E-cigarettes may be better than nicotine patches in helping pregnant women stop smoking and in reducing the risk of low birthweight

E-cigarettes (vapes) may be more effective than nicotine patches for pregnant women trying to quit smoking, research led by Queen Mary University of London and funded by the National Institute for Health and Care Research (NIHR), has found

Peer-Reviewed Publication

QUEEN MARY UNIVERSITY OF LONDON

Smoking in pregnancy can harm developing babies, especially their growth . Current guidelines recommend that pregnant smokers who find quitting difficult should be provided with nicotine replacements products and stop-smoking services usually recommend nicotine patches.

This research published in NIHR Journals Library, suggests that pregnant women should also consider e-cigarettes.

The study included 1,140 pregnant women who were trying to stop smoking who were divided into two groups. Half of the women received e-cigarettes; the other half received nicotine patches. Both approaches were equally safe. The only meaningful difference was that fewer women in the e-cigarette group had children with low birthweight (weighing less than 2,500 grams).

The researchers say this is most likely because e-cigarettes were more effective in reducing the use of conventional cigarettes. Low birthweight has been linked with poor health later in life. 

At the end of their pregnancy, women reported whether they had quit. However, some women had quit smoking using a product they were not assigned, mostly women given patches stopping with the help of e-cigarettes they had procured for themselves.

When the researchers looked at successful quitters who only used the treatment they were allocated, almost twice as many women quit with e-cigarettes than with nicotine patches.

The researchers looked at safety outcomes, including low birthweight, baby intensive care admissions, miscarriage, stillbirth, and premature birth.

It is not clear whether nicotine is harmful to developing babies. National Institute of Health and Care Excellence (NICE) states that most health problems are caused by toxins other than nicotine in cigarettes and therefore recommends that nicotine replacement therapy (such as nicotine patches, gum and mouth spray) is considered alongside behavioural support. However, most pregnant women still struggle to quit.  

E-cigarettes can be seen as a form of nicotine replacement therapy, but they have an advantage over nicotine gum and patches in allowing smokers to select strength and flavours they like and make the transition to stopping smoking easier. This is most likely why e-cigarettes have been shown more effective than the traditional nicotine replacement therapy in people who are not pregnant.

Peter Hajek, Director of Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London said: “E-cigarettes seem more effective than nicotine patches in helping pregnant women to quit smoking and because of this, they seem to also lead to better pregnancy outcomes. The evidence-based advice to smokers already includes, among other options, a recommendation to switch from smoking to e-cigarettes. Such a recommendation can now be extended to smokers who are pregnant as well.’

 

Ends

Helping pregnant smokers quit: a multi-centre randomised controlled trial of electronic cigarettes versus nicotine replacement therapy.

Health Technology Assessment vol 27 no 10. 2023 HTA 15/57/85

(DOI to come) 10.3310/AGTH6901

Available here after the embargo lifts: https://www.journalslibrary.nihr.ac.uk/hta/AGTH6901/#/abstract

 

NOTES TO EDITORS:

Contact

Lee Pinkerton

Faculty Communications Officer – Medicine and Dentistry

Queen Mary University of London

Email: l.pinkerton@qmul.ac.uk

Tel: +44 (0) 7985 446 280

 

 

About Queen Mary University of London

At Queen Mary University of London, we believe that a diversity of ideas helps us achieve the previously unthinkable.

Throughout our history, we’ve fostered social justice and improved lives through academic excellence. And we continue to live and breathe this spirit today, not because it’s simply ‘the right thing to do’ but for what it helps us achieve and the intellectual brilliance it delivers.

Our reformer heritage informs our conviction that great ideas can and should come from anywhere. It’s an approach that has brought results across the globe, from the communities of east London to the favelas of Rio de Janeiro.

We continue to embrace diversity of thought and opinion in everything we do, in the belief that when views collide, disciplines interact, and perspectives intersect, truly original thought takes form.

 

The National Institute for Health and Care Research (NIHR) 

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by: Funding high quality, timely research that benefits the NHS, public health and social care;

• Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
• Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
• Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
• Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
• Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low- and middle-income countries is principally funded through UK Aid from the UK government.

 

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JOURNAL

Health Technology Assessment

DOI

10.3310/AGTH6901 

METHOD OF RESEARCH

Randomized controlled/clinical trial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Helping pregnant smokers quit: a multi-centre randomised controlled trial of electronic cigarettes versus nicotine replacement therapy.

