Trust in the Healthcare System and Physicians in Croatia: A Survey of the General Population

Trust in healthcare systems and physicians is considered important for the delivery of good healthcare. A cross-sectional survey was conducted on a random three-stage sample of the general population of Croatia (N = 1230), stratified by regions. Of respondents, 58.7% displayed a high or very high level of trust in the healthcare system, 65.6% in physicians, and 78.3% in their family physician. Respondents’ views regarding patients’ roles in the discussion of treatment options, confidence in physicians’ expertise, and underlying motives of physicians were mixed. Respondents with a lower level of education, those with low monthly incomes, and those from smaller settlements had lower levels of trust in physicians and the healthcare system. Trust in other institutions, religiosity and religious beliefs, tolerance of personal choice, and experience of caring for the seriously ill and dying were predictors of trust in healthcare and physicians. Our findings suggest that levels of healthcare-related trust in Croatia are increasing in comparison with previous research, but need improvement. Levels of trust are lowest in populations that are most vulnerable and most in need of care and protection.

COVID-19 Vaccine Early Skepticism, Misinformation and Informational Needs among Essential Workers in the USA

This study presents the results of a survey of 1591 hesitant U.S. essential workers, conducted over Pollfish in December 2020 when they were the only group eligible for the vaccine, aiming to describe their concerns regarding COVID-19 vaccine safety, effectiveness and distribution policies. We computed frequencies using the SAS software for each answer, using chi-squared statistics and Cochran–Armitage trend tests to determine how informational needs differ by age, gender, level of education, race, source of COVID-19 information and levels of vaccine acceptance. The results of this study show that freedom of choice, equal access to the vaccine and being able to live a life with no restrictions once vaccinated were important concerns since the early days of the distribution campaign, with 53% (836/1591), 42% (669/1591) and 35% (559/1591) of hesitant respondents, respectively, indicating they would be more likely to receive the COVID-19 vaccine if they felt these issues were satisfactorily addressed. Early risk communication and immunization campaign strategies should address not only the reported efficacy and safety of new vaccines, but, as equally important, the population’s perceptions and beliefs regarding personal choice, effectiveness and adverse consequences.

Vaccine hesitancy and implications on childhood immunisation in Malaysia

PurposeThe World Health Organization identified vaccine hesitancy as one of the ten threats to global health in 2019. The purpose of this paper is to evaluate the implications and factors affecting parental decision on childhood immunisation in Malaysia.Design/methodology/approachThis paper reviews literature on vaccine hesitancy and evaluation of factors affecting parental decision on childhood immunisation in Malaysia.FindingsVaccine hesitancy is a growing public health concern in Malaysia with factors such as influence of Internet and social media, personal choice and individual right, conspiracy theory, religious reasons and alternative medicine as among the influencing dynamics. An urban, educated demography operating within a postmodern medical paradigm compounds the diminishing value of vaccines.Originality/valueThis paper provides a comprehensive examination of vaccine hesitancy in Malaysia. Critical appraisal on personal choice over societal responsibility within an Asian/Muslim collectivist society has not been discussed in previous studies. The acceptance of homeopathy as an Islamic medicine alternative is peculiar to multi-ethnic, multi-cultural Malaysia.

Case C-243/19 A v. Veselības ministrija

The issue at stake in Case C-243/19 A v. Veselības ministrija is whether a personal choice on the part of a patient, based on religious beliefs, must be considered when assessing the need for cross-border healthcare. The Court of Justice of the European Union holds that the Charter of Fundamental Rights of the European Union is applicable and the right to freedom of religion can be invoked, in addition to medical criteria. However, the sustainability of the healthcare system can be an objective justification for refusal to grant authorisation for cross-border healthcare. Furthermore, the case clarifies – to a certain extent – the parallel tracks for claiming cross-border healthcare.

Symbolic Ethnicity and the Dilemmas of Difference: Talking Indianness with New Zealand-Born Gujaratis

