scholarly journals Trans*Forming Access and Care in Rural Areas: A Community-Engaged Approach

2021 ◽  
Vol 18 (23) ◽  
pp. 12700
Author(s):  
Megan E. Gandy ◽  
Kacie M. Kidd ◽  
James Weiss ◽  
Judith Leitch ◽  
Xavier Hersom
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Rural Areas ◽  
Health Care Systems ◽  
Community Advisory Board ◽  
Care Needs ◽  
Gender Diverse ◽  
Care Systems ◽  
Quantitative Results ◽  
And Gender

Research indicates that rural transgender and gender diverse (TGD) populations have a greater need for health services when compared with their urban counterparts, face unique barriers to accessing services, and have health disparities that are less researched than urban TGD populations. Therefore, the primary aim of this mixed-methods study (n = 24) was to increase research on the health care needs of TGD people in a rural Appalachian American context. This study was guided by a community-engaged model utilizing a community advisory board of TGD people and supportive parents of TGD children. Quantitative results indicate that travel burden is high, affirming provider availability is low, and the impacts on the health and mental health of TGD people in this sample are notable. Qualitative results provide recommendations for providers and health care systems to better serve this population. Integrated mixed-methods results further illustrate ways that rural TGD people and families adapt to the services available to them, sometimes at significant economic and emotional costs. This study contributes to the small but growing body of literature on the unique needs of rural TGD populations, including both adults and minors with supportive parents, by offering insights into strategies to address known disparities.

Service Delivery and the Challenges of Providing Service to People Who Are Transgender

2015 ◽  
Vol 25 (2) ◽  
pp. 59-65 ◽  
Author(s):  
Christella Antoni
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Clinical Experience ◽  
Private Practice ◽  
Health Care Systems ◽  
Gender Diverse ◽  
Recent Developments ◽  
Communication Work ◽  
Care Systems ◽  
And Gender

An increasing number of speech-language pathologists (SLPs) are working with individuals who are transgender (TG) and gender diverse people. This trend likely reflects a growing number of TG and gender diverse patients seeking treatment. Whilst voice and communication outcomes can be highly satisfying for both the client and the therapist, there can be many challenges associated with service delivery to the transgender population. This article will discuss the challenges for SLPs, both in public state-funded health care systems, and clinicians in private practice. This discussion is informed by my 15 years of clinical experience in both systems and by recent developments in the field of TG voice and communication work.

Out of the Shadows

2019 ◽  
pp. 123-144
Author(s):  
Douglas C. Haldeman
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Low Socioeconomic Status ◽  
Health Care Professionals ◽  
Rural Areas ◽  
Access To Health Care ◽  
Gender Diverse ◽  
Health Care Training ◽  
Evidence Based Treatments ◽  
And Gender

Sexual minority and gender-diverse (SM/GD) persons experience depression, anxiety, suicidality, and substance use issues at a disproportionate rate when compared with heterosexuals. Stigma, minority stress, and prejudicial social attitudes and institutional policies are viewed as the reason for this. The disparities in access to health care for SM/GD persons is significant and is perceived as due to lack of access to competent care as well as mistrust of health care professionals on the part of SM/GD persons. SM/GD teens and elders, as well as individuals with low socioeconomic status, those living in rural areas, and those with disabilities, are particularly vulnerable. Recommendations for changes in health care policy, as well as strategies for improving the cultural competence of health care providers and evidence-based treatments, are discussed. Additionally, further research, standardizing health care training to include SM/GD persons, prevention, and inter-organizational advocacy are recommended.

scholarly journals Mining Physicians’ Opinions on Social Media to Obtain Insights Into COVID-19: Mixed Methods Analysis

10.2196/19276 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e19276 ◽  
Author(s):  
Abdullah Wahbeh ◽  
Tareq Nasralah ◽  
Mohammad Al-Ramahi ◽  
Omar El-Gayar
Keyword(s):  
Health Care ◽  
Social Media ◽  
Mixed Methods ◽  
Qualitative Analysis ◽  
Health Care Systems ◽  
Supervised Machine Learning ◽  
Machine Learning Techniques ◽  
Medical Professionals ◽  
Social Media Analytics ◽  
Care Systems

