Policymakers, practitioners and academics expect mental health and psychosocial support (MHPSS) interventions to have social outcomes. Surprisingly, the existing academic literature on the ...effectiveness of MHPSS has focused almost exclusively on clinical outcomes. The evidence base of MHPSS interventions is in that way limited. To feed the research agenda on MHPSS (i.e., MHPSS-SET2), this scoping review analyses the presence and understanding of social outcomes in the grey literature. Open-access documents were systematically searched from various online grey literature databases and websites of organisations. Documents which describe psychosocial programming in low- and middle-income countries for people affected by humanitarian emergencies were included. Data characteristics were extracted, such as the type of document, intervention and outcome. A textual analysis of social outcomes was conducted to categorise the descriptions of these outcomes.
A total number of 95 grey literature documents were included in the review. It was found that in the vast majority of the reviewed documents, social outcomes are being described. However, social outcomes have been poorly conceptualised both theoretically and methodologically, meaning that most documents lack definitions of theoretical concepts and measurement instruments. Mechanisms relating interventions to social outcomes have remained implicit. These findings are interpreted in light of key developments in the field of MHPSS, in particular the introduction of the Inter-Agency Standing Committee (IASC) guidelines, and the review traces the underexposed position of social outcomes back to the clinical historical roots of the field.
In conclusion, those who develop and evaluate interventions should focus more structural attention on social outcomes to fully understand the possible impact of psychosocial interventions. Further harmonisation between academic research and practice is necessary, by drawing from practice-based insights on social outcomes as found in the grey literature, and using methods and measurement instruments from social sciences in MHPSS research.
•Mental health and psychosocial support is expected to have social outcomes.•Academia focuses on the clinical outcomes of mental health and psychosocial support.•We reviewed grey literature; the work of policy makers and practitioners.•The resulting categorisation and conceptual model can guide academic research.•Methods and measurement tools of social sciences can complement current research.
Despite their familiar sensitivity to transformation by dominant-acting ras oncogenes, NIH/3T3 cells carry a ras suppressor. When tested by cell fusion they were able to suppress the ...anchorage-independent phenotype of both mouse and human cells transformed by activated H-ras or N-ras. This suppression occurred without a decrease in expression of the activated ras oncogene. Ras-transformed NIH/3T3 clones cured of their oncogene by benzamide treatment reverted to a nontransformed phenotype, but had lost the ability to suppress other ras transformants, indicating that their initial transformation was accompanied by suppressor loss. In hamster cells an active ras oncogene increased the rate of chromosome segregation by > 100-fold. These results suggest that in vitro transformation of NIH/3T3 cells by ras may be more similar to multistep in vivo tumor development than previously suspected, involving not only expression of an active oncogene but also loss of a suppressor activity, perhaps induced by the clastogenic oncogene.
Day care centres (DCCs) are ideal settings for drug-resistant bacteria to emerge. Prevalence numbers of faecal carriage of antimicrobial resistant bacteria in these settings are rare. We aimed to ...determine the prevalence of faecal antimicrobial resistant bacteria carriage in children attending DCCs and to assess and identify infection risk factors within DCCs in The Netherlands and Belgium.
A point-prevalence study was conducted in 28 Dutch (499 children) and 18 Belgian (448 children) DCCs. Stool samples were taken from the children's diapers and a questionnaire was filled in by their parents. Hygiene related to stool and toilet use, hygiene related to food, environmental contamination, hand hygiene and hygiene guidelines were assessed conform a standardized questionnaire by the infection prevention and control expert visiting the DCC. Multilevel logistical regression analyses were used to define which characteristics predicted the presence of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E), carbapenemase-producing Enterobacterales (CPE), vancomycin-resistant enterococci (VRE), and ciprofloxacin-resistant Enterobacterales (CipR-E).
The ESBL-E prevalence was 16% (n = 71) in Belgium and 6% (n = 30) in the Netherlands. The CipR-E prevalence was 17% (n = 78) in Belgium and 8% (n = 38) in the Netherlands. Antimicrobial use (RR: 0.30; 95% CI: 0.33-0.48) and hospital admissions (RR: 0.37; 95% CI: 0.25-0.54) were lower in the Netherlands. Children travelling to Asia were at higher risk of being an ESBL-E carrier. Children using antimicrobials were at higher risk of being a CipR-E carrier. Cleaning the changing mat after each use was found as a protective factor for CipR-E carriage.
