Priority Interventions Research Articles

Community-Based Health Information Systems in Africa: A Scoping Review of Data Generation, Utilization, and Community Empowerment.

The community-based health information system (CBHIS) is a vital component of the community health system, as it assesses community-level healthcare service delivery and generates data for community health programme planning, monitoring, and evaluation. CBHIS promotes data-driven decision-making, by identifying priority interventions and programs, guiding resource allocation, and contributing to evidence-based policy development. This scoping review aims to comprehensively examine the use of CBHIS in African countries, focusing on data generation, pathways, utilisation of CBHIS data, community accessibility to the data and use of the data to empower communities. We utilised Arksey and O'Malley's scoping review methodology. We searched eight databases: PubMed, EMBASE, HINARI, Cochrane Library, Web of Science, Scopus, Google Scholar, and grey literature databases (Open Grey and OAIster). We synthesised findings using a thematic approach. Our review included 55 articles from 27 African countries, primarily in Eastern and Southern Africa, followed by West Africa. Most of the studies were either quantitative (42%) or qualitative (33%). Paper-based systems are primarily used for data collection in most countries, but some have adopted electronic/mobile-based systems or both. The data flow for CBHIS varies by country and the tools used for data collection. CBHIS data informs policies, resource allocation, staffing, community health dialogues, and commodity supplies for community health programmes. Community dialogue is the most common approach for community engagement, empowerment, and sharing of CBHIS data with communities. Community empowerment tends towards health promotion activities and health provider-led approaches. CBHIS utilises both paper-based and electronic-based systems to collect and process data. Nevertheless, most countries rely on paper-based systems. Most of the CBHIS investments have focused on digitisation and enhancing data collection, process, and quality. However, there is a need to shift the emphasis towards enabling data utilisation at the community level and community empowerment.

A Literature Review of Maternal Mortality in the Countryside. What are the Policies and Prevention?

Maternal mortality in rural areas is still high and is a health problem that is a priority for intervention and policy. Various studies have been conducted to create a prevention model and various policies implemented in several countries have been carried out to deal with maternal mortality in rural areas. This study aims to determine the policies and models or concepts of preventing maternal mortality in rural areas. This study is a literature review using the Scopus database. The strategy in finding articles uses PICOS (Population, Intervention, Comparison, Outcome and Study design). 6 articles that fit the criteria and are relevant to the research objectives. Policy and prevention of maternal mortality in rural areas: (1) Fulfillment of health workers, (2) Fulfillment of health facilities, (3) Maternity waiting homes, (4) Community-based continuous training programmes, (5) HEP (Health Extension Program) and HDA (Health Development Army) policies, (6) Health Insurance. The findings of this study indicate that some of the policies and prevention models implemented were successful in reducing maternal mortality in rural areas, so policies and models for preventing maternal mortality can be applied in rural areas.

Setting the Priorities for LGBT+ Research and Intervention Effort in Malaysia Through Community Voices: A Brief Report.

Internationally, there is a growing acceptance of gender and sexuality diversity and acknowledgment of LGBT + identities as health determinants. However, caution is warranted when applying research and intervention priorities from Global North countries to regions where LGBT + identities remain criminalized. In 2024, Malaysia maintains legal stances persecuting LGBT + individuals and shows no intent to address this human rights issue. This study offers an overview of pivotal issues identified by LGBT + communities in Malaysia that urgently require attention and resolution. Data were employed from a large-scale community-based survey: the KAMI Survey that recruited LGBT + participants in Malaysia in late 2023 and descriptive analyses were conducted on the responses of 637 participants (mean age = 27.75). Results revealed key issues deemed 'very important' to address by participants comprised HIV/AIDS, training for healthcare providers, police mistreatment, and discrimination, with more than 80% reporting each of these. When prompted to select a single issue for urgent resolution, three-fifths (61.0%) prioritized 'criminalizing laws affecting LGBT + individuals'. Echoing prolonged advocacy by local LGBT + community organizations, the author emphasizes the need for collective allyship across stakeholders to develop evidence-based practices and policies to address the concerns articulated in this paper.

