Delaware journal of public health最新文献

Historically nurses have been drivers of innovation, from Florence Nightingale's sanitation movement in the 1850's to Anita Dorr creation of the code cart. This article explores the ingenuity of nursing and emphasizes the importance of education and professional development of bedside nurses. Amid the demands of increasing patient acuity and healthcare challenges, equipping bedside nurses with specialized education can yield improved patient outcomes alongside bedside nurse retention. The pioneering Nursing Research Fellowship in Robotics and Innovation at a local Delaware hospital is leading the way for nurses to engage in research, acquire new skills and become voices of change on their units. This fellowship demonstrates how a structured investment in nurses fosters curiosity and innovation, by offering nurses the tools, time, and support to ask "why not" and unlock solutions to today's healthcare challenges.

Designed in 2022, the Overdose Response Center, was created to provide a centralized, near real-time center for raw data and street intelligence analytics, and deployment operations and coordination of community response assets across the state. As the center began to operate during 2023, it became clear that the utilization of geospatial mapping software was a critical component to providing targeted direction and responses. Today, the center regularly maps relevant data, providing staff with multi-layered analysis of the current situation around the state, allowing us to provide clearly targeted (and personally walk-able) zones for both internal state field teams and partner programs, organizations, and outreach teams.

This commentary describes approaches by Delaware health and justice practitioners that divert justice-involved individuals presenting with substance use disorder (SUD) symptoms out of the criminal justice system and enhance connections to treatment and supportive services. It applies the Sequential Intercept Model (SIM) used by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) to discern opportunities for intervention at various stages of criminal processing. Examples of deflection/diversion programs at six of the SIM points are presented. Such cross-system collaborations are helping to redefine criminal justice reform and pathways of care after contact with the criminal justice system.

Objective: To determine the prevalence and determinants of beliefs in substance use deflection programs' effectiveness among police officers working in agencies with diversion initiatives.

Methods: We present responses from an anonymous online survey about deflection programs fielded to all law enforcement officers in the State of Delaware in January 2025. A total of 111 officers reported working in an agency with a substance use deflection program and completed relevant survey questions. Descriptive statistics summarize police officers' views on program effectiveness, attitudes toward leadership, beliefs in enforcing the law, occupational experiences, and personal characteristics. Logistic regression models isolate the factors associated with beliefs in program effectiveness. Descriptive statistics identify common barriers to deflection program implementation.

Results: A majority (59%) believe their programs are effective. On average, over three-quarters of respondents express that deflection programs are appropriate, feasible, and implementable. Tough-on-crime attitudes and being in a position for less than five years diminish the likelihood of stating that a deflection program is effective. Knowing someone who has a substance use or mental health disorder and working in a larger police department increases perceptions of program effectiveness. The three most commonly cited barriers to program implementation were having people interested in treatment, homelessness/housing issues, and the potential ineffectiveness of diversion.

Conclusions: Police officers generally believe their departments' substance use deflection programs are successful. Even more officers think programs can be easily and appropriately implemented. Commonly cited barriers highlight the difficulties in addressing substance use in communities.

Policy implications: This overall support for deflection underscores the potential for further cross-system collaborations with public health practitioners. Such partnerships may also be vital in addressing barriers that inhibit law enforcement-based deflection efforts. Further evaluation and research efforts can demonstrate the impacts of substance use deflection and the practices that make deflection programs more successful.

Recruitment and retention of nurses is a national health issue with implications for patients, nurses, and other healthcare providers. This article describes an innovative opportunity for the professional development of nurses at a local health system. This Nursing Research and Innovation Fellowship provided participating nurses with the knowledge of a design thinking framework and fostered the application in the context of complex challenges they face in their daily work. The potential impact of such programs on job satisfaction, retention, and relevance to public healthcare issues is discussed.

As cannabis legalization expands across the United States, its use among adolescents remains a pressing public health concern. This analytic essay analyzes the current prevalence, patterns, and consequences of cannabis use in adolescents. While legalization has not substantially increased adolescent use, it has contributed to normalization and greater access, ultimately lowering perceived risk and complicating prevention efforts. Increasing product potency and diversified consumption methods (e.g., vaping, dabbing, edibles) add to these challenges. Adolescent cannabis use is associated with adverse outcomes in brain development, mental health, and physical health including its effects on the gastrointestinal, cardiovascular, respiratory and endocrine systems of body. Cannabis Use Disorder (CUD) is underdiagnosed and undertreated in youth, with no FDA-approved pharmacological treatments. Psychosocial interventions such as contingency management and cognitive behavioral therapy (CBT) show modest efficacy, particularly when involving families. This paper highlights the urgent need for targeted education, policy measures, and accessible evidence-based interventions specifically tailored to adolescent populations to address the evolving challenges of cannabis use and its long-term consequences.

From the Buggery laws of 1533, to the hundreds of years of medical experiments taking advantage of already historically oppressed communities throughout the world, to the current anti-Trans laws and policies that are bombarding the nation today, reproductive autonomy has long been treated as a privilege as opposed to an inalienable right. The notion of reproductive freedom should be uncompromisable but it has not been fully realized due to the fostering and the legitimizing of coercive systems that keep marginalized communities oppressed, perpetuate violations to a person's body, and that prevent individuals from asserting themselves as the experts of their lives. While self-declaration, reproductive autonomy, and clear informed consent should always be the highest standard, we continue to see that these basic human rights are simply not afforded to all. This paper explores the history of coerced, forced, and involuntary sterilization, globally and in the United States, as a means of population control through criminalized punishment, "cures" to gynecological issues, and the gatekeeping of bodily autonomy, with a call to attention on how this practice has and continues to impact persons of color, the poor, and the LGBTQIA+ community. The authors of this paper aim to shift the oppressive standards that currently exist towards self-declaration, reproductive and sexual autonomy, and self-advocacy as a means to combat the harm of coerced sterilization and its intentional practice in medicine and policies. The clinical considerations provided intend to challenge the reader to examine their own actions as a possible "conspirator" to the passive eugenic practices that lead to sterilization by default, as outlined by the authors.

Many transgender masculine individuals experience gender dysphoria, including body dysphoria. Body dysphoria is the experience that our body does not align with our gender identification. For many of these individuals, their chest is an area of body dysphoria. Subsequently, many seek out a surgical masculinization of their chest, or what is commonly called "top surgery" to reduce the dysphoria. This systemic review aims to evaluate the current literature on changes in quality of life in trans masculine individuals after top surgery. APA PsychArticles, APA PsycInfo, PubMed, Scopus, Web of Science, and ProQuest Dissertations & Theses Global were the databases utilized for this search. Chaining was also used as the literature is sparse concerning this subject. There was no date range, and exclusions were minimal due to the sparsity of literature. The search produced 8 articles that could be used for this review. All of the studies that utilized proper data analysis found statistically significant evidence that top surgery results in improved body image or body congruence. The studies that included psychological wellbeing or psychological symptomology as a form of quality of life found statistically significant improvement in those areas. All studies found that the majority of participants felt more satisfied with their chests than dissatisfied. Based on the above studies, there is evidence that quality of life does improve for trans masculine individuals who receive top surgery. These studies imply that the gender affirming model of care of transgender individuals is a viable model to use for the treatment of body dysphoria. More studies in this area need to be conducted on this topic in order to validate these findings.