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  1. Article ; Online: A call to action: Improving urban green spaces to reduce health inequalities exacerbated by COVID-19.

    Geary, Rebecca S / Wheeler, Benedict / Lovell, Rebecca / Jepson, Ruth / Hunter, Ruth / Rodgers, Sarah

    Preventive medicine

    2021  Volume 145, Page(s) 106425

    Abstract: Health is not equally distributed across society; there are avoidable, unfair, systematic differences in health between population groups. Some of these same groups (older people, BAME communities, those with some non-communicable diseases (NCDs)) may be ...

    Abstract Health is not equally distributed across society; there are avoidable, unfair, systematic differences in health between population groups. Some of these same groups (older people, BAME communities, those with some non-communicable diseases (NCDs)) may be particularly vulnerable to risk of exposure and severe COVID-19 outcomes due to co-morbidities, structural vulnerabilities, and public-facing or health and social care jobs among other factors. Additionally, some of the restrictions designed to reduce SARS-CoV-2 spread impact specifically on these same groups by limiting their activity and access to preventive or health promotion services. Greenspaces, accessed with social distancing, may mitigate some of the predicted negative health effects of COVID-19 restrictions. Maintaining or increasing publicly accessible urban greenspaces, particularly for marginalised groups, is reflected in the Sustainable Development Goals, and its importance amplified in the COVID-19 pandemic. Urban greenspaces should be considered a public health and social investment and a chance to rebalance our relationship with nature to protect against future pandemics. By investing in urban public greenspaces, additional benefits (job/food creation, biodiversity promotion, carbon sequestration) may coincide with health benefits. Realising these requires a shift in the balance of decision making to place weight on protecting, enhancing and providing more appropriate greenspaces designed with local communities. The current pandemic is a reminder that humanity placing too many pressures on nature has damaging consequences. COVID-19 economic recovery programs present an opportunity for sustainable transformation if they can be leveraged to simultaneously protect and restore nature and tackle climate change and health inequalities.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; COVID-19/prevention & control ; COVID-19/psychology ; Female ; Health Status Disparities ; Humans ; Male ; Middle Aged ; Pandemics/prevention & control ; Parks, Recreational/statistics & numerical data ; Parks, Recreational/supply & distribution ; Risk Factors ; SARS-CoV-2 ; Social Environment
    Language English
    Publishing date 2021-01-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 184600-0
    ISSN 1096-0260 ; 0091-7435
    ISSN (online) 1096-0260
    ISSN 0091-7435
    DOI 10.1016/j.ypmed.2021.106425
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Changes in the prevalence and profile of users of contraception in Britain 2000-2010: evidence from two National Surveys of Sexual Attitudes and Lifestyles.

    French, Rebecca S / Gibson, Lorna / Geary, Rebecca / Glasier, Anna / Wellings, Kaye

    BMJ sexual & reproductive health

    2020  Volume 46, Issue 3, Page(s) 200–209

    Abstract: Aim: To describe prevalence and trends in contraceptive method use in Britain through a comparison of the second and third National Surveys of Sexual Attitudes and Lifestyles (Natsal-2 and Natsal-3).: Methods: Cross-sectional probability sample ... ...

