Health Guidelines Research Articles

Balancing on a slack line - Staffs' experiences of talking about sexuality and sexual health with patients cared for in forensic psychiatry in Sweden.

Sexuality is a central part of being human, however, talking about sexual health is generally avoided in forensic psychiatry. The aim of this qualitative study was to explore how healthcare professionals experience talking about sexuality and sexual health with patients cared for in forensic psychiatry. Individual interviews were conducted with eighteen healthcare professionals from ten different forensic psychiatry care units in Sweden. The interviews were semi-structured, and the data was analyzed with qualitative content analysis. The findings showed the overarching theme "Balancing on a slack line". The conversations the healthcare professionals have about sexuality and sexual health with patients in this setting are affected by forensic psychiatry's dual mission; to provide care and at the same time protect patients and society. These conversations can be about opening up for having responsive conversations, but also closing conversations since the field of sexuality and sexual health is fraught with norms and preconceptions. To be able to conduct these conversations can be a challenge since the professionals can experience uncertainty due to a lack of competence, indicating that knowledge and resources are needed to facilitate conversations. In conclusion, the study indicates that there is a lack of support and structure for performing conversations about sexuality and sexual health in forensic psychiatry care, and there is a need for increased knowledge among healthcare professionals. In order to support staff, the forensic psychiatry services need to acknowledge the national guidelines for sexual and reproductive health and rights and to develop and adapt the local guidelines.

Evaluating Operation Good Food & Beverages, a Black Youth-Driven Public Advocacy Campaign.

Food and beverage (F&B) marketing practices that contradict health guidelines are particularly concerning for children and adolescents, who are developmentally more susceptible than adults to persuasive advertising and to Black communities, due to ethnically-targeted marketing, contributing to higher rates of obesity and other diet-related chronic diseases. Accordingly, here we evaluated Operation Good Food and Beverages (OGF&B), an online social marketing campaign calling for shifting toward more marketing of healthier F&B to Black youth and Black communities. OGF&B was developed and implemented by a multidisciplinary team of academic, advocacy, and advertising partners and active for four months in 2022 during the COVID-19 pandemic. Primary campaign components were social media content (e.g., TikTok, Instagram), and an informational website with a signable petition and a social media toolkit. Our mixed-methods evaluation used qualitative data to contextualize quantitative metrics like online impressions, website visits, and petition signatures. Qualitative data consisted of analysis of social media content and thematic elements from 15 interviews with campaign advisors, youth consultants, and influencers. The campaign achieved 3,148,869 impressions, 3,799 unique website visits, and 1,077 petition signatures. Instagram Reels and content featuring people had higher engagement. Instagram Reels received more likes than static posts or TikTok videos. Interviewees who participated mentioned personal values and community welfare as key motivations. Social media influencers who declined participation noted time constraints and lack of compensation as barriers. Despite pandemic-related restrictions that precluded in-person engagement, this brief campaign implementation period provided useful insights for leveraging OGF&B or similar campaigns.

"Life as We Knew It": Continued Challenges in Getting Up-to-Date COVID-19 Vaccinations Amongst Black and Latinx Michigan Residents.

Minority communities are disproportionately impacted by COVID-19. In Michigan in 2024, 59% of Latinx residents, 46% of Black residents, and 57% of White residents have received at least one dose of the vaccine. However, just 7% of Black residents and 6% of Latinx residents report being up-to-date per CDC definition, versus 13% of White residents. Drawing from protection motivation theory, we aimed to identify barriers to COVID-19 vaccination. Interviews with 24 Black and 10 Latinx Michigan residents self-reported as not up-to-date (n = 15) or up-to-date (n = 19) on COVID-19 vaccines were conducted in 2022-2023. We used a community-based participatory approach in collaboration with 16 leaders from 15 organizations to develop research questions, interview protocols, and methods for data collection and analysis. Thematic coding of interviews was conducted. Findings indicate participants' lack of confidence in the COVID-19 vaccine's efficacy, with those not up-to-date expressing greater doubt. Participants were also concerned about vaccine benefits versus risks, safety, and side effects. Distrust in medicine, confusion about public health guidelines, and conspiracy theories were often reported. Younger unvaccinated individuals cited low health risk as reason to remain unvaccinated. Many participants felt that health education, especially through medical professionals, was beneficial. There is great need for more data to make informed decisions given ongoing lack of understanding of the public health benefits of COVID-19 vaccination. Identifying drivers of vaccine uptake, particularly boosters, in communities of color and developing age-appropriate and culturally responsive interventions to increase vaccination rates are of utmost importance.

