of which are associated with substantial risk for OUD patients. To fill in these gaps, researchers pulled a random 40% sample of Medicare beneficiaries with disability—a group of Americans among the most affected by OUD—who experienced at least one acute OUD-related event between 2016 and 2019. Using the Medicare claims, researchers observed 25,904 OUD-related events—15.2% of which occurred among Black patients, 8.1% among Hispanic patients, and 76.7% among White patients.

In 180 days following these events, Black patients received and filled a prescription for buprenorphine, a lifesaving therapy for OUD, 12.7% of the time; Hispanic patients, 18.7% of the time; and White patients, 23.3% of the time. Naloxone, a drug for reversing overdoses that has few restrictions on its distribution (in contrast to buprenorphine), followed the same pattern: Black patients received and filled a prescription after 14.4% of OUD events; Hispanic patients, 20.7%; and White patients, 22.9%. In a follow-up analysis using data from 2020 to 2021, researchers found that these differences were not explained by differing access to methadone by racial/ethnic group. Black patients received and filled these prescriptions after 8.3% of OUD events; Hispanic patients after 11.2% of OUD events; and White patients after 8.6% of OUD events.

Despite well-known and substantial risks, prescriptions for opioid analgesics and benzodiazepines were received and filled frequently. Prescriptions for opioid analgesic were received and filled after 23% of OUD-related events regardless of race. But prescriptions for benzodiazepines were received and filled by Black patients 23.4% of the time, by Hispanic patients 29.6% of the time, and by White patients 37.1% of the time.

“Skyrocketing rates of overdoses in minority groups are unlikely to shift without a major overhaul in the addiction treatment system,” said Barnett. “Addressing the overdose crisis and racial disparities in addiction will likely require community-specific interventions that engage with minority populations and the clinicians who serve them to reduce stigma and bolster trust.”

Ellen Meara, professor of health economics and policy at Harvard Chan School, was a co-author.

Funding came from National Institute on Drug Abuse grants R01 DA049757, R01 DA048533, and P30 DA035772 and National Institute on Aging grant K23 AG058806.

“Racial inequality in receipt of medications for opioid use disorder,” Michael L. Barnett, Ellen Meara, Terri Lewinson, Brianna Hardy, Deanna Chyn, Moraa Onsando, Haiden A. Huskamp, Ateev Mehrotra, Nancy E. Morden, New England Journal of Medicine, May 11, 2023, doi: 10.1056/NEJMsa2212412

Visit the Harvard Chan School website for the latest news, press releases, and multimedia offerings.

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Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people’s lives—not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health.

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JOURNAL

New England Journal of Medicine

DOI

10.1056/NEJMsa2212412 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Racial inequality in receipt of medications for opioid use disorder

ARTICLE PUBLICATION DATE

11-May-2023

Impacts of YouTube on loneliness and mental health

Peer-Reviewed Publication

GRIFFITH UNIVERSITY

Frequent users of YouTube have higher levels of loneliness, anxiety, and depression according to researchers from the Australian Institute for Suicide Research and Prevention (AISRAP).

Dr Luke Balcombe and Emeritus Professor Diego De Leo from Griffith University’s School of Applied Psychology and AISRAP sought to understand both the positive and negative impacts of the world’s most used streaming platform on mental health. 

They found the most negatively affected individuals were those under 29 years of age, or who regularly watched content about other people’s lives.

Lead author Dr Luke Balcombe said the development of parasocial relationships between content creators and followers could be cause for concern, however some neutral or positive instances of creators developing closer relationships with their followers also occurred.

“These online ‘relationships’ can fill a gap for people who, for example, have social anxiety, however it can exacerbate their issues when they don't engage in face-to-face interactions, which are especially important in developmental years,” he said.

“We recommend individuals limit their time on YouTube and seek out other forms of social interaction to combat loneliness and promote positive mental health.”

Dr Balcombe said the amount of time spent on YouTube was often a concern for parents, who struggled to monitor their children’s use of the platform for educational or other purposes.

For the purpose of the study, over two hours per day of YouTube consumption was classed as high frequency use and over five hours a day as saturated use.

The study also determined more needed to be done to prevent suicide-related content being recommended to users based on algorithms for suggested viewing. 

While ideally, people shouldn’t be able to search for these topics and be exposed to methods, the YouTube algorithm does push recommendations or suggestions based on previous searches, which can send users further down a disturbing ‘rabbit hole’. 

Users can report this type of content, but sometimes it may not be reported, or it could be there for a few days or weeks and with the sheer volume of content passing through, it's almost impossible for YouTube’s algorithms to stop all of it.

