scholarly journals Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Wei-Teng Yang ◽  
Celine R. Gounder ◽  
Tokunbo Akande ◽  
Jan-Walter De Neve ◽  
Katherine N. McIntire ◽  
...  
Keyword(s):  
Gender Differences ◽  
Public Health Problem ◽  
System Level ◽  
Global Public Health ◽  
Community Members ◽  
Quantitative Evidence ◽  
Individual Level ◽  
Treatment Services ◽  
Quantitative Studies ◽  
The Individual

Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation.Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences.Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men.Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

scholarly journals Gender-Related Barriers and Delays in Accessing Tuberculosis Diagnostic and Treatment Services: A Systematic Review of Qualitative Studies

2014 ◽  
Vol 2014 ◽  
pp. 1-14 ◽  
Author(s):  
Lakshmi Krishnan ◽  
Tokunbo Akande ◽  
Anita V. Shankar ◽  
Katherine N. McIntire ◽  
Celine R. Gounder ◽  
...  
Keyword(s):  
Developing Countries ◽  
Physical Dependence ◽  
Public Health Problem ◽  
Qualitative Studies ◽  
System Level ◽  
Service Access ◽  
Global Public Health ◽  
Coding System ◽  
Treatment Services ◽  
Variable Nature

Background. Tuberculosis (TB) remains a significant global public health problem with known gender-related (male versus female) disparities. We reviewed the qualitative evidence (written/spoken narrative) for gender-related differences limiting TB service access from symptom onset to treatment initiation.Methods. Following a systematic process, we searched 12 electronic databases, included qualitative studies that assessed gender differences in accessing TB diagnostic and treatment services, abstracted data, and assessed study validity. Using a modified “inductive coding” system, we synthesized emergent themes within defined barriers and delays limiting access at the individual and provider/system levels and examined gender-related differences.Results. Among 13,448 studies, 28 studies were included. All were conducted in developing countries and assessed individual-level barriers; 11 (39%) assessed provider/system-level barriers, 18 (64%) surveyed persons with suspected or diagnosed TB, and 7 (25%) exclusively surveyed randomly sampled community members or health care workers. Each barrier affected both genders but had gender-variable nature and impact reflecting sociodemographic themes. Women experienced financial and physical dependence, lower general literacy, and household stigma, whereas men faced work-related financial and physical barriers and community-based stigma.Conclusions. In developing countries, barriers limiting access to TB care have context-specific gender-related differences that can inform integrated interventions to optimize TB services.

scholarly journals Unmet Need for Healthcare Among People with Hypertension in Indonesia

2020 ◽  
Author(s):  
Asmaripa Ainy ◽  
Amrina Rosyada ◽  
Haerawati Idris ◽  
Asri Maharani
Keyword(s):  
Unmet Need ◽  
Public Health Problem ◽  
Care Utilization ◽  
Global Public Health ◽  
Cross Sectional ◽  
Household Level ◽  
Individual Level ◽  
Indonesia Family Life Survey ◽  
Education And Employment ◽  
The Individual

Abstract Background: Hypertension is a leading global public health problem in both developed and developing countries including Indonesia, mainly due to its high frequency and risks of cardiovascular diseases. Prevalence of hypertension in the Indonesian population aged> 18 years in 2018 was 34.11%. Unmet need for healthcare generally has been explored, but limited empirical study explores it among people with hypertension. The objective of this study is to investigate the determinants of unmet need for healthcare among people with hypertension. Methods: The design of this study is cross-sectional, using the data from the Indonesia Family Life Survey wave 5 (IFLS-5). The sample of the survey was 6,302 adults age >40 years old, stratified by rural/urban status. Three-level multilevel analysis was performed to estimate the individual level, household level, and community-level determinants of unmet needs for hypertension care. Results: The data shows that 78.4% of respondents with hypertension reported an unmet need for healthcare. Age, female, single, income, having insurance, living in the urban area, and the number of health posts for elderly (Posyandu Lansia) are significantly associated with meet needs for health care utilization among hypertension, while education and employment status shows no association with them. Conclusion: Improving access to healthcare and reducing health inequality are required to address this problem.

