ORCID Profile
0000-0002-5011-3615
Current Organisation
KU Leuven
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Publisher: Wiley
Date: 12-2011
DOI: 10.1002/JRSM.55
Abstract: There is an increasing interest in the conduct of qualitative evidence syntheses (QES), particularly in the field of health care. Approaches to QES vary in the way they conduct a search, a critical appraisal or the data-analysis. To date, the use of multi-context versus context-specific QES has not yet been fully considered. In a multi-context, QES exhaustive searches are used that retrieve studies from a broad variety of geographical, socio-cultural, political, historical, economical, health care, linguistic, or other context relevant to the review. Authors of a context-specific QES would generally have a particular end user in mind, therefore, using a selective search strategy with a focus on one particular context in order to provide lines of actions or theories that are sensitive to a local setting. We used the insights from a recently conducted, context-specific QES to map out potential strengths and weaknesses of these two approaches and make recommendations regarding the future conduct of QES. We propose two ways of combining the best of both: the production of umbrella reviews of context-specific syntheses and/or the trans-cultural modification and trans-contextual adaptation of findings from multi-context syntheses. Copyright © 2012 John Wiley & Sons, Ltd.
Publisher: SAGE Publications
Date: 10-06-2022
DOI: 10.1177/19408447221097061
Abstract: Participant created visual data are increasingly being used in social-behavioral sciences projects. They have become a popular medium in community-based research adopting an arts-informed approach to study challenging life circumstances of community members. We argue that visual data can do more than just illustrate ideas or concepts, particularly in the process of research where participants contribute to the data collection phase. Visual images record the tacit meanings of the person who makes them, and they can—with the help of a researcher skilled in qualitative reasoning—form another stream of textual analysis. The authors developed an Analytical Apparatus for Visual Imagery (AAVI), constructed from the elements of art and the principles of design and other arts-based sources, and applied it to two different arts-based research projects where participants created visual images or artworks for analysis. Through a combination of storylines and the AAVI analysis, a deeper level of analytical interpretation and a better understanding of the complexity of human experience were reached, particularly in trying to understand the emotional layers linked to experiences.
Publisher: SAGE Publications
Date: 04-2015
Abstract: – Systematic reviews have evaluated a wide variety of programmes aiming to prevent, reduce or delay substance use in adolescents. This paper presents an overview of recent systematic reviews, summarising the evidence on the effectiveness of prevention strategies which target adolescents misusing alcohol and/or drugs. – We performed a comprehensive search in major electronic databases, consulted websites and checked reference lists of relevant articles. Studies that met our inclusion criteria were critically appraised using the AMSTAR instrument. The findings from the included systematic reviews were synthesised using a vote counting procedure. – Twenty-one systematic reviews were identified. Ten of these were rated as of high quality. There was little overlap between reviews in terms of the target group, intervention, setting and outcome measures. The components or mechanisms of the prevention programmes were poorly described. Ten reviews evaluated school-based prevention. The effects of these prevention programmes are promising, while effects of community-based, family-based and multi-faceted programmes were less convincing. – Based on the current evidence, there is a small but consistent positive effect of school-based prevention programmes, but it is less clear what the “active ingredient” is. For ex le, which group should one target, in which setting and in which circumstances? A set of standardised process and outcome measures would allow us to better compare and statistically pool the results of original studies and reviews. This overview of reviews, like similar other overviews, should encourage researchers to increase uniformity and consistency between studies. This would improve the comparability of evidence, which is needed to formulate valid recommendations for practice.
Publisher: University of Alberta Libraries
Date: 05-03-2020
DOI: 10.18432/ARI29533
Abstract: None, editorial!
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.JCLINEPI.2017.11.028
Abstract: This article provides reviewers with guidance on methods for identifying and processing evidence to understand intervention implementation. Strategies, tools, and methods are applied to the systematic review process to illustrate how process and implementation can be addressed using quantitative, qualitative, and other sources of evidence (i.e., descriptive textual and nonempirical). Reviewers can take steps to navigate the heterogeneity and level of uncertainty present in the concepts, measures, and methods used to assess implementation. Activities can be undertaken in advance of a Cochrane quantitative review to develop program theory and logic models that situate implementation in the causal chain. Four search strategies are offered to retrieve process and implementation evidence. Recommendations are made for addressing rigor or risk of bias in process evaluation or implementation evidence. Strategies are recommended for locating and extracting data from primary studies. The basic logic is presented to assist reviewers to make initial review-level judgments about implementation failure and theory failure. Although strategies, tools, and methods can assist reviewers to address process and implementation using quantitative, qualitative, and other forms of evidence, few exemplar reviews exist. There is a need for further methodological development and trialing of proposed approaches.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.JCLINEPI.2017.11.029
Abstract: The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method evidence from process evaluations. Despite a proliferation of methods for the synthesis of qualitative research, less attention has focused on how to integrate these syntheses within intervention effectiveness reviews. In this article, we report updated guidance from the group on approaches, methods, and tools, which can be used to integrate the findings from quantitative studies evaluating intervention effectiveness with those from qualitative studies and process evaluations. We draw on conceptual analyses of mixed methods systematic review designs and the range of methods and tools that have been used in published reviews that have successfully integrated different types of evidence. We outline five key methods and tools as devices for integration which vary in terms of the levels at which integration takes place the specialist skills and expertise required within the review team and their appropriateness in the context of limited evidence. In situations where the requirement is the integration of qualitative and process evidence within intervention effectiveness reviews, we recommend the use of a sequential approach. Here, evidence from each tradition is synthesized separately using methods consistent with each tradition before integration takes place using a common framework. Reviews which integrate qualitative and process evaluation evidence alongside quantitative evidence on intervention effectiveness in a systematic way are rare. This guidance aims to support review teams to achieve integration and we encourage further development through reflection and formal testing.
