Search

Your search keyword '"Wang, Shr-Jie Sharlenna"' showing total 6 results
Start Over Author "Wang, Shr-Jie Sharlenna"
6 results on '"Wang, Shr-Jie Sharlenna"'

1. Family Therapy for Kosovar Mothers Who Experienced Conflict‐Related Sexual Violence and Their Children in Postwar Times: A Pilot Randomised Waitlist‐Controlled Trial.

Author

Seery, Christina, Rushiti, Feride, Krasniqi, Sebahate Pacolli, Çarkaxhiu, Selvi Izeti, Xhemaili, Vjosa Devaja, Limani, Dafina Arifaj, Prapashtica, Qëndresa, Turjaka, Vesa, Zekaj, Nebahate, Salihu, Mimoza, Hjort, Line, Ryan, Joanne, Kaas‐Petersen, Sara Helene, and Wang, Shr‐Jie Sharlenna

Abstract

Women who have experienced conflict‐related sexual violence report significant long‐term effects, including posttraumatic stress disorder (PTSD), depression and relationship difficulties. Research has demonstrated that maternal trauma is associated with children's behavioural difficulties and challenges in family functioning, such as impaired communication and harsh parenting. This pilot study is aimed at evaluating the preliminary effectiveness of family therapy for Kosovar mothers who experienced conflict‐related sexual violence in 1998–1999 and later developed PTSD and their children in improving family functioning and reducing behavioural difficulties in postwar times. Sixty‐four mothers were randomised to an intervention group or a waitlist control group. Data was collected during a screening phase, at baseline before intervention initiation, after the intervention group completed family therapy and once the waitlist control group received the intervention. Generalised linear mixed models were used to analyse group differences in family functioning and children's behaviours over time. At follow‐up, mothers in the intervention group reported improved family functioning. However, mothers in the waitlist control group reported significantly fewer behavioural difficulties than mothers in the intervention group before the control group had started family therapy. There was no significant interaction between group condition and time for child‐rated family functioning. Overall, this pilot study suggests that family therapy could be effective in reducing the effects of intergenerational trauma related to PTSD and conflict‐related sexual violence. Future research should evaluate the long‐term effects of family therapy to assess if immediate effects were maintained. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

3. Global research priorities for interpersonal violence prevention: a modified Delphi study/Priorites mondiales de recherche pour la prevention de la violence interpersonnelle: une etude Delphi modifiee/Prioridades de investigacion globales para la prevencion de la violencia interpersonal: un estudio de Delphi modificado

Author

Mikton, Christopher R., Tanaka, Masako, Tomlinson, Mark, Streiner, David L., Tonmyr, Lil, Lee, Bandy X., Fisher, Jane, Hegadoren, Kathy, Pim, Joann Evans, Wang, Shr-Jie Sharlenna, and MacMillan, Harriet L.

Subjects
Market surveys -- Usage -- Research -- Surveys, Public health -- Usage -- Research -- Surveys, Domestic violence -- Usage -- Research -- Surveys, Elder abuse -- Usage -- Research -- Surveys, Health, World Health Organization -- Surveys
Abstract

