Showing papers in "Health in 2015"
TL;DR: Interventions are needed to enhance the practice of health promoting behaviours of university students in Jordan and focus on demographic variations among university students.
Abstract: Objectives: To determine health promoting behaviors of university students in Jordan and factors influencing them. Design and Methods: A cross-sectional descriptive design was used to recruit convenience sample (n = 525) of university students receiving education from two governmental and one private universities in Jordan. Data were collected between September 2013 and January 2014 by using Health Promoting Lifestyle Profile II. Pender Model provided conceptual framework to guide the study. Results: The mean score of Health Promoting Lifestyle Profile of the student was at (127.87 ± 19.91). Significant differences were found between Health Promoting Lifestyle Profile mean score and the mean score of its subscales and student’s age, gender, employment status, family income, university type, and faculty type. Conclusions: These findings suggest that interventions are needed to enhance the practice of health promoting behaviours. These interventions should focus on demographic variations among university students.
60 citations
TL;DR: Interestingly, class showed more of an association with stigma for the asthma vignette than it did for both the depression and schizophrenia vignettes, suggesting that mental illness stigma needs to be contextualised alongside physical illness stigma.
Abstract: The relationship between social class and mental illness stigma has received little attention in recent years. At the same time, the concept of mental health literacy has become an increasingly popular way of framing knowledge and understanding of mental health issues. British Social Attitudes survey data present an opportunity to unpack the relationships between these concepts and social class, an important task given continuing mental health inequalities. Regression analyses were undertaken which centred on depression and schizophrenia vignettes, with an asthma vignette used for comparison. The National Statistics Socio-economic Classification, education and income were used as indicators of class. A number of interesting findings emerged. Overall, class variables showed a stronger relationship with mental health literacy than stigma. The relationship was gendered such that women with higher levels of education, especially those with a degree, had the lowest levels of stigma and highest levels of mental health literacy. Interestingly, class showed more of an association with stigma for the asthma vignette than it did for both the depression and schizophrenia vignettes, suggesting that mental illness stigma needs to be contextualised alongside physical illness stigma. Education emerged as the key indicator of class, followed by the National Statistics Socio-economic Classification, with income effects being marginal. These findings have implications for targeting health promotion campaigns and increasing service use in order to reduce mental health inequalities.
55 citations
TL;DR: Key to understanding lesbian, gay, bisexual and trans youth suicide and self-harm problems are emotions such as shame which arise from negotiating norms connected to heterosexuality, adolescence and rationality, which act to regulate what emotions it is possible to feel, what emotions its possible to articulate and what type of young lives that can be told.
Abstract: International evidence suggests that young people are less likely to seek help for mental health problems in comparison with adults. This study focused on lesbian, gay, bisexual and trans young people who are a population group with an elevated risk of suicide and self-harm, and little is known about their help-seeking behaviour. Utilising qualitative virtual methods, lesbian, gay, bisexual and trans youth web-based discussions about seeking help for suicidal feelings and self-harming were investigated. Findings from a thematic analysis indicate that these young people wanted assistance but found it difficult to (1) ask for help, (2) articulate emotional distress and (3) ‘tell’ their selves as ‘failed’. This analysis suggests that key to understanding these problems are emotions such as shame which arise from negotiating norms connected to heterosexuality, adolescence and rationality. I argue that these norms act to regulate what emotions it is possible to feel, what emotions it is possible to articulate ...
50 citations
TL;DR: Evaluating sleep duration for nighttime sleep from early infancy to late adolescence in a German sample to illustrate the developmental course and age-specific variability of these variables among subjects found age- specific variability of sleep duration as well as sleep difficulties from infancy to adolescence.
Abstract: Objective: The main purpose of the present study was to evaluate sleep duration for nighttime sleep from early infancy to late adolescence in a German sample to illustrate the developmental course and age-specific variability of these variables among subjects. Methods: A total of 17,641 subjects from the KiGGS study were evaluated. The questionnaires contained questions about physical health, living circumstances, health behavior and risks, health supply, mental health, health-related quality of life and sleep. KiGGS assessed sleep by using parent questionnaire of children aged 0 to 10 years (n = 9944) and self-reports of adolescents (n = 7697) aged 11 to 17 years. Results: Total sleep duration decreased from 14.28 hours (SD = 2.33) at the ages 0 - 0.5 to 9.50 hours (SD = 0.82) at the ages of 10.5 - 11. Above the age of 11 adolescents report a decrease of sleep at night from 9.41 hours (SD = 1.33) at the age of 11 - 11.5 to 7.42 (SD = 1.73) at the age of 17.5 - 18 years. Unspecified sleep problems were reported of 19.5%, 13.0% of the children had difficulties falling asleep, difficulties sleeping through the night showed 8.8% of the children, whereas 3.0% report both symptoms—difficulties falling asleep and difficulties sleeping through the night. Conclusions: Age-specific variability of sleep duration is reported as well as sleep difficulties from infancy to adolescence. This is important knowledge for the health care professional who deals with sleep problems in pediatric practice.