Publisher: John Wiley & Sons, Ltd
Date: 08-07-2009
Publisher: Springer Science and Business Media LLC
Date: 26-04-2017
Publisher: Guilford Publications
Date: 04-2016
DOI: 10.1521/AEAP.2016.28.2.180
Abstract: Information about factors associated with condom use among Nepalese labor migrant couples that are considered being at high risk of HIV infection is not clearly understood. Therefore, we carried out a cross-sectional study to identify the factors associated with condom use among Nepalese labor migrant couples. A total of 266 wives of Nepalese labor migrants were invited for an interview. Hierarchical logistic regression analysis was performed to analyze data. We found that almost 39% of the women reported having used a condom while having sex with their husbands. Age was the only husband-related factor independently associated with condom use. School education, knowledge about HIV/AIDS, discussion of HIV with peers and sexual negotiation with the husband were the wife-related factors independently associated with condom use. Our findings highlight a clear need to develop effective HIV prevention interventions targeting illiterate labor migrant couples, with a particular emphasis on increasing women's ability to negotiate condom use.
Publisher: Research Square Platform LLC
Date: 12-2020
DOI: 10.21203/RS.3.RS-113510/V1
Abstract: Introduction Renin-angiotensin system (RAS) inhibitors have been postulated to influence susceptibility to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This study investigated whether there is an association between their prescription and the incidence of COVID-19 and all-cause mortality. Methods We conducted a propensity-score matched cohort study comparing the incidence of COVID-19 among patients with hypertension prescribed ACE inhibitors or ARBs to those treated with calcium channel blockers (CCBs) in a large UK-based primary care database (The Health Improvement Network). We estimated crude incidence rates for confirmed/suspected COVID-19 in each drug exposure group. We used Cox proportional hazards models to produce adjusted hazard ratios for COVID-19. We assessed all-cause mortality as a secondary outcome. Results The incidence rate of COVID-19 among users of ACE inhibitors and CCBs was 9.3 per 1000 person-years (83 of 18,895 users [0.44%]) and 9.5 per 1000 person-years (85 of 18,895 [0.45%]), respectively. The adjusted hazard ratio was 0.92 (95% CI 0.68 to 1.26). The incidence rate among users of ARBs was 15.8 per 1000 person-years (79 out of 10,623 users [0.74%]). The adjusted hazard ratio was 1.38 (95% CI 0.98 to 1.95). There were no significant associations between use of RAS inhibitors and all-cause mortality. Conclusion Use of ACE inhibitors was not associated with the risk of COVID-19 whereas use of ARBs was associated with a statistically non-significant increase compared to the use of CCBs. However, no significant associations were observed between prescription of either ACE inhibitors or ARBs and all-cause mortality.
Publisher: BMJ
Date: 09-04-2020
DOI: 10.1136/HEARTJNL-2019-316091
Abstract: The objective of this study is to use latent class analysis of up to 20 comorbidities in patients with a diagnosis of ischaemic heart disease (IHD) to identify clusters of comorbidities and to examine the associations between these clusters and mortality. Longitudinal analysis of electronic health records in the health improvement network (THIN), a UK primary care database including 92 186 men and women aged ≥18 years with IHD and a median of 2 (IQR 1–3) comorbidities. Latent class analysis revealed five clusters with half categorised as a low-burden comorbidity group. After a median follow-up of 3.2 (IQR 1.4–5.8) years, 17 645 patients died. Compared with the low-burden comorbidity group, two groups of patients with a high-burden of comorbidities had the highest adjusted HR for mortality: those with vascular and musculoskeletal conditions, HR 2.38 (95% CI 2.28 to 2.49) and those with respiratory and musculoskeletal conditions, HR 2.62 (95% CI 2.45 to 2.79). Hazards of mortality in two other groups of patients characterised by cardiometabolic and mental health comorbidities were also higher than the low-burden comorbidity group HR 1.46 (95% CI 1.39 to 1.52) and 1.55 (95% CI 1.46 to 1.64), respectively. This analysis has identified five distinct comorbidity clusters in patients with IHD that were differentially associated with risk of mortality. These analyses should be replicated in other large datasets, and this may help shape the development of future interventions or health services that take into account the impact of these comorbidity clusters.
Publisher: Elsevier BV
Date: 12-2012
Publisher: Springer Science and Business Media LLC
Date: 04-11-2010
DOI: 10.1007/S10597-009-9260-1
Abstract: This study aims to explore the obstacles to Evidence-Based Practice (EBP) experienced by Belgian Dutch-speaking psychiatrists. We used an inductive, qualitative research strategy. Thirty-nine psychiatrists participated in five focus groups organised between September 2004 and September 2006. Data-analysis was guided by a 'grounded theory approach'. Three major themes emerged from the data: (1) Characteristics of evidence, including the lack of (use of) evidence and the applicability of evidence (2) Characteristics of other partners in mental health care, including government, patients and drug companies and (3) Discipline-related barriers, including the complexity of diagnoses, the importance of the therapeutic relationship and personal experience, and the different schools of thoughts. A problem tree was developed, linking all obstacles. Although context-specific, the problem tree can assist policy makers working in health care systems with similar characteristics in formulating objectives and developing strategies that facilitate EBP in the field of psychiatric care.
Publisher: Wiley
Date: 14-03-2015
Publisher: Springer Science and Business Media LLC
Date: 31-07-2009
Publisher: Springer Science and Business Media LLC
Date: 16-09-2017
DOI: 10.1007/S10900-016-0251-1
Abstract: Nepalese labor migrants and their wives are considered as at-risk populations for HIV infection. There may be a risk of HIV transmission from the labor migrant and their wives to the general population due to HIV-related risk behaviors, but so far empirical evidence to support this hypothesis is scarce. Therefore, this study was conducted to compare HIV-related risk behaviors between labor migrants, their wives, and males and females from the general population in the far-western region of Nepal. This was a cross-sectional study, in which structured face-to-face interviews were conducted with 261 male labor migrants, 262 wives of labor migrants, 123 males and 122 females from the general population. We found that the proportion of the labor migrants and their wives reporting having had extramarital sex in the previous year did not differ significantly with the males (11.9 vs. 13.4 %, p value 0.752) and females (2.0 vs. 1.7 %, p value 0.127) from the general population. However, the labor migrants compared with the males from the general population were 1.51 times and the wives of labor migrants compared with the females from the general population were 2.37 times more likely to have been tested for HIV. Both the males from the general population and the labor migrants are equally engaged in unprotected extramarital sex. Therefore, it is recommended that the prevention programs, including access to condoms and HIV testing, should be scaled up targeting a broader range of in iduals in the far-western region of Nepal.
