Health Units Research Articles

Epidemiological analysis of cardiac risk factors in elderly people

This study analyzed cardiac risk factors found in older adults, highlighting the increased incidence of cardiovascular diseases with advancing age. A total of 372 elderly individuals were evaluated at Basic Health Units, and divided into sedentary and active groups. Research emphasized the importance of physical activity in reducing cardiovascular risk, using the Framingham Score to identify high cardiovascular risk and to guide interventions. The sociodemographic analysis included age group, ethnicity, marital status, education, income, and family history of diseases. Bayesian inferences were conducted to assess the number of simultaneous changes in variables and calculate the proportion of individuals with potential cardiac risk. The final conclusion of Bayesian inferences indicates that approximately 29.0% of individuals in the sample may bear potential cardiovascular risk due to two or more alterations in the evaluated variables.

Does broad autism phenotype traits effect mother-child interaction?: a cross-sectional study from Turkey

Objectives Broad Autism Phenotype (BAP) is defined as personality, social, and language features that parallel the defining behavioral characteristics of autism spectrum disorder, including social deficits, communication abnormalities, and stereotyped repetitive behavior. The objective of this study was to assess the impact of maternal BAP characteristics on the dynamic interaction between mothers and their children. Methods Children aged 12–60 months who were referred to the Infant Mental Health Unit of our outpatient clinic were analyzed. Forty-one children who were diagnosed with autism and 35 children who were diagnosed with global developmental delay (GDD) and their mothers were included in the study. The Parent–Infant Relationship Global Assessment Scale (PIR-GAS), Autism-Spectrum Quotient (ASQ), Parental Acceptance–Rejection Questionnaire, and Recognition of Emotional Maltreatment Scale (REMS) were used. Results The PIR-GAS score was significantly lower in the autism group than in the GDD group, and mothers of children with autistic children exhibited higher BAP scores. Conclusions Our study suggests a link between maternal BAP scores and the quality of mother-child relationships. Further studies are needed to examine and improve our ability to evaluate the effects of parental BAP in terms of parental intervention effectiveness.

Situational diagnosis carried out at ESF 303

The Family Health Strategy (ESF) is crucial to expanding health coverage. This study, carried out by the second term of the Medicine course at the Centro Universitário de Goiatuba, analyzed the Family Health Strategy - 303, in Goiatuba, through situational diagnosis, which assesses the health conditions of a population, allowing us to know the challenges experienced in that place and plan strategic actions for possible improvements. Goiatuba, in Goiás, has 13 Family Health Units serving 35,664 inhabitants. Data from the health unit was collected and analyzed, including interviews with the preceptor and nurses, as well as site visits. A prevalence of cases of hypertension, diabetes and schizophrenia was observed, as well as structural weaknesses such as the lack of a vaccination room, a preventive care room, problems in the dental office and the absence of a full team of collaborators. These factors hamper the efficiency of the service and the quality of care. Pamphlets were distributed and an awareness campaign on healthy lifestyles was carried out, encouraging healthy eating, physical exercise and structural improvements to the unit were suggested, such as implementing psychological counseling. The research highlighted the importance of situational diagnosis in order to understand the reality of local health and implement more effective actions aimed at serving the entire population.

Perspectives of Mental Health Nurses About Sexual Safety in Acute Inpatient Mental Health Units.

The overall aim of this study is to explore the views of mental health nurses (MHNs) about the sexual safety of consumers receiving care in acute inpatient units. In Australia, people accessing mental health inpatient units have reported feeling unsafe while receiving care including experiences of sexual harassment and abuse from other patients. There has been no study to date that has explored the views of the MHNs providing care. An explorative descriptive qualitative study. Data were collected through semi-structured interviews involving n = 8 MHNs working on a metropolitan acute inpatient unit recruited using purposive convenience sampling. Data were analysed using thematic analysis. The findings of this study highlighted the themes of 'It's everyone's job to keep the patient safe', 'Going over expectations', 'Impact on patients' and 'Built environment'. Participants in this study believed that the sexual safety of patients in the inpatient unit is everyone's responsibility and that it was important during the admission process to ensure patients are aware of how to both seek help if needed and ensure that their actions or behaviours do not pose sexual safety concerns in others. Ensuring sexual safety in the mental health inpatient units is a complex issue that requires evidence-based multipronged interventions involving all key stakeholders within the units.