46 citations
TL;DR: The findings suggest that a full ‘recovery’ may be impossible after a cancer diagnosis, and that such diagnoses will continue to threaten biographical trajectory and self-identity forever.
Abstract: Cancer survival is increasing, and many people are living years after cancer treatment. For example, it is predicted that 46 per cent of men and 56 per cent of women diagnosed in 2007 in England and Wales will survive their cancer for 5 years or more. However, 'survivors' may be living with significant physical, psychological and social disruption caused by their illness. Furthermore, huge disparities exist in the outcomes for different cancer 'types', and there has been little investigation of those living with 'poor prognostic' cancers. Our aim was to explore the experience of living after the diagnosis of a poor prognostic cancer. Data were gathered from 30 people via interviews and participants' own photographs. Our findings suggest that a full 'recovery' may be impossible after a cancer diagnosis. Such diagnoses will continue to threaten biographical trajectory and self-identity forever. 'Returning to normal' was considered highly important for participants, but a changed normality had to be accepted in which lives were managed carefully and a constant fear of recurrence created liminality and made 'survivorship' ambiguous. Experience was often complicated by the social response associated with cancer that hindered communication and increased isolation. Participant-produced photographs, used here for the first time specifically by a sample of people with poor prognosis cancer, proved to be an acceptable data collection method and have added a poignancy and 'completeness' to the data that have arguably led to a more comprehensive understanding.
45 citations
TL;DR: This study presents a gy-rometer and accelerometer based algorithm for stride length estimation requiring only one inertial sensor attached to the subject shank and provides a reliable portable solution for monitoring the in-stantaneous stride length.
Abstract: As low cost and highly portable sensors, inertial measurements units (IMU) have become increas-ingly used in gait analysis, embodying an efficient alternative to motion capture systems. Mean-while, being able to compute reliably accurate spatial gait parameters using few sensors remains a relatively complex problematic. Providing a clinical oriented solution, our study presents a gy-rometer and accelerometer based algorithm for stride length estimation. Compared to most of the numerous existing works where only an averaged stride length is computed from several IMU, or where the use of the magnetometer is incompatible with everyday use, our challenge here has been to extract each individual stride length in an easy-to-use algorithm requiring only one inertial sensor attached to the subject shank. Our results were validated on healthy subjects and patients suffering from Parkinson’s disease (PD). Estimated stride lengths were compared to GAITRite© walkway system data: the mean error over all the strides was less than 6% for healthy group and 10.3% for PD group. This method provides a reliable portable solution for monitoring the in-stantaneous stride length and opens the way to promising applications.
43 citations
TL;DR: The intersecting roles of gender, ethnicity, and professional status in shaping the experiences of internationally educated health professionals in Canada are examined.
Abstract: This article examines the intersecting roles of gender, ethnicity, and professional status in shaping the experiences of internationally educated health professionals in Canada. The article is base...
41 citations
TL;DR: This study provides a nuanced understanding of heart transplant recipients’ embodied experiences of self and identity and is valuable to educate transplant professionals to develop new supportive interventions both pre- and post-transplant, and to improve the process of informed consent.
Abstract: Of heart transplant recipients, 30 per cent report ongoing or episodic emotional issues post-transplant, which are not attributable to medications or pathophysiological changes. To this end, our team theorized that cardiac transplantation introduces pressing new questions about how patients incorporate a transplanted heart into their sense of self and how this impacts their identity. The work of Merleau-Ponty provided the theoretical underpinning for this project as it rationalizes how corporeal changes affect one's self and offer an innovative framework to access these complex aspects of living with a transplanted heart. We used visual methodology and recorded 25 semi-structured interviews videographically. Both visual and verbal data were analyzed at the same time in an iterative process. The most common theme was that participants expressed a disruption to their own identity and bodily integrity. Additionally, participants reported
39 citations
TL;DR: The present theoretical article explores some of the consequences of applying this psychiatric label to the distress experienced by refugee and asylum-seeking women and presents an alternative way of conceptualizing and alleviating this distress.
