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  • 1
    In: Nature, Springer Science and Business Media LLC, Vol. 600, No. 7889 ( 2021-12-16), p. 472-477
    Abstract: The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-19 1,2 , host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases 3–7 . They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.
    Type of Medium: Online Resource
    ISSN: 0028-0836 , 1476-4687
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    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
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    detail.hit.zdb_id: 1413423-8
    SSG: 11
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  • 2
    In: The Lancet Gastroenterology & Hepatology, Elsevier BV, Vol. 7, No. 5 ( 2022-05), p. 388-390
    Type of Medium: Online Resource
    ISSN: 2468-1253
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
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  • 3
    In: Obesity Reviews, Wiley, Vol. 24, No. 10 ( 2023-10)
    Abstract: Weight stigma research is largely focused on quantifiable outcomes with inadequate representation of the perspectives of those that are affected by it. This study offers a comprehensive systematic review and synthesis of weight stigma experienced in healthcare settings, from the perspective of patients living with obesity. A total of 1340 studies was screened, of which 32 were included in the final synthesis. Thematic synthesis generated three overarching analytical themes: (1) verbal and non‐verbal communication of stigma, (2) weight stigma impacts the provision of care, and (3) weight stigma and systemic barriers to healthcare. The first theme relates to the communication of weight stigma perceived by patients within patient–provider interactions. The second theme describes the patients' perceptions of how weight stigma impacts upon care provision. The third theme highlighted the perceived systemic barriers faced by patients when negotiating the healthcare system. Patient suggestions to reduce weight stigma in healthcare settings are also presented. Weight stigma experienced within interpersonal interactions migrates to the provision of care, mediates gaining equitable access to services, and perpetuates a poor systemic infrastructure to support the needs of patients with obesity. A non‐collaborative approach to practice and treatment renders patients feeling they have no control over their own healthcare requirements.
    Type of Medium: Online Resource
    ISSN: 1467-7881 , 1467-789X
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2020497-8
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  • 4
    In: Obesity Facts, S. Karger AG, Vol. 15, No. 6 ( 2022), p. 736-752
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 This Clinical Practice Guideline (CPG) for the management of obesity in adults in Ireland, adapted from the Canadian CPG, defines obesity as a complex chronic disease characterised by excess or dysfunctional adiposity that impairs health. The guideline reflects substantial advances in the understanding of the determinants, pathophysiology, assessment, and treatment of obesity. 〈 b 〉 〈 i 〉 Summary: 〈 /i 〉 〈 /b 〉 It shifts the focus of obesity management toward improving patient-centred health outcomes, functional outcomes, and social and economic participation, rather than weight loss alone. It gives recommendations for care that are underpinned by evidence-based principles of chronic disease management; validate patients’ lived experiences; move beyond simplistic approaches of “eat less, move more” and address the root drivers of obesity. 〈 b 〉 〈 i 〉 Key Messages: 〈 /i 〉 〈 /b 〉 People living with obesity face substantial bias and stigma, which contribute to increased morbidity and mortality independent of body weight. Education is needed for all healthcare professionals in Ireland to address the gap in skills, increase knowledge of evidence-based practice, and eliminate bias and stigma in healthcare settings. We call for people living with obesity in Ireland to have access to evidence-informed care, including medical, medical nutrition therapy, physical activity and physical rehabilitation interventions, psychological interventions, pharmacotherapy, and bariatric surgery. This can be best achieved by resourcing and fully implementing the Model of Care for the Management of Adult Overweight and Obesity. To address health inequalities, we also call for the inclusion of obesity in the Structured Chronic Disease Management Programme and for pharmacotherapy reimbursement, to ensure equal access to treatment based on health-need rather than ability to pay.