ARTICLE PUBLICATION DATE

1-Aug-2023

Oxycodone prescriptions after delivery not linked to longer-term opioid use compared to codeine prescriptions

Peer-Reviewed Publication

CANADIAN MEDICAL ASSOCIATION JOURNAL

Postpartum prescriptions for oxycodone were not associated with increased risk of longer-term opioid use compared to codeine prescriptions, according to new research published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.221351.

Over the last 10 years, there has been a shift to fewer codeine prescriptions and an increase in prescriptions for stronger opioids, such as hydrocodone, hydromorphone and oxycodone for patients postpartum.

“This occurred in part because of safety concerns related to the use of codeine while breastfeeding, which have since been questioned,” writes Dr. Jonathan Zipursky, Sunnybrook Health Sciences Centre, ICES and the University of Toronto, Toronto, Ontario, with coauthors. “The consequences of this trend on postpartum health have not been well characterized but are potentially concerning, for several reasons. Principally, patients have a strong expressed preference for oxycodone over other prescription opioids, which may impart a greater potential for nonmedical use.”

To understand whether this emphasis on more potent opioid prescribing is linked to persistent opioid use after giving birth, researchers looked at data on 70,607 individuals who filled an opioid prescription after discharge from an Ontario hospital between 2012 and 2020. More than two-thirds, 49,299 (70%), received oxycodone and 21,308 (30%) received codeine. The majority (56,485 [80%]) had cesarean deliveries.

Compared to codeine, receipt of oxycodone was not associated with persistent opioid use after delivery (relative risk 1.04; 95% confidence interval 0.91–1.20).

In secondary analyses, the researchers found a 60% increase in the risk of persistent opioid use among people prescribed oxycodone compared with codeine after vaginal delivery, but no such association for those who delivered by cesarean. This finding warrants further research to explore why those who deliver vaginally may be at greater risk of using opioids longer term following oxycodone use after delivery. Higher dosages and longer duration of a prescription were also associated with increased risk of persistent opioid use.

“Our findings suggest that initial postpartum prescriptions containing large amounts of [morphine milligram equivalents] might represent an additional risk factor for persistent opioid use. Therefore, limiting the quantity of initial opioid prescriptions might be an additional strategy to reduce the risk of new, persistent opioid use after delivery,” the authors suggest.

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JOURNAL

Canadian Medical Association Journal

DOI

10.1503/cmaj.221351 

ARTICLE TITLE

Prescription of oxycodone versus codeine after childbirth and risk of persistent opioid use: a population-based cohort study

ARTICLE PUBLICATION DATE

31-Jul-2023

National Autism Indicators Report calls for health care policy improvements for future public health emergencies

COVID-19 pandemic highlighted gaps in access to health care for autistic individuals during the public health emergency.

Reports and Proceedings

DREXEL UNIVERSITY

 

IMAGE: THE JULY 2023 NATIONAL AUTISM INDICATORS REPORT EXAMINES CHANGES IN ACCESS AND DISRUPTIONS TO HEALTH CARE SERVICES FOR AUTISTIC CHILDREN AND ADULTS DURING THE BEGINNING OF THE COVID-19 PANDEMIC. view more 

CREDIT: PLEASE CREDIT: POLICY IMPACT PROJECT AT A.J. DREXEL AUTISM INSTITUTE

The COVID-19 pandemic and mitigation measures changed how people accessed health care services and engaged in their communities. Access to appropriate services and accommodations help autistic individuals in maintaining employment, pursuing education, caring for their health and establishing independence. Because autistic people often have greater health care needs than non-autistic peers, the pandemic-related changes in access to health care may have been an extra burden on their health and, ultimately, quality of life, according to the latest National Autism Indicators Report, issued by Drexel University's A.J. Drexel Autism Institute. 

Researchers at Autism Institute’s Policy and Analytics Center examined changes in access and disruptions to health care services for autistic children and adults during the beginning of the COVID-19 pandemic. These findings will inform better evidence-based practices for future public health emergencies to improve policies and programs for autistic individuals.

“The COVID-19 pandemic was an unprecedented public health emergency, and the impacts were far reaching,” said Jessica Rast, PhD, research scientist at the Autism Institute and lead author of the report. “Our hope is that we can learn from this pandemic response, so we can improve systems of care for autistic people, for all people. While such improvements would help in future times of crisis, we hope they can be implemented in times of less turmoil to improve care overall.”

