scholarly journals Medicolegal Alienation in Physicians Practising in Informal Clinics Servicing Undocumented Migrants

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J T V Greenbrook ◽  
K Reichenberg
Keyword(s):  
Qualitative Interviews ◽  
Healthcare Services ◽  
Constructivist Grounded Theory ◽  
Medical Institution ◽  
Legal Consciousness ◽  
Social Injustice ◽  
Undocumented Migrants ◽  
Patients Rights ◽  
Professional Dissonance ◽  
Insight Into

Abstract Background Globally, undocumented migrants have relied on informal clinics for their healthcare services. Empirical explorations of physicians' moral, ethical, and legal consciousness surrounding practising within this context remain lacking. The present study sought to contribute to this gap. Methods Constructivist grounded theory was applied to qualitative interviews with 16 physicians working in informal humanitarian clinics in Sweden. Results Physicians' experiences were synthesised into three categories: Ambiguity in navigating illegality, due to awareness of vulnerabilities surrounding patient-safety and own involvement, whilst simultaneously feeling enriched through interactions in the clinic; Being exposed to patients' accounts of structural violence and social injustice; Experiencing isolation in practice, when discovering professional limitations and feeling severed from the conventional medical institution. In navigating the threshold between their societally commended role and structurally condemned undocumentedness, differing processes of alienation synthesised in physicians in medical, ethical, and legal terms; identified as a novel dimension of legal consciousness theory, a process coined medicolegal alienation. Conclusions The process of medicolegal alienation occurs when, functioning as arbiters of patients' rights within the conventional medical institution, questions surrounding undocumented migrants' deservingness force physicians into a position of moral, ethical, and professional dissonance. Struggling to dictate their own practice, they are propelled out into informal clinics, in search for congruence. Through this process, physicians become alienated from both their profession and from legality. Though able to navigate freely between the medical institution and humanitarian clinics, the burden of insight into the threshold between legal realms and the plight of the undocumented patient is heavily ambiguous, being both transformative and isolating. Key messages In navigating the threshold between their societally commended role and structurally condemned undocumentedness, differing processes of medical, ethical, and legal alienation synthesised in physicians. When undocumented migrants’ deservingness is questtioned, physicians are forced into a position of moral, ethical, and professional dissonance, giving rise to the process of medicolegal alienation.

scholarly journals Policy implementation analysis on access to healthcare among undocumented immigrants in seven autonomous communities of Spain, 2012–2018

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045626
Author(s):  
Megi Gogishvili ◽  
Sergio A Costa ◽  
Karen Flórez ◽  
Terry T Huang
Keyword(s):  
Policy Implementation ◽  
Undocumented Immigrants ◽  
Healthcare Services ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Undocumented Migrants ◽  
Royal Decree ◽  
La Mancha ◽  
Free Healthcare ◽  
Implementation Analysis

BackgroundIn 2012, the Government of Spain enacted Royal Decree-Law (RDL) 16/2012 and Royal Decree (RD) 1192/2012 excluding undocumented immigrants from publicly funded healthcare services. We conducted a policy implementation analysis to describe and evaluate the legal and regulatory actions taken at the autonomous community (AC) level after enactment of 2012 RDL and RD and their impact on access to general healthcare and HIV services among undocumented immigrants.MethodsWe reviewed documents published by the governments of seven ACs (Andalucía, Aragón, Euskadi (Basque Country), Castilla-La Mancha, Galicia, Madrid, Valencia) from April 2012 to July 2018, describing circumstances under which undocumented immigrants would be able to access free healthcare services. We developed indicators according to the main systemic barriers presented in official documents to analyse access to free healthcare across the participating ACs. ACs were grouped under five access categories: high, medium-high, medium, medium-low and low.ResultsAndalucía provided the highest access to free healthcare for undocumented immigrants in both general care and HIV treatment. Medium-high access was provided by Euskadi and medium access by Aragón, Madrid and Valencia. Castilla-La Mancha provided medium-low access. Galicia had low access. Only Madrid and Galicia provided different and higher level of access to undocumented migrants in HIV care compared with general healthcare.ConclusionsImplementation of 2012 RDL and RD across the ACs varied significantly, in part due to the decentralisation of the Spanish healthcare system. The challenge of healthcare access among undocumented immigrants included persistent systemic restrictions, frequent and unclear rule changes, and the need to navigate differences across ACs of Spain.