Evaluation of the drug-drug interactions management system for appropriate use of nirmatrelvir/ritonavir: a retrospective observational study

PurposeWhile nirmatrelvir/ritonavir (NMV-r) has been positioned as a first-line treatment for mild to moderate COVID-19, it has multiple and significant drug-drug interactions (DDIs). The use of NMV-r in Japan has been limited compared to the United States. This study aimed to describe the distribution of DDIs with NMV-r and their management in patients with COVID-19 under the control of a management system for the appropriate use of NMV-r.MethodsA retrospective observational study was conducted at a Japanese university hospital. The management system included a flowchart for selecting antivirals and a list for reviewing DDI management, based on the National Institutes of Health guidelines and the guidance of the Japanese Society of Pharmaceutical Health Care and Sciences. Patients with mild to moderate COVID-19 and prescribed NMV-r or molnupiravir (MOV) were included. The primary outcome was DDI management practices, including the selected COVID-19 medications. The secondary outcome included the distribution of DDI classification and the 30-day all-cause mortality.ResultsThis study included 241 patients (median age of 60 years, 112 [46.5%] females), of whom 126 and 115 received NMV-r and MOV, respectively. Of the 241 patients, 145 (60.2%) received concomitant medications that have DDIs with NMV-r. All 30 patients with severe renal impairment or insufficient details on concomitant medications received MOV. Forty-nine patients with concomitant medications required alternative COVID-19 therapy consideration due to DDIs, of whom 42 (85.7%) patients received MOV. Eighty-one patients had concomitant medications requiring temporary adjustment, of whom 44 (54.3%) patients received NMV-r, and 42 of these patients temporarily adjusted these concomitant medications. Five patients with concomitant medications that can continued by monitoring the effects/adverse effects, of whom 4 (80.0%) patients received NMV-r. Seventy-six patients without concomitant medications requiring DDI management, of whom 71 (93.4%) patients received NMV-r. The 30-day all-cause mortality for eligible patients was 0.9% [95% confidence interval, 0.1–3.1].ConclusionsMost patients received appropriate antivirals according to the classification of DDIs, and most patients with concomitant medications requiring temporary adjustment received the recommended DDI management. Our management system is effective in promoting the use of NMV-r in the appropriate patients and managing problematic DDIs.

Description Of Nutritional Status In Students Mts Al-Amin Pakis

Adolescents are an age group that is vulnerable to experiencing malnutrition or excess nutrition problems. Teenagers generally carry out higher physical activity compared to other ages, so they require more nutritional fulfillment. However, the incidence of overnutrition in adolescents can also occur due to poor eating habits so that the amount of energy input is greater than the energy expended. The purpose of this study was to describe the nutritional status of students. This type of research is quantitative with an analytical descriptive design on 85 students of MTs Al-Amin Pakis. Data on nutritional status were obtained by measuring the height using a microtoise and the respondent's weight using a mechanical scale. Nutritional status is classified based on the value of the BMI/age z-score table for children aged 5-18 years from the 2011 Indonesian Ministry of Health guidelines. The results of the data analysis obtained the nutritional status category of junior high school students who were involved as the majority of respondents who were in the normal nutritional status category, namely 77 people (90.58%). However, there were still 8 students (9.41%) who were obese.

Health policies and guidelines to promote, protect and support early childhood development: A narrative review.

This comprehensive review examines the pivotal role of health policies and guidelines in promoting, protecting, and supporting early childhood development (ECD). Recognizing the multifaceted nature of ECD, the study explores key elements commonly found in policies that span health, education, social services, and community support. The focus is on creating an integrated approach that ensures the optimal well-being and growth of children during their formative years. The review highlights the significance of maternal and child health care, emphasizing contact toward prenatal and postnatal care for pregnant women and newborns. Nutritional policies center around supporting breastfeeding and ensuring access to nutritious food, laying the foundation for a healthy start in life. Early childhood education programs and parental education initiatives are crucial components, emphasizing cognitive, social, and emotional development from the earliest stages. The review underscores the importance of a holistic perspective, urging the integration of services across sectors to provide a comprehensive framework for ECD. Research-based policies, continuous monitoring, and evaluation mechanisms ensure evidence-driven decision-making and ongoing refinement of strategies. Additionally, the role of legislation and advocacy is highlighted in protecting the rights and well-being of children and advocating for ECD at various levels. In the end, this review highlights the importance of ECD guidelines and health policies as investments that not only help individual children but also enhance societal productivity and general well-being. By prioritizing the early years, policymakers can lay a strong foundation for future health, learning, and success.

