6 research outputs found
The Microbiopolitics of Human-Microbe Relationships: Hospital-Acquired Infection Control in Latvia
Despite infection control being a quintessential element of biomedicine, the problem of hospital-acquired infections (HAIs) is the most common patient safety problem worldwide. Regardless of the high priority on the global health agenda, evidence shows suboptimal results in terms of providing safe healthcare, free from these infections. Healthcare and research responses have focused upon behaviour change of medical personnel and organisational barriers/facilitators to address the gap between how HAI control should and is done.
The research aims to understand the phenomenon of HAI control, by looking at how it is negotiated and navigated within and between different settings and people in Latvia. I achieved this by utilising a conceptual framework of the microbiopolitics of human-microbe relationships and multi-sited ethnographic approach to trace HAI control through media, policy, and hospital settings. In this study, I have offered a recalibration of the HAI problem: instead of scrutinising the imperative of insufficient HAI control, I have steered my research towards ethnographically examining the phenomena of HAI control itself and how it is assembled in the first place.
The study reveals that process of achieving germ-free and safe healthcare goes far beyond the individual and isolated behaviour of compliance and non-compliance with HAI control requirements. Instead, research illustrates the phenomenon of HAI control has local and historical embeddedness and it is an instance of dynamic epistemic and socio-material assemblages of human and non-human entities. The study therefore demonstrates that context- and situational-dependent recognition and understanding of microbes and management of microbial encounters manifest in different approaches to HAI control. Moreover, achieving HAI control not only depends on levels of compliance with HAI control policy but also on the quality of policy itself. As study revealed, HAI control can not only produce recognition and management of HAI risks but also spaces of neglect and exclusion
Role of multidimensional factors in the diagnosis and treatment of tonsillopharyngitis in primary care : a qualitative study
Funding Information: We thank to all GPs for their time and support in this study. Publisher Copyright: Ā© 2022, The Author(s).Background: Tonsillopharyngitis is one of the most frequently observed upper respiratory tract infections, for which antibiotics are prescribed in ambulatory care. In most cases, tonsillopharyngitis is benign and self-limiting, mostly a viral condition. The aim of this study was to explore the diagnostic and treatment process of tonsillopharyngitis by general practitioners and to understand decisions regarding antibiotic prescribing and the factors that shape these practices. Methods/design: This was a qualitative interview study in primary care practices in Latvia. Semi-structured face-to-face interviews were conducted with general practitioners from November 2016 to January 2017. Thematic analysis was applied to identify factors that influence the prescribing practice in a primary care setting in conjunction with a specific context in which the prescriber practices. Results: Decisions and practice of general practitioner are not static over time or context; they occur within an environmental setting influenced by individual factors of general practitioners, the health care system, and practice-specific factors that shape the diagnosis and antibiotic prescribing in the tonsillopharyngitis. Interviewed general practitioners rely primarily on their personal experience, perception, and skills acquired in their practice, which are encouraged by the environment, where the necessary tools and resources are not in place to encourage rational prescribing of antibiotics. Conclusions: General practitionersā decision regarding antibiotic prescribing is an unstable concept that differs between prescribers. The health care system could augment the experience of general practitioners through structural changes such as guidelines, availability of antibiotics, and available antibiotics package size.publishersversionPeer reviewe
The Development of a Screening Tool for Childcare Professionals to Detect and Refer Infant and Toddler Maltreatment and Trauma: A Tale of Four Countries
Abstract: Child maltreatment is considered a pressing social question, compromising the present
and future mental and physical health of one in four children in Europe. While children younger
than three years of age are especially vulnerable, few screening instruments are available for the
detection of risk in this age group. The purpose of this research was to develop a screening tool
for childcare professionals working in public and private daycare settings to support them in the
early identification and referral of infants and toddlers exposed to emotional and physical abuse
and neglect by primary caregivers, to be used in different settings across four European countries:
Belgium, Italy, Latvia, and Hungary. Method: A stratified process was used to create the screening
tool: We started by using Living lab methodology to co-create the screening tool with its final users,
which was followed by testing the tool with a total of 120 childcare professionals from the four
participating countries. Results: During the Living Lab phase, a screening tool with three layers
was developed. The initial layer includes five āred flagsā that signal particular concern and require
immediate action. The second layer is a quick screener with twelve items focused on four areas:
neglect of basic needs, delays in development, unusual behaviors, and interaction with caregivers.