    Abstract Aim: To describe prevalence and trends in contraceptive method use in Britain through a comparison of the second and third National Surveys of Sexual Attitudes and Lifestyles (Natsal-2 and Natsal-3).
    Methods: Cross-sectional probability sample surveys. General population sample of women aged 16-44 years, resident in Britain, with ever-experience of vaginal sex and, for analysis by sociodemographic characteristics, vaginal sex in the last year. Main outcome measure was current contraceptive method use ('usual these days'), categorised by effectiveness.
    Results: Prevalence of current contraceptive use among women who had ever had vaginal sex declined between Natsal-2 and Natsal-3, 83.5% (95% CI 82.4 to 84.5) and 76.4% (95% CI 75.0 to 77.7), respectively. The condom and oral contraceptive pill remain the most commonly used methods. One in five women reported use of a most effective method. While no difference was found between surveys in use of most effective methods, a decline in sterilisation use was compensated by an increase in long-acting reversible contraceptive (LARC) use. Increased LARC use was particularly evident among under-25s compared with women aged 40-44 years (OR 11.35, 95% CI 3.23 to 39.87) and a decline was observed among those with two or more children relative to those with none (OR 0.21, 95% CI 0.13 to 0.35).
    Conclusions: Strategies to improve access to LARC methods have been particularly successful in increasing uptake among young people in the first decade of the 21st century. Whether this trajectory is maintained given changing sociodemographic characteristics and more recent financial cuts to sexual health service provision will warrant investigation.
    MeSH term(s) Adolescent ; Adult ; Aged ; Contraception/methods ; Contraception Behavior/psychology ; Contraception Behavior/statistics & numerical data ; Cross-Sectional Studies ; Female ; Humans ; Middle Aged ; Prevalence ; Sexual Behavior/psychology ; Sexual Behavior/statistics & numerical data ; Surveys and Questionnaires ; United Kingdom/epidemiology
    Language English
    Publishing date 2020-01-21
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2515-2009
    ISSN (online) 2515-2009
    DOI 10.1136/bmjsrh-2019-200474
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Pregnancy-associated homicide, suicide and unintentional opioid-involved overdose deaths, North Carolina 2018-2019.

    Austin, Anna E / Naumann, Rebecca B / DiPrete, Bethany L / Geary, Shana / Proescholdbell, Scott K / Jones-Vessey, Kathleen

    Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention

    2024  

    Abstract: Objective: Rates of death due to homicide, suicide and overdose during pregnancy and the first year postpartum have increased substantially in the USA in recent years. The aims of this study were to use 2018-2019 data on deaths identified for review by ... ...

    Abstract Objective: Rates of death due to homicide, suicide and overdose during pregnancy and the first year postpartum have increased substantially in the USA in recent years. The aims of this study were to use 2018-2019 data on deaths identified for review by the North Carolina Maternal Mortality Review Committee (NC-MMRC), data from the North Carolina Violent Death Reporting System (NC-VDRS) and data from the Statewide Unintentional Drug Overdose Reporting System (NC-SUDORS) to examine homicide, suicide and unintentional opioid-involved overdose deaths during pregnancy and the first year postpartum.
    Methods: We linked data from the 2018-2019 NC-MMRC to suicide and homicide deaths among women ages 10-50 years from the 2018-2019 NC-VDRS and to unintentional opioid-involved overdose deaths among women ages 10-50 years from the 2018-2019 NC-SUDORS. We conducted descriptive analyses to examine the prevalence of demographic characteristics and the circumstances surrounding each cause of death.
    Results: From 2018 to 2019 in North Carolina, there were 23 homicides, nine suicides and 36 unintentional opioid-involved overdose deaths (9.7, 3.8 and 15.1 per 100 000 live births, respectively) during pregnancy and the first year postpartum. Most homicide deaths (87.0%) were by firearm, and more than half (52.5%) were related to intimate partner violence. More than two-thirds of women who died by suicide had a current mental health problem (77.8%). Less than one-fourth (22.2%) of those who died by unintentional opioid-involved overdose had a known history of substance use disorder treatment.
    Conclusion: Our approach to quantifying and describing these causes of pregnancy-associated death can serve as a framework for other states to inform data-driven prevention.
    Language English
    Publishing date 2024-01-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 1433667-4
    ISSN 1475-5785 ; 1353-8047
    ISSN (online) 1475-5785
    ISSN 1353-8047
    DOI 10.1136/ip-2023-045112
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Cohort Profile: The Green and Blue Spaces (GBS) and mental health in Wales e-cohort.