Objective To establish global research priorities for interpersonal violence prevention using a systematic approach. Methods Research priorities were identified in a three-round process involving two surveys. In round 1, 95 global experts in violence prevention proposed research questions to be ranked in round 2. Questions were collated and organized according to the four-step public health approach to violence prevention. In round 2,280 International experts ranked the importance of research in the four steps, and the various substeps, ofthe public health approach. In round 3,131 international experts ranked the importance of detailed research questions on the public health step awarded the highest priority In round 2. Findings In round 2, 'developing, Implementing and evaluating interventions' was the step of the public health approach awarded the highest priority for four of the six types, of violence considered (i.e. child maltreatment, intimate partner violence, armed violence and sexual violence) but not for youth violence or elder abuse. In contrast, 'scaling up interventions and evaluating their cost-effectiveness' was ranked lowest for all types of violence. In round 3, research into' developing, implementing and evaluating interventions' that addressed parenting or laws to regulate the use of firearms was awarded the highest priority. The key limitations of the study were response and attrition rates among survey respondents. However, these rates were in line with similar priority-setting exercises. Conclusion These findings suggest It is premature to scale up violence prevention interventions. Developing and evaluating smaller-scale interventions should be the funding priority. Objectif Definir les priorites mondiales de recherche pour la prevention de la violence Interpersonnelle a l'aide d'une approche systematique. Methodes Les priorites de recherche ont ete etablies au cours d'un processus en trois cycles, comprenant deux questionnaires. Durant le premier cycle, 95 experts mondiaux dans le domaine de la prevention de la violence ont propose des questions de recherche, qui seraient classees au cours du deuxieme cycle. Ces questions ont ete rassemblees et organisees suivant l'approche en quatre etapes de la prevention de la violence axee sur la sante publique. Lors du deuxieme cycle du processus, 280 experts Internationaux ont classe parordre d'importance les recherches concernant les quatre etapes et les differentes sous-etapes de cette approche axee sur la sante publique. Au cours du troisieme cycle, 131 experts internationaux ont classe par ordre d'importance des questions de recherche detaillees sur l'etape consideree comme prioritaire au cycle no. 2. Resultats Lors du deuxieme cycle, <> etait l'etape de l'approche de sante publique jugee prioritaire pour quatre des six types de violence consideres (a savoir maltraitance de l'enfant, violence a l'encontre du partenaire intime, violence armee et violence sexuelle) mais non pour la violence chez les jeunes ou la maltraitance des personnes agees. A l'inverse, <> etait juge comme letape la moins importante pour tous les types de violence. Lors du troisieme cycle, <> relatives au role des parents ou aux lois reglementant l'utilisation des armes a feu etait considere comme le domaine de recherche prioritaire. Les principales limitations de l'etude etaient les taux de reponse et d'abandon de l'etude par les repondants. Ces taux etalent toutefois comparables a ceux d'exercices similaires de definition de priorites. Conclusion Ces resultats laissent entendre qu'il est premature d'etendre les interventions de prevention de la violence. La priorite de financement devrait porter sur l'elaboration et l'evaluation d'interventions de moindre ampleur. Objetivo Establecer prioridades de investigacion globales para la prevencion de la violencia interpersonal mediante el uso de un enfoque sistematico. Metodos Se identificaron las prioridades de investigacion en un proceso de tres etapas que incluia dos encuestas. En la primera etapa, 95 expertos mundiales en la prevencion de la violencia propusieron preguntas de investigacion para su clasificacion en la segunda etapa. Las preguntas se recopilaron y organizaron segun el enfoque de salud publica de cuatro fases sobre la prevencion de la violencia. En la segunda etapa, 280 expertos internacionales clasificaron la importancia de la Investigacion en cuatro fases, y en distintas subfases, del enfoque de salud publica. En la tercera fase, 131 expertos internacionales clasificaron la importancia de las preguntas de investigacion detalladas sobre la fase de salud publica que, en la segunda fase, se consideraron de mayor prioridad. Resultados En la segunda etapa, la fase de'desarrollo, implementacion y evaluacion de Intervenciones' fue la que se considero de mayor prioridad del enfoque de salud publica para cuatro de los seis tipos de violencia considerados (esto es, maltrato infantil, violencia conyugal, violencia armada y violencia sexual), pero no para la violencia juvenil o el abuso de ancianos. Sin embargo, la fase de 'incremento de las intervenciones y evaluacion de su rentabilidad' obtuvo la menor calificacion de todos los tipos de violencia. En la tercera etapa, la Investigacion sobre la fase de'tiesarrollo, Implementacion y evaluacion de intervenciones' que abordo la paternidad o las leyes para regular el uso de las armas de fuego se considero la de mayor prioridad. Las limitaciones fundamentales del estudio fueron las tasas de respuesta y abandono entre los encuestados. No obstante, dichas tasas concordaron con los ejercicios de prioridad similar. Conclusion Los resultados sugieren que aun es pronto para ampliar las intervenciones para prevenir la violencia. La mayor prioridad deberia ser el desarrollo y la evaluacion de intervenciones a menor escala., Introduction Almost half a million people are victims of homicide every year (1) and one in three women has experienced violence from an intimate partner at some point during her [...]