Publisher: Springer Science and Business Media LLC
Date: 02-11-2015
Publisher: Springer Science and Business Media LLC
Date: 09-09-2005
Abstract: Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners) to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful s ling was used to recruit participants. A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' in idual practice), commercial and consumer organisations on the meso-level (institutions, organisations) and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community). Existing barriers and possible strategies to overcome these barriers were described. In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed.
Publisher: Springer Science and Business Media LLC
Date: 17-10-2013
Publisher: Springer Science and Business Media LLC
Date: 18-02-2016
Publisher: Elsevier BV
Date: 03-2014
Publisher: Wiley
Date: 10-2019
DOI: 10.1111/NIN.12317
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.JCLINEPI.2017.06.020
Abstract: The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method implementation evidence. Choice of appropriate methodologies, methods, and tools is essential when developing a rigorous protocol and conducting the synthesis. Cochrane authors who conduct qualitative evidence syntheses have thus far used a small number of relatively simple methods to address similarly written questions. Cochrane has invested in methodological work to develop new tools and to encourage the production of exemplar reviews to show the value of more innovative methods that address a wider range of questions. In this paper, in the series, we report updated guidance on the selection of tools to assess methodological limitations in qualitative studies and methods to extract and synthesize qualitative evidence. We recommend application of Grades of Recommendation, Assessment, Development, and Evaluation-Confidence in the Evidence from Qualitative Reviews to assess confidence in qualitative synthesized findings. This guidance aims to support review authors to undertake a qualitative evidence synthesis that is intended to be integrated subsequently with the findings of one or more Cochrane reviews of the effects of similar interventions. The review of intervention effects may be undertaken concurrently with or separate to the qualitative evidence synthesis. We encourage further development through reflection and formal testing.
Publisher: John Wiley & Sons, Ltd
Date: 19-10-1996
Publisher: John Wiley & Sons, Ltd
Date: 19-04-1996
Publisher: Wiley
Date: 16-12-2011
Publisher: Wiley
Date: 25-07-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
DOI: 10.1016/J.JANA.2017.04.004
Abstract: A scoping review of grey and peer-reviewed literature was conducted to develop a conceptual framework to illustrate mechanisms involved in reducing HIV stigma and increasing HIV test uptake. We followed a three-step approach to exploring the literature: developing concepts, organizing and categorizing concepts, and synthesizing concepts into a framework. The framework contains four types of intervention strategies: awareness creation, influencing normative behavior, providing support, and developing regulatory laws. The awareness creation strategy generally improves knowledge and the influencing normative behavior strategy changes stigmatizing attitudes and behaviors, and subsequently, increases HIV test uptake. Providing support and development of regulatory law strategies changes actual stigmatizing behaviors of the people, and subsequently, increases HIV test uptake. The framework further outlines that the mechanisms described are influenced by the interaction of various social-contextual and in idual factors. The framework sheds new light on the effects of HIV stigma-reduction intervention strategies and HIV test uptake.
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.JCLINEPI.2017.10.022
Abstract: To outline contemporary and novel developments for the presentation and reporting of syntheses of qualitative, implementation, and process evaluation evidence and provide recommendations for the use of reporting guidelines. An overview of reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses drawing on current international literature and the collective expert knowledge of the Cochrane Qualitative and Implementation Methods Group. Several reporting guidelines exist that can be used or adapted to report syntheses of qualitative, implementation, and process evaluation evidence. Methods to develop in idual guidance varied. The use of a relevant reporting guideline can enhance the transparency, consistency, and quality of reporting. Guidelines that exist are generic, method specific, and for particular aspects of the reviewing process, searching. Caution is expressed over the potential for reporting guidelines to produce a mechanistic approach moving the focus away from the content and toward the procedural aspects of the review. The use of a reporting guideline is recommended and a five-step decision flowchart to guide the choice of reporting guideline is provided. Gaps remain in method-specific reporting guidelines such as mixed-study, implementation, and process evaluation evidence syntheses.
Publisher: Public Library of Science (PLoS)
Date: 11-05-2021
DOI: 10.1371/JOURNAL.PONE.0251406
Abstract: Back pain is a common and costly health problem worldwide. There is yet a lack of consistent methodologies to estimate the economic burden of back pain to society. To systematically evaluate the methodologies used in the published cost of illness (COI) literature for estimating the direct and indirect costs attributed to back pain, and to present a summary of the estimated cost burden. Six electronic databases were searched to identify COI studies of back pain published in English up to February 2021. A total of 1,588 abstracts were screened, and 55 full-text studies were subsequently reviewed. After applying the inclusion criteria, 45 studies pertaining to the direct and indirect costs of back pain were analysed. The studies reported data on 15 industrialised countries. The national cost estimates of back pain in 2015 USD ranged from $259 million ($29.1 per capita) in Sweden to $71.6 billion ($868.4 per capita) in Germany. There was high heterogeneity among the studies in terms of the methodologies used for analysis and the resulting costs reported. Most of the studies assessed costs from a societal perspective (n = 29). The magnitude and accuracy of the reported costs were influenced by the case definition of back pain, the source of data used, the cost components included and the analysis method. Among the studies that provided both direct and indirect cost estimates (n = 15), indirect costs resulting from lost or reduced work productivity far outweighed the direct costs. Back pain imposes substantial economic burden on society. This review demonstrated that existing published COI studies of back pain used heterogeneous approaches reflecting a lack of consensus on methodology. A standardised methodological approach is required to increase credibility of the findings of COI studies and improve comparison of estimates across studies.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.JCLINEPI.2017.10.023
Abstract: This paper updates previous Cochrane guidance on question formulation, searching, and protocol development, reflecting recent developments in methods for conducting qualitative evidence syntheses to inform Cochrane intervention reviews. Ex les are used to illustrate how decisions about boundaries for a review are formed via an iterative process of constructing lines of inquiry and mapping the available information to ascertain whether evidence exists to answer questions related to effectiveness, implementation, feasibility, appropriateness, economic evidence, and equity. The process of question formulation allows reviewers to situate the topic in relation to how it informs and explains effectiveness, using the criterion of meaningfulness, appropriateness, feasibility, and implementation. Questions related to complex questions and interventions can be structured by drawing on an increasingly wide range of question frameworks. Logic models and theoretical frameworks are useful tools for conceptually mapping the literature to illustrate the complexity of the phenomenon of interest. Furthermore, protocol development may require iterative question formulation and searching. Consequently, the final protocol may function as a guide rather than a prescriptive route map, particularly in qualitative reviews that ask more exploratory and open-ended questions.
