Addressing the unmet social needs of gynecologic oncology patients as identified by a universal screening tool in a safety net hospital

Objectives: To identify the unmet, actionable social needs of gynecologic oncology patients using a self-administered social needs assessment tool and quantify the interventions subsequently provided to our patients. Method(s): This is a study of data collected in an ongoing performance improvement initiative in a gynecologic oncology clinic at a safety net hospital and was determined to be exempt from review by the institutional IRB. Eligible patients completed the social needs screening tool from October 2021 to March 2022. The following social needs domains were assessed: food insecurity, utility insecurity, housing insecurity, transportation insecurity, need for childcare, exposure to violence, lack of companionship, difficulty reading, or difficulty accessing medical care due to fear of losing job. Patients were asked if they desired to speak with a social worker and if any needs were urgent. Data from the screening tool was collected and supplemented by data from the EMR. Univariate descriptive statistics were used to report the patient demographic information, prevalence of social needs, and referral rates for social needs identified. Result(s): There were 475 patients seen in the gynecologic oncology clinic since October 2021. 286 (60%) patients completed the screening tool. 139 (49%) screened positive for at least 1 social need;of those 98 (70%) were Hispanic with a median age of 56 years. 27 (6%) patients were receiving treatment for a gynecologic malignancy, of whom 19 (70%) had at least 1 social need. 25 (92%) patients were insured through Medi-Cal. 12 (44%) patients were being treated for endometrial cancer, followed by ovarian (7, 26%) and cervical (4, 15%). The social needs identified in all patients and in patients actively receiving cancer treatment are summarized in Fig. 1. Patients reporting lack of companionship were referred to mental health or cancer support groups through the American Cancer Society or the Los Angeles County Department of Public Health. Those needing transportation or utility services were linked with services available through their insurance or LA County, ride share vouchers, low-income energy assistance programs, COVID rent/mortgage relief programs. Patients with food and housing insecurity were assisted in applying for public housing or food stamps;local food banks were provided. Patients were assisted with applying for disability insurance as needed. To date, all actively treated patients reporting lack of companionship, need for transportation, avoiding medical care for fear of losing their job, and utility insecurity were provided resources;80% received resources for food insecurity. Conclusion(s): Universal screening for social needs in gynecologic cancer patients identifies a high rate of unmet needs within a safety net hospital. Cancer care navigators can successfully provide these patients community-based resources tailored to their individual social needs. Our next steps will be to determine if and how these resources impact our patients' experiences and treatment outcomes.[Formula presented]Copyright © 2022 Elsevier Inc.

The effect of neighborhood characteristics on HIV risk behaviors, HIV testing, and Covid-19 incidence in Louisiana

Both the HIV pandemic and the COVID-19 pandemic have highlighted underlying racial and socioeconomic health disparities in Louisiana, as well as in the United States. Neighborhood factors, such as community violence and social vulnerability, likely play a significant role in these disparities.The goals of this study were to examine the relationship between community violence exposure and HIV sexual risk behaviors and to examine the impact of neighborhood-level social vulnerability on HIV testing practices and COVID-19 incidence.Data from the National HIV Behavioral Surveillance System, the CDC Social Vulnerability Index (SVI) Database, and the Louisiana Department of Health were analyzed. The CDC SVI was used to measure neighborhood-level social vulnerability, which comprises four related factors: socioeconomic status, household composition and disability, minority and language, and housing characteristics and transportation.First, the relationship between community violence exposure and HIV sexual risk behaviors was examined among an age-diverse population of heterosexually active adults. A positive association was observed between community violence exposure and HIV sexual risk behaviors. Gender did not modify this relationship.Second, the relationship between neighborhood-level social vulnerability and recent HIV testing history was examined. Neighborhood-level socioeconomic status was the only social vulnerability factor observed to be associated with recent HIV testing, where individuals residing in lower socioeconomic neighborhoods had lower odds of receiving a recent HIV test than those residing in higher socioeconomic neighborhoods. This association diminished as age increased.Third, the relationship between social vulnerability and COVID-19 incidence during the first six months of the COVID-19 pandemic within Louisiana census tracts was examined. All four factors measuring social vulnerability were found to be associated with COVID-19 incidence;Louisiana census tracts with higher levels of overall social vulnerability exhibited higher levels of COVID-19 incidences. The results of this study provide further evidence that neighborhood characteristics can influence health behaviors (e.g., sexual risk behaviors), access to healthcare (e.g., HIV testing), and health outcomes (e.g., COVID-19 infections). In conclusion, future public health initiatives should focus on identifying and removing barriers to health within identified vulnerable neighborhoods. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Resilience and Resistance in the Community Sector: Organisational Challenges and Responses by the Australian DFV Sector in the Time of COVID-19 Pandemic

