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This chapter emphasizes the significance of cultural competency and its relevance to health care through an Islamic lens. While Islamic texts do not directly address cultural competence, they highlight principles aligning with its values and highlight the importance of understanding and respecting various cultures. Addressing the health care needs of Muslim patients necessitates a thorough integration of cultural, religious, and spiritual considerations, recognizing the substantial influence of religion and spirituality on health care decisions. This chapter discusses the importance for public health care practitioners to be equipped with the requisite skills and knowledge to cater to the specific needs of Muslim patients and communities and the adherence to religious beliefs and practices. The foundational principles of cultural competencies, deeply rooted in Islamic values, can be universally applied in health care settings, ensuring health care providers are culturally competent and capable of offering culturally congruent care within an Islamic context.
Religious beliefs and practices play a critical role in how public health and health care outcomes are realized. While there is little research on non-Muslim experiences with public health initiatives and health outcomes in Muslim Majority Countries (MMCs), there is a body of literature that identifies multiple social determinants of health that lead to poorer indicators of health and health outcomes in these countries. In addition, in societies where there are large immigrant Muslim populations, perceptions of the quality of care, participation in public health initiatives, and access to health care that is culturally relevant and aligned with belief systems has been found to impact health outcomes. Barriers and facilitators to accessing and receiving care in both MMCs and communities serving Muslim populations have been identified. Social determinants of health such as economic status, access to and quality of education and health care, social and built environment, foodways, and collaborative community action to advance cultural competence of providers and other public health stakeholders can all improve health indicators and health outcomes of MMCs and communities with Muslim populations.
Adolescents’ ability to access health care depends on sharing accurate information about concerns, needs, and conditions. Parents and other adults serve as both resources and gatekeepers in adolescents’ ability to access and manage care. Understanding information sharing between adolescents and parents, adolescents and providers, and parents and providers is thus critical. This chapter distinguishes between adolescents’ routine and self-disclosure of information. The former refers to sharing information required for the partner to perform their role. The latter refers to voluntarily sharing more information than required. Because the roles of parent and provider are distinct relative to the adolescent, disclosure decisions can conflict. These differences are discussed in the context of communication privacy management theory and the literature on legitimacy of authority. A framework for understanding information sharing processes is developed that considers stage of care, type of care, stigma/privacy associated with the condition, and the age of the adolescent.
Meeting social need is usually associated in social policy with the provision of benefits and public services, and the role of taxation often confined to an acknowledgement of its revenue-raising function for the purpose of funding them. Against a backdrop of multiple concurrent challenges shared by many high-income societies, including inadequate social care for an ageing population and unprecedented waiting lists for health care, the UK’s experience of the short-lived Health and Social Care Levy is used as a case study to reveal how the relationship between taxation and social need is complex, mediated by a range of factors, and how these contributed to its abolition. The article proposes five different relationships between taxation and social need evident in the story of the rise and fall of the Levy.
This chapter provides additional justifications for the human right to free internet access. It shows that today internet access is practically indispensable for having adequate opportunities for the exercise and enjoyment of socio-economic and cultural human rights. Examples from around the globe provide evidence for the internet’s practical systemic indispensability for human rights to, for example, education, health care, housing (adequate standard of living), finding work, and participation in cultural life. Specific attention is paid to the differing ways in which internet access matters in developed countries (where internet access is already widespread and public services generally available) versus developing societies (in which internet access is often lacking and universal public service provision is precarious. In developed countries, internet access greatly increases opportunities to use socio-economic human rights, thereby putting those who involuntarily remain offline at risk of social, economic, or cultural exclusion. By contrast, in developing countries internet access is sometimes the only way for at least some realisation of people’s socio-economic human rights.
Health care and health security are the fundamental pillars of disaster preparedness and crisis management. An established routine health care is necessary for any society, enabling full access to care and fulfilling the rights of every individual. Health security, on the other hand, is what a society needs to be flexible in managing an unexpected situation. To overcome a disaster with minimal damage or to avert such a critical situation, health care and health security should exist simultaneously. Thus, resilience in disaster preparedness and crisis management requires investment in both health care and health security. This ensures local public health services and infrastructure, local ambulances, both acute and chronic care referral systems, prompt vaccinations, and prevention of communicable diseases to name but a few. These measures which have proven to be the most sensitive evaluation of fair governance are critically absent in several nations, particularly in areas with long-standing conflicts. Strengthening health care and health security measures are paramount to the maintenance of the health system in peace and recovery of health delivery post-conflict and require political and economic considerations.
