scholarly journals The Jonas Hypertension Program: An Academic–Community Partnership to Address Hypertension in Four Dominican Bateyes

2018 ◽  
Vol 17 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Tammie Conley ◽  
Maithe Enriquez ◽  
An-Lin Cheng ◽  
Dorcas Jorge ◽  
Sandy Yan Meristal ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Access To Health Care ◽  
Health Care Services ◽  
Positive Impact ◽  
Participant Observation ◽  
Demographic Data ◽  
Community Based Participatory Research ◽  
Academic Community ◽  
Antihypertensive Medications ◽  
Control Evaluation

Introduction: Adults living in bateyes (i.e., sugarcane plantation villages) in the Dominican Republic have minimal access to health care services. Hypertension (HTN) is a serious and often unrecognized health problem among batey residents. The Jonas Batey Hypertension Program was built on existing social networks to address the detection and treatment of HTN. Methods: An ongoing community-based participatory research endeavor involves a partnership among three organizations and collaboration with promotoras who engage their batey communities in a mobile HTN screening and treatment program. Adults are screened and, if indicated, are treated with antihypertensive medications. Data collection includes project documentation, participant observation, demographic data, blood pressure (BP) measurements, and pill counts. Results: To date, 243 adults have received HTN treatment in four batey communities. A within-group, as-treated, repeated-measures, pre-/postanalysis showed that among participants who had been receiving antihypertensive treatment for 12 months ( n = 70), there was a significant decrease in BP ( p < .005). Conclusion: Results of an interim data analysis indicate that the program model has been implemented successfully and is making a positive impact on BP control. Evaluation is ongoing with regard to the long-term HTN-related health outcomes of batey residents. Ensuring program sustainability is an important consideration for the future.

“PHONE-CONNECT” - A Pilot Program Prescribing Phones to Address Digital Health Equity Needs in the COVID-19 Era (Preprint)

2020 ◽  
Author(s):  
Gill Kazevman ◽  
Marck Mercado ◽  
Jennifer Hulme ◽  
Andrea Somers
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Point Of Care ◽  
Digital Health ◽  
Contact Tracing ◽  
Health Care Intervention ◽  
Care Intervention

UNSTRUCTURED Vulnerable populations have been identified as having higher infection rates and poorer COVID-19 related outcomes, likely due to their inability to readily access primary care, follow public health directives and adhere to self-isolation guidelines. As a response to the COVID-19 pandemic, many health care services have adopted new digital solutions, relying on phone and internet connectivity. Yet, persons who are digitally inaccessible, such as those struggling with poverty or homelessness, are often unable to utilize these services. In response to this newly highlighted social disparity known as “digital health inequity”, emergency physicians at the University Health Network, Toronto, initiated a program called “PHONE CONNECT”. This novel approach attempts to improve patients’ access to health care, information and social services, as well as improve their ability to adhere to public health directives (social isolation and contact tracing). While similar programs addressing the same emerging issues have been recently described in the media, this is the first time phones are provided as a health care intervention in an emergency department. This innovative ED point-of-care intervention may have a significant impact on improving the health outcomes for vulnerable people during the COVID-19 pandemic, and even beyond it.

scholarly journals Using Prospective Methods to Identify Fieldwork Locations Favourable to Understanding Divergences in Health Care Accessibility

2021 ◽  
Vol 10 (8) ◽  
pp. 506
Author(s):  
Jan Ketil Rød ◽  
Arne H. Eide ◽  
Thomas Halvorsen ◽  
Alister Munthali
Keyword(s):  
Health Care ◽  
Low Income ◽  
Access To Health Care ◽  
Health Care Services ◽  
Good Health ◽  
Low Income Countries ◽  
Care Services ◽  
Health Care Accessibility ◽  
Barriers To Health ◽  
Walking Time