If a piece of content is flagged as possibly containing suicide or self-harm topics, YouTube then provides a warning and asks the user if they want to play the video.

“With vulnerable children and adolescents who engage in high frequency use, there could be value in monitoring and intervention through artificial intelligence,” Dr Balcombe said.

“We’ve explored human–computer interaction issues and proposed a concept for an independent-of-YouTube algorithmic recommendation system which will steer users toward verified positive mental health content or promotions.

“YouTube is increasingly used for mental health purposes, mainly for information seeking or sharing and many digital mental health approaches are being tried with varying levels of merit, but with over 10,000 mental health apps currently available, it can be really overwhelming knowing which ones to use, or even which ones to recommend from a practitioner point of view.

“There is a gap for verified mental health or suicide tools based on a mix of AI-based machine learning, risk modelling and suitably qualified human decisions, but by getting mental health and suicide experts together to verify information from AI, digital mental health interventions could be a very promising solution to support increasing unmet mental health needs.”  

The full study, ‘The Impact of YouTube on Loneliness and Mental Health’, can be accessed online at https://www.mdpi.com/2227-9709/10/2/39.

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JOURNAL

Informatics

DOI

10.3390/informatics10020039 

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The Impact of YouTube on Loneliness and Mental Health

Higher mortality rate for Porton Down veterans involved in chemical weapons research

Peer-Reviewed Publication

LANCASTER UNIVERSITY

 

IMAGE: GAS MASK PROTECTION AGAINST A CHEMICAL ATTACK view more 

CREDIT: LANCASTER UNIVERSITY

Military veterans involved in chemical warfare agent research at Porton Down faced a 6% higher mortality rate than similar veterans who were not involved.

The research from the King’s Centre for Military Health Research (KCMHR) at King’s College London, in partnership with Lancaster University, is published in the International Journal of Epidemiology.

Researchers compared the medical records of 16,721 male UK veterans who participated in the ‘Service Volunteer Programme’ from 1941-1989, comparing them with 16,228 non-Porton Down veterans, placing a particular focus on the most common causes of death and types of cancer.

They found that these military veterans had higher rates of mortality from diseases of the genitourinary systems (for example, kidney disease), as well as deaths attributable to alcohol, but found little evidence of an association between attendance at Porton Down and higher rates of overall cancer incidence.

Porton Down first opened during World War I in response to the use of chemical weapons. Since 1916, over 20,000 service personnel have exposed to low doses of chemical warfare agents and their antidotes, some of which are known to be carcinogenic. This has raised questions over the long-term impacts on the health of veterans attached to the Program.

While there was only a small increased risk overall, the researchers did find that veterans who took part in the Porton Down Volunteer Program between 1960-64 were at significantly greater risk of dying from a range of causes including cancerous tumours, diseases within the circulatory system, and smoking related deaths.

The researchers suggest that health providers need to be aware of the specific health issues connected to military veterans, and the wider population, who may have been exposed to chemical warfare agents.

Dr Tom Keegan, one of the study’s authors and a Senior Lecturer in Epidemiology from Lancaster Medical School said: “Military personnel were exposed to over four hundred different types of chemicals over the course of the programme, so we now want to investigate whether particular chemicals are associated with increased risk of poorer health.”

Dr Gemma Archer, from KCMHR, the study’s first author said: “Veterans of the Porton Down Service Volunteer Program were often exposed to small doses of chemical agents designed to be used in war. Our study followed the health of veterans for over fifty years, and we are thankful that it indicates that the large majority of veterans were unlikely to have come to harm. A small number of veterans did appear to have higher rates of death and a variety of other illnesses, and it is something that healthcare professionals need to be mindful of when treating victims of chemical exposure.” 

Professor Nicola Fear, co-director of KCMHR and the study’s senior author said: “There has, for some time, been a question mark hanging over the volunteers who contributed to the research of Porton Down. While it is reassuring that our study found no evidence of increased risk of cancer in veterans who attended Porton Down, the 6% higher rate of all-cause mortality compared to veterans who didn’t attend Porton Down is not something that should be overlooked”.

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JOURNAL

International Journal of Epidemiology

DOI

10.1093/ije/dyad050 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Mortality and cancer incidence in UK military veterans involved in human experiments at Porton Down: 48-year follow-up

ARTICLE PUBLICATION DATE

11-May-2023

Pediatric clinical studies’ underfunding risk

Peer-Reviewed Publication

UNIVERSITY OF GOTHENBURG

 

IMAGE: JENNY KINDBLOM, SAHLGRENSKA ACADEMY AT THE UNIVERSITY OF GOTHENBURG. view more 

CREDIT: PHOTO BY JOHAN WINGBORG/UNIVERSITY OF GOTHENBURG

A clinical study with children as participants entails extra costs often omitted in the initial budget. Clinical studies involving children are thus at risk of being undercompensated, new research shows.