This study aims to identify midwives’ post-earthquake caregiving experiences.
Methods
A phenomenological study was undertaken in May-June 2023. The participants of the study consisted of 15midwives who were included in the study with the purposeful sampling method and volunteered to provide care during the earthquake. Data were collected by an in-depth interview method using a demographic information form and a semi-structured interview form. Thematic analysis was conducted on interview transcripts.
Results
The research identified 2main themes: difficulties in managing midwifery care and the psychological impact of the earthquake on midwives. Challenges included issues with disaster organization, management, and coordination; communication gaps; insufficient medical supplies; harsh environmental conditions; inability to fulfill basic needs; lack of disaster-related knowledge and experience among midwives; and the overall survival conditions of disaster victims. The disaster caused several psychological effects on midwives, including shock, surprise, sadness, confusion, feelings of inadequacy, insomnia upon returning from the disaster area, nightmares, difficulty adapting, guilt about returning, feelings of helplessness, and experiences of loss and mourning.
Conclusions
This study detailed midwives’ experiences during disasters, difficulties, and barriers to effective care. It is crucial to record midwives’ experiences during disasters and use this information and solutions to prepare for future disasters. Disaster preparedness training for midwives should be planned to increase physical and emotional resilience.
This study evaluates the Emergency Medical Service system and overall emergency preparedness by analyzing ambulance-transported patients during the February 6, 2023 earthquakes, focusing on those without earthquake-related injuries (medical emergencies and traumas not caused by earthquakes).
Methods
A retrospective, observational case series was conducted, involving patients aged 18 and above transported by ambulance between February 6 and March 6, 2023. Patient demographic characteristics, vital signs, diagnoses, treatments, and outcomes were recorded. Predisposing factors for ambulance transportation including post-earthquake health facility issues, housing problems, hygiene, heating, and smoke exposure were meticulously analyzed.
Results
The study included 1872 patients, with a 55.4% hospitalization rate and a 13.7% mortality rate. Cardiovascular emergencies were the primary reason for admission (28.9%). Patients from the hospital in the study’s location form Group 1, whereas those from other earthquake-affected provinces constitute Group 2. Significant predisposing factors for ambulance transportation included post-earthquake health facilities (P < 0.001), housing problems (P < 0.001), hygiene (P < 0.001), heating (P = 0.001), and smoke exposure (P < 0.001). In Group 2, pneumonia (P = 0.001), soft tissue infection (P = 0.002), sepsis (P = 0.004), carbon monoxide poisoning (P < 0.001), and diabetic emergencies (P = 0.013) were statistically significantly more frequent.
Conclusions
Analyzing post-earthquake ambulance-transported patients is vital to comprehend the demand for emergency health care and address post-disaster health care challenges.
This article outlines a human-centered approach to developing digital patient stories, for sharing their experiences in health care, while preserving patient and others’ privacy. Employing a research-through-design approach, the study proposes a design solution using visualization and digital storytelling to document patients’ and families’ experiences and emotions, as well as their interactions with healthcare professionals in the postnatal unit. By transforming selected observational data into animated stories, this approach has the potential to elicit empathy, stimulate stakeholder engagement, and serve as a practical training tool for clinicians. This work was conducted as part of a broader study that aims to contribute to the existing knowledge base by advancing our understanding of stakeholder needs in birthing facilities and through postpartum discharge. This study primarily focuses on strategies for the development of digital stories and summarizes the factors that contributed to the production of digital stories within the context of sensitive data. It may serve as a valuable resource for students, researchers and practitioners interested in utilizing digital stories to encourage discussions, education and ultimately to enhance systems of health care for respect, equity and support.
We use Benford's law to examine the non-random elements of health care costs. We find that as health care expenditures increase, the conformity to the expected distribution of naturally occurring numbers worsens, indicating a tendency towards inefficient treatment. Government insurers follow Benford's law better than private insurers indicating more efficient treatment. Surprisingly, self-insured patients suffer the most from non-clinical cost factors. We suggest that cost saving efforts to reduce non-clinical expenses should be focused on more severe, costly encounters. Doing so focuses cost reduction efforts on less than 10% of encounters that constitute over 70% of dollars spent on health care treatment.