Abstract: Canada has one of the world's largest refugee resettlement programs in the world. Just over 48 percent of Canadian refugees are women, with many of them of childbearing age and pregnant. Refugee and asylum-seeking women in Canada face a five times greater risk of developing postpartum depression than Canadian-born women. Mainstream psychological approaches to postpartum depression emphasize individual-level risk factors (e.g. hormones, thoughts, emotions) and individualized treatments (e.g. psychotherapy, medication). This conceptualization is problematic when applied to refugee and asylum-seeking women because it fails to acknowledge the migrant experience and the unique set of circumstances from which these women have come. The present theoretical article explores some of the consequences of applying this psychiatric label to the distress experienced by refugee and asylum-seeking women and presents an alternative way of conceptualizing and alleviating this distress.
35 citations
TL;DR: The emergence of a ‘regime of hope’ in the context of oncology care, practice and research and the significance of hope as a naturalised vitalistic attribute of biopolitical life is charted.
Abstract: This article explores the emergence of a ‘regime of hope’ in the context of oncology care, practice and research. More specifically, my focus is the emergence, since the 1970s or so, of hope scales and indexes used to metricise the emotional states of cancer patients. These usually take the form of psychometric tests designed and deployed in order to subject affective life to calculative and rational scrutiny. This article locates this within the tensions of a ‘turn’ towards the emotions in critical social science literature. Scholarship has, for instance, been anxious not to deny the embodied reality of affectivity and the emotions. But it has been equally important to recognise the extent to which emotions are discursively ordered and structured as objects and effects of power. This article charts the emergence of hope scales historically alongside wider historical forces in the metrification of life and health and more specifically the emotions. It locates hope scales in a post-war climate of individua...
33 citations
TL;DR: It is argued that analysing accounts of how advisors respond to patient enquiries about stem cell treatments offers a window for examining the workings of the politics of hope within contemporary bioscience and biomedicine.
Abstract: Stem cell science provides an exemplary study of the ‘management of hope’. On the one hand, raising ‘hopes’ and expectations is a seen as a necessary aspect of securing investment in promising innovative research. On the other, such hyperbole risks raising hopes to a level that may lead people to undertake undue risks, which may ultimately undermine confidence in medical research. In this context, the ‘management of hope’ thus involves the negotiation of competing claims of truth about the value and safety of particular treatments and about the trustworthiness of providers. Using Gieryn’s concept of boundary-work, this article examines the means by which this work of ‘managing hope’ is undertaken. Drawing on data collected as part of our study that investigated the perspectives of those who are consulted by patients and their carers about stem cell treatments, we explore how these community advisors – both scientists and clinicians with a stake in stem cell research and representatives from patient advoca...
TL;DR: Assessment of the determinants of long acting reversible contraception method use among mothers in extended postpartum period in Durame Town, Southern Ethiopia found participant’s education, previous history of using LARC methods, receiving counseling services on LARC during delivery and immediate post partum periods were found major determinant for LARC use.
Abstract: Background: After a live birth, there is much unsatisfied interest in, and unmet family planning need for contraception. Waiting at least for 24 months before attempting the next pregnancy was recommended to reduce the risk of adverse maternal, perinatal and infant outcomes. The purpose of this study was to assess the determinants of long acting reversible contraception method use among mothers in extended postpartum period in Durame Town, Southern Ethiopia. Methods: A community based cross sectional study was conducted in Durame Town, Southern Ethiopia in December, 2014. Systematic random sampling technique was employed to recruit a total 460 study participants. Structured and pretested questioner was used to collect the data. Descriptive statistics was employed to characterize the study population using frequencies and proportions. Bivariate logistic regression analysis was conducted to identify all possible factors affecting utilization of LARC method. Multivariable logistic regression model was developed to control the confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed in identifying the real factors associated with use of LARC methods. Results: In this study we found that the prevalence of LARC method use among mothers during their extended postpartum period was 36.7% (95%CI: 32.2, 41.0). The unmet family planning need of mothers in the extended postpartum period was 123 (27.9%). The odds of using LARC by literate mother were four fold higher than their counterpart illiterate mothers (AOR 4.09 95%CI: 1.68, 9.58, P value < 0.001). The odds of mother who had pervious experiences of using LARC were up to eight folds higher than mother never used LARC methods (AOR 7.84 95% CI: 3.78, 16.23, P value< 0.001). Mother who received counseling service on LARC methods during delivery was up to three times more likely to utilize the services than not counseled (AOR 3.29 95% CI: 1.53, 7.03, P value < 0.001). And odds of mothers who received counseling service on LARC during immediate postpartum period were up to five fold more likely to opt method than never got the counseling service (AOR 4.55 95 % CI: 1.94, 10.66, P value < 0.001). Conclusions: In the study area, about one third of mothers utilized LARC methods during their extended postpartum period. Another one third of mother had unmet need for family planning. Participant’s education, previous history of using LARC methods, receiving counseling services on LARC during delivery and immediate postpartum periods were found major determinant for LARC use. Educating women, providing counseling service on LARC methods during antenatal, delivery and postnatal were recommended.