<p>Marcus Banks (1996: 8) argues that the life of ethnicity has been lived out through the writings of academics rather than in the lives of the people they have studied and, indeed, local discourses of ethnicity are remarkably understudied. This thesis takes a step towards addressing the lack of attention given to local discourses of ethnicity by exploring the ways in which sixteen New Zealand-born Gujaratis talked about their Indianness in interviews conducted specifically for this project. Herbert Gans’ (1979) notion of symbolic ethnicity is initially employed as a framework for understanding participants’ narratives. Although this analysis gives an indication of the salience of ethnicity in the lives of my participants, it fails to account for the complex dilemmas of difference they expressed – the definition of ‘Indian culture’ in terms of difference from other ‘cultures’ and the suggestion that they were different from other New Zealanders by virtue of their Indianness. These issues are explained through an exploration of the assumptions about the cultural and the person that were inherent in notions expressed by participants of living in ‘two worlds’ and having to find a balance between them. This analysis suggests that participants constructed both ‘culture’ and ‘the individual’ as highly individuated categories. It is argued that these conceptualizations of ‘culture’ and ‘the individual’ can be usefully understood in terms of reflexive, or liquid, modernity and reflexive individualism. Under the conditions of late modernity, reflexive – that is, selfdirected and self-oriented – thought and activity become idealised and individuals are ideologically cast as the producers of their own biographies. My participants’ discussions of their Indianness can, therefore, be understood to represent a kind of ‘self-reflexive ethnicity’ that is centred on the person rather than on social networks or cultural practices. This mode of ethnicity does not necessarily require the decline of such networks and practices; they are simply reconfigured in terms of personal choice.</p>

Symbolic Ethnicity and the Dilemmas of Difference: Talking Indianness with New Zealand-Born Gujaratis

<p>Marcus Banks (1996: 8) argues that the life of ethnicity has been lived out through the writings of academics rather than in the lives of the people they have studied and, indeed, local discourses of ethnicity are remarkably understudied. This thesis takes a step towards addressing the lack of attention given to local discourses of ethnicity by exploring the ways in which sixteen New Zealand-born Gujaratis talked about their Indianness in interviews conducted specifically for this project. Herbert Gans’ (1979) notion of symbolic ethnicity is initially employed as a framework for understanding participants’ narratives. Although this analysis gives an indication of the salience of ethnicity in the lives of my participants, it fails to account for the complex dilemmas of difference they expressed – the definition of ‘Indian culture’ in terms of difference from other ‘cultures’ and the suggestion that they were different from other New Zealanders by virtue of their Indianness. These issues are explained through an exploration of the assumptions about the cultural and the person that were inherent in notions expressed by participants of living in ‘two worlds’ and having to find a balance between them. This analysis suggests that participants constructed both ‘culture’ and ‘the individual’ as highly individuated categories. It is argued that these conceptualizations of ‘culture’ and ‘the individual’ can be usefully understood in terms of reflexive, or liquid, modernity and reflexive individualism. Under the conditions of late modernity, reflexive – that is, selfdirected and self-oriented – thought and activity become idealised and individuals are ideologically cast as the producers of their own biographies. My participants’ discussions of their Indianness can, therefore, be understood to represent a kind of ‘self-reflexive ethnicity’ that is centred on the person rather than on social networks or cultural practices. This mode of ethnicity does not necessarily require the decline of such networks and practices; they are simply reconfigured in terms of personal choice.</p>

How Does a Family Caregiver’s Sense of Role Loss Impact the Caregiving Experience?

Family caregivers reportedly have a powerful sense of role loss, which is felt when one senses a change in role or responsibility, relationship distancing, or a changed asymmetry. Little is known about the impact it has on the caregiving experience, so the purpose of this study was to clarify this in three distinct settings: when an individual’s primary role changed to the caregiver role after the start of caregiving; when their primary role was other than the caregiver role after this start; and when their primary role was the caregiver role before caregiving started. Sixty-six individuals responded to an online survey, and a framework method was employed to organize the collected data and uncover themes for analysis. Our findings shed light on the sense of caregiver role loss and pointed to the possibility of generating it when family caregivers rotate through held roles and the use of it as a tool to maintain or regain a sense of personal choice in life and self-priority. Our study is probably the first to analyze this phenomenon in different caregiving settings based on an individual’s primary role and role transitions and brings to light a new perspective of the phenomenon by understanding how it arises, its nuances, and its impact on the caregiver’s experience.

Islam Is Not Bad, Muslims Are: I’m Done with Islam

The present paper addresses the motives that make some inhabitants of the Spanish province of Granada that converted to Islam leave it after some time. We have approached this reality using grounded theory and conducting nineteen in-depth interviews. Two of the main conclusions are that all interviewees were under great pressure due to the expectations that Muslims they interacted with—partners, family, people from Muslim associations or internet groups, etc.—had of them, and that said expectations were based on interpretations of a fundamentalist nature. Additionally, the fact that these people left Islam makes it evident that their existence is grounded in a ‘self’ under constant construction and open to the possibility of starting to be, continuing to be, or changing depending on their personal choice.