Kids will be kids when they take part in clinical studies, as at other times. Sometimes they need a break to do something else for a while before the next study session can start. With children as study participants, researchers also need to involve more people — frequently two legal guardians— and this, too, boosts the time a study requires.

The person responsible for the current study is Jenny Kindblom, associate professor (docent) at the Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, and senior consultant clinical pharmacologist at Sahlgrenska University Hospital.

Kindblom and her colleagues at the Hospital’s clinical trials unit for children and adolescents had long noticed that, in budget proposals from the pharmaceutical companies to cover study activities performed at the hospital, activities in pediatric clinical studies were often undercompensated. This pattern emerged clearly when the researchers embarked on a more structured type of work, supported by a team member with expertise in budget and contract issues.

Studies costing 59 percent more

The article in Acta Paediatrica is based on ten clinical studies with children as participants, and their true costs proved to be 59 percent higher, on average, than the total initial budget in the proposal from the pharmaceutical company sponsoring the trial. The problem was that the studies were based on adults and had not been adapted to the paediatric setting.

Child studies require extensive planning and coordination with various people, including some around the child. In addition, child studies often comprise a great many investigations, with staff and resources from various units.

“In implementing the study, you need to have the child on your side. Forcing kids to participate in study activities never works. You need to adjust to what the child can cope with — and sometimes have a break and a bit of rest and recreation,” Kindblom says.

Younger children, unlike adults, may also need to be sedated during, for instance, a magnetic resonance imaging (MRI) scan or bowel examination. Anesthesia comes with a wide range of input requirements from different units, which makes the activity more time-consuming.

Budget processing important

The study’s first author is Stavros Koulizakos, the team expert in charge of budget and contractual matters for the pediatric clinical studies underway at Sahlgrenska University Hospital. He describes the major gaps between budgeted and actual costs as follows.

“The budget items that generate the biggest discrepancies are, first, the expenses involved in clinical trials; second, the estimated time required for the study activities; and third, the costs of examinations.”

The researchers emphasize that drug companies are enormously important for driving development in the direction of new and improved medicines, for children and adolescents as well as adults. Nevertheless, the compensation for study activities must be as much as possible representative of the study costs  for the Hospital and the respective companies alike.

Kindblom again:

“There’s a definite risk of fewer studies being conducted because of underfunding. An increased risk of pediatric studies not reaching completion has been observed. To an extreme extent, undercompensation can contribute to this outcome. But an even more clearcut consequence is for the health care services to engage in paediatric trials sponsored by  drug companies, without getting compensation. It’s not a reasonable state of affairs,” she concludes.

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JOURNAL

Acta Paediatrica

DOI

10.1111/apa.16808 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Paediatric clinical trials need paediatric clinical trial budgets

International Nurses Day: World’s oldest children’s nursing organization recognizes outstanding contributions to the care of children and young people

Grant and Award Announcement

SAGE

 

IMAGE: ABPN TEA PARTY-GOVERNANCE AND DEVELOPMENT BOARD view more 

CREDIT: ASSOCIATION OF BRITISH PAEDIATRIC NURSES

At a recent event to celebrate the Association’s 85th Anniversary, the Association of British Paediatric Nurses awarded Honorary Fellowships to eight children’s nurses in recognition of their outstanding contribution to the nursing care of children and young people.

The 2023 Honorary Fellows

• Ann Bisbrown Lee for services to children’s nursing and for many years’ service to the Association of British Paediatric Nurses, especially in leading marketing and conference activities.
• Professor Steven Campbell for services to children’s nurse education and to the Association of British Paediatric Nurses as the first Editor of the Association’s journal, the Journal of Child Health Care.
• Rachel Cooke for services to children’s nursing, especially in the field of children’s palliative care and childhood bereavement services in the UK and overseas. 
• Norman Long for services to children’s nurse education and for many years’ service to the Association of British Paediatric Nurses as the finance officer.
• Professor Bertha Ochieng for services to children’s nursing and child health, especially in the field of community empowerment and engagement of socially disadvantaged populations.
• Dr Gerri Sefton for services to children’s nursing, especially in the field of paediatric intensive care and children’s nursing research.
• Fiona Smith for services to children’s nursing in the UK and globally, including playing a key role in establishing the Paediatric Nursing Associations of Europe.
• Clinical Associate Professor Michael Tatterton for services to children’s nursing and children’s nurse education, especially in the field of children’s palliative and community care.