TL;DR: It is argued practice theory’s attention to context as more than mere backdrop to action helps shift inequality theorising beyond the individual and reproduction towards deeper, detailed social understandings of transformation and change.
Abstract: Recent public health policies have re-endorsed the key role all health and social care professionals have in tackling the social determinants of health inequalities. With inequalities firmly entrenched, and much theorising focused on reproduction rather than transformation, sustaining practitioner commitment and engagement with this work and maintaining confidence in achieving change is challenging. One increasingly popular way to intervene in practice to begin to address inequalities has been the use of resilience, even though resilience is frequently critiqued for its collusion with neoliberal imperatives in favouring individualised rather than socio-political responses. This article examines these concerns through the use of the practice turn and specifically 'slim-line' practice theory and 'tinkering' to explore the potential for reframing resilience theory and practice. Using an original data set derived from evaluations of resilience-based programmes, held with parents and practitioners between 2008 and 2012, this article re-examines participants' understandings of resilience. We show how practice theory reveals entangled and emergent meanings, competencies and materials that constitute resilience as a social practice comprised of resilient moves. The implications of this reframing are discussed in relation to ontology, agency and change; but also for resilience theory and practice and public health practices more generally. In conclusion, we argue practice theory's attention to context as more than mere backdrop to action helps shift inequality theorising beyond the individual and reproduction towards deeper, detailed social understandings of transformation and change.
TL;DR: In this article, a survey of 360 male secondary school children in Taif, Saudi Arabia was conducted to assess the awareness of Saudi secondary school students regarding first-aid and basic life support (BLS).
Abstract: Background: Increasing the number of qualified people, including school students who can play a significant role in first-aid (FA) and basic life support (BLS) arena is a public health demand. Aim: To assess the awareness of Saudi secondary school students regarding FA and BLS. Methodology: 360 male secondary school children in Taif, Saudi Arabia were surveyed. Results: The mean students’ age was 17.4 ± 1.21 years. The mean participants’ FA knowledge score was 64.8% ± 11%. Generally, trained students reported both better FA knowledge and skills than untrained counter-parts; for 79.6% trained-compared to 53.7% untrained-students recorded such score > 70% [χ2 (df 1) = 11.60, p 70%) [62.3% <17 y vs. 49.3% ≥17 y, χ2(df 1) = 5.90, p = 0.02] was. Trained students better deal with critical cases, bleeding and bodily injury compared to untrained peers [89.8% vs. 55.9%, χ2 (df 1) = 20.3, p < 0.001; 83.7% vs. 58.2%, χ2 (df 1) = 11.62, p = 0.04; 81.6% vs. 67.2%, χ2 (df 1) = 4.13, p = 0.04, respectively]. Only 37.2% of schools had FA incorporated in the education curriculum. Eventually, FA training and the presence of FA group were significant predictors for improved FA knowledge among students [odds ratio (OR) 3.35, 95% CI 1.60 - 7.06; OR 2.28, 95% CI 1.34 - 3.95, respectively). Conclusions: First-aid training is crucial to enhance school children’s FA skills and to thrust their contribution to health emergency control efforts. Incorporating FA training within the educational curriculum of Saudi schools is a step forward to disseminate FA message in the community.
TL;DR: Exploring the relationship between resilience and acceptance reveals the opportunities, as well as the limitations, embedded in the normative constructs that inflect individual experience of this transition, whereby participants’ experiences were characterised by talk of initiating change, while also acquiescing to the terminal progression of their illness.
Abstract: Specialist palliative care is a prominent and expanding site of health service delivery, providing highly specialised care to people at the end of life. Its focus on the delivery of specialised life-enhancing care stands in contrast to biomedicine's general tendency towards life-prolonging intervention. This philosophical departure from curative or life-prolonging care means that transitioning patients can be problematic, with recent work suggesting a wide range of potential emotional, communication and relational difficulties for patients, families and health professionals. Yet, we know little about terminally ill patients' lived experiences of this complex transition. Here, through interviews with 40 inpatients in the last few weeks of life, we explore their embodied and relational experiences of the transition to inpatient care, including their accounts of an ethic of resilience in pre-palliative care and an ethic of acceptance as they move towards specialist palliative care. Exploring the relationship between resilience and acceptance reveals the opportunities, as well as the limitations, embedded in the normative constructs that inflect individual experience of this transition. This highlights a contradictory dynamic whereby participants' experiences were characterised by talk of initiating change, while also acquiescing to the terminal progression of their illness.
