Public Health in Practice最新文献_第8页

Prevalence of antibiotic-resistant Salmonella in kratom: Three-year monitoring study 克拉托姆地区耐抗生素沙门氏菌流行情况：三年监测研究

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health in Practice

Pub Date : 2025-12-01 Epub Date: 2025-09-08 DOI: 10.1016/j.puhip.2025.100652

Vaclav Peroutka, Katerina Demnerova, Jana Kadava, Simona Lencova

Objectives

Kratom, powder from Mitragyna speciosa leaves, is a popular psychoactive drug. It poses a health risk to consumers not only because of its narcotic and stimulating effects, but also because its quality is not controlled by the same laws as other food and pharmaceutical products. Due to the absence of mandatory quality control, kratom carries an increased risk of pathogenic bacteria contamination. Based on previous studies, the most relevant of these from a public health perspective are bacteria of the genus Salmonella, particularly serotypes that may cause severe gastrointestinal illness and exhibit resistance to antimicrobial agents. To assess the scale of the problem, we monitored the occurrence of Salmonella in commercially available kratom in the Czech Republic and determined its antimicrobial resistance.

Study design

Original microbiological research (long-term monitoring).

Methods

In 2022–2024, we tested 96 different kratom samples, from which Salmonella was isolated by the cultivation method according to EN ISO 6579. Series of biochemical and agglutination tests were used to determine the species, subspecies and serotypes. The disk diffusion method was used for testing susceptibility to 16 antimicrobial agents, and the results were interpreted using EUCAST and CLSI criteria.

Results

Salmonella was isolated from 16 out of all 96 tested samples. Biochemical and agglutination tests revealed that Salmonella enterica subsp. enterica was the most prevalent species and subspecies (14 samples), with some of the identified serotypes being relatively rare. Regarding the susceptibility to antimicrobial agents, out of all isolates 15 were resistant to at least one tested antimicrobial agent, and three isolates were classified as multidrug resistant.

Conclusions

Based on our analysis, the rate of Salmonella contamination did not differ statistically over the three years of study. Our results highlight the need for the continuous monitoring of Salmonella in kratom and provide a basis for the implementation of legal restrictions of its sale.

目的密天牛叶粉是一种常用的精神药物。它对消费者的健康构成威胁，不仅因为它具有麻醉和刺激作用，而且因为它的质量不受与其他食品和药品相同的法律控制。由于缺乏强制性的质量控制，kratom携带致病菌污染的风险增加。根据以往的研究，从公共卫生的角度来看，其中最相关的是沙门氏菌属细菌，特别是可能导致严重胃肠道疾病并对抗菌剂表现出耐药性的血清型。为了评估问题的规模，我们监测了捷克共和国市售克拉托姆中沙门氏菌的发生情况，并确定了其抗微生物药物耐药性。原始微生物研究（长期监测）。方法在2022-2024年对96份不同的克拉托姆样品进行检测，采用EN ISO 6579培养法分离沙门氏菌。采用一系列生化和凝集试验确定种、亚种和血清型。采用纸片扩散法对16种抗菌药物进行药敏试验，并采用EUCAST和CLSI标准对结果进行解释。结果96份样品中有16份检出沙门氏菌。生化和凝集试验表明：肠杆菌是最常见的种和亚种（14个样本），一些已确定的血清型相对罕见。在对抗菌药物的敏感性方面，所有分离株中有15株对至少一种所测抗菌药物耐药，3株被分类为多重耐药。结论：根据我们的分析，在三年的研究中，沙门氏菌污染率没有统计学差异。本研究结果强调了对克拉通沙门氏菌进行持续监测的必要性，并为实施法律限制其销售提供了依据。

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引用次数: 0

Age verification in alcohol online sales and delivery: results from a mystery shopping study in Estonia 酒精在线销售和配送中的年龄验证：爱沙尼亚神秘购物研究的结果

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health in Practice

Pub Date : 2025-12-01 Epub Date: 2025-09-30 DOI: 10.1016/j.puhip.2025.100656

Rainer Reile , Tiina Kuusik , Triin Mäll , Krista Tarlap , Anneli Sammel

Objectives

As the current evidence on the adherence to age verification requirement in alcohol online sale and delivery is scarce and inconclusive, we studied the age verification rate of alcohol deliveries via courier and parcel machine services to evaluate the accessibility of alcohol to the minors in Estonia.

Study design

Experimental study.