Strategic Planning for Post-Earthquake Health Services Continuity: Leveraging Family Healthcare Centers in Istanbul

Abstract Earthquakes, known for their widespread devastation, annually inflict catastrophic consequences globally. Swift and well-structured healthcare responses following earthquakes are pivotal in reducing their impact and mitigating loss of life. However, achieving this demands proactive strategic planning and effective preparedness before disaster strikes. While countries craft disaster response plans, their implementation often proves inadequate in managing the ensuing crisis comprehensively. This study proposes a paradigm shift by advocating for the utilization of widely accessible Family Health Centers (FHCs) as crucial hubs for post-earthquake healthcare continuity. Focused on these community-centric health units, our research delineates a strategic blueprint ensuring uninterrupted health services post an Istanbul earthquake. Integrating SWOT analysis, balanced scorecard, and operations research, this study holistically assesses the current landscape of FHCs and identifies imperative post-earthquake requisites. Insights gleaned from extensive literature review and expert consultations underpin this multifaceted approach.

Ticks and lyme disease in natural areas: A segmentation analysis of visitor perceptions of risk and preferred communication strategies

Reported Lyme disease cases have been rapidly increasing globally in recent years. Despite this, few studies have explored how the public perceives health risks associated with ticks and Lyme disease, especially within the context of visitor experiences in natural areas. To address this knowledge gap, we conducted a survey of visitors to one of Ontario, Canada’s most visited provincial parks. Despite high perceptions of risk, few visitors feel sufficiently educated about ticks and Lyme disease. Further, only 51% of visitors would return to the park if future regional incidents of tick-borne illnesses increased by 10–30% (under climate change). Interestingly, no significant correlations were uncovered between home distance and tick-related risk perceptions or self-reported tick education levels. These results may be indicative of the normalization of tick-related risk throughout many of southern Ontario’s most populated regions. Finally, our results also revealed that there is no preferred “one-size-fits-all” risk communication strategy that can be used to support risk-reducing behaviour change in a natural areas context. We recommend a diversity of evidence-based, on-site, and off-site strategies, that can be considered by governing authorities not only in Canada but indeed globally to reduce tick-related health and safety risks and ultimately safeguard visitor experiences in natural areas subject to increasing tick prevalence. Management ImplicationsManagement Implications: The expanding range of ticks and increasing cases of Lyme disease are presenting significant risks to those who visit natural areas, requiring increasing management attention and action by governing authorities, including park managers and regional health units. Through a mixed-methods approach, we examined park visitor perceptions, behaviours, and preferred communication strategies regarding tick and Lyme disease risk. The results revealed a number of key findings, including:•While risk perceptions of tick bites are high, few visitors feel sufficiently educated about ticks and Lyme disease;•Only 51% of visitors would return to the park if future regional incidents of tick-borne illnesses increased by 10–30% (under climate change);•Visitors with further travel distances were significantly less likely to return to the park after experiencing an in-park tick bite; and,•There is no preferred “one-size-fits-all” risk communication strategy within a park visitor context.

Kegiatan Skrinning Tekanan Darah Dan Penyakit Hipertensi Pada Populasi Usia Produktif Di Sekolah SMA Kalam Kudus II, Kelurahan Duri Kosambi, Jakarta

Hypertension is a condition where a person's blood pressure exceeds normal limits. In order to detect hypertension and provide health education, this community service activity evaluates the basic characteristics and blood pressure of men and women of productive age at Kalam Kudus II High School, Duri Kosambi Village, Jakarta. A total of 68 respondents participated, consisting of 26 men (38.2%) and 42 women (61.8%), with the majority being in the 18-35 year age group (52.9%). The results showed that 77.9% of respondents had normal systolic blood pressure and 82.4% had normal diastolic blood pressure. However, 22.1% of respondents experienced systolic hypertension and 17.6% experienced diastolic hypertension, with the highest prevalence in the 51-64 year age group. These findings emphasize the importance of early detection and health education about hypertension to prevent serious complications such as stroke and heart disease. Prevention can be done by changing lifestyle, such as exercising, avoiding smoking and alcohol, and consuming foods high in fiber and low in salt. Collaboration with schools and health units is very important for regular monitoring and comprehensive education. This community service activity aims to increase awareness and quality of life for individuals of productive age through prevention and early screening for hypertension.

