The notion of vulnerability is critical to person-centred and high-quality nursing and healthcare practice, and underpins all nursing education. Understanding Vulnerability: a Nursing and Healthcare ...Approach focuses on vulnerability experienced every day by patients and clients in healthcare, and provides clear and supportive guidance to nurses and other healthcare practitioners on protecting and caring for vulnerable patients. Taking a fresh, critical and reflective perspective that reflects current trends towards the promotion of equality and acknowledges everyone's vulnerability, this book is essential reading for all nursing and healthcare students, as well as healthcare practitioners who are committed to providing person-centred care. Special features: •One of the first books to address the issue of vulnerability from a nursing and healthcare perspective •Written by a group of experienced professionals, academics and educationalists with both educational and research expertise in the exploration of vulnerability •Includes narratives, perspectives and case studies, illustrating and bringing to life the issues within the book
In Romania, the school dropout rate increased immediately after the political changes from 1989. School dropout rate remained high throughout the transition period. In this analysis we try to ...identify the characteristics of school dropout in four of the eight development regions of Romania on various forms of education. School dropout rate analysis for primary and secondary schools students in four development regions from the south of the country is achieved in three distinct cases: for all students, for the students from urban and rural areas and for male and female students.
The US Department of Health and Human Services Administration on Development Disabilities estimates the number of people diagnosed with a developmental disability in the United States as 4.5 million ...persons, which would translate to about 17,000 residents of Hennepin County, Minnesota. This research paper examines the transportation needs of adults with developmental disabilities either residing or working in Hennepin County through a survey of their existing travel behavior and their unmet transportation needs. The survey had both demographic and attitude questions as well as a travel diary to record both actual and desired but untaken trips. In this paper we report and discuss the main findings of the survey. It was clear from observing the returned sample that almost the entire surveyed population does not live independently. More than half of the surveyed population worked every day, while recreation occurred at least once a week for about two-thirds of the population, and more than half undertook social trips weekly. About 30% reported being unable to make trips they want to make and 46% unable to make trips they need to make. Public transit poses difficulties for this population both physically and intellectually. There were also specific complaints about the lack of transit service in addition to concerns regarding paratransit services. Community service providers received praise.
Social media use has been increasing in public health and health promotion because it can remove geographic and physical access barriers. However, these interventions also have the potential to ...increase health inequities for people who do not have access to or do not use social media. In this paper, we aim to assess the effects of interactive social media interventions on health outcomes, behaviour change and health equity.
We conducted a rapid response overview of systematic reviews. We used a sensitive search strategy to identify systematic reviews and included those that focussed on interventions allowing two-way interaction such as discussion forums, social networks (e.g. Facebook and Twitter), blogging, applications linked to online communities and media sharing.
Eleven systematic reviews met our inclusion criteria. Most interventions addressed by the reviews included online discussion boards or similar strategies, either as stand-alone interventions or in combination with other interventions. Seven reviews reported mixed effects on health outcomes and healthy behaviours. We did not find disaggregated analyses across characteristics associated with disadvantage, such as lower socioeconomic status or age. However, some targeted studies reported that social media interventions were effective in specific populations in terms of age, socioeconomic status, ethnicities and place of residence. Four reviews reported qualitative benefits such as satisfaction, finding information and improved social support.
Social media interventions were effective in certain populations at risk for disadvantage (youth, older adults, low socioeconomic status, rural), which indicates that these interventions may be effective for promoting health equity. However, confirmation of effectiveness would require further study. Several reviews raised the issue of acceptability of social media interventions. Only four studies reported on the level of intervention use and all of these reported low use. More research on established social media platforms with existing social networks is needed, particularly in populations at risk for disadvantage, to assess effects on health outcomes and health equity.
Disparities in Access to Oral Health Care Northridge, Mary E; Kumar, Anjali; Kaur, Raghbir
Annual review of public health,
04/2020, Letnik:
41, Številka:
1
Journal Article
Recenzirano
Odprti dostop
In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and or members of racial ethnic minority, immigrant, or rural populations who have suboptimal ...access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course.
Summarise the published evidence on otitis media and associated hearing loss in low to middle-income countries (LMIC) and disadvantaged populations.
PubMed and other databases.
Firstly, sensitive ...search strategy using ‘otitis media’, combined with specific key words for each topic of the review, from January 2015 to June 2019. Then, restriction to LMIC and disadvantaged populations. Topics covered included prevention, epidemiology, risk factors, microbiology, prognosis, diagnosis, and treatment.