Contextual determinants of family-driven care implementation in juvenile justice settings

IntroductionEngaging families in behavioral health services is a high priority for juvenile justice (JJ) systems and family advocacy groups. Family-driven care (FDC) enhances family engagement and decision-making power in youth behavioral health services, ultimately, improving youth and family mental health and substance abuse outcomes. Despite the benefits, there is limited guidance on how to integrate FDC into behavioral health care within the JJ system. Therefore, the goal of this study is to understand factors that promoted adoption of FDC the JJ context.MethodsJJ staff and leadership across the state of Georgia participated in surveys and interviews to understand contextual implementation determinants related to the adoption of FDC. Between November 2021- July 2022, 140 JJ staff participated in the survey from 61 unique JJ organizations. In addition, 16 staff participated in follow-up key informant interviews to explain quantitative findings.ResultsBased on a mixed methods analysis, JJ agencies were more likely to implement FDC if they had the following characteristics: (1) presence of site leaders that were strongly committed to family engagement, (2) a shared understanding that family engagement was a top priority, (3) staff training related to family engagement, (4) external partnerships with organizations that serve families, (5) a workplace culture that was supportive of innovation, and (6) presence of family engagement programs that were easier (or more feasible) for staff to implement.DiscussionThis mixed methods study underscores the importance of strengthening these 6 inner and outer setting implementation determinants when preparing to integrate FDC into JJ systems. Findings are used to promote the adoption and delivery of this high priority intervention in a state-level JJ system.

Setting priorities in outpatient cardiovascular care to guarantee equitable access: the case of Tuscany region

Universal healthcare systems orient their actions towards promoting, restoring, and improving public health with a particular focus on the need to guarantee equitable access to care. Unwarranted variation in healthcare delivery poses significant challenges to health systems globally, impacting quality of care, financial sustainability, and equity of access. It is therefore important to assist healthcare management in measuring unwarranted variation in order to prioritise intervention strategies to ensure continuity of care and equity. Through an investigation of geographical variation in visit rates and waiting times, the study identifies vulnerable health districts which need priority interventions for patients with cardiovascular disease in the Tuscany region (Italy). Furthermore, a benchmarking-based method for identifying a quantitative estimate of the supply gap to be reduced is proposed. Results illustrate variation in visit rates and waiting times across local health districts in 2021, with some districts experiencing substantially lower rates and longer waiting times compared to the regional median. To address this gap, two targeted interventions aimed at increasing visit volumes and reduced waiting times through advanced training activities, technology integration, and multidisciplinary collaborations are presented. This study contributes to the topic of unwarranted variation by highlighting the necessity of tailored interventions to address diverse healthcare challenges across heterogeneous geographical areas. As healthcare systems globally navigate evolving complexities, the findings and tools presented here offer valuable guidance for policymakers and managers, aiming towards more equitable, efficient, and responsive healthcare services.

Health-Related Quality of Life Among Irregular Sub-Saharan Migrants in Northern Morocco.

