Posttraumatic Growth in Women With a Long-Standing Experience of Involuntary Childlessness in the Czech Republic

This qualitative research study aimed to examine aspects of posttraumatic growth (PTG) in women with a long-standing experience of involuntary childlessness. In-depth semi-structured interviews, lasting an average of 53 min, were conducted in the Czech Republic. Twenty-four women, averaging 38.8 years old with an average of 6.2 years of infertility experience, participated. They were asked how involuntary childlessness affected/changed their partnerships, sexual life, job, future plans, attitude to children/values/faith, and leisure time. Participants shared both positive and negative aspects of the infertility experience. Data were analyzed using thematic analysis. Five main themes of PTG were identified: strengthening of partnership, greater humility, deeper self-appreciation, reassessment of relationships, and changes in the philosophy of life. These findings could be useful to mental health providers to facilitate the PTG process in patients.

Implementation of the Healthy Indonesia Card Program at the Sayang Rakyat Regional General Hospital, Makassar City

Quality health services are a hope for every Indonesian people, because this is closely related to one aspect of fulfilling basic life needs for humans, therefore it requires commitment from these health service providers, especially hospitals in supporting the implementation of government programs through the Healthy Indonesia Card. The purpose of this study is to determine and analyze the implementation of services based on the Healthy Indonesia Card program at the Sayang Rakyat Regional General Hospital in Makassar City using qualitative research methods. The results showed that the implementation of the Healthy Indonesia Card program at the Sayang Rakyat Regional General Hospital in Makassar in general was in accordance with the South Sulawesi Provincial Regulation regarding health providers and regarding cooperation in providing free health services, and presidential regulation (Perpres) Number 64 of 2020 concerning National health insurance. This is reflected in the implementation of services provided by the Sayang Rakyat Hospital to patients using the Healthy Indonesia Card (KIS) (PBI) which do not differentiate from general patients or other insurance users, provided that the patient has met the terms and conditions as a KIS patient (PBI). All medical expenses for KIS patients (PBI) who undergo outpatient or inpatient treatment are entirely borne by the government.

Transition Readiness in Adolescents and Young Adults With Chronic Rheumatic Disease in Oman: Today’s Needs and Future Challenges

Introduction:In Oman, the “transfer” healthcare rather than the “transition” of health care of adolescents to adult care occurs at a young age, like many other GCC countries for cultural reasons. In order to address this concern, this study was conducted to determine the transition readiness skills of adolescents and young adults with childhood onset rheumatic diseases using a cross-cultural adaptation of the UNC TRxANSITION scale.Methods: We used a professionally translated/back translated, provider-administered UNC TRxANSITION Scale. This 32-question scale measures HCT in ten domains including knowledge about diagnosis or treatment, diet, reproductive health, school/work, insurance, ability to self-manage and looking for new health providers. The maximum transitional score of 10, was categorized as low (1-4), moderate (4 - 7) and high (7 -10) transitional readiness scores.Results:We enrolled 81 Omani adolescents and young adults (AYA) with chronic childhood onset rheumatic diseases. The cohort consisted of 79% females, with mean age of 15.8 years (± 3.53) and mean disease duration of 6.95 years (± 4.83). Our cohort's overall mean score is low 5.22 (±1.68). Only 14.8% of the cohort achieved a high transition score ≥7). Significant direct relationship was observed between age and the mean transition readiness score (r = .533, P < .001). The mean transition readiness score in the younger age group (10-13 years) was 4.07 (±1.29), the middle age group (14-18 years) was 5.43 ( ±1.27), while the older age group (19-21 year), was 6.12 ( ±1.81), Mean transition score of youngest age group was found to be significantly lower than the other two age groups (p =.003).Conclusion:Overall, the transition readiness of AYA in Oman is low compared to other western countries indicating the need to initiate a health care transition preparation program for patients with chronic diseases across the country. In addition, we need to establish regional guidelines to address the transitional age policy to be in line to international recommendations.

Facility and care provider emergency preparedness for neonatal resuscitation in Kano, Nigeria

