Exploration of barriers to screening for domestic violence in the perinatal period using an ecological framework

Aims: To explore Australian healthcare providers' perspectives on factors that influence disclosure and domestic violence screening through the lens of Heise's (1998) integrated ecological framework. Design: This paper reports the findings that were part of a sequential mixed methods study with survey data informing interview questions. Participants for interviews were recruited after expressing an interest after completing surveys, as well as via snowball sampling. Methods: Semi-structured interviews were undertaken in 2017 with 12 practicing healthcare providers delivering care to women in the perinatal period in Greater Western Sydney, NSW, Australia. Data were analysed using Braun and Clarke's (2006) six-step thematic approach. Findings: The findings were framed within Heise's integrated ecological framework under four main themes. The main themes were ‘Ontogenic: Factors preventing women from disclosing’; ‘Microsystem: Factors preventing healthcare providers from asking’; ‘Exosystem: Organizational structures not conducive to screening’; and ‘Macrosystem: Cultural attitudes and socioeconomic influences affecting screening’. Conclusion: Organizational policies are needed for better systems of reminding healthcare providers to enquire for domestic and family violence and mandating this within their practices. Mandatory domestic and family violence education and training that is suitable for the time constraints and learning needs of the healthcare provider is recommended for all healthcare providers caring for perinatal women. Further research is needed in addressing culturally specific barriers for healthcare providers to enquire about domestic and family violence in a culturally appropriate way. Public and Patient Engagement and Involvement in Research (PPEI): No Patient or Public Contribution was embedded into the research reported in this paper as this research was specifically exploring healthcare providers’ perspectives on domestic violence screening within their own practice experience

PROJECTING THE IMPACT OF DEMOGRAPHIC CHANGE ON THE DEMAND FOR AND DELIVERY OF HEALTH CARE IN IRELAND. RESEARCH SERIES NUMBER 13 OCTOBER 2009

Primary care is often the first point of contact with the health care system for people requiring care. Primary care is often thought synonymous with general practitioners, but actually encompasses a large range of different professionals and services including nurses/midwives; physiotherapists; occupational therapists; dentists; opticians; chiropodists; psychologists and pharmacists. The list is not exhaustive, but still gives an indication of the wide range of services that can be grouped under the general heading of primary care. Nonetheless, GPs do have a core part to play in primary care as well as performing the role of ‘gate keeper’ to other health services such as accident and emergency or outpatient care in hospitals. The balance of treatment and referral between general practice and secondary care is, therefore, a very important issue and it has been argued that the under development of primary care services in Ireland in recent decades has contributed, and indeed, may be the most important reason, for the over-crowding of accident and emergency services and long waiting lists for elective procedures in Irish health care (Layte et al., 2007b; Tussing and Wren, 2006)

Workplace gender discrimination in the nursing workforce : an integrative review

Aim: To critically synthesise the literature that explores the experiences of workplace gender discrimination from the perspective of registered nurses. Design: Integrative review. Review Methods: Primary research articles reporting on the experience of workplace gender discrimination towards registered nurses in any setting were eligible for inclusion. Studies were critically appraised for methodological quality using a modified Critical Appraisal Skills Program list. The six phases of thematic analysis proposed by Braun and Clarke (2006) were used to guide the analysis. Data were extracted and coded, and themes were identified according to the review aims and significant findings of each study. Data Sources: CINAHL, MEDLINE, SCOPUS, Cochrane Library, published between January 2012 and June 2022. Results: Twenty studies met the inclusion criteria. Major themes identified were (1) career progression, (2) career interruption, (3) positioning of men in nursing and (4) positioning of women in nursing. Conclusion: This review shows that both men and women in nursing experience workplace gender discrimination; however, the forms and consequences of this discrimination differ substantially by gender. Conclusion: This review shows that both men and women in nursing experience workplace gender discrimination; however, the forms and consequences of this discrimination differ substantially by gender. Implications for the Profession: It is important that the pursuit of greater numerical representation of men in nursing does not result in further reinforcing patriarchal advantage. Professional development for nurse leaders in managing gender issues is recommended. Impact: This integrative review presents current issues on workplace gender discrimination for men and women in nursing. The findings suggest gender roles and norms have an effect on the careers of both men and women in nursing. The time has come to alter restrictive gender norms and to challenge notions of hegemonic masculinity and femininity. Reporting Method: We have adhered to relevant EQUATOR guidelines—PRISMA. No Patient or Public Contribution: For this literature review on workplace gender discrimination for registered nurses, we did not engage members of the patient population, nor the general public

