Health Communication in Neonatal Intensive Care: Results of Focus Groups or Interviews with Parents, Nurses and Physicians

Background and Purpose: Health communication interventions to successfully promote satisfaction with care among parents in the Neonatal Intensive Care Unit (NICU) are limited. This study investigated strategies for effective health communication in the NICU through focus groups with parents and nurses, and individual interviews with neonatologists. Methods: Eight parents, seventeen nurses, and three neonatologists from one NICU in Genesee County, Michigan participated. Results: Parents expressed a preference for daily, face-to-face communication with the physician. They recommended the use of visual aids to help with understanding infants� conditions. One such aid would be a baby diary to serve as the infant�s daily progress report for the parent to review during the visit. A communication strategy used by nurses was providing parents with the most up-to-date information in an approachable, reassuring manner. Physicians suggested interactive communication practice sessions as strategies to increase effective communication between physicians and parents. Physician-to-nurse strategies consisted of building trustworthy relationships by holding scientific forums, discussing health care disagreements, and accepting differing opinions. Conclusion: Future research may assess the influence of strategies recommended in this study on parental satisfaction with care and adherence to treatment recommendations as well as on health care provider self-efficacy

Growing old in a transnational social field: belonging, mobility and identity among Italian migrants

This article focuses on ageing in transnationalism. Drawing on the experiences of Italians in the UK as a paradigmatic example of settled European migrants, it explores the lived experiences of this group of older migrants. Using Levitt and Glick Schiller’s framework,it concentrates first on migrants’ways of being and then on their ways of belonging. The article argues that a transnational lens is necessary to understand the experiences of older migrants and that a focus on older people needs to be incorporated into studies of transnationalism. Through a discussion of their narratives and experiences, the article offers a long view on the migration process and brings attention to the significance of gender, time and the life course to understand both migrants’transnationalism and their integration

The Making Assessment Count (MAC) consortium- maximising assessment and feedback design by working together

The Making Assessment Count (MAC) project started at the University of Westminster in 2008. It sought to align staff and student expectations of feedback and support greater use of feed-forward approaches. A baseline analysis of staff views in the School of Life Sciences suggested that students did not make strategic use of the feedback they received. A similar analysis of the student position revealed that as a group they felt that the feedback provided to them was often insufficiently helpful. To address this dichotomy, a MAC process was developed in the School of Life Sciences and trialled with a cohort of about 350 first year undergraduate students. The process was based on a student-centred, three-stage model of feedback: Subject specific, Operational, and Strategic (SOS model). The student uses the subject tutor’s feedback on an assignment to complete an online self-review questionnaire delivered by a simple tool. The student answers are processed by a web application called e-Reflect to generate a further feedback report. Contained within this report are personalised graphical representations of performance, time management, satisfaction and other operational feedback designed to help the student reflect on their approach to preparation and completion of future work. The student then writes in an online learning journal, which is shared with their personal tutor to support the personal tutorial process and the student’s own development plan (PDP). Since the initial development and implementation of the MAC process within Life Sciences at Westminster, a consortium of universities has worked together to maximise the benefits of the project outcomes and collaboratively explore how the SOS model and e-Reflect can be exploited in different institutional and subject contexts. This paper presents and discusses an evaluation of the use of the MAC process within Life Sciences at Westminster from both staff and student perspective. In addition, the paper will show how the consortium is working to develop a number of scenarios for utilisation of the process as a whole as well as the key individual process components, the SOS model and e-Reflec

Knowledge, confidence, and reported behaviors that promote safe water drinking among women of reproductive age

IntroductionDrinking lead contaminated water during pregnancy is associated with infant mortality. All women of reproductive age are advised by health agencies to adhere to healthy behaviors due to the chance of unintended pregnancy. Our objectives are to understand knowledge, confidence, and reported behaviors that promote safe water drinking and prevent lead exposure among women of reproductive age.MethodsA survey among females of reproductive age from the University of Michigan - Flint was administered. A total of 83 females who wished to become pregnant one day participated.ResultsLow levels of knowledge, confidence, and reported preventative health behaviors related to safe water drinking and lead exposure prevention existed. Specifically, 71.1% of respondents (59 of 83) were not at all or were somewhat confident in their ability to choose an appropriate lead water filter. Most participants rated their knowledge on how to decrease exposure to lead during pregnancy as poor/fair. No statistically significant differences were detected between respondents residing inside and outside of the city of Flint, Michigan for most variables assessed.ConclusionWhile the small sample size is a limitation, the study adds to an area of scarce research. Despite widespread media attention and resources directed toward reducing the negative health effects of lead exposure following the Flint Water Crisis, significant gaps in knowledge related to safe water drinking remain. Interventions are needed to increase knowledge, confidence, and healthy behaviors that promote safe water drinking among women of reproductive age