Publisher: Wiley
Date: 16-12-2011
Publisher: Wiley
Date: 10-2007
DOI: 10.1111/J.1365-2648.2007.04389.X
Abstract: This paper reports a study to explore the barriers to evidence-based nursing among Flemish (Belgian) nurses. Barriers obstructing the call for an increase in evidence-based nursing have been explored in many countries, mostly through quantitative study designs. Authors report on lack of time, resources, evidence, authority, support, motivation and resistance to change. Relationships between barriers are seldom presented. We used a grounded theory approach, and five focus groups were organized between September 2004 and April 2005 in Belgium. We used purposeful s ling to recruit 53 nurses working in different settings. A problem tree was developed to establish links between codes that emerged from the data. The majority of the barriers were consistent with previous findings. Flemish (Belgian) nurses added a potential lack of responsibility in the uptake of evidence-based nursing, their 'guest' position in a patient's environment leading to a culture of adaptation, and a future 'two tier' nursing practice, which refers to the different education levels of nurses. The problem tree developed serves as (1) a basic model for other researchers who want to explore barriers within their own healthcare system and (2) a useful tool for orienting change management processes. Despite the fact that the problem tree presented is context-specific for Flanders (Belgium), it gives an opportunity to develop clear objectives and targeted strategies for tackling obstacles to evidence-based nursing.
Publisher: SAGE Publications
Date: 31-05-2007
Abstract: Practitioners working in social welfare, education, judicial circuits, psychology, and many other domains of human sciences daily decide on best treatments for their clients. The authors expect those practitioners to base their decisions on evidence from scientific research. The C bell collaboration is an international nonprofit organization that supports a systematic evaluation of the effects of existing and new arising interventions in social sciences. In November 2005, 20 local volunteers launched the Belgian C bell group. The most important tasks of this group are (a) to organize course programs on systematic reviews and (b) to assist Belgian authors willing to contribute to the C bell collaboration in the writing of their protocol and systematic review. In this article, the authors introduce the concept of a systematic review and present the first achievements of the Belgian C bell group, its current strengths, weaknesses, opportunities, and threats.
Publisher: Springer Science and Business Media LLC
Date: 30-12-2016
DOI: 10.1007/S10508-016-0868-2
Abstract: When confronted with cancer, a prominent challenge for patients and their partners is their changed sexual relationship. An empirically based theoretical model of the sexual adaptation process during cancer might be helpful in guiding the development of adequate interventions for couples who struggle with their sexual relationship. Therefore, the purpose of this study was to synthesize evidence from primary qualitative research studies and to arrive at a detailed description of the process of sexual adjustment during cancer. We conducted a qualitative evidence synthesis of a purposeful s le of 16 qualitative papers, using the meta-ethnography approach to synthesis. We found that the subsequent studies used different theoretical approaches to describe the sexual adaptation process. This led to three ergent sexual adaptation processes: (1) the pathway of grief and mourning, depicting sexual changes as a loss (2) the pathway of restructuring, depicting the adjustment process toward sexual changes as a cognitive process with a strong focus on the social and cultural forces that shape the values and experiences of sexuality and (3) the pathway of sexual rehabilitation, depicting sexual changes as a bodily dysfunction that needs treatment and specific behavioral strategies. All three pathways have their own opportunities and challenges. A greater awareness of these different pathways could help healthcare providers to better understand the ways a particular couple might cope with changed sexuality, offering them opportunities to discover alternative pathways for sexual adjustment.
Publisher: Springer Science and Business Media LLC
Date: 22-07-2009
Publisher: Wiley
Date: 06-04-2021
Abstract: To describe the prevalence and incidence of endometriosis and to estimate the risk of cardiovascular outcomes in women with endometriosis. Population‐based cohort study using The Health Improvement Network database. UK primary care. Women aged 16–50 years were followed from 1995 to 2018. Adjusted hazard ratios (aHR) for cardiovascular outcomes comparing women with endometriosis with those without endometriosis were estimated using multivariable Cox regression models. Prevalence and incidence of endometriosis were estimated using annual (1998–2017) sequential cross‐sectional and cohort studies, respectively. The primary outcome was composite cardiovascular disease (CVD) including, ischaemic heart disease (IHD), heart failure (HF) and cerebrovascular disease. Secondary outcomes were arrhythmia, hypertension and all‐cause mortality. In all, 56 090 women with endometriosis and 223 669 matched controls without endometriosis were included in the analysis of cardiovascular risk. Compared with women without endometriosis, the aHR for cardiovascular outcomes among women with endometriosis were: composite CVD 1.24 (95% CI 1.13–1.37) IHD 1.40 (95% CI 1.22–1.61) cerebrovascular disease 1.19 (95% CI 1.04–1.36) HF 0.76 (95% CI 0.54–1.07) arrhythmia 1.26 (95% CI 1.11–1.43) hypertension 1.12 (95% CI 1.07–1.17) and all‐cause mortality 0.66 (95% CI 0.59–0.74). The incidence of endometriosis was 12.3 per 10 000 person‐years in 1998 and 11.5 per 10 000 person‐years in 2017. The prevalence of endometriosis increased from 119.7 per 10 000 population in 1998 to 201.3 per 10 000 population in 2017. Endometriosis is associated with an increased risk of cardiovascular outcomes. Young women with endometriosis are a potential target for CVD risk assessment and prevention. Endometriosis is associated with increased risk of cardiovascular outcomes: a UK retrospective matched cohort study.
