The association of the quality of life with Afghan households' food insecurity before and after the recent political change in Afghanistan: a comparative analysis.

The overreaching objective of the current study is to investigate the association of quality of life with Afghan households' food insecurity. The data was collected immediately after the Taliban took control of a large part of Afghanistan. About a total of 555 households' heads participated in a face-to-face interview, using the HFIAS and WHOQOL-100 questionnaires along with some questions related to their socioeconomic characteristics at two different times, before and after the Taliban's takeover. The comparative analysis showed that 98% of Afghan households were food insecure after the Taliban takeover, while 70% of them faced food insecurity before the Taliban's takeover. The quality of life in the Taliban era is worse than before the Taliban. All dimensions of quality of life have decreased, and this decrease was more pronounced for the psychological, environmental, and physical domains. It is recommended that international organizations, NGOs, and local agents focus on these dimensions of the quality of life to improve food security.

"If You Can Just Break the Stigma Around It": LGBTQI+ Migrants' Experiences of Stigma and Mental Health.

Migrants, that is people who experience forced displacement or move based on being lesbian, gay, bisexual, trans, two-spirit, queer, and intersex (LGBTQI+), experience increased trauma and stigma when compared to heterosexual and cisgender people. The aim of this paper is to highlight LGBTQI+ migrants' experiences of health and social care encounters in Canada. Gadamerian hermeneutics and an intersectionality lens was used to understand LGBTQI+ migrants' experiences. A total of 16 semi-structured individual interviews were conducted with LGBTQI+ migrants. Themes of stigma and discrimination were identified as (1) "I never went back": Stigma as an exclusionary experience, (2) "Is [your country of birth] really that bad": Fear, safety, and cultural stigma, and (3) "The circle … is not going to fix my life": LGBTQI+ migrants' call for affirming care. Results suggest that health and social care practices are stigmatizing and discriminatory which negatively impacts LGBTQI+ migrant mental health. Salient practices for promoting mental health included affirming LGBTQI+ identities and orientations through health and social care practices that are culturally safe as well as trauma and violence informed.

Student Perspectives of Interprofessional Group Debriefing: Use of the National League for Nursing Guide for Teaching Thinking.

ABSTRACT: This innovative pilot study used the Critical conversations: The NLN Guide for Teaching Thinking monograph to promote critical conversation during debriefing in an interprofessional education group setting following a disaster preparedness simulation. Interprofessional health care students (n = 120) participated in the Debriefing Assessment for Simulation in Healthcare survey as well as four focus groups to understand student perspectives related to the Context, Content, and Course format used to cocreate meaning related to the simulation experience. Findings revealed that use of this method promoted critical dialogue underscored by self-efficacy, critical reflection, safety, group size, and interdisciplinary learning.

Immigrant Women and Mental Health Care: Findings from an Environmental Scan.

Immigrant women's mental health is a growing public health policy issue. New immigrant mothers may be particularly vulnerable to less than optimal mental health following childbirth given the cultural and geographic isolation, socioeconomic factors, gender roles, and language difficulties that influence their postpartum experiences. The purpose of this environmental scan was to increase understanding of immigrant women's perinatal mental health care services within the interior of a western Canadian province. Four interrelated themes emerged to impact postpartum health of immigrant women: (i) community capacity building, (ii) facilitators of mental health support and care, (iii) barriers of mental health promotion and support, and (iv) public policy and postpartum depression. Knowledge gained from this study contributes to healthy public policy and practices that promote mental health and support among immigrant women.

Ebola virus disease in a humanitarian aid worker - New York City, October 2014.

In late October 2014, Ebola virus disease (Ebola) was diagnosed in a humanitarian aid worker who recently returned from West Africa to New York City (NYC). The NYC Department of Health and Mental Hygiene (DOHMH) actively monitored three close contacts of the patient and 114 health care personnel. No secondary cases of Ebola were detected. In collaboration with local and state partners, DOHMH had developed protocols to respond to such an event beginning in July 2014. These protocols included safely transporting a person at the first report of symptoms to a local hospital prepared to treat a patient with Ebola, laboratory testing for Ebola, and monitoring of contacts. In response to this single case of Ebola, initial health care worker active monitoring protocols needed modification to improve clarity about what types of exposure should be monitored. The response costs were high in both human resources and money: DOHMH alone spent $4.3 million. However, preparedness activities that include planning and practice in effectively monitoring the health of workers involved in Ebola patient care can help prevent transmission of Ebola.

When Violence Hits the Religious Home: Raising Awareness about Domestic Violence in Seminaries and amongst Religious Leaders.