Due to its geographical proximity to Europe, Morocco experiences a significant influx of migrants from neighboring Sub-Saharan African countries. Attempts to cross the Strait of Gibraltar make Northern Morocco a stopover for Sub-Saharan migrants. However, faced with increasingly restrictive measures from European Union countries, many of these migrants are compelled to turn this transit into a prolonged stay in Morocco, often in irregular status and facing challenging socio-economic conditions that threaten their health and their quality of life-related to health. This study aims to assess the level of health-related quality of life and its determinants among irregular Sub-Saharan migrants in Northern Morocco using the 36-Item Short Form Survey (SF-36) measurement scale. A total of 526 irregular Sub-Saharan migrants residing in the cities of Tangier and Tetouan were recruited using snowball sampling. A socio-demographic information sheet and the SF-36 scale were used to collect data. Subsequently, the data were entered and statistically analyzed using Statistical Product and Service Solutions (SPSS, version 21.0; IBM SPSS Statistics for Windows, Armonk, NY). Numerical variables were summarized as mean ± standard deviation and categorical variables as frequency and percentage. Non-parametric tests, including the Mann-Whitney U test and Kendall's Tau-B, were used to measure the association of physical and mental component scores with sociodemographic variables, for a significance level set at p < 0.05. Multivariate logistic regression was conducted to identify factors determining health-related quality of life, using odds ratios (OR) and a 95% confidence interval (CI) for p < 0.05. Participants were aged between 18 and 50 years, with a mean age of 29.7 ± 7.6 years; 80% were single, and the majority were male (63.7%). In terms of education, 57.2% have a secondary level. The physical (PCS = 46.5 ± 9.03) and mental (MCS = 35.5 ± 9.9) summary scores were low. PCS and MCS were lower among subjects aged ≥ 36 years compared to those aged 18-25 years (p = 0.000). Women had lower PCS than men (p = 0.002). The migrants having more than three years in Morocco had lower MCS compared to those recently settled (p = 0.002). PCS and MCS were lower among participants who were assaulted compared to those who were not (p = 0.000). Multivariate logistic regression results showed that age, type of habitat, and assault significantly affected both PCS and MCS scores. Gender is a significant determinant for PCS and duration of stay in Morocco for MCS. The quality of life of Sub-Saharan irregular migrants appears to be low, particularly concerning the mental health component, highlighting the need for priority interventions in this area to improve their health status.

Research &amp; Intervention Priorities for Transition-Age Youth &amp; Young Adults With IDD from the Perspectives of Community Partners

Abstract Date Presented 03/21/24 Transition to adulthood is a significant time for young adults with intellectual and developmental disabilities (IDD). Results of an environmental scan identify the research priorities perceived as important for key stakeholders in transitional services and supports. Primary Author and Speaker: Elizabeth Pfeiffer Contributing Authors: Eva Weiss, Luke D. Tomczuk, Laura Slugg

Combined strategies for green roof incentive policies in Lisbon: Evaluating the potentiality of concession grants and identifying priority intervention areas

Incentive policies to promote new technologies is a strategy often employed by policymakers and governments. In some cities worldwide, mechanisms to encourage the adoption of Green Roofs (GR) have been implemented over the years. Although GR is not a new technology, the use of incentives, such as subsidies and tax abatements and/or exemptions, is still a recent strategy in many countries. The study covered in this paper proposes to explore the potential of combined incentive mechanisms for green roofs, using direct incentives (financial subsidies) and indirect incentives (tax/fee rebates). The granting incentives were verified by the feasibility assessment from both private (saved money) and public perspectives (reduction in municipal revenue) using scenarios of abatement percentages for fees and taxes and combining direct and indirect incentives. In addition, priority intervention areas for the installation of green roofs were defined based on three parameters: (i) the proportion of existing green spaces, (ii) urban heat islands and (iii) the potential of the building stock for green roof retrofit. The results show that granting a combined solution can be an effective option for facilitating the implementation of green roof projects. Moreover, the study serves as a decision support guide for politicians, urban planners, and public managers to formulate incentive proposals and make well-informed decisions regarding the incentive policies for GR.

A Simplified Procedure for the Out-of-Plane Seismic Assessment of Free-Standing URM Elements: Application to the Abandoned Ancient Village of Bussana (Sanremo, Imperia - Italy)

ABSTRACT This paper addresses the safety of connections within urban areas, where free-standing elements that menacingly overlook them are susceptible to potential overturning mechanisms. Such a condition recurs in post-earthquake scenarios and in historical centers abandoned after disasters in seismic-prone areas, which aimed to be restored to create safe pathways for tourists. The paper presents a simplified procedure for the out-of-plane seismic risk assessment of free-standing unreinforced masonry (URM) elements in historical centers. The procedure can be applied to several URM free-standing elements, such as artistic pieces or nonstructural components, but also rocking panels resulting from the collapse of structures in post-event damage scenarios. The procedure is based on the definition of hazard, exposure, and vulnerability, which are combined to assign a risk class to each element and define a priority of intervention. The procedure relies on the kinematic approach but requires a limited number of parameters to be feasible when applied to many elements. Some of them can also be acquired through innovative survey techniques, like unmanned aerial vehicle photogrammetry. To demonstrate its utility, the procedure is applied to the abandoned village of Bussana (Sanremo, Imperia — Italy), severely hit by the 1887 earthquake and partially reoccupied in the 1960s.