scholarly journals Implementation Research to Understand and Target Complex Needs: A Case Study of US-based Food Assistance Programming (P10-147-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Andrea Warren ◽  
Edward Frongillo ◽  
Shana Alford ◽  
Erin McDonald ◽  
Jessica Escobar-Alegria
Keyword(s):  
Implementation Research ◽  
Qualitative Interviews ◽  
Food Assistance ◽  
Functional Abilities ◽  
Social Environments ◽  
Physical Strength ◽  
Complex Needs ◽  
Assistance Programs ◽  
The Right ◽  
Insight Into

Abstract Objectives The objective of this study was to understand needs among seniors for food and food assistance and to develop a comprehensive taxonomy for these needs. Methods A total of 147 seniors were purposively sampled from 12 food-assistance programs in 9 states. Of the 12 programs, 10 provided unprepared foods and 2 provided pre-cooked meals. Data were semi-structured qualitative interviews. Coding and analysis of transcripts followed an inductive qualitative analysis approach. A series of thematic summaries were prepared to reflect the content of the interviews for discussion and refinement of the analytic approach. Results An emergent taxonomy comprised 3 categories consisting of abilities and ranges or variants of those abilities. The category of physical ability consists of physical strength, the ability to prepare food, the ability to walk or stand, and health status. These relate to an individual's functional abilities to live and act independently and may be considered pre-conditions for program uptake and benefit distinct from dietary and food security-related needs and limitations. The category of consuming food consists of preferences, accessibility, affordability, and dietary needs. This category highlights the relationship between economic constraints and dietary needs that often necessitates meaningful tradeoffs in consuming the right foods for their health. The category of access and use of transportation consists of own means, friends or family, and public or private services. This category highlights challenges in accessing programs and provides insight into seniors’ experiences of poverty, declining functional abilities, social networks and connectedness, geography, and public services. Conclusions The process used to develop the taxonomy and the taxonomy itself provide an exemplar for implementation research when the nature of need is complex and programs integrated across sectors are required to address the need. The taxonomy provides structure to facilitate the identification of key factors in program engagement—and insight into the economic and social environments in which they occur—that translate into needs relevant to the design, targeting, and uptake of food assistance in a diverse population of seniors. Funding Sources Enterprise Rent-a-Car Foundation.

scholarly journals Use of symptom checkers for COVID-19-related symptoms among university students: a qualitative study

2021 ◽  
pp. bmjinnov-2020-000498
Author(s):  
Stephanie Aboueid ◽  
Samantha B Meyer ◽  
James R Wallace ◽  
Shreya Mahajan ◽  
Teeyaa Nur ◽  
...  
Keyword(s):  
Young Adults ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Qualitative Interviews ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Positive Experience ◽  
Perceived Credibility ◽  
Inductive Thematic Analysis

ObjectiveSymptom checkers are potentially beneficial tools during pandemics. To increase the use of the platform, perspectives of end users must be gathered. Our objectives were to understand the perspectives and experiences of young adults related to the use of symptom checkers for assessing COVID-19-related symptoms and to identify areas for improvement.MethodsWe conducted semistructured qualitative interviews with 22 young adults (18–34 years of age) at a university in Ontario, Canada. Interviews were audio-recorded, transcribed, and analysed using inductive thematic analysis.ResultsWe identified six main themes related to the decision of using a symptom checker for COVID-19 symptoms: (1) presence of symptoms or a combination of symptoms, (2) knowledge about COVID-19 symptoms, (3) fear of seeking in-person healthcare services, (4) awareness about symptom checkers, (5) paranoia and (6) curiosity. Participants who used symptom checkers shared by governmental entities reported an overall positive experience. Individuals who used non-credible sources reported suboptimal experiences due to lack of perceived credibility. Five main areas for improvement were identified: (1) information about the creators of the platform, (2) explanation of symptoms, (3) personalised experience, (4) language options, and (5) option to get tested.ConclusionsThis study suggests an increased acceptance of symptom checkers due to the perceived risks of infection associated with seeking in-person healthcare services. Symptom checkers have the potential to reduce the burden on healthcare systems and health professionals, especially during pandemics; however, these platforms could be improved to increase use.

Black Voices, White Power

2016 ◽  
Vol 48 (2) ◽  
pp. 143-164 ◽  
Author(s):  
Robert Redding
Keyword(s):  
Cultural Studies ◽  
White Privilege ◽  
Qualitative Interviews ◽  
Communication Studies ◽  
Media Ownership ◽  
Black Voices ◽  
Black Media ◽  
Personal Accounts ◽  
Insight Into

