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Blue justice: A review of emerging scholarship and resistance movements
- Jessica L. Blythe, David A. Gill, Joachim Claudet, Nathan J. Bennett, Georgina G. Gurney, Jacopo A. Baggio, Natalie C. Ban, Miranda L. Bernard, Victor Brun, Emily S. Darling, Antonio Di Franco, Graham Epstein, Phil Franks, Rebecca Horan, Stacy D. Jupiter, Jacqueline Lau, Natali Lazzari, Shauna L. Mahajan, Sangeeta Mangubhai, Josheena Naggea, Rachel A. Turner, Noelia Zafra-Calvo
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- Journal:
- Cambridge Prisms: Coastal Futures / Volume 1 / 2023
- Published online by Cambridge University Press:
- 26 January 2023, e15
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The term “blue justice” was coined in 2018 during the 3rd World Small-Scale Fisheries Congress. Since then, academic engagement with the concept has grown rapidly. This article reviews 5 years of blue justice scholarship and synthesizes some of the key perspectives, developments, and gaps. We then connect this literature to wider relevant debates by reviewing two key areas of research – first on blue injustices and second on grassroots resistance to these injustices. Much of the early scholarship on blue justice focused on injustices experienced by small-scale fishers in the context of the blue economy. In contrast, more recent writing and the empirical cases reviewed here suggest that intersecting forms of oppression render certain coastal individuals and groups vulnerable to blue injustices. These developments signal an expansion of the blue justice literature to a broader set of affected groups and underlying causes of injustice. Our review also suggests that while grassroots resistance efforts led by coastal communities have successfully stopped unfair exposure to environmental harms, preserved their livelihoods and ways of life, defended their culture and customary rights, renegotiated power distributions, and proposed alternative futures, these efforts have been underemphasized in the blue justice scholarship, and from marine and coastal literature more broadly. We conclude with some suggestions for understanding and supporting blue justice now and into the future.
Identification of Colonized Patients During an Outbreak of Candida auris Using a Regional Health Information Exchange
- Richard Brooks, Elisabeth Vaeth, Heather Saunders, Tim Blood, Brittany Grace, David Blythe, Liore Klein, Jacqueline Reuben, Regan Trappler, Preetha Iyengar, Emily Blake, Sarah Lineberger, Rehab Abdelfattah, Kathleen Tully, Kaitlin Forsberg, Maroya Walters, Snigdha Vallabhaneni
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, pp. s255-s256
- Print publication:
- October 2020
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Background: In June 2019, the Maryland Department of Health (MDH) was notified of a hospitalized patient with Candida auris bloodstream infection. The MDH initiated a contact investigation to identify additional patients with C. auris colonization. Many of the contacts had been discharged home from the hospital and were therefore not available for screening. Healthcare facilities in Maryland, Virginia, and Washington, DC, submit patient data to a regional health information exchange (HIE) called the Chesapeake Regional Information System for our Patients (CRISP). CRISP includes a notification system that alerts providers when flagged patients have healthcare encounters. We aimed to use this system to identify discharged C. auris contacts on their next inpatient encounter to rapidly screen them and to detect new cases. Methods:C. auris contacts were defined as patients located on an inpatient unit on the same day, receiving wound care from the same team, or having a procedure in the same operating room on the same day as the index patient or any patients subsequently identified as having C. auris infection or colonization detected either during the normal course of clinical care or through screening. Contacts who remained hospitalized were screened during inpatient point prevalence surveys (PPSs). Contacts discharged to postacute-care facilities were screened by facility staff. Contacts who had been discharged home were flagged in CRISP, and MDH staff received CRISP encounter alerts when these patients were readmitted. MDH staff then contacted the admitting facilities to recommend screening for C. auris. Axilla and groin swabs were collected and tested by rt-PCR at the Mid-Atlantic Regional Antibiotic Resistance Laboratory Network laboratory. Results: As of October 8, 2019, 4,017 contacts were identified. Among these, 936 (23%) contacts at 56 healthcare facilities (33 acute-care hospitals and 23 postacute-care facilities) were screened for C. auris, and 10 patients with C. auris colonization were identified (1.1% of contacts who underwent C. auris screening). Of these, 6 (60%) were identified through CRISP notification and 4 (40%) were identified by PPSs conducted in acute-care hospitals. Conclusions: In this ongoing C. auris outbreak, a large proportion of colonized patients was identified using an electronic encounter notification system within a regional HIE. This approach was effective for identifying opportunities to screen contacts at their next healthcare encounter and can augment other means of case detection, like PPSs. HIEs should incorporate mechanisms to facilitate contact tracing for public health investigations.