Priority Intervention Evaluation of Community Regeneration in Megacities Based on the Business Improvement District (BID) Model: A Case Study of Tianjin, China

This study aims to start from the macroscale of the megacity, explore a top-down operational technical path from the identification of community regeneration units as the evaluation objects to the BID priority intervention evaluation, and then propose differentiated community regeneration strategies based on the BID model. In the post-epidemic era, it is necessary for global megacities to take new measures in urban regeneration to respond to worldwide changes and challenges. As an innovative tool to promote central city revitalization, the BID model has played an important role in community transformation. In the context of the continuous decentralization of population and industry in China’s megacities, it is urgent to explore the technical path to apply the BID model to local community regeneration. Given the shortcomings of existing studies in the method to identify the scope of BID implementation and evaluate intervention priorities, this study takes Tianjin, a megacity in China, as an example and uses DBSCAN (density-based spatial clustering of applications with noise) and service area analysis to define the community regeneration units with commercial agglomeration characteristics as the objects. Then, the BID priority intervention evaluation system is constructed from the two measurement aspects of the intervention potential and the necessity of community regeneration to classify the BID intervention priorities of community regeneration units. The main conclusions are as follows: 1. When the DBSCAN analysis parameters take the minimum number of elements as 30 and the search distance as 120 m, the result is most suitable for identifying community units with commercial agglomeration of the study area; 2. Population vitality, especially working and residential population density, is the key factor affecting BID intervention potential, while road network density is an important indicator for determining the necessity of community regeneration; 3. Community regeneration units with high BID priority levels need to develop differentiated regeneration strategies combining their BID intervention potential, regeneration necessity characteristics, and location attributes. These conclusions can provide references for the governments of megacities to screen and establish BIDs.

Prevention & management of snakebite envenomation: A qualitative study on perspectives & practices in Maharashtra & Odisha.

Background & objectives Snakebite envenoming (SBE) is a major public health concern, with India bearing the highest global burden of SBE-related deaths. SBE is concentrated in rural and tribal regions of India, where the knowledge, attitude and behaviour of the dwelling communities largely influence mortality and morbidity. Understanding these factors is crucial to designing effective SBE prevention and management strategies. The present study's objective was to document the perspectives of community members and practices in selected blocks of Maharashtra and Odisha States regarding SBE prevention, first aid and health-seeking behaviour. Methods Between March and April 2022, 28 focus group discussions (FGDs) were conducted. Study sites included Shahapur block in Thane district, Aheri block in Gadchiroli district of Maharashtra, and Khordha block in Khordha district, Kasipur block in Rayagada district of Odisha. Separate FGDs were held for males (n=14) and females (n=14), involving about 8-16 participants above 18 yr. All discussions were audio recorded, and a grounded theory approach was employed to identify key themes from the translated transcripts. Results The findings of this study revealed a variety of perspectives and practices determining the SBE burden at the study sites. The findings included insufficient knowledge about snake species and their nature of toxicity, use of non-scientific first aid techniques, inaccessible health care and reliance on traditional healers, non-utilization of prevention methods, varied cultural beliefs and practices, and differential treatments based on gender. The findings have been collated in two simplistic frameworks; barriers to effective prevention and barriers to effective management. Interpretation & conclusions SBE burden results from a complex interplay between socioeconomic, cultural, and demographic factors, necessitating a collaborative inter-sectoral effort for adequate control. Through crucial regional inputs and the barriers to prevention and management models, this study provides critical insights and priority intervention areas to strengthen India's upcoming National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE) in all high-burden States.

Considerations on How to Prevent Parkinson's Disease Through Exercise.

