ORCID Profile
0000-0003-1677-0811
Current Organisations
The London School of Economics and Political Science
,
Orygen
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Publisher: Wiley
Date: 29-05-2022
DOI: 10.1111/HEX.13539
Abstract: Empowerment of families raising children with developmental disabilities (DDs) is essential to achieving rights‐based service development. In this qualitative study, we investigated stakeholder perceptions on the role of advocacy and empowerment in developing caregiver interventions for families of children with DDs in a global context. Participants had experience with at least one intervention, namely the Caregiver Skills Training developed by the World Health Organization (WHO). Participants were clinicians, caregivers and researchers representing five continents, and representatives of WHO and Autism Speaks. Two focus group discussions and 25 in idual interviews were conducted. Data were analysed thematically. Three themes were developed: empowerment as independence and as a right the role and practices of advocacy and using evidence to drive advocacy. Many professional participants defined empowerment within the realms of their expertise, focusing on caregivers' in idual skills and self‐confidence. Caregivers expressed that this expert‐oriented view fails to acknowledge their intuitive knowledge and the need for community‐level empowerment. Participants discussed the challenges of advocacy in light of competing health priorities. The gap between the rights of caregivers and the availability of services, for ex le, evidence‐based interventions, was highlighted as problematic. Scientific evidence was identified as a key for advocacy. Rights‐orientated empowerment of caregivers and advocacy may make vital contributions to service development for children with DDs in contexts worldwide. Research questions were revised based on views presented during focus group discussions. Participant feedback on preliminary themes informed the development of the interview guides.
Publisher: Walter de Gruyter GmbH
Date: 2015
Abstract: This study investigated approaches to continuing professional development (CPD) for specialists in laboratory medicine within four European countries: Croatia, the Czech Republic, Malta and the UK. The research questions focussed on ascertaining if continued registration/licence was linked to CPD and if so, were there requirements for certain amounts and types of CPD and for CPD activities to meet specified accreditation criteria. The Professional Associations Research Network (PARN) model of CPD measurement was applied to each country’s registration/licencing body’s CPD requirements. Our results indicate a spectrum of approaches to CPD within participating countries. It will be necessary for European employers to be familiar with these differences and to take them into account for this increasingly mobile European workforce.
Publisher: Public Library of Science (PLoS)
Date: 28-09-2022
DOI: 10.1371/JOURNAL.PONE.0272077
Abstract: There are increasing efforts to scale up services globally for families raising children with developmental disabilities (DDs). Existing interventions, often developed in high income, Western settings, need substantial adaptation before they can be implemented in different contexts. The aim of this study was to explore perspectives on the role that context plays in the adaptation and implementation of interventions targeting caregivers of children with DDs across settings. The study question was applied to the Caregiver Skills Training (CST) programme of the World Health Organization specifically, as well as to stakeholder experiences with caregiver interventions more broadly. Two focus group discussions (FGDs n = 15 participants) and 25 in idual semi-structured interviews were conducted. Participants were caregivers of children with DDs and professionals involved in adapting or implementing the CST across five continents and different income settings. Data were analysed thematically. Four main themes were developed: 1) Setting the scene for adaptations 2) Integrating an intervention into local public services 3) Understanding the reality of caregivers 4) Challenges of sustaining an intervention. Informants thought that contextual adaptations were key for the intervention to fit in locally, even more so than cultural factors. The socio-economic context of caregivers, including poverty, was highlighted as heavily affecting service access and engagement with the intervention. Competing health priorities other than DDs, financial constraints, and management of long-term collaborations were identified as barriers. This study validates the notion that attention to contextual factors is an essential part of the adaptation of caregiver interventions for children with DDs, by providing perspectives from different geographical regions. We recommend a stronger policy and research focus on contextual adaptations of interventions and addressing unmet socio-economic needs of caregivers.
