Relatively little is known about the role that leave policies--family, parental, or maternity-leave policies--play in facilitating time off work after childbirth. Yet time off is a critical element of leave policies, as it facilitates the mother's recovery from childbirth and promotes maternal-infant attachment. Using data from Minnesota, the state with the highest rate of female labor force participation, we examine the extent to which policies, relative to personal, job, and workplace characteristics, determine the duration of women's childbirth-related leaves from work. A random sample of women identified from vital statistics records is used to estimate the relationship between leave policies and time off work after childbirth. Of our sample 85 percent had access to some paid leave benefits, although only 46 percent had paid maternity leave benefits. The difference in duration of leave between women with and without paid leave policies was approximately four weeks, a substantial difference for most women and their infants. Paid leave policies and spousal earnings as primary determinants of maternal time off work, suggest problems in the use of unpaid leave for economically vulnerable women.

Since the NHS is recruiting staff from areas of high HIV prevalence, VCT should be encouraged. NHS staff require information on how to access testing as well as the benefits of early detection of blood-borne viruses.

This paper describes the development of a designated in-house service for the management of adult female victims of sexual assault within the Department of Genitourinary Medicine (GUM) at St Mary's Hospital, London. This was set up in 1994 as a need was identified by medical, nursing, psychological and health advising staff for an appropriate streamlined service which would provide comprehensive sexual health screening, psychological support and therapy and adequate medico-legal documentation within the limitations of a busy GUM clinic. A structured package of care consisting of medical and psychological protocols with training for relevant staff and a specialist in-house referral clinic was introduced. Fifty-four patients were seen during the first 17 months of the service, the notes of 48 of these were examined and relevant epidemiological and audit data are presented here. By auditing the quality of documentation before and after the introduction of the protocols specifically looking at the appropriateness and comprehensiveness of the sexually transmitted diseases screen and the medico-legal documentation it was clear that the quality of care to these patients was improved. We present here the development of these protocols, a detailed description of the protocols themselves and the method of their implementation.

New Zealand’s National Travel Assistance scheme is intended to provide financial support for people who need to either travel frequently or over long distances for specialist health care treatment. Taking an Indigenous Psychology orientation to “away-from-home” hospital admissions, we broaden the focus beyond an individual’s physical experience of hospitalization to the wider social and political context. Based on our research, we recommend a whānau-centered approach to travel assistance that will offer better coordination and remove factors negatively impacting whānau Māori (Indigenous families in New Zealand) health outcomes and contribute to United Nations Sustainable Development Goal 10 of reducing inequality. Our research is congruent with the community psychology value of “accountability” and the World Health Organisation value of “better health for everyone, everywhere.”

This exploratory, qualitative study set out to identify the encountered and perceived barriers to public health (PH) data sharing in a Canadian province with a view to assessing blockchain technology as a potential solution. A topic guide was developed, based on previous research in the area. This was then utilised for ten in-depth, semi-structured interviews with PH professionals between 27 May and 18 June 2019. Each stage of research was congruent with the philosophical underpinning of Gadamerian hermeneutic phenomenology. The major themes that emerged from the data collected were related to the information systems in use, data quality and ownership, as well as client identity management. The recurring core theme throughout all interviews was related to ineffective leadership and management, contributing to each major theme. Overwhelmingly the results show that the majority of barriers faced in this province are human-related. It is concluded that while blockchain technology shows promise for enhancing data sharing in healthcare, it is still many years away from being implemented in this Canadian province. As the results of this study indicate, there are human related barriers that could be addressed in the meantime, which are outside the scope of a technical solution. Future work should explore the perspectives of other stakeholders, such as the provincial government to fully understand the potential for using blockchain to share PH data in this province.

