Braille Technology Beyond the Financial Barriers

Little is known about the level of service demand and preparedness of Aotearoa New Zealand’s aged residential care facilities to care for older adults with extreme obesity. The aim of this study was to assess the current state of bariatric (extreme obesity) services within aged residential care. An environmental scan was conducted to identify bariatric resident needs and gaps in service provision to inform the development of policy and service provision. Observational and interview data from three facilities in Aotearoa New Zealand was collected along with a retrospective review of national resident admissions over a three-year period. Poor environmental design that included infrastructure deficiencies and financial barriers impacted on the ability to deliver safe and equitable care for this population. Specifically, equipment procurement and safe staffing ratios were of concern to the sector. There is an increasing need for bariatric level support within aged care, necessitating more equipment and staff, adaptation of physical care environments, and enhanced funding. Significant investment is required to address care concerns of older adults with extreme obesity at government and organisational levels.

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Removing Financial Barriers to Organ and Bone Marrow Donation: The Effect of Leave and Tax Legislation in the U.S. - Online Appendix

SSRN Electronic Journal ◽

10.2139/ssrn.2337645 ◽

2013 ◽

Author(s):

Nicola Lacetera ◽

Mario Macis ◽

Sarah Stith

Keyword(s):

Bone Marrow ◽

Financial Barriers ◽

Tax Legislation ◽

Online Appendix ◽

Bone Marrow Donation ◽

The U.S

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Population-based rapid assessment of avoidable blindness survey in Sohag governorate in Egypt

BMJ Open ◽

10.1136/bmjopen-2019-036337 ◽

2020 ◽

Vol 10 (10) ◽

pp. e036337

Author(s):

Heba AlSawahli ◽

Ian McCormick ◽

Caleb D Mpyet ◽

Gamal Ezzelarab ◽

Mohammad Shalaby

Keyword(s):

Cataract Surgery ◽

Census Data ◽

Rapid Assessment ◽

Population Based ◽

Vision Impairment ◽

Health System Strengthening ◽

Secondary Outcome ◽

Institutional Setting ◽

Financial Barriers

ObjectivesTo determine the prevalence and causes of blindness and vision impairment, and the coverage and quality of cataract surgical services, among population aged 50 years and older in Sohag governorate in Egypt.DesignA population-based cross-sectional survey using two-stage cluster random sampling following the rapid assessment of avoidable blindness methodology.SettingA community-based survey conducted by six teams of ophthalmologists, assistants and local guides. Enrolment and examination were door-to-door in selected clusters.ParticipantsUsing 2016 census data, 68 population units were randomly selected as clusters (of 60 people) with probability proportionate to population size. Anyone aged 50 years and older, residing in a non-institutional setting in a cluster for at least 6 months, was eligible to participate.Primary and secondary outcome measuresThe prevalence and causes of blindness and vision impairment. Secondary outcomes were CSC and effectiveness and participant-reported barriers to cataract surgery.ResultsOf 4078 participants enrolled, 4033 (98.9%) were examined. The age-adjusted and sex-adjusted prevalence of blindness, severe vision impairment and moderate vision impairment were 5.9% (95% CI 4.8% to 6.9%), 4.7% (95% CI 3.8% to 5.7%) and 18.9% (95% CI 16.8% to 21.0%), respectively. Cataract caused most of blindness (41.6%), followed by non-trachomatous corneal opacity (15.7%) and posterior segment diseases (14.5%). Cataract surgical coverage (CSC) for persons for visual acuity <3/60 was 86.8%, the proportion of cataract surgeries with poor visual outcome was 29.5% and effective CSC (eCSC) was 44.9%. eCSC was lower in women than men. The most frequently reported barrier to surgery was cost (51.5%).ConclusionsThe prevalence of blindness in Sohag governorate is higher than districts in other middle-income countries in the region. CSC was high; however, women suffer worse quality-corrected CSC than men. The quality of cataract surgery needs to be addressed, while health system strengthening across government and private settings could alleviate financial barriers.