Using data envelopment analysis, we examine the efficiency of Canada's universal health care system by considering a set of labour (physicians) and capital (beds) inputs, which produce a level of care (measured in terms of health quality and quantity) in a given region. Data from 2013–2015 were collected from the Canadian Institute for Health Information regarding inputs and from the Canadian Community Health Survey and Statistics Canada regarding our output variables, health utility (quality) and life expectancy (quantity). We posit that variation in efficiency scores across Canada is the result of regional heterogeneity regarding socioeconomic and demographic disparities. Regressing efficiency scores on such covariates suggests that regional unemployment and an older population are quite impactful and associated with less efficient health care production. Moreover, regional variation indicates the Atlantic provinces (Newfoundland, Prince Edward Island, Nova Scotia, New Brunswick) are quite inefficient, have poorer economic prospects, and tend to have an older population than the rest of Canada. Oaxaca-Blinder decompositions suggest that the latter two factors explain about one-third of this efficiency gap. Based on our two-stage semi-parametric analysis, we recommend Canada adjust their transfer payments to reflect these disparities, thereby potentially reducing inequality in regional efficiency.
City institutions engage with language provisions in order to ensure equal access to services. Global provisions are intertwined with local knowledge resources introduced by individual agents. As UK austerity measures post-2012 led to a reduction of resources and specialised provisions, institutions began to rely more and more on the deployment of local individualised knowledge in response to communication challenges. Multilingual spaces became in some areas improvised and driven by the agency of both institutional agents and clients. The city’s day-to-day operations can be seen as a space of resistance to monolingual ideologies, born out of the necessity to provide front-line services to all and tightly embedded into the shared experience of a multilingual reality. But city-based institutions have limited powers to legislate or to fund operations.
Balance dysfunction and vestibular conditions are major problems requiring significant resources. There is significant national and international variation in management pathways for such patients.
Methods
This paper outlines a collaborative project run by the ENT department and two vestibular rehabilitation trained physiotherapists to establish a clinic to manage patients referred to ENT with vestibular and/or balance complaints. As part of a six-month pilot, two physiotherapy-led balance clinics were provided per week.
Results
A total of 159 new patients were seen, with only 15 needing ENT consultant input. This led to the successful creation of substantive posts; the clinic has seen 698 patients in its first two years.
Conclusion
Patient outcomes and experience have been positive, and accompanied by reduced waiting and in-service times. The authors discuss some of the pitfalls, challenges and opportunities of developing this type of clinic.
This retrospective study aimed to establish a robust rating system for assessing post-operative outcomes in congenital aural atresia patients undergoing auricular reconstruction. The newly introduced EAR scale, a weighted grading system, not only considers anatomical landmarks but also factors such as ear alignment. In addition, the outer-ear cartilage scale and the visual analogue scale (VAS) were introduced. These scales were compared among themselves and against two established scales.
Methods
Nine raters assessed 17 eligible patients who underwent auricular reconstruction between 2001 and 2020.
Results
The study compared inter-rater agreement among scales, with the EAR scale proving the most reliable (Krippendorff's alpha coefficient, α = 0.45), outperforming existing measures. The outer-ear cartilage scale and the VAS exhibited lower inter-rater agreement, indicating inferiority in assessing aesthetic outcomes.
Conclusion
The EAR scale emerged as an effective tool for evaluating post-operative outcomes in congenital aural atresia auricular reconstruction.
Joe Biden’s first two years became a turning point. The country had reached a point where it was obvious that the mix of government and markets had titled too much in the direction of markets. Besides the COVID pandemic, Biden confronted growing inflation, an economic recession, and Trump’s refusal to do anything to address climate change, together with a deeply divided partisan Congress. Biden galvanized the Democrats to unite around significant and bold responses and even obtained bipartisan support for some of his legislative agenda. He passed legislation to address COVID and increase government investment in infrastructure and technological developments. Regarding these successes and the inability to do more, Biden focused on how the balance between government and markets depends on the role of government right-sizing that balance by trying to restore confidence in American government and American democracy.
China’s age of abundance has led to the creation of wealth and a surplus. Using a lifecycle approach this chapter examines the sources of this surplus creation, and estimates the impact of population aging and welfare expansion on future lifecycle surplus. It also estimates future fiscal pressure on the state with the changes in lifecycle surplus.
