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3 results on '"Shama D. Karanth"'

1. Clinician and patient perspectives on screening mammography among women age 75 and older: A pilot study of a novel decision aid

Author

Dejana Braithwaite, Anthony Chicaiza, Katherine Lopez, Kenneth W. Lin, Ranit Mishori, Shama D. Karanth, Stephen Anton, Kristen Miller, Mara A. Schonberg, Nancy L. Schoenborn, and Suzanne C. O’Neill

Subjects
Breast cancer screening, Older adults, Person-centered decision-making, Benefits and harm, Public aspects of medicine, RA1-1270
Abstract

Objective: Supporting patient-clinician communication is key to implementing tailored, risk-based screening for older adults. Objectives of this multiphase mixed methods study were to identify factors that primary care clinicians consider influential when making screening mammography recommendations for women ≥75 years, develop a patient decision aid that incorporates these factors, and gather feasibility and acceptability from the patients’ perspective. Methods: Clinicians from a Mid-Atlantic practice network completed online surveys. Women in the same network completed surveys before and after receiving a tailored booklet that included information about the benefits and harms of screening for women ≥ 75 years, a breast cancer risk-estimate, and a question prompt list to support patient-clinician communication Results: Clinicians (N=21) were primarily women [57.1%] and practiced family medicine [81.0%]. They cited patients’ age ≥75 years [95.4%], comorbidity [86.4%], functional status [77.3%], cancer family history [63.6%], U.S. Preventive Services Task Force guidelines [81.8%] and new research [77.3%] as factors influencing their recommendations. Fourteen women completed baseline surveys and received personalized decision aids (Mean age=79.1 years). Eleven completed the post-intervention survey. All were satisfied with the booklet length, 81.8% found the booklet easy to understand and 72.7% helpful in decision-making Perceived lifetime breast cancer risk decreased significantly from pre- to post-intervention (p = 0.02). Conclusions: Results suggest this decision aid, which incorporates key decisional factors from the clinician's perspective, is feasible and acceptable to patients. Innovation: A tailored decision aid booklet is innovative as it provides information on personalized risk and potential benefits and harms to older women considering screening.

Published
2023
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2. Food insecurity is associated with chronic pain and high-impact chronic pain in the USA

Author

Javier A Tamargo, Larissa J Strath, Shama D Karanth, Antoinette L Spector, Kimberly T Sibille, Stephen Anton, and Yenisel Cruz-Almeida

Subjects
Food insecurity, Social determinants of health, Chronic pain, High-impact chronic pain, Health disparities, Vulnerable populations, Public aspects of medicine, RA1-1270, Nutritional diseases. Deficiency diseases, RC620-627
Abstract

Abstract Objective: This study evaluated whether food insecurity (US Adult Food Security Survey) was associated with chronic pain (≥ 3 months) and high-impact chronic pain (i.e. pain that limits work and life) among US adults. Design: Cross-sectional analysis. Setting: Nationally representative sample of non-institutionalised adults in the USA. Participants: 79 686 adults from the National Health Interview Survey (2019–2021). Results: Marginal, low and very low food security were associated with increased prevalence odds of chronic pain (OR: 1·58 (95 % CI 1·44, 1·72), 2·28 (95 % CI 2·06, 2·52) and 3·37 (95 % CI 3·01, 3·78), respectively) and high-impact chronic pain (OR: 1·28 (95 % CI 1·14, 1·42), 1·55 (95 % CI 1·37, 1·75) and 1·90 (95 % CI 1·65, 2·18), respectively) in a dose–response fashion (P-trend < 0·0001 for both), adjusted for sociodemographic, socio-economic and clinically relevant factors. Participation in Supplemental Nutrition Assistance Program (SNAP) and age modified the association between food insecurity and chronic pain. Conclusions: These findings illustrate the impact of socio-economic factors on chronic pain and suggest that food insecurity may be a social determinant of chronic pain. Further research is needed to better understand the complex relationship between food insecurity and chronic pain and to identify targets for interventions. Moreover, the consideration of food insecurity in the clinical assessment of pain and pain-related conditions among socio-economically disadvantaged adults may be warranted.