Published
2017
Full Text
View/download PDF

5. Changing malaria epidemiology in four urban settings in sub-Saharan Africa

Author

Wang, Shr-Jie Sharlenna, Tanner, Marcel, Lengeler, Christian, and Barnish, Guy

Subjects
parasitic diseases, Vector control
Abstract

Background An estimated 200 million persons in sub-Saharan Africa (SSA) live currently in urban centres in malaria endemic areas. The epidemiology and control of urban malaria poses a number of specific challenges in comparison to rural areas, most notably the heterogeneous spatial distribution of transmission and the low state of immunity in the population. Interestingly, much less is currently known about malaria in urban settings than in rural areas. As a result there is an essential need for more information on disease burden, distribution and control strategies. In this multi-country study we undertook to study systematically key malariological features in four large SSA cities: Abidjan (Côte d’Ivoire), Ouagadougou (Burkina Faso), Cotonou (Benin) and Dar es Salaam (United Republic of Tanzania). Objectives The general objective of this series of case studies was to further our understanding of malaria transmission and epidemiology in the urban environment in SSA, in view of developing and implementing effective control measures. Study methodology The basic study design of RUMA in each site included six components: 1) An extensive literature review and contacts with national malaria experts, 2) The collection of routine health statistics, disaggregated by sex, age and residence, 3) The mapping of health facilities and the identification of the main breeding sites on the basis of existing maps, 4) School parasitaemia surveys (200 school children aged 5-10 years in 3-4 schools, 5) Health facility-based fever surveys (200 fever cases and 200 non-fever controls in 3-4 facilities) and 6) A systematic description of the health care delivery system. For components 4 and 5 we categorized each city into 3-4 areas (centre, intermediate, periphery and rural areas), and randomly chose one clinic and one nearby school from each area. All work was completed within six to ten weeks on-site. The main emphasis was put on describing the burden of malaria (components 1, 2, 4), transmission patterns (components 1, 2, 3, 4) and the diagnosis of malaria in urban settings (component 5, 6). Finally, key risk factors for infection were explored (components 4 and 5). Key results Abidjan: The field work was carried out in August-September 2002 during the rainy season. According to national statistics, approximately 240,000 malaria cases were reported by health facilities in Abidjan in 2001 (40.2% of all consultations). The peak malaria incidence was in July-September. In the health facilities of the Yopougon commune, the malaria infection rates in presenting fever cases were 22.1% (under 1 year-old), 42.8% (1-5 years-old), 42.0% (6-15 years-old) and 26.8% (over 15 years-old), while those in the control group were 13.0%, 26.7%, 21.8% and 14.6%. Malaria prevalence in health facilities was homogenous in the different areas of Yopougon. The malaria-attributable fractions (MAFs) among presenting fever cases were 0.12, 0.22, 0.27 and 0.13 for the age groups listed above, suggesting that malaria played only a low to moderate role in fever episodes during the rainy season. Among all patients, 10.1% used a Background An estimated 200 million persons in sub-Saharan Africa (SSA) live currently in urban centres in malaria endemic areas. The epidemiology and control of urban malaria poses a number of specific challenges in comparison to rural areas, most notably the heterogeneous spatial distribution of transmission and the low state of immunity in the population. Interestingly, much less is currently known about malaria in urban settings than in rural areas. As a result there is an essential need for more information on disease burden, distribution and control strategies. In this multi-country study we undertook to study systematically key malariological features in four large SSA cities: Abidjan (Côte d’Ivoire), Ouagadougou (Burkina Faso), Cotonou (Benin) and Dar es Salaam (United Republic of Tanzania). Objectives The general objective of this series of case studies was to further our understanding of malaria transmission and epidemiology in the urban environment in SSA, in view of developing and implementing effective control measures. Study methodology The basic study design of RUMA in each site included six components: 1) An extensive literature review and contacts with national malaria experts, 2) The collection of routine health statistics, disaggregated by sex, age and residence, 3) The mapping of health facilities and the identification of the main breeding sites on the basis of existing maps, 4) School parasitaemia surveys (200 school children aged 5-10 years in 3-4 schools, 5) Health facility-based fever surveys (200 fever cases and 200 non-fever controls in 3-4 facilities) and 6) A systematic description of the health care delivery system. For components 4 and 5 we categorized each city into 3-4 areas (centre, intermediate, periphery and rural areas), and randomly chose one clinic and one nearby school from each area. All work was completed within six to ten weeks on-site. The main emphasis was put on describing the burden of malaria (components 1, 2, 4), transmission patterns (components 1, 2, 3, 4) and the diagnosis of malaria in urban settings (component 5, 6). Finally, key risk factors for infection were