/library/oar/handle/123456789/343 2026-06-19T16:10:22Z /library/oar/handle/123456789/146886 Title: Position statement : integrating planetary health into infection prevention and control in healthcare settings ― towards a balanced and evidence-based approach Authors: Tartari, Ermira; MeÅŸe, Emine Alp; Bulabula, Andre N.H.; Dancer, Stephanie J.; Giacobbe, Daniele Roberto; Krone, Manuel; Kilpatrick, Claire; Marek, Aleksandra; Petrosillo, Nicola; Presterl, Elisabeth; Ranjan, Manish; Severin, Juliëtte; Stroffolini, Giacomo; Tostmann, Alma; Vos, Margreet C.; Widmer, Andreas F.; Zingg, Walter; ESCMID Study Group for Nosocomial Infections (ESGNI) Abstract: Background Infection prevention and control (IPC) is fundamental for patient safety. Effective IPC generates direct ecological benefits by preventing healthcare-associated infections, thereby reducing prolonged hospitalization, antibiotic use, and resource consumption. Paradoxically, IPC measures single-use materials, chemical disinfectants, and resource-intensive waste streams, which contribute to healthcare’s greenhouse gas emissions and environmental burden. As climate change and environmental degradation threaten human and ecosystem health, there is growing urgency to evaluate IPC measures through a planetary health lens, ensuring sustainability considerations complement rather than compromise infection prevention outcomes. Aims This position paper by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Nosocomial Infections examines intersections between IPC practice and planetary health. Drawing on a synthesis of current evidence and expert consensus, it identifies opportunities to reduce the environmental footprint of IPC where evidence supports equivalent or superior IPC outcomes, and outlines research and policy priorities where evidence remains insufficient. Content The paper analyses five key domains at the IPC-planetary health interface: (1) single-use vs. reusable, (2) biocides and environmental contamination, (3) healthcare waste, (4) antimicrobial resistance—IPC priorities within a One Health framework, and (5) IPC and planetary health in low- and middle-income countries. Cross-cutting themes, including circular economy principles, life-cycle assessment, regulatory barriers, and climate-related risks, are explored, with implications for regulation, procurement, infrastructure, and workforce competencies. Implications Sustainability considerations in IPC must function as a complement to, not a substitute for, infection prevention outcomes. Where evidence supports equivalent safety with a reduced environmental footprint, change is justified and should be pursued through evidence-based, risk-stratified, and context-specific approaches. Achieving this requires regulatory reform, interdisciplinary collaboration, and targeted investment in research, education, and capacity building. Positioning IPC as a partner in sustainable healthcare offers a pathway to reduce avoidable environmental harm while strengthening resilience against infectious threats—with patient safety as the primary and non-negotiable objective. 2026-01-01T00:00:00Z /library/oar/handle/123456789/146630 Title: Beyond 42 days : a national cohort study of maternal and late maternal deaths in Brazil from 2010 to 2023 Abstract: Background/Objectives: Maternal mortality is a serious public health problem and reflects social, ethnic, racial, and regional inequalities in access to and quality of obstetric care. Despite advances in the surveillance and investigation of maternal deaths in Brazil, late maternal deaths (occurring between 43 days and 1 year after birth) are still underestimated and underexplored. Therefore, the objective of this study was to analyze the distribution and factors associated with maternal deaths and late maternal deaths in Brazil between 2010 and 2023. Methods: This was a population-based, retrospective cohort study with a quantitative approach, using secondary data from the Mortality ¸£ÀûÔÚÏßÃâ·Ñ System. All maternal deaths (Chapter XV of ICD-10) and late deaths recorded during the period were included. Sociodemographic, clinical, and administrative variables were analyzed. Statistical tests of association (chi-square, test of proportions, and 95% CI) were used, with a significance level of 5%. Results: A total of 26,953 deaths were identified, of which 24,387 were maternal and 2,566 were late deaths. Most deaths occurred among single, mixed-race women with 8 to 11 years of schooling, and residing in the Southeast region. Late deaths were more frequent in the South and among women aged 40 to 49. The main causes were direct obstetric conditions. A statistically significant association was observed between the type of death and sociodemographic variables. Conclusions: The results highlight structural inequalities in maternal mortality in Brazil and reinforce the importance of expanding postpartum surveillance beyond 42 days, with a focus on equity and continuity of care. 2026-01-01T00:00:00Z /library/oar/handle/123456789/143844 Title: Spiritual assessment in childbirth Authors: Attard, Josephine; Prinds, Christina Abstract: There is a growing realization of the need to adopt a lifespan approach to understanding spirituality. This chapter will focus on spirituality within the context of childbirth and parenthood transition, looking at the current evidence and application within this important area of healthcare practice. It will explore firstly how mothers’ and families may experience the need for spiritual care, and secondly on the personal challenges faced by midwives in providing spiritual care and their need for support. The chapter will provide a rationale for how and why spiritual assessment is needed within midwifery practice and the events surrounding childbirth. 2025-01-01T00:00:00Z /library/oar/handle/123456789/143842 Title: Cross-cultural adaptation of the EPICC spiritual care education standard into European Portuguese Authors: Sitefane, Sara; Afonso, Ana; De Andrade Alvarenga, Willyane; Mcsherry, Wilfred; Ross, Linda; Attard, Josephine; Rabiais, Isabel; Caldeira, Sílvia Abstract: Background: Spiritual care is a dynamic and multifaceted concept. The EPICC project, launched to improve nurses' competence in spiritual care through innovative education, supports this approach. The EPICC framework includes several tools and resources with the Spiritual Care Education Standard as the core tool. Aim: Translation, validation and cross-cultural adaptation of the EPICC Spiritual Care Education Standard into European Portuguese language and culture. Methods: Validation study using the Cross-Cultural Adaptation method. This method involves a six-step framework: translation, synthesis, back-translation, review by the expert panel (n=6), pre-testing, and concluding with the submission and approval of all documents by the original instrument authors and the expert panel. EQUATOR checklist: GRRAS. Ethical Issues and Approval: Doctoral research project (approved by the Ethics Committee on 19 July 2023). Results: The data were collected between November 2023 and April 2024 and showed 100% agreement and a Content Validity Index (CVI) of 1 for all items among experts. The pre-test, collected in May 2024, with 39 nursing students showed 90% agreement and minimal response variability among the items. Conclusions: The study successfully adapted the EPICC Spiritual Care Education Standard to European Portuguese, highlighting the need for ongoing investment in spiritual care education in nursing curricula. Implications: This study highlights the importance of students' spiritual care competencies in nursing education and practice, emphasising their integration into curricula and the ongoing relevance of healthcare policy in supporting this dimension of holistic care. 2026-01-01T00:00:00Z