scholarly journals Guidelines for Pregnancy Management During the COVID-19 Pandemic: A Public Health Conundrum

2020 ◽  
Vol 17 (21) ◽  
pp. 8277
Author(s):  
Caroline Benski ◽  
Daria Di Filippo ◽  
Gianmarco Taraschi ◽  
Michael R. Reich
Keyword(s):  
Public Health ◽  
At Risk ◽  
Maternal Health ◽  
Pregnant Women ◽  
Royal College ◽  
Health Workers ◽  
Healthcare Providers ◽  
Management Guidelines ◽  
Limited Knowledge ◽  
The Impact

Pregnant women seem to be at risk for developing complications from COVID-19. Given the limited knowledge about the impact of COVID-19 on pregnancy, management guidelines are fundamental. Our aim was to examine the obstetrics guidelines released from December 2019 to April 2020 to compare their recommendations and to assess how useful they could be to maternal health workers. We reviewed 11 guidelines on obstetrics management, assessing four domains: (1) timeliness: the time between the declaration of pandemics by WHO and a guideline release and update; (2) accessibility: the readiness to access a guideline by searching it on a common browser; (3) completeness: the amount of foundational topics covered; and (4) consistency: the agreement among different guidelines. In terms of timeliness, the Royal College of Obstetricians and Gynaecologists (RCOG) was the first organization to release their recommendation. Only four guidelines were accessible with one click, while only 6/11 guidelines covered more than 80% of the 30 foundational topics we identified. For consistency, the study highlights the existence of 10 points of conflict among the recommendations. The present research revealed a lack of uniformity and consistency, resulting in potentially challenging decisions for healthcare providers.

scholarly journals Zika Pregnancy Surveillance: Transforming Data into Educational and Clinical Tools

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Kara Polen ◽  
Titilope Oduyebo ◽  
Jazmyn Moore ◽  
Sascha Ellinton ◽  
Regina Simeone ◽  
...  
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
Surveillance System ◽  
Healthcare Providers ◽  
Surveillance Data ◽  
Clinical Settings ◽  
Educational Materials ◽  
The Us ◽  
Clinical Tools ◽  
The Impact

ObjectiveTo describe how Zika virus (Zika) surveillance data informs and improves testing guidance, clinical evaluation and management of pregnant women and infants with possible Zika infectionIntroductionLittle was known about the maternal and fetal/infant effects of Zika infection before the 2015 outbreak in the Americas, which made it challenging for public health practitioners and clinicians to care for pregnant women and infants exposed to Zika. In 2016, CDC implemented a rapid surveillance system, the US Zika Pregnancy and Infant Registry, to collect information about the impact of Zika infection during pregnancy and inform the CDC response and clinical guidance. In partnership with state, tribal, local, and territorial health departments, CDC disseminated information from this surveillance system, which served as the foundation for educational materials and clinical tools for healthcare providers.MethodsThroughout the Zika response, CDC worked closely with health officers, epidemiologists, and clinical partners to seek expert input on the interpretation of emerging data and the evaluation and management of these vulnerable populations. In response to requests from clinical and public health partners, CDC created targeted educational materials and tools to facilitate the implementation of clinical guidance. These materials equipped healthcare providers with the information needed to care for pregnant women and infants with Zika infection. Examples of products developed included: 1) screening tools to identify pregnant women for whom testing is indicated; 2) an interactive web tool to assist with implementation and interpretation of Zika testing guidance (Pregnancy and Zika Testing Widget); 3) patient counseling scripts; and 4) videos to explain critical clinical concepts (e.g., measurement of infant head circumference). These tools were informally pre-tested with the target audiences prior to dissemination, specifically to assess usefulness in clinical settings. CDC disseminated these tools through the CDC website and through comprehensive outreach (e.g., webinars, calls, email alerts) to various audiences. Additionally, several professional organizations incorporated these tools into regular communication with their membership.ResultsThe US Zika Pregnancy and Infant Registry is currently monitoring infants from approximately 7,300 pregnancies in the US states and territories with laboratory evidence of Zika. Surveillance data provided valuable information, including clues toward the pattern of defects and other neurologic disabilities associated with congenital Zika infection, estimates of the risks associated with congenital infection, and timeframes of greatest risk during pregnancy, to help clinicians counsel pregnant patients with potential Zika exposure. CDC used these data to inform their clinical tools, particularly in pretest counseling materials and educational factsheets for healthcare providers to use with pregnant women with potential Zika exposure.After informal testing among healthcare providers, the tools received positive feedback regarding usefulness and applicability in clinical settings. Collectively, CDC’s Zika clinical tools were downloaded more than 300,000 times from CDC’s website. The Pregnancy and Zika Testing Widget was accessed and followed to an endpoint (e.g., Zika testing recommended) more than 17,000 times, with more than 75% of users self-identifying as clinicians.ConclusionsRapid implementation of Zika surveillance captured evolving data about the impact of Zika on pregnant women and their infants. These data informed the development of clinical tools for healthcare providers caring for and counseling patients with Zika exposure. These tools ensured pregnant women and infants were adequately monitored during the Zika outbreak. Health education materials and clinical tools based on surveillance data should be considered in future emergency responses, particularly when knowledge is rapidly evolving.ReferencesCDC Zika Pregnancy Website: https://www.cdc.gov/pregnancy/zika/materials/index.html 