The True Believers

2018 ◽  
Author(s):  
Barbara J. Risman
Keyword(s):  
Gender Differences ◽  
Social Networks ◽  
Social Life ◽  
Gender Ideology ◽  
Macro Level ◽  
Individual Level ◽  
Gender Differentiation ◽  
The World ◽  
The Individual ◽  
Gendered Expectations

This is the first data chapter. In this chapter, respondents who are described as true believers in the gender structure, and essentialist gender differences are introduced and their interviews analyzed. They are true believers because, at the macro level, they believe in a gender ideology where women and men should be different and accept rules and requirements that enforce gender differentiation and even sex segregation in social life. In addition, at the interactional level, these Millennials report having been shaped by their parent’s traditional expectations and they similarly feel justified to impose gendered expectations on those in their own social networks. At the individual level, they have internalized masculinity or femininity, and embody it in how they present themselves to the world. They try hard to “do gender” traditionally.

scholarly journals System models for resilience in gerontology: application to the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katarzyna Klasa ◽  
Stephanie Galaitsi ◽  
Andrew Wister ◽  
Igor Linkov
Keyword(s):  
The Elderly ◽  
System Level ◽  
Improve Quality ◽  
Care Needs ◽  
Individual Level ◽  
Chronic Stressors ◽  
The World ◽  
Aging Adults ◽  
The Individual

AbstractThe care needs for aging adults are increasing burdens on health systems around the world. Efforts minimizing risk to improve quality of life and aging have proven moderately successful, but acute shocks and chronic stressors to an individual’s systemic physical and cognitive functions may accelerate their inevitable degradations. A framework for resilience to the challenges associated with aging is required to complement on-going risk reduction policies, programs and interventions. Studies measuring resilience among the elderly at the individual level have not produced a standard methodology. Moreover, resilience measurements need to incorporate external structural and system-level factors that determine the resources that adults can access while recovering from aging-related adversities. We use the National Academies of Science conceptualization of resilience for natural disasters to frame resilience for aging adults. This enables development of a generalized theory of resilience for different individual and structural contexts and populations, including a specific application to the COVID-19 pandemic.

scholarly journals Pooled Sputum for Xpert MTB/RIF Testing: A Cost Effectiveness Diagnostic Tool in Mwanza, Tanzania

2021 ◽  
Author(s):  
Shimba Henerico ◽  
Richard V. Makapa ◽  
Bernard C. Okamo ◽  
Benson R. Kidenya ◽  
Geoffrey Japhet ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Low Income ◽  
Public Health Problem ◽  
Positive Sample ◽  
Low Income Countries ◽  
Global Public Health ◽  
Testing Strategy ◽  
Pooled Testing ◽  
The Individual ◽  
Pooled Samples

Abstract Background: Tuberculosis (TB) is a global public health problem, with the highest burden occurring in low-income countries, wherein the use of more sensitive diagnostics, such as Xpert MTB/RIF (GeneXpert), is still limited by costs. Testing of pooled samples from various individuals has been thought and thus investigated as a cost saving strategy to diagnose some diseases including TB. Then in cases where a pool is positive, retesting of the individual samples in that pool is done to identify the positive sample. We assessed the utility of a pooled testing strategy to optimize the affordability of GeneXpert for the diagnosis of TB Mwanza Tanzania. Methods: Remainder of samples from presumptive TB patients submitted for routine TB diagnosis were used for pooled samples (5 per pool) testing. The agreement of the results between individual sample testing against pooled samples testing and cost-effectiveness were assessed.Results: A total of 250 individual routinely submitted samples for TB diagnosis were tested using the established protocols. The median age of study participants was 35 [IQR 27 – 40] years and 143 (57.2%) were males. Of the 250 samples, 28 (11.2%) were detected to have MTB whereas 222 (88.8%) samples, were negative. Of the 50 sputum pools made, MTB were detected in 17 (34.0%) pools. Following retesting of these 17 positive pools, all 28 (100%) individual MTB samples were detected with the overall agreement being 100% (With the sensitivity of 100% and specificity of 100%). The number of individual MTB positive ranged from 1 to 3 per pool. Using pooling of sputum samples, the technique saved 115 (46.0%) of the cartridges in running 250 samples. This is equivalent to saving US$ 1147.7. Conclusion: The pooled sputum testing strategy reduced cartridge costs by 46.0%. The use of the pooled testing strategy reduces costs and has the potential to increase the affordability of GeneXpert testing in countries with limited resources. Pooled sputum for Xpert MTB/RIF can be used as an affordable diagnostic and/or screening tool in resource limited settings, such as Tanzania.