Central to this article is the issue of choosing sites for where a fieldwork could provide a better understanding of divergences in health care accessibility. Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need. Most inhabitants of low-income countries need to walk long distances along meandering paths to get to health care services. Individuals in Malawi responded to a survey with a battery of questions on perceived difficulties in accessing health care services. Using both vertical and horizontal impedance, we modelled walking time between household locations for the individuals in our sample and the health care centres they were using. The digital elevation model and Tobler’s hiking function were used to represent vertical impedance, while OpenStreetMap integrated with land cover map were used to represent horizontal impedance. Combining measures of walking time and perceived accessibility in Malawi, we used spatial statistics and found spatial clusters with substantial discrepancies in health care accessibility, which represented fieldwork locations favourable for providing a better understanding of barriers to health access.

A Scoping Review of Telehealth-Assisted Case Management for Chronic Illnesses

2021 ◽  
pp. 019394592110089
Author(s):  
Jee Young Joo ◽  
Megan F. Liu
Keyword(s):  
Health Care ◽  
Case Management ◽  
Scoping Review ◽  
Access To Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Management Practice ◽  
Empirical Studies ◽  
Chronic Illnesses ◽  
Future Research

This scoping review aimed to examine telehealth-assisted case management for chronic illnesses and assess its overall impact on health care delivery. Guided by the PRISMA statement, this review included 36 empirical studies published between 2011 and 2020. This study identified three weaknesses and four strengths of telehealth-assisted case management. While the weaknesses were negative feelings about telehealth, challenges faced by patients in learning and using telehealth devices, and increased workload for case managers, the strengths included efficient and timely care, increased access to health care services, support for patients’ satisfaction, and cost savings. Future research can be designed and conducted for overcoming the weaknesses of telehealth-assisted case management. Additionally, the strengths identified by this review need to be translated from research into case management practice for chronic illness care. This review not only describes the value of such care strategy, but also provides implications for future nursing practice and research.

Access to health care and Informal Patient Payments for health care in Serbia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Buch Mejsner ◽  
S Lavasani Kjær ◽  
L Eklund Karlsson
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Health Care Services ◽  
Local Population ◽  
Civil Servants ◽  
Care Providers ◽  
Care Services ◽  
Access To Health

Abstract Background Evidence often shows that migrants in the European region have poor access to quality health care. Having a large number of migrants seeking towards Europe, crossing through i.e. Serbia, it is crucial to improve migrants' access to health care and ensure equality in service provision Aim To investigate what are the barriers and facilitators of access to health care in Serbia, perceived by migrants, policy makers, health care providers, civil servants and experts working with migrants. Methods six migrants in an asylum center and eight civil servants in the field of migration were conducted. A complementary questionnaire to key civil servants working with migrants (N = 19) is being distributed to complement the data. The qualitative and quantitative data will be analysed through Grounded Theory and Logistic Regression respectively. Results According to preliminary findings, migrants reported that they were able to access the health care services quite easily. Migrants were mostly fully aware of their rights to access these health care services. However, the interviewed civil servants experienced that, despite the majority of migrants in camps were treated fairly, some migrants were treated inappropriately by health care professionals (being addressed inappropriately, poor or lacking treatment). The civil servants believed that local Serbs, from their own experiences, were treated poorer than migrants (I.e. paying Informal Patient Payments, poor quality of and access to health care services). The interviewed migrants were trusting towards the health system, because they felt protected by the official system that guaranteed them services. The final results will be presented at the conference. Conclusions There was a difference in quality of and access to health care services of local Serbs and migrants in the region. Migrants may be protected by the official health care system and thus have access to and do not pay additional fees for health care services. Key messages Despite comprehensive evidence on Informal Patient Payments (IPP) in Serbia, further research is needed to highlight how health system governance and prevailing policies affect IPP in migrants. There may be clear differences in quality of and access to health care services between the local population and migrants in Serbia.