explored (components 4 and 5). Key results Abidjan: The field work was carried out in August-September 2002 during the rainy season. According to national statistics, approximately 240,000 malaria cases were reported by health facilities in Abidjan in 2001 (40.2% of all consultations). The peak malaria incidence was in July-September. In the health facilities of the Yopougon commune, the malaria infection rates in presenting fever cases were 22.1% (under 1 year-old), 42.8% (1-5 years-old), 42.0% (6-15 years-old) and 26.8% (over 15 years-old), while those in the control group were 13.0%, 26.7%, 21.8% and 14.6%. Malaria prevalence in health facilities was homogenous in the different areas of Yopougon. The malaria-attributable fractions (MAFs) among presenting fever cases were 0.12, 0.22, 0.27 and 0.13 for the age groups listed above, suggesting that malaria played only a low to moderate role in fever episodes during the rainy season. Among all patients, 10.1% used a mosquito net (treated or not) the night before the survey and this was protective (OR=0.52, 95% CI 0.29-0.97). Travel to rural areas within the last three months was frequent (31% of all respondents) and associated with a malaria infection (OR=1.75, 95% CI 1.25-2.45). The health facility and breeding site mapping, as well as the school surveys could not be carried out because of political troubles. Ouagadougou: The field work was carried out in November-December 2002 at the start of cold and dry season. Seasonal variations in reported clinical malaria cases were marked. The highest incidence rate was reported from July to September and incidence rates went down in October-December until a low point during the dry season, from January to March. In 2001, there were 203,466 simple malaria cases (29.3-41.4% of consultations) and 19 deaths reported among 596,365 consultations in all public health facilities. A further 20,071 complicated malaria cases were reported. The malaria infection rates in presenting fever cases were 12.1% (under 1 year-old), 25.9% (1-5 years-old), 37.1% (6-15 years-old) and 18.0% (over 15 years-old), while those in the control group were 14.3%, 14.4%, 34.5% and 19.8%. The MAFs among presenting fever cases were 0.00, 0.13, 0.04 and 0.00 for the age groups cited above, suggesting that malaria played only a small role in fever episodes at the start of cold and dry season. The school parasitaemia prevalence was rather high (overall: 48.3%) and there was heterogeneity between the 3 surveyed schools (31.6%, 37.6%, 73.1%). The mapping of Anopheles sp. breeding sites correlated with this gradient of endemicity between the urban centre and the periphery of Ouagadougou. We found a link between malaria infections and urban agriculture activities and the availability of water supply. In total 42.0% of patients used a mosquito net the night before the survey and this was protective (OR=0.74, 95% CI 0.54-1.00). Travelling to a rural area (8.7% of all respondents) did not increase the infection risk (OR=1.14, 95% CI 0.70-1.90). Cotonou: The field work was carried out in February-March 2003. In 2002, there were 100,257 reported simple malaria cases and 12,195 complicated malaria cases reported for 289,342 consultations in the public health facilities of Cotonou. Between 1996 and 2002, on average 34% of total consultations were attributed to simple malaria and 1-4.2% to complicated malaria cases. There was no clear seasonal pattern. The malaria infection rates in presenting fever cases were 0% (under 1 year-old), 6.8% (1-5 years-old), 0% (6-15 years-old) and 0.9% (over 15 years-old), while those in the control group were 1.4%, 2.8%, 1.3% and 2.0%. The MAFs among presenting fever cases were 0.04 in the 1-5 years-old and 0 in the over 15 years-old. MAFs could not be calculated for the other two age groups. Hence, malaria played only a small role in fever episodes at the end of the rainy season. In the school parasitaemia surveys, a malaria infection was found in 5.2 % of all samples. The prevalence of parasitaemia in the centre, intermediate and periphery areas was 2.6%, 9.0% and 2.5%, respectively. In total 69.2% of patients used a mosquito net the night before the survey (OR=0.61, not significant). Traveling to a rural area (5.8% of all respondents) did not increase the infection risk since none of those who had traveled had parasitaemia. No mapping of health facilities and breeding sites could be carried out. Dar es Salaam: The field work was carried out in June-August 2003. An estimated 1.1 million annual malaria cases were reported in 2000 from a total of 2,200,000 outpatient visits in the health facilities (49% of all consultations). A clear seasonal pattern of clinical malaria was recorded, with high rates from March to June and a low point in July-August. The malaria infection rates in presenting fever cases were 2.0 % (under 1 year-old), 7.0% (1-5 years-old), 7.2 (6-15 years-old) and 4.2 % (over 15 years-old), while those in the control group were 3.4%, 4.5%, 3.6% and 1.9%. The MAFs were very low in all age groups: 0.00, 0.03, 0.04 and 0.02 for the age categories shown above. School surveys in Dar es Salaam during a prolonged dry season in 2003 showed that the prevalence of malaria parasites was low: 0.8%, 1.4%, 2.7% and 3.7% in the centre, intermediate, periphery and rural areas, respectively. Anopheles sp. breeding sites were fairly well distributed within the city. We found a remarkably high coverage rate of mosquito nets in the households (91.8% users) and this seemed to be