The COVID-19 pandemic led to increases in family violence in Australia and elsewhere. In response, organisations in the domestic and family violence (DFV) sector, had to adapt to the emerging public health measures and worked collaboratively to protect the most vulnerable in the community. These services, including courts, rapidly transformed their methods of service delivery that are likely to continue for some time. But what have been the implications/impacts of these rapid changes on the DFV service sector in Australia? How have these impacts informed the future needs of the DFV sector? And what is needed to strengthen this community sector of the future? This article reports on the findings of a national research project examining the impacts of COVID-19 on the DFV service sector and the adaptations and innovations that emerged in response. The study highlights that the surge in demand for services put pressure on an already overwhelmed workforce/service sector and provided an opportunity for front line workers to contribute to building a robust sector to respond to future crisis events. These findings have significant implications for future DFV sector service delivery, and for the social work profession as a whole.

Understanding the Health care Needs of Migrant Children in Government Custody

Background: There are increasing numbers of immigrant children held in government custody at the US-Mexico border and across the US. Further, anti-immigrant policies and the US COVID-19 pandemic response exacerbated detention conditions under the Trump administration. Thus, there is a greater need to identify the health concerns and challenges clinicians face when caring for these children. Methods: A national cross-sectional 66- question online survey was distributed from October 2020 to January 2021 through national pediatric and migrant health listservs including the Academy of Pediatrics (AAP). The reported total number of listserv members was 6200, but the degree of redundancy among these groups was not able to be assessed. Clinicians were asked about care delays, health problems encountered, and resources needed while caring for children under government custody. “Children in government custody” was defined as children (0-17 years) who currently or previously (in the past 5 years) were under the custody of the US Immigration Customs Enforcement, Customs Border Protection and/or the Office of Refugee and Resettlement. Results: Eightytwo clinicians responded and cared for children clinically. Thirty four cared for children who were in government custody. About 1/3 of this subset of respondents noted care delays while in custody and delays in establishing primary care after custody release. The two main health issues seen were a lack of routine health maintenance and traumatic exposures. Most commonly, children were behind on vaccinations and needed mental health screening. Exposure to violence was the most common traumatic exposure. Furthermore, 47% of clinicians felt that their current resources were inadequate and requested legal assistance and mental health support. Importantly, 58% of respondents were not aware of or were unsure of the Centers for Disease Control and Prevention domestic refugee health guidelines for the care of migrant children and adults. Conclusion: Children who experience detention have significant healthcare needs, many of which clinicians do not feel equipped to address. The reported health complications emphasize the need for policy measures, such as those recommended by the AAP, namely, the provision of evidence-based medical evaluations, trauma-informed care, and family-centered medical homes with comprehensive primary care and embedded mental health and legal support systems. Child detention should end. If present, children should be released to ORR shelters with pediatric clinicians providing healthcare and oversite until children can be safely released to vetted legal guardians and established in medical homes. This process should be swift with improved integration of detainment and post-detainment healthcare. Clinicians can be supported with training on immigrant screening guidelines. Of note, the low response rate and inability to distinguish between ICE, CBP, and ORR on the survey limits these results. Nonetheless, these findings support further research and recommendations for policy changes to improve the health and well-being of newly-arrived immigrant children.

Threats to operating room personnel's occupational safety and health: a qualitative study

Background & Objective: Every operating room has been associated with a variety of occupational hazards, but not many studies have been conducted to assess and address these hazards. We used a qualitative approach to explore operating room personnel's experiences of workplace hazards and how these hazards threaten their occupational safety and health (OSH). Methodology: This qualitative study was conducted in five teaching hospitals in the south-west of Iran from February 2019 to March 2021. The sample was 24 operating room personnel who were selected under convenient sampling technique. Data were collected using semi-structured, individual interviews, document review and non-participant observation. The collected data were analyzed according to the qualitative content analysis method using MAXQDA v. 2020. Results: After prolonged analysis of the data, the researchers extracted 644 codes, 13 subcategories, 4 categories, and 1 main theme. The main theme of the study was working in a context of occupational hazards. Conclusions: Operating rooms are full of potential dangers, which, when combined with the personnel's negligence and management inefficiencies, increase the risk of occupational health and safety. Therefore, making working conditions safe by providing adequate personal protective equipment (PPE), in-service training, and identifying and managing the causes of personnel negligence are recommended. Moreover, strategies should be introduced to manage stress and conflicts among the healthcare personnel, thus controlling psychological hazards.