scholarly journals The Impact of Internalized Stigma on LGBT Parenting and the Importance of Health Care Structures: A Qualitative Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5373
Author(s):  
Carolina Alday-Mondaca ◽  
Siu Lay-Lisboa
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Universal Access ◽  
Civil Society Organizations ◽  
Support Network ◽  
Internalized Stigma ◽  
Lgbt People ◽  
Mental Health Programs ◽  
The Impact

Research on LGBTIQ+ families has focused on the effects of being in a diverse family on the development of children. We seek to show the experience of parenthood from the perspective of LGBTIQ+ people, considering its particularities and the role that health care services play as a potential support network. We used the biographical method through open-ended interviews, participants were LGBT people, and key informants from Chile, Colombia, and Mexico were selected based on a sociostructural sampling. We found that internalized stigma impacts LGBTIQ+ parenting in five ways: the impossibility of thinking of oneself as a parent, fear of violating children’s rights, fear of passing on the stigma, fear of introducing their LGBTIQ+ partner, and the greater discrimination that trans and intersex people suffer. We identified gaps in health care perceptions: the need to guarantee universal access to health care, the need to include a gender perspective and inclusive treatment by health personnel, mental health programs with a community approach, access to assisted fertilization programs, and the generation of collaborative alliances between health services, civil society organizations, and the LGBTIQ+ community. We conclude that the health system is a crucial space from which to enable guarantees for the exercise of rights and overcome internalized stigma.

scholarly journals Autologous Matrix-Induced Chondrogenesis for Treatment of Focal Cartilage Defects in the Knee: A Follow-up Study

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098187
Author(s):  
Justus Gille ◽  
Ellen Reiss ◽  
Moritz Freitag ◽  
Jan Schagemann ◽  
Matthias Steinwachs ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Demographic Data ◽  
Case Series ◽  
Defect Size ◽  
Lysholm Score ◽  
Outcome Analysis ◽  
Cartilage Defects ◽  
Chondral Defects ◽  
The Mean

Background: Autologous matrix-induced chondrogenesis (AMIC) is a well-established treatment for full-thickness cartilage defects. Purpose: To evaluate the long-term clinical outcomes of AMIC for the treatment of chondral lesions of the knee. Study Design: Case series; Level of evidence, 4. Methods: A multisite prospective registry recorded demographic data and outcomes for patients who underwent repair of chondral defects. In total, 131 patients were included in the study. Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS) score for pain were used for outcome analysis. Across all patients, the mean ± SD age of patients was 36.6 ± 11.7 years. The mean body weight was 80.0 ± 16.8 kg, mean height was 176.3 ± 7.9 cm, and mean defect size was 3.3 ± 1.8 cm2. Defects were classified as Outerbridge grade III or IV. A repeated-measures analysis of variance was used to compare outcomes across all time points. Results: The median follow-up time for the patients in this cohort was 4.56 ± 2.92 years. Significant improvement ( P < .001) in all scores was observed at 1 to 2 years after AMIC, and improved values were noted up to 7 years postoperatively. Among all patients, the mean preoperative Lysholm score was 46.9 ± 19.6. At the 1-year follow-up, a significantly higher mean Lysholm score was noted, with maintenance of the favorable outcomes at 7-year follow-up. The KOOS also showed a significant improvement of postoperative values compared with preoperative data. The mean VAS had significantly decreased during the 7-year follow-up. Age, sex, and defect size did not have a significant effect on the outcomes. Conclusion: AMIC is an effective method of treating chondral defects of the knee and leads to reliably favorable results up to 7 years postoperatively.