When a former Black editor says he was told that Blacks do not care about news by his White boss and a Black deejay is told that his commentary is too hard hitting and not to go to an event featuring a Black militant leader by his White boss, these personal accounts could be extrapolated to mean that there may still be a world filled with White privilege and an ensuing hegemonic bifurcation in a communication studies context. This study utilizes Afrocentricity and the agency that is denied to these two individuals to provide insight into a world where these Black media/newsroom personnel describe how they lost ground to their White media owners. Those interviewed said this world does not promote the agency that comes with Afrocentricity, which is utilized as a critical cultural studies lens to interpret these 18-question qualitative interviews. The environment that those interviewed described is a world not often viewed in the context of White media ownership and the Black-focused content that is produced within them, but is a phenomenon that may be better understood by utilizing an Afrocentric lens in a Communication Studies context.

scholarly journals Undocumented migrants’ right to health care: Physicians’ rejection of law in their gatekeeper roles

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J T V Greenbrook
Keyword(s):  
Health Care ◽  
Medical Ethics ◽  
Phenomenological Study ◽  
Medical Profession ◽  
Healthcare Access ◽  
Right To Health ◽  
Legal Consciousness ◽  
Legal Knowledge ◽  
Undocumented Migrants ◽  
Right To Health Care

Abstract Background Legal consciousness theory acknowledges the known gap between law in writing and law in its everyday practical application in society. Limited research has explored legal consciousness in medical contexts, and limited knowledge exists surrounding how the intrusion of law in medical authority impacts applied medical ethics. Conflicts between law and medical ethics can be saliently observed in Sweden, where current law forcibly places physicians in a gatekeeper role in satisfying undocumented migrants' right to health care access, relying on physicians' assessments of whether patients without legal residency status should be provided 'care that cannot be deferred'. Methods In this context, the present phenomenological study sought to explore how legal terminology is experienced, understood, and applied by physicians, contextualising the perceived meaning ascribed to the imposed gatekeeper role. Qualitative interviews were conducted with 42 physicians from five major Swedish hospitals, and analysed through the lens of legal consciousness theory. Results Participants actively rejected law by taking a firm, and often collective, stance against its intrusion in their work. Rejection of law was constructed through: rejecting legal hegemony and government imposed non-medical responsibilities; perceiving professional authority and medical ethics as empowering; considering repercussions of legal non-compliance unthreatening; believing increased legal knowledge would not influence their professions' foundational role. Conclusions The study produced novel findings, contributing to the limited body of work exploring legal consciousness in medicine. Regardless of legal knowledge held, when law conflicted with foundational medical ethics, the intrusion of law in the medical profession lead to the explicit rejection of law. Findings accent the need for laws addressing healthcare access to be compatible with foundational medical ethics and principles of non-discrimination. Key messages Regardless of legal knowledge held, when law conflicted with foundational medical ethics, the intrusion of law in the medical profession lead to the explicit rejection of law. Findings accent the need for laws addressing healthcare access to be compatible with foundational medical ethics and principles of non-discrimination.

scholarly journals IoT-Based Applications in Healthcare Devices

2021 ◽  
Vol 2021 ◽  
pp. 1-18
Author(s):  
Bikash Pradhan ◽  
Saugat Bhattacharyya ◽  
Kunal Pal
Keyword(s):  
Medical Devices ◽  
Healthcare Costs ◽  
Healthcare Professionals ◽  
Healthcare Services ◽  
The Internet ◽  
Healthcare Industry ◽  
Healthcare Applications ◽  
Source Of Information ◽  
The Internet Of Things ◽  
Insight Into

The last decade has witnessed extensive research in the field of healthcare services and their technological upgradation. To be more specific, the Internet of Things (IoT) has shown potential application in connecting various medical devices, sensors, and healthcare professionals to provide quality medical services in a remote location. This has improved patient safety, reduced healthcare costs, enhanced the accessibility of healthcare services, and increased operational efficiency in the healthcare industry. The current study gives an up-to-date summary of the potential healthcare applications of IoT- (HIoT-) based technologies. Herein, the advancement of the application of the HIoT has been reported from the perspective of enabling technologies, healthcare services, and applications in solving various healthcare issues. Moreover, potential challenges and issues in the HIoT system are also discussed. In sum, the current study provides a comprehensive source of information regarding the different fields of application of HIoT intending to help future researchers, who have the interest to work and make advancements in the field to gain insight into the topic.