TL;DR: This article bridges sociological and anthropological approaches with a more definition-oriented literature, developing understandings of hoping and its key characteristics in relation to other processes of coping amidst vulnerability and uncertainty.
Abstract: Sociological and anthropological analyses of hope in health-care contexts have tended to address institutional processes, especially the power dynamics that function through such systems or political economies of hope, which in turn shape interactions through which hopes are managed. This article extends this approach through a more detailed consideration of the experience of hoping itself. Our post-formal analysis denotes the tensions that are intrinsic and defining features of lifeworlds around hope, emphasising the dissonance and fragility of hoping. Drawing upon interview and observational data involving patients with advanced-cancer diagnoses who were taking part in clinical trials, we explore three main tensions which emerged within the analysis: tensions involving time and liminality between future and present; ontological tensions involving the concrete and the possible, the 'realistic' and the positive; and tensions in taken-for-grantedness between the reflective and the mundane, the specific and the ambiguous. Rather than three separate sets of tensions, those involving time, ontology and taken-for-grantedness are very much interwoven. In denoting the influence of social processes in engendering tensions, we bridge sociological and anthropological approaches with a more definition-oriented literature, developing understandings of hoping and its key characteristics in relation to other processes of coping amidst vulnerability and uncertainty
TL;DR: This article explores the strategies by which two groups of complementary and alternative medicine practitioners, namely, non-medically qualified acupuncturists and homeopaths in the United Kingdom, pragmatically accommodate holistic notions as a professional resource, a process of negotiation between maintaining their holistic premise and the drive to professionalise and enhance their societal status.
Abstract: Complementary and alternative medicine practitioners have often utilised 'holism' as a key identification mark of their practice, distancing themselves from 'the reductionist biomedicine'. However, the past couple of decades have witnessed increased engagement of several complementary and alternative medicines in professionalisation, which includes a degree of biomedical alignment while 'reducing' holistic claims in order to provide practice with a 'credible outlook' and move closer to the mainstream, a development which challenges the role of holism in complementary and alternative medicine practices. This article explores the strategies by which two groups of complementary and alternative medicine practitioners, namely, non-medically qualified acupuncturists and homeopaths in the United Kingdom, pragmatically accommodate holistic notions as a professional resource, a process of negotiation between maintaining their holistic premise, on the one hand, and the drive to professionalise and enhance their societal status, on the other. Based on in-depth interviews with non-medically qualified acupuncture and homeopathy practitioners and school principals, textual analysis of practitioners' web sites and observation of practice, the findings demonstrate the dynamic approach to 'holism' in complementary and alternative medicine practice. This discourse, through which practitioners use a range of strategies in order to 'narrow' or 'expand' their holistic expression, can be described as 'pragmatic holism', by which they try to make gains from the formalisation/standardisation processes, without losing the therapies' holistic outlook and appeal.
TL;DR: Sustained focus on developing psychometrically sound instruments that account for all levels (i.e. theoretical and operational) and aspects of fidelity of intervention implementation is imperative to strengthen the methodological literature for interventions research.
Abstract: Background: Interventions, whether simple or complex, are increasing in health care in response to the growing complexity and acuity of patient’s conditions. Monitoring the fidelity of implementing interventions is challenging. A common method to assess and monitor fidelity of intervention implementation is through a structured, reliable and valid instrument. Purpose: The purpose of this paper is to examine existing instruments measuring fidelity of intervention implementation in order to determine aspects of fidelity that have been assessed and reported on the reliability and validity of these instruments. Design: A descriptive review was conducted. Studies were included if they described and reported on the fidelity of intervention implementation instruments, their psychometric properties were published between 1980 and 2015. Methods: Data were extracted on the study characteristics, levels and aspects of fidelity and the psychometric properties, specifically the reliability and validity of the fidelity of intervention implementation instruments. Results: In total, 21 studies were included in the review. Overall results showed that some aspects and levels of fidelity of intervention implementation are included in the instruments. At the theoretical level, fidelity of intervention implementation is not accounted for majority of the studies and few explicitly reports on the use of instruments to evaluate intervention differentiation. At the operational level, interventionists’ adherence and competence are included in the instruments; however, participants’ engagement, exposure and enactment are not. The instruments demonstrate acceptable level of validity and reliability. Conclusion: Sustained focus on developing psychometrically sound instruments that account for all levels (i.e. theoretical and operational) and aspects of fidelity of intervention implementation is imperative to strengthen the methodological literature for interventions research; and for researchers to correctly interpret research findings and to arrive at valid conclusions on the effectiveness of interventions, whether simple or complex.