Published
2024
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3. Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026

Author

Angela E Micah, Kayleigh Bhangdia, Ian E Cogswell, Dylan Lasher, Brendan Lidral-Porter, Emilie R Maddison, Trang Nhu Ngoc Nguyen, Nishali Patel, Paola Pedroza, Juan Solorio, Hayley Stutzman, Golsum Tsakalos, Yifeng Wang, Wesley Warriner, Yingxi Zhao, Bianca S Zlavog, Cristiana Abbafati, Jaffar Abbas, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Michael Abdelmasseh, Deldar Morad Abdulah, Aidin Abedi, Kedir Hussein Abegaz, E S Abhilash, Richard Gyan Aboagye, Hassan Abolhassani, Michael R M Abrigo, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Mohammed Hussien Adem, Muhammad Sohail Afzal, Ali Ahmadi, Haroon Ahmed, Tarik Ahmed Rashid, Budi Aji, Hossein Akbarialiabad, Yibeltal Akelew, Hanadi Al Hamad, Khurshid Alam, Fahad Mashhour Alanezi, Turki M Alanzi, Mohammed Khaled Al-Hanawi, Robert Kaba Alhassan, Syed Mohamed Aljunid, Sami Almustanyir, Rajaa M Al-Raddadi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Azmeraw T Amare, Edward Kwabena Ameyaw, Mostafa Amini-Rarani, Hubert Amu, Robert Ancuceanu, Tudorel Andrei, Sumadi Lukman Anwar, Francis Appiah, Muhammad Aqeel, Jalal Arabloo, Morteza Arab-Zozani, Aleksandr Y Aravkin, Olatunde Aremu, Raphael Taiwo Aruleba, Seyyed Shamsadin Athari, Leticia Avila-Burgos, Martin Amogre Ayanore, Samad Azari, Atif Amin Baig, Abere Tilahun Bantie, Amadou Barrow, Pritish Baskaran, Sanjay Basu, Abdul-Monim Mohammad Batiha, Bernhard T Baune, Zombor Berezvai, Nikha Bhardwaj, Pankaj Bhardwaj, Sonu Bhaskar, Micheal Kofi Boachie, Virginia Bodolica, João Silva Botelho Botelho, Dejana Braithwaite, Nicholas J K Breitborde, Reinhard Busse, Lucero Cahuana-Hurtado, Ferrán Catalá-López, Collins Chansa, Jaykaran Charan, Vijay Kumar Chattu, Simiao Chen, Isaac Sunday Chukwu, Omid Dadras, Lalit Dandona, Rakhi Dandona, Abdollah Dargahi, Sisay Abebe Debela, Edgar Denova-Gutiérrez, Belay Desye, Samath Dhamminda Dharmaratne, Nancy Diao, Linh Phuong Doan, Milad Dodangeh, Wendel Mombaque dos Santos, Leila Doshmangir, John Dube, Ebrahim Eini, Maysaa El Sayed Zaki, Maha El Tantawi, Daniel Berhanie Enyew, Sharareh Eskandarieh, Mohamad Ezati Asar, Adeniyi Francis Fagbamigbe, Emerito Jose A Faraon, Ali Fatehizadeh, Hamed Fattahi, Ginenus Fekadu, Florian Fischer, Nataliya A Foigt, Kayode Raphael Fowobaje, Alberto Freitas, Takeshi Fukumoto, Nancy Fullman, Peter Andras Gaal, Amiran Gamkrelidze, M A Garcia-Gordillo, Mesfin Gebrehiwot, Urge Gerema, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Reza Ghanbari, Ahmad Ghashghaee, Ali Gholamrezanezhad, Mahaveer Golechha, Davide Golinelli, Yitayal Ayalew Goshu, Girma Garedew Goyomsa, Avirup Guha, Damitha Asanga Gunawardane, Bhawna Gupta, Samer Hamidi, Harapan Harapan, Reza Hashempour, Khezar Hayat, Golnaz Heidari, Ileana Heredia-Pi, Claudiu Herteliu, Demisu Zenbaba