Search results

The purpose of this paper is to describe non-specialised, group-based interventions in displaced populations from reviewed literature, and to explore their outcomes.

A literature review was conducted using the PubMed database, Web of Science, The Cochrane Library of Systematic Reviews, and defined “grey literature”. Characteristics of the interventions were summarised into a table under key categories such as targeted persons, study setting, level of evidence, outcome measures, assessment tools used and summary of results.

In total, 11 articles were identified stemming from nine separate interventions. Three of these were considered level 1 evidence as they were randomised controlled trials. The described interventions were markedly heterogeneous in nature and produced diverse findings. There were noted methodological issues in the majority of interventions reviewed.

This original research has demonstrated clear need for research that uses robust methodology accounting for the complex and challenging nature of this context.

Following the collapse of the banking system in October 2008, the Icelandic authorities attempted to restore confidence in the country’s institutions, improve their functioning and gradually improve the country’s credit rating. The authorities took ownership of an International Monetary Fund-sponsored economic programme that managed to turn the macroeconomic development around when, following a trough in the summer of 2010, an economic expansion started that has continued ever since. They applied for membership in the European Union in order to show their commitment to be part of the international economic community and to have a lender of last resort in the European Central Bank in future crises. The causes of the collapse were investigated and many bankers were prosecuted. Finally, financial regulations were made stricter and the structures of the Central Bank and the supervisory authority were changed for the better. The net effect was to lower the credit default swap rate on the government’s debt, gain access to capital markets and make the Iceland story one of resurrection rather than only hubris and collapse.

Disasters bring about communities of focussed discourse. We show how a segment of one such community controlled the early stages of discourse during a financial crisis as a variety of professionals (bankers, analysts, editorial writers and academics) made multiple types of arguments (emotional and technical) to allay citizens’ concerns about an impending banking collapse. We examine the rapid rise of this segment by mapping and analysing the responses printed in Icelandic newspapers to a Danish bank’s warning of Icelandic banking instability. Using social network analysis, we illustrate the networks of public actors and their immediate public responses, showing how close-knit both networks became after just one week of commentary in the Icelandic press. We demonstrate the power that professionals of various kinds have over an uninformed citizenry through their rapid responses and closely connected networks and underscore the obstacles awaiting those who want to alter discourse during crisis.

In this chapter, we focus on the major reforms intended to ensure the sustainability of health care in Denmark between 2000 and 2020 and the evidence for the effectiveness of these reforms. We take a broad definition of sustainability and include reforms that aimed to improve the productivity of the health care sector both in terms of increasing activity for the same set of inputs and in terms of improving the quality of care. A characterisation of the Danish health care system as having gone through evolution rather than revolution (Pedersen, Christiansen, & Bech, 2005) is, with one exception, still true today, and reforms have been relatively few. As we demonstrate there is a relative lack of formal evaluations of these reforms.

In the first decade of the period, the majority of new policy measures aimed to increase the quantity of care provided by the health care sector. With the introduction of diagnosis-related groups (DRGs) to measure hospital activity, a wave of reforms created a stronger link between activity and hospital reimbursement, and introduced additional incentives for increasing activity, alongside requirements for increased technical efficiency. A centralisation reform in 2007 reduced the number of administrative units and saw the beginning of a development that would also lead to fewer hospital units. Procurements of medicines were professionalised, and a national council was established to consider the use of expensive hospital medicine.

In the second-half of the period, policy makers began questioning whether increased activity was always for the better, and slowly began experimenting with initiatives that would shift the focus to the quality and appropriateness of care. As in many other countries, this move occurred in the light of a realisation of a shift in the demographic structure of the country and the change this was expected to create for the future demand for health care.

Although some empirical evidence exists, it is striking that few of the changes to the health care sector has been subject to formal academic evaluation – especially when considering the availability of high quality nationwide micro data. We point to a number of important lessons that could be drawn from the Danish experiences.

However, the greatest potential for research into the sustainability of health care in the Danish setting is probably still to be realised by taking advantage of the possibilities of linking micro data on individuals' health care utilisation, schooling outcomes and labour supply, with the possibility of following individuals across decades. For example, Danish micro data make it possible to follow newborns in 1990 until they reach adulthood and simultaneously follow their parents from adulthood until they reach 60 years of age where the prevalence of chronic diseases begins to show.

The purpose of this paper is to propose the method of measurement of competencies using exploratory factor analysis and the evaluation of the relation between competencies and economic activity of mature people.

The empirical analysis is based on the Study of Human Capital data (conducted in Poland). The study population people are aged 50+. In statistical analysis explanatory factor analysis and logistic regression were used.

