Care Agencies Research Articles

Monkeypox (Mpox) outbreak during COVID-19 pandemic-Past and the future.

Monkeypox infection (Mpox) is caused by the Orthopoxvirus (OPXV) genus of the Poxviridae family, closely resembling its more famous sibling smallpox. Recently World Health Organization (WHO), have renamed monkeypox as Mpox citing racial concerns, so we will be referring to monkeypox as Mpox. There has been a recent outbreak in May 2022 when Mpox cases were identified in all six WHO regions. On July 23, 2022, WHO declared it a public health emergency. Before the current outbreak, Mpox had been reported in people from several parts of central and west African countries; and almost all Mpox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs or through imported animals. With the waning of smallpox vaccine-induced immunity, Mpox can spread in the global population. Though the virus generally does not cause high mortality in immunocompetent individuals, however, severe disease and mortality may result if the virus spreads to immunocompromised individuals, children, elderly individuals, pregnant women, and individuals living with comorbidities such as diabetes. The current transmission was suspected to have occurred through sexual activity in 95% of the persons with infection. It was found that 98% of the persons with infection were either gay or bisexual men, with 41% suffering from HIV infection. The reasons behind this current epidemiological behavior have to be studied further to formulate a hypothesis that, is it the homosexuals who need to be more concerned or is it a global concern, and is monkeypox changing its behaviour toa sexually transmitted infection? The rash, along with associated lymphadenopathy, is a clue toward Mpox infection, but polymerase chain reaction is needed for the confirmative diagnosis. With the discovery of a vaccine, repurposed antivirals, and precautionary steps to prevent the spread of infection, it might help in the containment of the virus. In addition, what we already know about Mpox has to be re-evaluated, because most of the information gathered is from low-resource settings in Africa. The world at large and health care agencies specifically needs to galvanize a well-funded global plan and research initiatives to contain the spread of Mpox. In this article, we have attempted to make the readers aware of the biology, etiopathogenesis including the changes at the cellular level the virus is causing, the changing trends of the virus transmission, and the clinical manifestations. We have also attempted to elaborate on the potential challenges and the need for early diagnosis and containment of this Mpox outbreak. This could be achieved by effectieve use of vaccination and taking social safety measures, especially by the communities at risk.

A Path Analysis for Health-related Quality of Life in Long-term Care Insurance In-home Service Users

Purpose: The purpose of this study is to construct and verify a path model for the factors affecting on quality of life in long-term care insurance in-home service users.Methods: Total 246 participants using long-term care insurance in-home service were recruited from long-term care agencies. Data collection was conducted using a structured questionnaire from March 1st to March 31st 2021. The collected data were analyzed using SPSS 26 and AMOS 26 programs.Results: The hypothetical path model was suitable for explaining the health-related quality of life in long-term care insurance in-home service users and has an explanatory power of 39.8%. Long-term care grade, depression, perceived health status, social support, age and living arrangement had a significant total effect on the quality of life in long-term care insurance in-home service users.Conclusion: Long-term care insurance in-home service policies need to be expanded, such as screening and relieving depression, strengthening social support, and fostering a positive perception of health to improve the quality of life of the elderly.

Home Health Care Workers' Interactions with Medical Providers, Home Care Agencies, and Family Members for Patients with Heart Failure.

Despite providing frequent care to heart failure (HF) patients, home health care workers (HHWs) are generally considered neither part of the health care team nor the family, and their clinical observations are often overlooked. To better understand this workforce's involvement in care, we quantified HHWs' scope of interactions with clinicians, health systems, and family caregivers. Community-partnered cross-sectional survey of English- and Spanish-speaking HHWs who cared for a HF patient in the last year. The survey included 6 open-ended questions about aspects of care coordination, alongside demographic and employment characteristics. Descriptive statistics were performed. Three hundred ninety-one HHWs employed by 56 unique home care agencies completed the survey. HHWs took HF patients to a median of 3 doctor appointments in the last year with 21.9% of them taking patients to ≥ 7 doctor appointments. Nearly a quarter of HHWs reported that these appointments were in ≥ 3 different health systems. A third of HHWs organized care for their HF patient with ≥ 2 family caregivers. HHWs' scope of health-related interactions is large, indicating that there may be novel opportunities to leverage HHWs' experiences to improve health care delivery and patient care in HF.

