scholarly journals Perinatal Distress During COVID-19: Thematic Analysis of an Online Parenting Forum (Preprint)

2020 ◽  
Author(s):  
Bonnie R Chivers ◽  
Rhonda M Garad ◽  
Jacqueline A Boyle ◽  
Helen Skouteris ◽  
Helena J Teede ◽  
...  
Keyword(s):  
Public Health ◽  
High Risk ◽  
Sentiment Analysis ◽  
Thematic Analysis ◽  
Public Discourse ◽  
External Environment ◽  
Perinatal Period ◽  
System Level ◽  
Anticipatory Grief ◽  
Increased Risk

BACKGROUND The COVID-19 global pandemic has impacted the whole of society, requiring rapid implementation of individual-, population-, and system-level public health responses to contain and reduce the spread of infection. Women in the perinatal period (pregnant, birthing, and postpartum) have unique and timely needs for directives on health, safety, and risk aversion during periods of isolation and physical distancing for themselves, their child or children, and other family members. In addition, they are a vulnerable group at increased risk of psychological distress that may be exacerbated in the context of social support deprivation and a high-risk external environment. OBJECTIVE The aim of this study is to examine the public discourse of a perinatal cohort to understand unmet health information and support needs, and the impacts on mothering identity and social dynamics in the context of COVID-19. METHODS A leading Australian online support forum for women pre- through to postbirth was used to interrogate all posts related to COVID-19 from January 27 to May 12, 2020, inclusive. Key search terms included “COVID,” “corona,” and “pandemic.” A three-phase analysis was conducted, including thematic analysis, sentiment analysis, and word frequency calculations. RESULTS The search yielded 960 posts, of which 831 were included in our analysis. The qualitative thematic analysis demonstrated reasonable understanding, interpretation, and application of relevant restrictions in place, with five emerging themes identified. These were (1) heightened distress related to a high-risk external environment; (2) despair and anticipatory grief due to deprivation of social and family support, and bonding rituals; (3) altered family and support relationships; (4) guilt-tampered happiness; and (5) family future postponed. Sentiment analysis revealed that the content was predominantly negative (very negative: n=537 and moderately negative: n=443 compared to very positive: n=236 and moderately positive: n=340). Negative words were frequently used in the 831 posts with associated derivatives including “worried” (n=165, 19.9%), “risk” (n=143, 17.2%), “anxiety” (n=98, 11.8%), “concerns” (n=74, 8.8%), and “stress” (n=69, 8.3%). CONCLUSIONS Women in the perinatal period are uniquely impacted by the current pandemic. General information on COVID-19 safe behaviors did not meet the particular needs of this cohort. The lack of nuanced and timely information may exacerbate the risk of psychological and psychosocial distress in this vulnerable, high-risk group. State and federal public health departments need to provide a central repository of information that is targeted, consistent, accessible, timely, and reassuring. Compensatory social and emotional support should be considered, using alternative measures to mitigate the risk of mental health disorders in this cohort.

scholarly journals Perinatal Distress During COVID-19: Thematic Analysis of an Online Parenting Forum

10.2196/22002 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e22002
Author(s):  
Bonnie R Chivers ◽  
Rhonda M Garad ◽  
Jacqueline A Boyle ◽  
Helen Skouteris ◽  
Helena J Teede ◽  
...  
Keyword(s):  
Public Health ◽  
High Risk ◽  
Sentiment Analysis ◽  
Thematic Analysis ◽  
Public Discourse ◽  
External Environment ◽  
Perinatal Period ◽  
System Level ◽  
Anticipatory Grief ◽  
Increased Risk