Methods

We adapted the mystery shopping methodology to the context of alcohol distance sale in Estonia to study the age verification ratio defined as ID requests during alcohol distance sale deliveries via couriers and parcel machines. A stratified random sample of 110 test purchases was created based on mapping of alcohol vendors offering alcohol distance sales in Estonia. Test purchasers (n = 7) aged 18–19 years old were recruited for the study. In total, 91 test purchases were conducted in between August and September 2024. Descriptive statistics and prevalence ratio from crude and adjusted log-binomial regression models were used to compare the ID validation by key test purchase characteristics.

Results

In total, 81.3 % of orders were delivered without ID validation. Although crude proportions of ID validation at the delivery varied for several test purchase characteristics, statistically significantly (p = 0.038) difference was only found for the delivery method. Courier deliveries had substantially lower age verification rate with 87.5 % of orders delivered without ID validation compared to 66.7 % in parcel machine deliveries. After adjustment to other test purchase characteristics, the corresponding prevalence ratio was 1.36 (95 % CI 1.02–1.82).

Conclusions

The findings indicate that online alcohol sales are accompanied with inconsistent and ineffective age verification practices that may increase alcohol availability to minors. The study highlights the need for stricter regulations and enforcement to prevent minors from accessing alcohol through online sales and delivery services.

由于目前关于酒精在线销售和配送中遵守年龄验证要求的证据很少且不确定，我们研究了通过快递和包裹机服务的酒精配送的年龄验证率，以评估爱沙尼亚未成年人获得酒精的可能性。研究设计：实验研究。方法将神秘购物方法应用于爱沙尼亚酒类远程销售的背景下，研究通过快递员和包裹机进行酒类远程销售交付时的年龄验证比率（定义为ID请求）。根据爱沙尼亚提供酒类远程销售的酒类供应商的地图，创建了110个测试购买的分层随机样本。测试购买者（n = 7）年龄在18-19岁。在2024年8月到9月之间总共进行了91次测试采购。采用粗糙和调整后的对数二项回归模型的描述性统计和患病率来比较关键测试购买特征的ID验证。结果81.3 %的订单在未验证ID的情况下发货。虽然交付时ID验证的粗比例在几个测试购买特征中有所不同，但仅在交付方法中发现了统计学上显著（p = 0.038）的差异。快递投递的年龄验证率要低得多，没有身份验证的订单中有87.5% %，而包裹机器投递的订单中有66.7% %。调整其他测试购买特征后，相应的患病率为1.36（95 % CI 1.02-1.82）。研究结果表明，在线酒精销售伴随着不一致和无效的年龄验证实践，这可能会增加未成年人获得酒精的机会。该研究强调需要更严格的法规和执法，以防止未成年人通过在线销售和送货服务获得酒精。

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引用次数: 0

Reducing health inequalities through work-a public health emergency? 通过工作减少健康不平等——突发公共卫生事件？

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health in Practice

Pub Date : 2025-12-01 Epub Date: 2025-09-29 DOI: 10.1016/j.puhip.2025.100659

N. Amedzro, S. Boorman, G. Allsopp

引用次数: 0

Exploring physical activity in the nursery setting in England. A qualitative study with staff and children 探索英国幼儿园环境中的体育活动。对工作人员和儿童进行定性研究

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health in Practice

Pub Date : 2025-12-01 Epub Date: 2025-08-05 DOI: 10.1016/j.puhip.2025.100644

M. Winder, S. Busby, E. Wilson

Objectives

Young children spend substantial time at formal childcare providers, including nurseries. Physical activity (PA) in childcare is highly varied. Qualitative research which can provide more in-depth understanding has been focused on adults, the voice of children is largely missing. This study aimed to triangulate staff and children's views and perspectives to develop a holistic understanding of PA in the nursery setting.

Study design

Qualitative study.

Methods

Separate focus groups with nursery staff and children in the nursery's preschool room (3 to <5 years of age) were conducted at nurseries (Nottinghamshire, England). Analysis followed Braun and Clarke's 6 steps of thematic analysis.

Results

55 children and 47 staff participated. 6 themes were identified: PA and learning theory in the nursery setting, children's understanding of PA, nursery ethos and resource, staff understanding of PA, PA and the link to development, PA in the nursery setting and the interaction with the home environment.

