Search results

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.

The locational disadvantage of a health-care centre often restricts adequate delivery of health-care services in an area. The purpose of this study is to examine the status of primary health-care services in such a geographically disadvantageous area which is confined by forests, tea gardens and undulating topography.

Necessary secondary data of 13 primary health centres and 236 sub-centres has been collected from the Office of the Chief Medical Officer of Health. Based on obtained data, Health-care Infrastructure Index has been prepared which has been validated by an expert panel, and subsequently, the Thiessen Polygon method has been applied through Arc GIS software to show spatial variation of health-care services delivered by different health-care centres.

In the study area, there is wide variation found in the case of physical facilities, caregivers and connectivity of road networks, which altogether affect the overall status of health-care services. Among all the indicators, some health-care centres experience staff shortages for prolonged non-recruitment, inaccessibility and inconsistent patient load in different health centres.

In spite of the unfavourable geographical landscape, health-care centres have to be set up wherever possible. There is a need to make new roads and simultaneously the existing road connectivity should be improved so that patients and caregivers can move quickly whenever required. Existing physical facilities need to be renewed or redeveloped along with increasing the number of doctors and other health-care providers as per the need of people with an adequate and optimum level of services.

Taking a business lens of telehealth, this article aims to review and provide a state-of-the-art overview of telehealth research.

This research conducts a systematic literature review using the scientific procedures and rationales for systematic literature reviews (SPAR-4-SLR) protocol and a collection of bibliometric analytical techniques (i.e. performance analysis, keyword co-occurrence, keyword clustering and content analysis).

Using performance analysis, this article unpacks the publication trend and the top contributing journals, authors, institutions and regions of telehealth research. Using keyword co-occurrence and keyword clustering, this article reveals 10 major themes underpinning the intellectual structure of telehealth research: design and development of personal health record systems, health information technology (HIT) for public health management, perceived service quality among mobile health (m-health) users, paradoxes of virtual care versus in-person visits, Internet of things (IoT) in healthcare, guidelines for e-health practices and services, telemonitoring of life-threatening diseases, change management strategy for telehealth adoption, knowledge management of innovations in telehealth and technology management of telemedicine services. The article proposes directions for future research that can enrich our understanding of telehealth services.

This article offers a seminal state-of-the-art overview of the performance and intellectual structure of telehealth research from a business perspective.

In Chapter 5, the author will centralise the discourse on youth sexual misconduct in the focused SEA countries (Indonesia and Malaysia as the two Muslim-majority countries and Thailand as a Buddhist-majority country). Addressed youth sexual misconduct encompasses underage sex, teenage pregnancy, and extramarital sex in SEA. The focus on these kinds of youth sexual misconduct hints at why these three countries are particularly highlighted owing to the controversy and significance. Per Islamic law, non-marital sex is religiously prohibited, where Indonesia recently passed the relevant law that criminalises non-marital sex. Upon the problematisation of these forms of youth sexual misconduct, the author will recommend policies that both local governments and the ASEAN could adopt and exercise in response to curtailing the prevalence of discussed delinquency. Overall, this chapter shall contain the scholarly value that helps SEA control or contain the social harms, directly or indirectly, inflicted by the prevalence of sexual youth delinquency.

Agricultural extension has played a central role in building the capacity of smallholders for decades. In efforts to improve extension outcomes, demand-driven approaches have emerged to better align extension content with smallholder context. The aim of this paper is to explore the challenges facing demand-driven extension in Papua New Guinea.

Exploratory case study methodology was used to explore the challenges facing demand-driven extension from the perspectives of 11 practitioners experienced in community engagement in Papua New Guinea.

Although there is great potential for demand-driven extension, this research found extension services in Papua New Guinea are ill-equipped to introduce and sustain a resource-intensive approach like demand-driven extension. It further found that rural farmers who extension organisations have long neglected lack the necessary skills and trust to gain from these services.

A limitation of this research is that it only reflects the opinions of practitioners working in Papua New Guinea. Further research featuring a broader sample of value chain actors connected to extension would provide a more complete understanding of the potential challenges to demand-driven engagement in this context.

With a growing interest among development projects to utilise demand-driven engagement with farmers, this research is the first study to explore the challenge facing this promising approach in Papua New Guinea.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

The purpose of this review paper was identifying barriers to the use of telemedicine systems in primary health-care individual level among professionals.

This study used Scopus and PubMed databases for scientific records identification. A systematic review of the literature structured by PRISMA guidelines was conducted on 37 included papers published between 2009 and 2019. A qualitative approach was used to synthesize insights into using telemedicine by primary care professionals.

Three barriers were identified and classified: system quality, data quality and service quality barriers. System complexity in terms of usability, system unreliability, security and privacy concerns, lack of integration and inflexibility of systems-in-use are related to system quality. Data quality barriers are data inaccuracy, data timeliness issues, data conciseness concerns and lack of data uniqueness. Finally, service reliability concerns, lack of technical support and lack of user training have been categorized as service quality barriers.

This review identified and mapped emerging themes of barriers to the use of telemedicine systems. This paper also through a new conceptualization of telemedicine use from perspectives of the primary care professionals contributes to informatics literature and system usage practices.

Sexual and reproductive health (SRH) interventions demand diverse services, encompassing medical, social and psychological care to ensure the overall wellbeing of service users. In the absence of multidisciplinary response to SRH interventions, service users could be deprived of crucial SRH services, which could undermine their safety and wellbeing. Based on this knowledge, our study was designed to map the interprofessional space in primary healthcare (PHC) facilities in Ebonyi State, Nigeria that deliver SRH services.

Interviews with 20 health workers and group discussions with 72 young people aged 15–24 years provided the data for the study. We analyzed data deductively, focusing on the assessments of the presence or absence of specific professionals that are typically expected to provide different aspects of SRH services.

We found conspicuous absence of laboratory diagnostic, social care, psycho-cognitive and some medical services expected of primary care. These absences necessitated unnecessary referrals, encouraged breaches in confidentiality, undermined social care and justice, increased cost of care and discouraged young clients from utilizing SRH services provided in PHCs. Our study, therefore, emphasizes the need for integrated care in the delivery of SRH services, which would involve relevant diverse professionals contributing their expertise toward comprehensive care for SRH service users.

The study provides human resource insights toward strengthening primary healthcare in Nigeria vis-à-vis efficient delivery of SRH services to guarantee the health security of service users.

The study compares the social services functioning in two local contexts, one urban and one rural, in the same Italian region, to understand how contextual features affect frontline workers' work.

By applying the framework of the street-level bureaucracy theory (SLB) and proposing a framing of the spatial contexts under analysis, the present study adopts a qualitative approach. In particular, semi-structured interviews were conducted among street-level workers, decision-makers and privileged witnesses.

The study shows how the typical features of the rural and urban Italian contexts analyzed impact differently on the working conditions of frontline workers, leading to substantive differences in the possibility of exercise their role at the street-level.

The article contributes to a wider understanding of social services provision in a highly fragmented system like the Italian one by taking into consideration contexts that are usually little investigated in SLB and welfare studies in the Mediterranean Europe area: those rural and, in particular, those belonging to the so-called “inner areas”.