Developing Capacity for the American Indian Health Professional Workforce: An Academic-Community Partnership in Spirit Lake, North Dakota

Background: American Indians/Alaskan Native (AIAN) populations experience significant disparities in health when compared to the average US population who are under-represented in the health care professional workforce. Current research suggests that racial concordance between patients and providers has a positive effect on patient care. Objective: We describe a successful academic-community partnership between a tribal college, a local state academic center, an urban public health institution, and an urban academic center all aligned with the goal to increase AIAN health care professional capacity. Methods: A tribal college course and youth education program were developed with the intent to expose AIAN youth to the health care professions and encourage entry into health professional career tracks. Evaluation using a pre- and post-survey design is underway to assess the impact of the intervention on participating AIAN attitudes and career intentions. Conclusion: We believe this model is one way of addressing the need for an increased AIAN health care professional career force

Comparing the Clinical and Histological Diagnosis of Leprosy and Leprosy Reactions in the INFIR Cohort of Indian Patients with Multibacillary Leprosy

Leprosy affects skin and peripheral nerves. Although we have antibiotics to treat the mycobacterial infection, the accompanying inflammation is a major part of the disease process. This can worsen after starting antibacterial treatment with episodes of immune mediated inflammation, so called reactions. These are associated with worsening of nerve damage. However, diagnosing these reactions is not straightforward. They can be diagnosed clinically by examination or by microscopic examination of the skin biopsies. We studied a cohort of 303 newly diagnosed leprosy patients in India and compared the diagnosis rates by clinical examination and microscopy and found that the microscopic diagnosis has higher rates of diagnosis for both types of reaction. This suggests that clinicians and pathologists have different thresholds for diagnosing reactions. More work is needed to optimise both clinical and pathological diagnosis. In this cohort 43% of patients had Borderline Tuberculoid leprosy, an immunologically active type, and 20% of the biopsies showed only minimal inflammation, perhaps these patients had very early disease or self-healing. The public health implication of this work is that leprosy centres need to be supported by pathologists to help with the clinical management of difficult cases

Infections in relapsed myeloma patients treated with isatuximab plus pomalidomide and dexamethasone during the COVID-19 pandemic: Initial results of a UK-wide real-world study

© 2022 The Authors. Published by Taylor & Francis. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1080/16078454.2022.2082725Objectives There are no real-world data describing infection morbidity in relapsed/refractory myeloma (RRMM) patients treated with anti-CD38 isatuximab in combination with pomalidomide and dexamethasone (IsaPomDex). In this UK-wide retrospective study, we set out to evaluate infections experienced by routine care patients who received this novel therapy across 24 cancer centres during the COVID-19 pandemic. Methods The primary endpoint was infection morbidity (incidence, grading, hospitalization) as well as infection-related deaths. Secondary outcomes were clinical predictors of increased incidence of any grade (G2–5) and high grade (≥G3) infections. Results In a total cohort of 107 patients who received a median (IQR) of 4 cycles (2–8), 23.4% of patients experienced ≥1 any grade (G2–5) infections (total of 31 episodes) and 18.7% of patients experienced ≥1 high grade (≥G3) infections (total of 22 episodes). Median time (IQR) from start of therapy to first episode was 29 days (16–75). Six patients experienced COVID-19 infection, of whom 5 were not vaccinated and 1 was fully vaccinated. The cumulative duration of infection-related hospitalizations was 159 days. The multivariate (MVA) Poisson Regression analysis demonstrated that a higher co-morbidity burden with Charlson Co-morbidity Index (CCI) score ≥4 (incidence rate ratio (IRR) = 3, p = 0.012) and sub-optimal myeloma response less than a partial response (<PR) (p = 0.048) are independent predictors of ≥ G3 infections. Conclusion Our study described initial results of infection burden during IsaPomDex treatment. We recommend close monitoring particularly in elderly patients with co-morbidities, the effective use of an-infective prophylaxis, as well as optimal vaccination strategies, to limit infections