Supporting Ontario public health units to address adverse childhood experiences in pandemic recovery planning: A priority-setting exercise

BackgroundAdverse childhood experiences (ACEs) are potentially traumatic exposures experienced during childhood, for example, neglect. There is growing evidence that the coronavirus disease 2019 (COVID-19) pandemic and related socioeconomic conditions contributed to an increased risk of ACEs. As public health programs/services are re-evaluated and restored following the state of emergency, it is important to plan using an ACEs-informed lens. The aim of this study was to identify and prioritize initiatives or activities that Public Health Ontario (PHO) could undertake to support Ontario public health units’ work towards ACEs-informed pandemic recovery plans.MethodsThe Child Health and Nutrition Research Initiative method was adapted to conduct a priority-setting exercise (May–October 2022). Two online surveys were administered with members of the Healthy Growth and Development (HGD) Evidence Network, comprised of public health unit staff working in child and family health/HGD from Ontario’s 34 public health units. In the first survey, participants were asked to propose activities or initiatives that PHO could undertake to support Ontario public health units’ work towards ACEs-informed planning. In the second survey, participants were asked to score the final list of options against pre-determined prioritization criteria (for example, relevance). Responses were numerically coded and used to calculate prioritization scores, which were used to rank the options.ResultsIn all, 76% of public health units (n = 26) responded to the first survey to identify options. The 168 proposed ideas were consolidated into a final list of 13 options, which fall under PHO’s scientific and technical support mandate areas (data and surveillance, evidence synthesis, collaboration and networking, knowledge exchange and research). A total of 79% of public health units (n = 27) responded to the follow-up survey to prioritize options. Prioritization scores ranged from 76.4% to 88.6%. The top-ranked option was the establishment of a new provincial ACEs community of practice.ConclusionsOver three quarters of public health units contributed to identifying and ranking 13 options for PHO to support public health units in considering and addressing ACEs through pandemic recovery planning. In consultation with the ACEs and Resilience Community of Practice, recently formed on the basis of this exercise, PHO will continue to use the ranked list of options to inform work-planning activities/priorities.

Prevalence and characteristics of anemia in patients with diabetes mellitus aged 50 or older in health unit area of Cadiz (Spain)

BackgroundAnemia is a common comorbidity in patients with diabetes mellitus (DM), particularly in older adults. However, there is a lack of data on the prevalence and the characteristics of anemia in this population in Spain. ObjectiveTo describe the prevalence and the characteristics of anemia in patients with DM aged 50 or older (PDM50) in a healthcare district in the province of Cádiz. MethodsA retrospective cross-sectional study was conducted that included outpatient’s laboratory tests (OLT) performed over 30 months at PDM50. ResultsThe prevalence of anemia was 29.9% (95% CI: 28.7%–31.1%), predominating in women (33.3% vs 26.7%; P < 0.01), in older people stratified by decades (61.7% in 9th decade vs 12% in 5th decade; P < 0.01), and in those with kidney disease (44.7% vs 28%; P < 0.01). Most cases were mild (68.3%), normocytic (78.7%), and hypochromic (52%). Similarly, moderate-to-severe anemia was more frequent in women (39% vs 23%), their prevalence increased with age (45% in the 9th decade vs 24% in the 5th decade), and with the progression of kidney damage, either measured by a decreased glomerular filtration rate (GFR) (49% in G4 vs 25% in G1), or the presence of albuminuria (P < 0.01). No association was found between DM control, based on glycated hemoglobin (HbA1c), and anemia in either sex (P = 0.887). ConclusionThis study describes a high prevalence of anemia in PDM50, particularly in women, in the most advantageous people and in the presence of kidney disease, even in early stages, highlighting the clinical importance of this coexistence.

Efforts to Increase Knowledge of Clean and Healthy Living

Clean and Healthy Living Behavior (PHBS) is an action taken to improve individual and community health through daily habits that support cleanliness and health. This empowerment aims to understanding of PHBS through educational programs involving lectures, discussions and questions and answers. This program was held on 23-24 September 2023 and was attended by 57 grade 7 students. The pre-test and post-test results showed an increase in students' knowledge from an average score of 6.49 to 8.91, indicating the effectiveness of the educational program in increasing awareness and knowledge about PHBS. The main emphasis in this program is the importance of washing hands properly to prevent disease, as well as the role of a clean school environment in supporting student health and learning achievement. The research conclusion shows that education about PHBS is effective in increasing students' knowledge, which in turn can contribute to creating a healthier school environment and supporting learning achievement. Support from families and schools, as well as the active role of the School Health Unit (UKS), is very important in maintaining and improving clean and healthy living behavior among students.