protective (OR=0.60, 95% CI 0.27-0.93). An increased malaria infection rate was seen in the 11.8% of children who traveled to rural areas within last 3 month (OR=3.62, 95% CI 1.48-8.88). Conclusion RUMA was successfully implemented in 4 selected urban areas within a period of six to ten weeks per site. The financial cost for conducting a RUMA in these four sites ranged from 8,500-13,000 USD. All components were feasible (with the exception of breeding site mapping which clearly exceeded what can be done in such a short time period) and highly informative. The RUMA allowed to describe transmission patterns in the four cities and highlighted the enormous level of over-treatment with antimalarials. The collected information should prove of high value as a basis for further investigations and for planning effective control interventions. (treated or not) the night before the survey and this was protective (OR=0.52, 95% CI 0.29-0.97). Travel to rural areas within the last three months was frequent (31% of all respondents) and associated with a malaria infection (OR=1.75, 95% CI 1.25-2.45). The health facility and breeding site mapping, as well as the school surveys could not be carried out because of political troubles. Ouagadougou: The field work was carried out in November-December 2002 at the start of cold and dry season. Seasonal variations in reported clinical malaria cases were marked. The highest incidence rate was reported from July to September and incidence rates went down in October-December until a low point during the dry season, from January to March. In 2001, there were 203,466 simple malaria cases (29.3-41.4% of consultations) and 19 deaths reported among 596,365 consultations in all public health facilities. A further 20,071 complicated malaria cases were reported. The malaria infection rates in presenting fever cases were 12.1% (under 1 year-old), 25.9% (1-5 years-old), 37.1% (6-15 years-old) and 18.0% (over 15 years-old), while those in the control group were 14.3%, 14.4%, 34.5% and 19.8%. The MAFs among presenting fever cases were 0.00, 0.13, 0.04 and 0.00 for the age groups cited above, suggesting that malaria played only a small role in fever episodes at the start of cold and dry season. The school parasitaemia prevalence was rather high (overall: 48.3%) and there was heterogeneity between the 3 surveyed schools (31.6%, 37.6%, 73.1%). The mapping of Anopheles sp. breeding sites correlated with this gradient of endemicity between the urban centre and the periphery of Ouagadougou. We found a link between malaria infections and urban agriculture activities and the availability of water supply. In total 42.0% of patients used a mosquito net the night before the survey and this was protective (OR=0.74, 95% CI 0.54-1.00). Travelling to a rural area (8.7% of all respondents) did not increase the infection risk (OR=1.14, 95% CI 0.70-1.90). Cotonou: The field work was carried out in February-March 2003. In 2002, there were 100,257 reported simple malaria cases and 12,195 complicated malaria cases reported for 289,342 consultations in the public health facilities of Cotonou. Between 1996 and 2002, on average 34% of total consultations were attributed to simple malaria and 1-4.2% to complicated malaria cases. There was no clear seasonal pattern. The malaria infection rates in presenting fever cases were 0% (under 1 year-old), 6.8% (1-5 years-old), 0% (6-15 years-old) and 0.9% (over 15 years-old), while those in the control group were 1.4%, 2.8%, 1.3% and 2.0%. The MAFs among presenting fever cases were 0.04 in the 1-5 years-old and 0 in the over 15 years-old. MAFs could not be calculated for the other two age groups. Hence, malaria played only a small role in fever episodes at the end of the rainy season. In the school parasitaemia surveys, a malaria infection was found in 5.2 % of all samples. The prevalence of parasitaemia in the centre, intermediate and periphery areas was 2.6%, 9.0% and 2.5%, respectively. In total 69.2% of patients used a mosquito net the night before the survey (OR=0.61, not significant). Traveling to a rural area (5.8% of all respondents) did not increase the infection risk since none of those who had traveled had parasitaemia. No mapping of health facilities and breeding sites could be carried out. Dar es Salaam: The field work was carried out in June-August 2003. An estimated 1.1 million annual malaria cases were reported in 2000 from a total of 2,200,000 outpatient visits in the health facilities (49% of all consultations). A clear seasonal pattern of clinical malaria was recorded, with high rates from March to June and a low point in July-August. The malaria infection rates in presenting fever cases were 2.0 % (under 1 year-old), 7.0% (1-5 years-old), 7.2 (6-15 years-old) and 4.2 % (over 15 years-old), while those in the control group were 3.4%, 4.5%, 3.6% and 1.9%. The MAFs were very low in all age groups: 0.00, 0.03, 0.04 and 0.02 for the age categories shown above. School surveys in Dar es Salaam during a prolonged dry season in 2003 showed that the prevalence of malaria parasites was low: 0.8%, 1.4%, 2.7% and 3.7% in the centre, intermediate, periphery and rural areas, respectively. Anopheles sp. breeding sites were fairly well distributed within the city. We found a remarkably high coverage rate of mosquito nets in the households (91.8% users) and this seemed to be protective (OR=0.60, 95% CI 0.27-0.93). An increased malaria infection rate was seen in the 11.8% of children who traveled to rural areas within