Rast and her co-authors noted that changes in access to services result in long-term consequences, which can be dire for autistic people.

“This is an equity issue. If the people who need more care can’t access it, we’re disadvantaging a whole population,” said Rast. “And unfortunately, the people who are disadvantaged in other ways, such as Black autistic people, saw more disruptions in care during the COVID-19 pandemic.”

The research team examined various data sources from before and after the start of the COVID-19 pandemic, including health care claims and administrative records; the availability of services for autistic children based on caregiver reports from the National Survey of Children’s Health; national emergency hospitalization records through the National Emergency Department Sample; hospital admissions data via the National Inpatient Sample; and service use among autistic adult patients in records from Kaiser Permanente Northern California. The data sources cover various populations from nationally representative pictures of autistic children and adults to other sources that covered specific, but still diverse, populations.  

The research team found autistic adults, ages 45 and older, had higher rates of visits to the emergency department and hospitalizations for COVID-19 compared to non-autistic adults and autistic children and younger adults (younger than 44). The significant increase in hospital visits among older autistic adults – compared to other older adults – demonstrates the need for improved public health care policies to maintain usual health care services for individuals during a public health emergency.

For younger autistic people access to care – including well-child visits, dental care, emergency department visits and inpatient hospitalizations – decreased during the COVID-19 pandemic. Black and Hispanic autistic children experienced larger decreases compared to white children. Virtual health care became an important avenue for care during the COVID-19 pandemic. About half of autistic children had a virtual or telehealth care visit in 2021, as did non-autistic children with special health care needs. Just over one-third of autistic children missed or delayed a well visit because of the COVID-19 pandemic. 

There were also policy changes at the beginning of the COVID-19 pandemic to increase access to health care. However, enrollment in public health insurance – like Medicaid – among autistic children remained about the same as before the pandemic. Although, there were differences in insurance coverage by race and ethnicity among autistic children – with an increase of Black non-Hispanic autistic children being covered by public health insurance in 2021, compared to before the COVID-19 pandemic.

“The changes in health policy during the COVID-19 pandemic, including increased Medicaid and Children’s Health Insurance Program (CHIP) enrollment and continuous coverage requirements, played a crucial role in safeguarding the health insurance and access to healthcare for autistic individuals,” said Kaitlin Koffer Miller, DrPH, director of the Policy Impact Project at the Autism Institute and co-author of the report. “These policies helped mitigate negative impacts, ensuring uninterrupted health care services and reducing the uninsured rates across the U.S. While the expiration of the continuous coverage requirement through Medicaid raises concerns, the overall improvements highlight the importance of inclusive health policies for the well-being of autistic individuals.”

Rast and Koffer Miller highlighted recommendations from the report, including having health care providers ensure equitable and high-quality access on virtual platforms.

“This can include creating physical and virtual environments that provide individuals the opportunity to request accommodations and are sensory-friendly,” said Koffer Miller. “Additionally, providers can use communication strategies that cater to diverse communication preferences. This may include using visual aids, written instructions, or plain language to enhance understanding and ensuring any online platforms are user-friendly and accessible for individuals with diverse sensory and cognitive profiles. Organizations like the ASERT Collaborative have been beacons of information, providing accessible resources focused on COVID-19 that could be a model for health care providers.”  

They also note that health care policies should continue to support telehealth and virtual care options for mental health services, including easing portability restrictions and expanding coverage. The report showed there were no substantial changes in mental health care early in the COVID-19 pandemic, but just under half of autistic children received mental health care before and during the pandemic. According to the researchers, about 10% had unmet needs for mental health care in 2019 and 2021.  

By supporting telehealth and virtual care, individuals on the autism spectrum and other neurodivergent populations can benefit from increased accessibility and convenience, the report suggests.

Rast and Koffer Miller also called for further examination of the long-term mental health changes among autistic people in the years following the official conclusion of the COVID-19 pandemic, with a focus on the impact, effectiveness and disparities of access of telehealth for mental health care.

In continuation of the National Autism Indicator Reports series, this report provides crucial information to better understand the health care experiences of autistic people and highlights the impact that the COVID-19 pandemic has had on autistic individuals. By better understanding the challenges they face, steps can be taken to develop interventions that will improve their health care and quality of life. 