An applied model of cultural competence in child protection practice

This empirical qualitative study explores the application of a model of cultural competence in child protection practice with families from Black, Asian and minority ethnic backgrounds in the United Kingdom. Data were collected through audio-recorded and transcribed semi-structured interviews with a sample of 17 social workers and family support workers across two local government children's social care agencies. The interview route explored practitioners’ experiences of professional work with children and families from Black, Asian and minority ethnic backgrounds. They were asked to describe good practices in relation to cultural competence around the initial contact, assessment and care planning. Transcripts of these interviews were uploaded to Nvivo12 software and coded in two stages, initially for emergent themes and subsequently in relation to the ASKED model of cultural competence. Data analysis revealed multiple examples of good practice which were analysed employing the five dimensions of the ASKED model, namely, cultural awareness, cultural skill, cultural knowledge, cultural encounter, and cultural desire. By mapping the approaches developed and employed by practitioners onto the five ASKED dimensions, these became discernible and therefore potentially transferable learning for others. The ASKED model of cultural competence is a means of capturing good practice in a systematic and detailed way, making it sharable with other child protection professionals. ASKED is also a framework for moving beyond anti-oppressive theory to practical implementable antioppressive practices with families from Black, Asian and minority ethnic backgrounds

To care for them, we need to take care of ourselves: A qualitative study on the health of home health aides.

To understand the perspectives of home health aides (HHAs) toward their own health and health behaviors, and how their job impacts both. Interviews were conducted with 28 HHAs from 16 unique home care agencies from August 2021 to January 2022. The study was conducted in partnership with the 1199SEIU Training and Employment Fund, a labor-management fund of the largest health care union in the US. A qualitative study with English and Spanish-speaking HHAs. Interviews were conducted using a semi-structured topic guide, informed by Pender's Health Promotion Model and the National Institute for Occupational Safety and Health's Total Worker Health Model. To be eligible, HHAs had to be currently employed by a home care agency in New York, NY. Interviews were recorded, professionally transcribed, and analyzed thematically. The 28 HHAs had a mean age of 47.6 years (SD 11.1), 39% were non-Hispanic Black, 43% were Hispanic, and they had a mean of 14.1 years (SD 7.8) of job experience. Five themes emerged; HHAs were: (1) Healthy enough to work, but were managing their own chronic conditions while working; (2) Motivated to be healthy, in part driven by their desire to care for others; (3) Worked closely with sick patients, which influenced their perceptions of health; (4) Experienced occupational and patient-level barriers to practicing healthy behaviors; (5) Sought support and resources to improve their health and wellbeing. HHAs have numerous health challenges, many of which are influenced by their job. Culturally and occupationally tailored interventions may mitigate the barriers that HHAs experience to achieve optimal health.

Collaborative Care Model Gaining Traction in North Carolina

Collaborative Care Model Gaining Traction in North Carolina

Secular trends of suicide risk for residents in mainland China (2004 to 2019): An updated age–period–cohort analysis