Published
2005
Full Text
View/download PDF

6. Does multidisciplinary rehabilitation of tortured refugees represent 'value-for-money'? A follow-up of a Danish case-study.

Author

Bager, Line, Hansen, Kristian Schultz, Andersen, Carit Jacques, Wang, Shr-Jie Sharlenna, and Wang, Shr-Jie

Subjects
POLITICAL refugees, TORTURE victims, COST effectiveness, RESOURCE allocation, MEDICAL economics
Abstract

Background: The recent surge of asylum seekers in the European Union (EU) is raising questions about the EU's ability to integrate newcomers into the economy and into society; particularly those who need specialized services for the treatment of severe trauma. This study investigated whether rehabilitating traumatised refugees represents 'value-for-money' (VfM) in terms of intervention cost per health gain and in a long-term and societal perspective.Methods: The economic evaluation comprised a cost-utility analysis (CUA) and a partial cost-benefit analysis (CBA). The CUA incorporated data on Quality Adjusted Life Years (QALY) for 45 patients who were treated at the Rehabilitation and Research Centre for Torture Victims, Copenhagen, Denmark, in 2001-2004 and followed for up to 2 years, to determine the incremental cost effectiveness ratio (ICER). For the CBA, data was collected for 44 patients who completed treatment between 2001 and 2004 and 44 matched controls on the waiting list, for the patients' primary health care utilisation, and personal and family labour income from 2001 to 2014. This was analysed to evaluate the Net Social Benefit (NSB) of the programme.Results: The average cost of treatment was found to be about 32,000 USD per patient (2016 prices) with an average gain in QALY of 0.82. The treatment was cost effective according to the ICER threshold suggested by the National Institute of Health and Care Excellence (UK). At the individual level, the NSB remained negative throughout the study period. However, at the family income level the intervention proved to have been beneficial after 3 years.Conclusion: The implication of the study is, that providing rehabilitation to severely traumatised refugee families can be an economically viable strategy, considering the economic effects observed at the family level. [ABSTRACT FROM AUTHOR]

Published
2018
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results