The third layer is an in-depth questionnaire that aids in formalizing a thorough observation of
twenty-five items within the same four areas as the quick screener. After a one-day training session,
120 childcare professionals caring for children aged 0ā3 from four countries assessed the screening
tool and their overall training experience. Childcare professionals reported great satisfaction with
the three-layered structure, which made the tool versatile, and agreed on its content, which was
considered helpful in the daycare setting for the regular evaluation of the behavior of children and
their primary caregivers, thus improving the early observation of change from the normal behavior of
the infant or toddler. Conclusion: The three-layered screening tool was reported as feasible, practical,
and with great content validity by childcare professionals working in four European countries
Genetic biotechnologies in daily practices of medicine
Izmantojot A. Kleinmana piedÄvÄto slimÄ«bas izskaidroÅ”anas modeļu perspektÄ«vu, Å”ajÄ maÄ£istra darbÄ tiek aplÅ«kots, kÄ Ä£enÄtiskÄs biotehnoloÄ£ijas maina veselÄ«bas aprÅ«pes praksÄs iesaistÄ«to puÅ”u attiecÄ«bas un slimÄ«bas skaidrojumus. DarbÄ parÄdÄ«ts Ä£enÄtiÄ·u, Ä£imenes Ärstu un nespeciÄlistu skatÄ«jums uz Ŕīm tehnoloÄ£ijÄm un to vietu medicÄ«nÄ. PÄtÄ«jums atklÄj, ka Ä£enÄtiskÄs saslimÅ”anas tiek marginalizÄtas biomedicÄ«nas modelÄ«, kas, no vienas puses, atklÄj daudznozÄ«mÄ«go biomedicÄ«nas modeļa raksturojumu, taÄu, no otras puses, neleÄ£itimizÄtais statuss biomedicÄ«nas modelÄ« apgrÅ«tina tehnoloÄ£iju iekļauÅ”anos medicÄ«nas ikdienas praksÄs.
AtslÄgas vÄrdi: medicÄ«nas prakses, Ä£enÄtiskÄ testÄÅ”ana, A. Kleinmana slimÄ«bas skaidroÅ”anas modeļi.Drawing upon Arthur Kleinman's explanatory model of illness, this paper explores how biotechnology changes the explanations of disease and influences the relationships of participants of the health care system. This paper shows how geneticists, general practitioners and lay persons form their perspective on these technologies and their place in medical system. The theses argue that genetic diseases become marginalized in the biomedical model, on one hand, revealing the polysemantic character of biomedical model, but, on other hand, displaying the illegitimate status of those technologies in the biomedical model and preventing their incorporation in the everyday medical practices.
Key words: medical practices, genetic testing, Arthur Kleinman's explanatory model of illness
Care When It Counts: Establishing Trauma-Sensitive Care as a Preventative Approach for 0ā3-Year-Old Children Suffering from Trauma and Chronic Stress
Adverse childhood experiences are an important societal concern. Children aged 0ā3 are particularly vulnerable to unpredictable chronic stress due to the critical period for brain development and attachment. Trauma-sensitive care is a preventative approach to reduce the burden of stressful experiences by committing to positive relationships. Professional caregivers are ideally placed to offer trauma-sensitive care; however, earlier research reveals that the tools they need to consciously apply trauma-sensitive care principles are missing. The current study organized living labs (co-creative research method) to present trauma-sensitive care as a preventative approach aimed at children aged 0ā3. Two living labs were organized in Belgium and Hungary, where professional caregivers collaborated to create a protocol that offers guidelines on how to implement trauma-sensitive care. The resulting protocol included a theoretical foundation on trauma as well as a translation of these guidelines into practical recommendations. The protocol was evaluated by incorporating it into a training intervention delivered to 100 professional caregivers from childcare organizations across four European countries. The protocol received positive feedback from participants, with results indicating a self-reported increase in knowledge, attitude and practice of trauma-sensitive care principles. We conclude that this trauma-sensitive care protocol is a promising answer to the needs of professional caregivers working with children aged 0ā3