scholarly journals Opposite outcomes of coinfection at individual and population scales

2018 ◽  
Vol 115 (29) ◽  
pp. 7545-7550 ◽  
Author(s):  
Erin E. Gorsich ◽  
Rampal S. Etienne ◽  
Jan Medlock ◽  
Brianna R. Beechler ◽  
Johannie M. Spaan ◽  
...  
Keyword(s):  
Reproduction Number ◽  
Negative Impact ◽  
Scale Up ◽  
Population Level ◽  
Clear Understanding ◽  
African Buffalo ◽  
Global Public Health ◽  
Individual Level ◽  
Secondary Infections ◽  
The Individual

Coinfecting parasites and pathogens remain a leading challenge for global public health due to their consequences for individual-level infection risk and disease progression. However, a clear understanding of the population-level consequences of coinfection is lacking. Here, we constructed a model that includes three individual-level effects of coinfection: mortality, fecundity, and transmission. We used the model to investigate how these individual-level consequences of coinfection scale up to produce population-level infection patterns. To parameterize this model, we conducted a 4-y cohort study in African buffalo to estimate the individual-level effects of coinfection with two bacterial pathogens, bovine tuberculosis (bTB) and brucellosis, across a range of demographic and environmental contexts. At the individual level, our empirical results identified bTB as a risk factor for acquiring brucellosis, but we found no association between brucellosis and the risk of acquiring bTB. Both infections were associated with reductions in survival and neither infection was associated with reductions in fecundity. The model reproduced coinfection patterns in the data and predicted opposite impacts of coinfection at individual and population scales: Whereas bTB facilitated brucellosis infection at the individual level, our model predicted the presence of brucellosis to have a strong negative impact on bTB at the population level. In modeled populations where brucellosis was present, the endemic prevalence and basic reproduction number (R0) of bTB were lower than in populations without brucellosis. Therefore, these results provide a data-driven example of competition between coinfecting pathogens that occurs when one pathogen facilitates secondary infections at the individual level.

The Gatekeeping of iNews.id about News on Worship in Mosques Due to the Covid-19 Pandemic

MEDIASI ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 100-107
Author(s):  
Shania Shaufa ◽  
Thalitha Sacharissa Rosyidiani
Keyword(s):  
Production Process ◽  
Media Coverage ◽  
System Level ◽  
Organizational Level ◽  
Online Media ◽  
Individual Level ◽  
The Public ◽  
The Social ◽  
The Media ◽  
The Individual

This article explains about online media iNews.id in implementing gatekeeping function. This study aims to find out how gatekeeping efforts iNews.id in the production process on the issue of preaching restrictions on worship in mosques during Ramadan in 2020. During the Covid-19 pandemic, the current media situation, especially in the midst of a crisis, encourages the public to become heavily dependent on media coverage. With a qualitative approach, researchers analyzed five levels of influence on the gatekeeping process in online media iNews.id. The results of this study show that factors that influence the way iNews.id in the production process of preaching restrictions on worship in mosques due to the Covid-19 pandemic are the individual level of media workers, the level of media routine, the organizational level, the extramedia level, and the social system level. The conclusions of this study state the most dominant levels is the organization level and the media routine level in the iNews.id.

scholarly journals Extending the reach and impact of management research: a question of legitimacy