Primary care physicians' knowledge and attitudes about obesity, adherence to treatment guidelines and its' association with confidence to treat obesity at the Saudi Ministry of Interior primary health care centers.

Many primary care physicians (PCPs) believed that managing overweight and obesity is essential to their jobs, however, many believe that they were doing it ineffectively, unsatisfying, and had negative attitudes. We conducted this study to explore the knowledge, attitudes and adherence to obesity management guidelines, identify potential barriers that may prevent adherence of PCPs to obesity treatment guidelines. We conducted this cross-sectional study and conducted a questionnaire sent via email to all PCPs in the Ministry of Interior centers in Riyadh, Al-Kharj, AlQassim, Wadi Ad Dawasir, Hail and Tabuk in Saudi Arabia. A total of 119 PCPs participated in the survey, 61 (51.3%) males and 58 (48.7%) females. All respondents (n = 119, 100%) answered correctly that obesity is a disease. Of PCPs surveyed, genetics accounted for 75.6% of the responses as the cause of obesity. 79.8% believed that the best way for patients with obesity to lose weight was to engage in regular physical activity. The majority of PCPs (87.4%) thought that treating obesity should be a top priority, and 88.2% would typically recommend obesity therapy to their patients. Around 68.9% of PCPs thought that it's their patients' responsibility to lose weight. The majority will recommend obesity treatment and 75.6% would talk to their patients about weight concerns, while 60.5% would refer their patients to obesity surgery. There was a positive significant association between higher knowledge and better attitude and better adherence to treatment guidelines. More experienced PCPs were more confident. The most common perceived barrier was the patients' lack of desire to follow obesity treatment. Primary care clinics and PCPs play a crucial role in diagnosing and treating patients with obesity, according to Ministry of Health guidelines on the prevention and management of obesity. PCPs must not only acknowledge obesity as a chronic illness and the possible long-term consequences it may cause, but also provide comprehensive, multi-component interventions that include lifestyle changes, medication, and appropriate referrals for bariatric surgery when needed. Healthcare professionals must form a cooperative relationship with obese patients to ensure that the patients follow treatment protocols.

Effect of Booklet Education and Cadre Assistance on Iron Tablets Consumption among Anemic Pregnant Women in East Jakarta

Background: Anemia during pregnancy significantly increases maternal risk and poor pregnancy outcomes by 1.71-fold. Enhancing pregnant women's knowledge and adherence to health guidelines requires a comprehensive approach. Objectives: This study analyzed the effects of booklet education and cadre assistance on adherence to iron tablet consumption among anemic pregnant women in East Jakarta. Methods: This quasi-experimental study was conducted in 2019 on anemic pregnant women in Makasar Public Health Center, Jakarta. This study comprised three groups: iron-folic acid supplementation only (IF), iron-folic acid supplementation with booklet education (IFB), and iron-folic acid supplementation with booklet education and cadre assistance (IFBA), serving as control, intervention I, and intervention II, respectively. The interventions lasted for three months. Adherence to iron supplementation and knowledge, attitude, and behavior (KAB) regarding anemia were measured. The data were analyzed using ANOVA/Kruskall-Wallis test, Wilcoxon test, and Mc-Nemar test with a significance level of 0.05. Results: There was no difference in the increase of knowledge and behavior regarding anemia among the three groups (p < 0.05) although the behavior score in the IFBA group was significantly higher than in the other two groups. In addition, there was no difference in the percentage of adherence to iron tablet consumption before and after the intervention in the IF, IFB, and IFBA groups (p > 0.05). However, the IFBA group showed an increase of about 41% in adherence. Conclusions: There was no difference in the increase of knowledge and attitude regarding anemia among the three groups, except for behavior. However, the IFBA group showed a significant increase in knowledge, attitude, and behavior after the intervention.