The increasing prevalence of people with Parkinson's disease (PD) necessitates a high priority for finding interventions to delay or even prevent the onset of PD. There is converging evidence that exercise may exert disease-modifying effects in people with clinically manifest PD, but whether exercise also has a preventive effect or is able to modify the progression of the pathology in the prodromal phase of PD is unclear. Here we provide some considerations on the design of trials that aim to prevent PD through exercise. First, we discuss the who could benefit from exercise, and potential exercise-related risks. Second, we discuss what specific components of exercise mediate the putative disease-modifying effects. Third, we address how methodological challenges such as blinding, adherence and remote monitoring could be handled and how we can measure the efficacy of exercise as modifier of the course of prodromal PD. We hope that these considerations help in designing exercise prevention trials for persons at risk of developing PD.

Young People's Barriers and Facilitators of Engagement with Web-Based Mental Health Interventions for Anxiety and Depression: A Qualitative Study.

The prevalence of anxiety and depressive symptoms in young people have increased in many countries around the world. Web-based mental health interventions (or W-MHIs) have the potential to reduce anxiety and depression symptoms for young people. Although W-MHIs have become more widely used by young people since the coronavirus disease 2019 (COVID-19) pandemic, real-world engagement in these W-MHIs has remained low compared with engagement reported in research studies. Moreover, there are limited studies examining factors influencing engagement with W-MHIs in the post-COVID-19 pandemic years. This study aims to explore barriers and facilitators of engagement with W-MHIs for anxiety and depression among young people. Seventeen semi-structured interviews and one focus group with three participants were conducted online via Zoom between February and March 2023. Participants were young people aged 18-25 years who had self-reported experience of anxiety and/or depression in the past 6months, lived in Australia, and considered using W-MHIs to manage their anxiety and/or depression symptoms. Inductive thematic analysis was performed to understand the key barriers and facilitators of young people's engagement with W-MHIs. Both individual- and intervention-related factors influenced young people's engagement with W-MHIs. Facilitators of engagement included personal trust and beliefs in W-MHIs, ability to contact a health professional, programme suitability (e.g., affordability, content aligning with user needs), programme usability (e.g., user interface), and accessibility of the online platform. Barriers included concerns about online security, lack of human interaction and immediate responses from health professionals (if any), and negative experience with mental health programmes. Participants expressed greater willingness to pay if they could contact health professionals during the programme. Better promotion strategies for mental health and W-MHI awareness are needed to increase the perceived importance and priority of mental health interventions among young people. Young people should be involved in the W-MHI co-design to enhance the programme suitability and usability for young people, fostering their engagement with W-MHIs.

Eliciting psychiatric nurses' preferences for workplace violence prevention: a protocol for discrete choice experiment.

Workplace violence against healthcare workers has become a serious global public health problem. The incidence of workplace violence towards Psychiatric nurses is higher than in all other medical institutions, up to 84.2% per year. It not only negatively affects many aspects of healthcare workers' lives, but also destroys the harmony of the nurse-patient relationship and reduces the quality of nursing care. The number of psychiatric nurses in China was approximately 96,000, far lower than most other countries and unable to meet the growing demand for mental health. However, the increase in workplace violence has future exacerbates the current shortage of nurses. Therefore, it is necessary to develop effective strategies to prevent psychiatric nurses from suffering from workplace violence, thereby to reduce nurse turnover and improve the quality of nursing care. A comprehensive understanding of psychiatric nurses' preferences and priorities for preventing workplace violence is an important prerequisite before formulating strategies and taking measures. Unfortunately, to date, no research has investigated the psychiatric nurses' preferences. Therefore, a discrete choice experiment (DCE) is conducting to explore the psychiatric nurses' preferences for workplace violence prevention. This article reports on methodological details of the DCE. Six attributes were developed through a literature review, one-on-one interviews and focus group discussions. D-efficient design in NGENE was used to generate choice sets. SPSS 24.0 will be used for descriptive analysis of social Demography, and Stata 16.0 will be used for analysis of DCE data. A multinomial logit model will be used to preliminarily explore trade-offs between workplace violence prevention characteristics included in the choice tasks. Then, in a mixed logit model, we plan to choose some arbitrarily defined base violence prevention program and will use the nlcom command to evaluate the probability of an alternative violence prevention program. The study was approved by the relevant ethics committees. Our findings will emphasize priority intervention areas based on the preferences of psychiatric nurses and provide references for hospitals to develop and improve workplace violence prevention strategies. The results will be shared through seminars, policy briefs, peer-reviewed journal articles and online blogs.

