ABSTRACT
Background The COVID-19 pandemic highlighted the stark health inequities affecting minority ethnic populations in Europe. However, research on ethnic inequities and healthcare utilisation in children has seldom entered the policy discourse. A scoping review was conducted in the UK, summarising and appraising the quantitative evidence on ethnic differences (unequal) and inequities (unequal and unfair or disproportionate to healthcare needs) in paediatric healthcare utilisation. Methods Embase, Medline and grey literature sources were searched for studies published 2001-2021. Studies that found differences and inequities were mapped by ethnic group and healthcare utilisation outcome. They were appraised using the National Institute for Health and Care Excellence appraisal checklists. The distribution of studies was described across various methodological parameters. Results Of the 61 included studies, most found evidence of ethnic variations in healthcare utilisation (n = 54, 89%). Less than half attempted to distinguish between ethnic differences and inequities (n = 27, 44%). Studies were concentrated on primary and preventive care and hospitalisation, with minimal evidence on emergency and outpatient care. The quality of studies was often limited by a lack of theory underpinning analytical decisions, resulting in conflation of difference and inequity, and heterogeneity in ethnic classification. The majority of studies examined children's ethnicity but overlooked parent/caregiver ethnicity, and also didn't investigate patterns across age, year or location. Conclusions To improve the validity, generalisability and comparability of research on ethnicity and paediatric healthcare utilisation, findings from this scoping review were used to develop recommendations for future research. These lessons could be applied more broadly across the European context to improve evidence generation and evidence-based policy-making to reduce inequities in healthcare. Key messages • Quantitative studies of ethnicity and paediatric healthcare utilisation in the UK lack the use of sound theoretical frameworks, and often do not distinguish between ethnic differences and inequities. • The quality of future studies can be improved with greater attention to how ethnicity is classified and analysed, alongside specific considerations for examining healthcare utilisation in children.
ABSTRACT
Methods: This cluster-randomized pilot compared 5-minute slow DB with treatment-as-usual among four 12th-grade public high school classes. Students individually participated in the curriculum after school during COVID-19-related hybrid teaching, with DB 3 times/week and breath science education once/week. Feasibility was based on overall compliance and qualitative assessments. Preliminary effectiveness was measured with the State-Trait Anxiety Inventory (STAI) and a timed-exhale carbon dioxide tolerance test (CO2TT). Descriptive statistics and repeated analysis of variance were performed to quantify and compare cross-sectional and temporal outcomes between classes and time periods. Human subjects research approval was granted through WCG-IRB. Results: Forty-two students consented to participate. Intervention and effectiveness assessments' compliance varied from 29-91% across classes and weeks, and decreased on average 40% from baseline to follow-up. Compliance of ease/ tolerability assessments ranged from 41% to 86%, and averaged 55% for open-ended assessments. Usefulness, ease and tolerability ratings for the DB ranged from 1.63±0.74 to 2.88±0.35 on scales of 0-3 (“not at all” - “very much”);and from 2.24±0.84 to 2.60±0.55 for effectiveness assessments. Students reported enjoying the DB, CO2TT, and breath science;some found the extended exhales challenging and the curriculum and assessments time-consuming. Outcome measures demonstrated trends towards improvements (e.g., improved STAI and CO2TT before-to-after breathing exercises), but were not statistically significant. Background: Nearly 1 in 3 US adolescents meet the criteria for anxiety, an issue that has worsened with the COVID-19 pandemic. We developed a video-based, 5-week, slow diaphragmatic breathing (DB) stress-reduction curriculum for high school students and evaluated its feasibility and preliminary effectiveness. Conclusion: Implementation of this 5-week slow breathing curriculum was feasible and tolerable to this cohort. Compliance, tolerability, and effectiveness may be improved with in-class participation. Future research on simple and accessible slow-breathing exercises is warranted to address today's adolescent stress-management crisis.
ABSTRACT
Coronavirus disease 2019 (COVID-19) has seen a shift in remote work from being a discretionary flexible work policy to a mandatory requirement for several workplaces. This 'forced flexibility' has meant that organisations and their employees have had to adapt swiftly to new requirements and arrangements for how work is done. Working remotely, often at home in 'virtual workspaces', has become commonplace for many employees across Australia and globally. Drawing on findings from two qualitative phases of research in an Australian resources company, we use conservation of resources theory to explore the factors influencing processes related to wellbeing and productivity for employees working remotely in the COVID-19 environment. We identify challenges associated with working remotely, as well as important resources for wellbeing and productivity. Practical implications are also discussed. Copyright © Cambridge University Press and Australian and New Zealand Academy of Management 2021.