Publications by authors named "Alice Wheeler"
Introduction: Stigma has negative consequences for the health of people who inject drugs and people living with hepatitis C virus (HCV). This study evaluated factors associated with stigma related to injecting drug use (IDU) or HCV and those associated with being treated negatively by health workers.
Methods: ETHOS Engage is an observational cohort study of people who inject drugs attending drug treatment clinics and needle and syringe programs in Australia.
Introduction: Understanding needle/syringe sharing is crucial for reducing hepatitis C virus (HCV) infection and reinfection. This study aimed to assess the prevalence and factors associated with needle/syringe sharing among people who inject drugs in Australia, including those previously receiving HCV treatment.
Methods: The ETHOS Engage study was an observational cohort study which collected self-reported survey data on demographic and drug use information from people who inject drugs attending drug treatment clinics and needle and syringe programs over two waves between May 2018 and June 2021.
Direct-acting antivirals (DAAs) for hepatitis C virus (HCV) infection have delivered high response rates (>95%) and simplified the management of HCV treatment, permitting non-specialists to manage patients without advanced liver disease. We collected and reviewed global data on the registration and reimbursement (government subsidised) of HCV therapies, including restrictions on reimbursement. Primary data collection occurred between Nov 15, 2021, and July 24, 2023, through the assistance of a global network of 166 HCV experts.
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- People who inject drugs are heavily impacted by HIV and hepatitis C virus infections, but there is a lack of global data on their testing and treatment coverage, prompting a systematic review to gather this information.
- The review involved searching various databases for studies published between January 2017 and April 2022, focusing on the proportions of people who inject drugs receiving testing and treatment for HIV and HCV across different countries.
- The findings revealed that of the data analyzed, about 48.8% of people who inject drugs were recently tested for HIV antibodies and 47.1% had ever been tested for HCV antibodies, with some countries showing notably high testing coverage.
Background: Transitional times in opioid use, such as release from prison and discontinuation of opioid agonist treatment (OAT), are associated with health harms due to changing drug consumption practices and limited access to health and social supports. Using a self-controlled (within-person) study design, we aimed to understand if these transitions increase risks of injection drug use-associated bacterial infections.
Methods: We performed a self-controlled case series among a cohort of people with opioid use disorder (who had all previously accessed OAT) in New South Wales, Australia, 2001-2018.
Rates of parental incarceration in the USA have increased dramatically over the past four decades. The Adverse Childhood Experiences study identified parental incarceration as one of several risk factors related to multiple health outcomes during childhood and adulthood. Parents and other caregivers are widely regarded as sources of resilience for children experiencing adversity, yet few studies have examined caregivers' parenting practices as sources of resilience for children with incarcerated parents.
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- A systematic review updated global coverage estimates of essential harm reduction services for people who inject drugs (PWID), including needle and syringe exchange programs (NSPs) and opioid agonist treatment (OAT), based on studies published from 2017 to 2022.* -
- Key findings revealed that 90 countries offer OAT and 94 countries provide NSPs, benefiting a significant percentage of the PWID population, but very few countries (only five) achieve high coverage of both services.* -
- The study highlighted that other harm reduction initiatives, like take-home naloxone programs and supervised consumption facilities, were less commonly implemented, with varying coverage levels observed across different countries.*
Article Synopsis
- The study conducted a global systematic review to assess the prevalence of injecting drug use (IDU) and its associated harms, including infections like HIV and hepatitis, as well as overdose.
- Researchers analyzed a vast number of reports published from 2017 to 2022 to gather data on socio-demographic characteristics, risk exposures, and health outcomes related to IDU.
- The findings revealed that 14.8 million individuals aged 15-64 worldwide inject drugs, with a notable gender disparity in the prevalence of IDU, as well as unique risks faced by women and transgender individuals.