Conclusions

The nursery setting was perceived as important for PA and physical development (opportunity for risk taking and peer learning) and promotion of equity. The study identified possible opportunities to enhance PA in nurseries including separating the concepts of outdoors and PA, limiting use of unhealthy rewards, addressing staff knowledge gaps (e.g. recommended daily amount of PA) and including ‘understanding the importance of PA’ into the ‘managing self’ section of the EYFS. Future research should aim to incorporate parental views and explore the use of technology as a learning source for PA.

幼儿在正规的托儿服务机构（包括托儿所）花费大量时间。儿童保育中的身体活动（PA）变化很大。可以提供更深入理解的定性研究主要集中在成人身上，儿童的声音在很大程度上被忽视。本研究旨在三角测量员工和儿童的观点和观点，以发展对幼儿园环境中PA的整体理解。研究设计定性研究。方法在英国诺丁汉郡各幼儿园分别对幼儿园工作人员和幼儿园学前班儿童（3 ~ 5岁）进行焦点小组调查。分析遵循Braun和Clarke的6个主题分析步骤。结果儿童55名，工作人员47名。确定了6个主题：幼儿园环境中的PA和学习理论，儿童对PA的理解，托儿所精神和资源，员工对PA的理解，PA与发展的联系，托儿所环境中的PA以及与家庭环境的互动。结论托儿所环境对儿童的心理健康和身体发育（承担风险和同伴学习的机会）以及促进公平至关重要。该研究确定了加强托儿所PA的可能机会，包括分离户外和PA的概念，限制使用不健康的奖励，解决员工知识差距（例如推荐的每日PA量），并将“理解PA的重要性”纳入EYFS的“自我管理”部分。未来的研究应旨在纳入家长的观点，并探索使用技术作为PA的学习来源。

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引用次数: 0

Rent as a toxic exposure: The Bronx and Manhattan 暴露在有毒环境中的租房：布朗克斯和曼哈顿

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health in Practice

Pub Date : 2025-12-01 Epub Date: 2025-10-17 DOI: 10.1016/j.puhip.2025.100670

Deborah Wallace

Objectives

New York City, like many global cities, suffers from an ever-intensifying housing famine, especially of low-cost rental units, which has led to steeply rising rents and housing code violations. The purpose of this study is to explore whether rent affects public health patterns over the Bronx and Manhattan.

Study design

Median rent was regressed against public health indicators by borough 2005–2021.

Data and methods

Bronx and Manhattan annual birth rates, rates of low-weight births, obesity prevalence, and mortality rates from drug overdose, cerebrovascular disease, heart disease, and diabetes were acquired from the NYC Department of Health. Annual median rent for each borough was acquired from the American Community Survey. Bivariate and multivariate regressions revealed the associations.

Results

Both boroughs’ birth rates and obesity prevalence associated strongly with median rent, negatively for birth rate, positively for obesity prevalence. Rates of Bronx low-weight births, of Bronx and Manhattan drug deaths, and of Bronx cerebrovascular deaths declined in the early years but came to a threshold and rose. The threshold year-2021 rates associated strongly with annual median rents for those years. Rates of heart disease and diabetes mortalities showed a threshold effect, but plateaued, not rising.

Conclusion

Median rent behaved like a toxic chemical, eliciting defined patterns of public health degradation. The mix of responses to median rent mimic public health responses to the heavy metal lead: some without and some with a threshold. Toxic chemicals are regulated. Rent should be also.

与许多全球城市一样，纽约市也面临着日益严重的住房短缺问题，尤其是低成本租赁单元，这导致了租金的急剧上涨和住房法规的违反。本研究的目的是探讨租金是否影响布朗克斯和曼哈顿的公共健康模式。研究设计2005-2021年按行政区对租金中位数与公共卫生指标进行回归。数据和方法从纽约市卫生局获得布朗克斯和曼哈顿的年出生率、低体重新生儿率、肥胖症患病率、药物过量死亡率、脑血管疾病、心脏病和糖尿病死亡率。每个行政区的年租金中位数来自美国社区调查。双变量和多变量回归揭示了这种关联。结果两个行政区的出生率和肥胖率与租金中位数密切相关，出生率负相关，肥胖率正相关。布朗克斯区的低体重新生儿、布朗克斯区和曼哈顿的毒品死亡率以及布朗克斯区脑血管死亡率在最初几年有所下降，但后来达到了一个临界值并有所上升。2021年的门槛利率与这几年的年租金中位数密切相关。心脏病和糖尿病的死亡率显示出阈值效应，但趋于稳定，没有上升。结论中位数租金表现为一种有毒化学物质，引发了明确的公共卫生退化模式。对中位数租金的反应类似于对重金属铅的公共卫生反应：有些没有，有些有阈值。有毒化学品受到管制。租金也应该如此。

