Public health infection prevention: An analysis of existing training during the COVID-19 pandemic.

OBJECTIVES: In response to the COVID-19 pandemic, agencies and organizations required trainings to support the needs of the public health workforce. To better understand the training resources available, this study identified, organized, and classified infection prevention and control (IPC) training and educational opportunities. STUDY DESIGN: Environmental scan. METHODS: A total of 306 IPC training resources were compiled between January and April 2021. Key themes and topics were identified and compared to the Healthcare Infection Control Practices Advisory Committee's (HICPAC) core IPC practices. RESULTS: Three hundred and six training resources, including webinars, fact sheets, module-based learning activities, infographics, and professional practice guidance materials, were identified. Common themes included proper use of personal protective equipment (e.g., masks, gloves), community reopening guidance, and mass vaccination resources. A large proportion (74.9%) of trainings were under 60 min. Using the HICPAC framework, the most frequently addressed content included standard precautions (40%), leadership support (31.6%), and transmission-based precautions (25.8%). Few trainings addressed performance monitoring and feedback (17.1%). CONCLUSIONS: A wide range of organizations developed IPC-specific content during the pandemic. However, these resources did not address the breadth of knowledge required to implement IPC concepts effectively. The creation of universally applicable IPC core competencies and the development of high-quality IPC education and trainings for public health and the overall responder workforces should be prioritized. Accessible high-quality online and just-in-time trainings are critical for future pandemic and disaster preparedness.

Fulminant meningococcemia in children.

In all respects, the child with fulminant meningococcemia presents a formidable challenge to those who care for him/her. Only with prompt recognition of the disease and immediate institution of intensive treatment can the likelihood of survival be improved and morbidity minimized.

[Integrated treatment for severe mental illness and substance abuse: Effective components of programs for persons with co-occurring disorders.]. / Troubles mentaux graves et abus de substances : composantes efficaces de progammes de traitements intégrés à l'intention des personnes présentant une comorbidité

Traditional approaches to treating clients with co-occurring disorders based sequential or parallel mental health and substance abuse treatments have failed, leading to the development of integrated treatment programs. In this article we define integrated treatment for clients with co-occurring disorders, and identify the core components of effective integrated programs, including: assertive outreach, comprehensiveness, shared decision-making, harm-reduction, long-term commitment, and stage-wise (motivation-based) treatment. The concept of stages of treatment is described to illustrate the different motivational states through which clients progress as they recover from substance abuse: engagement, persuasion, active treatment, and relapse prevention. The stages of treatment have clinical utility for guiding clinicians in identifying appropriate treatment goals matched to clients' motivational states, and selecting interventions based on these goals. By recognizing each client's current stage of treatment, clinicians can optimize outcomes by selecting interventions that are appropriate to the client's current motivational state or stage of treatment, and minimize clients dropping out from treatment. Effective integrated treatment programs for clients with co-occurring disorders differ in the specific services they provide, but share common elements in their philosophy and values. Research documents the beneficial effects of these programs, which bodes well for the long-term prognosis of clients with co-occurring disorders.

Surveying and screening preschool language development in community-focused intervention programmes: a review of instruments.

Preschool language intervention has come increasingly to the fore with the development of community-focused interventions including Sure Start in the UK. Successful intervention methods may well be incorporated into mainstream service delivery, especially in areas of disadvantage. The question of whether such interventions will work and of their impact on children's language development has focused attention on measures of language. This paper distinguishes two reasons for measuring language development: (1) surveying language; and (2) screening language. It goes on to suggest a set of criteria for selecting instruments for these applications. The review includes a wide range of language assessment instruments for preschool children and examines those most likely to be suitable. It suggests a role for paraprofessionals in survey and screening and argues that this may be advantageous in terms of reaching families and thereby achieving high levels of coverage of a population group. Finally, there is a discussion of the implications of such measures in community-focused preschool interventions.

Variation in the process of pediatric asthma care.

In May 1994, the continuous quality improvement team at Hermann Children's Hospital in Houston, TX, began to study the structure, process, and outcome of asthma care for pediatric patients. The team's immediate goals were to identify variation in the treatment of pediatric asthma and to determine the most cost-effective interventions. This article details the team's development of a clinical pathway to reduce variation in patient care; use of the pathway led to a reduction in length of stay and a corresponding reduction in costs.

Improving reproductive health: integrating STD and contraceptive services.

The International Conference on Population and Development held in Cairo in 1994 recommended that family planning (FP) services be expanded, with more attention given to the prevention and treatment of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Although such integration of FP and STD services seems a natural union, historical, philosophical, and structural differences in the two fields pose obstacles to integration in many settings. This paper examines selected experiences with FP/STD integration in the United States and developing countries and reviews practical issues that have application to FP providers, STD prevention programs, and those in general practice. Priority areas for future research include: 1) the usefulness and uses of STD risk assessment in FP populations, 2) the relationship between STD/HIV transmission and use of various contraceptive methods, 3) the feasibility of getting high-risk individuals to use dual methods for pregnancy and STD prevention, and 4) the impact adding STD services will have on training requirements, clinic costs, and quality of care within established FP programs. As clinicians in public and private settings assume more comprehensive roles in the provision of both types of services, program managers can facilitate the process of FP and STD service integration by promoting a focus on meeting the client's reproductive health needs.

The role of self-help programs in the rehabilitation of persons with severe mental illness and substance use disorders.

Substance abuse treatment programs in the United States frequently incorporate self-help approaches, but little is known about the use of self-help groups by individuals with dual disorders. This paper brings together several current studies on the role of self-help programs in treating substance use disorders among individuals with severe mental illness. These studies indicate that only a minority of individuals with dual disorders become closely linked to self-help. Psychiatric diagnosis and possibly social skills are correlates of participation. Dually disorders consumers often experience the use of 12-step philosophy and jargon by mental health professionals as alienating and unempathic. The authors propose suggestions for incorporating self-help approaches into the comprehensive community care of individuals with dual disorders.