Transition Into LTRC During the COVID-19 Pandemic: An Ethnographic Case Study

COVID-19 has affected long-term residential care (LTRC) disproportionally due to the high-risk population, lack of resources and insufficient preventative measures. Protective measures, including quarantine and strict visitation restrictions have made transitions into LTRC more challenging. Further insight is needed to understand how residents, relatives and staff have experienced this during the COVID-19 pandemic. During four months of fieldwork in a LTRC facility in Switzerland, a rapid ethnography consisting of interviews, observations, informal conversations and document analysis was conducted. This study included a total of 14 residents, 21 healthcare staff from varying departments and 7 relatives of residents. First results indicate that protective measures interfere with a resident’s ability to find meaningful activities and interactions within LTRC as well as the possibility to maintain mobility. This and limited family contact following a move into LTRC prevents a smooth transition from home to LTRC and impacts overall resident quality of life.

A need of COVID19 vaccination for children aged <12 years: Comparative evidence from the clinical characteristics in patients during a recent Delta surge (B.1.617.2)

Objective: To evaluate the necessity of Covid-19 vaccination in children aged < 12 y by comparing the clinical characteristics in unvaccinated children aged < 12 y with vaccinated patients aged > 12y during the Delta surge (B.1.617.2) in Putian, Fujian, China. Methods: A total of 226 patients with SARS-Cov-2 Delta variant (B.1.167.2; confirmed by Realtime PCR positive and sequencing) were enrolled from Sep 10th to Oct 20th, 2021, including 77 unvaccinated children (aged < 12y) and 149 people aged > 12y, mostly vaccinated. The transmission route was explored and the clinical data of two groups were compared;the effect factors for the time of the nucleic acid negativization (NAN) were examined by R statistical analysis. Results: The Delta surge in Putian spread from children in schools to factories, mostly through family contact. Compared with those aged; 12y, patients aged < 12y accounted for 34.07% of the total and showed milder fever, less cough and fatigue; they reported higher peripheral blood lymphocyte counts [1.84(1.32,2.71)× 10^9/L vs. 1.31(0.94,1.85)× 10^9/L; p<0.05), higher normal CRP rate (92.21% vs. 57.72%), lower IL-6 levels [5.28(3.31,8.13) vs. 9.10(4.37,15.14); p<0.05]. Upon admission, their COVID19 antibodies (IgM and IgG) and IgG in convalescence were lower [0.13(0.00,0.09) vs. 0.12(0.03,0.41), p<0.05; 0.02(0.00,0.14) vs. 1.94(0.54,6.40), p <0.05; 5.46(2.41,9.26) vs. 73.63 (54.63,86.55), p<0.05, respectively], but longer NAN time (18 days vs. 16 days, p=0.13). Conclusion: Children aged < 12y may be critical hidden spreaders, which indicates an urgent need of vaccination for this particular population.

Intentional Kinship through Caring Relationships, Heritage, and Identity: Adoptive Parents’ Inclusion of Non-Biological and Non-Affinal Relationships on Family Maps

Structural open adoption has been beneficial to adoptees in integrating their birth heritage and identity. Adoptive parents also may sometimes seek out others who are neither related biologically nor through partnership to support their child in developing an integrated sense of identity. To what extent do these intentional kinship relationships become incorporated within the adoptive family network and how do adoptive parents view their role in their child’s life? Qualitative data on family inclusion of non-biological and non-affinal kin are reported from interviews with lesbian, gay, bisexual, and heterosexual adoptive parents (n = 25 families). Analyses of verbal and visual data from family map drawing interviews indicated that adoptive parents from the different types of families similarly included intentional kin in their conceptualization of their child’s family. Adopted children’s foster carers, family friends, other adoptive families, and other children and adults were specifically included on family maps to facilitate children’s knowledge of different aspects of their birth heritage and adoption story. The implications of open adoption policy therefore move beyond considerations of only birth family contact. In practice, open adoption procedures convey a broad message to families that appear to widen adoptive parents’ conceptualization of kinship.