BackgroundThe overall suicide rate in China has dropped substantially since the 1990s, but a slowdown in the decrease and even a reversing trend was observed in specific groups in recent years. This study aims to investigate the latest suicide risk in mainland China by using the age-period-cohort (APC) analysis. MethodThis population-based multiyear cross-sectional study included Chinese ages 10 to 84 years using data from the China Health Statistical Yearbook (2005–2020). Data were analyzed by the APC analysis and intrinsic estimator (IE) technique. ResultsThe data satisfactorily fit the constructed APC models. The cohort effect indicated a high risk of suicide among people birth in 1920–1944 and a sharp decline in the 1945–1979 cohort. The lowest risk occurred in the 1980–1994 cohort before a sharp increase in generation Z (birth years in 1995–2009). The period effect showed a declining trend since 2004. The age effect indicated that the suicide risk increased over time, except for a gradual decline from age 35 to 49. The suicide risk increased greatly in adolescents and reached the highest among the elderly. LimitationsThe aggregated population-level data and the non-identifiability of the APC model could result in bias in the accuracy of results in this study. ConclusionsThis study successfully updated the Chinese suicide risk from the age, period and cohort perspective using the latest available data (2004–2019). The findings enhance the understanding of suicide epidemiology and provide evidence supporting policies and strategies at the macro-level for suicide prevention and management. Immediate action is needed to focus on a national suicide prevention strategy that targets generation Z, adolescents and the elderly which will require a collaborative effort by government officials, public/community health planners and health care agencies.

Caregivers of youth in foster care in Texas and their role in contraception decision-making for adolescents in care

ObjectivesThis study describes the perspectives of caregivers of youth in foster care in Texas about the caregiver’s role in adolescent contraception decision-making for adolescents in their care, particularly for long-acting reversible contraception. The study also explores how providers and foster care agencies can better support pregnancy prevention for youth in care. Study designResearchers recruited 18 caregivers of youth in care from an academic center in Texas to complete in-person, one-on-one, semistructured interviews from August to December 2019. Two independent coders identified the main concepts with thematic analysis; discrepancies were resolved by consensus. ResultsMost caregivers identified as female (88%), Black (59%), and ranged in age from 30 to 69 years old. Half (47%) reported previously caring for an adolescent who was pregnant or parenting. Themes from the interviews included the importance of building relationships before contraception conversations, the balance between adolescent autonomy and strict caregiver oversight in contraceptive decision-making, variation in beliefs about contraception for youth in care, and extreme reactions to long-acting reversible contraception in both directions. Providers and foster care agencies played an important role managing confidential expectations and providing resources or trainings about contraception. ConclusionsIn a region of the country with high rates of adolescent pregnancy, strategies that empower adolescent autonomy allow delicate caregiver oversight, provide comprehensive information about all contraceptive options, and respond to extreme long-acting reversible contraception reactions and trainings that focus on the context of contraception that should inform communication-based interventions to address teen pregnancy prevention among youth in care. ImplicationsFew studies address the experiences of caregivers of adolescents in foster care. This study highlights a range of caregiver attitudes about contraception for adolescents in care. Provider training regarding contraception should include strategies to manage caregiver beliefs and extreme reactions to contraception use among youth in care.

Shared responsibility: conceptualising how a public health approach may enhance police response to missing persons

When a person is reported missing there are substantial costs for the individual, their family and society. This paper conceptualises the experience of missing persons episodes, through a public health approach. This then allows police, stakeholders and the community to engage in discussions about who is vulnerable to going missing by intervening in a way that addresses risk. Historically, a missing persons episode involves an absence, typically followed by police involvement in consultation with next of kin with establishing the whereabouts of the missing person being the primary focus. Yet, the risk factors of going missing relate more to the psychosocial aspects that trigger a disappearance – family disconnection, mental health, poverty, intergenerational trauma. A narrative review of the literature reflects that the police are public health interventionists regarding social issues; however, this concept is untested in a missing persons context. Successful examples of public health approaches in the injury and violence prevention fields demonstrate that a public health approach is critical to address risk and protective factors. In a context of going missing (and the aftermath of a missing episode), enhanced awareness of the social and economic costs of an absence may prevent future episodes. This paper proposes a conceptual framework to address key challenges and risk factors in missing persons cases. The paper also proposes a future framework that emphasises shared responsibility between police working alongside public health and social care agencies to better support those at risk of going missing while fully engaging with the experiences of those who return.

Social Suffering: Indigenous Peoples' Experiences of Accessing Mental Health and Substance Use Services.