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引用次数: 0

Short Communication: What interest and influence do Directors of Public Health in London have in local gambling policy? 简短交流：伦敦公共卫生主管对当地赌博政策有什么兴趣和影响？

IF 2.2 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health in Practice

Pub Date : 2025-12-01 Epub Date: 2025-06-25 DOI: 10.1016/j.puhip.2025.100635

Jenny Blythe Dr

Objectives

Gambling harms are increasingly conceptualised as a public health issue, affecting not only the individual who gambles but those close to them and to wider society too. However, the Gambling Act 2005 gives public health teams no statutory role in decisions by local councils on ‘land-based’ gambling licensure, unlike alcohol premises licensing where public health teams are a responsible authority. We surveyed Directors of Public Health in London to gain understanding of their interest and influence in local gambling policy.

Study design

a survey was created in conjunction with representatives from London public health teams and disseminated via an online platform. It was sent to Directors of Public Health in all 32 London boroughs.

Methods

Survey questions were a mixture of fact-finding questions about the public health teams structure (including staff number) and Likert scale questions about their interest and influence in gambling policy, using comparator questions with alcohol policy (where public health teams have a formal role).

Results

the response rate for the survey was 28 %. The place of public health teams within individual councils varies widely, as does the number of Full-Time Equivalent staff members. There was positive correlation between a public health teams perceived influence on alcohol and gambling policy. Public health teams identified a wide number of existing effective partnerships within their organisations.

Conclusions

The findings suggest that it is public health team integration rather than pure legislative factors that influence their involvement in local gambling policy. Existing effective partnerships, particularly licensing and planning, should be harnessed to further integrate public health teams into decision-making.

赌博危害越来越被视为一个公共健康问题，不仅影响到赌博的个人，也影响到与他们亲近的人以及更广泛的社会。然而，2005年《赌博法》没有赋予公共卫生小组在地方议会关于“陆上”赌博许可证的决定中发挥法定作用，这与公共卫生小组是负责当局的酒精场所许可证不同。我们调查了伦敦的公共卫生主管，以了解他们对当地赌博政策的兴趣和影响。研究设计调查是与伦敦公共卫生团队的代表一起创建的，并通过在线平台传播。它被送到伦敦所有32个行政区的公共卫生主管那里。方法调查问题是关于公共卫生团队结构（包括工作人员数量）的事实调查问题和关于他们对赌博政策的兴趣和影响的李克特量表问题的混合，使用与酒精政策（公共卫生团队具有正式作用）比较的问题。结果本次调查的回复率为28%。公共卫生小组在各个理事会的位置差别很大，相当于全职工作人员的人数也差别很大。公共卫生团队对酒精和赌博政策的感知影响之间存在正相关关系。公共卫生小组在其组织内确定了大量现有的有效伙伴关系。结论公共卫生团队的整合而非纯粹的立法因素影响了他们对地方赌博政策的参与。应利用现有的有效伙伴关系，特别是许可和规划，使公共卫生小组进一步参与决策。

{"title":"Short Communication: What interest and influence do Directors of Public Health in London have in local gambling policy?","authors":"Jenny Blythe Dr","doi":"10.1016/j.puhip.2025.100635","DOIUrl":"10.1016/j.puhip.2025.100635","url":null,"abstract":"<div><h3>Objectives</h3><div>Gambling harms are increasingly conceptualised as a public health issue, affecting not only the individual who gambles but those close to them and to wider society too. However, the Gambling Act 2005 gives public health teams no statutory role in decisions by local councils on ‘land-based’ gambling licensure, unlike alcohol premises licensing where public health teams are a responsible authority. We surveyed Directors of Public Health in London to gain understanding of their interest and influence in local gambling policy.</div></div><div><h3>Study design</h3><div>a survey was created in conjunction with representatives from London public health teams and disseminated via an online platform. It was sent to Directors of Public Health in all 32 London boroughs.</div></div><div><h3>Methods</h3><div>Survey questions were a mixture of fact-finding questions about the public health teams structure (including staff number) and Likert scale questions about their interest and influence in gambling policy, using comparator questions with alcohol policy (where public health teams have a formal role).</div></div><div><h3>Results</h3><div>the response rate for the survey was 28 %. The place of public health teams within individual councils varies widely, as does the number of Full-Time Equivalent staff members. There was positive correlation between a public health teams perceived influence on alcohol and gambling policy. Public health teams identified a wide number of existing effective partnerships within their organisations.</div></div><div><h3>Conclusions</h3><div>The findings suggest that it is public health team integration rather than pure legislative factors that influence their involvement in local gambling policy. Existing effective partnerships, particularly licensing and planning, should be harnessed to further integrate public health teams into decision-making.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100635"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Satisfaction of indigenous pregnant women with a mobile voice application in Quechua developed by midwives for prenatal care in Peru 土著孕妇对秘鲁助产士为产前护理开发的克丘亚语移动语音应用程序的满意度