Publisher: Public Library of Science (PLoS)
Date: 05-02-2021
DOI: 10.1371/JOURNAL.PONE.0246441
Abstract: Bisphosphonate drugs can be used to improve the outcomes of women with breast cancer. Whilst many meta-analyses have quantified their potential benefits for patients, attempts at comprehensive quantification of potential adverse effects have been limited. We undertook a meta-analysis with novel methodology to identify and quantify these adverse effects. We systematically reviewed randomised controlled trials in breast cancer where at least one of the treatments was a bisphosphonate (zoledronic acid, ibandronate, pamidronate, alendronate or clodronate). Neoadjuvant, adjuvant and metastatic settings were examined. Primary outcomes were adverse events of any type or severity (excluding death). We carried out pairwise and network meta-analyses to estimate the size of any adverse effects potentially related to bisphosphonates. In order to ascertain whether adverse effects differed by in idual factors such as age, or interacted with other common adjuvant breast cancer treatments, we examined in idual-level patient data for one large trial, AZURE. We identified 56 trials that reported adverse data, which included a total of 29,248 patients (18,301 receiving bisphosphonate drugs versus 10,947 not). 24 out of the 103 different adverse outcomes analysed showed a statistically and practically significant increase in patients receiving a bisphosphonate drug compared with those not (2 additional outcomes that appeared statistically significant came only from small studies with low event counts and no clinical suspicion so are likely artifacts). Most of these 24 are already clinically recognised: ‘flu-like symptoms, fever, headache and chills increased bone pain, arthralgia, myalgia, back pain cardiac events, thromboembolic events hypocalcaemia and osteonecrosis of the jaw as well as possibly stiffness and nausea. Oral clodronate appeared to increase the risk of vomiting and diarrhoea (which may also be increased by other bisphosphonates), and there may be some hepatotoxicity. Four additional potential adverse effects emerged for bisphosphonate drugs in this analysis which have not classically be recognised: fatigue, neurosensory problems, hypertonia/muscle spasms and possibly dysgeusia. Several symptoms previously reported as potential side effects in the literature were not significantly increased in this analysis: constipation, insomnia, respiratory problems, oedema or thirst/dry mouth. In idual patient-level data and subgroup analysis revealed little variation in side effects between women of different ages or menopausal status, those with metastatic versus non-metastatic cancer, or between women receiving different concurrent breast cancer therapies. This meta-analysis has produced estimates for the absolute frequencies of a range of side effects significantly associated with bisphosphonate drugs when used by breast cancer patients. These results show good agreement with previous literature on the subject but are the first systematic quantification of side effects and their severities. However, the analysis is limited by the availability and quality of data on adverse events, and the potential for bias introduced by a lack of standards for reporting of such events. We therefore present a table of adverse effects for bisphosphonates, identified and quantified to the best of our ability from a large number of trials, which we hope can be used to improve the communication of the potential harms of these drugs to patients and their healthcare providers.
Publisher: Center for Open Science
Date: 09-03-2020
Abstract: According to the United Nations (UN), 41% of the world’s population is under the age of 24 (United Nations Population Division). Despite being a considerably large group, the youth has been commonly underrepresented in decision-making in the public and private sectors. To combat this situation, the UN launched the Youth 2030 strategy in 2018 thereby recognizing the need to empower the youth to reach their full potential (Youth 2030: The UN Youth Strategy). In this contribution, we provide a brief description of some of the recent transnational youth networks (TYNs) and their features in order to discuss the role of such networks to empower the youth. We propose here that such networks constitute a novel and powerful form of public diplomacy (PD) because of their experiential educational aspects that they develop in their members. Moreover, these networks also offer a rather unique opportunity of building interpersonal relationships among global prominent in iduals thereby influencing the international agenda. We further discuss how such networks can advance substantially the UN Sustainable Development Goals (SDGs) agenda (Sustainable Development Goals).
Publisher: Frontiers Media SA
Date: 31-05-2021
DOI: 10.3389/FPSYT.2021.655211
Abstract: The Coronavirus disease 2019 (COVID-19) posed unexpected global economic and societal challenges. These include a heavy impact on mental health due to fast changing lockdown and quarantine measures, uncertainty about health and safety and the prospect of new waves of infections. To provide crisis mental health support during the pandemic, Eötvös Loránd University in Hungary launched a specialist online counselling programme, consisting of one to three sessions. The programme was available to all university members between 4th March and 25th May 2020. Overall, 47 clients received support. In this paper we discuss challenges reported by clients, key features of providing a brief mental health intervention online, reflect on counsellor experiences and give recommendations on how mental health services could be developed in the time of crisis. Most clients had challenges with developing a daily routine under quarantine and many had hardship related to finances, housing, and distance learning. Common mental health consequences included fear from the virus and stress, anxiety, and fatigue due to the interruption to everyday life. In some cases, more complex conditions were triggered by the pandemic. Ex les include addictive behaviours and symptoms of depression or psychosis. However, referring cases beyond the competency of counselling proved to be a challenge due to the closure of specialist services. Counsellors observed three key features to the online delivery of a brief crisis mental health intervention: [1] an explicit problem-oriented approach to counselling [2] challenges of building rapport online and [3] frames of online counselling. Counsellor experiences often overlapped with those of clients and included challenges of working from home and adjusting to online counselling methods. The possibility of online counselling allowed that mental health care could take place at all during the pandemic. Client experiences reflect findings from previous literature. Like other mental health initiatives launched to tackle COVID-19, the intervention's effectiveness was not measured given the unexpected context and short time frame for programme development. We recommend the use of impact measurement tools to develop mental health services in crises. Meanwhile, the pandemic brought to attention the need to better understand online delivery models. Counsellors should have access to training opportunities on online counselling and managing work-life balance in a remote setting. The COVID-19 counselling programme in Eötvös Loránd University, Hungary is an ex le of providing online mental health counselling in the time of crisis. Clearly, more studies are needed discussing delivery models and effectiveness of mental health interventions during the pandemic. Experience and knowledge sharing across practitioners should be encouraged to improve how the field reacts to unexpected, high risk events and crises.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Zsofia Szlamka.