Long-term home visiting with vulnerable young mothers: an interpretive description of the impact on public health nurses

The purpose of this analysis was to understand public health nurses’ experiences in preventing and addressing suspected child maltreatment within the context of home visiting. The principles of interpretive description guided study decisions and data were generated from interviews with 47 public health nurses. Data were analyzed using reflexive thematic analysis. The findings highlighted that public health nurses have an important role in the primary prevention of child maltreatment. These nurses described a six-step process for managing their duty to report suspected child maltreatment within the context of nurse-client relationships. When indicators of suspected child maltreatment were present, examination of experiential practice revealed that nurses developed reporting processes that maximized child safety, highlighted maternal strengths, and created opportunities to maintain the nurse-client relationship. Even with child protection involvement, public health nurses have a central role in continuing to work with families to develop safe and competent parenting skills.

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The Impact of Enhanced Antimicrobial Stewardship Support on Antibiotic Starts in Long-Term Care Facilities

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1212 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s527-s527

Author(s):

Gabriela Andujar-Vazquez ◽

Kirthana Beaulac ◽

Shira Doron ◽

David R Snydman

Keyword(s):

Public Health ◽

Pilot Study ◽

Infection Control ◽

Antimicrobial Stewardship ◽

Long Term Care ◽

Medical Center ◽

Term Care ◽

Care Facilities ◽

The Impact

Background: The Tufts Medical Center Antimicrobial Stewardship (ASP) Team has partnered with the Massachusetts Department of Public Health (MDPH) to provide broad-based educational programs (BBEP) to long-term care facilities (LTCFs) in an effort to improve ASP and infection control practices. LTCFs have consistently expressed interest in individualized and hands-on involvement by ASP experts, yet they lack resources. The goal of this study was to determine whether “enhanced” individualized guidance provided by an ASP expert would lead to antibiotic start decreases in LTCFs participating in our pilot study. Methods: A pilot study was conducted to test the feasibility and efficacy of providing enhanced ASP and infection control practices to LTCFs. In total, 10 facilities already participating in MDPH BBEP and submitting monthly antibiotic start data were enrolled, were stratified by bed size and presence of dementia unit, and were randomized 1:1 to the “enhanced” group (defined as reviewing protocols and antibiotic start cases, providing lectures and feedback to staff and answering questions) versus the “nonenhanced” group. Antibiotic start data were validated and collected prospectively from January 2018 to July 2019, and the interventions began in April 2019. Due to staff turnover and lack of engagement, intervention was not possible in 2 of the 5 LTCFs randomized to the enhanced group, which were therefore analyzed as a nonenhanced group. An incidence rate ratios (IRRs) with 95% CIs were calculated comparing the antibiotic start rate per 1,000 resident days between periods in the pilot groups. Results: The average bed sizes for enhanced groups versus nonenhanced groups were 121 (±71.0) versus 108 (±32.8); the average resident days per facility per month were 3,415.7 (±2,131.2) versus 2,911.4 (±964.3). Comparatively, 3 facilities in the enhanced group had dementia unit versus 4 in the nonenhanced group. In the per protocol analysis, the antibiotic start rate in the enhanced group before versus after the intervention was 11.35 versus 9.41 starts per 1,000 resident days (IRR, 0.829; 95% CI, 0.794–0.865). The antibiotic start rate in the nonenhanced group before versus after the intervention was 7.90 versus 8.23 antibiotic starts per 1,000 resident days (IRR, 1.048; 95% CI, 1.007–1.089). Physician hours required for ASP for the enhanced group totaled 8.9 (±2.2) per facility per month. Conclusions: Although the number of hours required for intervention by an expert was not onerous, maintaining engagement proved difficult and in 2 facilities could not be achieved. A statistically significant 20% decrease in the antibiotic start rate was achieved in the enhanced group after interventions, potentially reflecting the benefit of enhanced ASP support by an expert.Funding: This study was funded by the Leadership in Epidemiology, Antimicrobial Stewardship, and Public Health (LEAP) fellowship training grant award from the CDC.Disclosures: None

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Long-term Prescription? Digital Surveillance is Here to Stay

Mezinárodní vztahy ◽

10.32422/mv-cjir.1821 ◽

2021 ◽

Vol 56 (4) ◽

pp. 105-118

Author(s):

Žilvinas Švedkauskas ◽

Ahmed Maati

Keyword(s):

Public Health ◽

The State ◽

Digital Data ◽

Stanford University ◽

Digital Surveillance ◽

Complex Relationships ◽

The Impact ◽

Everyday Communication

An emerging literature has shown concerns about the impact of the pandemic on the proliferation of digital surveillance. Contributing to these debates, in this paper we demonstrate how the pandemic facilitates digital surveillance in three ways: (1) By shifting everyday communication to digital means it contributes to the generation of extensive amounts of data susceptible to surveillance. (2) It motivates the development of new digital surveillance tools. (3) The pandemic serves as a perfect justification for governments to prolong digital surveillance. We provide empirical anecdotes for these three effects by examining reports by the Global Digital Policy Incubator at Stanford University. Building on our argument, we conclude that we might be on the verge of a dangerous normalization of digital surveillance. Thus, we call on scholars to consider the full effects of public health crises on politics and suggest scrutinizing sources of digital data and the complex relationships between the state, corporate actors, and the sub-contractors behind digital surveillance.