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health in Practice

Pub Date : 2025-12-01 Epub Date: 2025-07-25 DOI: 10.1016/j.puhip.2025.100645

Augusto Felix Olaza-Maguiña, Yuliana Mercedes De La Cruz-Ramirez

Objectives

Despite the effort shown by health personnel, many of them still have limitations in communicating with Peruvian Quechua-speaking pregnant women. The mobile applications have become an alternative to complement health care during pregnancy, especially if, as in Peru, the use of mobile devices has increased significantly, even in indigenous communities. Thus, the objective of this research was to evaluate the satisfaction of indigenous pregnant women from a Peruvian rural community with a mobile voice application in Quechua developed by midwives for prenatal care.

Study design

Cross-sectional study with a questionnaire.

Methods

The research was developed with 120 pregnant women from the rural community of Marian (3320 m a.s.l., Huaraz, Peru), who after a thorough explanation and the voluntary signing of a declaration of informed consent, accepted the free installation of the application. Thus, after at least 6 months of use, they answered a previously validated questionnaire with 23 questions between August 2023 and July 2024. A descriptive analysis was applied.

Results

It was evidenced that 82.5 % of pregnant women were satisfied with the application. Three (21.4 %) of 14 features were rated with dissatisfaction or indifference such as speed of functions, content about maternal-foetal bonding and appearance, with scores of 2.98, 2.92 and 3.46, respectively. The best valued aspect was the information about warning signs during pregnancy, childbirth and postpartum with a score of 4.71, while the information about activities that promote maternal-foetal bonding received the lowest score (2.92).

Conclusions

The majority of indigenous pregnant women from Marian community were satisfied with mobile voice application in Quechua for prenatal care, so with some improvements such as appearance, speed of functions and content about maternal-foetal bonding, it could be used for free in rural areas as a solution proposal to language barriers that limit health care in vulnerable populations.

尽管卫生人员做出了努力，但他们中的许多人在与讲克丘亚语的秘鲁孕妇沟通方面仍然受到限制。移动应用程序已成为怀孕期间补充保健的一种替代办法，特别是在秘鲁，即使在土著社区，移动设备的使用也大大增加的情况下。因此，本研究的目的是评估来自秘鲁农村社区的土著孕妇对助产士开发的用于产前护理的克丘亚语移动语音应用程序的满意度。研究设计采用问卷调查的横断面研究。方法本研究选取了120名来自Marian （3320 m a.s.l, Huaraz, Peru）农村社区的孕妇为研究对象，经详细说明并自愿签署知情同意声明后，接受免费安装应用程序。因此，在使用至少6个月后，他们在2023年8月至2024年7月期间回答了一份包含23个问题的预先验证问卷。采用描述性分析。结果82.5%的孕妇对应用满意。在14个特征中，有3个（21.4%）被评为不满意或不满意，分别为功能速度、母婴关系内容和外观，得分分别为2.98、2.92和3.46。最受重视的方面是怀孕、分娩和产后的警告信号信息，得分为4.71，而促进母婴关系的活动信息得分最低，得分为2.92。结论玛丽安社区大多数土著孕妇对克丘亚语移动语音产前保健服务感到满意，在外观、功能速度和母婴结合内容等方面进行改进，可在农村地区免费使用，解决弱势群体的语言障碍问题。

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引用次数: 0

Letter to editor regarding: “Local authorities need tailored research ethics processes to support research capacity building” [Pub. Health Pract. 10 (2025) 100640] 致编辑的信关于：“地方当局需要量身定制的研究伦理程序来支持研究能力建设”[Pub。保健实践。10 (2025)100640]