Funding: None
Disclosures: None
SPARC-ing Change—The Maryland Statewide Prevention and Reduction of Clostridioides difficile (SPARC) Collaborative
- Clare Rock, David Blythe, Jacqueline Bork, Kimberly Christine Claeys, Sara Cosgrove, Kathryn Dzintars, Valeria Fabre, Anthony Harris, Emily Heil, Sara Keller, Lisa Maragakis, Aaron Michael Milstone, Daniel Morgan, Richard Brooks, Surbhi Leekha
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, p. s80
- Print publication:
- October 2020
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Background: In 2018, the Maryland Department of Health, in collaboration with the University of Maryland and Johns Hopkins University, created the Statewide Prevention and Reduction of Clostridioides difficile (SPARC) collaborative to reduce C. difficile as specified in Healthy People 2020. Methods: The SPARC collaborative recruited hospitals contributing most cases to statewide C. difficile standardized infection ratio (SIR), according to data reported to the National Healthcare Safety Network (NHSN). SPARC developed intervention bundles around 4 domains: infection prevention, environmental cleaning, and diagnostic and antimicrobial stewardship. Each facility completed a self-assessment followed by an on-site, day-long, peer-to-peer (P2P) evaluation with 8–12 SPARC subject matter experts (SMEs) representing each domain. The SMEs met with hospital executive leadership and then led 4 domain-based group discussions with relevant hospital team leaders. To identify policy and practice gaps, SMEs visited hospital inpatient units for informal interviews with frontline staff. In a closing session, SPARC SMEs, hospital executives, and team leaders reconvened to discuss preliminary findings. This included review of covert observation data (hand hygiene, personal protective equipment compliance, environmental cleaning) obtained by SPARC team 1–2 weeks prior. Final SPARC P2P written recommendations guided development of customized interventions at each hospital. SPARC provided continuous support (follow up phone calls, educational webinars, technical support, didactic training for antimicrobial stewardship pharmacists) to enhance facility-specific implementation. For every quarter, we categorized C. difficile NHSN data for each Maryland hospital into “SPARC” or “non-SPARC” based on participation status. Using negative binomial mixed models, we analyzed difference-in-difference of pre- and postincidence rate ratios (IRRs) for SPARC and non-SPARC hospitals, which allowed estimation of change attributable to SPARC participation independent of other time-varying factors. Results: Overall, 13 of 48 (27%) hospitals in Maryland participated in the intervention. The baseline SIR for all Maryland hospitals was 0.92, and the post-SPARC SIR was 0.67. The SPARC hospitals had a greater reduction in hospital-onset C. difficile incidence; 8.6 and 4.3 events per 10,000 patient days for baseline and most recent quarter, respectively. For non-SPARC hospitals, these hospital-onset C. difficile incidences were 5.1 preintervention and 4.3 postintervention. We found a statistically significant difference-in-difference between SPARC and non-SPARC hospital C. difficile reduction rates (ratio of IRR, 0.63; 95% CI, 0.44−0.89; P = .01). Conclusions: The Maryland SPARC collaborative, a public health-academic partnership, was associated with a 25% reduction in the Maryland C. difficile SIR. Hospitals participating in SPARC demonstrated significantly reduced C. difficile incidences to match that of high-performing hospitals in Maryland.
Funding: None
Disclosure: Aaron Milstone, BD – consulting.
Linguistic validation of a disease-specific quality of life measure for children and teenagers with cardiac disease
- Jo Wray, Rodney Franklin, Kate Brown, Jacqueline Blyth, Bradley S. Marino
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- Journal:
- Cardiology in the Young / Volume 22 / Issue 1 / February 2012
- Published online by Cambridge University Press:
- 21 June 2011, pp. 13-17
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Introduction
To anglicise an American – that is, English language – disease-specific health-related quality of life measure, using the Paediatric Cardiac Quality of Life Inventory, for children in the age group of 8–12 years and adolescents in the age group of 13–18 years with cardiac disease, and to assess conceptual equivalence of the American and British versions.
MethodsA process of forward and backward translation of the measure was undertaken before focus groups and individual interviews with 40 participants – that is, 20 children/adolescents with cardiac disease and 20 parents of children/adolescents with cardiac disease – to determine their understanding of the meaning of the questions.
ResultsInterviews established that participants understood the meaning of the questions, although some found it difficult to explain the meaning of questions in which the language was explicit and wanted instead to answer the individual questions as they applied to them/their child. There was agreement that all versions of the questionnaire were relevant and comprehensive, and that the length of the questionnaires was acceptable and practical.
ConclusionsThe anglicised version of the Paediatric Cardiac Quality of Life Inventory appears to be a linguistically valid measure of health-related quality of life for children and adolescents with cardiac disease. The psychometric properties of the anglicised Paediatric Cardiac Quality of Life Inventory are now being tested in a multi-centre study in the United Kingdom.