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Effect of the COVID-19 on perceptions of health, anticipated need for health services, and cost of healthcare

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.174 ◽

2021 ◽

pp. 1-28

Author(s):

Natalia Rekhter ◽

Natalia Ermasova

Keyword(s):

Health Services ◽

Healthcare Services ◽

Care Seeking ◽

Financial Barriers ◽

Health Concerns ◽

Anova Test ◽

Targeted Interventions ◽

Early Stages ◽

Care Seeking Behavior ◽

Related Stress

Abstract Objective: This article investigates how perceived vulnerability to the COVID-19 pandemic at its early stages is associated with people’s perception of their health, the need for healthcare services, and expenses related to addressing the COVID-19 impact on their health. Methods: The results are based on the analysis of surveys that were distributed among members of 26 random Facebook groups in April-May, 2020. Perceived COVID-19 pandemic related stress and health concerns were examined by using the ANOVA test. Results: Among 315 respondents, 64% have experienced COVID-19 related stress and identified anxiety, headache, insomnia, and weight gain as their primary health concerns. The ANOVA test revealed that females are more impacted by the COVID-19 stress than males. Around 40% of respondents believed that the COVID-19 would lead to an increase in the cost of health services, and 20% of respondents anticipated that the COVID-19 pandemic would increase their need for health services. Conclusions: Learning about how people perceive the COVID-19 pandemic impact on their health, particularly in the pandemic’s early stages can allow health professionals to develop targeted interventions that can influence pandemic preventative behaviors among different population groups. This study can help understand utilization patterns and mitigate financial barriers that could interfere with patients’ care-seeking behavior.

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Environmental Citizenship and Energy Efficiency in Four European Countries (Italy, The Netherlands, Switzerland and Hungary)

Sustainability ◽

10.3390/su12031154 ◽

2020 ◽

Vol 12 (3) ◽

pp. 1154

Author(s):

Ibolya Czibere ◽

Imre Kovách ◽

Gergely Boldizsár Megyesi

Keyword(s):

Energy Efficiency ◽

The Netherlands ◽

Energy Use ◽

European Countries ◽

Linear Regression Models ◽

Financial Barriers ◽

Self Identity ◽

Horizon 2020 ◽

Number Of Factors ◽

The Social

In our paper we aim at analysing the social factors influencing energy use and energy efficiency in four different European countries, using the data from the PENNY research (Psychological social and financial barriers to energy efficiency—Horizon 2020). As a part of the project, a survey was conducted in four European countries (Italy, The Netherlands, Switzerland and Hungary) to compare environmental self-identity, values and attitudes toward the energy use of European citizens. Previous research has examined the effect of a number of factors that influence individuals’ energy efficiency, and attitudes to energy use. The novelty of our paper that presents four attitudes regarding energy use and environmental consciousness and compares them across four different regions of Europe. It analyses the differences between the four attitudes among the examined countries and tries to understand the factors explaining the differences using linear regression models of the most important socio-demographic variables. Finally, we present a typology of energy use attitudes: four groups, the members of which are basically characterised by essentially different attitudes regarding energy use. A better understanding of the diversity of energy use may assist in making more accurate policy decisions.

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Establishing a postgraduate programme in nutritional epidemiology to strengthen resource capacity, academic leadership and research in the democratic republic of Congo

BMC Medical Education ◽

10.1186/s12909-021-02557-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mapatano Mala Ali ◽

Lyn Haskins ◽

Vaughn John ◽

Anne Hatløy ◽

Silondile Luthuli ◽

...

Keyword(s):

Democratic Republic ◽

Democratic Republic Of Congo ◽

Lessons Learned ◽

Academic Leadership ◽

Nutritional Epidemiology ◽

Rural Site ◽

Educational Approach ◽

Financial Barriers ◽

Republic Of Congo ◽

Health And Nutrition

Abstract Background Low- and Middle-income countries (LMIC) face considerable health and nutrition challenges, many of which can be addressed through strong academic leadership and robust research translated into evidence-based practice. A North-South-South partnership between three universities was established to implement a master’s programme in nutritional epidemiology at the Kinshasa School of Public Health (KSPH), Democratic Republic of Congo (DRC). The partnership aimed to develop academic leadership and research capacity in the field of nutrition in the DRC. In this article we describe the educational approach and processes used, and discuss successes, challenges, and lessons learned. Methods Self-administered questionnaires, which included both open and closed questions, were sent to all graduates and students on the master’s programme to explore students’ experiences and perceptions of all aspects of the educational programme. Quantitative data was analysed using frequencies, and a thematic approach was used to analyse responses to open-ended questions. Results A two-year master’s programme in Nutritional Epidemiology was established in 2014, and 40 students had graduated by 2020. Key elements included using principles of authentic learning, deployment of students for an internship at a rural residential research site, and support of selected students with bursaries. Academic staff from all partner universities participated in teaching and research supervision. The curriculum and teaching approach were well received by most students, although a number of challenges were identified. Most students reported benefits from the rural internship experience but were challenged by the isolation of the rural site, and felt unsupported by their supervisors, undermining students’ experiences and potentially the quality of the research. Financial barriers were also reported as challenges by students, even among those who received bursaries. Conclusion The partnership was successful in establishing a Master Programme in Nutritional Epidemiology increasing the number of nutrition researchers in the DRC. This approach could be used in other LMIC settings to address health and nutrition challenges.