Changes of Periodontal Tissues Because of Orthodontic Treatment: A Retrospective Study

2021 ◽  
pp. 232020682110034
Author(s):  
Hamad Alzoman ◽  
Khalid Alamoud ◽  
Waad K. Alomran ◽  
Abdullazez Almudhi ◽  
Naif A. Bindayel
Keyword(s):  
Retrospective Study ◽  
Orthodontic Treatment ◽  
Tooth Movement ◽  
Positive Impact ◽  
Demographic Data ◽  
Gingival Recession ◽  
Confounding Factors ◽  
Crown Height ◽  
Periodontal Tissues ◽  
Before And After

Aim: To evaluate the periodontal status before and after orthodontic treatment and to analyze the confounding factors associated with it. Materials and Methods: The present retrospective study analyzed pre- and posttreatment records of a total of 60 patients. Intraoral digital photographs before and after the orthodontic treatment were used to measure the following three periodontal variables: (a) width of the keratinized gingiva, (b) gingival recession, and (c) the status of interdental papilla. The ImageJ 46 software imaging program was used to perform the required measurements. The clinical data were then analyzed in an association with the participants’ demographic data, the type of orthodontic tooth movement, and other confounding factors. The data obtained were manually entered into the statistical package and analyzed using a significance level set at P < .05. Descriptive statistics, paired t-tests, and Pearson’s correlation analysis were used to identify differences among the studied variables. Results: Among the 60 patients, the majority (66.7%) were females. Most cases of the treated malocclusion were Class II, and most patients underwent intrusion and retrusion movements. The width of keratinized gingiva increased for most sites of upper teeth. In contrast, the lower teeth showed a mix of improvement and compromised width of keratinized gingiva. As a measure of gingival recession, the difference of clinical crown height revealed the tendency toward a reduced clinical crown height for most sites. Upper left lateral incisors and canines showed significant values with regard to keratinized gingival width measurements and tooth movements such as extrusion and intrusion movements. Likewise, with regard to the clinical crown height, upper right central incisors showed significant differences when correlated with the interincisal angle, lower incisors to the mandibular plane, and upper incisors to the NA line. The upper lateral incisors also showed significant correlations to certain cephalometric measurements. Conclusions: The orthodontic treatment was found to exert a significantly positive impact on the surrounding periodontium, particularly in the upper canine areas. Likewise, various types of tooth movement were found to positively affect the periodontium.

Substantive Equality in South African Health Care: The Limits of Law

2000 ◽  
Vol 4 (2) ◽  
pp. 111-131 ◽  
Author(s):  
Charles Ngwena
Keyword(s):  
Health Care ◽  
South African ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Care Reforms ◽  
Structural Inequality ◽  
Care Services ◽  
Substantive Equality ◽  
African Health ◽  
Access To Health

The article considers the scope and limits of law as an instrument for facilitating equitable access to health care in South Africa. The focus is on exploring the extent to which the notion of substantive equality in access to health care services that is implicitly guaranteed by the Constitution and supported by current health care reforms, is realisable for patients seeking treatment. The article highlights the gap between the idea of substantive equality in the Constitution and the resources at the disposal of the health care sector and the country as a whole. It is submitted that though formal equality in access to health care services has been realised, substantive equality is currently unattainable, if it is attainable at all, on account of entrenched structural inequality, general poverty and a high burden of disease.

Academic mobility or the Russian style networking?

2021 ◽  
pp. 139-151
Author(s):  
E. I. Trubnikova
Keyword(s):  
Positive Impact ◽  
Academic Community ◽  
Academic Collaboration ◽  
Academic Mobility ◽  
Scientific Schools ◽  
Social Interests ◽  
Academic Relations ◽  
Academic Rankings ◽  
The Way

Academic mobility facilitates interactions of different scientific schools and collectives, influences formation of academic relations and indirectly affects positions of universities in academic rankings. Mobility helps establish networks of professional contacts, and that might have a positive impact on the level of research, allowing efficient academic collaboration, access to results of different studies and collected data. Mobility is an important issue not only for universities, but also for researchers because their collaboration with the colleagues and participation in joint projects characterize them for other members of the academic community, and that increases the value of academic networking. However, the way of evolution of the institution of networking raises various questions about the objectivity of the recruiting process and advantages that some candidates get over their rivals. The purpose of this article is identification and analysis of those factors that force the institution of mobility in the Russian academic reality to work against general social interests and the interests of universities.

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