Publisher: BMJ
Date: 2023
DOI: 10.1136/BMJGH-2022-010850
Abstract: Poor access to water, sanitation and hygiene (WASH) services threatens population health and contributes to gender and social inequalities, especially in low-resource settings. Despite awareness in the WASH sector of the importance of promoting gender equality and social inclusion (GESI) to address these inequalities, evaluations of interventions focus largely on health outcomes, while gender equality and other social outcomes are rarely included. This review aimed to collate and describe available research evidence of GESI outcomes evaluated in WASH intervention studies. We applied a systematic mapping methodology and searched for both academic and grey literature published between 2010 and 2020 in 16 bibliographic databases and 53 specialist websites. Eligibility screening (with consistency checking) was conducted according to predetermined criteria, followed by metadata coding and narrative synthesis. Our evidence base comprises 463 intervention studies. Only 42% of studies measured transformative GESI outcomes of WASH interventions, referring to those that seek to transform gender relations and power imbalances to promote equality. A majority of studies disaggregated outcome data by sex, but other forms of data disaggregation were limited. Most included studies (78%) lacked a specific GESI mainstreaming component in their intervention design. Of the interventions with GESI mainstreaming, the majority targeted women and girls, with very few focused on other social groups or intersectional considerations. The review points to various areas for future primary and secondary research. Given the potential contribution of WASH to GESI, GESI considerations should be incorporated into the evaluation of WASH interventions. Regular collection of data and monitoring of GESI outcomes is needed as well as developing new and testing existing methods for monitoring and evaluation of such data.
Publisher: Springer Science and Business Media LLC
Date: 07-09-2015
Publisher: Springer Science and Business Media LLC
Date: 15-03-2021
DOI: 10.1186/S12879-021-05951-W
Abstract: Renin-angiotensin system (RAS) inhibitors have been postulated to influence susceptibility to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This study investigated whether there is an association between their prescription and the incidence of COVID-19 and all-cause mortality. We conducted a propensity-score matched cohort study comparing the incidence of COVID-19 among patients with hypertension prescribed angiotensin-converting enzyme I (ACE) inhibitors or angiotensin II type-1 receptor blockers (ARBs) to those treated with calcium channel blockers (CCBs) in a large UK-based primary care database (The Health Improvement Network). We estimated crude incidence rates for confirmed/suspected COVID-19 in each drug exposure group. We used Cox proportional hazards models to produce adjusted hazard ratios for COVID-19. We assessed all-cause mortality as a secondary outcome. The incidence rate of COVID-19 among users of ACE inhibitors and CCBs was 9.3 per 1000 person-years (83 of 18,895 users [0.44%]) and 9.5 per 1000 person-years (85 of 18,895 [0.45%]), respectively. The adjusted hazard ratio was 0.92 (95% CI 0.68 to 1.26). The incidence rate among users of ARBs was 15.8 per 1000 person-years (79 out of 10,623 users [0.74%]). The adjusted hazard ratio was 1.38 (95% CI 0.98 to 1.95). There were no significant associations between use of RAS inhibitors and all-cause mortality. Use of ACE inhibitors was not associated with the risk of COVID-19 whereas use of ARBs was associated with a statistically non-significant increase compared to the use of CCBs. However, no significant associations were observed between prescription of either ACE inhibitors or ARBs and all-cause mortality.
Publisher: SAGE Publications
Date: 2023
DOI: 10.1177/16094069231176391
Abstract: Artistic research studies produce a felt and often physically embodied type of knowledge initiated in an artistic experience and consolidated as an art form. The actual art work as the outcome of these studies, complements other types of knowledge and therefore requires attention from systematic review authors who synthesize evidence from primary studies. Working with artistic research evidence in a systematic review context requires a different approach to searching, appraising, analysing and integrating research findings than what is usually promoted by international review organisations. In this paper we outline how the different steps in a systematic review process can be adapted to include art work as as a multimodal type of research evidence in systematic reviews. We discuss useful tactics of identifying artistic research evidence, judging its value, analysing and synthesizing such evidence, hereby building on iconographic, thematic and/or art and design related analytical frameworks. In addition, we feature a gallery approach to present artistic research evidence to end-users and feature a multimodal type of evidence synthesis in which in idual art works are comprehensively integrated in an audio visual production.
Publisher: University of Alberta Libraries
Date: 22-04-2021
DOI: 10.18432/ARI29553
Abstract: On the 23rd of January 2020, a radio talk show of the future, 20:30 Bruxsels Talks, took place in Brussels. With guests and artists from the year 2030, it discussed how the transition to a climate-proof city had happened since 2019. In this article, we present and frame the development of the show and provide insight into the participative creation process. The radio show exemplifies (a) how future fiction can be used as a tool to evoke change and (b) how the participatory development of futurist fiction can be used as a method to trigger imagination and conversation on what citizens want for our cities. We argue that there is an opportunity for researchers to explore fiction as a method, as a format and as a space. Foresight practitioners who want to create engaging stories may find inspiration in the body of knowledge of arts-based research and the arts. Note: This article should be read in conjunction with 20:30 Bruxsels Talks: A Script for a Future Fiction Radio Show, in this issue, written by the same author team and published in this volume.