Alignment of contraception use with the ACR reproductive health guidelines in women with systemic lupus erythematosus within the RISE registry

ObjectivesContraception is crucial for safely timing pregnancies in patients with SLE. This study investigated predictors of contraception documentation in patients with SLE, and the alignment of contraception practices with the...

Evaluation of physiological and thermal comfort effectiveness of ceiling fan and table fan during a heat wave

Heat waves are becoming a significant global concern as they have substantial repercussions on human health. Further, the adverse impact of heat waves on health will likely worsen globally. The use of electric fans is an energy-saving and sustainable cooling strategy against heat waves, but current health guidelines discourage fan use during heat waves. Previous research has shown that health guidelines underestimated the evaporative cooling impact of fans. These studies mainly focused on the effects of table fans on various physiological parameters of occupants in hot environments. Nevertheless, the air movement produced by both table fans and ceiling fans may influence the occupants’ physiological and perceptual responses significantly. Hence, the present study investigated the effectiveness of no-fan, table-fan and ceiling-fan conditions during heat waves through an experimental approach. Sixteen healthy young participants were exposed to an air temperature of 41.0 ± 0.5 °C and relative humidity of 35 ± 2 % for 2 hours. The participants’ physiological parameters and perceptual responses were collected. We found that both table and ceiling fans delay the changes in thermoregulatory and cardiovascular strain compared to the no-fan scenario. Moreover, table fans minimize physiological strain and provide greater comfort than ceiling fans. Hence, people should opt for table fans over ceiling fans during heat waves.

Update on the role of S100B in traumatic brain injury in pediatric population: a meta-analysis.

Cranial computed tomography (CT) scan is the most widely used tool to rule out intracranial lesions after pediatric traumatic brain injury (TBI). However, in pediatric population, the radiation exposure can lead to an increased risk of hematological and brain neoplasm. Defined in 2019 National Institute for Health and Care Excellence (NICE) guidelines as "troponins for the brain", serum biomarkers measurements, particularly S100B, have progressively emerged as a supplementary tool in the management of TBI thanks to their capacity to predict intracranial post-traumatic lesions. This systematic review was conducted following the PRISMA protocol (preferred reporting items for systematic reviews and meta-analyses). No chronological limits of study publications were included. Studies reporting data from children with TBI undergoing serum S100B measurement and computed tomography (CT) scans were included. Of 380 articles screened, 10 studies met the inclusion criteria. Patients admitted with mild-TBI in the Emergency Department (ED) were 1325 (80.25%). The overall pooled sensitivity and specificity were 98% (95% CI, 92-99%) and 45% (95% CI, 29-63%), respectively. The meta-analysis revealed a high negative predictive value (NVP) (99%; 95% CI, 94-100%) and a low positive predictive value (PPV) (41%; 95% CI, 16-79%). Area under the curve (AUC) was 76% (95% CI, 65-85%). The overall pooled negative predictive value (NPV) was 99% (95% CI, 99-100%). The measurement of serum S100B in the diagnostic workflow of mTBI could help informed decision-making in the ED setting, potentially safely reducing the use of CT scan in the pediatric population. The high sensitivity and excellent negative predictive values look promising and seem to be close to the values found in adults. Despite this, it must be pointed out the high heterogeneity (> 90%) found among studies. In order for S100B to be regularly introduced in the pediatric workflow for TBI, it is important to conduct further studies to obtain cut-off levels based on pediatric reference intervals.

Facilitators and barriers to implementing successful exclusion among children with shiga toxin-producing Escherichia coli: a qualitative analysis of public health case management records

