Assessing the scalability of an integrated falls prevention service for community-dwelling older people: a mixed methods study

Background There is growing acknowledgement of the need for a phased approach to scaling up health interventions, beginning with an assessment of ‘scalability’, that is, the capacity of an individual intervention to be scaled up. This study aims to assess the scalability of a multi-component integrated falls prevention service for community-dwelling older people and to examine the applicability of the Intervention Scalability Assessment Tool (ISAT). The ISAT consists of 10 domains for consideration when determining the scalability of an intervention, and each domain comprises a series of questions aimed at examining readiness for scale-up. Methods Multiple methods were used sequentially as recommended by the ISAT: a review of policy documents, results from a service evaluation and falls-related literature; one-to-one interviews (n = 11) with key stakeholders involved in management and oversight of the service; and a follow-up online questionnaire (n = 10) with stakeholders to rate scalability and provide further feedback on reasons for their scores. Results Three of the ISAT domains were rated highly by the participants. Analysis of the qualitative feedback and documents indicated that the issue of falls prevention among older people was of sufficient priority to warrant scale-up of the service and that the service aligned with national health policy priorities. Some participants also noted that benefits of the service could potentially outweigh costs through reduced hospital admissions and serious injuries such as hip fracture. The remaining domains received a moderate score from participants, however, indicating considerable barriers to scale-up. In the qualitative feedback, barriers identified included the perceived need for more healthcare staff to deliver components of the service, for additional infrastructure such as adequate room space, and for an integrated electronic patient management system linking primary and secondary care and to prevent duplication of services. Conclusions Plans to scale up the service are currently under review given the practical barriers that need to be addressed. The ISAT provides a systematic and structured framework for examining the scalability of this multi-component falls prevention intervention, although the iterative nature of the process and detailed and technical nature of its questions require considerable time and knowledge of the service to complete.

Child Maltreatment Prevention Service Cases are Significantly Reduced During the COVID-19 Pandemic: A Longitudinal Investigation Into Unintended Consequences of Quarantine

Unprecedented financial and emotional stress, paired with measures to slow the spread of COVID-19 (e.g., school closures), place youth at risk for experiencing increased rates of abuse. We analyzed data from New York City’s Administration for Children’s Services to investigate the frequency of child maltreatment prevention service case openings during this time. Longitudinal counts of case openings were compiled for January through June of the years 2014–2020. An independent samples Kruskal–Wallis H-test suggested that pre-quarantine case openings were significantly larger than case openings during quarantine. To account for the possible influence of other historical events impacting data, a secondary Kruskal–Wallis H-test was conducted comparing only the 4 months of quarantine data available to the 4 months immediately preceding quarantine orders. The second independent samples Kruskal–Wallis H-test again suggested that pre-quarantine case openings were significantly larger than case openings during quarantine. A Poisson regression model further supported these findings, estimating that the odds of opening a new child maltreatment prevention case during quarantine declined by 49.17%. These findings highlight the severity of COVID-19 impacts on child maltreatment services and the gap between demand for services and service accessibility. We conclude with recommendations for local governments, community members, and practitioners.

The UK’s first (unsanctioned) overdose prevention site

Background: The UK is currently experiencing a public health crisis of drug-related deaths. The government has rejected recommendations to open overdose prevention services, under the Misuse of Drugs Act 1971. To report on the operation and use of an unsanctioned overdose prevention service which operated in Glasgow city centre from September 2020 to May 2021.Methods: Description of the service, with analysis of data collected on its use.Results: The service operated for nine months without permission or funding from official sources. We report on the 894 injections supervised and recorded, and nine successful interventions with overdose events (seven opioid/two cocaine). Powder cocaine injection predominated either alone (60.6%) or with heroin (22.1%). Injection was mostly in the groin (68.0%) or arm (16.8%). More injections were recorded by males (70.1%). Conclusion: It is possible to operate an overdose prevention service in the UK without it being shut down by the police. There is an urgent need and demand for these services in the UK to reduce harm, prevent and intervene during overdose, and provide vital psychosocial support for health and wellbeing in a highly marginalised population.

Strategic management of the enterprise in the conditions in the instability of the market environment

The article discusses the role of preventive anti-crisis management on the basis of comprehensive measures to overcome the crisis situations. The reasons and moments of crisis beginning are considered, and in case of objective impossibility to avoid entering the crisis period, the approaches to overcoming them are indicated. The basic concepts of anti-crisis management, preventive management and preventive anti-crisis management, which are effective tools for crisis management in the conditions of cyclical crisis phenomena, are defined. The main tasks of preventive anti-crisis management are revealed, and the estimation of probability of occurrence and analysis of consequences of influence of potential crisis phenomena and situations, at development of anti-crisis strategy, realization of action plans on crisis prevention is presented. The key areas of preventive management and the necessary tools for the implementation of anti-crisis measures at the enterprise are identified. The crisis warning functions that will be performed by the crisis prevention service are presented.