This report was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) Autism Intervention Research Network on Physical Health (AIR-P) and the Working for Inclusive and Transformative Healthcare (WITH) Foundation’s COVID-19 Response Fund.

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ARTICLE TITLE

Health and the COVID-19 Pandemic: July 2023

ARTICLE PUBLICATION DATE

31-Jul-2023

NOT THE GOOD DOCTOR

One in four autistic doctors have attempted suicide, new study shows

Peer-Reviewed Publication

UNIVERSITY OF SUSSEX

 

A quarter (24%) of autistic doctors have attempted suicide, and more than three-quarters (77%) have considered it, according to a new study by Brighton and Sussex Medical School (BSMS), Thomas Jefferson University and Autistic Doctors international (ADI) – published in Frontiers in Psychiatry. Nearly half (49%) had also engaged in self harm.

Lead author Dr Sebastian Shaw, Lecturer in Medical Education at BSMS and the Research Lead of ADI, said: “Whilst it is deeply concerning to see the extent to which my fellow autistic doctors have struggled with their mental health, it is perhaps not surprising when we consider the many barriers and challenges faced by autistic people working in the healthcare sector.

“We also found that those who considered autism to be a ‘disorder’, rather than a difference or disability, were more likely to have attempted suicide. This may reflect a degree of internalised shame from being trained to understand autism as a disorder through their medical practice. This association would seem to support a neurodiversity-affirmative view of autism. Fostering more acceptance of autism as a difference may potentially improve the wellbeing of autistic healthcare professionals and patients alike.”

The study also found that many autistic doctors did not disclose their diagnosis in the workplace, with 29% not having told anyone at work, 32% having disclosed being autistic to their supervisor and 30% to their colleagues. Linked to this appears to be a sense of isolation. Although four fifths reported having worked with another doctor they suspected was autistic, only one fifth reported having worked with another doctor they knew was autistic. Those having never worked with any suspected autistic colleagues were also more likely to have considered suicide.

As awareness and diagnosis of autism grow, more medical students and doctors are discovering they are autistic; the study showed an average age of formal diagnosis of 36. Some were diagnosed following difficulties in stressful clinical environments, or highly demanding career paths – and found that support from employers was inconsistent, with some colleagues refusing to believe a qualified doctor could be autistic.

Dr Shaw added: “Key to improving the experience of autistic doctors is ensuring that neurodivergence is viewed in a positive light. Workplaces need to provide better support and improve awareness of autistichealthcare professionals. Employing a well-supported and neurodiverse medical workforce will mean that the diversity of the public is reflected in their medical providers, with likely improved experiences and outcomes for neurodivergent patients.”

Despite these striking findings, overall, three quarters usually enjoyed their work as doctors (74%) and three quarters (73%) felt being autistic was helpful in their role as doctors.

Dr Mary Doherty, senior author and founder of ADI, commented: “Autistic doctors are a hidden minority in the medical workforce, and the range of specialties in ADI challenges autistic stereotypes. General practitioners are the largest subgroup, followed by psychiatrists.”

Dr Wendy Ross, Director of the Jefferson Center for Autism and Neurodiversity, added: "This study is a call to action for the entire medical field to meet the needs of autistic medical talent as well as patients."

The cross-sectional study, the first to gauge the experience of autistic doctors, modified a pre-existing survey of autistic school staff, with 225 members of the organisation ADI taking part in the study.

The full study is published at https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1160994/

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JOURNAL

Frontiers in Psychiatry

DOI

10.3389/fpsyt.2023.1160994 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The experiences of autistic doctors: a cross-sectional study

 

KU project to help women transition from incarceration with training for tech careers

NSF funding to provide technology skills, work to reduce recidivism

Grant and Award Announcement

UNIVERSITY OF KANSAS

LAWRENCE — For women who are incarcerated and lack access to the internet and other technologies, it can be difficult to navigate an increasingly online world when transitioning back to society. An interdisciplinary team at the University of Kansas has been awarded a grant from the National Science Foundation to expand their employment-related technology education program for women leaving incarceration and Train-the-Trainer program for peer mentors and library practitioners.