BackgroundShiga toxin-producing Escherichia coli (STEC) infections are a significant public health concern as they can cause serious illness and outbreaks. In England, STEC incidence is highest among children and guidance recommends that children under six diagnosed with STEC are excluded from childcare until two consecutive stool cultures are negative. We aimed to describe the barriers and facilitators to implementing exclusion and the impact of exclusion policies on young children and their families.MethodsIndividual level data was obtained from a wider study focusing on shedding duration among STEC cases aged < 6 years between March 2018 – March 2022. Data was extracted from England’s public health case management system. The case management system includes notes on telephone conversations, email correspondence and meeting minutes relating to the case. Collected data consisted of free text in three forms: (1) quotes from parents, either direct or indirect, (2) direct quotes from the case record by health protection practitioners or environmental health officers, and (3) summaries by the data collector after reviewing the entire case record. We analysed free text comments linked to 136 cases using thematic analysis with a framework approach.ResultsThe median age of included cases was 3 years (IQR 1.5-5), with males accounting for 49%. Nine key themes were identified. Five themes focused on barriers to managing exclusion, including (i) financial losses, (ii) challenges with communication, engagement and collaboration, (iii) issues with sampling, processing, and results, (iv) adverse impact on children and their families and (v) conflicting exclusion advice. Four themes related to facilitators to exclusion, including (i) good communication with parents and childcare settings, (ii) support with childcare, (iii) improvements to sampling, testing, and reporting of results, and (iv) provision of supervised control measures.ConclusionsQualitative analysis of public health case records can provide evidence-based insights around complex health protection issues to inform public health guidelines. Our analysis highlights the importance of considering wider social and economic consequences of exclusion when developing policies and practices for the management of STEC in children.

Identifying Work-Related Injuries Among Healthcare Workers in Makkah Hospitals, Saudi Arabia: A Cross-Sectional Study in 2024.

Background Work-related injuries (WRIs) are a major occupational health issue among healthcare workers (HCWs) worldwide. HCWs face numerous daily hazards including needlestick injuries, chemical exposures, ergonomic strains, and psychological stressors crucial for their health and healthcare system functionality.In Makkah, Saudi Arabia, healthcare infrastructure advances raise concerns about work-related injuries among HCWs. This study in Makkah hospitals aims to identify, understand, and manage WRIs for improved occupational health guidelines and strategies. Methods This descriptive cross-sectional study on HCWs was conducted at Makkah hospitals using an electronic questionnaire that investigated the demographics, work-related injuries, and occupational hazards. The data collected from the retrieved questionnaires were analyzed using the IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). Results Among 379 enrolled HCWs, 172 (49.3%) were physicians and 89 (19.8%) were nurses; 304 (80.2%) of the total participants knew about occupational safety. The total incidence of WRIs was 67.8%. WRIs were significantly associated with age (P˂0.001), gender (P=0.02), educational level (P˂0.001), profession (P˂0.001), working hours (P˂0.001), and shift time (P˂0.001). Conclusion WRIs were highly prevalent among HCWs with varying rates based on the type of injury and the frequency of injury. WRIs were associated with various factors including age, gender, education, profession, working house, and shift time of the participants.

Nice to know 2: The impact of NICE guidelines on ketogenic diet services in the UK and Ireland - An update.

Ketogenic diet therapy (KDT) has been recommended as a treatment for drug-resistant epilepsy in children and young people since 2012 in the National Institute for Health and Care Excellence Clinical Guidelines for Epilepsies. The Ketogenic Dietitians Research Network completed a survey in 2017 to assess the impact of these guidelines. An online survey was circulated to ketogenic dietitians across the UK and Ireland. The results were compared with those of the 2017 survey. The number of individuals following KDT was 854, comprising an increase of 13% since 2017. Service sizes ranged widely, with 1-74 (median 16) patients on the diet. Of 36 services, 30 had a waiting list, ranging from 2 to 67 (median 9) patients. The classical diet continued to be the most common KDT used (58% of patients). Ten services reported use of a new flexible medium chain triglyceride protocol. Some 48% of patients (n = 427) had been following the KDT for over 2 years, comprising an 18% increase since 2017. Of these, 68 (15.9%) had attempted to wean off KDT but had to re-start as a result of a deterioration in seizures. The number of individuals following medical KDT remains stable. Referral numbers and waiting lists remain high, highlighting that KDT is still a well-recognised treatment option for drug-resistant epilepsy. The types of KDT used are similar to previous years, although increasingly flexible protocols are being adopted. Longer-term use of KDT is increasing, with a proportion of patients requiring long-term use to maintain seizure control.