There was a high degree of methodological heterogeneity and high risk of bias. The majority of studies were school-based. In Africa, Asia and Oceania (e.g., Australian Aboriginal populations) the prevalence of OM was respectively 8% (range 3-16%), 14% (range 7–22%) and 50% (4–95%). Prevalence of any hearing loss in these regions was 12% (range 8–17%), 12% (range 3–24%), and 26% (range 25–28%) respectively. Risk factors in LMIC and disadvantaged populations included age, gender, exposure to smoke and pollution. Microbiology was reported for otitis media with effusion at time of surgery or ear discharge (acute otitis media with perforation or chronic suppurative otitis media). Specimen handling and processing in hospital laboratories was associated with low detection of S. pneumoniae and H. influenzae. Case series described complicated cases of OM due to M. tuberculosis, multidrug resistance and HIV. QOL studies identified discrimination of persons with OM and hearing loss. Diagnostic methods varied greatly, from naked eye to tympanometry. Treatment interventions were reported from four RCTs. Non-RCTs included evaluations of guidelines, surgery outcomes, access to ENTs.
Chronic suppurative otitis media, otitis media with effusion and conductive hearing loss are common in LMIC and disadvantaged populations. Paucity of research, poor regional representation, non-standardised methods and low-quality reporting preclude accurate assessment of disease burden in LMIC and disadvantaged populations. Awareness and adherence to reporting Guidelines should be promoted.
The Disadvantaged Business Enterprise program, established by the United States Department of Transportation, aims to remove barriers to participation of Disadvantaged Business Enterprises (DBEs) in ...highway projects, to promote the use of DBEs in federally assisted contracts, and to assist the development of DBEs. A DBE is a small, for-profit business owned by socially and economically disadvantaged individuals such as women or minorities. DBEs need various supportive services, depending on many factors, such as business area, size, and strategy. State Departments of Transportation often provide or hire third parties to provide supportive services to DBEs that are relatively expensive and inefficient. These services may also support only some and unintentionally exclude other DBEs. Under many challenges, one ultimate goal is to find a framework that covers all valuable DBE supportive services. This study proposes, tests, and validates a framework for providing effective and comprehensive DBE supportive services in the transportation sector. Based on discussions with DBE liaison officers and service providers, we propose the business, engineering, construction, and other (BECO) framework to provide DBE supportive services. We then use a sequential explanatory design in mixed methods, collecting quantitative and qualitative data to evaluate and validate the BECO framework. We analyze quantitative data using confirmatory factor analysis and qualitative data using pattern coding techniques. The results provide insights and reveal useful DBE supportive services using the BECO framework. The framework is useful for assessing DBE needs, informing DBE liaison officers and service providers, and offering the most useful supportive services to DBEs.
Systemic lupus erythematosus (SLE) is an autoimmune disorder with significant health disparities, as it disproportionately and more severely affects vulnerable and disadvantaged population groups in ...the United States and around the world, that is, women, ethnic minorities, individuals living in poverty, less educated, and lacking medical insurance. Both, genetic and non-genetic factors, contribute to these disparities. To overcome these health disparities and reduce poor outcomes among disadvantaged SLE populations, interventions on non-genetic amendable factors, especially on social health determinants, are necessary.
As of 18 October 2020, over 39.5 million cases of coronavirus disease 2019 (COVID-19) and 1.1 million associated deaths have been reported worldwide. It is crucial to understand the effect of social ...determination of health on novel COVID-19 outcomes in order to establish health justice. There is an imperative need, for policy makers at all levels, to consider socioeconomic and racial and ethnic disparities in pandemic planning. Cross-sectional analysis from COVID Boston University's Center for Antiracist Research COVID Racial Data Tracker was performed to evaluate the racial and ethnic distribution of COVID-19 outcomes relative to representation in the United States. Representation quotients (RQs) were calculated to assess for disparity using state-level data from the American Community Survey (ACS). We found that on a national level, Hispanic/Latinx, American Indian/Alaskan Native, Native Hawaiian/Pacific Islanders, and Black people had RQs > 1, indicating that these groups are over-represented in COVID-19 incidence. Dramatic racial and ethnic variances in state-level incidence and mortality RQs were also observed. This study investigates pandemic disparities and examines some factors which inform the social determination of health. These findings are key for developing effective public policy and allocating resources to effectively decrease health disparities. Protective standards, stay-at-home orders, and essential worker guidelines must be tailored to address the social determination of health in order to mitigate health injustices, as identified by COVID-19 incidence and mortality RQs.
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