TL;DR: Drawing on a keyword and text-mining analysis of 156 interviews with doctors and nurses involved in end-of-life care, differences between countries in care providers’ ethical rationales for the use of sedation are reported.
Abstract: The application of ethically controversial medical procedures may differ from one place to another. Drawing on a keyword and text-mining analysis of 156 interviews with doctors and nurses involved in end-of-life care (‘care providers’), differences between countries in care providers’ ethical rationales for the use of sedation are reported. In the United Kingdom, an emphasis on titrating doses proportionately against symptoms is more likely, maintaining consciousness where possible. The potential harms of sedation are perceived to be the potential hastening of social as well as biological death. In Belgium and the Netherlands, although there is concern to distinguish the practice from euthanasia, rapid inducement of deep unconsciousness is more acceptable to care providers. This is often perceived to be a proportionate response to unbearable suffering in a context where there is also greater pressure to hasten dying from relatives and others. This means that sedation is more likely to be organised like euthanasia, as the end ‘moment’ is reached, and family farewells are organised before the patient is made unconscious for ever. Medical and nursing practices are partly responses to factors outside the place of care, such as legislation and public sentiment. Dutch guidelines for sedation largely tally with the practices prevalent in the Netherlands and Belgium, in contrast with those produced by the more international European Association for Palliative Care whose authors describe an ethical framework closer to that reportedly used by UK care providers.
TL;DR: It is found that response to existing needs, local tailoring, involvement and commitment are all crucial for the care pathway to function as a boundary object in this setting, thus potentially contributing to a more equal relationship between specialist healthcare services and home care services.
Abstract: The need for integration of healthcare services and collaboration across organisational boundaries is highlighted as a major challenge within healthcare in many countries. Care pathways are often p...
TL;DR: The literature review identified three steps necessary to successfully conduct a needs assessment that fitted the definition of the Affordable Care Act and have been used as a guide for developing a protocol for conducting a community health needs assessment in Meadville, PA.
Abstract: We conducted a review of the peer-reviewed literature focused on conducting community health needs assessments and highlighted the necessary steps to conduct a community health needs assessment in a rural community. From the literature review, we identified three steps necessary— establishing partnerships, using a mixed methods approach, and disseminating results—to successfully conduct a needs assessment that fitted the definition of the Affordable Care Act. These three steps have been used as a guide for developing a protocol for conducting a community health needs assessment in Meadville, PA. We detail our preliminary project protocol here.
TL;DR: Injuries are highly expensive and they account for heavy losses to GDP, so injury prevention should be prioritized in order to save such losses to life and economies.
Abstract: Economic burdens of injuries at the country level are unknown. In the current study we tried to explore the economic burden of DALYs loss due to injuries at the country level, then distributed according to the World Bank’s income groups. Methods: Data from the World Bank and the World Health Organization websites were used. Disability adjusted life year (DALY) and gross domestic product (GDP) per capita were used to estimate the economic loss for RTIs. Estimates of economic burdens were presented in tables and figures. Results: The total economic loss of the world during 2004 by means of DALYs due to injuries was 613. 144 billion USD, corresponding value of 848.205 billion USD in 2014. DALYs burden of injuries were concentrated (almost 75%) among low and lower middle income countries. Economic burdens of injuries were concentrated (over 80%) among higher middle and high income countries. Iraq had lost almost one-fifth of its GDP due to injuries. The USA had the highest amount of economic loss for injuries (169.136 billion USD) among all countries. Conclusion: Injuries are highly expensive and they account for heavy losses to GDP. Injury prevention should be prioritized in order to save such losses to life and economies.
TL;DR: Significant divergences are identified in terms of the impact of different sociocultural values and their implications for clinical practice in light of an unfavourable health care environment for patients with advanced cancer and a social support system sustained mainly by Chinese families.