Treating children exposed to domestic violence: Group-based intervention

Domestic violence is a serious societal problem that sadly threatens many children. Results from the National Survey of Children's Exposure to Violence (NatSCEV) demonstrate that nearly 26% of children are exposed to family violence during their lifetime, including psychological/emotional intimate partner violence, physical intimate partner violence, parental assault of a sibling, and/or other family violence (Hamby et al., 2011). The consequences can be significant. For instance, childhood exposure to intimate partner violence is associated with mental health issues, such as posttraumatic stress and anxiety symptoms (Hamby et al., 2011). While rates of domestic violence have been declining in the past few decades (Truman & Morgan, 2014), an increase in rates may be occurring from COVID-19. More specifically, Bradbury-Jones and Isham (2020) gave the following bleak warning regarding COVID-19: "Domestic violence rates are rising, and they are rising fast" (p. 2047). As Bradbury-Jones and Isham (2020) explain, one reason for this rise could be because "home is often the space where physical, psychological, and sexual abuse occurs" (p. 2047), making increased time at home during the pandemic problematic for sufferers of domestic violence. In all, it is clear that childhood exposure to domestic violence is serious and consequential, as well as a timely issue to consider given the COVID-19 pandemic. Fortunately, results for interventions discussed in the two articles by Overbeek et al. (2017) and Pernebo et al. (2019) give hope that the consequences of childhood exposure to domestic violence can be mitigated through proper intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Epidemiological Study of Violence against Children and Its Increase during the COVID-19 Pandemic.

The aim of this study was to identify the epidemiological profiles of violence against children, victims, and their aggressors, and their correlations between socioeconomic and demographic factors analyzed before and during the COVID-19 pandemic. This was a cross-sectional, retrospective observational study based on a review of Individual Notification Forms from the Information System for Notifiable Diseases, including child victims of violence, under 18 years, assisted by a pediatric emergency service in Brazil, from 2016-2020. Data were stratified, then statistical analysis was performed using the two-proportion equality test and the Chi-square test, with p < 0.05 and a 95% confidence interval. A total of 609 notifications were analyzed and a prevalence of sexual violence (63.2%) was reported. The prevalent profile of victim was female (76.7%), aged between 2-9 years (38.1%) and 14-18 years (35.6%). The violence occurs in the victim's home (58.9%). The prevalent profile of perpetrator was male (82.4%), young adolescent (59.2%), living as family (64%), mainly the parents (18.4%). No correlation was found between the classified socioeconomic and demographic variables and violence. There was an increase in notifications during the COVID-19 pandemic, compared to the same period in the previous year; self-harm was reported in 59.7% of physical violence in 2020. Prevalence of sexual violence was higher for females, aged between 2-9 and 14-18 years, victimized in their homes, by male offenders, living as family, mainly by their parents. No association was found between child violence and the socioeconomic and demographic.

Nurses' exposure to violence and their professional commitment during the COVID-19 pandemic.

AIMS AND OBJECTIVES: This study aimed to determine the relationship between nurses' exposure to violence and their professional commitment during the COVID-19 pandemic. BACKGROUND: Violence against nurses is a common problem that persists worldwide. DESIGN: This was a descriptive cross-sectional study. METHODS: An online questionnaire form and the Nursing Professional Commitment Scale were used to collect the data. The study was carried out online during the COVID-19 pandemic between October-December 2020. A total of 263 nurses agreed to participate in the study. The STROBE checklist was followed for observational studies. RESULTS: During the COVID-19 pandemic, 8.4% of the nurses stated that they were exposed to physical violence, 57.8% to verbal violence, 0.8% to sexual violence and 61.6% to mobbing. 52.1% of the nurses stated that they thought of quitting the profession during the COVID-19 pandemic. The mean total Nursing Professional Commitment Scale score was 71.33 ± 15.05. CONCLUSIONS: This study revealed that nurses' exposure to physical, verbal and sexual violence during the COVID-19 pandemic decreased compared to before the pandemic. Nurses' exposure to mobbing during the pandemic was found to increase. A statistically significant difference was found between the status of the nurses' exposure to physical violence, verbal violence, and mobbing, working hours, number of patients given care, and their thoughts of quitting the profession. It was found that the status of exposure to physical violence, thinking of quitting the profession and working hours decreased professional commitment. RELEVANCE TO CLINICAL PRACTICE: In the light of these results, it is recommended that measures to prevent violence should be addressed in a multifaceted way. In managing the pandemic process, the decisions and practices should not be left to the managers' initiative to prevent mobbing. Initiatives that will increase nurses' professional commitment during the pandemic process should be planned and implemented.