Stakeholder Insights on Malaria Elimination Strategies in Pangandaran, West Java: a Qualitative Analysis

Indonesia has launched a determined effort to eliminate malaria by 2023, focusing on Java and Bali. Despite these efforts, Pangandaran in Java still faces malaria cases. This study aims to meticulously delve into the intricacies of the malaria elimination program's implementation while conducting a comprehensive evaluation of its effectiveness. Structured interviews were conducted with key stakeholders responsible for the malaria program in Pangandaran to extract invaluable insights. The study, carried out in November 2022, followed qualitative research with narrative analysis to reveal nuanced narratives from the participants. Findings from this rigorous analysis revealed a harmonious alignment between the malaria control program in Pangandaran and the Indonesian Ministry of Health guidelines. The strategy to combat malaria vectors in Pangandaran included mosquito net distribution, strategic larvicide application, and educational campaigns like Malaria Awareness Society (MASAMA). The expectation is that the current effective control program will resonate within the Pangandaran community, ultimately leading to the realization of the 2023 elimination target.

A Practical Approach to Tailor the Term Long COVID for Diagnostics, Therapy and Epidemiological Research for Improved Long COVID Patient Care.

The term long COVID (LC) effectively describes the broad long-term disease burden of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infections, encompassing individual suffering and significant socioeconomic impacts. However, its general use hampers precise epidemiological research, diagnostics and therapeutic strategies. Misinterpretations occur, for example, when population surveys are compared to studies using health record data, because both refer to these data as LC. This also emphasizes the need for different terminology. The National Institute for Health and Care Excellence (NICE) rapid guideline differentiates ongoing symptomatic COVID-19 from post-COVID conditions, yet real-world observations challenge these two subgroup definitions. We propose refining the term LC into three subgroups: ongoing symptomatic COVID-19, SARS-CoV-2 induced or exacerbated diseases and post-acute COVID condition. This stratification aids targeted diagnostics, treatment and epidemiological research. Subgroup-specific documentation using the International Classification of Diseases, Tenth Revision (ICD-10) codes ensures accurate tracking and understanding of long-term effects. The subgroup of post-acute COVID condition again includes various symptoms, syndromes and diseases like post-exertional malaise (PEM), dysautonomia or cognitive dysfunctions. In this regard, differentiation, especially considering PEM, is crucial for effective diagnostics and treatment.

Real-world evaluation of early remdesivir in high-risk COVID-19 outpatients during Omicron including BQ.1/BQ.1.1/XBB.1.5

BackgroundA trial performed among unvaccinated, high-risk outpatients with COVID-19 during the delta period showed remdesivir reduced hospitalization. We used our real-world data platform to determine the effectiveness of remdesivir on reducing 28-day hospitalization among outpatients with mild-moderate COVID-19 during an Omicron period including BQ.1/BQ.1.1/XBB.1.5.MethodsWe did a propensity-matched, retrospective cohort study of non-hospitalized adults with SARS-CoV-2 infection between April 7, 2022, and February 7, 2023. Electronic healthcare record data from a large health system in Colorado were linked to statewide vaccination and mortality data. We included patients with a positive SARS-CoV-2 test or outpatient remdesivir administration. Exclusion criteria were other SARS-CoV-2 treatments or positive SARS-CoV-2 test more than seven days before remdesivir. The primary outcome was all-cause hospitalization up to day 28. Secondary outcomes included 28-day COVID-related hospitalization and 28-day all-cause mortality.ResultsAmong 29,270 patients with SARS-CoV-2 infection, 1,252 remdesivir-treated patients were matched to 2,499 untreated patients. Remdesivir was associated with lower 28-day all-cause hospitalization (1.3% vs. 3.3%, adjusted hazard ratio (aHR) 0.39 [95% CI 0.23–0.67], p < 0.001) than no treatment. All-cause mortality at 28 days was numerically lower among remdesivir-treated patients (0.1% vs. 0.4%; aOR 0.32 [95% CI 0.03–1.40]). Similar benefit of RDV treatment on 28-day all-cause hospitalization was observed across Omicron periods, aOR (95% CI): BA.2/BA2.12.1 (0.77[0.19–2.41]), BA.4/5 (0.50[95% CI 0.50–1.01]), BQ.1/BQ.1.1/XBB.1.5 (0.21[95% CI 0.08–0.57].ConclusionAmong outpatients with SARS-CoV-2 during recent Omicron surges, remdesivir was associated with lower hospitalization than no treatment, supporting current National Institutes of Health Guidelines.