Background The coronavirus disease (COVID-19) pandemic is considered to be the most daunting public health challenge in decades. With no effective treatments and with time needed to develop a vaccine, alternative approaches are being used to control this pandemic. Objective The objective of this paper was to identify topics, opinions, and recommendations about the COVID-19 pandemic discussed by medical professionals on the Twitter social medial platform. Methods Using a mixed methods approach blending the capabilities of social media analytics and qualitative analysis, we analyzed COVID-19–related tweets posted by medical professionals and examined their content. We used qualitative analysis to explore the collected data to identify relevant tweets and uncover important concepts about the pandemic using qualitative coding. Unsupervised and supervised machine learning techniques and text analysis were used to identify topics and opinions. Results Data were collected from 119 medical professionals on Twitter about the coronavirus pandemic. A total of 10,096 English tweets were collected from the identified medical professionals between December 1, 2019 and April 1, 2020. We identified eight topics, namely actions and recommendations, fighting misinformation, information and knowledge, the health care system, symptoms and illness, immunity, testing, and infection and transmission. The tweets mainly focused on needed actions and recommendations (2827/10,096, 28%) to control the pandemic. Many tweets warned about misleading information (2019/10,096, 20%) that could lead to infection of more people with the virus. Other tweets discussed general knowledge and information (911/10,096, 9%) about the virus as well as concerns about the health care systems and workers (909/10,096, 9%). The remaining tweets discussed information about symptoms associated with COVID-19 (810/10,096, 8%), immunity (707/10,096, 7%), testing (605/10,096, 6%), and virus infection and transmission (503/10,096, 5%). Conclusions Our findings indicate that Twitter and social media platforms can help identify important and useful knowledge shared by medical professionals during a pandemic.

scholarly journals Rapid Implementation of Video Visits in Neurology During COVID-19: Mixed Methods Evaluation (Preprint)

2020 ◽  
Author(s):  
Erika A Saliba-Gustafsson ◽  
Rebecca Miller-Kuhlmann ◽  
Samantha M R Kling ◽  
Donn W Garvert ◽  
Cati G Brown-Johnson ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Care Delivery ◽  
Medical Center ◽  
Health Care Systems ◽  
Clinical Care ◽  
Academic Medical Center ◽  
Traditional Health ◽  
Traditional Health Care ◽  
Care Systems

BACKGROUND Telemedicine has been used for decades. Despite its many advantages, its uptake and rigorous evaluation of feasibility across neurology’s ambulatory subspecialties has been sparse. However, the COVID-19 pandemic prompted health care systems worldwide to reconsider traditional health care delivery. To safeguard health care workers and patients, many health care systems quickly transitioned to telemedicine, including across neurology subspecialties, providing a new opportunity to evaluate this modality of care. OBJECTIVE To evaluate the accelerated implementation of video visits in ambulatory neurology during the COVID-19 pandemic, we used mixed methods to assess adoption, acceptability, appropriateness, and perceptions of potential sustainability. METHODS Video visits were launched rapidly in ambulatory neurology clinics of a large academic medical center. To assess adoption, we analyzed clinician-level scheduling data collected between March 22 and May 16, 2020. We assessed acceptability, appropriateness, and sustainability via a clinician survey (n=48) and semistructured interviews with providers (n=30) completed between March and May 2020. RESULTS Video visits were adopted rapidly; overall, 65 (98%) clinicians integrated video visits into their workflow within the first 6 implementation weeks and 92% of all visits were conducted via video. Video visits were largely considered acceptable by clinicians, although various technological issues impacted their satisfaction. Video visits were reported to be more convenient for patients, families, and caregivers than in-person visits; however, access to technology, the patient’s technological capacity, and language difficulties were considered barriers. Many clinicians expressed optimism about future utilization of video visits in neurology. They believed that video visits promote continuity of care and can be incorporated into their practice long-term, although several insisted that they can never replace the in-person examination. CONCLUSIONS Video visits are an important addition to clinical care in ambulatory neurology and are anticipated to remain a permanent supplement to in-person visits, promoting patient care continuity, and flexibility for patients and clinicians alike.

scholarly journals Conceptual Framework to Guide Intervention Research Across the Trajectory of Dementia Caregiving

2020 ◽  
Vol 60 (Supplement_1) ◽  
pp. S29-S40 ◽  
Author(s):  
Dolores Gallagher-Thompson ◽  
Ann Choryan Bilbrey ◽  
Ester Carolina Apesoa-Varano ◽  
Rita Ghatak ◽  
Katherine K Kim ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Conceptual Framework ◽  
Longitudinal Research ◽  
Health Care Systems ◽  
Care Recipient ◽  
Sociocultural Factors ◽  
Care Needs ◽  
Dementia Caregiving ◽  
Care Systems

Abstract This article presents a comprehensive conceptual framework designed to foster research in the changing needs of caregivers and persons with dementia as they move through their illness trajectory. It builds on prior theoretical models and intervention literature in the field, while at the same time addressing notable gaps including inadequate attention to cultural issues; lack of longitudinal research; focus on primary caregivers, almost to the exclusion of the person with dementia and other family members; limited outcome measures; and lack of attention to how the culture of health care systems affects caregivers’ quality of life. The framework emphasizes the intersectionality of caregiving, sociocultural factors, health care systems’ factors, and dementia care needs as they change across time. It provides a template to encourage longitudinal research on reciprocal relationships between caregiver and care recipient because significant changes in the physical and/or mental health status of one member of the dyad will probably affect the physical and/or mental health of the partner. This article offers illustrative research projects employing this framework and concludes with a call to action and invitation to researchers to test components, share feedback, and participate in continued refinement to more quickly advance evidence-based knowledge and practice in the trajectory of dementia caregiving.