Frequency of Confirmed Corona Infection (COVID-19) in Children in Affected Families of Gujrat

Aim: To detect the frequency of confirmed corona infection (covid-19) in children in affected families in Gujrat. Study design; cross sectional study. Place and duration of study: This study was conducted from January 2020 to 10 June 2020 at Gujrat Pakistan. Methods: Total 214 children were included in the study from 141 families in which at least one family member was confirmed positive for corona virus infection (COVID-19). This study was started in the beginning of year 2020 but in Gujrat first positive case was reported in March 2020. First of all a family was decided where a confirmed positive case was there. This particular family was included and decided for testing if there was abroad travelling history within 14 days or there was a contact with a confirmed positive patient for corona infection (COVID-19). Results: Total 214 children were included from January 2020 to June 2020. Out of total 214 children, 78 children were positive for (COVID-19) corona infection. Out of 78 (COVID-19) corona infection positive children, 46(58.97%) were female children whereas 32(41.02%) were male children. 37 children (47.44%) were from 1 to 6 years of age whereas 41 (52.56%) were 7-15 years of age. Conclusions: Children can acquire corona virus infection (COVID-19) from adults. Though the severity of corona virus infection (COVID-19) is mild in children, in spite of all this the children should not come in contact with positive person for corona virus infection (COVID-19). Keywords: COVID-19, affected family, contact with positive patients

Pertussis in a child of the first month of life from family contact

A case of whooping cough in a moderate form in a child of the first month of life is described in the presented clinical observation. The moderate form was manifested by the duration of the preconvulsive period up to 5 days, the appearance of cyanosis of the face when coughing in the early stages of the disease (1 week), an increase in the number of coughing attacks. The difficulties of treating pertussis in young children are demonstrated by our observation of the course of the disease. There is no vaccination against pertussis in children in the family due to the refusal of parents and children with prolonged coughing were not examined at the outpatient stage. As a result, chemoprophylaxis was not performed on time and the newborn was discharged from the hospital to the center of pertussis infection. The solution to the problem of reducing the incidence in children in the first months of life should be vaccination of pregnant women in the last stages, and vaccination of the environment, including agerelated revaccinations.

THE PECULIARITIES OF DETECTION AND DIAGNOSIS OF TUBERCULOSIS IN CHILDREN AND ADOLESCENTS

Objectives. To assess the peculiarities of diagnosis and clinical course of tuberculosis in children and adolescents. Material and methods. Retrospective analysis of outpatient records of children and adolescents with tuberculosis in Vitebsk region during the period from 2016 to 2020 was made. Results. In the tuberculous disease structure in children and adolescents, pulmonary tuberculosis (infiltrative pulmonary tuberculosis) prevails. In the majority of cases, tuberculosis was diagnosed during adolescence. Almost all of the sick had close family contact with tuberculosis patients. The medical risk group included 25% of patients. In patients with infiltrative pulmonary tuberculosis, symptoms and changes in the total blood count were observed only in the phase of disintegration and seeding. Bacteriological excreters made up 75% of cases. More than half of children and adolescents with tuberculosis had multidrug resistance of mycobacterium tuberculosis. Immunodiagnosing plays an important role in the detection of tuberculosis in children and adolescents. Among the sick children, only extrapulmonary forms of tuberculosis were recorded. Conclusions. Most often, tuberculosis in children and adolescents affects the respiratory organs and is asymptomatic or oligosymptomatic. 75% of patients were bacteria discharging persons, more than half of them having multidrug resistance. Family contact is of great importance in tuberculosis in children and adolescents. Doctors of all specialties need to have phthisiatric alertness in relation to patients with diseases of various localization resistant to nonspecific therapy, especially to persons with chronic diseases and to those who contact with patients suffering from tuberculosis. In case of ineffective antibiotic therapy, it is necessary to take the material for the study and verification of tuberculous infection and to carry out immunodiagnosing of tuberculosis.

A Scoping Review of Family Focussed Interventions to Prevent Prison Violence

Violence is an ongoing concern for many people who live and work in correctional settings and yet relatively little is known about the effects of institutional violence prevention efforts. This paper reports the findings of a scoping review of recent research relevant to understanding the influence of one factor, contact with family, that potentially influences institutional violence in countries such as Aotearoa New Zealand where Indigenous peoples are over-represented in prison settings. A total of 15 different studies were identified that provided consistent evidence of an association between family contact and prison violence. The implications of this work for the development of evidence-based prison violence prevention strategies are discussed.

