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This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.

This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.

Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.

The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.

Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.

To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.

This study aims to explore the role of rebel group legitimacy and ideology in durable peace (DP) following peace agreements to end civil wars. It builds on earlier research showing that justice and civil society involvement are critical in achieving DP. This study adds the impacts of rebel group activities and support on DP. Activities include service delivery and mobilization. Support is gauged with outcomes of presidential and parliamentary elections held following peace agreements.

Five data sets were used to measure the key variables: DP, inclusive commissions (IC), legitimacy symmetry (electoral outcomes), service delivery and ideological mobilization. A measure of rebel group integration in the political system was also constructed. Impacts of the integration, legitimacy and ideology variables were assessed with a hierarchical regression model (HRM). This study begins with a base model drawn from earlier research showing the key predictors were procedural justice (PJ) and IC. The authors ask about the extent to which the rebel group variables contribute additional variance to the prediction of DP.

The main contributors to the prediction of DP were PJ, IC and integration in the political system. None of the legitimacy or mobilization variables added significant variance to the prediction. Only one of the mobilization variables, forced recruitment, was significant. The decision to integrate into the political system following the agreement did not mediate the relationship between PJ in the negotiation process and DP. Results of a factor analysis showed that DP, PJ, IC and integration formed a cluster with strong loadings on the first factor.

The negative results for the legitimacy and mobilization variables may not be the last word on rebel group influences. Lack of support for the key hypotheses spurs attempts to discover other sources that contribute to the survival of rebel group actors in the political system and, in turn, to DP.

The issues raised by this study contribute to debates about ways to attain peaceful relations among competing groups following a civil war. It appears that attention to factors inside and around the negotiation process (PJ, ICs and conversion) may be more important than rebel group activities outside of these processes. The results call attention, in particular, to the important role played by political integration. From a policy perspective, it would be useful to develop levers for encouraging rebel groups to emerge as political actors in the post-agreement environment.

Developing measures of the symmetry of rebel group legitimacy and integration in the context of a comparative case study are the primary original contributions of this study. Furthermore, the mode of analysis (HRM) is novel in this literature. This approach builds on and extends the earlier research on factors influencing DP.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) goal to end the acquired immunodeficiency syndrome (AIDS) epidemic as a public health threat by 2030 emphasises the importance of leaving no one behind. To determine progress towards the elimination goal in Ghana, an in-depth understanding of human immunodeficiency virus (HIV) care from the perspective of vulnerable populations such as persons living with HIV in incarceration is necessary. This study aims to explore the experiences of incarcerated individuals living with HIV (ILHIV) and on antiretroviral therapy (ART) in selected Ghanaian prisons to help inform policy.

The study adopted a qualitative approach involving in-depth interviews with 16 purposively selected ILHIV on ART from purposively selected prisons. Interviews were conducted between October and December 2022. Thematic analysis was performed using the ATLAS.Ti software.

Three themes were generated from the analysis: waking up to a positive HIV status; living with HIV a day at a time; and being my brother’s keeper: preventing HIV transmission. All participants underwent HIV screening at the various prisons. ILHIV also had access to ART although those on remand had challenges with refills. Stigma perpetuated by incarcerated individuals against those with HIV existed, and experiences of inadequate nutrition among incarcerated individuals on ART were reported. Opportunities to improve the experiences of the ILHIV are required to improve care and reduce morbidity and mortality.

Through first-hand experiences from ILHIV in prisons, this study provides the perception of incarcerated individuals on HIV care in prisons. The insights gained from this study can contribute to the development of targeted interventions and strategies to improve HIV care and support for incarcerated individuals.

There has been a move towards the implementation of digital/e-health interventions for some time. Digital/e-health interventions have demonstrable efficacy in increasing individual empowerment, providing timely access to psychological interventions for those experiencing mental ill-health and improving outcomes for those using them. This study aims to determine the efficacy of digital/e-health interventions for individuals detained in prison who experience mental ill-health.