A market intelligence model for the health care business system

Health in Brazil is an old problem that has worsened with the Covid-19 pandemic and resources have become scarce. Studying market behavior and growth trends has become fundamental. This research aims to build a Market Intelligence Model, based on information obtained from official secondary data sources, using the Fuzzy logic methodology. The concepts of Data Analytics and Decision Making applied in the Health Area are addressed. The model was developed in RSdudio software, stored in SQL Database, and presented in Power BI and QGis. The model was validated in private health units in the southeast and northeast regions of Brazil for the treatment of chronic diseases, mainly in the areas of nephrology and oncology. The results were obtained, and it can be concluded that the proposed model has become very effective in estimating the growth of chronic diseases.

The Hospital Burden of Flu in Italy: a retrospective study on administrative data from season 2014–2015 to 2018–2019

BackgroundEvery year in Italy, influenza affects about 4 million people. Almost 5% of them are hospitalised. During peak illness, enormous pressure is placed on healthcare and economic systems. This study aims to quantify the clinical and economic burden of severe influenza during 5 epidemic seasons (2014–2019) from administrative claims data.MethodsPatients hospitalized with a diagnosis of influenza between October 2014, and April 2019, were analyzed. Clinical characteristics and administrative information were retrieved from health-related Administrative Databases (ADs) of 4 Italian Local Health Units (LHUs). The date of first admission was set as the Index Date (ID). A follow-up period of six months after ID was considered to account for complications and re-hospitalizations, while a lookback period (2 years before ID) was set to assess the prevalence of underlying comorbidities.ResultsOut of 2,333 patients with severe influenza, 44.1% were adults ≥ 65, and 25.6% young individuals aged 0–17. 46.8% had comorbidities (i.e., were at risk), mainly cardiovascular and metabolic diseases (45.3%), and chronic conditions (24.7%). The highest hospitalization rates were among the elderly (≥ 75) and the young individuals (0–17), and were 37.6 and 19.5/100,000 inhabitants/year, respectively. The average hospital stay was 8 days (IQR: 14 − 4). It was higher for older individuals (≥ 65 years, 11 days, [17 − 6]) and for those with comorbidities (9 days, [16 − 6]), p-value < 0.001. Similarly, mortality was higher in elderly and those at risk (p-value < 0.001). Respiratory complications occurred in 12.7% of patients, and cardiovascular disorders in 5.9%. Total influenza-related costs were €9.7 million with hospitalization accounting for 95% of them. 47.3% of hospitalization costs were associated with individuals ≥ 65 and 52.9% with patients at risk. The average hospitalisation cost per patient was € 4,007.ConclusionsThis retrospective study showed that during the 2014–2019 influenza seasons in Italy, individuals of extreme ages and those with pre-existing medical conditions, were more likely to be hospitalized with severe influenza. Together with complications and ageing, they worsen patient’s outcome and may lead to a prolonged hospitalization, thus increasing healthcare utilization and costs. Our data generate real-world evidence on the burden of influenza, useful to inform public health decision-making.

Variability in public health programming and priorities to address health inequities across public health units in Ontario, Canada.

In 2018, Ontario Public Health Standards were updated to include the foundational Health Equity Standard to guide planning, implementation, and evaluation of public health programs and services. Public health units (PHUs), the regional public health bodies, are now required to address health equity through four requirements: (a) Assessing and Reporting; (b) Modifying and Orienting Public Health Interventions; (c) Engaging in Multi-sectoral Collaboration; and (d) Health Equity Analysis, Policy Development, and Advancing Healthy Public Policies. This qualitative descriptive study explored how the 27 participating PHUs (out of 34) serving urban (N = 10), mixed urban-rural (N = 15), and rural (N = 9) populations addressed the Health Equity Standard. Using document analysis, we inductively and deductively coded the content of 68 PHU Annual Service Plan and Budget Submissions from a 3-year period (2018-2020) received from the 27 PHUs. Emergent categories were organized into the four requirements and one additional emergent theme: Organizational Implementation of Health Equity. The approaches of embedding health equity into PHUs' activities varied across groups. Urban PHUs presented more diverse strategies, including working with a larger number of organizations, and participating in academic research projects. We found more process standardization and greater discussion of capacity building in urban and mixed urban-rural PHUs. Rural PHUs strategically addressed the needs of their diverse populations through relationship building with Indigenous communities. Findings suggest broad implementation of health equity approaches in public health independent of PHUs' geographic size and population dispersion, though strategies and key challenges differ across units.