scholarly journals More Than Shelter: Housing for Urban Maternal and Infant Health

2021 ◽  
Vol 18 (7) ◽  
pp. 3331
Author(s):  
Jason Reece
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Health Outcomes ◽  
City Planning ◽  
Infant Health ◽  
The United States ◽  
Housing Quality ◽  
Housing Discrimination ◽  
Maternal Health Outcomes ◽  
The Impact

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.

The complication of cyber manhunt: How cyber manhunt further complicated the ethical conflict between breaching the confidentiality and endangering the society in face of the COVID-19 pandemic (Preprint)

2021 ◽  
Author(s):  
Yen-Chang Chen ◽  
Yen-Yuan Chen
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Health Workers ◽  
Early Stage ◽  
Personal Information ◽  
Public Health Intervention ◽  
Contact Tracing ◽  
Online Activity ◽  
Contact Investigation ◽  
The Impact

UNSTRUCTURED While health care and public health workers are working on measures to mitigate the COVID-19 pandemic, there is an unprecedentedly large number of people spending much more time indoors, and relying heavily on the Internet as their lifeline. What has been overlooked is the influence of the increasing online activities on public health issues. In this article, we pointed out how a large-scale online activity called cyber manhunt may threaten to offset the efficacy of contact tracing investigation, a public health intervention considered highly effective in limiting further transmission in the early stage of a highly contagious disease outbreak such as the COVID-19 pandemic. In the first section, we presented a case to show how personal information obtained from contact investigation and disclosed in part on the media provoked a vehement cyber manhunt. We then discussed the possible reasons why netizens collaborate to reveal anonymized personal information about contact investigation, and specify, from the perspective of public health and public health ethics, four problems of cyber manhunt, including the lack of legitimate public health goals, the concerns about privacy breach, the impact of misinformation, and social inequality. Based on our analysis, we concluded that more moral weight may be given to protecting one's confidentiality, especially in an era with the rapid advance of digital and information technologies.

scholarly journals Accessibility of maternal health information and its influence on maternal health preferences in rural Tanzania: A case study of Chamwino District

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Hilda A. Mwangakala
Keyword(s):  
Rural Communities ◽  
Maternal Health ◽  
Pregnant Women ◽  
Health Information ◽  
Phenomenological Study ◽  
Healthcare Providers ◽  
Primary Source ◽  
Healthcare Personnel ◽  
Health Providers ◽  
Leading Role