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Access to Healthcare for Immigrant Children in Canada

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17093320 ◽

2020 ◽

Vol 17 (9) ◽

pp. 3320

Author(s):

Bukola Salami ◽

Alleson Mason ◽

Jordana Salma ◽

Sophie Yohani ◽

Maryam Amin ◽

...

Keyword(s):

Health Outcomes ◽

Service Providers ◽

Social Determinant ◽

Immigrant Children ◽

Access To Healthcare ◽

Cultural Barriers ◽

Immigrant Parents ◽

Financial Barriers ◽

University Of Alberta ◽

The University

Immigrants experience poorer health outcomes than nonimmigrants in Canada for several reasons. A central contributing factor to poor health outcomes for immigrants is access to healthcare. Previous research on access to healthcare for immigrants has largely focused on the experience of immigrant adults. The purpose of this study was to investigate how immigrants access health services for their children in Alberta, Canada. Our study involved a descriptive qualitative design. Upon receiving ethics approval from the University of Alberta Research Ethics Board, we invited immigrant parents to participate in this study. We interviewed 50 immigrant parents, including 17 fathers and 33 mothers. Interviews were audio recorded, transcribed, and analyzed according to the themes that emerged. Findings reveal that systemic barriers contributed to challenges in accessing healthcare for immigrant children. Participants identified several of these barriers—namely, system barriers, language and cultural barriers, relationship with health professionals, and financial barriers. These barriers can be addressed by policymakers and service providers by strengthening the diversity of the workforce, addressing income as a social determinant of health, and improving access to language interpretation services.

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Mapping Instructional Barriers during COVID-19 Outbreak: Islamic Education Context

Religions ◽

10.3390/rel12010050 ◽

2021 ◽

Vol 12 (1) ◽

pp. 50

Author(s):

Akhmad Habibi ◽

Amirul Mukminin ◽

Lalu Nurul Yaqin ◽

Lalu Parhanuddin ◽

Rafiza Abdul Razak ◽

...

Keyword(s):

Mother Tongue ◽

Teaching Experience ◽

Islamic Education ◽

Educational Systems ◽

Structured Interviews ◽

Financial Barriers ◽

Instructional Activities ◽

Years Of Teaching Experience ◽

Technological Barriers

Coronavirus disease 2019 (COVID-19) is currently the most potent threat to educational systems, a crisis that may become disastrous. For the current study, a qualitative design within a case study tradition was implemented to investigate instructional barriers during COVID-19 faced by Indonesian teachers in Islamic boarding schools (Pesantren). Within this study, we applied a purposeful convenient sampling in which the access was obtained through communication with the principals of two Pesantren. Seven invited participants with more than ten years of teaching experience agreed to participate. Semi-structured interviews were addressed for data collection; each interview lasted from 40 to 50 min. The interviews were conducted in the participants’ mother tongue to provide an in-depth understanding of their perceptions, ideas, and arguments regarding instructional barriers during the COVID-19 outbreak. The thematic analysis revealed three major findings regarding the barriers; technological barriers, financial barriers, and pedagogical barriers affecting instructional activities in the two Pesantren. Based on the three themes, the development of a qualitative conceptual map of teachers’ instructional barriers was finalized. Recommendations are also proposed by the participants and the study for the betterment of Indonesian Islamic education facing future similar outbreaks.

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The Feasibility of Renewable Natural Gas in New Jersey

Sustainability ◽

10.3390/su13041618 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1618

Author(s):

Anneliese Dyer ◽

Amelia Christine Miller ◽

Brianna Chandra ◽

Juan Galindo Maza ◽

Carley Tran ◽

...

