Suchergebnisse

Background and aim: Early action is important for promoting newly arrived migrants' health. Politicians are major actors in decision-making that affects health outcomes in the population. Therefore, the aim of this study was to explore local and regional politicians' considerations of newly arrived migrants' health in political decision-making: whether politicians reflect on or discuss the effects of decision-making specifically on newly arrived migrants' health, whether considerations differ between municipality and regional politicians, and how knowledge and attitudes are associated with such considerations. Subject and methods: A cross-sectional quantitative study was conducted. A total of 667 municipality and regional politicians from northern Sweden responded to a questionnaire developed based on interviews with politicians. Bivariate analyses were performed using χ2 tests, the independent samples t-test, and the Wilcoxon signed-rank test. Multivariate analysis was performed using binary logistic regression. Results: Politicians considered the effects on newly arrived migrants' health significantly less frequently than those on the total population's health. Regional politicians discussed such effects more often than municipality politicians. Knowledge (odds ratio [OR] = 1.343), attitude (OR = 5.962), previous experience working on public health issues (OR = 1.784), and female gender (OR = 1.787) were positively associated with considering effects on newly arrived migrants' health in decision-making. Conclusion: Politicians play important roles in health promotion, and most consider health-related effects in their decision-making. However, about a third do not consider such effects. General health-related knowledge and attitude are important factors that could be affected or changed during political assignments.

Newly arrived migrants in Sweden risk facing ill health. Politicians at the local and regional levels are involved in many decisions regarding the social determinants of health. The aim of this study was to explore politicians' views on different societal actors' responsibility and possibility to promote newly arrived migrants' health. Data were collected through online questionnaires completed by 667 politicians from municipality and regional councils in northern Sweden. Bivariate analysis was performed using the Wilcoxon signed-rank test. Multivariate analyses were performed using cluster analysis and binary logistic regression analysis. The results show that politicians generally rate societal actors' responsibility and possibility to promote the general population's health higher than newly arrived migrants' health. Moreover, they consider societal actors' responsibility to be greater than their possibility to promote health. Factors significantly contributing to politicians' high ratings of societal responsibility and possibility are attitude (odds ratio [OR] = 2.156, 95% confidence interval [CI]: 1.306–3.558), specific knowledge of newly arrived migrants' health status (OR = 1.528, 95% CI: 1.005–2.323), personal interest in public health (OR = 2.452, 95% CI: 1.460–4.119), being a municipality politician (OR = 1.659, 95% CI: 1.031–2.670) and being female (OR = 1.934, 95% CI: 1.333–2.806). This study shows that politicians generally rate societal responsibility and possibility to promote newly arrived migrants' health rather high. Personal characteristics are important for politicians' high or low ratings of responsibility and possibility, suggesting insufficient structural support for politicians in health promotion.

Aim: The aim of this study was to analyse discourses of parenting training in official inquires in Sweden that explicitly deal with the bringing up of children and parental education and how the representations of the problems and their solutions affect parental subject positions in the early welfare state and at the onset of the 21st century. Method: We carried out a discourse analysis of two public inquiries of 1947 and 2008, drawing on theories about governmentality and power regimes. Tools from political discourse analysis were used to investigate the objectives of political discourse practices. Results: Both inquiries referred to a context of change and new life demands as a problem. Concerning suggestions for solutions, there were discrepancies in parents' estimated need of expert knowledge and in descriptions of parental capacity. In a discourse of trust and doubt, the parents in 1947 were positioned as trusted welfare partners and secure raisers of future generations, and in 2008, as doubted adults, feared to be faltering in their child-rearing tasks. Conclusions: The analysis revealed how governmental problem descriptions, reasoning about causes and suggestions of solutions influenced parents' subject positions in a discourse of trust and doubt, and made way for governmental interventions with universal parenting training in the 21st century.

BACKGROUND: Improving access to optimal quality of care is a core priority and ambitious health policy goal in spite of impediments, threats and challenges in Palestine. Understanding the factors that may impede quality of care is essential in developing an effective healthcare intervention for patient with non-communicable disease (NCD) or war-injured survivors. METHODS: Qualitative interviews were performed using a purposive sampling strategy of 18 political-key informants, 10 patients with NCD and 7 war-injured survivors from different health facilities in Gaza Strip. A semi-structured interview guide was developed for data collection. The interviews were audio recorded and transcribed verbatim. Important field notes of the individual interviews were also reported. Thematic-driven analytic approach was used to identify key themes and patterns. RESULTS: From the policy maker's perspective, the following important barriers to accessing optimal healthcare for patients with NCD or war-injured survivors' treatment were identified; 1) organizational/structural 2) availability 3) communication 4) personnel/lack of staff 5) financial and political barriers. Patient with NCD or war-injury had similar experiences of barriers as the policy makers. In addition, they also identified socioeconomic, physical and psychological barriers for accessing optimal healthcare and treatment. CONCLUSIONS: The main perceived barriers explored through this study will be very interesting and useful if they are considered seriously and handled carefully, in order to ensure efficient, productive, cost-effective intervention and delivery of a high-standard quality of care and better disease management.

