Conectar
Women and men/partners who experience miscarriage often report poor care experiences within health services around the time of miscarriage and beyond; less is known about recurrent miscarriage (RM) care. Research is needed to explore the potential targets for improvement, in addition to identifying factors that support or hinder service improvement efforts and the implementation and/or sustainment of desired models of RM care. This study aimed to explore the views of knowledge users regarding RM services and supports; specifically: (a) practices and experiences and (b) facilitators and barriers to providing desired services and supports.
We adopted a qualitative study design underpinned by constructivism, incorporating semistructured interviews. Data were analysed using reflexive thematic analysis.
Participants were recruited across the Republic of Ireland, incorporating perspectives from different geographical areas, hospital types and RM services.
We interviewed 13 women and 7 men/partners who had experienced ≥2 consecutive miscarriages, and 42 people involved in the delivery and/or management of RM services and supports, between June 2020 and February 2021.
We generated three themes from the data: (1) dedicated staff; (2) dedicated space and time and (3) dedicated funding and support—prioritise RM. Our analysis supports the need for a standardised, dedicated and adequately resourced and supported service. One in which people experiencing RM are offered appropriate, individualised, timely and accessible care and support—beginning following the first miscarriage, and following a graded model. Implementation requires several multilevel actions, including prioritising RM care, adequately funding and resourcing services, enhancing health professional education and support, care coordination within and between hospitals and primary care and improving public awareness of, and addressing stigma surrounding, miscarriage.
Our analysis provides context to ‘good’ and ‘poor’ care experiences and identifies what facilitators and barriers exist to affecting change in RM care within healthcare and broader systems. In light of recent debates regarding how best to deliver RM care, and changing international guidelines, this work provides timely and important knowledge that should be harnessed to inform service improvement efforts in the Republic of Ireland and beyond.
by Alexandra Goldblatt, Michael J. Loccisano, Mazharul I. Mahe, John J. Dennehy, Fabrizio Spagnolo
The COVID-19 pandemic highlighted the role of indoor environments on disease transmission. However, our understanding of how transmission occurred evolved as the pandemic progressed. Enclosed spaces where pathogen-laden aerosols accumulate were strongly linked to increased transmission events. Most classrooms, particulalry in the U.S., do not have any mechanical ventilation systems but do have many people congregating indoors for long periods of time. Here we employ a safe, non-pathogenic surrogate virus, the bacteriophage phi6, to interrogate aerosol transmission in classroom environments that do not have any natural or mechanical ventilation in order to provide baseline understanding of how effectively aerosols facilitate new infections. We measure exposure risk using a modified passive monitoring technique compliant with applicable standards, including ISO 14698–1:2003. We find that virus-laden aerosols establish new infections over all distances tested within minutes and that the time of exposure did not change transmission rate. We further find that relative humidity, but not temperature nor a UV-based disinfection device, significantly lowered transmission rates. Our data suggest that, even without mechanical ventilation, relative humidity remains an inexpensive and highly effective mitigation strategy while UV air treatment may not.
FreshRSS 