The three-year, $1.6 million grant will support “Developing Sustainable Ecosystems that will Support Women Transitioning from Incarceration into Technology Careers.” KU’s Center for Digital Inclusion is leading the project training women leaving incarceration in Kansas and Missouri in digital skills for entry-level positions in the technology sector as well as general employment. The funding also allows the project team to offer workshops for “digital navigators,” or peer mentors, who have successfully taken part in previous iterations of the program to guide other women now making the switch. Researchers will also partner with public libraries, employment agencies, and jails and prisons in the two states to make the programs sustainable for the future.

“We will be able to expand and improve our existing evidence-based technology education program to include a greater number of women, as well as professional organizations, public libraries and workforce centers,” said Hyunjin Seo, Oscar Stauffer Professor of Journalism & Mass Communications and principal investigator for the project. “These days, if you are not able to use digital technology, you are not able to utilize many services in society, whether cultural, social, civic or others. Women transitioning from incarceration face significant challenges in this area.”

Research has shown that employment is a significant factor in reducing rates of recidivism. The project will help women transitioning from incarceration gain employment through a holistic approach. Participants will learn how to navigate online job applications, secure housing and develop job skills. The digital skills trainings will range from introductory to advanced levels and provide participants with skills from competence with office technologies to building websites, online security, coding and other technology career-specific skills. The education content and topics are determined by the project team’s empirical research with women transitioning from incarceration as well as co-design sessions with the women and community partners. The project team includes professors, research staff, graduate students, undergraduate students and digital navigators.

The online security portion of this project builds on Seo’s participation in an interdisciplinary cybersecurity research team that received KU’s Research Rising grant, as well as her past collaborations with Fengjun Li, KU associate professor of computer science and co-principal investigator.

Jodi Whitt, a digital navigator in the Center for Digital Inclusion, said her experience learning new skills when leaving incarceration inspired her to help women in a similar situation.

“Helping other women in the program has given me a purpose in life that I never dreamed would be possible. I want to be an example to other women, that it is possible to learn new skills. I know how important it is to have someone who understands and believes in me. Having that connection and building those relationships is crucial to help empower and build confidence,” Whitt said. “From experience, I also know learning new skills can help reduce recidivism. There is not a lot of opportunities for job training or employment for formerly incarcerated women. This program helps them gain experience and develop confidence for better opportunities in the workforce.”

Dozens of digital navigators, librarians and employment navigators will receive training on mentorship and teaching as well as advanced technology topics. The project team will begin its work with program participants shortly before they leave jail or prison. Another new feature is an ecosystem approach that is designed to build and strengthen capacity of local communities in supporting individuals with justice involvement. Tanesha Whitelaw, one of the program’s digital navigators, said it is all too common to lose technical skills during incarceration.

“This training is important to this population because you can easily adapt to an environment which doesn’t offer any technical skills or employment skills and you’re left behind when you are coming back into society,” she said. “Being able to communicate in today’s society requires technical skills. The systemic mechanism of communicating is gravitating toward technology, so this will be imperative for to day-to-day functions.”

During the grant’s three-year life cycle, the program aims to support up to 600 women leaving or recently released from jails or prisons in Kansas and Missouri. During that time, researchers will also conduct extensive research and evaluation of the program. They will conduct interviews and surveys before, during and after trainings to gauge their skill levels, how they have improved, employment rates among participants as well as recidivism rates.

Data will be combined with information gathered from focus groups with public libraries where trainings take place and with other partners to determine which aspects of the program are most effective and what is needed to enable community organizations to continue the trainings after the grant project.

The project, led by the Center for Digital Inclusion in the William Allen White School of Journalism & Mass Communications, will build on previous efforts to help women transition from incarceration by gaining new skills. KU’s Institute for Policy & Social Research manages the grant.

Partners and members of the research team also include:

• Hannah Britton, professor of political science and women, gender & sexuality studies, senior researcher
• Doug Ward, associate director of KU’s Center for Teaching Excellence and associate professor of journalism & mass communications, senior researcher
• Marilyn Ault, senior research associate at the KU Center for Research on Learning, senior researcher
• Tanesha Whitelaw, digital navigator at KU’s Center for Digital Inclusion
• Kim Bruns, project coordinator at KU’s Center for Digital Inclusion
• Macy Burkett, doctoral student in journalism & mass communications, graduate research assistant
• Pramil Paudel, doctoral student in computer science, graduate research assistant
• Taylor Doyle, undergraduate student in journalism & mass communications, undergraduate research assistant
• Aisha Malik, undergraduate student in speech-language-hearing, undergraduate research assistant.