Background The COVID-19 global pandemic has impacted the whole of society, requiring rapid implementation of individual-, population-, and system-level public health responses to contain and reduce the spread of infection. Women in the perinatal period (pregnant, birthing, and postpartum) have unique and timely needs for directives on health, safety, and risk aversion during periods of isolation and physical distancing for themselves, their child or children, and other family members. In addition, they are a vulnerable group at increased risk of psychological distress that may be exacerbated in the context of social support deprivation and a high-risk external environment. Objective The aim of this study is to examine the public discourse of a perinatal cohort to understand unmet health information and support needs, and the impacts on mothering identity and social dynamics in the context of COVID-19. Methods A leading Australian online support forum for women pre- through to postbirth was used to interrogate all posts related to COVID-19 from January 27 to May 12, 2020, inclusive. Key search terms included “COVID,” “corona,” and “pandemic.” A three-phase analysis was conducted, including thematic analysis, sentiment analysis, and word frequency calculations. Results The search yielded 960 posts, of which 831 were included in our analysis. The qualitative thematic analysis demonstrated reasonable understanding, interpretation, and application of relevant restrictions in place, with five emerging themes identified. These were (1) heightened distress related to a high-risk external environment; (2) despair and anticipatory grief due to deprivation of social and family support, and bonding rituals; (3) altered family and support relationships; (4) guilt-tampered happiness; and (5) family future postponed. Sentiment analysis revealed that the content was predominantly negative (very negative: n=537 and moderately negative: n=443 compared to very positive: n=236 and moderately positive: n=340). Negative words were frequently used in the 831 posts with associated derivatives including “worried” (n=165, 19.9%), “risk” (n=143, 17.2%), “anxiety” (n=98, 11.8%), “concerns” (n=74, 8.8%), and “stress” (n=69, 8.3%). Conclusions Women in the perinatal period are uniquely impacted by the current pandemic. General information on COVID-19 safe behaviors did not meet the particular needs of this cohort. The lack of nuanced and timely information may exacerbate the risk of psychological and psychosocial distress in this vulnerable, high-risk group. State and federal public health departments need to provide a central repository of information that is targeted, consistent, accessible, timely, and reassuring. Compensatory social and emotional support should be considered, using alternative measures to mitigate the risk of mental health disorders in this cohort.

Defining the PrEP care continuum among recently incarcerated men at high risk for HIV infection (Preprint)

2021 ◽  
Author(s):  
Matthew Murphy ◽  
Colette Sosnowy ◽  
Brooke Rogers ◽  
Siena Napoleon ◽  
Drew Galipeau ◽  
...  
Keyword(s):  
Public Health ◽  
High Risk ◽  
Hiv Infection ◽  
Care Continuum ◽  
Increased Risk ◽  
Biomedical Intervention ◽  
Prep Implementation ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Prospective Longitudinal

BACKGROUND HIV disproportionately impacts criminal justice (CJ)-involved individuals, including men who experience incarceration. Men make up the vast majority of those experiencing incarceration as well as those newly diagnosed with HIV infection. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention that significantly reduces the risk of HIV acquisition. However, implementation in CJ-systems is limited. Little is known about effective PrEP implementation and use in this unique public health context. OBJECTIVE This article describes a PrEP care continuum for men experiencing incarceration who are at increased risk of HIV acquisition, which can help conceptualize approaches to evaluating PrEP implementation. METHODS Men incarcerated in the Rhode Island Department of Corrections, a correctional system composed of all of the state's sentenced and awaiting trial population, are screened for HIV acquisition risk during the course of routine clinical care. Those identified at high risk for HIV acquisition are referred for evaluation for PrEP initiation and enrollment in this study. Individuals who express interest in initiating PrEP and consent to the study are then followed in a prospective longitudinal cohort. RESULTS The outlined study will enroll 100 men experiencing incarceration at high risk for HIV acquisition prior to release into the community. The goal is to initiate PrEP prior to incarceration and link individuals to PrEP providers in the community, capturing barriers and facilitators to PrEP use during this uniquely vulnerable time period for HIV acquisition. CONCLUSIONS Based on the proposed care continuum and what is known about HIV risk and prevention efforts in the CJ-context, we outline key future research efforts to better understand effective approaches to preventing HIV infection among this vulnerable population. The described approach presents a powerful public health opportunity to help end the HIV epidemic.

scholarly journals Identifying Vulnerable Populations in Subtropical Brisbane, Australia: A Guide for Heatwave Preparedness and Health Promotion

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Margaret Loughnan ◽  
Nigel Tapper ◽  
Thu Phan
Keyword(s):  
Public Health ◽  
Health Promotion ◽  
Spatial Distribution ◽  
High Risk ◽  
Urban Areas ◽  
Spatiotemporal Analysis ◽  
Prevention Policy ◽  
Increased Risk ◽  
Risk Areas ◽  
Heat Events