Abstract: In our study that explored the current end-of-life care provision for Chinese older people with advanced/terminal cancer, hope emerged as a significant aspect of coping with their condition. Drawing on data from in-depth interviews with a group of older people, their family carers and health professionals, this article explores participants’ constructions of hope in terms of what they were hoping for, how their hopes helped them cope with their illness and what sociocultural resources they drew on to build and sustain these hopes. While acknowledging similarities to Western studies of hope in terminal illness, this article identifies significant divergences in terms of the impact of different sociocultural values and their implications for clinical practice in light of an unfavourable health care environment for patients with advanced cancer and a social support system sustained mainly by Chinese families. It argues that hope represents an important resource for coping with terminal illness among these patients.
TL;DR: Sick-listing can be improved by further developing tacit skills of persuasion and negotiation and acknowledging the structural context within which protagonists negotiate sick- listing, according to policy-makers.
Abstract: The UK government is promoting the health benefits of work, in order to change doctors' and patients' behaviour and reduce sickness absence. The rationale is that many people 'off sick' would have better outcomes by staying at work; but reducing the costs of health care and benefits is also an imperative. Replacement of the 'sick note' with the 'fit note' and a national educational programme are intended to reduce sickness-certification rates, but how will these initiatives impact on doctor-patient relationships and the existing tension between the doctor as patient advocate and gate-keeper to services and benefits? This tension is particularly acute for problems like chronic pain where diagnosis, prognosis and work capacity can be unclear. We interviewed 13 doctors and 30 chronic pain patients about their experiences of negotiating medical certification for work absence and their views of the new policies. Our findings highlight the limitations of naive rationalist approaches to judgements of work absence and fitness for work for people with chronic pain. Moral, socio-cultural and practical factors are invoked by doctors and patients to contest decisions, and although both groups support the fit note's focus on capacity, they doubt it will overcome tensions in the consultation. Doctors value tacit skills of persuasion and negotiation that can change how patients conceptualise their illness and respond to it. Policy-makers increasingly recognise the role of this tacit knowledge and we conclude that sick-listing can be improved by further developing these skills and acknowledging the structural context within which protagonists negotiate sick-listing.
TL;DR: An econometric analysis of the determinants of acute illness indicates the insufficiency of basic amenities like sanitation, garbage disposal and potable water indicates continued vulnerability of the urban poor, and the need for urgent government action.
Abstract: This paper analyzes the state of health and access to health services among the urban poor in India. Analysis is based on data from a primary survey conducted among 2000 households, covering 10,929 individuals from four cities of India. Summary statistics and regressions (using STATA) are used for data analysis. Results show lack of government facilities and services, a very high preference for private health facilities, high expenses especially in private but also in public facilities, and a perception that private facilities are offering high quality services as important concerns. An econometric analysis of the determinants of acute illness indicates the insufficiency of basic amenities like sanitation, garbage disposal and potable water. Together with the lack of availability of government health facilities in the vicinity, these results indicate continued vulnerability of the urban poor, and the need for urgent government action.
TL;DR: Through analysis of qualitative interviews conducted with 13 health care practitioners who provide care for economically marginalized people who use drugs in New York City, it was found that the absence of will articulated in constructions of addiction as disease offered a gateway through which health Care practitioners could bring in ideological commitments associated with harm reduction, such as the de-stigmatization of drug use.
Abstract: The concept of addiction as a disease is becoming firmly established in medical knowledge and practice at the same time as the logics of the harm reduction approach are gaining broader acceptance. How health care practitioners understand and intervene upon drug use among their patients is complicated by these two models. While harm reduction can be understood as a form of governmentality wherein drug-taking individuals express their regulated autonomy through self-governance, the notion of addiction as a disease removes the option of self-governance through negating the will of the individual. Through analysis of qualitative interviews conducted with 13 health care practitioners who provide care for economically marginalized people who use drugs in New York City, it was found that the absence of will articulated in constructions of addiction as disease offered a gateway through which health care practitioners could bring in ideological commitments associated with harm reduction, such as the de-stigmatization of drug use. Despite differences in the attribution of agency, sewing together these two approaches allowed health care practitioners to work with drug-using patients in practical and compassionate ways. This resembles the strategic deployment of diverse subjectivities found in feminist, post-structural liberatory projects wherein differential subjectification proves tactical and productive. Although drug-using patients may enjoy the benefits of practical and compassionate health care, the conjoint facilitation and denouncement of their will occasioned by the use of both harm reduction and the disease model of addiction imply their management by both pastoral and disciplinary technologies of power.