The Smoking Behavior of Health Workers in Asia: A Literature Review

Health workers are role models in preventing smoking behavior, yet many are smokers themselves. This study reviews and analyzes the smoking behavior of health workers in Asian countries, based on databases such as PubMed, EBSCO, and Google Scholar in 2013–2018. It is shown that the prevalence of smoking amongst health workers was 4.6–44%, with the nursing profession showing a higher level than other health professions and with a higher ratio of male to female smokers. Health workers are aware of the dangers of smoking, including the effects of cardiovascular disease, respiratory disease, oral cancer, atherosclerosis, hypertension, fetal disorders, and infertility. However, the factors that lead to smoking include stress, the influence of friends or family who smoke, and addiction. Health workers are responsible for providing smoking prevention education. However, there are still obstacles to its implementation due to their smoking habits and lack of expertise in educating others. Smoking prohibition policies in the workplace, the training of health workers, and smoking prevention service facilities need to be considered by Asian countries to prevent smoking. Abstrak Analisis Perilaku Merokok pada Petugas Kesehatan di Asia: Literatur Review. Petugas kesehatan merupakan role model dalam pencegahan perilaku merokok, akan tetapi masih banyak petugas kesehatan yang merokok. Studi ini meninjau dan menganalisis perilaku merokok petugas kesehatan di negara-negara Asia, bersumber pada basis data seperti PubMed, EBSCO, dan Google Scholar, tahun 2013–2018. Hasil studi menunjukkan perilaku merokok petugas kesehatan memiliki prevalensi sebesar 4,6–44% dengan profesi keperawatan menunjukkan tingkat yang lebih tinggi daripada profesi kesehatan lainnya, dan dengan rasio perokok laki-laki lebih tinggi dari perokok perempuan. Petugas kesehatan menyadari bahaya merokok dan dampak penyakitnya seperti penyakit kardiovaskuler, penyakit pernapasan, kanker mulut, aterosklerosis, hipertensi, gangguan janin, dan kemandulan. Faktor yang memengaruhi merokok adalah stres, pengaruh teman atau keluarga yang merokok, dan kecanduan. Petugas kesehatan bertanggung jawab untuk mem-berikan pendidikan pencegahan merokok. Namun, masih terdapat kendala dalam pelaksanaannya karena kebiasaan pribadi merokok mereka dan kurangnya keahlian dalam mendidik orang lain. Kebijakan larangan merokok di tempat kerja, pelatihan tenaga kesehatan, dan fasilitas layanan pencegahan merokok perlu diperhatikan oleh negara-negara Asia untuk pencegahan perilaku merokok. Kata kunci: perilaku merokok, petugas kesehatan, role model

The work of the medical prevention service of the Ulyanovsk Region during the spread of the novel coronavirus infection (COVID-19)

The purpose of the study was to monitor the activities of departments and offices of medical prevention of public health institutions during the period of restrictive measures related to the spread of the new coronavirus infection COVD19. Results: in health care institutions providing primary health care, the work of primary care was strengthened by specialists from departments, medical prevention offices: this is work with the district service, monitoring COVID-19 patients and contact, taking tests, forming mobile teams, visiting patients as part of the data brigades. Work was carried out at the entrance sanitary checkpoints, the population was informed through the Internet, print media (newspapers) on the prevention and non-proliferation of a new coronavirus infection. Conclusion: the monitoring made it possible to assess the actual activities of specialists in departments and offices of medical prevention of public health institutions during the period of restrictive measures. The temporary change in the functionality of the medical prevention service of the Ulyanovsk region made a significant contribution to the common cause of combating the COVID-19 pandemic.

Advancing Public Mental Health in Canada through a National Suicide Prevention Service: Setting an Agenda for Canadian Standards of Excellence: Promouvoir la santé mentale publique au Canada par un service de prévention nationale du suicide : Établir un programme de normes canadiennes d’excellence

The Public Health Agency of Canada is funding a new Canada Suicide Prevention Service (CSPS), timely both in recognition of the need for a public health approach to suicide prevention, and also in the context of the COVID-19 pandemic, which is causing concern about the potential for increases in suicide. This editorial reviews priorities for suicide prevention in Canada, in relation to the evidence for crisis line services, and current international best practices in the implementation of crisis lines; in particular, the CSPS recognizes the importance of being guided by existing evidence as well as the opportunity to contribute to evidence, to lead innovation in suicide prevention, and to involve communities and people with lived experience in suicide prevention efforts.