    Thompson, Daniel A / Geary, Rebecca S / Rowney, Francis M / Fry, Richard / Watkins, Alan / Wheeler, Benedict W / Mizen, Amy / Akbari, Ashley / Lyons, Ronan A / Stratton, Gareth / White, James / Rodgers, Sarah E

    International journal of epidemiology

    2022  Volume 51, Issue 5, Page(s) e285–e294

    MeSH term(s) Cohort Studies ; Humans ; Mental Health ; Parks, Recreational ; Residence Characteristics ; Wales/epidemiology
    Language English
    Publishing date 2022-04-21
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 187909-1
    ISSN 1464-3685 ; 0300-5771
    ISSN (online) 1464-3685
    ISSN 0300-5771
    DOI 10.1093/ije/dyac080
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Ambient greenness, access to local green spaces, and subsequent mental health: a 10-year longitudinal dynamic panel study of 2·3 million adults in Wales.

    Geary, Rebecca S / Thompson, Daniel / Mizen, Amy / Akbari, Ashley / Garrett, Joanne K / Rowney, Francis M / Watkins, Alan / Lyons, Ronan A / Stratton, Gareth / Lovell, Rebecca / Nieuwenhuijsen, Mark / Parker, Sarah C / Song, Jiao / Tsimpida, Dialechti / White, James / White, Mathew P / Williams, Susan / Wheeler, Benedict W / Fry, Richard /
    Rodgers, Sarah E

    The Lancet. Planetary health

    2023  Volume 7, Issue 10, Page(s) e809–e818

    Abstract: Background: Living in greener areas, or close to green and blue spaces (GBS; eg, parks, lakes, or beaches), is associated with better mental health, but longitudinal evidence when GBS exposures precede outcomes is less available. We aimed to analyse the ...

    Abstract Background: Living in greener areas, or close to green and blue spaces (GBS; eg, parks, lakes, or beaches), is associated with better mental health, but longitudinal evidence when GBS exposures precede outcomes is less available. We aimed to analyse the effect of living in or moving to areas with more green space or better access to GBS on subsequent adult mental health over time, while explicitly considering health inequalities.
    Methods: A cohort of the people in Wales, UK (≥16 years; n=2 341 591) was constructed from electronic health record data sources from Jan 1, 2008 to Oct 31, 2019, comprising 19 141 896 person-years of follow-up. Household ambient greenness (Enhanced Vegetation Index [EVI]), access to GBS (counts, distance to nearest), and common mental health disorders (CMD, based on a validated algorithm combining current diagnoses or symptoms of anxiety or depression [treated or untreated in the preceding 1-year period], or treatment of historical diagnoses from before the current cohort [up to 8 years previously, to 2000], where diagnosis preceded treatment) were record-linked. Cumulative exposure values were created for each adult, censoring for CMD, migration out of Wales, death, or end of cohort. Exposure and CMD associations were evaluated using multivariate logistic regression, stratified by area-level deprivation.
    Findings: After adjustment, exposure to greater ambient greenness over time (+0·1 increased EVI on a 0-1 scale) was associated with lower odds of subsequent CMD (adjusted odds ratio 0·80, 95% CI 0·80-0·81), where CMD was based on a combination of current diagnoses or symptoms (treated or untreated in the preceding 1-year period), or treatments. Ten percentile points more access to GBS was associated with lower odds of a later CMD (0·93, 0·93-0·93). Every additional 360 m to the nearest GBS was associated with higher odds of CMD (1·05, 1·04-1·05). We found that positive effects of GBS on mental health appeared to be greater in more deprived quintiles.
    Interpretation: Ambient exposure is associated with the greatest reduced risk of CMD, particularly for those who live in deprived communities. These findings support authorities responsible for GBS, who are attempting to engage planners and policy makers, to ensure GBS meets residents' needs.
    Funding: National Institute for Health and Care Research Public Health Research programme.
    MeSH term(s) Humans ; Adult ; Mental Health ; Wales/epidemiology ; Parks, Recreational ; Longitudinal Studies ; Anxiety
    Language English
    Publishing date 2023-08-12
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2542-5196
    ISSN (online) 2542-5196
    DOI 10.1016/S2542-5196(23)00212-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Contraceptive use and pregnancy planning in Britain during the first year of the COVID-19 pandemic: findings from a large, quasi-representative survey (Natsal-COVID).