In this paper, we present findings from a qualitative study that explored Indigenous people's experiences of mental health and addictions care in the context of an inner-city area in Western Canada. Using an ethnographic design, a total of 39 clients accessing 5 community-based mental health care agencies were interviewed, including 18 in-depth individual interviews and 4 focus groups. Health care providers also were interviewed (n = 24). Data analysis identified four intersecting themes: normalization of social suffering; re-creation of trauma; the challenge of reconciling constrained lives with harm reduction; and mitigating suffering through relational practice. The results highlight the complexities of experiences of accessing systems of care for Indigenous people marginalized by poverty and other forms of social inequity, and the potential harms that arise from inattention to the intersecting social context(s) of peoples' lives. Service delivery that aims to address the mental health concerns of Indigenous people must be designed with awareness of, and responsiveness to, the impact of structural violence and social suffering on peoples' lived realities. A relational policy and policy lens is key to alleviate patterns of social suffering and counter the harms that are unwittingly created when social suffering is normalized.

Qualitative studies of the lived experiences of being in foster care: A scoping review protocol

The aim of this scoping review is to provide an overview of the existing qualitative research concerning the lived experiences of children and young people currently in foster care.IntroductionLived experience...

Evaluating Take 5: Virtual Learning Sessions on Trauma Informed Care for Healthcare Staff During COVID-19

Trauma disproportionately impacts people with HIV. To mitigate these adverse impacts, primary care providers can identify and address trauma with clients using a trauma informed care (TIC) approach. In 2018, CAI, an organization that provides national level training and capacity-building developed a TIC implementation model, now delivered in HIV and primary care agencies throughout the United States to integrate TIC into their culture, environment, and service delivery. New Jersey Trauma Informed Care (NJTIC) is the organization’s longest standing TIC initiative. To respond to the complex challenges of the COVID-19 pandemic, we developed a webinar series, Take 5, to leverage and expand upon the existing knowledge and skills of providers across 15 agencies part of the NJTIC project. This article describes the series’ purpose, to support staff and sustain and develop their TIC competencies during this unprecedented reality. Results of our evaluation indicated the reaction, satisfaction, and impact described by staff, who enhanced their TIC knowledge and utilized new skills with clients and themselves. Staff and their supervisors reported that the series offered consistency and support during an uncertain time. These promising practices can be applied broadly during crises to bolster knowledge, skills, collaboration, and self-care.

A Data-Driven Approach to Allocating Personal Protective Equipment During the COVID-19 Pandemic in King County, Washington.

From the Field is a semiregular column that provides insight into the experiences of local, county, or state health professionals on the frontlines of health emergencies. National Association of County and City Health Officials members share the challenges faced and the solutions developed as they prepared for and responded to disasters, epidemics, and other major health issues. The aim of sharing these practical experiences is to provide other public health champions with the information and tools they need to help keep their communities safe even in extreme situations. The COVID-19 pandemic created an extraordinarily high demand for personal protective equipment (PPE). Acute need and supply chain disruptions made hospitals, emergency medical services, and other critical care agencies particularly vulnerable to PPE shortages. In March 2020, King County, Washington, developed computational tools, operating procedures, and data visualizations to fulfill its responsibilities to prioritize, allocate, and distribute scarce PPE equitably and efficiently during a public health emergency. King County distributed over 1.6 million gowns, 22 million gloves, 3.9 million surgical masks, and 1.5 million N95 respirators (among other items) during its PPE distribution mission. An algorithm processed resource requests from the community, with respect to available inventory, emergency allocation policies, prioritization constraints, estimated PPE use rates, agency-specific needs, and other parameters. With these inputs and constraints, the requests were translated into instructions for fulfillment and delivery and several tabular and graphical data visualizations were produced for quality assurance and transparency. Access to timely, relevant, and stable data was a constant challenge, and constraints invariably changed as the emergency response unfolded. King County's PPE distribution mission provides a useful case study in how to develop a scalable and data-driven approach to resource allocation and distribution under emergency response conditions.