The focus of this article by our research team looks specifically at the teaching of domestic violence classes in a seminary or religious context, as well as the ongoing professional education of religious leaders, such as pastors. It also considers ways to introduce therapeutic staff to the unique vulnerabilities of highly religious clients who have been abused or who act abusively. Based on data that we have collected at North American theological seminaries and in congregations, we explain some of the challenges of including instruction about domestic violence in a religious context.

Intervention model for contaminated consumer products: a multifaceted tool for protecting public health.

Lead-based paint and occupational lead hazards remain the primary exposure sources of lead in New York City (NYC) children and men, respectively. Lead poisoning has also been associated with the use of certain consumer products in NYC. The NYC Department of Health and Mental Hygiene developed the Intervention Model for Contaminated Consumer Products, a comprehensive approach to identify and reduce exposure to lead and other hazards in consumer products. The model identifies hazardous consumer products, determines their availability in NYC, enforces on these products, and provides risk communication and public education. Implementation of the model has resulted in removal of thousands of contaminated products from local businesses and continues to raise awareness of these hazardous products.

Extreme heat awareness and protective behaviors in New York City.

Heat waves can be lethal and routinely prompt public warnings about the dangers of heat. With climate change, extreme heat events will become more frequent and intense. However, little is known about public awareness of heat warnings or behaviors during hot weather. Awareness of heat warnings, prevention behaviors, and air conditioning (AC) prevalence and use in New York City were assessed using quantitative and qualitative methods. A random sample telephone survey was conducted in September 2011 among 719 adults and follow-up focus groups were held in winter 2012 among seniors and potential senior caregivers. During summer 2011, 79 % of adults heard or saw a heat warning. Of the 24 % who were seniors or in fair or poor health, 34 % did not own AC or never/rarely used it on hot days. Of this subgroup, 30 % were unaware of warnings, and 49 % stay home during hot weather. Reasons for not using AC during hot weather include disliking AC (29 %), not feeling hot (19 %), and a preference for fans (18 %). Seniors in the focus groups did not perceive themselves to be at risk, and often did not identify AC as an important health protection strategy. While heat warnings are received by most New Yorkers, AC cost, risk perception problems, and a preference for staying home leave many at risk during heat waves. Improving AC access and risk communications will help better protect the most vulnerable during heat waves.

Vulvar dermatitis from allergy to moist flushable wipes.

Methylchloroisothiazolinone/methylisothiazolinone is a preservative found in cosmetic and industrial products, and is a common ingredient in moist toilet paper. It is a well-known allergen and is capable of causing allergic contact dermatitis.We present the case of a 58-year-old white woman with a cutaneous vulvar eruption with associated discomfort and pruritus of 6 months in duration. She had been treated with antibiotic and antifungal agents without improvement of symptoms. Careful history taking revealed that the patient was using moist toilet paper. Patch testing confirmed an allergy to methylchloroisothiazolinone, a preservative in the moist toilet paper. After discontinuation of the product and treatment with potent topical steroids, the eruption completely cleared.With the growing use of moist toilet paper among adults, the risk of exposure and potential sensitization is increasing. Health care providers should be aware of the risks of moist toilet paper containing potential allergens because perianal and perineal dermatitis caused by these products may be unrecognized or misdiagnosed. After proper treatment, patients must be educated about alternatives and the importance of label reading.

Use of participatory action research to support Syrian refugee mothers in the resettlement period in Canada: A longitudinal study.

Research has shown that refugees in a foreign country often experience physical and mental health challenges upon resettlement (Ahmad et al., 2021; Salam et al., 2022). In Canada, refugee women experience a range of physical and mental barriers, including poor access to interpreter services and transportation, and a lack of accessible childcare, all of which can negatively affect their successful integration (Stirling Cameron et al., 2022). Social factors that support Syrian refugees to settle successfully in Canada have been unexplored systematically. This study examines these factors from the perspectives of Syrian refugee mothers living in the province of British Columbia (BC). Framed by principles of intersectionality and community-based participatory action research (PAR), the study draws on Syrian mothers' perspectives of social support in early, middle, and later phases of resettlement. A qualitative longitudinal design consisting of a sociodemographic survey, personal diaries, and in-depth interviews was used to gather information. Descriptive data were coded, and theme categories were assigned. Six themes emerged from data analysis: (1) Steps in the Migration Journey; (2) Pathways to Integrated Care; (3) Social Determinants of Refugee Health; (4) COVID-19 Pandemic Impacts and Ongoing Resettlement; (5) Strength-Based Capabilities of Syrian mothers; (6) Peer Research Assistant's Research (PRAs) Experience. Results from themes 5 and 6 are published separately. Data obtained in this study contribute to the development of support services that are culturally appropriate and accessible to refugee women living in BC. Our objectives are to promote the mental health and improve the quality of life of this female population, and to enable it to access healthcare services and resources in a timely manner.