    Type of Medium: Online Resource
    ISSN: 1662-4025 , 1662-4033
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 2455819-9
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  • 5
    In: Health Expectations, Wiley, Vol. 27, No. 3 ( 2024-06)
    Abstract: Obesity is a complex, chronic, relapsing disease that requires an individualised approach to treatment. However, weight stigma (WS) experienced in healthcare settings poses a significant barrier to achieving person‐centred care for obesity. Understanding the experiences of people living with obesity (PwO) can inform interventions to reduce WS and optimise patient outcomes. This study explores how patients with obesity perceive WS in general practice settings; its impact on their psychological well‐being and health behaviours, and the patients suggestions for mitigating it. Methods In‐depth semistructured interviews were conducted with 11 PwO who had experienced WS in general practice settings in Ireland. The interviews were conducted online via Zoom between May and August 2023; interviews lasted between 31 and 63 min ( M = 34.36 min). Interviews were audio‐recorded, transcribed verbatim and analysed using inductive reflexive thematic analysis. Results Three overarching themes specific to participants' experience of WS in general practice were generated: (1) shame, blame and ‘failure’; (2) eat less, move more—the go‐to treatment; (3) worthiness tied to compliance. A fourth theme: (4) the desire for a considered approach, outlines the participants' suggestions for reducing WS by improving the quality of patient–provider interactions in general practice. Conclusion The findings call for a paradigm shift in the management of obesity in general practice: emphasising training for GPs in weight‐sensitive communication and promoting respectful, collaborative, and individualised care to reduce WS and improve outcomes for people with obesity. Patient or Public Contribution PPI collaborators played an active and equal role in shaping the research, contributing to the development of the research questions, refining the interview schedule, identifying key themes in the data, and granting final approval to the submitted and published version of the study.
    Type of Medium: Online Resource
    ISSN: 1369-6513 , 1369-7625
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2006357-X
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  • 6
    In: Obesity Reviews, Wiley, Vol. 23, No. 8 ( 2022-08)
    Abstract: Quality of life is a key outcome that is not rigorously measured in obesity treatment research due to the lack of standardization of patient‐reported outcomes (PROs) and PRO measures (PROMs). The S.Q.O.T. initiative was founded to Standardize Quality of life measurement in Obesity Treatment. A first face‐to‐face, international, multidisciplinary consensus meeting was conducted to identify the key PROs and preferred PROMs for obesity treatment research. It comprised of 35 people living with obesity (PLWO) and healthcare providers (HCPs). Formal presentations, nominal group techniques, and modified Delphi exercises were used to develop consensus‐based recommendations. The following eight PROs were considered important: self‐esteem, physical health/functioning, mental/psychological health, social health, eating, stigma, body image, and excess skin. Self‐esteem was considered the most important PRO, particularly for PLWO, while physical health was perceived to be the most important among HCPs. For each PRO, one or more PROMs were selected, except for stigma. This consensus meeting was a first step toward standardizing PROs (what to measure) and PROMs (how to measure) in obesity treatment research. It provides an overview of the key PROs and a first selection of the PROMs that can be used to evaluate these PROs.
    Type of Medium: Online Resource
    ISSN: 1467-7881 , 1467-789X
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2020497-8
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  • 7
    In: International Journal of Qualitative Methods, SAGE Publications, Vol. 21 ( 2022-01), p. 160940692211027-
    Abstract: Background: Weight stigma is enacted by healthcare providers across healthcare settings where it has been consistently shown to contribute to poor physical health outcomes and the maintenance of obesity via physiological, cognitive, emotional and behavioural pathways. Despite key stakeholders identifying obesity as a disease, people with obesity continue to experience denigration and discrimination, particularly in healthcare settings. Qualitative studies which capture the experience of enacted weight stigma from the patient perspective can increase awareness of how stigma presents within patient-provider interactions and ultimately inspire change in healthcare provision. The current review aims to systematically search for and synthesise enacted weight stigma experienced in primary, secondary and tertiary healthcare settings, explicitly from the patient perspective. Methods: Electronic searches will be conducted in PubMed, Medline, PsycInfo, Cinahl, Embase and Scopus to locate relevant studies published in English from May 2011. Two reviewers will independently conduct title and abstract screening and full text screening, any disagreements will be resolved through discussion with a third reviewer. The methodological quality of the included studies will be appraised using the critical appraisal skills programme (CASP) check list. A thematic synthesis will be conducted by the lead author in collaboration with the review team. Confidence in the review findings will be assessed by the review team using GRADE CERQual. Discussion: It is anticipated that the findings of the review will facilitate a deep and broad understanding of the patient experience to inform best practice and future intervention design.
    Type of Medium: Online Resource
    ISSN: 1609-4069 , 1609-4069
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2135788-2
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