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health in Practice

Pub Date : 2025-12-01 Epub Date: 2025-12-09 DOI: 10.1016/j.puhip.2025.100646

Geoff Middleton , Sarah Varga , Susan Hampshaw , Geraldine Byrne , Alex-Jade Delahunty , Richard Gettings , Lorna Dowrick , Catherine Homer

引用次数: 0

Medicaid reimbursement policies for long-acting reversible contraceptives immediately postpartum: A systematic literature review 产后立即长效可逆避孕药的医疗补助报销政策：系统的文献回顾

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health in Practice

Pub Date : 2025-12-01 Epub Date: 2025-10-31 DOI: 10.1016/j.puhip.2025.100680

Greta Lozano-Ortega , Sarah E. Walker , Simone Crespi , Emilia Kourmaeva , Vanessa Perez Patel

Objectives

Medicaid reimbursement for long-acting reversible contraceptives provisioned immediately postpartum (IPP-LARC) has historically been included as part of the diagnosis-related group (DRG) fee for delivery. To rectify this financial disincentive, policies to reimburse hospitals for IPP-LARC, supplemental to the DRG fee, were implemented. This review synthesizes the impact of these policies.

Study design

Systematic literature review.

Methods

A search in Medline, EMBASE, and CINAHL was executed on November 21, 2022. Impacts on uptake of IPP-LARC, short-interval pregnancy, and author conclusions were synthesized.

Results

Twenty studies reporting on Medicaid reimbursement policies across 15 states were included. The average age of women across study populations ranged from 22.2 to 31.0 years; populations were racially, and ethnically diverse; primarily urban hospitals were included. Sixteen studies reported on uptake and 7 studies reported on birth outcomes. Statistically significant increases in uptake after policy implementation were reported in 9 studies across Delaware, Georgia, New York, Rhode Island, Wisconsin, Washington, Louisiana, Missouri, and South Carolina. Policy implementation in South Carolina and Ohio resulted in significantly lower rates of short-interval pregnancy, as reported in 6 studies. Smaller, rural, and religiously affiliated hospitals were significantly less likely to leverage Medicaid policies for IPP-LARC. Key determinants of increased uptake were provider champion advocacy, co-interventions for training hospital staff, and relieving the up-front financial burden associated with stocking LARCs.

Conclusions

Medicaid reimbursement policies targeting IPP-LARC access are associated with increased adoption and reduced short-interval pregnancy. Co-interventions supporting hospitals and individuals who are immediately postpartum would further facilitate IPP-LARC access.

医疗补助对产后立即提供的长效可逆避孕药（IPP-LARC）的报销历来被纳入分娩诊断相关组（DRG）费用的一部分。为了纠正这种财政上的不利因素，实施了补偿医院IPP-LARC的政策，作为DRG费用的补充。本次审查综合了这些政策的影响。研究设计系统文献综述。方法于2022年11月21日在Medline、EMBASE和CINAHL中进行检索。综合了对IPP-LARC摄取、短间隔妊娠和作者结论的影响。结果20项研究报告了15个州的医疗补助报销政策。研究人群中女性的平均年龄从22.2岁到31.0岁不等；人口在种族和民族上是多样化的；主要包括城市医院。16项研究报告了摄取情况，7项研究报告了出生结果。在特拉华州、佐治亚州、纽约州、罗德岛州、威斯康星州、华盛顿州、路易斯安那州、密苏里州和南卡罗来纳州的9项研究中，报告了政策实施后的统计显着增加。据6项研究报告，在南卡罗来纳州和俄亥俄州实施的政策显著降低了短间隔妊娠率。较小的、农村的和宗教附属的医院明显不太可能利用医疗补助政策为IPP-LARC服务。增加吸收的关键决定因素是提供者倡导，培训医院工作人员的联合干预措施，以及减轻与储备larc相关的前期经济负担。结论针对IPP-LARC获取的医疗补助报销政策与提高采用率和减少短间隔妊娠有关。支持医院和立即产后的个人的联合干预措施将进一步促进IPP-LARC的获取。

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引用次数: 0

Needle length selection for intramuscular vaccine administration: Time for an evidence-based approach 肌注疫苗注射针头长度的选择：循证方法的时机

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health in Practice

Pub Date : 2025-12-01 Epub Date: 2025-09-29 DOI: 10.1016/j.puhip.2025.100657

Marjan Doppen , Ciléin Kearns , Nethmi Kearns , Thomas Hills , Gabrielle Shortt , Lesley Gray , Mark Weatherall , Nicole J. Moreland , Ali Mirjalili , Richard Beasley

引用次数: 0