Using Narrative Inquiry to Understand Anti-Muslim Racism in Canadian Nursing.

BACKGROUND: Islamophobia or, anti-Muslim racism, and more specifically, gendered islamophobia targeting Muslim women who wear a hijab is rising globally and is aggravated by the COVID-19 pandemic. However, anti-Muslim racism is not well understood in Canadian nursing. PURPOSE: This study utilized narrative inquiry to understand anti-Muslim racism through the experiences of nurses who wear a hijab with the goal of putting forward their counter-narrative that disrupts anti-Muslim racism in Canadian nursing. METHODS: Narrative inquiry informed by Critical Race Feminism, care ethics, and intersectionality were used to analyze the factors shaping anti-Muslim racism and composite narratives were used to present the results. RESULTS: The three composite narratives are: 'This is Who I Am: A Muslim Nurse with a Hijab and an Accent'; 'I Know What is at Play: Unveiling Operating Power Structures and Power Relations'; and 'Rewriting the Narrative: Navigating Power Structures and Power Relations'. These composite narratives constituted the nurses' counter-narrative. They revealed intersections of gendered, racial divisions of labour and religious narratives that shape anti-Muslim racism, as operating power relations in nursing, and how Muslim nurses reclaimed control to resist their racialized stereotypes. CONCLUSION: Findings suggest that anti-Muslim racism in nursing operates through multiple intersecting power relations. Using stories can mobilize transformational change so that anti-racist practices, policies, and pedagogy can be embraced.

JBI systematic review protocol of text/opinions on how to best collect race-based data in healthcare contexts.

INTRODUCTION: Racialized population groups have worse health outcomes across the world compared with non-racialized populations. Evidence suggests that collecting race-based data should be done to mitigate racism as a barrier to health equity, and to amplify community voices, promote transparency, accountability, and shared governance of data. However, limited evidence exists on the best ways to collect race-based data in healthcare contexts. This systematic review aims to synthesize opinions and texts on the best practices for collecting race-based data in healthcare contexts. METHODS AND ANALYSES: We will use the Joanna Briggs Institute (JBI) method for synthesizing text and opinions. JBI is a global leader in evidence-based healthcare and provides guidelines for systematic reviews. The search strategy will locate both published and unpublished papers in English in CINAHL, Medline, PsycINFO, Scopus and Web of Science from 1 January 2013 to 1 January 2023, as well as unpublished studies and grey literature of relevant government and research websites using Google and ProQuest Dissertations and Theses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement methodology for systematic reviews of text and opinion will be applied, including screening and appraisal of the evidence by two independent reviewers and data extraction using JBI's Narrative, Opinion, Text, Assessment, Review Instrument. This JBI systematic review of opinion and text will address gaps in knowledge about the best ways to collect race-based data in healthcare. Improvements in race-based data collection, may be related to structural policies that address racism in healthcare. Community participation may also be used to increase knowledge about collecting race-based data. ETHICS AND DISSEMINATION: The systematic review does not involve human subjects. Findings will be disseminated through a peer-reviewed publication in JBI evidence synthesis, conferences and media. PROSPERO REGISTRATION NUMBER: CRD42022368270.

Equity Promoting Integrated Care: Definition and Future Development.

Over the last three decades, integrated care has emerged as an important health system strategy to improve population health while addressing the unique needs of structurally marginalised communities. However, less attention has been given to the role of integrated care in addressing issues related to inequities in health and health care. In this commentary we introduce the concept of Equity Promoting Integrated Care (EPIC) that situates integrated care in a social justice context to frame the actions necessary to center equity as a priority for integrated care. We suggest that efforts to advance the design and implementation of integrated care should focus on three avenues for future research and practice, namely, the collaborative mobilization of a global network of integrated care stakeholders to advocate for social justice and health equity, investing in equity-focused approaches to implementation science that highlight the importance of social concepts such as colonialism and intersectionality to advance the theory and practice of implementing EPIC models of care, and leveraging innovative approaches to measuring equity-related aspects of integrated care to inform continuous improvement of health systems.

Factors associated with Afghan household food security pre- and post-Taliban regime.

To determine multifaceted determinants of household vulnerability to food insecurity in Afghanistan before and after the Taliban takeover, we randomly selected 555 households from 13 provinces, conducted in-person surveys, and applied the Household Food Insecurity Assess Scale (HFIAS) and Structural Equation Modeling (SEM). We collected data from January to April 2022. We observed an increase in both prevalence and severity of food insecurity among Afghan households after the Taliban takeover. Approximately, 98% and 70% of interviewed households were food insecure after and before the Taliban takeover, respectively. Similarly, households were more likely to be severely food insecure (81%) than before (40%). Our results showed that policy and political conditions contributed substantially to the food insecurity of Afghan households after the Taliban takeover. We recommend that the Taliban forces facilitate the presence of humanitarian organizations and NGOs to improve low-income households' food security, especially for women and children. We also recommend that international organizations enhance their attempts to negotiate with the Taliban to ensure freedom for women.