We established a significant difference in ESBL-E and CipR-E carriage and antimicrobial use and hospital admissions between the Netherlands and Belgium among children attending DCCs. The differences between both countries should be further studied to improve the policy on anti-microbial use and hospital admissions in children.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In this contribution we will shed light on how individual and social post-migration factors affect the well-being of undocumented migrants. Using retrospective interviews, this study involves ...undocumented migrants who live in the Netherlands and have received psychosocial support. The stories of these undocumented migrants demonstrate that individual and social post-migration factors (such as health and social contacts) are closely entangled. These pathways are not often considered by mental health and psychosocial support organizations. A better understanding of these pathways will strengthen support for as yet untapped factors of change, and be effective in improving the well-being of undocumented migrants.
In the Netherlands, charitable behavior for international development purposes is subject to important changes. Whereas established development organizations suffer from a declining support base, ...private development initiatives (PDIs) that execute concrete, small-scale projects within direct personalized aid networks can count on increasing enthusiasm from individual donors of money and time. We investigate to what extent cost-benefit evaluations of volunteers (supply side) and characteristics of PDIs (demand side) affect the time allocation for volunteering in these organizations. The study is based on a survey among 661 volunteers active in Dutch PDIs. PDI volunteers face time and budget restrictions, partly due to their position on the (paid) labor market. Volunteers who are skeptical toward established development organizations increase voluntary time investment in PDIs. Corroborating the proximity hypothesis, volunteers perceiving a smaller distance to beneficiaries, spend more volunteering hours in PDIs. Volunteers also spend more hours volunteering for PDIs with larger budgets and more staff.
A tool, the Infection Risk Scan has been developed to measure the quality of infection control and antimicrobial use. This tool measures various patient-, ward- and care-related variables in a ...standardized way. We describe the implementation of this tool in nine hospitals in the Dutch/Belgian border area and the obtained results.
The IRIS consists of a set of objective and reproducible measurements: patient comorbidities, (appropriate) use of indwelling medical devices, (appropriate) use of antimicrobial therapy, rectal carriage of Extended-spectrum beta-lactamase producing Enterobacterales and their clonal relatedness, environmental contamination, hand hygiene performance, personal hygiene of health care workers and presence of infection prevention preconditions. The Infection Risk Scan was implemented by an expert team. In each setting, local infection control practitioners were trained to achieve a standardized implementation of the tool and an unambiguous assessment of data.
The IRIS was implemented in 34 wards in six Dutch and three Belgian hospitals. The tool provided ward specific results and revealed differences between wards and countries. There were significant differences in the prevalence of ESBL-E carriage between countries (Belgium: 15% versus The Netherlands: 9.6%), environmental contamination (median adenosine triphosphate (ATP) level Belgium: 431 versus median ATP level The Netherlands: 793) and calculated hand hygiene actions based on alcohol based handrub consumption (Belgium: 12.5/day versus The Netherlands: 6.3/day) were found.
The Infection risk Scan was successfully implemented in multiple hospitals in a large cross-border project and provided data that made the quality of infection control and antimicrobial use more transparent. The observed differences provide potential targets for improvement of the quality of care.
The objective of this study was to determine the level of environmental contamination in hospitals in the Dutch/Belgian border area, using ATP measurements.
A cross-sectional observational survey.
...Standardized ATP measurements were conducted in 9 hospitals on 32 hospital wards. Thirty pre-defined surfaces per hospital ward were measured with the 3 M Clean Trace NG luminometer. Results are displayed in relative light units (RLU). RLU > 1000 was considered as "not clean." Differences in RLU values were compared between countries, hospitals, fomite groups and medical specialties.
A total of 960 ATP measurements were performed, ranging from 60 up to 120 per hospital. The median RLU-value was 568 (range: 3-277,586) and 37.7% of the measurements were rated as not clean (RLU > 1000). There were significant differences between countries, hospitals and fomite groups.
ATP measurements can be used as a more objective approach to determine the level of environmental contamination in hospitals. Significant differences in ATP levels were found between hospitals and between countries. Also, substantial differences were found between different fomite groups. These findings offer potential targets for improvement of cleanliness in healthcare facilities.
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