ABSTRACT
Introduction: Despite considerable developments made in the representation of women in cardiology (WIC) recently, there still remain substantial disparities in the representation of women participants in clinical trials, as well as women physicians and scientists in clinical trial leadership. Under-representation of women in Randomized Clinical Trials (RCTs) remains the bane of the modern medicine, impeding the development of sexspecific guidelines in cardiovascular diseases. Female leadership in clinical trials has been shown to enhance the inclusion of women as trial participants. Furthermore, while the COVID-19 pandemic has impacted women in academia, there is no data thus far reporting the impact of the pandemic in terms of presenters and leadership of late-breaking clinical trials (LBCT) in cardiology during this period. Purpose(s): We aimed to determine inclusion of WIC in LBCTs leadership and their correlation to inclusion of women in reported RCTs. Method(s): In our comprehensive analysis, we included all LBCTs presented at major international cardiovascular meetings reported over the period of January 2020 to February 2022. Data were derived from the original presentation at the meeting and/or simultaneous/ subsequent publication of manuscript. Sex of the presenter (woman or man), was assessed by either original videos of the presentation at the meeting, or based on pronoun use in the biographies derived from institutional profiles. The presence or absence of reporting of sex distribution of study participants were also recorded from original presentation at the meeting and/or published manuscript. Proportion of women included in each trial was sourced from either original publication or calculated from any similar data shown during the presentations. Result(s): A total of 400 of RCTs from 19 meetings were included with a total of 400 presenters/principal investigators recorded - 32 (8%) women and 368 (92%) men. There were no significant differences between 2020 and 2021 [15 (7.2%) women in 2021 vs. 17 (19.3%) in 2020 (P=0.446)]. Proportions of women included in RCTs with WIC (37.3%) vs. non-WIC (38.7%) presenters were comparable (p=0.559), while 45% of RCTs didn't report sex distribution of participants. Except for 2 meetings (CRT 2020 and 2022), all others were virtual. Conclusion(s): WIC representation as RCTs presenters was significantly low, despite the opportunity of virtual attendance afforded during the COVID-19 pandemic. Modest inclusion of women irrespective of sex of RCT leadership emphasizes multi-level problems that require more actionable solutions: I.e. implicit bias training started as early as medical school, continuing education on necessity for diversity, equity and inclusion, patient and public involvement, and comprehensive guidance on trial design, such that future RCT participants reflect the populations intended to treat. (Figure Presented).
ABSTRACT
Background Physical activity and dietary habit optimization in women with gestational diabetes mellitus (GDM) or such a history can improve both short-term [1,2] and long-term outcomes [3]. This requires strategies that are accessible, usable, and perceived as beneficial. Aim To examine uptake and engagement for the following interventions: (1) step and weight tracking through an online platform using a pedometer and weight scale, with delivery of weekly goals;(2) weekly telephone-based health coaching;and (3) a combination of these. We are assessing recruitment, completion of health coaching sessions and/or step count and weight data upload, and participant perspectives. Method Five-city pilot randomized controlled trial (Montreal, Halifax, Calgary, Winnipeg, Toronto;Canada). Women with GDM are recruited at 20-32 weeks' gestation. Data collection is through web-based questionnaire, electronic tracking of data upload, coaching session logs, chart review (gestational weight gain;blood pressure;A1C;glucose levels;offspring sex, weight, and gestational age), in-depth telephone interview (perspectives, breastfeeding status), and mailed in pedometers with concealed windows worn for 7 days (baseline and 37 weeks). Participants are randomized to one of the 3 interventions described or a control arm (resource website only). Results The trial started in August 2019 with COVID-related interruptions. By June 30, 2022, 192/225 mothers were recruited (recruitment ongoing): 27/192 (14%) withdrew, 13 are currently undergoing interventions, and 152 completed final questionnaires. An interim process analysis of the first 52 indicates that those randomized to step and weight tracking employ the pedometer and scale a mean 81.6% (SD 29.6%) and 69.0% (SD 32.0%) of the time, respectively. High proportions report step tracking (92.3%, n = 24/26) and health coach conversations (87.5% n = 21/24) as useful, with weight tracking endorsed by over half (61.5%, n = 16/26). Conclusion The findings will inform a larger scale clinical trial in terms of impacts on gestational weight gain and appropriate for size offspring status.Copyright © 2023 Elsevier B.V.