Study of Real-Time Cardiac Monitoring System

2018 ◽  
pp. 188-198 ◽  
Author(s):  
Uma Arun ◽  
Natarajan Sriraam
Keyword(s):  
Real Time ◽  
Monitoring System ◽  
Cost Effective ◽  
Healthcare Services ◽  
Cardiac Monitoring ◽  
Diagnostic Quality ◽  
Ecg Signals ◽  
Comprehensive Survey ◽  
Primary Advantage ◽  
Insight Into

Today's healthcare technology provides promising solutions to cater to the needs of patients. The development of wearable physiological monitoring system has reached home-centric patients by ensuring faster healthcare services. The primary advantage of this system is activation of alarms to alert the specialist in a nearby hospital to attend to any sort of emergency. Specifically, cardiac-related problems need special attention when a 24-hour Holter monitors ECG signals and identifies the level of abnormalities under various circumstances. Although several brands of Holters exist in market, there is a huge demand for digitized Holter recorders. These recorders can simultaneously analyse cardiac signals in real time mode and store the data and reuse them for next 24 hours. As home-centric based wearable cardiac monitoring system gains much attention recently, there is a need to design and develop a cardiac monitoring system by establishing a trade-off between the required clinical diagnostic quality and cost. This research study highlights a comprehensive survey of various cardiac monitoring systems under wire, wireless and wearable modes. This provides an insight into the need of the hour in bringing a cost-effective wearable system. The study provides an insight of the technological aspects of the existing cardiac monitoring system and suggests a viable design suitable for developing countries.

scholarly journals Redrawing the border through the ‘Right to Rent’: Exclusion, discrimination and hostility in the English housing market

2020 ◽  
pp. 026101831989704 ◽  
Author(s):  
Kim Mckee ◽  
Sharon Leahy ◽  
Trudi Tokarczyk ◽  
Joe Crawford
Keyword(s):  
Racial Profiling ◽  
Qualitative Interviews ◽  
Criminal Prosecution ◽  
Undocumented Migrants ◽  
Hostile Environment ◽  
Home Office ◽  
Illegal Migrants ◽  
Guidance Documents ◽  
The Uk ◽  
The Right

The UK Immigration Act 2016 is central to the Conservative Government’s drive to create a more hostile environment for potential migrants and current ‘illegal’ migrants residing in the UK. The Right to Rent provisions of the Act, which require private landlords in England to conduct mandatory immigration document checks on prospective tenants, or face sizeable fines and criminal prosecution, have been highlighted as a key facet of the legislation. Drawing on qualitative interviews with key experts and analysis of Home Office guidance documents, we argue the Right to Rent has turned the private rental market into a border-check, with landlords responsibilised to perform ‘everyday bordering’ on behalf of the State. This creates a potentially discriminatory environment for all migrants, as well as for British citizens who lack documentation and/or may be subject to racial profiling. It may also be forcing vulnerable, undocumented migrants into even more precarious housing situations.

Working around the Law: Navigating Legal Barriers to Employment during Reentry

2019 ◽  
Vol 44 (03) ◽  
pp. 726-751 ◽  
Author(s):  
Dallas Augustine
Keyword(s):  
Qualitative Interviews ◽  
Alternative Form ◽  
Legal Consciousness ◽  
Double Bind ◽  
Job Seekers ◽  
Criminal Records ◽  
Formerly Incarcerated ◽  
Barriers To Employment ◽  
The Law ◽  
Legal Barriers

Employment has been cited as one of the most effective protections against recidivism for formerly incarcerated people; however, job seekers with criminal records face barriers to employment after prison. They find themselves in a legal double bind where they are simultaneously compelled to obey the law (by finding “legit” work) but also legally barred from doing so. To navigate this conflictual legal positioning, job seekers with felony records develop strategies of working around the law to find employment. Through thirty qualitative interviews with people with felony records, I examine this alternative form of legal consciousness and detail the ways in which individuals navigate the legal barriers to acquiring “good” work. Ultimately, job seekers’ often extralegal strategies of law abidance blur the line between compliance with and defiance of the law.

scholarly journals Researching Professional Footballers: Reflections and Lessons Learned

2019 ◽  
Vol 18 ◽  
pp. 160940691984932 ◽  
Author(s):  
Graeme Law
Keyword(s):  
Qualitative Interviews ◽  
Research Process ◽  
Lessons Learned ◽  
Current Position ◽  
Case Study Approach ◽  
Study Approach ◽  
Sensitive Issue ◽  
Conducting Research ◽  
Insight Into

In this article, the author reflects on the process of interviewing professional footballers about the sensitive issue of money and the lessons learned from this process. The article discusses a case study approach using in-depth qualitative interviews, which generates an innovative insight into a closed social world. The focus is on the difficulties of obtaining a sample where challenges faced are discussed. The article also focuses on the interview style employed when dealing with individuals who are experienced at being interviewed regularly. It also examines the issues of being an “insider” when conducting research and ways in which this can benefit the research process. The issue of research being a messy process is also discussed as when conducting this research, it was imperative that the author could deal with unpredictability and had to be flexible to conduct the research. Finally, the article discusses the insecurities of the participants and the issues of trust, as the current position of the author led him to be seen as an “outsider” by some participants.

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