Heyi, Kamal Hezam, Yuta Hiraike, Mbuzeleni Mbuzeleni Hlongwa, Ramesh Holla, Mohammad Enamul Hoque, Mehdi Hosseinzadeh, Sorin Hostiuc, Salman Hussain, Olayinka Stephen Ilesanmi, Mustapha Immurana, Arnaud Iradukunda, Nahlah Elkudssiah Ismail, Gaetano Isola, Linda Merin J, Mihajlo Jakovljevic, Mahsa Jalili, Manthan Dilipkumar Janodia, Tahereh Javaheri, Sathish Kumar Jayapal, Digisie Mequanint Jemere, Tamas Joo, Nitin Joseph, Jacek Jerzy Jozwiak, Mikk Jürisson, Billingsley Kaambwa, Vidya Kadashetti, Rajendra Kadel, Dler Hussein Kadir, Laleh R Kalankesh, Rajesh Kamath, Himal Kandel, Rami S Kantar, Shama D Karanth, Ibraheem M Karaye, Salah Eddin Karimi, Bekalu Getnet Kassa, Gbenga A Kayode, Leila Keikavoosi-Arani, Vikash Ranjan Keshri, Cumali Keskin, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Himanshu Khajuria, Hamid Reza Khayat Kashani, Zemene Demelash Kifle, Hanna Kim, Jihee Kim, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Stefan Kohler, Farzad Kompani, Soewarta Kosen, Sindhura Lakshmi Koulmane Laxminarayana, Ai Koyanagi, Kewal Krishan, Dian Kusuma, Judit Lám, Demetris Lamnisos, Anders O Larsson, Sang-woong Lee, Shaun Wen Huey Lee, Wei-Chen Lee, Yo Han Lee, Jacopo Lenzi, Lee-Ling Lim, László Lorenzovici, Rafael Lozano, Vanessa Sintra Machado Machado, Farzan Madadizadeh, Mohammed Magdy Abd El Razek, Razzagh Mahmoudi, Azeem Majeed, Mohammad-Reza Malekpour, Ana Laura Manda, Borhan Mansouri, Mohammad Ali Mansournia, Lorenzo Giovanni Mantovani, Carlos Alberto Marrugo Arnedo, Miquel Martorell, Ali Masoud, Elezebeth Mathews, Richard James Maude, Enkeleint A Mechili, Entezar Mehrabi Nasab, José João João Mendes Mendes, Atte Meretoja, Tuomo J Meretoja, Mohamed Kamal Mesregah, Tomislav Mestrovic, Andreea Mirica, Erkin M Mirrakhimov, Mizan Kiros Mirutse, Moonis Mirza, Mohammad Mirza-Aghazadeh-Attari, Awoke Misganaw, Marcello Moccia, Javad Moghadasi, Esmaeil Mohammadi, Mokhtar Mohammadi, Abdollah Mohammadian-Hafshejani, Marita Mohammadshahi, Shafiu Mohammed, Mohammad Mohseni, Ali H Mokdad, Lorenzo Monasta, Elias Mossialos, Ebrahim Mostafavi, Haleh Mousavi Isfahani, Christine Mpundu-Kaambwa, Shruti Murthy, Saravanan Muthupandian, Ahamarshan Jayaraman Nagarajan, Kovin S Naidoo, Mukhammad David Naimzada, Vinay Nangia, Atta Abbas Naqvi, Biswa Prakash Nayak, Rawlance Ndejjo, Trang Huyen Nguyen, Nafise Noroozi, Jean Jacques Noubiap, Khan M Nuruzzaman, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Felix Chukwudi Abrahams Obi, Abiola Ogunkoya, In-Hwan Oh, Osaretin Christabel Okonji, Andrew T Olagunju, Tinuke O Olagunju, Babayemi Oluwaseun Olakunde, Ahmed Omar Bali, Obinna E Onwujekwe, John Nelson Opio, Adrian Otoiu, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Tamás Palicz, Raffaele Palladino, Adrian Pana, Tarang Parekh, Deepak Kumar Pasupula, Jay Patel, George C Patton, Uttam Paudel, Mihaela Paun, Shrikant Pawar, Simone Perna, Navaraj Perumalsamy, Ionela-Roxana