TL;DR: This article analyzes the experiences of patients and their “journeys of hope” to NuTech Mediworld, an embryonic stem cell therapy clinic in New Delhi, India, and utilizes Gilles Deleuze and Felix Guattari’s “concepts,” lines of flight and deterritorialization, to highlight how embryonic stemcell therapy’'s “political economy ofHope” embodies deterritzorialization of several “regimes of
Abstract: Stem cell therapy in non-Western countries such as India has received a lot of attention. Apart from media reports, there are a number of social science analyses of stem cell policy, therapy, and research, their ethical implications, and impact of advertising on patients. Nevertheless, in the media reports as well as in academic studies, experiences of patients, who undertake overseas journeys for stem cell therapy, have largely been either ignored or presented reductively, often as a “false hope.” In this article, I analyze the experiences of patients and their “journeys of hope” to NuTech Mediworld, an embryonic stem cell therapy clinic in New Delhi, India. My analysis, which draws on my observations in the clinic and patients’ experiences, instead of seeking to adjudicate whether embryonic stem cell therapy in clinics such as NuTech is right or wrong, true or false, focuses on how patients navigate and contest these concerns. I utilize Gilles Deleuze and Felix Guattari’s “concepts,” lines of flight and...
TL;DR: A study comparing levels of empathy gender of students in 18 schools of dentistry from six Latin American countries found that the observed results do not support the belief that women are more empathetic than men.
Abstract: Background: It is well-founded that empathy is an attribute that increases the likelihood of good communication between health professionals and patients, and it is usual that there is the conviction that empathy levels are higher in women than in men. Aims: A study comparing levels of empathy gender of students in 18 schools of dentistry from six Latin American countries was conducted. Method: An exploratory cross-sectional study of which empathy levels were measured by the Jefferson Scale of Empathy for dental students (S version) and these levels were compared between genders by t-student test, after verification of normal distribution and homoscedasticity. Results: Variability was found in the results of the comparisons. In some cases, empathy levels were higher in women, others in men and in most of them there were no differences between genders. Conclusions: The observed results do not support the belief that women are more empathetic than men. However, more studies must be performed in more powers and countries to verify that the results described constitute a scientific fact and not just a feature of dental students specifically in the countries studied.
TL;DR: It might be argued, however, that it is in relation to matters of health, illness, and healing that hope finds its fullest expression and is most forcefully addressed as a vital concern.
Abstract: We live in an era saturated with the language and imagery of hope. Patient advocacy groups, welfare groups, and organizations oriented to various humanitarian causes often make direct reference to hope in their official titles and campaign bylines: “Pink Hope,” “Giving children hope,” “Hope: Global,” “Hope: Preventing Euthanasia and Assisted Suicide,” “Hope Foundation,” and “Australia HOPE International,” to name a few. Politicians of both the left and right have sought to deploy the rhetoric of hope to announce promises of economic prosperity and their commitments to provide improved social services and to deliver better futures for all. The now-famous “Hope” poster, which represented President Barak Obama’s 2008 presidential campaign, serves as a powerful illustration of the symbolic power of the hope message, a message that Australia’s Prime Minister, Tony Abbott, also appropriated for his 2013 “Hope, Reward, and Opportunity” election poster campaign. People’s hopes readily feature within the language of advertisements (Petersen and Seear, 2011). As Raymond Williams (1980) noted, the enticement of hope is an essential part of the “magic system,” whereby efforts are made to persuade and identify consumerism as the means to personal fulfillment and happiness. It might be argued, however, that it is in relation to matters of health, illness, and healing that hope finds its fullest expression and is most forcefully addressed as a vital concern. This is not only due to the fact that the lived disruption and distress of injury and
TL;DR: A statistically significant relationship between nursing students’ handwashing compliance and their handwashing knowledge, attitudes, and beliefs is found and specific handwashing training courses integrated in nursing education curriculum are recommended.
Abstract: Information regarding current status of handwashing knowledge, beliefs, attitudes and compliance with handwashing practice in nursing students in Jordan is limited. This study aims to explore handwashing knowledge, beliefs, attitudes, and self-reported compliance and to examine significant variables predicting compliance with handwashing practice among nursing students. The study used a cross-sectional survey design. Results found a statistically significant relationship between nursing students’ handwashing compliance and their handwashing knowledge, attitudes, and beliefs (r = 0.68, 0.65, 0.58, P < 0.05), respectively. Also, results revealed three statistically significant predictors. Namely, handwashing knowledge was the strongest predictor (β = 0.423, P = 0.000), followed by attitudes (β = 0.322, P = 0.000), and beliefs (β = 0.171, P = 0.027). Specific handwashing training courses integrated in nursing education curriculum are recommended. These courses need to consider nursing students’ handwashing attitudes and beliefs in conjunction with handwashing knowledge.