Building healthy societies is a key step towards climate resilient communities. Ill health is related to increased risk during heat events and is disproportionally distributed within and between communities. To understand the differences in the spatial distribution of climate related health risks and how this will change in the future we have undertaken a spatiotemporal analysis of heatwave risks in urban populations in Brisbane, Australia. The aim of this was to advise emergency managers and public health authorities of high-risk areas during extreme heat events (EHEs). The spatial distribution of heat related morbidity identified areas of high healthcare service demand during EHEs. An index of risk was developed based on social and environmental determinants of vulnerability. Regression analysis was used to determine the key drivers of heat related morbidity from the index. A weighted map of population vulnerability was produced which identified the high risk areas and provided key information to target public health interventions and heat stress prevention policy. The predicted changes in high risk populations such as the proportion of elderly people living in urban areas were also mapped to support longer term adaptation and develop health care infrastructure and health promotion strategies.

Peer Crowd Identification and Adolescent Health Behaviors: Results From a Statewide Representative Study

2018 ◽  
Vol 46 (1) ◽  
pp. 40-52 ◽  
Author(s):  
Jeffrey W. Jordan ◽  
Carolyn A. Stalgaitis ◽  
John Charles ◽  
Patrick A. Madden ◽  
Anjana G. Radhakrishnan ◽  
...  
Keyword(s):  
Public Health ◽  
Substance Use ◽  
High Risk ◽  
Health Behaviors ◽  
Representative Sample ◽  
Risky Behaviors ◽  
Risk Groups ◽  
Representative Study ◽  
Increased Risk ◽  
Peer Crowds

Purpose. Peer crowds are macro-level subcultures that share similarities across geographic areas. Over the past decade, dozens of studies have explored the association between adolescent peer crowds and risk behaviors, and how they can inform public health efforts. However, despite the interest, researchers have not yet reported on crowd size and risk levels from a representative sample, making it difficult for practitioners to apply peer crowd science to interventions. The current study reports findings from the first statewide representative sample of adolescent peer crowd identification and health behaviors. Methods. Weighted data were analyzed from the 2015 Virginia Youth Survey of Health Behaviors ( n = 4,367). Peer crowds were measured via the I-Base Survey™, a photo-based peer crowd survey instrument. Frequencies and confidence intervals of select behaviors including tobacco use, substance use, nutrition, physical activity, and violence were examined to identify high- and low-risk crowds. Logistic regression was used to calculate adjusted odds ratios for each crowd and behavior. Results. Risky behaviors clustered in two peer crowds. Hip Hop crowd identification was associated with substance use, violence, and some depression and suicidal behaviors. Alternative crowd identification was associated with increased risk for some substance use behaviors, depression and suicide, bullying, physical inactivity, and obesity. Mainstream and, to a lesser extent, Popular, identities were associated with decreased risk for most behaviors. Conclusions. Findings from the first representative study of peer crowds and adolescent behavior identify two high-risk groups, providing critical insights for practitioners seeking to maximize public health interventions by targeting high-risk crowds.

scholarly journals High-risk lifestyle and all-cause mortality in older Australians with stroke: A data linkage study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
W Peng ◽  
Andrew Hayen ◽  
J a n e Maguire ◽  
J o n Adams ◽  
David Sibbritt
Keyword(s):  
Public Health ◽  
High Risk ◽  
Cox Regression ◽  
Healthy Lifestyle ◽  
Lifestyle Factors ◽  
Stroke Survivors ◽  
Vigorous Exercise ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Stroke prevention via lifestyle modification is a public health priority in developed countries. Few studies have examined the association of high-risk lifestyle factors with long-term mortality of stroke survivors. Therefore, this study aims to explore the effect of key lifestyle factors on all-cause mortality after stroke. Methods Sample is derived from the 45 and Up Study, the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. The lifestyle data in the 45 and Up Study between 2006 to 2015 were linked with data from the NSW Registry of Births, Deaths and Marriages, NSW Cause of Death Unit Record File, and NSW Admitted Patient Data Collection by the Centre for Health Record Linkage. We defined a high-risk lifestyle as no vigorous exercise, smokers, or > 10 alcoholic drinks/week. Multivariate Cox regression model is used to examine the effect of high-risk lifestyle on survival using 10-year all-cause mortality as the main outcome, adjusted for key confounders. Results We analysed information on 8410 adults with a stroke event occurring prior to the baseline 45 and Up Study, and 31% of them died in 10 years. 6219 participants were identified as having a high-risk lifestyle at baseline. Being a current smoker and without vigorous exercise were associated with 41% (95% CI: 16%, 73%) and 52% (95% CI: 30%, 78%) increase in the likelihood of death in 10 years, respectively. However, high-risk alcohol drinking was not significantly associated with survival. Of note, having cardiovascular-related comorbidities showed greater risks of mortality (HR range, 3.6-7.2). Conclusions High-risk lifestyle factors were associated with an increased risk of long-term all-cause mortality, suggesting that enhancing public health initiatives to promote 'healthy' lifestyle behaviours can be of great benefit to stroke survivors. Key messages It is essential for stroke survivors to maintain a healthy lifestyle to delay all-cause mortality. Stroke survivors with high-risk lifestyle may be associated with increased likelihood of death if they have comorbidities such as diabetes and hypertension.