Communication in COVID: a quality improvement project into staff communication with family/carers at New Haven Older Adult Mental Health Inpatient Unit

AimsIn the psychiatric care of patients, family involvement is key to recovery. At the New Haven Unit, there have been a number of complaints regarding poor communication and lack of updates given to families during COVID-19.The aim is to:To increase the overall satisfaction of the family with the service received for their loved onesEnsure effective and timely communication of updates to the families, to prevent further complaints, by assigning a member of staff per patient to be the primary individual responsible for family contactCreate an addition to the weekly ward round MDT proforma on ‘Carenotes’ where communication can be documentedMethodA standardised questionnaire has been sent to the relatives of inpatients at the New Haven Unit. Qualitative data are being collated, which will lead to quantitative statistical analysis of the satisfaction ratings.Based on the current bed state on the ward at the time of the project all 32 relatives of current inpatients were contacted and 23 agreed to complete the survey which was sent out either by email or post.The new MDT proforma will be added, which will be used to record actions needed to be taken involving communication and updating family members on a weekly basis. This opportunity to record communication will improve continuity of care and satisfaction amongst family members.There will be follow-up via a second questionnaire to identify improvement.ResultThe average results of selected categories so far are shown below (still awaiting further responses):Frequency of updates regarding loved ones = 4.33/10 (10-excellent)To what degree were your concerns listened to? 7.33/10Quality of content discussed with staff members = 3.33/4 (4- excellent)Other categories scoring below the expected standard, included awareness of visiting guidelines and questions regarding lasting power of attorney, in which 33.3% of participants responded either ‘no’ or ‘not sure’ respectively.Questions addressing formalities of introduction and confidentiality through identity confirmation, scored highly.ConclusionWe are awaiting more survey responses in order to identify additional areas of improvement; however, it is already clear to see that there are areas that would be advanced through structured, assigned reminders via an MDT amendment.We will also be introducing set dates for conference calls with the families now involving the whole MDT; one within the first week of admission, one after six weeks and one at the point of discharge as a minimum.

Transient symptomatic zinc deficiency in an exclusively breastfed infant

A 3-month-old, full term female infant, adequate for gestational age, and exclusively breastfed, was admitted with a 10 day history of generalised scaling erythematous dermatitis, affecting the face (perinasal, nasolabial folds and periauricular), acral and intertriginous areas, with irritability and failure to thrive. Her mother had been treated with isoniazid since the third trimester because of family contact with tuberculosis. Based on a diagnosis of suspected impetiginised eczema, the infant was treated with flucloxacillin and prednisolone, and maternal isoniazid was suspended, with no improvement. Investigations found low serum zinc levels in the infant (33 μg/dL; normal range (NR) >60 μg/dL), normal plasma zinc levels in the mother (111.3 μg/dL; NR 68–120 μg/dL) and lower than the normal range of zinc levels in breast milk (270μg/L; NR 1000–2500 μg/L), suggesting acrodermatitis caused by zinc deficiency. Oral zinc supplementation (3 mg/kg/day) was started with a marked improvement in skin lesions, as well as good weight gain. At the age of 6 months, after food diversification, supplementation was suspended, without any recurrence of symptoms.

Intimate partner violence and social connection among married women in rural Bangladesh

BackgroundIntimate partner violence (IPV) is high among married women in Bangladesh. Social isolation is a well-established correlate of women’s exposure to IPV, but the role of such factors in low-income and middle-income countries is not well understood. In this study, we explore whether social connection is protective against IPV among married women in rural Bangladesh.MethodsData were drawn from a multistage, stratified, population-based longitudinal sample of 3355 married women in rural Bangladesh, who were surveyed on individual and contextual risk factors of IPV. Negative binomial regression models were used to estimate the association between three different domains of social connection (natal family contact, female companionship and instrumental social support), measured at baseline in 2013, and the risk of three different forms of IPV (psychological, physical and sexual), approximately 10 months later, adjusted for woman’s level of education, spouse’s level of education, level of household wealth, age and age of marriage.ResultsAdjusted models showed that instrumental social support was associated with a lower risk of past year psychological IPV (risk ratio (RR)=0.84, 95% CI 0.769 to 0.914), sexual IPV (RR=0.90, 95% CI 0.822 to 0.997) and physical IPV (RR=0.81, 95% CI 0.718 to 0.937). Natal family contact was also associated with a lower risk of each type of IPV, but not in a graded fashion. Less consistent associations were observed with female companionship.ConclusionOur findings suggest that social connection, particularly in the form of instrumental support, may protect married women in rural Bangladesh from experiencing IPV.