    Baxter, Andrew J / Geary, Rebecca S / Dema, Emily / Bosó Pérez, Raquel / Riddell, Julie / Willis, Malachi / Conolly, Anne / Oakley, Laura L / Copas, Andrew J / Gibbs, Jo / Bonell, Christopher / Sonnenberg, Pam / Mercer, Catherine H / Clifton, Soazig / Field, Nigel / Mitchell, Kirsten

    BMJ sexual & reproductive health

    2023  Volume 49, Issue 4, Page(s) 260–273

    Abstract: Background: Contraceptive services were significantly disrupted during the COVID-19 pandemic in Britain. We investigated contraception-related health inequalities in the first year of the pandemic.: Methods: Natsal-COVID Wave 2 surveyed 6658 adults ... ...

    Abstract Background: Contraceptive services were significantly disrupted during the COVID-19 pandemic in Britain. We investigated contraception-related health inequalities in the first year of the pandemic.
    Methods: Natsal-COVID Wave 2 surveyed 6658 adults aged 18-59 years between March and April 2021, using quotas and weighting to achieve quasi-representativeness. Our analysis included sexually active participants aged 18-44 years, described as female at birth. We analysed contraception use, contraceptive switching due to the pandemic, contraceptive service access, and pregnancy plannedness.
    Results: Of 1488 participants, 1619 were at risk of unplanned pregnancy, of whom 54.1% (51.0%-57.1%) reported routinely using effective contraception in the past year. Among all participants, 14.3% (12.5%-16.3%) reported switching or stopping contraception due to the pandemic. 3.2% (2.0%-5.1%) of those using effective methods pre-pandemic switched to less effective methods, while 3.8% (2.5%-5.9%) stopped. 29.3% (26.9%-31.8%) of at-risk participants reported seeking contraceptive services, of whom 16.4% (13.0%-20.4%) reported difficulty accessing services. Clinic closures and cancelled appointments were commonly reported pandemic-related reasons for difficulty accessing services. This unmet need was associated with younger age, diverse sexual identities and anxiety symptoms. Of 199 pregnancies, 6.6% (3.9%-11.1%) scored as 'unplanned'; less planning was associated with younger age, lower social grade and unemployment.
    Conclusions: Just under a third of participants sought contraceptive services during the pandemic and most were successful, indicating resilience and adaptability of service delivery. However, one in six reported an unmet need due to the pandemic. COVID-induced inequalities in service access potentially exacerbated existing reproductive health inequalities. These should be addressed in the post-pandemic period and beyond.
    MeSH term(s) Pregnancy ; Adult ; Infant, Newborn ; Humans ; Female ; Contraceptive Agents ; Pandemics ; COVID-19/epidemiology ; United Kingdom/epidemiology ; Contraception/methods
    Chemical Substances Contraceptive Agents
    Language English
    Publishing date 2023-03-23
    Publishing country England
    Document type Journal Article
    ISSN 2515-2009
    ISSN (online) 2515-2009
    DOI 10.1136/bmjsrh-2022-201763
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Green-blue space exposure changes and impact on individual-level well-being and mental health: a population-wide dynamic longitudinal panel study with linked survey data.

    Geary, Rebecca S / Thompson, Daniel A / Garrett, Joanne K / Mizen, Amy / Rowney, Francis M / Song, Jiao / White, Mathew P / Lovell, Rebecca / Watkins, Alan / Lyons, Ronan A / Williams, Susan / Stratton, Gareth / Akbari, Ashley / Parker, Sarah C / Nieuwenhuijsen, Mark J / White, James / Wheeler, Benedict W / Fry, Richard / Tsimpida, Dialechti /
    Rodgers, Sarah E

    Public health research (Southampton, England)

    2023  Volume 11, Issue 10, Page(s) 1–176

    Abstract: Background: Cross-sectional evidence suggests that living near green and blue spaces benefits mental health; longitudinal evidence is limited.: Objectives: To quantify the impact of changes in green and blue spaces on common mental health disorders, ... ...