Publisher: Wiley
Date: 29-04-2021
DOI: 10.1002/ART.41593
Publisher: Elsevier BV
Date: 07-2018
Publisher: Royal College of General Practitioners
Date: 11-2011
Publisher: Wiley
Date: 06-04-2011
DOI: 10.1111/J.1365-2648.2011.05636.X
Abstract: This paper presents a discussion of the role of the philosophy of pragmatism in the Joanna Briggs meta-aggregative approach to qualitative evidence synthesis. An increasing number of qualitative evidence syntheses are being published in journals, many of them influenced by an interpretive or a critical-realist perspective. One approach to qualitative evidence synthesis is meta-aggregation. Originally designed to model the transparency, auditability and reliability of the established process for effectiveness reviews, meta-aggregation makes a case for the production of synthesized statements that refer to 'lines of action' informing decision-making at the clinical or policy level. This paper draws from the literature written on the philosophy of pragmatism (1877-2008) and from the user guidance on meta-aggregation developed by the Joanna Briggs Institute between 2004 and 2007. Meta-aggregation as a methodology is founded on the principles and assumptions of the philosophical traditions of pragmatism. Meta-aggregation can only reach its full potential if the 'lines of action' suggested will somehow be supported by measures of effectiveness, as demonstrated in mixed method research. The 'lines of action' presented as the result of a meta-aggregative synthesis are directive in nature and inform healthcare practitioners at the point of practical decision-making. The real verification of the 'lines of action' suggested in a meta-aggregation consists of the satisfactorily ending consequences, mental or physical, which the synthesized statements that summarize the basic ideas emerging from the studies are able to generate in end users.
Publisher: Ghent University
Date: 20-02-2018
DOI: 10.21825/SOCIOLOGOS.86963
Abstract: This study builds on recent literature that calls for a renewed attention for the sensorial dimension in research. The researchers examine the potential of a sensory research approach in studying the relationship between citizens and their living environment. They illustrate this by means of their own exploratory research in an urban renewal setting. Eight local residents were invited to walk together with the researchers in their own city while ‘opening up’ their senses and sharing their lived experiences. The sensory focus allowed researchers to tap into the concrete physical aspects as well as inner processes (feelings, memories, imaginations) related to the place under research. The paper draws attention to the implications of a sensory research approach with regard to how we are accustomed to collect and analyze qualitative research materials. It concludes with a number of challenges and directions for further research.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2014
Publisher: STAR Scholars Network
Date: 10-12-2021
DOI: 10.32674/JCIHE.V13I5.2763
Abstract: Due to an increase in mobility programs, the number of South African international students is on the rise. Despite this increase there is a lack of research on South African international students. The acculturation challenges of South African international students, studying in Flanders, Belgium in a non-Anglophonic context was investigated. A Photovoice method explored barriers and facilitators in their adjustment process. Participants captured their experiences through a visual lens. Focus groups conducted, utilized images as prompts to the narratives. The data was analyzed using a thematic analysis approach. The two main themes identified were related to Sociocultural and Psychological adjustment. We adapted Berry’s bidimensional acculturation model, used it as an overarching framework and merged it with an Ubuntu African perspective. The data suggest that for facets of the host nation superficially rooted and easy to adapt to, participants generally adopted an assimilation strategy. Whereas a separation strategy was adopted for facets of the host nation that were deeply ingrained such as worldviews.
Publisher: Wiley
Date: 22-09-2008
Publisher: Elsevier BV
Date: 2015
Publisher: Wiley
Date: 07-10-2013
DOI: 10.1111/JCPP.12145
Abstract: Context-specific evidence-based guidelines on how to prevent and treat substance misuse among adolescents are currently lacking in many countries. Due to the time consuming nature of de novo guideline development, the ADAPTE collaboration introduced a methodology to adapt existing guidelines to a local context. An important step in this method is a systematic review to identify relevant high-quality evidence-based guidelines. This study describes the results of this step for the development of guidelines on adolescent alcohol and drug misuse in Belgium. Rigorous systematic review methodology was used. This included searches of electronic databases (Medline, Embase, Cinahl, PsychInfo, and ERIC in June 2011), websites of relevant organizations, and reference lists of key publications. Experts in the field were also contacted. Included were Dutch, English, French, or German evidence-based practice guidelines from 2006 or later on the prevention, screening, assessment, or treatment of alcohol or illicit drug misuse in persons aged 12-18 years. Two independent reviewers assessed the quality of the guidelines using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument. This overview provides a framework of current knowledge in adolescent alcohol and drug misuse prevention and treatment. This systematic review identified 32 relevant evidence-based guidelines on substance misuse among adolescents. Nine guidelines were judged to be of high quality of which four had recommendations specifically on adolescents: one on school-based prevention, one on substance misuse prevention in vulnerable young people and two on alcohol misuse with specific sections for the adolescent population. There were few commonalities as guidelines focused on different target groups, professional disciplines and type and level of substance misuse. Evidence to support the recommendations was sparse, and many recommendations were based on expert consensus or on studies among adults. Also, the link between evidence and recommendations was often unclear. There are a substantial number of guidelines addressing substance misuse in adolescents. However, only four high-quality guidelines included recommendations specific for adolescents. The current level of evidence that underpins the recommendations in these high-quality guidelines is low.