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The Impact of the COVID-19 Pandemic on Antibiotic Prescribing Trends in Outpatient Care: A Nationwide, Quasi-Experimental Approach

Antibiotics ◽

10.3390/antibiotics10091040 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1040

Author(s):

Tânia Magalhães Silva ◽

Marta Estrela ◽

Eva Rebelo Gomes ◽

Maria Piñeiro-Lamas ◽

Adolfo Figueiras ◽

...

Keyword(s):

Public Health ◽

Outpatient Care ◽

Experimental Approach ◽

National Level ◽

Series Data ◽

Antibiotic Prescribing ◽

Prescribing Trends ◽

Quasi Experimental ◽

The Impact

Coronavirus disease 2019 (COVID-19) has spread globally and is currently having a damaging impact on nearly all countries in the world. The implementation of stringent measures to stop COVID-19 dissemination had an influence on healthcare services and associated procedures, possibly causing antibiotic consumption fluctuations. This paper aims to evaluate the immediate and long-term impact of the COVID-19 pandemic on antibiotic prescribing trends in outpatient care of the Portuguese public health sector, including in primary healthcare centers and hospitals, as well as on specific antibiotic groups known to be closely associated with increased resistance. Segmented regression analysis with interrupted time series data was used to analyze whether the COVID-19 pandemic had an impact in antibiotic prescribing tendencies at a national level. The outcomes from this quasi-experimental approach demonstrate that, at the beginning of the pandemic, a significant, immediate decrease in the overall antibiotic prescribing trends was noticed in the context of outpatient care in Portugal, followed by a statistically non-significant fall over the long term. The data also showed a significant reduction in the prescription of particular antibiotic classes (antibiotics from the Watch group, 3rd-generation cephalosporins, fluoroquinolones, and clarithromycin) upon COVID-19 emergence. These findings revealed an important disruption in antibiotics prescribing caused by the current public health emergency.

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Exploring experiences and impact of the COVID-19 pandemic on young racially minoritised people in the United Kingdom: A Qualitative Study

10.31235/osf.io/t4wqs ◽

2021 ◽

Author(s):

Rochelle Ann Burgess ◽

Nancy Kanu ◽

Tanya Matthews ◽

Owen Mukotekwa ◽

Amina Smith-Gul ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Young People ◽

Survival Strategies ◽

Emotional Wellbeing ◽

Policy And Practice ◽

Public Health Response ◽

Significant Research ◽

The Impact

Within high-income-countries, the COVID-19 pandemic has disproportionately impacted people from racially minoritised backgrounds. There has been significant research interrogating the disparate impact of the virus, and recently, interest in the long-term implications of the global crisis on young people’s mental health and wellbeing. However, less work explores the experiences of young people from racialised backgrounds as they navigate the pandemic, and the specific consequences this has for their mental health. Forty young people (age 16-25) from black, mixed and other minority backgrounds and living in London, participated in consecutive focus group discussions over a two-month period, to explore the impact of the pandemic on their lives and emotional wellbeing. Thematic analysis identified seven categories describing the impact of the pandemic, indicating: deepening of existing socioeconomic and emotional challenges; efforts to navigate racism and difference within the response; and survival strategies drawing on communal and individual resources. Young people also articulated visions for a future public health response which addressed gaps in current strategies. Findings point to the need to contextualize public health responses to the pandemic in line with the lived experiences of racialised young people. We specifically note the importance of long-term culturally and socio-politically relevant support interventions. Implications for policy and practice are discussed

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The Preparation of Community/Public Health Nurses: Amplifying the Impact

Public Health Nursing ◽

10.1111/phn.12236 ◽

2015 ◽

Vol 32 (6) ◽

pp. 595-597 ◽

Cited By ~ 5

Author(s):

Barbara L. Joyce ◽

Monica J. Harmon ◽

Lucille B. Pilling ◽

Regina H. Johnson ◽

Vicki L. Hicks ◽

...