A deluge of state “anti-equity” legislative bills seek to reverse prevailing trends in diversity, equity, and inclusion; withdraw protections of LGBTQ+ communities; and deny access to gender-based care for trans minors and adults. While the political and constitutional fate of these acts is undetermined, profound impacts on patients and their providers are already affecting the delivery of health care and public health services.
Home to 60 per cent of the world’s population, Asia is the locus for significant global challenges such as the future of work, gender inequality, inequitable access to health care, and climate change. For these entrenched socio-economic challenges, the time is ripe for philanthropist and philanthropic capital to taking a leading role in addressing and resolving these issues. Connecting like-minded individuals and building bridges to collaboration is one of the core functions of ecosystem builders like the Asian Venture Philanthropy Network (AVPN). Since its founding in 2011, AVPN has grown into Asia’s largest social investment network, with over 600 members active across 33 markets. It has incubated several successful partnerships, but the journey has not always been smooth sailing. As the network has grown and evolved, so has its value proposition and role in the community. This chapter shares some of the lessons AVPN has learned in its journey to become an inclusive, responsive, and resilient ecosystem builder for philanthropy in Asia. It calls on philanthropists to build more intentional partnerships with ecosystem builders to facilitate more long-term, sustained change on the ground. The chapter points out that sector intermediaries should seek out opportunities to support philanthropists in building the community – the best way to resolve systemic development issues – rather than work alone.
Health technology assessment (HTA) programs inform decision making about the value and reimbursement of new and existing health technologies; however, they are under increasing pressure to demonstrate that they are a cost-effective use of finite healthcare resources themselves. The 2023 HTAi Global Policy Forum (GPF) discussed the value and impact of HTA, including how it is assessed and communicated, and how it could be enhanced in the future. This article summarizes the discussions held at the 2023 HTAi GPF, where the challenges and opportunities related to the value and impact of HTA were debated. Core themes and recommendations identified that defining the purpose of value and impact assessment is an essential first step prior to undertaking it, and that it can be done through the use and expansion of existing tools. Further work around aligning HTA programs with underlying societal values is needed to ensure the long-term value and impact of HTA. HTA could also have a role in assessing the efficiency of the wider health system by applying HTA methods or concepts to broader budgetary allocations and organizational aspects of health care. Stakeholders (particularly patients, industry, and clinicians but also payers, wider society, and the media) should ideally be actively engaged when undertaking the value and impact assessment of HTA. More concerted efforts in communicating the role and remit of HTA bodies would also help stakeholders to better understand the value and impact of HTA, which in turn could improve the implementation of HTA recommendations and application to future actions in the lifecycle of technologies.
This study aimed to analyze stress, anxiety, depression, and self-efficacy levels among Spanish out-of-hospital emergency medical professionals from February 1, 2021, to April 30, 2021.
Methods:
A nationwide survey was completed by 1666 Emergency Medical Services (EMS) workers. The Depression, Anxiety, and Stress Scale (DASS-21) and the General Self-Efficacy Scale (GSE) were used. Data analysis used chi-squared, análisis of variance (ANOVA), and logistic regressions.
Results:
The sample comprised 833 (50%) men, with an average age of 44.3 ± 9.9 y (range: 19-67 y). Occupational distribution included 453 (27.2%) physicians, 474 (28.4%) nurses, and 739 (44.4%) emergency medical technicians (EMTs). EMTs exhibited higher odds of severe or extremely severe depression compared with physicians (odds ratio [OR]: 1.569; 95% confidenceinterval [95% CI]: 1.213-2.030) and nurses (OR: 1.561; 95% CI: 1.211-2.012). EMTs also displayed higher probabilities of severe or extremely severe anxiety compared with nurses (OR: 1.944; 95% CI: 1.529-2.701). Furthermore, EMTs demonstrated elevated probabilities of severe or extremely severe stress compared with physicians (OR: 1.387; 95% CI: 1.088-1.770). However, no significant differences were found in self-efficacy, with a median value of 73 [20].
Conclusions:
Out-of-hospital EMS workers experienced mental health challenges, showing varying levels of depression, stress, and anxiety across different occupational groups. EMTs were particularly affected.