BACKGROUND: Improving access to optimal quality of care is a core priority and ambitious health policy goal in spite of impediments, threats and challenges in Palestine. Understanding the factors that may impede quality of care is essential in developing an effective healthcare intervention for patient with non-communicable disease (NCD) or war-injured survivors. METHODS: Qualitative interviews were performed using a purposive sampling strategy of 18 political-key informants, 10 patients with NCD and 7 war-injured survivors from different health facilities in Gaza Strip. A semi-structured interview guide was developed for data collection. The interviews were audio recorded and transcribed verbatim. Important field notes of the individual interviews were also reported. Thematic-driven analytic approach was used to identify key themes and patterns. RESULTS: From the policy maker's perspective, the following important barriers to accessing optimal healthcare for patients with NCD or war-injured survivors' treatment were identified; 1) organizational/structural 2) availability 3) communication 4) personnel/lack of staff 5) financial and political barriers. Patient with NCD or war-injury had similar experiences of barriers as the policy makers. In addition, they also identified socioeconomic, physical and psychological barriers for accessing optimal healthcare and treatment. CONCLUSIONS: The main perceived barriers explored through this study will be very interesting and useful if they are considered seriously and handled carefully, in order to ensure efficient, productive, cost-effective intervention and delivery of a high-standard quality of care and better disease management.

Purpose
– The purpose of this paper is to investigate chronicity (frequency) in different abuse types (e.g. psychological) and overall abuse (all abuse types) by severity (minor, severe, total) in seven European cities, and scrutinize factors associated with high chronicity levels (frequency on the median and higher) in psychological and overall abuse by severity.


Design/methodology/approach
– The study design was cross-sectional. The sample consisted of 4,467 randomly selected women/men (2,559 women) aged 60-84 years from seven European cities, and data were analysed with bivariate and multivariate methods.


Findings
– Chronicity varied across country and by abuse type. For instance, Germany had the highest chronicity means in physical and sexual abuse; Greece in physical, injury, sexual and overall abuse; Lithuania in physical, injury, financial and overall abuse; Portugal in physical abuse; Spain in physical, sexual and financial abuse; and Sweden in psychological, injury, financial and overall abuse. In general, Italy had the lowest chronicity means. The main perpetrators were people close to the respondents and women (in some cases).


Research limitations/implications
– The independent relationship (regressions) between chronicity/severity of abuse, country and other variables (e.g. depression) was examined only for psychological and overall abuse. More research into this issue with other types of abuse (e.g. sexual) is warranted.


Originality/value
– The paper reports data from the ABUEL survey, which gathered population-based data on elderly abuse.

Purpose -- The purpose of this paper is to investigate chronicity (frequency) in different abuse types (e.g. psychological) and overall abuse (all abuse types) by severity (minor, severe, total) in seven European cities, and scrutinize factors associated with high chronicity levels (frequency on the median and higher) in psychological and overall abuse by severity. Design/methodology/approach -- The study design was cross-sectional. The sample consisted of 4,467 randomly selected women/men (2,559 women) aged 60-84 years from seven European cities, and data were analysed with bivariate and multivariate methods. Findings -- Chronicity varied across country and by abuse type. For instance, Germany had the highest chronicity means in physical and sexual abuse; Greece in physical, injury, sexual and overall abuse; Lithuania in physical, injury, financial and overall abuse; Portugal in physical abuse; Spain in physical, sexual and financial abuse; and Sweden in psychological, injury, financial and overall abuse. In general, Italy had the lowest chronicity means. The main perpetrators were people close to the respondents and women (in some cases). Research limitations/implications -- The independent relationship (regressions) between chronicity/severity of abuse, country and other variables (e.g. depression) was examined only for psychological and overall abuse. More research into this issue with other types of abuse (e.g. sexual) is warranted. Originality/value -- The paper reports data from the ABUEL survey, which gathered population-based data on elderly abuse. Adapted from the source document.

Purpose– The purpose of this paper is to examine differences in the experience of somatic symptoms by domain (exhaustion, musculoskeletal, gastrointestinal, heart distress) between psychologically abused and non-abused older persons, and to scrutinize associations between abuse and somatic symptoms while considering other factors (e.g. social support).Design/methodology/approach– The design was cross-sectional. The participants were 4,467 women/men aged 60-84 years living in seven European cities. The data were analysed using bivariate/multivariate methods.Findings– Psychologically abused participants scored higher on all somatic symptom domains than non-abused, and thus were more affected by the symptoms. The regressions confirmed a positive association between psychological abuse and most somatic symptom domains, but other factors (e.g. depression, anxiety) were more salient. Demographics/socio-economics were positively (e.g. marriage/cohabitation) or negatively (e.g. education) associated with somatic symptoms depending on the domain. Social support and family structure "protected" the experience of somatic symptoms.Research limitations/implications– The research focused on psychological abuse. It did not incorporate other abuse types calling for further research on the effects of other abuse types on somatic symptoms. Nevertheless, the findings indicate that psychological abuse is linked to somatic symptoms, but the role of other factors (e.g. depression, anxiety, social support) is also important.Practical implications– Improvements in the older person's situation regarding somatic symptoms need to consider psychological abuse, co-morbidities, social support and living conditions.Originality/value– The paper reports data from the ABUEL Survey, which collected population-based data on elder abuse.