A systematic search of five academic databases – CINAHL, ASSIA, PsycINFO, Embase and Medline – was completed in December 2020 and updated in February 2022. The review was guided by the Whittemore and Knafl (2005) framework for integrative reviews. A total of 6,255 studies were returned and screened by title and abstract. A full-text screening of nine (n = 9) studies was conducted.

No study met the inclusion criteria for the clinical efficacy of digital/e-health interventions in a prison setting. Subsequently, a review of the literature that made it to the full-text review stage was conducted, and gaps in the literature were identified to inform policy, practice and future research.

To the best of the authors’ knowledge, this is the first integrative review conducted on the efficacy of digital/e-health interventions for mental ill-health in prison settings.

The present research paper aims to examine the inter-relationship between organizational justice (Henceforth termed as OJ), psychological well-being at work (henceforth termed as PWBW) and organizational citizenship behavior (henceforth termed as OCB). More specifically, this paper attempts to critically analyze the mediating role of PWBW in the relationship between OJ and OCB. The study solely focuses on nurses working at private hospitals in Kerala, who are the largest group of healthcare personnel.

Data collected from 308 nursing employees were analyzed by using statistical package for the social sciences (SPSS) software.

The outcomes of the analysis demonstrate that significant correlations exist between all the three key variables and their dimensions. Moreover, it has been found that the relationship between OJ and OCB is partially mediated by PWBW.

In the present healthcare scenario, just after the Covid-19 pandemic, there is a paramount need for the well-being of healthcare staff in order to improve the functioning of the healthcare system.

The study enabled us to develop and provide an explanation as to how social exchange relationship works between OJ and OCB.

The purpose of this study was to explore 232 service providers’ and policymakers’ experiences of supporting children’s well-being during the pandemic, across sectors, in 22 countries – including Kenya, the Philippines, South Africa, India, Scotland, Sweden, Canada and the USA, in the last quarter of 2020.

A smartphone survey delivered via a custom-built app containing mostly open-ended questions was used. Respondents were recruited via professional networks, newsletters and social media. Qualitative content analysis was used.

The findings reveal numerous system-level challenges to supporting children’s well-being, particularly virus containment measures, resource deficiencies and inadequate governance and stakeholder coordination. Those challenges compounded preexisting inequalities and poorly affected the quality, effectiveness and reach of services. As a result, children’s rights to an adequate standard of living; protection from violence; education; play; and right to be heard were impinged upon. Concurrently, the findings illustrate a range of adaptive and innovative practices in humanitarian and subsistence support; child protection; capacity-building; advocacy; digitalisation; and psychosocial and educational support. Respondents identified several priority areas – increasing service capacity and equity; expanding technology use; mobilising cross-sectoral partnerships; involving children in decision-making; and ensuring more effective child protection mechanisms.

This study seeks to inform resilience-enabling policies and practices that foster equity, child and community empowerment and organisational resilience and innovation, particularly in anticipation of future crises.

Using a novel approach to gather in-the-moment insights remotely, this study offers a unique international and multi-sectoral perspective, particularly from low- and middle-income countries.

Using a mixed methodology comprising interviews, case file analysis and descriptive statistics, this study aims to examine the experiences of all 43 young people in Wales subject to secure accommodation orders between 1st April 2016 and 31st March 2018.

Children in the UK aged 10–17 years who are deemed to be at a significant level of risk to themselves or others may be subject to a secure accommodation order, leading to time spent in a secure children’s home (SCH) on welfare grounds. Following a rise in the number of children in Wales referred to SCHs for welfare reasons, this paper describes these young people’s journeys into, through and out of SCHs, giving insight into their experiences and highlighting areas for policy and practice improvements.

Findings indicate that improvements in mental health support and placement availability are key in improving the experiences of this particularly vulnerable group of young people throughout their childhood.

Other practical implications of the study’s findings, such as improvements in secure transport arrangements, are also discussed.

While the findings are limited by the reliance on self-report methods and the size of the study, namely, the small number of young people with experience of SCHs who were able to participate, the findings build on the existing knowledge base around children’s residential accommodation and provide new insights into how best to support these children.

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.