scholarly journals Perinatal Cat and Dog Exposure and the Risk of Asthma and Allergy in the Urban Environment: A Systematic Review of Longitudinal Studies

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Caroline J. Lodge ◽  
Katrina J. Allen ◽  
Adrian J. Lowe ◽  
David J. Hill ◽  
Cliff S. Hosking ◽  
...  
Keyword(s):  
High Risk ◽  
Longitudinal Studies ◽  
Allergic Disease ◽  
Allergic Diseases ◽  
Risk Groups ◽  
Perinatal Period ◽  
Perinatal Exposure ◽  
Increased Risk ◽  
History Of ◽  
The Impact

Background. The literature is contradictory concerning pet exposure and the risk of development of asthma and other allergic diseases. Using longitudinal studies, we aimed to systematically review the impact of pet ownership in the critical perinatal period as a risk factor for allergies in childhood.Methods. Medline database was searched for urban cohort studies with perinatal exposure to cats and/or dogs and subsequent asthma or allergic disease.Results. Nine articles, comprising 6498 participants, met inclusion criteria. Six found a reduction in allergic disease associated with perinatal exposure to dogs or, cats or dogs. One study found no association. Two found increased risk only in high-risk groups.Conclusion. Longitudinal studies in urban populations suggest that perinatal pets, especially dogs, may reduce the development of allergic disease in those without a family history of allergy. Other unmeasured factors such as pet-keeping choices in allergic families may be confounding the association seen in these high-risk families, and further study is required.

scholarly journals Sexually transmitted infections among high-risk populations that use treatment as prevention or pre-exposure prophylaxis: a protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032054
Author(s):  
Makella Coudray ◽  
Sandra Kiplagat ◽  
Franklin Saumell ◽  
Purnima Madhivanan
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
High Risk ◽  
Sexually Transmitted Infections ◽  
Treatment As Prevention ◽  
Cochrane Central Register ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Prevention Method ◽  
Exposure Prophylaxis

BackgroundAmong men who have sex with men, pre-exposure prophylaxis (PrEP) reduces the risk of HIV by 95%. Based on the documented benefits, the Centre for Disease Control and Prevention has recommended PrEP as a prevention method for high-risk groups. Moreover, for those HIV-infected individuals, antiretroviral therapy has been shown to serve as both as a treatment and prevention method for HIV.Methods and analysisThis systematic review protocol was reported according to the Preferred Reporting Items for Systematic reviews and Analyses (PRISMA) P framework. Medline (1980–present), Embase (1980–present), CINAHL (1980–present), Cochrane Central Register of Controlled Trials and clinicaltrials.gov will be used to identify relevant articles based on a piloted search strategy. Peer-reviewed observational and experimental studies will be included. A narrative style will be used to describe descriptive data. A meta-analysis will be conducted if heterogeneity is not significant.Ethics and disseminationRecent evidence suggests that there is an increased risk of sexually transmitted infections (STIs) among high-risk persons that use PrEP. Furthermore, there is a paucity of data on the relationship of treatment as prevention and incidence of STIs. The findings of this review will assess this emerging public health phenomenon and serve to inform future public health policy. No formal ethical review is required for this protocol. All findings will be published in a peer reviewed journal.PROTOCOL registration numberCRD42019128720.