Background: The access to quality maternal health information amongst pregnant women plays an important role in determining woman’s health behaviour during pregnancy. Yet, access to maternal health information remains a major challenge in Tanzanian rural communities especially for pregnant women leading to low utilisation of skilled maternal health services.Objectives: The study aimed at examining the accessibility of maternal health information amongst pregnant women in rural Tanzania.Methods: A qualitative phenomenological study involving 25 pregnant women, 5 skilled healthcare providers (SHPs) and 5 traditional birth attendants (TBAs) was carried out in Chamwino District, Dodoma Region, Tanzania for a period of 6 months. Data were analysed thematically using the six-stage guide to thematic data analysis with NVivo Software.Results: The acute shortage of healthcare personnel and traditional beliefs influenced pregnant women’s access to quality maternal health information. The majority of women used mothers-in-law and TBAs as their primary source of maternal health information rather than skilled healthcare providers.Conclusion: Despite the acute shortage, healthcare providers need to play a leading role in providing maternal health information amongst the rural populations. Furthermore, skilled health providers need to work in collaboration with the TBAs to increase access to maternal health information and build a well-informed healthy society.

scholarly journals Risk assessment at work and prevention strategies on COVID-19 in Italy

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248874
Author(s):  
Sergio Iavicoli ◽  
Fabio Boccuni ◽  
Giuliana Buresti ◽  
Diana Gagliardi ◽  
Benedetta Persechino ◽  
...  
Keyword(s):  
Public Health ◽  
Occupational Safety ◽  
Health Workers ◽  
Risk Mitigation ◽  
Risk Index ◽  
Health And Safety ◽  
Epidemiological Surveillance ◽  
Risk Of Infection ◽  
Set Up ◽  
The Impact

The COVID-19 pandemic has spread worldwide, with considerable public health and socio-economic impacts that are seriously affecting health and safety of workers, as well as their employment stability. Italy was the first of many other western countries to implement extended containment measures. Health workers and others employed in essential sectors have continued their activity, reporting high infection rate with many fatalities. The epidemiological trend highlighted the importance of work as a substantial factor to consider both when implementing strategies aimed at containing the pandemic and shaping the lockdown mitigation strategy required for sustained economic recovery. To support the decision-making process, we have developed a strategy to predict the risk of infection by SARS-CoV-2 in the workplace based on the analysis of the working process and proximity between employees; risk of infection connected to the type of activity; involvement of third parties in the working processes and risk of social aggregation. We applied this approach to outline a risk index for each economic activity sector, with different levels of detail, also considering the impact on mobility of the working population. This method was implemented into the national epidemiological surveillance model in order to estimate the impact of re-activation of specific activities on the reproduction number. It has also been adopted by the national scientific committee set up by the Italian Government for action-oriented policy advice on the COVID-19 emergency in the post lockdown phase. This approach may play a key role for public health if associated with measures for risk mitigation in enterprises through strategies of business process re-engineering. Furthermore, it will make a contribution to reconsidering the organization of work, including also innovation and fostering the integration with the national occupational safety and health (OSH) system.

Apathy and Ignorance: False Prophets of Autism and the Anti-Vaccine Movement

2020 ◽  
pp. 389-398
Author(s):  
Michael B. A. Oldstone
Keyword(s):  
Public Health ◽  
Health Workers ◽  
Vaccination Rate ◽  
Personal Beliefs ◽  
The United Kingdom ◽  
False Reporting ◽  
The Face ◽  
Public Health Workers ◽  
The Impact ◽  
The Brain

This chapter highlights the story of autism, the widespread acceptance of its incorrect cause, and the impact on use of vaccines, all stemming directly from deliberate, false reporting. The basic conflict is twofold. First, involvement of a scientific method that must be reproducible, be reliable, and possess substantial proof is in conflict with common/personal beliefs. Second, doctors, scientists, and public health workers, despite their mandate to listen to parents and patients concerning their opinions, must base medical conclusions on evidence that validates the outcome of each patient’s health issue. It is in this milieu that autism and the anti-vaccine groups still do battle. In 1998, Lancet, a usually respectable and reputable English journal, published Dr. Andrew Wakefield’s opinion that the measles, mumps, rubella (German measles) vaccine injected into the arms of children caused inflammation, leading to harmful chemicals entering the bloodstream through the gut (intestine). These factors, he said, traveled to the brain, where the harmful chemicals/toxins caused autism. In the face of this “fake news” about the source of autism and measles, the vaccination rate for measles dropped in the United Kingdom and Ireland.