Factors influencing long-term care facility performance during the COVID-19 pandemic: a scoping review

BackgroundThe COVID-19 pandemic wreaked havoc on long-term care facilities (LTCFs). Some LTCFs performed better than others at slowing COVID-19 transmission. Emerging literature has mostly described infection prevention and control strategies implemented by LTCFs during the pandemic. However, there is a need for a comprehensive review of factors that influenced the performance of LTCFs in containing COVID-19 spread to inform public health policy.ObjectiveTo build on the existing literature, we conducted a scoping review of factors that influenced LTCF performance during the COVID-19 pandemic using a multidimensional conceptual framework of performance.MethodsWe followed the Joanna Briggs Institute’s methodology for scoping reviews. We queried CINAHL, MEDLINE (Ovid), CAIRN, Science Direct, Scopus, and Web of Science for peer-reviewed literature in English or French published between January 1st, 2020 and December 31st, 2021. Retrieved records were screened for context (COVID-19 pandemic), population (LTCFs), interest (internal and external factors that influenced LTCF performance), and outcomes (dimensions of performance: equity, accessibility, reactivity, safety, continuity, efficacy, viability, efficiency). Descriptive characteristics of included articles were summarized. Dimensions of performance as well as internal (e.g., facility characteristics) and external (e.g., visitors) factors identified to have influenced LTCF performance were presented.ResultsWe retained 140 articles of which 68% were classified as research articles, 47% originated in North America, and most covered a period between March and July 2020. The most frequent dimensions of performance were “efficacy” (75.7%) and “safety” (75.7%). The most common internal factors were “organizational context” (72.9%) and “human resources” (62.1%), and the most common external factors were “visitors” (27.1%) and “public health guidelines” (25.7%).ConclusionsOur review contributes to a global interest in understanding the impact of the COVID-19 pandemic on vulnerable populations residing and working in LTCFs. Though a myriad of factors were reported, a lack of randomized controlled trials makes it impossible to establish causality between the identified factors and LTCF performance. The use of a multidimensional framework can be recommended to evaluate healthcare system performance not merely in terms of efficacy and safety, but alongside other critical dimensions such as efficiency and equity.Trial registrationResearch Registry ID: researchregistry7026

Wildfires impact on PM2.5 concentration in galicia Spain

Wildfire intensity and severity have been increasing in the Iberian Peninsula in recent years, particularly in the Galicia region, due to rising temperatures and accumulating drier combustible vegetation in unmanaged lands. This leads to substantial emissions of air pollutants, notably fine particles (PM2.5), posing a risk to public health. This study aims to assess the impact of local and regional wildfires on PM2.5 levels in Galicia's main cities and their implications for air quality and public health. Over a decade (2013–2022), PM2.5 data during wildfire seasons were analyzed using statistical methods and Lagrangian tracking to monitor smoke plume evolution. The results reveal a notable increase in PM2.5 concentration during the wildfire season (June–November) in Galicia, surpassing health guidelines during extreme events and posing a significant health risk to the population. Regional wildfire analyses indicate that smoke plumes from Northern Portugal contribute to pollution in Galician cities, influencing the seasonality of heightened PM2.5 levels. During extensive wildfires, elevated PM2.5 concentration values persisted for several days, potentially exacerbating health concerns in Galicia. These findings underscore the urgency of implementing air pollution prevention and management measures in the region, including developing effective alerts for large-scale events and improved wildfire management strategies to mitigate their impact on air quality in Galician cities.

The Effects of Parental Food Education on Children's Food Literacy: The Mediating Role of Parent-Child Relationship and Learning Motivation.

Parental food education has been recognized among the important factors influencing children's food literacy; however, the intrinsic mechanisms through which this influence occurs are unclear. In this study, a mediation model was constructed to explore this issue, using the parent-child relationship and learning motivation as mediating variables. In total, 204 children, aged 9-14 years old, responded to questionnaires on parental food education, children's food literacy, the parent-child relationship, and learning motivation, which were used to measure the variables of interest. The results showed that parental food education was significantly and positively related to the parent-child relationship, learning motivation, and children's food literacy; the parent-child relationship was significantly and positively related to learning motivation; and learning motivation was significantly and positively related to children's food literacy. Parental food education influenced children's food literacy in the following two main ways: the mediating role of learning motivation and the chain-mediating roles of the parent-child relationship and learning motivation. In addition, we attempt to explore the moderating role of the teaching stage between parental food education and the parent-child relationship, learning motivation, and children's food literacy. In this paper, we discuss possible guidelines for family food education and children's health based on the findings of the current study.