    Abstract Background: Cross-sectional evidence suggests that living near green and blue spaces benefits mental health; longitudinal evidence is limited.
    Objectives: To quantify the impact of changes in green and blue spaces on common mental health disorders, well-being and health service use.
    Design: A retrospective, dynamic longitudinal panel study.
    Setting: Wales, UK.
    Participants: An e-cohort comprising 99,682,902 observations of 2,801,483 adults (≥ 16 years) registered with a general practice in Wales (2008-2019). A 5312-strong 'National Survey for Wales (NSW) subgroup' was surveyed on well-being and visits to green and blue spaces.
    Main outcome measures: Common mental health disorders, general practice records; subjective well-being, Warwick-Edinburgh Mental Well-being Scale.
    Data sources: Common mental health disorder and use of general practice services were extracted quarterly from the Welsh Longitudinal General Practice Dataset. Annual ambient greenness exposure, enhanced vegetation index and access to green and blue spaces (2018) from planning and satellite data. Data were linked within the Secure Anonymised Information Linkage Databank.
    Methods: Multilevel regression models examined associations between exposure to green and blue spaces and common mental health disorders and use of general practice. For the National Survey for Wales subgroup, generalised linear models examined associations between exposure to green and blue spaces and subjective well-being and common mental health disorders.
    Results and conclusions: Our longitudinal analyses found no evidence that changes in green and blue spaces through time impacted on common mental health disorders. However, time-aggregated exposure to green and blue spaces contrasting differences between people were associated with subsequent common mental health disorders. Similarly, our cross-sectional findings add to growing evidence that residential green and blue spaces and visits are associated with well-being benefits: Greater ambient greenness (+ 1 enhanced vegetation index) was associated with lower likelihood of subsequently seeking care for a common mental health disorder [adjusted odds ratio (AOR) 0.80, 95% confidence interval, (CI) 0.80 to 0.81] and with well-being with a U-shaped relationship [Warwick-Edinburgh Mental Well-being Scale; enhanced vegetation index beta (adjusted) -10.15, 95% CI -17.13 to -3.17; EVI
    Limitations: Longitudinal analyses were restricted by high baseline levels and limited temporal variation in ambient greenness in Wales. Changes in access to green and blue spaces could not be captured annually due to technical issues with national-level planning datasets.
    Future work: Further analyses could investigate mental health impacts in population subgroups potentially most sensitive to local changes in access to specific types of green and blue spaces. Deriving green and blue spaces changes from planning data is needed to overcome temporal uncertainties.
    Funding: This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (Project number 16/07/07) and will be published in full in
    MeSH term(s) Adult ; Humans ; Mental Health ; Retrospective Studies ; Cross-Sectional Studies ; Mental Disorders/epidemiology ; Surveys and Questionnaires
    Language English
    Publishing date 2023-11-06
    Publishing country England
    Document type Journal Article
    ISSN 2050-439X
    ISSN (online) 2050-439X
    DOI 10.3310/LQPT9410
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Green–blue space exposure changes and impact on individual-level well-being and mental health

    Rebecca S Geary / Daniel A Thompson / Joanne K Garrett / Amy Mizen / Francis M Rowney / Jiao Song / Mathew P White / Rebecca Lovell / Alan Watkins / Ronan A Lyons / Susan Williams / Gareth Stratton / Ashley Akbari / Sarah C Parker / Mark J Nieuwenhuijsen / James White / Benedict W Wheeler / Richard Fry / Dialechti Tsimpida /
    Sarah E Rodgers

    Public Health Research, Vol 11, Iss

    a population-wide dynamic longitudinal panel study with linked survey data

    2023  Volume 10

    Abstract: Background Cross-sectional evidence suggests that living near green and blue spaces benefits mental health; longitudinal evidence is limited. Objectives To quantify the impact of changes in green and blue spaces on common mental health disorders, well- ... ...