scholarly journals Haemophilia: Its Types and Prevalence in Pakistan

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Kiran Fatima ◽  
Rabeea Irfan ◽  
Laraib Azmat
Keyword(s):  
Health Care ◽  
Research Study ◽  
Health Care Systems ◽  
Age Groups ◽  
Health Resources ◽  
Bleeding Disorder ◽  
Care Systems ◽  
Limited Health ◽  
And Gender ◽  
Set Up

Background: Haemophilia; classified by the inefficacy of blood to clot appropriately, is a genetic bleeding disorder. As a developing country, Pakistan has limited health resources and very little awareness of hemophilia among its people. Objectives: This research study is designed to identify the prevalence of the disease and to report the types of haemophilia common in Pakistan in order to propose suitable treatments for the prevention and cure of the disease. Methodology: A survey questionnaire was designed and executed by the group members. Data was collected from registered Haemophilia Centers in Pakistan. Number of reported cases based on types of haemophilia, age groups, and gender were identified separately. Results: It was evaluated that Pakistan continues to have a growing number of hemophilia cases at an alarming rate. The research study also showed how there is a lack of affordable and proper health care in the country, due to which several cases go unreported and untreated. Conclusion: For the containment of this bleeding disorder, time for taking proper action is passing. Proper health care systems should be set up which are accessible to the majority of the population. Awareness programs should be designed and people should be encouraged for regular laboratory tests to prevent late diagnosis.

scholarly journals Health care funding in New South Wales: from health care needs to hospital outputs

2002 ◽  
Vol 25 (1) ◽  
pp. 40 ◽  
Author(s):  
Don Hindle
Keyword(s):  
Health Care ◽  
Health Services ◽  
Best Practice ◽  
Service Providers ◽  
Health Care Systems ◽  
Care Needs ◽  
South Wales ◽  
Care Systems ◽  
Common Framework ◽  
Area Health

This paper summarises the structure of the State's health care system, and then focuses on the main processes of resource allocation: needs-based funding of 17 Area Health Services, and output-based funding of specific service providers. The general model is widely accepted by informed observers to be fundamentally sound. In particular, the resource distribution formula whereby needs-based allocations are made is a largely valid model that has been progressively refined over fifteen years and is probably as good as any in the world. I conclude that the recent decision to require Area Health Services to use a common framework for out-put-based funding was long overdue, and that many of its features represent best practice. However, I argue that more shouldbe done to refine some of the details and that NSW Health might need to give more consideration to ideas that have been tested and evaluated in other health care systems.

The Rise and Decline of the Cooperative Medical System in Rural China

1993 ◽  
Vol 23 (4) ◽  
pp. 731-742 ◽  
Author(s):  
Xiao-Ming Chen ◽  
Teh-Wei Hu ◽  
Zihua Lin
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Health Care Services ◽  
Rural China ◽  
Health Care Systems ◽  
Medical System ◽  
Care Services ◽  
Treatment And Prevention ◽  
Care Systems ◽  
And Child Health

The Cooperative Medical System (CMS) in China is an established medical system that serves the rural areas and provides treatment and prevention of disease, immunization, family planning, and maternal and child health care services. Past experience suggests that the CMS benefited the peasants in rural China. During the 1980s, following reform of China's economic system, the CMS underwent major changes. In some places, CMS stations evolved into various other types of medical and health care systems; in other places, CMS stations ceased operation altogether. This article attempts to analyze the causes and meaning of these changes, and examines the conditions for continuation of this system.

SCANNING THE HORIZON IN A DECENTRALIZED HEALTHCARE SYSTEM: THE CANADIAN EXPERIENCE

2012 ◽  
Vol 28 (3) ◽  
pp. 327-332 ◽  
Author(s):  
Andra Morrison
Keyword(s):  
Health Care ◽  
Health Care System ◽  
New Technologies ◽  
Health Care Systems ◽  
Care Needs ◽  
Policy Issues ◽  
Health Technologies ◽  
Care Systems ◽  
Awareness Service ◽  
Care System

Canada has a highly decentralized health care system with 13 provinces and territories delivering health care within their own respective jurisdictions. Decisions regarding which innovative health technologies to adopt are often driven by the unique health care priorities of each jurisdiction's population. To understand these needs, the Canadian Agency for Drugs and Technologies in Health's (CADTH's) Early Awareness Service has expanded its activities. In addition to proactively scanning the horizon for new and emerging health technologies, the Early Awareness Service also scans the horizon for national and jurisdictional health policy issues. This paper looks at CADTH's process for identifying and monitoring policy issues at a national and jurisdictional level.CADTH's Early Awareness Service delivers timely information on emerging health care concerns and technologies that may affect health care finances, facilities, operations, and patient care. The identification of important policy issues can help determine which new and emerging technologies will have the most significant impact on the health care system. The information that CADTH scans can also be used to help decision-makers prepare for potential developments and events that may have an impact on health care systems.By improving its capability to identify and share policy issues across and within jurisdictions, CADTH is better situated to provide information that can be used by policy-makers to help them plan and anticipate for the introduction of new technologies and future developments affecting the unique health care needs of their jurisdictions.

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