 

Music therapy team increases collection of patient-reported outcomes to improve clinical research and practice

New study published in JMIR Human Factors

Peer-Reviewed Publication

UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER

CLEVELAND – A new study from University Hospitals (UH) Connor Whole Health describes a process-improvement study undertaken to improve documentation consistency and increase the capture of patient-reported outcomes (PROs) (i.e., stress, pain, anxiety, and coping) within the UH Connor Whole Health music therapy team. The study, entitled “Optimizing Patient-Reported Outcome Collection and Documentation in Medical Music Therapy: Process Improvement Study” is the first to describe a quality improvement initiative that combined trainings and electronic health record (EHR) modifications to improve PRO collection and documentation. The findings from this study were recently published in JMIR Human Factors, a leading journal focusing on redesigning health care and making health care interventions and technologies usable, safe, and effective.

For this quality improvement initiative conducted between July and December 2020, researchers from UH Connor Whole Health implemented two Plan-Do-Study-Act (PDSA) cycles to improve documentation processes among a music therapy team (13.3 clinical fulltime equivalent staff). Trainings focused on providing skills and resources for optimizing pre- and post-session PRO collection, specific guidelines for entering session data in the EHR, and opportunities for the team to provide feedback. The investigators then compared therapists’ rates of PRO collection 1) between the 6 months prior to PDSA Cycle 1 (T0) and PDSA Cycle 1 (T1), and 2) between T1 and PDSA Cycle 2 (T2).

Following the PDSA cycles, music therapists’ rates of capturing any PRO within music therapy sessions increased significantly (p < .001) from T0 to T1 and from T1 to T2 for all domains including stress (0.1% at T0, 36.3% at T1, and 50.7% at T2), pain (29.7% at T0, 51.8% at T1, and 61.4% at T2), anxiety (18.1% at T0, 34.1% at T1, and 51.6% at T2), and coping (0.0% at T0, 20.5% at T1, and 41.2% at T2). Music therapists’ feedback were then used to create an improved EHR documentation template.

This study was funded by the Kulas Foundation, a leading private foundation for funding scientific research in music therapy. The Kulas Foundation has a 30-year history of supporting groundbreaking music therapy research at UH, including studies that have demonstrated the efficacy of music therapy in palliative care, surgery, and sickle cell disease. The current study is the fourth manuscript to come from the Effectiveness of Medical Music therapy Practice: Integrative Research using the Electronic health record (EMMPIRE) project. Other recent publications from the EMMPIRE dataset have described the integration of music therapy throughout UH and supported the real-world clinical effectiveness of music therapy for addressing patients’ symptoms within community hospitals and at an academic cancer center.

“An important innovation in this quality improvement initiative was our ability to use simple tools like acronym expansions and existing note templates to document patient-reported outcomes in the EHR without having to build new documentation templates. We were then able to extract each note and use text analytics procedures to extract outcome data from therapists’ clinical narratives,” said Samuel Rodgers-Melnick, MPH, MT-BC, co-investigator for EMMPIRE and the lead author of the study.

“Collecting clinical outcomes data allows our providers to communicate therapeutic progress directly with patients, providers, and stakeholders, making the process crucial from both a clinical and operational standpoint,” said Seneca Block, The Lauren Rich Fine Endowed Director of Expressive Therapies at UH Connor Whole Health. UH Connor Whole Health manages the largest health system-based music therapy program in the US with 11 board-certified music therapists who collaborate with providers across the system to help patients and their families manage the physical and emotional toll of an illness or hospitalization. Additionally, UH Connor Whole Health provides a diverse offering of integrative health and medicine modalities, including acupuncture, chiropractic, and integrative medicine consults, that are centered on patients’ entire well-being.

“Consistent documentation in the electronic health record by the integrative health and medicine providers on these interventions and patient reported outcomes allow for future research to be aggregated across numerous health systems. We hope that EMMPIRE can serve as the impetus for future multi-site collaborations.” said Jeffery A. Dusek PhD, Director of Research, UH Connor Whole Health and Principal Investigator of EMMPIRE as well as the BraveNet Practice-Based Research Network, the largest such network of integrative health and medicine centers in the world.