Background Ireland has one of the lowest BF rates in the world. This study investigates the association between breastfeeding and infant health in Ireland. Methods A cross-sectional, secondary analysis of data collected from Growing Up in Ireland (GUI): the National Longitudinal Study of Children was conducted. The average morbidity for 2212. infants exclusively breastfed for at least 90 days (EBF90days) was compared to data for 3987 infants in the non-breastfed (Non-BF) group. Data were weighted using entropy balancing to ensure the comparability of groups. Sensitivity analyses considered alternative definitions of the breastfeeding group. Results Infants who were EBF90days were significantly less likely to be admitted to hospital (CI: − 0.06 to − 0.03), spent less nights in hospital (CI: − 0.37 to − 0.11), and were less likely to develop respiratory diseases including asthma (CI: − 0.03 to − 0.01), chest infections (CI: − 0.12 to − 0.08), snuffles/common colds (CI: − 0.07 to − 0.02), ear infections (CI: − 0.08 to − 0.04), eczema (CI: − 0.08 to − 0.04), skin problems (CI: − 0.04 to − 0.00), wheezing or asthma (CI: − 0.06 to − 0.03), vomiting (CI: − 0.03 to − 0.00), and colic (CI: − 0.04 to − 0.01). Further outcomes such as current health of the infant at time of interview (CI: − 0.04 to − 0.00), feeding problems (CI: − 0.04 to − 0.02) and sleeping problems (CI: − 0.02 to − 0.00) indicated a protective effect of EBF90days versus Non-BF. However, these infants were also more likely to fail to gain weight (CI: 0.01 to 0.02) and were at a slightly higher risk of developing nappy rash (CI: 0.00 to 0.02). Conclusion Exclusive breastfeeding for 90+ days is associated with protection against childhood morbidity. Given the protective effect of breastfeeding on adverse health effects in infants, policy makers should prioritise policies that support, promote and protect exclusive breastfeeding.

A lack of communication between junior doctors and phlebotomists means untaken blood tests are often not recognised until late in a junior doctor's day, resulting in additional hours worked, delays in patient management, and potentially avoidable handover of additional work to oncall doctors.We set out to improve communication, with an aim that ward doctors should be made aware of patients who have not been successfully bled by phlebotomists by 1:00pm. By introducing a formal handover clipboard in a designated ward space, we facilitated communication between phlebotomists and doctors, and minimised the potential for unrecognised "missed" blood tests.Our intervention was met with approval; 88% of junior doctors surveyed stated they found the clipboards useful, and 74% have noticed an improvement in communication, working efficiency and better patient safety. Post-intervention, junior doctors knew about 70% of booked blood tests that had not been taken by 1:00pm, compared to 26% pre-intervention. By allowing the recognition of missed blood tests to be noted early enough in the day for repeat samples to be taken, and the results to be acted upon, we feel our intervention has been a success. As a group of new foundation doctors we have felt empowered that as a result of recognising a problem, implementing simple changes, and monitoring results we have made a genuine improvement to multi-disciplinary team working, workload of junior doctors, and patient safety. ProblemWe have identified an ongoing problem in Southmead Hospital, Bristol, UK regarding the communication between the junior doctors and phlebotomists. Patients are regularly not being bled by phlebotomists for various reasons; the patient may be away from the bedside during the phlebotomy round, or phlebotomists may struggle to take blood from patients with difficult IV access.However, junior doctors often don't find out about missed samples until late in the day when they go to check the day's blood results.This often means that there is not enough time to bleed the patients and get results back before the end of the working day. This can be dangerous for patients since it means that important treatment can be delayed. Often it also leads to longer hours worked by doctors if bloods need to be repeated and treatment initiated later in the day.Additionally, this can mean an increase in the workload handed over to the already busy on-call team in the evenings.There is a clear need to improve phleobotomists handover to junior doctors about patients who haven't been bled that day.Aim: Junior doctors should be made aware of patients who have not been successfully bled by phlebotomists by 1pm.

ObjectiveIncreasingly the views of young people are sought when improving healthcare; however, it is unclear how they shape policy or practice. This paper presents a consultation with young people commissioned by the National Institute for Health and Care Excellence (NICE) to inform clinical guidelines for paediatric palliative care (end-of-life care for infants, children and young people).MethodsThe consultation involved qualitative thematic analysis of data from 14 young people (aged 12–18 years) with a life-limiting or life-threatening condition who took part in focus groups or interviews. The topics explored were predefined by NICE: information and communication; care planning; place of care; and psychological care. Data collection consisted of discussion points and activities using visual cues and was informed by a pilot consultation group with five young adults (aged 19–24 years). Findings were shared with participants, and feedback helped to interpret the findings.ResultsFour overarching themes were identified, cutting across the predetermined topic areas: being treated as individuals with individual needs and preferences; quality of care more important than place; emotional well-being; and living as a young person. Importantly, care planning was viewed as a tool to support living well and facilitate good care, and the young people were concerned less about where care happens but who provides this.ConclusionYoung people’s priorities differ from those of parents and other involved adults. Incorporating their priorities within policy and practice can help to ensure their needs and preferences are met and relevant research topics identified.