Identification of Priorities for Colorectal Cancer Screening Interventions Among US Hispanic/Latino Populations.

Objectives. To identify nationwide census tract‒level areas where improving colorectal cancer (CRC) screening uptake via targeted local preventive intervention may benefit Hispanic or Latino/a (H/L) groups defined by region or country of origin. Methods. Using 2021 Centers for Disease Control and Prevention PLACES and American Community Survey data, we applied geographically weighted regression and Getis-Ord Gi* hot spot procedures to identify CRC screening priority zones for H/L groups in the United States. Priority zones can be conceptualized as census tracts with strong inverse associations between percentage of a particular H/L group in the population and CRC screening rate, after adjusting for socioeconomic deprivation and lack of insurance. Results. We identified 6519, 3477, 3522, 1069, and 1424 census tract CRC screening priority zones for H/L communities of Mexican, Puerto Rican, Central/South American, Dominican, and Cuban heritage, respectively. Priority zones for H/L groups had strong spatial heterogeneity, and overlap of geographic patterns among H/L groups varied by region. Conclusions. Our findings and interactive web map may serve as a translational tool for public health authorities, policymakers, clinicians, and other stakeholders to target investment and interventions to increase guideline-concordant CRC screening uptake benefitting specific H/L communities in the United States. (Am J Public Health. 2024;114(S6):S515-S524. https://doi.org/10.2105/AJPH.2024.307733) [Formula: see text].

Temporal trends and cohort variations of gender-specific major depressive disorders incidence in China: analysis based on the age-period-cohort-interaction model

BackgroundMajor depressive disorders (MDDs) impose substantial burdens on individuals and society; however, further detailed analysis is still needed for its long-term trends.AimsThis study aimed to analyse the gender-specific temporal trends...

Strategies for reducing the burden of cardiovascular diseases in the United Arab Emirates

This commentary outlines the strategies implemented by the United Arab Emirates (UAE) to reduce the burden of cardiovascular diseases (CVDs) through national health policies and initiatives. These strategies aim to enable sustainable actions for CVDs prevention and control by addressing key risk factors, such as tobacco use, unhealthy dietary habits, and physical inactivity. Assessment of cardiovascular risk is fundamental for early detection and timely treatment. The UAE has reported the availability of essential medicines and basic technologies for preventing heart attack and stroke. Future directions include improving data reporting systems to provide up-to-date statistics on CVDs prevalence and risk factors, including diet, physical activity, body weight, smoking, blood pressure, blood sugar, and cholesterol control. In addition, these efforts will cover data on the quality of care, procedures, and economic costs. Strengthening collaboration between academic research institutes and government policymakers is crucial for shaping the UAE’s research agenda. Key steps to further reduce the burden of CVDs in the UAE include enhancing primary health care and emergency medical services, building health-care worker capacity, and improving the accessibility and affordability of priority interventions.

Identification and Prioritization of Thermal Environment Regulation Hotspots in Chengdu