    Abstract Background Cross-sectional evidence suggests that living near green and blue spaces benefits mental health; longitudinal evidence is limited. Objectives To quantify the impact of changes in green and blue spaces on common mental health disorders, well-being and health service use. Design A retrospective, dynamic longitudinal panel study. Setting Wales, UK. Participants An e-cohort comprising 99,682,902 observations of 2,801,483 adults (≥ 16 years) registered with a general practice in Wales (2008–2019). A 5312-strong ‘National Survey for Wales (NSW) subgroup’ was surveyed on well-being and visits to green and blue spaces. Main outcome measures Common mental health disorders, general practice records; subjective well-being, Warwick–Edinburgh Mental Well-being Scale. Data sources Common mental health disorder and use of general practice services were extracted quarterly from the Welsh Longitudinal General Practice Dataset. Annual ambient greenness exposure, enhanced vegetation index and access to green and blue spaces (2018) from planning and satellite data. Data were linked within the Secure Anonymised Information Linkage Databank. Methods Multilevel regression models examined associations between exposure to green and blue spaces and common mental health disorders and use of general practice. For the National Survey for Wales subgroup, generalised linear models examined associations between exposure to green and blue spaces and subjective well-being and common mental health disorders. Results and conclusions Our longitudinal analyses found no evidence that changes in green and blue spaces through time impacted on common mental health disorders. However, time-aggregated exposure to green and blue spaces contrasting differences between people were associated with subsequent common mental health disorders. Similarly, our cross-sectional findings add to growing evidence that residential green and blue spaces and visits are associated with well-being benefits: Greater ambient greenness (+ 1 enhanced vegetation index) ...
    Keywords green space ; blue space ; common mental health disorders ; well-being ; inequalities ; longitudinal ; data linkage ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2023-10-01T00:00:00Z
    Publisher NIHR Journals Library
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Variation in availability and use of surgical care for female urinary incontinence

    Rebecca S Geary / Ipek Gurol-Urganci / Jil B Mamza / Rebecca Lynch / Dina El-Hamamsy / Andrew Wilson / Simon Cohn / Douglas Tincello / Jan van der Meulen

    Health Services and Delivery Research, Vol 9, Iss

    a mixed-methods study

    2021  Volume 7

    Abstract: ... geographical factors associated with referral and surgery for urinary incontinence, and to explore women’s ...

    Abstract Background: Urinary incontinence affects between 25% and 45% of women. The availability and quality of services is variable and inequitable, but our understanding of the drivers is incomplete. Objectives: The objectives of the study were to model patient, specialist clinician, primary and secondary care, and geographical factors associated with referral and surgery for urinary incontinence, and to explore women’s experiences of urinary incontinence and expectations of treatments. Design: This was a mixed-methods study. Setting: The setting was NHS England. Participants: Data were collected from all women with a urinary incontinence diagnosis in primary care data, and all women undergoing mid-urethral mesh tape surgery for stress urinary incontinence were included. Interviews were also carried out with 28 women from four urogynaecology clinics who were deciding whether or not to have surgery, and surveys were completed by 245 members of the Royal College of Obstetricians and Gynaecologists with a specialist interest in urinary incontinence. Data sources: The sources were patient-level data from Hospital Episode Statistics, the Clinical Practice Research Datalink and the Office for National Statistics mortality data linked to Hospital Episode Statistics. Interviews were conducted with women. An online vignette survey was conducted with members of the Royal College of Obstetricians and Gynaecologists. Main outcome measures: The main outcome measures were the rates of referral from primary to secondary care and surgery after referral, the rates of stress urinary incontinence surgery by geographical area, the risk of mid-urethral mesh tape removal and reoperation after mid-urethral mesh tape insertion. Results: Almost half (45.8%) of women with a new urinary incontinence diagnosis in primary care were referred to a urinary incontinence specialist: 59.5% of these referrals were within 30 days of diagnosis. In total, 14.2% of women referred to a specialist underwent a urinary incontinence procedure (94.5% of women ...
    Keywords female urinary incontinence ; surgical treatment ; decision-making ; women’s views ; geographical variation ; case vignettes ; surgical mesh ; mid-urethral mesh tape ; Public aspects of medicine ; RA1-1270 ; Medicine (General) ; R5-920
    Subject code 360
    Language English
    Publishing date 2021-03-01T00:00:00Z
    Publisher National Institute for Health Research
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Mindfulness-Based Interdisciplinary Pain Management Program for Complex Polymorbid Pain in Veterans: A Randomized Controlled Trial.