Keyword(s):

New Jersey ◽

Natural Gas ◽

Conceptual Model ◽

Greenhouse Gas Emission ◽

Wastewater Treatment Plants ◽

The United States ◽

Outreach Program ◽

Financial Barriers ◽

The Us ◽

Renewable Natural Gas

With traditional natural gas being one of the top options for heating in the United States and the present threat of climate change, there is a demand for an alternative clean fuel source. A Renewable Natural Gas Implementation Decision-Making Conceptual Model was created to provide a framework for considering the feasibility of renewable natural gas (RNG) projects and applied to New Jersey, specifically investigating landfills and wastewater treatment plants (WWTPs). Data from the US EPA’s Landfill Methane Outreach Program and New Jersey’s Department of Environmental Protection Sewage Sludge databases were used to identify seven landfills and 22 WWTPs as possible locations for RNG projects. Landfills were found to have a higher potential for producing RNG, on average potentially producing enough RNG to heat 12,792 homes per year versus 1227 for the average WWTP. Additionally, landfills, while having higher capital expenses, have lower projected payback periods, averaging 5.19 years compared to WWTP’s 11.78 years. WWTPs, however, generally are located closer to existing natural gas pipelines than landfills and when they produce more than 362 million standard cubic feet per year (MMSCFY) of biogas are financially feasible. RNG projects at Monmouth County Reclamation Center, Ocean County Landfill, and Passaic Valley Sewerage Commission WWTP show the greatest potential. Greenhouse gas emission reductions from RNG projects at these facilities utilizing all available biogas would be 1.628 million metric tons CO2 equivalents per year, synonymous to removing over 351,000 passenger vehicles from the road each year. In addition, expanding federal and state incentives to encompass RNG as a heating fuel is necessary to reduce financial barriers to RNG projects throughout the US. Overall, this paper supports the hypothesized conceptual model in examining the feasibility of RNG projects through examples from New Jersey and confirms the potential for RNG production utilizing existing waste streams.

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Peer driven or driven peers? A rapid review of peer involvement of people who use drugs in HIV and harm reduction services in low- and middle-income countries

Harm Reduction Journal ◽

10.1186/s12954-021-00461-z ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Judy Chang ◽

Shaun Shelly ◽

Machteld Busz ◽

Claudia Stoicescu ◽

Arif Rachman Iryawan ◽

...

Keyword(s):

Harm Reduction ◽

Resource Scarcity ◽

Rapid Review ◽

People Who Use Drugs ◽

Financial Barriers ◽

Community Knowledge ◽

Middle Income ◽

Peer Involvement ◽

Stigma And Discrimination ◽

Low And Middle Income

Abstract Introduction Peer involvement of people who use drugs within HIV and harm reduction services is widely promoted yet under-utilised. Alongside political and financial barriers is a limited understanding of the roles, impacts, contexts and mechanisms for peer involvement, particularly in low- and middle-income settings. We conducted a rapid review of available literature on this topic. Methods Within a community-academic partnership, we used a rapid review approach, framed by realist theory. We used a network search strategy, focused on core journals and reference lists of related reviews. Twenty-nine studies were included. We developed thematic summaries framed by a realist approach of exploring interventions, their mechanisms, outcomes and how they are shaped by contexts. Results Reported outcomes of peer involvement included reduced HIV incidence and prevalence; increased service access, acceptability and quality; changed risk behaviours; and reduced stigma and discrimination. Mechanisms via which these roles work were trust, personal commitment and empathy, using community knowledge and experience, as well as ‘bridge’ and ‘role model’ processes. Contexts of criminalisation, under-resourced health systems, and stigma and discrimination were found to shape these roles, their mechanisms and outcomes. Though contexts and mechanisms are little explored within the literature, we identified a common theme across contexts, mechanisms and outcomes. Peer outreach interventions work through trust, community knowledge and expertise, and ‘bridge’ mechanisms (M) to counter criminalisation and constraining clinic and service delivery environments (C), contributing towards changed drug-using behaviours, increased access, acceptability and quality of harm reduction services and decreased stigma and discrimination (O). Conclusion Peer involvement in HIV and harm reduction services in low- and middle-income settings is linked to positive health outcomes, shaped by contexts of criminalisation, stigma, and resource scarcity. However, peer involvement is under-theorised, particularly on how contexts shape mechanisms and ultimately outcomes. Efforts to study peer involvement need to develop theory and methods to evaluate the complex mechanisms and contexts that have influence. Finally, there is a need to expand the range of peer roles, to embrace the capacities and expertise of people who use drugs.

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