Competencies are the crucial factor of professional position and career development. However, older people have often out-dated skills and it results in a higher propensity for economic deactivation. On the other hand, older people are valuable on the labour market due to their experience, knowledge and social skills. The survey results indicate that competencies, measured with using of factor analysis, similarly as health, marital status, place of residence and age are significant determinants of early employment deactivation.

Limitation in the evaluation of the risk of economic deactivation factors is the static approach of this analysis. The Study of Human Capital data are the best source of information about competencies of Poles, but its character is not longitudinal.

The analysis of mature people’s competencies is very important in the context of extending working life, but the scientific researches in this area are rare. This paper would reduce the knowledge gap on the topic of reasons for older workers’ deactivation in which competencies are included. Application of exploratory factor analysis in this area is unique.

Physicians who are primary care providers in rural communities form an essential stakeholder group in rural mobile health (mHealth) delivery. This study was exploratory in nature and was conducted in Udupi district of Karnataka, India. The purpose of this study is to examine the perceptions of rural medical officers (MOs) (rural physicians) regarding the benefits and challenges of mobile phone use by community health workers (CHWs).

In-depth interviews were conducted among 15 MOs belonging to different primary health centers of the district. Only MOs with a minimum five years of experience were recruited in the study using purposive and snowball sampling. This was followed by thematic analysis of the data collected.

The perceptions of MOs regarding the CHWs' use of mobile phones were largely positive. However, they reported the existence of some challenges that limits the potential of its full use. The findings were categorized under four themes namely, benefits of mobile phone use to CHWs, benefits of mobile phone-equipped CHWs, current mobile phone use by CHWs and barriers to CHWs' mobile phone use. The significant barriers reported in the CHWs' mobile phone use were poor mobile network coverage, technical illiteracy, lack of consistent technical training and call and data expense of the CHWs. The participants recommend an increased number of mobile towers, frequent training in mobile phone use and basic English language for the CHWs as possible solutions to the barriers.

Studies examining the perceptions of doctors who are a primary stakeholder group in mHealth as well as in the public health system scenario are limited. To the authors’ knowledge, this is one of the first studies to examine the perception of rural doctors regarding CHWs' mobile phone use for work in India.

Women experience a triple burden of ill-health spanning non-communicable diseases (NCDs), reproductive and maternal health conditions and human immunodeficiency virus (HIV) in sub-Saharan Africa. Whilst there is research on integrated service experiences of women living with HIV (WLHIV) and cancer, little is known regarding those of WLHIV, diabetes and/or hypertension when accessing integrated care. Our research responds to this gap.

The INTE-AFRICA project conducted a pragmatic parallel arm cluster randomised trial to scale up and evaluate “one-stop” integrated care clinics for HIV-infection, diabetes and hypertension at selected primary care centres in Uganda. A qualitative process evaluation explored and documented patient experiences of integrated care for HIV, diabetes and/or hypertension. In-depth interviews were conducted using a phenomenological approach with six WLHIV with diabetes and/or hypertension accessing a “one stop” clinic. Thematic analysis of narratives revealed five themes: lay health knowledge and alternative medicine, community stigma, experiences of integrated care, navigating personal challenges and health service constraints.

WLHIV described patient pathways navigating HIV and diabetes/hypertension, with caregiving responsibilities, poverty, travel time and cost and personal ill health impacting on their ability to adhere to multi-morbid integrated treatment. Health service barriers to optimal integrated care included unreliable drug supply for diabetes/hypertension and HIV linked stigma. Comprehensive integrated care is recommended to further consider gender sensitive aspects of care.

This study whilst small scale, provides a unique insight into the lived experience of WLHIV navigating care for HIV and diabetes and/or hypertension, and how a “one stop” integrated care clinic can support them (and their children) in their treatment journeys.

Cervical cancer (CC) is one of the most important health issues faced by women worldwide. The purpose of this study is to identify Jordanian women’s knowledge, barriers and measures pertaining to risk factors and screening choices of CC (Pap smear tests).

This study applied a cross sectional design by collecting data from a convenient sample of 200 women between 20 and 70 years of age in health and public centers in Jordan. Data was then analyzed using the descriptive statistical tools of SPSS, version 21.

The findings revealed that 55.5% of the participants had no information about the Pap smear, and 75% did not know the risk factors. Moreover, 50% of the sample did not know where to take the test, and 50% reported a lack of encouragement from the husband to undertake the test. More than half of the participants (56.5%) expressed fear that cervical screening would be a painful examination even though they reported not having any previous experience with the test.

Based on these findings, public education about CC screening is essential, including advertising and a campaign similar to the breast cancer awareness programs in Jordan, as a way of encouraging early screening to improve the health of women.