In addition to describing their methods and findings, the authors conclude with a series of practical tips for clinicians and researchers to use to improve PRO collection at their institutions. These include 1) requesting EHR documentation enhancements early, 2) providing clear and consistent training to clinicians, 3) monitoring documentation completion at regular intervals, 4) minimizing documentation burden by capturing all data within one form, 5) providing tools for therapists to document sessions in which PROs are unable to be assessed due to patient limitations, and 6) providing additional tools to facilitate therapists’ data collection such as a field note and a laminated form for patients to complete.

“Patient-reported outcomes are vitally important for understanding patients’ needs and delivering high quality compassionate care. When combined with clinically effective approaches such as music therapy, you get a patient-centered and data-driven approach to improving outcomes throughout health systems” said Peter Pronovost, MD, PhD, FCCM, Chief Quality & Clinical Transformation Officer for UH.

You can read “Optimizing Patient-Reported Outcome Collection and Documentation in Medical Music Therapy: A Process Improvement Study” in JMIR Human Factors by clicking here.

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About UH Connor Whole Health

UH Connor Whole Health is part of University Hospitals (UH), a comprehensive health system with annual revenues in excess of $5.0 billion, 23 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices located throughout 16 counties. UH’s goal is to be the most trusted health care partner in Northeast Ohio and UH Connor Whole Health furthers this objective by working to strengthen relationships between patients and providers to improve outcomes. The Whole Health approach prioritizes compassionate care centered on the patient’s entire well-being. The health care provider’s goal is to equip and empower each patient to take charge of their physical, mental, and spiritual health in order to live a full and meaningful life. Linking the patient’s larger purpose and life goals to their lifestyle allows clinical services, integrative medicine, and well-being programs to be delivered in a way that increases collaboration, motivation, and adherence to self-care and clinical needs. UH Connor Whole Health services include acupuncture, art therapy, chiropractic, expressive therapy (art, dance, and music), guided imagery, integrative medicine/lifestyle medicine consultations (adult and pediatric), massage therapy, meditation, mindfulness, osteopathic sports rehabilitation, stress management and resilience training workshops and yoga. For more information, visit UH Hospitals.org/ConnorWholeHealth. Follow UH Connor Whole Health on LinkedIn.

About University Hospitals / Cleveland, Ohio
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 21 hospitals (including five joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Northeast Ohio Medical University, Oxford University, the Technion Israel Institute of Technology and . National Taiwan University College of Medicine. The main campus also includes the UH Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH is one of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedIn, Facebook and Twitter. For more information, visit UHhospitals.org.

 

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JOURNAL

JMIR Human Factors

DOI

10.2196/46528 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Optimizing Patient-Reported Outcome Collection and Documentation in Medical Music Therapy: Process-Improvement Study

ARTICLE PUBLICATION DATE

27-Jul-2023

 

Social media marketing most effective when it prompts consumers to start posting

Peer-Reviewed Publication

UNIVERSITY OF NOTRE DAME

Social media is a critical marketing tool to help raise awareness when firms launch new products. The platforms can help inform consumers about product characteristics and benefits relative to competitors’ products.

New research from the University of Notre Dame analyzes data from the motion picture industry, which often relies on social media promotion, in an effort to understand how marketers could better promote other new products.

“The Ripple Effect of Firm-Generated Content on New Movie Releases,” forthcoming in the Journal of Marketing Research from lead author Shijie Lu, the Howard J. and Geraldine F. Korth Associate Professor of Marketing at Notre Dame’s Mendoza College of Business, analyzes 145,502 firm-generated and 5.9 million user-generated Twitter posts associated with 159 movies.

Lu and co-authors Isaac Dinner from Indeed and Rajdeep Grewal from the University of North Carolina at Chapel Hill find a positive and significant ripple effect of firm-generated content (FGC) on movie sales. FGC increases user-generated content (UGC), which then drives movie consumption.

The conventional belief has been that social media allows marketers to influence the purchase behavior of their followers directly. However, the team’s findings show that the way FGC works in new product releases is indirectly — through the UGC or word of mouth spread by followers of firms’ social media accounts.

The team looked at Twitter posts about movies released by the top 20 U.S. studios between January 2014 and June 2015. The movies were associated with 486 unique Twitter handles, including 158 movie accounts, 310 actor and director accounts and 18 studio accounts. They conducted an econometric analysis to test the relationships between FGC, UGC and box office sales.