Kidney Transplant Practice in Pandemic Times: Lessons Learned for the Future.

Kidney Transplant Practice in Pandemic Times: Lessons Learned for the Future.

Inequities in access to directly-funded home care in Canada: a privilege only afforded to some

BackgroundDirectly-funded home care (DF) provides government funds to people who need assistance with the activities of daily living, allowing them to arrange their own services. As programs expand globally, many allow DF clients to hire home care agencies to organize their services rather than finding their own workers. In Canada, half of the DF home care programs allow users to purchase agency services. The goal of this research is to describe the role of agency providers in DF home care in Canada and consider potential equity implications for service access from the perspectives of clients and families.MethodsFramed with intersectionality, the study included online focus groups with families and clients (n = 56) in the two Canadian provinces of Alberta and Manitoba between June 2021-April 2022. All transcripts underwent qualitative thematic analysis using open and axial coding techniques. Each transcript was analyzed by two of three possible independent coders using Dedoose qualitative analysis software.ResultsThe article presents five thematic findings. First, the focus groups document high rates of satisfaction with the care regardless of whether the client uses agency providers. Second, agency providers mediate some of the administrative barriers and emotional strain of using DF home care, and this is especially important for family caregivers who are working or have additional care responsibilities. Third, there are out-of-pocket expenses reported by most participants, with agency clients describing administrative fees despite lower pay for the frontline care workers. Fourth, agencies are not generally effective for linguistic and/or cultural matching between workers and families. Finally, we find that DF care programs cannot compensate for a limited informal support network.ConclusionsClients and families often intentionally choose DF home care after negative experiences with other public service options, yet the results suggest that in some Canadian contexts, DF home care is a privilege only afforded to some. Given the growing inequalities that exist in Canadian society, all public home care options must be open to all who need it, irrespective of ability to pay, degree of social support, or competence in the English language.

Impact of Nutrition Education Intervention Programme On Nutritional Awareness Among Pregnant Women in Ningi Local Government Area of Bauchi State. Nigeria

This study assessed the impact of nutrition education intervention programme on nutritional awareness among pregnant women in Ningi Local Government Area of Bauchi State. Nigeria. The population for this study comprised of thirty-three thousand and thirty-five (33,035) pregnant women in Ningi LGA, Bauchi State. Multi-stage sampling techniques of clustered, simple random sampling, proportionate sampling and systematic sampling technique were used to select one hundred (100) participants as a sample size of the study. Quasi-experimental research design was adopted for this study. The research instrument for the collection of relevant data for this study is a researcher-developed closed-ended questionnaire which is divided into four (4) sections (A, B, C and D) on the adapted General Nutritional Awareness Questionnaire (AGNAQ) developed by Kliemann, Wardle, Jonhson, and Croker (2016). The instrument was validated by five (5) experts in the field of Human Kinetics and Health Education, Public Health and Nursing Science. Reliability index of 0.71 was obtained using split-half method of thirty (30) pregnant women who were attending ANC at the general hospital in the Birnin Kudu Local Government Area of Jigawa State and data collected was subjected to statistical test using Spearman Brown’s Prophecy Formula. Frequency count and percentage were used to describe the described the socio-demographic information of the respondents. Paired sample t-test and independent t-test was used to test formulated null-hypotheses at 0.05 level of significant. The result of the study indicated that there is significant impact of nutrition education intervention programme on nutritional awareness among pregnant women in Ningi LGA, Bauchi State (t-52.723, df: 99; P<0.05); and there is significant difference between the experimental and the control groups after nutrition education intervention programme (t=-39.2, df: 98; P<0.05). It was recommended that Seminar and workshop should be organized periodically to the primary health workers on nutritional education intervention programme during ANC to improves nutritional awareness of pregnant women by optimising collaboration between primary health care agency, government, non-governmental organizations, and maternal and child health service providers.