Temperature condition in urban areas has a substantial impact on the well-being and safety of both urban residents and the ecosystems. Green spaces are crucial for mitigating urban heat impacts, and hence, their balanced supply and demand is essential. Due to rapid urbanization, Chengdu has had a significant increase in population, which has had an impact on the dynamic changes in its green space environment, making it a suitable case for our study. This study employs the high-temperature vulnerability framework to classify urban green spaces as entities that regulate the thermal environment. This classification is based on the analysis of ecosystem service supply and demand. The approach creates an assessment framework for managing the balance between the need for and availability of thermal environment regulation in urban green spaces. The study utilizes matching and a priority index to identify places in Chengdu where there are imbalances between supply and demand for services. Our findings suggest: (1) The demand for regulating the thermal environment in Chengdu’s green spaces is defined by three indices: thermal exposure, thermal sensitivity, and thermal adaptability. High-demand areas account for a relatively small proportion and exhibit a pattern of “global diffusion and local concentration”. (2) The supply capacity in Chengdu is determined by both the size of green spaces and the surface temperature. High-supply capacity areas are mainly located in the southeastern part of the city, and their distribution pattern is similar to that of green spaces. (3) The level of correspondence between the supply and demand in Chengdu varies significantly and can be classified into three categories: “insufficient supply and high demand”, “insufficient supply and low demand”, and “abundant supply and low demand”. Out of these, 32 units are located in the area with a shortage of supply, while 6 units are in the area with a significant imbalance of low supply and high demand. (4) The green space thermal environment regulation in Chengdu is categorized into four priority intervention levels: priority I, II, III, and IV zones. The priority IV zone, which has a high intervention priority level, consists of two units primarily located in the Inner Ring Qingyang, Inner Ring Jinjiang, Cuijiadian, Caotang, and Donghu, which are deemed crucial for needing prioritized regulation.

Social Workers’ Perceptions of the Nature of Child Neglect: A Systematic Literature Review

Abstract Neglect is the most common form of child maltreatment in the UK and the USA. This article reviews research about how child neglect is perceived by social workers. We conducted a systematic review and identified fifty relevant studies, using a range of methodologies, published since the 1989 Children Act. The themes were identified iteratively and synthesised using a narrative method. The review found that despite evidence that neglect is associated with several adverse outcomes, neglect is a lower priority for social work intervention compared to other forms of maltreatment. This is particularly true for emotional neglect and neglect of older children. The review found that social workers conceptualise poverty and neglect as being distinctly different and try to address poverty through practical, non-punitive interventions. However, assessments could better recognise how deprivation exacerbates other risk factors for neglect. The review found a lack of knowledge about perceptions of neglect in adolescents and children with a disability and about the threshold for intervention when neglect is cumulative. Practice may be improved by better recognising and addressing the societal context to neglect allegations and the risk of long-term harm. Achieving this may have resource and training implications.

Vaccinations, cardiovascular drugs, hospitalization, and mortality in COVID-19 and Long COVID

ObjectiveTo identify highest-risk subgroups for COVID-19 and Long COVID(LC), particularly in contexts of influenza and cardiovascular disease(CVD). MethodsUsing national, linked electronic health records for England (NHS England Secure Data Environment via CVD-COVID-UK/COVID-IMPACT Consortium), we studied individuals (of all ages) with COVID-19 and LC (2020-2023). We compared all-cause hospitalization and mortality by prior CVD, high CV risk, vaccination status (COVID-19/influenza), and CVD drugs, investigating impact of vaccination and CVD prevention using population preventable fractions. ResultsHospitalization and mortality were 15.3% and 2.0% among 17,373,850 individuals with COVID-19 (LC rate 1.3%), and 16.8% and 1.4% among 301,115 with LC. Adjusted risk of mortality and hospitalization were reduced with COVID-19 vaccination ≥ 2 doses(COVID-19:HR 0.36 and 0.69; LC:0.44 and 0.90). With influenza vaccination, mortality was reduced, but not hospitalization (COVID-19:0.86 and 1.01, and LC:0.72 and 1.05). Mortality and hospitalization were reduced by CVD prevention in those with CVD, e.g., anticoagulants- COVID:19:0.69 and 0.92; LC:0.59 and 0.88; lipid lowering- COVID-19:0.69 and 0.86; LC:0.68 and 0.90. COVID-19 vaccination averted 245044 of 321383 and 7586 of 8738 preventable deaths after COVID-19 and LC, respectively. InterpretationPrior CVD and high CV risk are associated with increased hospitalization and mortality in COVID-19 and LC. Targeted COVID-19 vaccination and CVD prevention are priority interventions. FundingNIHR. HDR UK.