Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review.

The ability of the public to remain psychologically resilient in the face of public health emergencies and disasters (such as the COVID-19 pandemic) is a key factor in the effectiveness of a national response to such events. Community resilience and social capital are often perceived as beneficial and ensuring that a community is socially and psychologically resilient may aid emergency response and recovery. This review presents a synthesis of literature which answers the following research questions: How are community resilience and social capital quantified in research?; What is the impact of community resilience on mental wellbeing?; What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, What types of interventions enhance community resilience and social capital?A scoping review procedure was followed. Searches were run across Medline, PsycInfo, and EMBASE, with search terms covering both community resilience and social capital, public health emergencies, and mental health. 26 papers met the inclusion criteria.The majority of retained papers originated in the USA, used a survey methodology to collect data, and involved a natural disaster. There was no common method for measuring community resilience or social capital. The association between community resilience and social capital with mental health was regarded as positive in most cases. However, we found that community resilience, and social capital, were initially negatively impacted by public health emergencies and enhanced by social group activities.Several key recommendations are proposed based on the outcomes from the review, which include: the need for a standardised and validated approach to measuring both community resilience and social capital; that there should be enhanced effort to improve preparedness to public health emergencies in communities by gauging current levels of community resilience and social capital; that community resilience and social capital should be bolstered if areas are at risk of disasters or public health emergencies; the need to ensure that suitable short-term support is provided to communities with high resilience in the immediate aftermath of a public health emergency or disaster; the importance of conducting robust evaluation of community resilience initiatives deployed during the COVID-19 pandemic.

Management of ENT emergencies during the coronavirus disease 2019 pandemic.

BACKGROUND: Coronavirus disease 2019 imposed dramatic changes on ENT service delivery. Pre-pandemic, such changes would have been considered potentially unsafe. This study outlines the impact of lockdown on the incidence and management of ENT emergencies at a large UK centre. METHODS: After modification of pre-pandemic guidelines, ENT emergency referrals data during the UK lockdown were prospectively captured. A comparative analysis was performed with retrospective data from a corresponding period in 2019. RESULTS: An overall reduction (p < 0.001) in emergency referrals (n = 119) and admissions (n = 18) occurred during the lockdown period compared to the 2019 period (432 referrals and 290 admissions). Specifically, there were reduced admission rates for epistaxis (p < 0.0001) and tonsillar infection (p < 0.005) in the lockdown period. During lockdown, 90 per cent of patients requiring non-dissolvable nasal packing were managed as out-patients. CONCLUSIONS: Coronavirus disease 2019 compelled modifications to pre-pandemic ENT guidelines. The enforced changes to emergency care appear to be safe and successfully adopted. Arguably, the measures have both economic and patient-related implications post-coronavirus disease 2019 and during future similar pandemics and lockdowns.

Loco-regional recurrence after skin and nipple-sparing mastectomy and immediate breast reconstruction using free flap autologous tissue in a single institution.

BACKGROUND: Immediate autologous tissue breast reconstruction after skin- and nipple-sparing mastectomy, is becoming increasingly popular, while the benefits are evident, the concern is in leaving breast tissue under the skin envelope, which could potentially lead to a higher chance of recurrence. We aim to determine the incidence and study the management of loco-regional recurrence (LR) of breast cancer following immediate autologous free flap reconstruction (AFFR) from a 10-year database at a single tertiary breast unit. METHODS: This is a retrospective analysis of a prospectively maintained database of consecutive patients who underwent AFFR between July 2008 and December 2018. All patients undergoing delayed reconstruction and risk-reducing surgery were excluded, leaving a total of 216 patients. Statistical analysis was performed to determine significance in the prediction of LR. Management and outcome of the LR was also studied. RESULTS: LR was found in 7/216 cases (3.25%). The median age at surgery for patients with LR, was 45 (range 31-54). Median time to recurrence was 54 months (7-79 months). Three patients presented with self-detected lesions. In all, 6/7 patients were ER/PR positive, 2/7 were HER2 + at recurrence, and 1/7 was triple negative. All patients underwent surgical excision for the LR followed by radiotherapy, either chemotherapy (n-5) and/or hormone therapy (n-2). No patients have developed further LR. Because of low numbers of recurrences, no statistical significance was observed for factors causing recurrence. CONCLUSION: The low LR we report demonstrates that immediate AFFR is oncologically safe. Timely recognition through post-reconstruction patient education and appropriate management results in good outcomes.

Putting the public (back) into public health: leadership, evidence and action.