Caron Eyre, ABPN Chair, said “This year’s ABPN Fellows are each of an extremely high calibre and have made inspirational improvements to the care of babies, children and young people.”

Professor Bernie Carter, President of the ABPN, said “The appointment of our Honorary Fellows acknowledges the amazing and diverse work undertaken by children’s nurses in practice, education, academia, research and leadership. We are immensely proud of their achievements and welcome them as special members of our ABPN family”.

Stress-management interventions may help individual healthcare workers for at least a year

Interventions aimed at reducing work-related stress for individual healthcare workers may lead to improvements in how people cope with stress up to a year later.

Peer-Reviewed Publication

COCHRANE

Interventions aimed at reducing work-related stress for individual healthcare workers may lead to improvements in how people cope with stress up to a year later. Findings from a Cochrane review of the latest available evidence build on the conclusions of a previous review in 2015 that found low-quality evidence that interventions, such as cognitive behavioural training (CBT), mental and physical relaxation, were better than none.

The researchers included 117 studies of the effects of different interventions on stress alleviation in the current review, of which 89 studies were new. These 89 studies were published between 2013 and 2022. A total of 11,119 healthcare workers worldwide were randomised to different interventions, and stress was assessed by questionnaires measuring stress symptoms in the short term (up to three months after an intervention ended), in the medium term (between three and 12 months) and long-term (follow-up after more than a year).

The review from Cochrane, a collaboration of independent, international experts, looked at interventions at the level of the individual healthcare worker that focused attention either on the experience of stress, or away from the experience of stress. Strategies for focusing attention on the stress included CBT, and training on assertiveness, coping and communication skills. Interventions that focus attention away from the stress included relaxation, mindfulness meditation, exercise such as yoga and tai chi, massage, acupuncture, and listening to music. The researchers wanted to see whether different types of interventions were better than no intervention in reducing stress.

The healthcare workers in the studies were experiencing low to moderate levels of stress and burnout, which can lead to physical symptoms such as headaches, muscle tension or pain, but also mental symptoms, such as depression, anxiety, impaired concentration and emotional and relationship problems.

Sietske Tamminga, assistant professor in public and occupational health at Amsterdam University Medical Centre, Amsterdam, The Netherlands, who led the research said: “Healthcare workers often deal with stressful and emotional situations in patient care, human suffering, and pressure from relationships with patients, family members and employers, as well as high work demands and long working hours.

“We found that healthcare workers might be able to reduce their stress by means of individual-level interventions such as cognitive behaviour training, exercising or listening to music. This may be beneficial for the healthcare workers themselves and it may spill over to the patients they care for, and the organisations they work for. The effect may last for up to a year and a combination of interventions may be beneficial as well, at least in the short term. Employers should not hesitate to facilitate a range of stress interventions for their employees. The long-term effects of stress management interventions remain unknown.”

The researchers say that larger, better-quality studies are needed to look at both the short- and long-term effects of individual level interventions in order to increase the certainty of the evidence.

“We need more studies on interventions addressing work-related risk factors both at the individual and organisational level,” said Dr Tamminga. “It might be even more beneficial to improve working conditions themselves, instead of only helping individuals to deal better with heavy psychosocial burdens. For example, employers could address problems of understaffing, over-work and anti-social shift patterns. If you’re dedicated to change, you need to change the underlying risk factors rather than focusing on the symptoms.”

Limitations of the research include: the estimates of the effects of individual-level stress management interventions may be biased because of a lack of blinding of the participants in the included studies; many studies were small; and there were too few studies that focused on specific factors that can cause stress in the workplace.

Studies have reported that between 30% to 70% of physicians and nurses and 56% of anaesthesiologists experience burnout symptoms as a result of their work. Previous research has tended to focus on a particular type of intervention in specific groups of healthcare workers. The authors of this Cochrane review write: “To the best of our knowledge there are no up-to-date reviews that examine the effectiveness of various types of individual-level interventions aimed at reducing stress in various healthcare workers to provide a more complete overview.”

Dr Tamminga concluded: “There is already a shortage of healthcare workers due to high turnover rates, and effective prevention of stress and burnout may help to reduce this.”

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JOURNAL

Cochrane Database of Systematic Reviews

DOI

10.1002/14651858.CD002892.pub6 

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Individual-level interventions for reducing occupational stress in healthcare workers