    McGeary, Donald D / Jaramillo, Carlos / Eapen, Blessen / Blount, Tabatha H / Nabity, Paul S / Moreno, Jose / Pugh, Mary Jo / Houle, Tim T / Potter, Jennifer S / Young-McCaughan, Stacey / Peterson, Alan L / Villarreal, Robert / Brackins, Nicole / Sikorski, Zhanna / Johnson, Tracy R / Tapia, Rebecca / Reed, David / Caya, Craig A / Bomer, Dillon /
    Simmonds, Maureen / McGeary, Cindy A

    Archives of physical medicine and rehabilitation

    2022  Volume 103, Issue 10, Page(s) 1899–1907

    Abstract: Objective: To evaluate the effects of interdisciplinary pain management on pain-related disability and opioid reduction in polymorbid pain patients with 2 or more comorbid psychiatric conditions.: Design: Two-arm randomized controlled trial testing a ...

    Abstract Objective: To evaluate the effects of interdisciplinary pain management on pain-related disability and opioid reduction in polymorbid pain patients with 2 or more comorbid psychiatric conditions.
    Design: Two-arm randomized controlled trial testing a 3-week intervention with assessments at pre-treatment, post-treatment, 6-month, and 12-month follow-up.
    Setting: Department of Veterans Affairs medical facility.
    Participants: 103 military veterans (N=103) with moderate (or worse) levels of pain-related disability, depression, anxiety, and/or posttraumatic stress disorder randomly assigned to usual care (n=53) and interdisciplinary pain management (n=50). All participants reported recent persistent opioid use. Trial participants had high levels of comorbid medical and mental health conditions.
    Interventions: Experimental arm-a 3-week, interdisciplinary pain management program guided by a structured manual; comparison arm-usual care in a large Department of Veterans Affairs medical facility.
    Main outcome measures: Oswestry Disability Index (pain disability); Timeline Followback Interview and Medication Event Monitoring System (opioid use). Analysis used generalized linear mixed model with all posttreatment observations (posttreatment, 6-month follow-up, 12-month follow-up) entered simultaneously to create a single posttreatment effect.
    Results: Veterans with polymorbid pain randomized to the interdisciplinary pain program reported significantly greater decreases in pain-related disability compared to veterans randomized to treatment as usual (TAU) at posttreatment, 6-month, and 12-month follow-up. Aggregated mean pain disability scores (ie, a summary effect of all posttreatment observations) for the interdisciplinary pain program were -9.1 (95% CI: -14.4, -3.7, P=.001) points lower than TAU. There was no difference between groups in the proportion of participants who resumed opioid use during trial participation (32% in both arms).
    Conclusion: These findings offer the first evidence of short- and long-term interdisciplinary pain management efficacy in polymorbid pain patients, but more work is needed to examine how to effectively decrease opioid use in this population.
    MeSH term(s) Analgesics, Opioid ; Humans ; Mindfulness ; Opioid-Related Disorders ; Pain ; Pain Management ; Veterans
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2022-08-06
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
    ZDB-ID 80057-0
    ISSN 1532-821X ; 0003-9993
    ISSN (online) 1532-821X
    ISSN 0003-9993
    DOI 10.1016/j.apmr.2022.06.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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