scholarly journals ‘Putting salt on the wound’: a qualitative study of the impact of FGM-safeguarding in healthcare settings on people with a British Somali heritage living in Bristol, UK

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e035039 ◽  
Author(s):  
Saffron Karlsen ◽  
Natasha Carver ◽  
Magda Mogilnicka ◽  
Christina Pantazis
Keyword(s):  
At Risk ◽  
Service Providers ◽  
Healthcare Providers ◽  
Female Genital Cutting ◽  
Snowball Sampling ◽  
Genital Mutilation ◽  
Healthcare Settings ◽  
Alternative Sources ◽  
The Impact ◽  
Female Genital

ObjectivesThis research documents the experiences of people with Somali heritage with female genital mutilation (FGM)-safeguarding services in healthcare and whether such services are considered appropriate by the people who encounter them.DesignSix focus groups conducted with ethnic Somalis living in Bristol, during the summer of 2018, divided by gender and whether people had experienced FGM-safeguarding as adults or children.SettingParticipants experienced FGM-safeguarding in primary and secondary care.Participants30 people (21 women and 9 men), identified through local organisations or snowball sampling. All participants were of Somali heritage and aged over 18.ResultsGovernment priorities to support those who have experienced female genital cutting/mutilation (FGC/M) are being undermined by their own approaches to protect those considered at risk. Participants argued that approaches to FGM-safeguarding were based on outdated stereotypes and inaccurate evidence which encouraged health and other service providers to see every Somali parent as a potential perpetrator of FGC/M. Female participants described providers in a range of healthcare settings, including Accident and Emergency Departments (A&E), antenatal care and general practice, as ‘fixated’ with FGC/M, who ignored both their health needs and their experience as victims. Participants felt stigmatised and traumatised by their experience. This undermined their trust in health services, producing a reticence to seek care, treatment delays and reliance on alternative sources of care. Associated recommendations include developing more accurate evidence of risk, more appropriate education for healthcare providers and more collaborative approaches to FGM-safeguarding.ConclusionAll the participants involved in this study are committed to the eradication of FGC/M. But the statutory approaches currently adopted to enable this are considered ill-conceived, unnecessarily heavy-handed and ultimately detrimental to this. Recognising these common aims can enable the development of services better able to protect and support those at risk of FGC/M in ways which are culturally competent and sensitive.

scholarly journals Plague and Pregnancy: Why Special Considerations Are Needed

2020 ◽  
Vol 70 (Supplement_1) ◽  
pp. S27-S29
Author(s):  
Dana Meaney-Delman ◽  
Nadia L Oussayef ◽  
Margaret A Honein ◽  
Christina A Nelson
Keyword(s):  
Public Health ◽  
United States ◽  
At Risk ◽  
Pregnant Women ◽  
Yersinia Pestis ◽  
The United States ◽  
Highly Pathogenic ◽  
Pathogenic Organism ◽  
Public Health Emergencies ◽  
Life Threatening

Abstract Pregnant women are an important at-risk population to consider during public health emergencies. These women, like nonpregnant adults, may be faced with the risk of acquiring life-threatening infections during outbreaks or bioterrorism (BT) events and, in some cases, can experience increased severity of infection and higher morbidity compared with nonpregnant adults. Yersinia pestis, the bacterium that causes plague, is a highly pathogenic organism. There are 4 million births annually in the United States, and thus the unique needs of pregnant women and their infants should be considered in pre-event planning for a plague outbreak or BT event.

scholarly journals A Preparedness Model for Mother-Baby Linked Longitudinal Surveillance for Emerging Threats