The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: a cluster-randomized controlled trial.

Treating children with acute malnutrition can be challenging, particularly regarding access to healthcare facilities during treatment. Task shifting, a strategy of transferring specific tasks to health workers with shorter training and fewer qualifications, is being considered as an effective approach to enhancing health outcomes in primary healthcare. This study aimed to assess the effectiveness of integrating the treatment of acute malnutrition by community health volunteers into integrated community case management in two sub-counties in northern Kenya (Loima and Isiolo). We conducted a two-arm non-inferiority cluster-randomized controlled trial across 20 community health units. Participants were children aged 6-59 months with uncomplicated acute malnutrition. In the intervention group, community health volunteers used simplified tools and protocols to identify and treat eligible children at home and provided the usual integrated community case management package. In the control group, community health volunteers provided the usual integrated community case management package only (screening and referral of the malnourished children to the health facilities). The primary outcome was recovery (MUAC ≥12.5 cm for 2 consecutive weeks). Results show that children in the intervention group were more likely to recover than those in the control group [73 vs 50; risk difference (RD) = 26% (95% CI 12 to 40) and risk ratio (RR) = 2 (95% CI 1.2 to 1.9)]. The probability of defaulting was lower in the intervention group than in the control group: RD = -21% (95% CI -31 to -10) and RR = 0.3 (95% CI 0.2 to 0.5). The intervention reduced the length of stay by about 13 days, although this was not statistically significant and varied substantially by sub-county. Integrating the treatment of acute malnutrition by community health volunteers into the integrated community case management programme led to better malnutrition treatment outcomes. There is a need to integrate acute malnutrition treatment into integrated community case management and review policies to allow community health volunteers to treat uncomplicated acute malnutrition.

Competing Risks Model to Evaluate Dropout Dynamics Among the Type 1 Diabetes Patients Registered with the Changing Diabetes in Children (CDiC) Program

Understanding the survival dynamics of registered patients on a disease control program is a vital issue for the success of program objectives. Dropout of registered patients from such a program is a critical issue, hindering the effectiveness of the program. This study aimed to identify the risk factors of dropout of patients who were registered on the Changing Diabetes in Children (CDiC) program, taking a case of Uganda. Survival analysis was done by integrating competing risk of factors associated with attrition from the CDiC program. The data for the study was obtained from patients with type 1 diabetes mellitus (T1DM) registered during 2009-2018 at health units with specialized pediatric diabetes clinics from various regions in Uganda. The study considered follow-up data of 1132 children with T1DM. Our analysis revealed that the Body Mass Index (BMI) significantly influences dropout time, with patients classified as underweight showing higher hazards than those with normal BMI. Moreover, when considering competing risks, dropout hazards increased. Comparing the Cox model with the Fine and Gray model shows the latter exhibiting a smaller AIC value, which indicates its superiority in the time-to-dropout analysis. Thus, utilizing methods that integrate competing risks for CDiC dropout analysis is preferable and recommended for related studies. These findings provide actionable insights for enhancing CDiC program efficacy.

The Utility of Annual Reassessment of the International Working Group on the Diabetic Foot Diabetes-Related Foot Ulcer Risk Classification in the Primary Care Setting—A Cohort Study

Background: We assessed the pertinence of updating the International Working Group on the Diabetic Foot (IWGDF) risk classification yearly in people with diabetes by quantifying the changes in the risk group and its accuracy in identifying those developing an ulcer (DFU) in a primary care setting. Methods: In our retrospective cohort study, we included all people with diabetes with a foot assessment registry between January 2016 and December 2018 in the Baixo Alentejo Local Health Unit. Foot-related data were collected at baseline after one and two years. DFU and/or death until December 2019 were registered. The proportion of people changing their risk status each year was calculated. Accuracy measures of the IWGDF classification to predict DFU occurrence at one, two, and three years were calculated. Results: A total of 2097 people were followed for three years, during which 0.1% died and 12.4% developed a DFU. After two years, 3.6% of the participants had progressed to a higher-risk group. The IWGDF classification presented specificity values superior to 90% and negative predictive values superior to 99%. Conclusion: Foot risk status can be safely updated every two years instead of yearly, mainly for those at very low risk. The IWGDF classification can accurately identify those not at risk of DFU.