Keyword(s):

Public Health ◽

Public Health Nurses ◽

The Impact

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The perceptions of public health nurses on using standardized care plans to translate evidence-based guidelines into family home visiting practice

Kontakt ◽

10.1016/j.kontakt.2016.04.001 ◽

2016 ◽

Vol 18 (2) ◽

pp. e75-e83 ◽

Cited By ~ 8

Author(s):

Karen A. Monsen ◽

Sadie M. Swenson ◽

Madeleine J. Kerr

Keyword(s):

Public Health ◽

Home Visiting ◽

Public Health Nurses ◽

Evidence Based ◽

Care Plans ◽

Family Home ◽

Evidence Based Guidelines ◽

Standardized Care

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Pharmacoepidemiology of psychotropic drugs: examples of current research challenges on major public health issues

Epidemiologia e Psichiatria Sociale ◽

10.1017/s1121189x00000981 ◽

2009 ◽

Vol 18 (2) ◽

pp. 107-113 ◽

Cited By ~ 7

Author(s):

Hélène Verdoux ◽

Marie Tournier ◽

Bernard Bégaud

Keyword(s):

Public Health ◽

Prenatal Exposure ◽

Psychotropic Drugs ◽

Antipsychotic Drugs ◽

Population Level ◽

Health Issues ◽

Review Of The Literature ◽

Research Challenges ◽

The Impact

SummaryBackground– As a large number of persons are exposed to prescribed psychotropic drugs, their utilisation and impact should be further explored at the population level.Aims– To illustrate the interest of pharmacoepidemiological studies of psychotropic drugs by selected examples of major public health issues.Method– Selective review of the literature. Results – Many questions remain unsolved regarding the behavioural teratogenicity of prenatal exposure to psychotropic drugs, the impact of their increasing use in children, the long-term cognitive consequences of exposure to benzodiazepines, and the risks associated with extension of indications of antipsychotic drugs.Conclusion– Pharmacoepidemiological studies need to be further developed owing to the large number of public health questions raised by the extensive and expanding use of psychotropic drugs.

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Years of life lost due to the psychosocial consequences of COVID-19 mitigation strategies based on Swiss data

European Psychiatry ◽

10.1192/j.eurpsy.2020.56 ◽

2020 ◽

Vol 63 (1) ◽

Cited By ~ 11

Author(s):

Dominik A. Moser ◽

Jennifer Glaus ◽

Sophia Frangou ◽

Daniel S. Schechter

Keyword(s):

Public Health ◽

Significant Risk ◽

Social Contact ◽

Mitigation Strategies ◽

Mitigation Measures ◽

Years Of Life Lost ◽

Psychosocial Consequence ◽

Psychosocial Consequences ◽

The Impact

Abstract Background. The pandemic caused by coronavirus disease 2019 (COVID-19) has forced governments to implement strict social mitigation strategies to reduce the morbidity and mortality from acute infections. These strategies, however, carry a significant risk for mental health, which can lead to increased short-term and long-term mortality and is currently not included in modeling the impact of the pandemic. Methods. We used years of life lost (YLL) as the main outcome measure, applied to Switzerland as an example. We focused on suicide, depression, alcohol use disorder, childhood trauma due to domestic violence, changes in marital status, and social isolation, as these are known to increase YLL in the context of imposed restriction in social contact and freedom of movement. We stipulated a minimum duration of mitigation of 3 months based on current public health plans. Results. The study projects that the average person would suffer 0.205 YLL due to psychosocial consequence of COVID-19 mitigation measures. However, this loss would be entirely borne by 2.1% of the population, who will suffer an average of 9.79 YLL. Conclusions. The results presented here are likely to underestimate the true impact of the mitigation strategies on YLL. However, they highlight the need for public health models to expand their scope in order to provide better estimates of the risks and benefits of mitigation.

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Preprints & Pandemics: Interventions into the Dynamic Scholarly System of Scholarly Communication

10.31222/osf.io/6nzhe ◽

2021 ◽

Author(s):

Micah Altman ◽

Philip N. Cohen ◽

Jessica Polka

Keyword(s):

Public Health ◽

Science Communication ◽

Ad Hoc ◽

Scholarly Communication ◽

External Shocks ◽

Scholarly Communications ◽

History Of ◽

Short And Long Term ◽

The Impact

The COVID-19 pandemic is an exemplar of how scholarly communication can change in response to external shocks, even as the scholarly knowledge ecosystem is evolving rapidly, and many argue that swift and fundamental interventions are needed. However, it is much easier to identify ongoing changes and emerging interventions than to understand their immediate and long term impacts. This is illustrated by comparing the approaches applied by the scientific community to understand public health risks and interventions with those applied by the scholarly communications community to the science of COVID-19. There are substantial disagreements over the short- and long- term benefits of most proposed approaches to changing the practice of science communication, and the lack of systematic, empirically-based research in this area makes these controversies difficult to resolve. We argue that the methodology of analysis and intervention developed within public health can be usefully applied to the science-of-science. Starting with the history of DDT application, we illustrate four ways complex human systems threaten reliable predictions and blunt ad-hoc interventions. We then show how these four threats apply lead to the last major intervention in scholarly publication -- the article publishing charge based open access model -- to yield surprising results. Finally, we outline how these four threats may affect the impact of preprint initiatives, and we identify approaches drawn from public health to mitigate these threats.

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