Background: With the advent of direct acting antiviral (DAA) therapies for the treatment of hepatitis C virus (HCV), the World Health Organization recommended a goal to eliminate HCV as a public health threat globally by 2030. With the majority of new and existing infections in high income countries occurring among people who inject drugs, achieving this goal will require the design and implementation of interventions which address the unique barriers to HCV care faced by this population.
Methods: In this systematic review and meta-analysis, we searched bibliographic databases and conference abstracts to July 21, 2020 for studies assessing interventions to improve the following study outcomes: HCV antibody testing, HCV RNA testing, linkage to care, and treatment initiation.
Article Synopsis
- This study examined hospitalisation rates for skin and soft tissue infections (SSTIs) among people who inject drugs (PWID) in Australia, finding that 40% were admitted for drug-related issues, with 20% specifically for SSTIs.* -
- The research highlighted that women and homeless individuals had higher chances of being hospitalised for SSTIs compared to those with non-bacterial harms, and both groups had an increased hospitalisation risk after being released from prison.* -
- The conclusions emphasize the need for community-based interventions targeting at-risk groups, such as women and the homeless, to help prevent SSTIs and related hospital admissions among PWID.*
Background: Despite the goal set by WHO to eliminate hepatitis C virus (HCV) as a public health threat, uptake of HCV testing and treatment remains low. To achieve this target, evidence-based interventions are needed to address the barriers to care for people with, or at risk of, HCV infection. We aimed to assess the efficacy of interventions to improve HCV antibody testing, HCV RNA testing, linkage to HCV care, and treatment initiation.
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- Point-of-care testing using finger-stick and dried blood spots (DBS) for hepatitis C virus (HCV) RNA detection has shown to improve testing rates and patient care linkage.
- A systematic review of 43 studies found that the Xpert HCV Viral Load Fingerstick assay had a sensitivity and specificity of 99%, and DBS testing had a sensitivity of 97% and a perfect specificity of 100% for HCV RNA detection.
- Despite high accuracy, the study emphasized the need for proper training and quality assurance, as there was a 6% rate of invalid results in the finger-stick testing method.
Article Synopsis
- Social isolation is on the rise in Western cultures and is linked to negative health outcomes like obesity and smoking.
- A study on adult rats showed that those in isolation had higher stress hormone levels, gained less weight, and were more active in both new and familiar environments.
- The negative effects of social isolation, such as altered reward processing, can be reversed by returning the rats to a social environment, highlighting the importance of social interaction for mental and physical health.
Disseminated bacillus Calmette-Guérin (BCG): a cause of delirium in an older adult.
J R Coll Physicians Edinb
June 2020
Article Synopsis
- - Intra-vesical Bacillus Calmette-Guérin (BCG) immunotherapy is a well-recognized treatment for high-risk bladder cancer, but less than 1% of patients may experience severe side effects known as disseminated BCG.
- - Symptoms of disseminated BCG can range from mild flu-like signs to severe systemic disorders, which could potentially lead to death in extreme cases.
- - Diagnosing disseminated BCG is challenging due to low diagnostic yield and the need to rule out more common causes of fever, highlighting the importance of early family involvement in patient care to identify underlying issues like delirium.
Article Synopsis
- An independent trial evaluated the Relief Nursery prevention program, which offers a variety of services like early childhood education, home visiting, and parent support to families at risk for child abuse and neglect in Oregon.
- Families participating in the program were randomly assigned to either the Full Program, accessing all services, or the Respite Care condition, receiving limited support.
- Results showed that families in the Full Program reported greater satisfaction and perceived helpfulness of services, indicating better social support compared to those in the Respite Care group, with implications for future child abuse prevention programs.
Child outcomes due to a paid professional mentoring program, Friends of the Children (FOTC), were investigated across the first 5 years of an ongoing multi-site randomized controlled trial. Participants were 278 children attending kindergarten or first grade who were identified as "at risk" for adjustment problems during adolescence. The program was delivered through established nonprofit community-based organizations.
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