Perspectives on competency-based feedback for training non-specialists to deliver psychological interventions: multi-site qualitative study of the EQUIP competency-based approach.

The use of feedback to address gaps and reinforce skills is a key component of successful competency-based mental health and psychosocial support intervention training approaches. Competency-based feedback during training and supervision for personnel delivering psychological interventions is vital for safe and effective care. For non-specialists trained in low-resource settings, there is a lack of standardised feedback systems. This study explores perspectives on competency-based feedback, using structured role-plays that are featured on the Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) platform developed by the World Health Organization and United Nations Children's Fund. Qualitative data were collected from supervisors, trainers and trainees from multiple EQUIP training sites (Ethiopia, Kenya, Lebanon, Peru and Uganda), from 18 key informant interviews and five focus group discussions (N = 41 participants). Qualitative analysis was conducted in Dedoose, using a codebook with deductively and inductively developed themes. Four main themes demonstrated how a competency-based structure enhanced the feedback process: (a) competency-based feedback was personalised and goal-specific, (b) competency-based feedback supported a feedback loop, (c) competency-based feedback supported a comfortable and objective feedback environment, and (d) competency-based feedback created greater opportunities for flexibility in training and supervision. A better understanding of the role of feedback supports the implementation of competency-based training that is systematic and effective for trainers and supervisors, which ultimately benefits the learning process for trainees.

Effect of electrophoretic deposition for selective detection of Pb2+ ions using nitrogen and sulphur-doped reduced graphene oxide

Lead is very hazardous, as it is present in environmental samples, and it causes severe health problems affecting neurological, cardiac, genital, and mental illnesses owing to exposure to even a trace amount. The achievement of selective detection of Pb2+ ions is challenging due to interfering relevant metal ions. Hence, in this work, we have synthesized the Nitrogen and Sulphur N and S-doped reduced graphene oxide (NS-rGO) and fabricated it using electrophoretic deposition (EPD) in glassy carbon electrode (GCE) and Bi film deposition (Bi/EPD-NS-rGO/GCE) for selective detection of Pb2+ ions. The synthesized materials were characterized to confirm their functionalities, elemental analysis, and morphology. Further, the electrochemical behaviours were also carried out through Cyclic Voltammetry (CV) and Electrochemical Impedimetric spectroscopy (EIS) studies. The above-modified electrodes were utilized for selective detection of Pb2+ in the presence of Cd2+ ionsusing the differential pulse anodic stripping voltammetry (DPASV) method. The electrode modified with NS-rGO using the EPD method, along with a thin film of Bi that was electrodeposited, has better and more selective catalytic activity for sensing Pb2+ ions. The linear working response was found to be in the range of 100–2200 nM with a limit of detection (LOD) of 0.180 nM and verified as 144 times lower than the recommended level (26 nM) by World Health Organization (WHO) and United States Environmental Protection Agency (USEPA). The developed sensor was further applied to the selective detection of Pb2+ ions in tap water and river water, and it shows good recovery. The Bi/EPD-NS-rGO/GCE will explore a new pathway for the simple and selective detection of Pb2+ ions.

Monitoring Initiation and Administration of Covert Medication(s) for Service Users in Amber Ward of Millbrook Mental Health Unit, Nottinghamshire Healthcare NHS Foundation Trust: A Re-Audit of Compliance With Maudsley Prescribing Guidelines in Psychiatry

Monitoring Initiation and Administration of Covert Medication(s) for Service Users in Amber Ward of Millbrook Mental Health Unit, Nottinghamshire Healthcare NHS Foundation Trust: A Re-Audit of Compliance With Maudsley Prescribing Guidelines in Psychiatry

Group A streptococcal outbreak in a geriatric mental health unit

We report a group A streptococcal outbreak in a geriatric mental health inpatient unit. Communication with cognitively impaired patients, limitations in adherence to hygiene practices, and communal dining may have facilitated transmission. Settle plates aided in identifying a colonized patient. Rapid access to whole-genome sequencing facilitated assessment and management.