Patients’ and providers’ perspectives and needs of telemonitoring to support clinical management and self-care of people at high-risk for preeclampsia (Preprint)

2021 ◽  
Author(s):  
Maria Aquino ◽  
Janessa Griffith ◽  
Tessy Vattaparambil ◽  
Sarah Munce ◽  
Michelle Hladunewich ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Thematic Analysis ◽  
Clinical Management ◽  
Healthcare Providers ◽  
Self Care ◽  
Self Management ◽  
Close Monitoring ◽  
Structured Interviews ◽  
Increased Risk

BACKGROUND Preeclampsia is one of the leading causes of maternal mortality in the world with the global prevalence at 2% to 8% of pregnancies. Patients at high-risk for preeclampsia (PHRPE) have an increased risk of complications such as fetal growth restriction, preterm delivery, abnormal clotting, and liver and kidney disease. Telemonitoring for PHRPE may allow for a timelier diagnosis and enhanced management, which may improve maternal and perinatal outcomes. OBJECTIVE The objective of this study was to determine the perceptions and needs of PHRPE and their healthcare providers with respect to telemonitoring through semi-structured interviews with both groups. This study explored: 1) What are the needs and challenges of monitoring PHRPE during pregnancy and in the postpartum period? 2) What are the features required in a telemonitoring program to support self-care and clinical management of PHRPE? METHODS This study used a qualitative descriptive approach and thematic analysis was conducted. PHRPE and healthcare providers from a high-risk obstetrical clinic in a large academic hospital in Toronto, Canada were asked to participate in individual semi-structured interviews. Two researchers jointly developed a coding framework and coded each interview separately to ensure that the interviews were double coded. The software program NVivo version 12 was used to help organize the codes. RESULTS Seven PHRPE and five healthcare providers, which included a nurse practitioner and physicians, participated in the semi-structured interviews. Using thematic analysis, perceptions on the benefits, barriers, and desired features were determined. Perceived benefits of telemonitoring for PHRPE included close monitoring of home blood pressure measurements and appropriate interventions for abnormal blood pressure readings; the development of a tailored telemonitoring system for pregnant patients; and facilitation of self-management. Perceived barriers of telemonitoring for PHRPE included financial and personal barriers as well as the potential for increased clinician workload. Desired features of a secure platform for PHRPE included the facilitation of self-management for patients and decision-making for clinicians, as well as the inclusion of evidence-based action prompts. CONCLUSIONS The perceptions of patients and providers on the use of telemonitoring for PHRPE support the need for a telemonitoring program for the management of PHRPE. Recommendations from this study included the specific features of a telemonitoring program for PHRPE, as well as use of frameworks and design processes in the design and implementation of a telemonitoring program for PHRPE.

Contraception and thrombophilia

2009 ◽  
Vol 29 (02) ◽  
pp. 193-196 ◽  
Author(s):  
H. Rott ◽  
A. Kruempel ◽  
G. Kappert ◽  
U. Nowak-Göttl ◽  
S. Halimeh
Keyword(s):  
Chronic Illness ◽  
High Risk ◽  
Children And Adolescents ◽  
Hormonal Contraception ◽  
Hormonal Contraceptives ◽  
Thromboembolic Events ◽  
Contraceptive Methods ◽  
Secondary Complications ◽  
Increased Risk ◽  
Coagulation Proteins

SummaryThe risk of thromboembolic events (TE) is increased by acquired or inherited thrombo -philias (IT). We know that some hormonal contraceptives also increase the risk of thrombosis, thus, the use of such contraceptives are discussed as contraindications in women with IT. TEs are infrequent events in children and adolescents and in the majority of cases are associated with secondary complications from underlying chronic illness. Although adolescents are not typically considered to be at high-risk for TE, this cohort is frequently using hormonal contraception, leading to an increased risk in cases with unknown IT. The risk of TE with pregnancy alone is higher than associated with combined hormonal contra -ception. Progestin-only methods have not been found to increase the risk of TE with only moderate changes of coagulation proteins compared to normal reference values. Conclusion: Thrombophilic women are good candidates for progestin-only contraceptive methods.

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