Publisher: Informa UK Limited
Date: 10-2009
Publisher: European Respiratory Society (ERS)
Date: 14-08-2019
DOI: 10.1183/13993003.00476-2019
Abstract: The association between allergic diseases and autoimmune disorders is not well established. Our objective was to determine incidence rates of autoimmune disorders in allergic rhinitis/conjunctivitis (ARC), atopic eczema and asthma, and to investigate for co-occurring patterns. This was a retrospective cohort study (1990–2018) employing data extracted from The Health Improvement Network (UK primary care database). The exposure group comprised ARC, atopic eczema and asthma (all ages). For each exposed patient, up to two randomly selected age- and sex-matched controls with no documented allergic disease were used. Adjusted incidence rate ratios (aIRRs) were calculated using Poisson regression. A cross-sectional study was also conducted employing Association Rule Mining (ARM) to investigate disease clusters. 782 320, 1 393 570 and 1 049 868 patients with ARC, atopic eczema and asthma, respectively, were included. aIRRs of systemic lupus erythematosus (SLE), Sjögren's syndrome, vitiligo, rheumatoid arthritis, psoriasis, pernicious anaemia, inflammatory bowel disease, coeliac disease and autoimmune thyroiditis were uniformly higher in the three allergic diseases compared with controls. Specifically, aIRRs of SLE (1.45) and Sjögren's syndrome (1.88) were higher in ARC aIRRs of SLE (1.44), Sjögren's syndrome (1.61) and myasthenia (1.56) were higher in asthma and aIRRs of SLE (1.86), Sjögren's syndrome (1.48), vitiligo (1.54) and psoriasis (2.41) were higher in atopic eczema. There was no significant effect of the three allergic diseases on multiple sclerosis or of ARC and atopic eczema on myasthenia. Using ARM, allergic diseases clustered with multiple autoimmune disorders. Three age- and sex-related clusters were identified, with a relatively complex pattern in females ≥55 years old. The long-term risks of autoimmune disorders are significantly higher in patients with allergic diseases. Allergic diseases and autoimmune disorders show age- and sex-related clustering patterns.
Publisher: Springer Science and Business Media LLC
Date: 17-09-2015
Publisher: Everything Is Connected Press
Date: 30-10-2020
DOI: 10.28963/3.1.19
Publisher: Informa UK Limited
Date: 21-12-2021
Publisher: BMJ
Date: 12-2021
DOI: 10.1136/BMJOPEN-2020-048296
Abstract: To identify the association between periodontal diseases (gingivitis and periodontitis) and chronic diseases including cardiovascular disease, cardiometabolic disease, autoimmune disease and mental ill health. Retrospective cohort. IQVIA Medical Research Data-UK between 1 January 1995 and 1 January 2019. 64 379 adult patients with a general practitioner recorded diagnosis of periodontal disease (exposed patients) were matched to 251 161 unexposed patients by age, sex, deprivation and registration date. Logistic regression models accounting for covariates of clinical importance were undertaken to estimate the adjusted OR (aOR) of having chronic diseases at baseline in the exposed compared with the unexposed group. Incidence rates for each outcome of interest were then provided followed by the calculation of adjusted HRs using cox regression modelling to describe the risk of outcome development in each group. The average age at cohort entry was 45 years and the median follow-up was 3.4 years. At study entry, the exposed cohort had an increased likelihood of having a diagnosis of cardiovascular disease (aOR 1.43 95% CI 1.38 to 1.48), cardiometabolic disease (aOR 1.16 95% CI 1.13 to 1.19), autoimmune disease (aOR 1.33 95% CI 1.28 to 1.37) and mental ill health (aOR 1.79 95% CI 1.75 to 1.83) compared with the unexposed group. During the follow-up of in iduals without pre-existing outcomes of interest, the exposed group had an increased risk of developing cardiovascular disease (HR 1.18 95% CI 1.13 to 1.23), cardiometabolic disease (HR 1.07 95% CI 1.03 to 1.10), autoimmune disease (HR 1.33 95% CI 1.26 to 1.40) and mental ill health (HR 1.37 95% CI 1.33 to 1.42) compared with the unexposed group. In this cohort, periodontal diseases appeared to be associated with an increased risk of developing cardiovascular, cardiometabolic, autoimmune diseases and mental ill health. Periodontal diseases are very common therefore, an increased risk of other chronic diseases represent a substantial public health burden.
Publisher: SAGE Publications
Date: 29-07-2010
Abstract: The concept of validity has been a central component in critical appraisal exercises evaluating the methodological quality of quantitative studies. Reactions by qualitative researchers have been mixed in relation to whether or not validity should be applied to qualitative research and if so, what criteria should be used to distinguish high-quality articles from others. We compared three online critical appraisal instruments’ ability to facilitate an assessment of validity. Many reviewers have used the critical appraisal skills program (CASP) tool to complete their critical appraisal exercise however, CASP appears to be less sensitive to aspects of validity than the evaluation tool for qualitative studies (ETQS) and the Joanna Briggs Institute (JBI) tool. The ETQS provides detailed instructions on how to interpret criteria however, it is the JBI tool, with its focus on congruity, that appears to be the most coherent.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2017
Publisher: Informa UK Limited
Date: 20-12-2017
DOI: 10.1080/09603123.2017.1415306
Abstract: A Theory of Change (ToC) is an approach to map programmes aimed at inducing change in a specific context, with the goal of increasing their impact. We applied this approach to the specific case of handwashing and sanitation practices in low- and middle-income countries and developed a ToC as part of a systematic review exercise. Different existing sources of information were used to inform the initial draft of the ToC. In addition, stakeholder involvement occurred and peer review took place. Our stakeholders included methodological (ToC/quantitative and qualitative research) and content experts (WASH (Water, Sanitation, Hygiene)/behaviour change), as well as end-users ractitioners, policy-makers and donors. In conclusion, the development of a ToC, and the involvement of stakeholders in its development, was critical in terms of understanding the context in which the promotional programmes are being implemented. We recommend ToC developers to work with stakeholders to create a ToC relevant for practice.