There is a strong evidence-based rationale for community capacity building and community empowerment as part of a strategic response to reduce health inequalities. Within the current UK policy context, there are calls for increased public engagement in prevention and local decision-making in order to give people greater control over the conditions that determine health. With reference to the challenges and opportunities within the English public health system, this essay seeks to open debate about what is required to mainstream community-centred approaches and ensure that the public is central to public health. The essay sets out the case for a reorientation of public health practice in order to build impactful action with communities at scale leading to a reduction in the health gap. National frameworks that support local practice are described. Four areas of challenge that could potentially drive an implementation gap are discussed: (i) achieving integration and scale, (ii) effective community mobilization, (iii) evidencing impact and (iv) achieving a shift in power. The essay concludes with a call to action for developing a contemporary public health practice that is rooted in communities and offers local leadership to strengthen local assets, increase community control and reduce health inequalities.

A knowledge translation project on community-centred approaches in public health.

This article examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues. Following a literature review and stakeholder consultation, evidence was published in a national guide to community-centred approaches. This was followed by a programme of work to translate the evidence into national strategy and local practice.The article outlines the key features of the knowledge translation framework developed. Results include positive impacts on local practice and national policy, for example adoption within National Institute for Health and Care Evidence (NICE) guidance and Local Authority public health plans and utilization as a tool for local audit of practice and commissioning. The framework was successful in its non-linear approach to knowledge translation across a range of inter-connected activity, built on national leadership, knowledge brokerage, coalition building and a strong collaboration between research institute and government agency.

Estilos sanos de vida en adultos con discapacidad intelectual: qué conocen, factores que los benefician y dificultan / No disponible

Las personas con discapacidad intelectual son más propensas a tener problemas de salud que las que no la tienen. Hasta ahora se ha investigado poco la salud desde la perspectiva de las propias personas con discapacidad intelectual. Intentamos centrarnos sobre qué es lo que estas personas entienden por estar sanos, y cuáles son sus experiencias sobre los estilos sanos de vida. Se llevaron a cabo entrevistas semiestructuradas a 13 adultos con discapacidad intelectual para preguntarles sobre su salud y estilos sanos de vida. Los datos fueron analizados por los temas recogidos. Los participantes demostraron comprender el significado de estar sanos, llevar una dieta sana, los peligros del uso de sustancias y los beneficios del ejercicio. Mostraron cierto conocimiento sobre las razones para embarcarse en conductas sanas. Surgió la idea de la moderación, así como la existencia de factores que benefician y dificultan la implicación en un estilo sano de vida. Estos resultados sugieren que las personas con discapacidad intelectual demuestran tener cierta comprensión de lo que constituye estar sano y ser conscientes de los estilos sanos de vida, las consecuencias de conductas poco sanas y la necesidad de tener moderación (AU)

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Prioritisation in speech and language therapy departments in Scotland and Malaysia.

This study investigates how prioritisation in health services have influenced speech and language therapy (SLT) services in Scotland in prioritising their caseload. Additionally, it evaluates how current prioritisation systems may contribute towards the development of the SLT service in Malaysia. Health, education and social agencies in Malaysia were contacted and a literature review was conducted. Information on prioritisation systems used in Malaysia was unavailable. Prioritisation systems from seven SLT departments within Scotland were investigated, of which three SLT managers took part in semi-structured interviews. The findings show that prioritisation is influenced by a combination of factors and that the principles could only be applied to the Malaysian SLT service if consideration is given to the political, economical, social, geographical and cultural factors.

Expressive pragmatic skills in pre-school children with and without Down's syndrome: parental perceptions.

Parental perceptions of the pragmatic skills of six pre-school children with Down's syndrome were compared to those of six children without cognitive impairment. Children were matched for language comprehension age on the Reynell Developmental Language Scale and parents were interviewed using the Pragmatics Profile of Early Communication Skills. Data from the parental interviews was analysed taking a qualitative approach, using the technique of content analysis. The results showed that the children with and without Down's syndrome had many similarities in reported behaviours and responses In addition, five out of the six children with Down's syndrome had some skills which were more advanced than their matched pairs. Possible reasons for these findings are discussed. The evidence suggests that children with Down's syndrome have a normal range of pragmatic skills and communicative intentions compared with children of similar levels of comprehension functioning at an early pre-school level.

A content analysis of the professional journal of the British Society of Speech Therapists. I: The first 10 years. Spotlight on 'Speech' 1935-1945.

The 24 editions of the professional journal 'Speech' published between 1935-1945 were examined by use of content analysis. The use of this approach enabled an in-depth survey of the professional, clinical and political issues of the period which saw the beginning of speech and language therapy as a profession. Two main areas were focused upon: the development of the professional body and the authored papers which appeared in the journal. 'Speech' at that time can be viewed as a blend of today's 'European Journal of Disorders of Communication' with today's 'Bulletin'.

Prevalence of stuttering and cluttering in adults with mental handicaps.

A survey (involving questionnaire, screening and assessment procedures) of 793 adults with mental handicaps revealed that 6.3% of the population had ideopathic dysfluencies. Issues in the differential diagnosis between stuttering, cluttering and other dysfluency are considered, and the contaminating factors involved in this diagnosis discussed.