2019 ◽  
Vol 1 (2) ◽  
pp. 58-78
Author(s):  
David J. Finch ◽  
John Nadeau ◽  
Bill Foster ◽  
Norm O’Reilly ◽  
Kim Bates ◽  
...  
Keyword(s):  
Strategic Orientation ◽  
Career Stage ◽  
Management Research ◽  
Community Members ◽  
Content Type ◽  
Individual Level ◽  
Sequential Mixed Methods ◽  
Stratified Sample ◽  
The Individual ◽  
External Community

Purpose The issues associated with the production and dissemination of management research have been widely debated amongst administrators, scholars and policymakers for decades. However, few studies to date have examined this issue at the level of the individual scholar. The purpose of this paper is to view a management scholar’s choice of knowledge dissemination (KD) outlets as a legitimacy judgment embedded in their social structure and community norms. Design/methodology/approach To explore this, the authors conduct a sequential mixed-methods study. The study uses qualitative methods, including one-on-one interviews (n=29) and five workshops (n=79) with administrators, management scholars, students and external community members (practitioners and policymakers). In addition, the authors analyzed the KD outcomes of 524 management scholars at seven Canadian universities drawn from a stratified sample of business schools. Findings The results of the research demonstrate the complex interaction between individual scholar-level factors, including socialization (degree type and practitioner experience) and tenure, and the institutional-level factors, such as strategic orientation and accreditation, and how these influence KD judgments. Specifically, the authors find that institutional factors (such as tenure and promotion) are a central predictor of scholarly KD; in contrast, the authors find that individual-level factors including degree, professional experience and career stage influence non-scholarly KD. Originality/value The results suggest that as management scholars face increasing pressure to demonstrate impact beyond academia, it may be more difficult than simply adapting the reward system. Specifically, the authors suggest that administrators and policymakers will have to consider individual factors, including their academic training (including interdisciplinary training), previous practitioner experience and career stage.

scholarly journals School Nurses Avoid Addressing Child Sexual Abuse

2016 ◽  
Vol 33 (2) ◽  
pp. 133-142 ◽  
Author(s):  
Lisbet Engh Kraft ◽  
GullBritt Rahm ◽  
Ulla-Britt Eriksson
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Sexually Abused ◽  
Secondary Analysis ◽  
Public Health Problem ◽  
School Nurses ◽  
Global Public Health ◽  
Abused Children ◽  
Group Interviews ◽  
The Individual

Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental ill-health is crucial.

Political Journalism

2018 ◽  
Author(s):  
Jesper Strömbäck ◽  
Adam Shehata
Keyword(s):  
System Level ◽  
Organizational Level ◽  
Strategic Game ◽  
Partisan Bias ◽  
Individual Level ◽  
Political Journalism ◽  
The Media ◽  
Media Systems ◽  
Conflict Framing ◽  
The Individual

Political journalism constitutes one of the most prominent domains of journalism, and is essential for the functioning of democracy. Ideally, political journalism should function as an information provider, watchdog, and forum for political discussions, thereby helping citizens understand political matters and help prevent abuses of power. The extent to which it does is, however, debated. Apart from normative ideals, political journalism is shaped by factors at several levels of analysis, including the system level, the media organizational level, and the individual level. Not least important for political journalism is the close, interdependent, and contentious relationship with political actors, shaping both the processes and the content of political journalism. In terms of content, four key concepts in research on political journalism in Western democratic systems are the framing of politics as a strategic game, interpretive versus straight news, conflict framing and media negativity, and political or partisan bias. A review of research related to these four concepts suggests that political journalism has a strong tendency to frame politics as a strategic game rather than as issues, particularly during election campaigns; that interpretive journalism has become more common; that political journalism has a penchant for conflict framing and media negativity; and that there is only limited evidence that political journalism is influenced by political or partisan bias. Significantly more important than political or partisan bias are different structural and situational biases. In all these and other respects, there are important differences across countries and media systems, which follows from the notion that political journalism is always influenced by the media systems in which it is produced and consumed.

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