“Interestingly, even when multiple social media accounts from the movie’s actors, directors and studio are used to promote a new movie, the FGC from the main movie account is more effective than other firm-related accounts in driving sales,” Lu said. “But the UGC resulting from that main account sells even more. So, FGC from celebrity actors and directors who are active on social media does not improve box office performances nearly as much as UGC from the fans.”

Additionally, firms’ regular posts with a movie-specific hashtag are more effective than replies, retweets and posts without the hashtag.

“This suggests that movie executives should focus on creating FGC that sparks conversations among followers when new movies are released,” Lu said. “The Barbie movie’s recent retweet of a father who dressed in a Barbie costume when taking his daughter to watch the movie is a good example of getting followers to talk about the movie spontaneously.”

Although the study focused on movies, Lu said the findings can be generalized to other products, including TV shows, games, music and books.

Contact: Shijie Lu, 574-631-5883, slyu@nd.edu

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JOURNAL

Journal of Marketing Research

ARTICLE TITLE

The Ripple Effect of Firm-Generated Content on New Movie Releases

 

Hole in one, not hole from sun

Aussie golfers must cover up to protect from skin cancer

Peer-Reviewed Publication

UNIVERSITY OF SOUTH AUSTRALIA

 

IMAGE: 27% OF GOLFERS ARE DIAGNOSED WITH SKIN CANCER, AS COMPARED WITH 7% OF THE GENERAL POPULATION. view more 

CREDIT: CLAPPSTAR

Golf is a game that doesn’t discriminate. Played across generations, abilities, and all walks of life, it presents the perfect blend of exercise, sociability, and the great outdoors.

 

Think again. Before you gear up to tee off, new research from the University of South Australia shows that golfers have a higher risk of skin cancer when compared to the general population.

 

Conducted with global partners*, the study shows that one in four golfers had received a skin cancer diagnosis, indicating 2.4 times greater risk of the disease.

 

The study is the first to explore the prevalence of skin cancers among an Australian golfing population.

 

Lead researcher, Dr Brad Stenner says the findings highlight the importance of being sun smart on the green.

 

“Playing golf regularly has a range of excellent health benefits – from helping you stay fit and active, to keeping you in touch with friends,” Dr Stenner says.

 

“For example, if you walk an average golf course, you’re walking at least five to seven kilometres every game, often more Add a bag of golf clubs and maybe two to three rounds a week, and you can see just how good golf is for your endurance, muscle tone and wellbeing.

 

“While there are clear health benefits of engaging in golf, this study explored the risks of playing golf as golfers tend to play for four or more hours in the sun, using various sun protection strategies.

 

“We found that that 27% of golfers – or one in four – had been diagnosed with skin cancer, as compared with 7% of the general population.

 

“So, while sun smart campaigns do exist and are promoted in Australia (especially in summer), it seems they may be missing the mark when it comes to golfers.”

 

Skin cancer accounts for the largest number of cancers diagnosed in Australia each year. Every year, skin cancers account for around 80% of all newly diagnosed cancers in Australia.

 

One in every three diagnosed cancers are skin related, with between two and three million non-melanoma skin cancers and 132,000 melanoma skin cancers occurring globally each year.

 

“This study confirms that golfers have an elevated risk of skin cancer. Knowing that, players should more actively strive to protect themselves,” Dr Stenner says.

 

“My advice is: before you go out and play golf make sure you put on some high SPF protective sunscreen, wear a broad brimmed hat and some sort of sleeve or arm protection to ensure you’ve got the maximum coverage, and don’t forget to reapply sunscreen as you go. Once you have that you’re all set to tee off.”

 

Notes for editors:

       *      Partners include: University of Dundee, University of Oxford, University College London, and University of
               Melbourne.

• Short one min video explainer also available upon request.

………………………………………………………………………………………………………………………..

Media contact: Annabel Mansfield M: +61 479 182 489 E: Annabel.Mansfield@unisa.edu.au

Researcher: Dr Brad Stenner E: Brad.Stenner@unisa.edu.au

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JOURNAL

BMJ Open Sport & Exercise Medicine

DOI

10.1136/bmjsem-2023-001597 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Golf participants in Australia have a higher lifetime prevalence of skin cancer compared with the general population

ARTICLE PUBLICATION DATE

1-Aug-2023

COI STATEMENT

none