2020 ◽  
Author(s):  
Kate R Woodworth ◽  
Megan R Reynolds ◽  
Veronica Burkel ◽  
Cymone Gates ◽  
Valorie Eckert ◽  
...  
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
Health Department ◽  
Population Based ◽  
Adverse Outcomes ◽  
Data Sources ◽  
Long Term Effects ◽  
Public Health Action ◽  
The Impact ◽  
Existing Data

Abstract Introduction Public health responses often lack the infrastructure to capture the impact of public health emergencies on pregnant women and infants, with limited mechanisms for linking pregnant women with their infants nationally to monitor long-term effects. In 2019, the Centers for Disease Control and Prevention (CDC), in close collaboration with state, local, and territorial health departments, began a five-year initiative to establish population-based mother-baby linked longitudinal surveillance, the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET).Objectives The objective of this report is to describe an expanded surveillance approach that leverages and modernizes existing surveillance systems to address the impact of emerging health threats during pregnancy on pregnant women and their infants.Methods Mother-baby pairs are identified prospectively during pregnancy and/or retrospectively after birth of the infant. All data are obtained from existing data sources (e.g., electronic medical records, vital statistics, laboratory reports, and health department investigations and case reporting).Results Variables were selected for inclusion to address key surveillance questions proposed by CDC and health department subject matter experts. General variables include maternal demographics and health history, pregnancy and infant outcomes, maternal and infant laboratory results, and child health outcomes up to the second birthday. Exposure-specific modular variables are included for hepatitis C, syphilis, and Coronavirus Disease 2019 (COVID-19). The system is structured into four relational datasets (maternal, pregnancy outcomes and birth, infant/child follow-up, and laboratory testing).Discussion SET-NET provides a population-based mother-baby linked longitudinal surveillance approach and has demonstrated rapid adaptation for use during COVID-19. This innovative approach leverages existing data sources and rapidly collects data to inform clinical guidance and practice. These data can help to reduce exposure risk and adverse outcomes among pregnant women and their infants, direct public health action, and strengthen public health systems.

scholarly journals Hubungan Pengetahuan dan Sikap Ibu Hamil dengan Perilaku Pencegahan Covid–19 dalam Adaptasi Kebiasaan Baru

2021 ◽  
Vol 1 (1) ◽  
pp. 9-15
Author(s):  
Nur Alfi Fauziah ◽  
Riting Yuliasari ◽  
Hellen Febriyanti
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
Health Center ◽  
Frequency Distribution ◽  
Health Workers ◽  
Research Result ◽  
P Value ◽  
Chi Square ◽  
Public Health Center ◽  
Chi Square Test

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2. Based on data from the Lampung Provincial Health Office (2020), four patients who are pregnant have been confirmed positive for COVID-19. At Gilang Tunggal Makarta Public Health Center of West Tulangbawang Regency (2020) there is 1 pregnant woman aged 22 years old and who has a history of having travelled from DKI Jakarta to be confirmed positive for COVID-19. The purpose of this research is to know the correlation between knowledge and pregnant women attitudes with covid-19 prevention behaviours on new habits adaptation in the working area of Gilang Tunggal Makarta Public Health Center West TulangBawang Regency in 2021. This type of research is quantitative by applying an analytic research design with a cross-sectional approach, the population is all pregnant women as many as 34 people, the total sample size from the population. Univariate data analysis used a percentage frequency distribution and bivariate used the chi-square test. The research result showed that the frequency distribution of pregnant women knowledge was higher in the unfavourable category as many 20 people (58.8%), the pregnant women attitude were higher in the negative category as many as 19 people (55.9%) and the prevention behaviour of COVID-19 was higher in the unfavourable category amounted to 21 people (61.8%). The results of the chi-square test showed a correlation between knowledge (p-value = 0.000 0.05) and behavior (p-value = 0.001 0.05) with COVID-19 prevention behavior on new habits adaptation. It is hoped that health workers will be more active in socializing COVID-19 prevention behaviour through direct counselling on demonstration methods accompanied by discussion using leaflets or brochures using interesting pictures and writing also using simple language.

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