Publisher: Elsevier BV
Date: 05-2018
Publisher: Oxford University Press (OUP)
Date: 16-02-2021
DOI: 10.1093/RHEUMATOLOGY/KEAB148
Abstract: To compare the incident risk of RA in patients with type 2 diabetes mellitus (T2DM) and to explore the role of glycaemic control and associated therapeutic use in the onset of RA. This study was a retrospective cohort study using patients derived from the IQVIA Medical Research Data (IMRD-UK) database between 1995 and 2019. A total of 224 551 newly diagnosed patients with T2DM were matched to 449 101 patients without T2DM and followed up to assess their risk of RA. Further analyses investigated the effect of glycaemic control, statin use and anti-diabetic drugs on the relationship between T2DM and RA using a time-dependent Cox regression model. During the study period, the incidence of RA was 8.1 and 10.6 per 10 000 person-years in the exposed and unexposed groups, respectively. The adjusted hazard ratio (aHR) was 0.73 (95% CI 0.67, 0.79). In patients who had not used statins in their lifetime, the aHR was 0.89 (95% CI 0.69, 1.14). When quantifying the effects of glycaemic control, anti-diabetic drugs and statins using time-varying analyses, there was no association with glycaemic control [aHR 1.00 (95% CI 0.99, 1.00)], use of metformin [aHR 1.00 (95% CI 0.82, 1.22)], dipeptidyl peptidase-4 inhibitors [DPP4is aHR 0.94 (95% CI 0.71, 1.24)] and the development of RA. However, statins demonstrated a protective effect for progression of RA in those with T2DM [aHR 0.76 (95% CI 0.66, 0.88)], with evidence of a duration–response relationship. There is a reduced risk of RA in patients with T2DM that may be attributable to the use of statins.
Publisher: Ghent University
Date: 20-05-2019
DOI: 10.21825/SOCIOLOGOS.87005
Abstract: This article presents the findings of a qualitative literature review on the central questions in the Western-European “multicultural debate”, with specific regard for the Belgian region. The multicultural debate is defined as the public discussion on problems that are rightly or wrongly linked to the fact of living together in a culturally erse context. The four key domains that are identified in this debate are the following: (im)migration, integration, discrimination/racism and the place of religion/Islam. This article attempts to offer an overview of the answers provided by the scientific literature within each of these domains. The main conclusion is that although there is undeniably a large volume of (raw) data available, especially with regard to migration and integration, the central questions in this debate are only to a very limited extent being answered with sound empirical findings. This makes it more difficult to reach a scientific consensus on these questions. Meanwhile, many have pointed out the series of political and societal shifts that have taken place in several western countries as a new “post-truth” era in which truth, facts and rationality no longer matter. As these developments have once again placed ersity and multicultural issues at the centre of public discourses and the collective imaginary, possible implications of the findings of this study in this context are discussed.
Publisher: Informa UK Limited
Date: 02-12-2016
DOI: 10.1080/03630242.2015.1118726
Abstract: HIV risk is determined by the interaction between social and in idual risk factors, but information about such factors among Nepalese women is not yet understood. Therefore, to assess the risk factors and vulnerability of the wives of Nepalese labor migrants to HIV infection, the authors conducted a mixed-methods study in which a descriptive qualitative study was embedded within a case-control study. Two hundred twenty-four wives of labor migrants were interviewed in the case-control study, and two focus group discussions (n = 8 and 9) were conducted in the qualitative study. The authors found that illiteracy, low socio-economic status, and gender inequality contributed to poor knowledge and poor sexual negotiation among the wives of labor migrants and increased their risk of HIV through unprotected sex. Among male labor migrants, illiteracy, low socio-economic status, migration to India before marriage, and alcohol consumption contributed to liaisons with female sex workers, increasing the risk of HIV to the men and their wives through unprotected sex. Both labor migrants and their wives feared disclosure of positive HIV status due to HIV stigma and thus were less likely to be tested for HIV. HIV prevention programs should consider the interaction among these risk factors when targeting labor migrants and their wives.
Publisher: Elsevier BV
Date: 09-2007
DOI: 10.1016/J.PEC.2007.04.008
Abstract: The project aimed to search for online evidence in a structured way in consultation with the patient, to investigate whether the evidence discovered changed decisions. We developed the "Online on-the-spot" method (OOS) as a part of a quality improvement program. Within a general practice consultation three physicians and two trainees searched in a fixed pattern and sequence the national guidelines of general practitioners developed by the Dutch College of General Practitioners, Clinical Evidence, Trip-database and the British Medical Journal. All GPs who performed this quality improvement program were in favor of the project. During 3 months five GPs registered 365 searches out of 2920 patient-doctor contacts. For each eight patient-doctor contacts there was one online search. Patients were actively involved in 53% of the searches (95%C.I.: 48-57%). On average, two databases were consulted. An answer to the question was found in 87% of cases and in almost half of cases it was relevant new information for the doctor. The GP changed his decision due to the problem in 26% (95%C.I.: 21-29) of cases. At the end of the OOS project, the number of searches within 5 min were significantly higher than at the start: 51% (95% C.I.: 44-59) to 33% (95% C.I.: 24-43), respectively. The OOS project is a timely answer to the doctors' educational needs in attending to the patient. OOS could connect the patient, the doctor and the evidence.
Publisher: Wiley
Date: 20-04-2020
DOI: 10.1111/ELE.13507
Publisher: University of Alberta Libraries
Date: 22-04-2021
DOI: 10.18432/ARI29607
Abstract: On the 23rd of January 2020, a radio talk show of the future, 20:30 Bruxsels Talks, took place in Brussels. With fictional guests and artists from the year 2030, it discussed how the transition to a climate-proof city had happened since 2019. The body of this article is the script of this fiction piece, produced by BrusselAVenir and BNA-BBOT. In the introduction we explain the relationship between the field of futures studies and fiction, we frame 20:30 Bruxsels Talks within futures studies, and highlight the potential of fiction for knowledge creation and dissemination. By publishing the script, we hope to inspire researchers, changemakers and artists to explore fiction as a method, as a format and as a space, to trigger conversation and imagination, and engage citizens to take up a role in shaping the cities they live in. Note: This article should be read in conjunction with “20:30 Bruxsels Talks: Fiction as a Method, Fiction as a Format, Fiction as a Space,” written by the same author team and published in this issue.
Publisher: Informa UK Limited
Date: 18-04-2023
No related grants have been discovered for Karin Hannes.