The use of independent foster care agencies by Swedish local authorities: Do structural factors matter?

ABSTRACT In Sweden, as in several other European countries, for example, Norway and the UK, social welfare service provision is increasingly being exposed to market competition. One service now being provided on the welfare market is foster care, as it is made available by independent foster care agencies (IFAs). However, current knowledge about the use of IFA is limited. To address this knowledge gap, this study explores (a) the extent of IFA use nationally and (b) whether structural factors (e.g. geographical location, socio-economic factors, local political governance) are associated with IFA use. The use of IFAs was analysed through a national survey answered by local authorities responsible for out-of-home care for children. The results of analysis indicate that approximately 90% of municipalities use IFA and on average 25% of foster care is provided by an IFA. A regression analysis shows that there are significantly higher odds of IFAs providing 20% or more of the foster care placements in small municipalities. No other significant correlations were found. Further, the results indicate a need for further in-depth studies to understand the use of IFAs and the rationality behind that use.

More-than-care: People with intellectual disability and emerging vulnerability during pandemic lockdown.

This paper offers more-than-care as a framework for analysing how vulnerability emerges in the lives of people with intellectual disability beyond relations of care. More-than-care detaches vulnerability from the identity category of disability. It provides a framework for conceptualising vulnerability in an unequal, neoliberalising, and ableist world and sheds new light on the ever-evolving constitution of vulnerability and disability. This intervention breaks with conceptions of vulnerability centred on care needs that leave other circumstances that inform vulnerabilities unexamined. Importantly, the framework shifts responsibility for managing vulnerabilities away from carers alone. The more-than-care framework is grounded in socio-material conceptualisations of disability and advances a tripartite framing of vulnerability. First, it grounds studies of vulnerability in histories of spatially uneven investment in infrastructure and resources that shape how care and other practices can assemble to produce, challenge, and manage vulnerability. Second, it recalibrates dominant conceptions of the temporality of vulnerability to ensure sensitivity to the unpredictability of emergent vulnerabilities. Third, in following a socio-material conceptualisation of intellectual disability, more-than-care expands discussions about agency in the context of vulnerability. These concepts are empirically examined through an analysis of how vulnerability emerges in the lives of four self-advocates with intellectual disability during Melbourne's first and second COVID-19 lockdowns. The analysis shows that vulnerability was highly dynamic and unpredictable as it emerged in complex socio-material assemblages that included care arrangements, embodied experiences and agencies, and past instances of neglect and exploitation.

Counterfactual Decomposition of Health Care Expenditures: From Cost-Based Payment to a Global Budget System

Abstract This study divides health care expenditures into observable effects and structural shifts to explore the impacts of population ageing and high technology on the growth in outpatient service, inpatient service, and prescription drug expenditures in a health care system that has experienced a shift in payment schemes from a cost-based to a global budget system. By using the quantile decomposition method to examine data from Taiwan, the study shows that, in the short run, all expenditures exhibit an increasing trend in the higher percentiles. In the long run, an observable effect dominates the growth of health care expenditures. Specifically, population ageing leads to the growth of prescription drug expenditures in the higher percentiles. The adoption of high technology drives the growth of the top outpatient and inpatient service expenditures. These results suggest that while the government health care agency aims to control health care expenditures, improving the management of high-cost patients is likely to be one important avenue to improving the effectiveness of the cost control policy.

Identifying Practical Knowledge for Introducing Information Systems in Community Social Care Agencies: A Scoping Review

Information systems (IS) are increasingly used in social care agencies. This scoping review examined the research literature to identity practical knowledge relevant to social care agencies introducing IS. Selected studies documented elements of practical knowledge, though this was not the direct focus of any individual article. A synthesis of the 50 selected studies into a themed matrix highlighted the practical knowledge gap for social care agencies, and community service agencies in particular. This review identified two features critical to generating relevant practical knowledge: the participatory role of the researcher-designer, and the active role of IS participants.