The temporal fragility of infrastructure: Theorizing decay, maintenance, and repair

Recent studies have reconceptualized infrastructure as comprising both material and social processes, thus offering insights into lived experiences, governance, and socio-spatial reordering. More specific attention to infrastructure’s temporality has challenged its supposed inertia and inevitable completeness, leading to an engagement with questions of the dynamics of infrastructure over different phases of its lifespan, and their generative effects. In this paper, we advance these debates through a focus on the processes of decay, maintenance, and repair that characterize such phases of infrastructural life, by exploring how specific infrastructures are materially shaped by, and shape, social, political, and socio-ecological arrangements. Our intervention has two related aims: firstly, to conceptualize decay, maintenance, and repair as both temporal phases of infrastructure’s dynamic materiality and its specific affective conditions; and, secondly, to trace how these phases of infrastructural life rework embodied labor, differentiated citizenship, and socio-ecological relations. We argue that attention to infrastructure's ‘temporal fragility’ elucidates the articulation between everyday capacities and desires to labor, the creation of and demands made by political constituents, and the uneven distribution of opportunities and resources

Routine immunization in Pakistan: comparison of multiple data sources and identification of factors associated with vaccination.

Background: Within Pakistan, estimates of vaccination coverage with the pentavalent vaccine, oral polio vaccine (OPV) and measles vaccine (MV) in 2011 were reported to be 74%, 75% and 53%, respectively. These national estimates may mask regional variation. The reasons for this variation have not been explored. Methods: Data from the Multiple Indicator Cluster Surveys (MICS) for Balochistan and Punjab (2010-2011) are analysed to examine factors associated with receiving three or more doses of the pentavalent vaccine and one or more MVs using regression modelling. Pentavalent and OPV estimates from the MICS were compared to vaccine dose histories from surveillance for acute flaccid paralysis (AFP; poliomyelitis) to ascertain agreement. Results: Adjusted coverage of children 12-23 months of age were estimated to be 16.0%, 75.5% and 34.2% in Balochistan and 58.0%, 87.7% and 72.6% in Punjab for the pentavalent vaccine, OPV and MV, respectively. Maternal education, healthcare utilization and wealth were associated with receiving the pentavalent vaccine and the MV. There was a strong correlation of district estimates of vaccination coverage between AFP and MICS data, but AFP estimates of pentavalent coverage in Punjab were biased toward higher values. Conclusions: National estimates mask variation and estimates from individual surveys should be considered alongside other estimates. The development of strategies targeted towards poorly educated parents within low-wealth quintiles that may not typically access healthcare could improve vaccination rates

Tooling-up for infectious disease transmission modelling.

In this introduction to the Special Issue on methods for modelling of infectious disease epidemiology we provide a commentary and overview of the field. We suggest that the field has been through three revolutions that have focussed on specific methodological developments; disease dynamics and heterogeneity, advanced computing and inference, and complexity and application to the real-world. Infectious disease dynamics and heterogeneity dominated until the 1980s where the use of analytical models illustrated fundamental concepts such as herd immunity. The second revolution embraced the integration of data with models and the increased use of computing. From the turn of the century an emergence of novel datasets enabled improved modelling of real-world complexity. The emergence of more complex data that reflect the real-world heterogeneities in transmission resulted in the development of improved inference methods such as particle filtering. Each of these three revolutions have always kept the understanding of infectious disease spread as its motivation but have been developed through the use of new techniques, tools and the availability of data. We conclude by providing a commentary on what the next revoluition in infectious disease modelling may be