In brief

Research shows that while inhaling gas and air (Entonox) in labour is safe for mothers and babies, long-term cumulative exposure may carry health risks. Work notice The right to strike The UK government's Strikes (Minimum Service Levels) Bill is, at the time of going to press, at the committee stage in the House of Lords (the first chance for line-by-line examination). Visit bit.ly/ Clementine-register Working mums Maternity leave Careers After Babies research has found that of 848 mothers interviewed, 98% want to return to work after having a child but just 13% can make it work full-time, citing the cost of childcare and lack of flexibility from businesses as the reason. Find out more at hegenbergermedical.com/training Research Healthy eating support Researchers at the University of Hertfordshire are calling for better information on diet and nutrition to be made available to expectant parents.

An Overlooked Strategic Powerhouse: How Nurses Can Rise to the Challenge of Integrating Public Health and Primary Care

Although the United States is one of the wealthiest countries in the world and a leader in biomedical innovation, its health care system is consistently ranked among the worst in terms of cost and health outcomes. Americans have short life expectancies, high infant mortality and obesity rates, and soaring chronic disease rates compared with other wealthy nations. In 2021, the National Academy of Medicine (NAM) was charged with examining what it would take to improve US primary care. The NAM report described the practice of siloing public health from primary care or treating these areas as separate fields of scientific inquiry, practice, and billable service.1 NAM identified this separation as a key driver of poor health outcomes and health inequities in the United States. The Institute of Medicine (IOM) examined similar phenomena in a 2012 report, noting how the two fields tend to operate independently, despite complementary functions and common goals.2Where these silos persist, we see communication and process breakdowns at the point of care. For instance, when large swaths of Americans turned to trusted primary care providers for COVID-19 vaccine insights, their primary care providers did not always have the most up-todate information, in part because of a lack of interprofessional cohesion (including fragmented public health messaging and data systems). If we are to remedy such issues, a substantive paradigm shift must take place: We must move toward what DeSalvo et al.3 termed "Public Health 3.0." In this model, multiple sectors, specialties, and stakeholders form coalitions to mobilize data, people power, and resources in a strategic manner to advance health for all. To be truly strategic, we must think carefully about how to leverage nurses-who care for patients across the lifespan and in nearly all public health nursing (PHN) and primary care settings-within these coalitions.The 2021 NAM report urges health care teams to undertake the mission of integrating systems. However, NAM stops short of describing exactly how teams ought to accomplish this aim and the proposed makeup ofsaid teams. Like any group project, success will depend on the ability of teams to identify leaders and clearly delineate responsibilities. The purpose of this editorial is to explore the potential of PHN and primary care nurses and to describe the roles they might assume in the collaborative integration of their respective silos.

Preventing Childhood Vision Loss Through Exploitative Prison Labor: A Call for Action

The California Prison Industry Authority (CALPIA), a semiautonomous prison labor agency under the California Department of Corrections and Rehabilitation, runs two optical laboratories operated by people incarcerated at Valley State Prison and California State Prison, Solano,1 and these laboratories supply ophthalmic lenses to eligible Medicaid recipients, such as this young patient. Documents we obtained through a public records request revealed that our state's public health agency, the California Department of Health Care Services (DHCS), agreed to pay CALPIA up to $37.9 million for the 2021/22 fiscal year for optical services alone. CALPIA wages in prison-based optical shops range between $0.35 and $1.00 per hour,6 up to 55% of which can be deducted by law for restitution and administrative costs, resulting in an effective pay rate as low as $0.16 per hour.7 Courts have routinely rejected legal challenges to these meager wages by concluding that, because the Thirteen Amendment permits the involuntary servitude of incarcerated people, the federal minimum wage law does not apply to prison labor.8 The result is a strange supply chain that is not always transparent or top of mind: medical devices produced by poorly paid imprisoned people are provided to the poorest members of free society, such as the infant who needed sight-saving glasses. Others have called for public health officials, researchers, and physicians to address the sprawling reach of the prison industrial complex.14 Medical providers could use their position of authority to advocate better pay and conditions for incarcerated workers who produce the very devices that providers prescribe.