Petcu, Zahra Zahid Piracha, Mohsen Poursadeqiyan, Naeimeh Pourtaheri, Sergio I Prada, Sima Rafiei, Pankaja Raghav Raghav, Fakher Rahim, Mohammad Hifz Ur Rahman, Mosiur Rahman, Amir Masoud Rahmani, Chhabi Lal Ranabhat, Temam Beshir Raru, Sina Rashedi, Mohammad-Mahdi Rashidi, Ramin Ravangard, Salman Rawaf, Reza Rawassizadeh, Elrashdy Moustafa Mohamed Redwan, Robert C Reiner, Jr., Andre M N Renzaho, Maryam Rezaei, Nazila Rezaei, Mavra A Riaz, Jefferson Antonio Buendia Rodriguez, Aly M A Saad, Basema Saddik, Saeid Sadeghian, Mohammad Reza Saeb, Umar Saeed, Maitreyi Sahu, Morteza Saki, Payman Salamati, Hedayat Salari, Sana Salehi, Abdallah M Samy, Juan Sanabria, Francesco Sanmarchi, João Vasco Santos, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Yaser Sarikhani, Brijesh Sathian, Maheswar Satpathy, Miloje Savic, Yaser Sayadi, Falk Schwendicke, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Naomi Setshegetso, Allen Seylani, Saeed Shahabi, Masood Ali Shaikh, Murad Ziyaudinovich Shakhmardanov, Mohd Shanawaz, Mequannent Melaku Sharew Sharew, Nigussie Tadesse Sharew, Rajesh Sharma, Maryam Shayan, Aziz Sheikh, Suchitra M Shenoy, Adithi Shetty, Pavanchand H Shetty, K M Shivakumar, Luís Manuel Lopes Rodrigues Silva, Wudneh Simegn, Jasvinder A Singh, Kuldeep Singh, Natia Skhvitaridze, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Yonatan Solomon, Suhang Song, Simona Cătălina Ștefan, Muhammad Suleman, Rafael Tabarés-Seisdedos, Nathan Y Tat, Vivian Y Tat, Belay Negash Tefera, Ales Tichopad, Ruoyan Tobe-Gai, Marcos Roberto Tovani-Palone, Lorainne Tudor Car, Derara Girma Tufa, Tommi Juhani Vasankari, Milena Vasic, Dominique Vervoort, Vasily Vlassov, Bay Vo, Linh Gia Vu, Yasir Waheed, Richard G Wamai, Cong Wang, Gizachew Tadesse Wassie, Nuwan Darshana Wickramasinghe, Sanni Yaya, Arzu Yigit, Vahit Yiğit, Naohiro Yonemoto, Mustafa Z Younis, Chuanhua Yu, Ismaeel Yunusa, Leila Zaki, Burhan Abdullah Zaman, Alireza Zangeneh, Ali Zare Dehnavi, Mikhail Sergeevich Zastrozhin, Wu Zeng, Zhi-Jiang Zhang, Liesl J Zuhlke, Yves Miel H Zuniga, Simon I Hay, Christopher J L Murray, and Joseph L Dieleman

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods: In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings: In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95% uncertainty interval [UI] 9·1–9·3) was spent on health worldwide. We found great disparities in the amount of resources devoted to health, with high-income countries spending $7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95% UI 24·3–25·3) spent by low-income countries in 2019. That same year, $43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and $37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation: There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained. Funding: Bill & Melinda Gates Foundation.

Published
2023
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