Introduction The knowledge, attitude, and practice of emergency neonatal resuscitation are critical requirements in any facility that offers obstetric and neonatal services. This study aims to conduct a needs assessment survey and obtain individual and facility-level data on expertise and readiness for neonatal resuscitation. We hypothesize that neonatal emergency preparedness among healthcare providers in Kano, Nigeria is associated with the level of knowledge, attitudinal disposition, practice and equipment availability at the facility level. Methods A semi-structured, self-administered questionnaire was administered to a cross-section of health providers directly involved with neonatal care (n = 112) and attending a neonatal resuscitation workshop in Kano state. Information regarding knowledge, attitude, practice and facility preparedness for neonatal resuscitation was obtained. Bloom’s cut-off score and a validated basic emergency obstetric and neonatal care assessment tool were adopted to categorize outcomes. Multivariable logistic regression was employed to determine independent predictors of knowledge and practice. Results Almost half (48% and 42% respectively) of the respondents reported average level of self-assessed knowledge and comfort during resuscitation. Only 7% (95% CI:3.2–13.7) and 5% (95% CI:2.0–11.4) of health providers demonstrated good knowledge and practice scores respectively, with an overall facility preparedness of 46%. Respondents’ profession as a physician compared to nurses and midwives predicted good knowledge (aOR = 0.08, 95% CI: 0.01–0.69; p = 0.01), but not practice. Conclusion Healthcare provider’s knowledge and practice including facility preparedness for emergency neonatal resuscitation were suboptimal, despite the respondents’ relatively high self-assessed attitudinal perception. Physicians demonstrated higher knowledge compared to other health professionals. The low level of respondents’ awareness, practice, and facility readiness suggest the current weak state of secondary health systems in Kano.

What Determines Vaccine Hesitancy: Recommendations from Childhood Vaccine Hesitancy to Address COVID-19 Vaccine Hesitancy

Vaccine hesitancy is a prevalent and ongoing issue. However, due to the COVID-19 pandemic, additional attention has been brought to the topic of vaccine hesitancy. Vaccine hesitancy is a threat to the population’s health globally. This article aims to acquire insights from previous literature to determine what works to increase vaccine uptake and how we can apply this knowledge to increase COVID-19 vaccine uptake. Research has focused chiefly on childhood vaccination and the hesitancy of caregivers. After conducting an extensive literature review, we have created a conceptual model of indicators that influence vaccine uptake for health providers and caregivers, which can also be used for vaccine recipients. Overall, the reasons for vaccine hesitancy are complex; therefore, a multifaceted approach is needed to address it. Understanding the factors that affect vaccine hesitancy will aid in addressing hesitancy and, in turn, lead to an increase in vaccine uptake.

Psychosocial concerns in a context of prolonged political oppression: Gaza mental health providers’ perceptions

In this qualitative exploratory study, we investigated the perspectives of mental health providers in Gaza, Palestine, regarding the primary concerns of their clients who are exposed to low-intensity warfare and structural violence. We conducted qualitative interviews with 30 psychologists, social workers, psychiatric nurses, and psychiatrists providing services to communities in Gaza. Participants were asked to discuss their clients’ most commonly occurring mental health problems, diagnoses, and psychosocial conditions. Thematic analysis identified one superordinate theme (Impact of the Blockade on Mental Health and Quality of Life) and four second-order themes (Concerns about Social Problems, General Concerns about Quality of Life, Concerns about the Mental Health of the Community, and Concerns Related to Children's Mental Health). Participants indicated that the social and political dimensions of mental health and the economic, educational, and health-related consequences of the ongoing blockade of Gaza were the main determinants of psychological burden among their clients. Findings demonstrated the importance of adopting an approach to mental health that includes understanding psychological indicators in a broader framework informed by human rights and social justice. Implications for research and clinical work are discussed, including the role of investments in social capital that may provide individuals with access to resources such as social support, which may in turn promote overall mental health.

Digital tools towards transplant first policy: Improving health literacy

End stage kidney disease (ESKD) is a prevalent health issue across the world and it is well established that kidney transplantation (KT), specifically from a living donor, is currently the best value-based treatment method. Ergo, it is crucial to invest heavily in making this care strategy the best possible option for the majority of eligible patients. Barriers to the kidney transplant process are mainly related to education and accessibility: awareness of the clinical and societal relevance of the therapy must be promoted at the level of patients, clinicians and health providers. A health-literacy-focused website has been developed as part of this, aiming to provide the general population, particularly potential organ receptors and donors, with better access to trustworthy information and data. This was meant to be the effective expression of knowledge diffusion and innovation as a result of an academic master thesis. This communication-focused digital resource is designed to combat these obstacles and to create a long-lasting, positive and significant impact.

Conflicted Reproductive Governance: The Co-existence of Rights-Based Approaches and Coercion in India’s Family Planning Policies

India’s current population policy is situated between two conflicting discourses of population management, one that is governed by a demographic rationale advocating strict State regulation of fertility, and the other that is delineated by a rights-based framework that promotes individual reproductive choice and bodily autonomy. In this chapter, I show how this conflicted policy discourse becomes supportive of processes that empower the State, rather than facilitate reproductive autonomy among claimants on the ground. The chapter draws on textual analysis of policy and programme documents and discussions with health providers, users and policy makers during long-term fieldwork in the state of Rajasthan. I show that, in their role in promoting regional state directives on reproductive health policies, health workers are at once agents and subjects of State policy processes and of their community’s ideologies, preferences and practices related to childbirth and reproductive care. It is in their work and embodied practice of family planning that we most clearly evidence the implications of ‘conflicted reproductive governance’. When health workers struggle for their own remuneration and recognition, the State’s rights-based health policy objectives will remain unreachable.