ABSTRACT
As a result of the global COVID-19 pandemic and subsequent national lockdown, general practices tried to limit unnecessary footfall into surgeries during this period. This paper aims to investigate how General Practice (GP) prescribing changed following the first COVID-19 lockdown by analysing open-source General Practice prescribing data in England and Northern Ireland. Prescribing data was obtained for the calendar years 2019 and 2020 at British National Formulary (BNF) chapter and section levels, aggregated and compared year on year and with each other. Particular attention was given to the change in prescribing between February and March of both years to examine the change in prescribing immediately following the start of the lockdown. Prescribing markedly increased across BNF categories in March 2020 followed by a dip and return to pre-COVID-19 levels in late summer. The rise in the number of items prescribed in England between February and March 2020 was nearly twice that seen in the same period the previous year (14.5% vs 7.6%). Northern Ireland saw a much greater relative increase of 20.7. The “peak, trough and recovery” pattern observed across BNF chapters reflected patients obtaining bigger stocks of prescriptions pre-lockdown. The higher Northern Ireland peak may be part-explained by lack of electronic transfer to pharmacies which exists in England. Increased antimicrobial prescribing, which spiked in March 2020, may relate to issuing “rescue packs” at the outset of the pandemic, with the sustained decline in the following months a possible effect of Covid measures and reduced consulting. © 2021 IEEE
ABSTRACT
Cardiovascular and reproductive health of women have been going hand in hand since the dawn of time, however, their links have been poorly studied and once the basis of their connections started to be established in late 20th century, it depended on local regional abilities and the level of progressive thinking to afford comprehensive women’s care beyond the “bikini medicine”. Further research identified different associations rendering more conditions sex-specific and launching therefore a slow, yet initial turn around in clinical trials’ concept as the majority of global cardiovascular guidelines rely on the results of research conducted on a very modest percentage of women and even less on the women of color. Currently, the concept of women’s heart centers varies depending on the local demographics’ guided needs, available logistics driven by budgeting and societal support of a broad-minded thinking environment, free of bias for everyone: from young adults questioning their gender identity, via women of reproductive age both struggling to conceive or keep working part time when healthy and line of work permits it during pregnancy, up to aging and the elderly. Using “Investigate-Educate-Advocate-Legislate” as the four pillars of advancing cardiovascular care of women, we aimed to sum-marize standing of women’s health in Serbia, present ongoing projects and propose actionable solutions for the future. © 2021, Serbia Medical Society. All rights reserved.
ABSTRACT
Digital technologies have been widely utilized to assist with disease detection and management throughout the Covid-19 pandemic. The prevalence of smartphone usage amongst populations has assisted the provision of mobile applications that citizens can use to manage their health. Covid-19 symptom checker smartphone apps enable users to enter their health characteristics and receive validated advice related to self-isolation, testing and whether to seek clinical care. Moreover, the collection of symptom data can assist healthcare providers with disease surveillance and resource allocation. However, the adoption of symptom checker apps can be influenced by several factors including the functionality of the app, and data privacy and protection policies. In this study, we reviewed nine symptom checker apps that were available on the Android and iOS platforms. We analyzed characteristics related to the functionality and accessibility of the apps, and factors that related to privacy, transparency and trust. We found that most of the apps were multifunctional and several (n = 4) combined contact tracing and symptom checking functionalities. Moreover, there was variation in the quantity of personal data collected and symptom checking questions. For all the apps reviewed information related to privacy and data protection was available, however, there was variability in the content and readability of this material. Information regarding the technical profile of the apps was also inconsistent. For several of the apps, access to the symptom checking functionality was restricted by location. This review suggests that symptom checker apps provide an effective tool for public health management during the Covid-19 pandemic. © 2021, Springer Nature Switzerland AG.