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74 results

Page 1 of 4

  • Attribution of nosocomial seeding to long-term care facility COVID-19 outbreaks

  • Joe Flannagan, Dimple Y Chudasama, Russell Hope, Simon M Collin, Alex Bhattacharya, Rachel Merrick, Nurin Abdul Aziz, Susan Hopkins, Gavin Dabrera, Theresa Lamagni
  • Journal:
    Epidemiology & Infection / Volume 151 / 2023
    Published online by Cambridge University Press:
    25 October 2023, e191
    • Article
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  • Residents of long-term care facilities (LTCFs) were disproportionately affected by the COVID-19 pandemic. We assessed the extent to which hospital-associated infections contributed to COVID-19 LTCF outbreaks in England. We matched addresses of cases between March 2020 and June 2021 to reference databases to identify LTCF residents. Linkage to health service records identified hospital-associated infections, with the number of days spent in hospital before positive specimen date used to classify these as definite or probable. Of 149,129 cases in LTCF residents during the study period, 3,748 (2.5%) were definite or probable hospital-associated and discharged to an LTCF. Overall, 431 (0.3%) were identified as index cases of potentially nosocomial-seeded outbreaks (2.7% (431/15,797) of all identified LTCF outbreaks). These outbreaks involved 4,521 resident cases and 1,335 deaths, representing 3.0% and 3.6% of all cases and deaths in LTCF residents, respectively. The proportion of outbreaks that were potentially nosocomial-seeded peaked in late June 2020, early December 2020, mid-January 2021, and mid-April 2021. Nosocomial seeding contributed to COVID-19 LTCF outbreaks but is unlikely to have accounted for a substantial proportion. The continued identification of such outbreaks after the implementation of preventative policies highlights the challenges of preventing their occurrence.

  • 12 - Community-Based Harm Reduction Approaches for Alcohol Use Disorder

  • from Part II - Meso Level
  • Edited by Jalie A. Tucker, University of Florida, Katie Witkiewitz, University of New Mexico
  • Book:
    Dynamic Pathways to Recovery from Alcohol Use Disorder
    Published online:
    23 December 2021
    Print publication:
    06 January 2022, pp 218-238

  • Summary

    Community-based harm reduction for alcohol use disorder (AUD) entails a compassionate stance and pragmatic strategies that minimize alcohol-related harm and enhance quality of life. Community-based harm reduction approaches aim to meet people where they are both in their communities and with respect to their motivation for change. Harm reduction approaches do not require or prioritize abstinence or alcohol use reduction as the sole or most desirable recovery pathway. To date, community-based harm reduction approaches have been applied and investigated primarily within marginalized populations, particularly people experiencing homelessness and AUD. Randomized controlled trials have established efficacy for the low-barrier, non-abstinence-based Housing First approach and for community-based harm-reduction treatment. Managed alcohol programs and meaningful activities programming have shown promising findings in nonrandomized trials and warrant further study. The chapter concludes with reflections on key themes undergirding work in community-based harm reduction and how it has positively affected individuals and communities.

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