Case study: nutrition challenges of a marathon runner with a gastric bypass.

A new type of athlete is appearing in the offices of sports dietitians: formerly obese people who have undergone gastric bypass surgery and now aspire to be marathoners, triathletes, and other types of endurance athletes. The standard nutrition advice offered to bypass patients is contrary to the standard sports advice given to athletes. Bypass athletes need to limit carbohydrates, fluids, and energy intake and consume a protein-based diet. This case study describes the sport nutrition concerns of a woman who, after having gastric bypass surgery, trained to run a marathon (42 km). Because of her limited ability to consume food and fluids, she experienced difficulty preventing fatigue and dehydration during her long training runs and the marathon itself. She learned through trial and error how to survive the nutritional challenges and complete the marathon. Health professionals need to be aware of the potential medical risks associated with endurance exercise in gastric bypass patients. Research is needed to determine the best sports nutrition practices for bypass patients. Only then can sport dietitians better educate this small but growing contingent of endurance athletes so the athletes can meet their training and performance goals and reduce their risk of experiencing serious health consequences.

Themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making in healthcare systems: a scoping review.

OBJECTIVE: To identify the key themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making across the organisation and system domains of healthcare systems. METHODS: We conducted a scoping review. Seven databases of journal articles were searched from their inception to June 2019. Eligible articles were literature reviews published in English and provided useful information for determining aspects of engaging patients and family caregivers in decision-making to evaluate. We extracted text under three predetermined categories: structure, process and outcomes that were adapted from the Donabedian conceptual framework. These excerpts were then independently open-coded among four researchers. The subsequent themes and their corresponding excerpts were summarised to provide a rich description of each theme. RESULTS: Of 7747 unique articles identified, 366 were potentially relevant, from which we selected the 42 literature reviews. 18 unique themes were identified across the three predetermined categories. There were six structure themes: engagement plan, level of engagement, time and timing of engagement, format and composition, commitment to support and environment. There were four process themes: objectives, engagement approach, communication and engagement activities. There were eight outcome themes: decision-making process, stakeholder relationship, capacity development, stakeholder experience, shape policy/service/programme, health status, healthcare quality, and cost-effectiveness. CONCLUSIONS: The 18 themes and their descriptions provide a foundation for identifying constructs and selecting measures to evaluate the quality of initiatives for engaging patients and family caregivers in healthcare system decision-making within the organisation and system domains. The themes can be used to investigate the mechanisms through which relevant initiatives are effective and investigate their effectiveness.

Public health and environmental response to the first case of naturally acquired inhalational anthrax in the United States in 30 years: infection of a new york city resident who worked with dried animal hides.

In Pennsylvania on February 16, 2006, a New York City resident collapsed with rigors and was hospitalized. On February 21, the Centers for Disease Control and Prevention and the New York City Department of Health and Mental Hygiene were notified that Bacillus anthracis had been identified in the patient's blood. Although the patient's history of working with dried animal hides to make African drums indicated the likelihood of a natural exposure to aerosolized anthrax spores, bioterrorism had to be ruled out first. Ultimately, this case proved to be the first case of naturally occurring inhalational anthrax in 30 years. This article describes the epidemiologic and environmental investigation to identify other cases and persons at risk and to determine the source of exposure and scope of contamination. Because stricter regulation of the importation of animal hides from areas where anthrax is enzootic is difficult, public healthcare officials should consider the possibility of future naturally occurring anthrax cases caused by contaminated hides. Federal protocols are needed to assist in the local response, which should be tempered by our growing understanding of the epidemiology of naturally acquired anthrax. These protocols should include recommended methods for reliable and efficient environmental sample collection and laboratory testing, and environmental risk assessments and remediation.

Applying Critical Race Feminism and Intersectionality to Narrative Inquiry: A Point of Resistance for Muslim Nurses Donning a Hijab.

Racism in nursing can be positioned through institutional forms of gendered, racialized, and religious structures. Muslim nurses who choose to honor the Islamic practice of donning hijab may be at risk of experiencing racism in contexts of post-September 11 era and the war on terror. Critical race feminism and intersectionality are theoretical frameworks that when applied to narrative inquiry can illuminate the standpoint of Muslim nurses donning hijab by providing a counternarrative as a point of resistant to racism in nursing.