Designing centralized waiting lists for attachment to a primary care provider: Considerations from a logic analysis

Access to a regular primary care provider is essential to quality care. In Canada, where 15 % of patients are unattached (i.e., without a regular provider), centralized waiting lists (CWLs) help attach patients to a primary care provider (family physician or nurse practitioner). Previous studies reveal mechanisms needed for CWLs to work, but focus mostly on CWLs for specialized health care. We aim to better understand how to design CWLs for unattached patients in primary care.In this study, a logic analysis compares empirical evidence from a qualitative case study of CWLs for unattached patients in seven Canadian provinces to programme theory derived from a realist review on CWLs. Data is analyzed using context-intervention-mechanism-outcome configurations.Results identify mechanisms involved in three components of CWL design: patient registration, patient prioritization, and patient assignment to a provider for attachment. CWL programme theory is revised to integrate mechanisms specific to primary care, where patients, rather than referring providers, are responsible for registering on the CWL, where prioritization must consider a broad range of conditions and characteristics, and where long-term acceptability of attachment is important. The study provides new insight into mechanisms that enable CWLs for unattached patients to work.     

农户地权诉求视角下农地制度的创新

目前我国农户的地权诉求已经发生了很大的变化，即由地权稳定、自主经营向农地资源的优化配置和高效利用转化。这一变化的内在动力是农户急切希望改变承包地过于细碎化以及改善农业生产经营基本条件。考察我国农地制度的发展史可以发现，我国农地制度变迁的基本逻辑就是农户的地权诉求决定农地制度的发展方向，这一点在当下一些地方的农地制度创新试验和经验中再次得到证明。今后我国农地制度创新必须遵循这一逻辑，根据我国农户地权诉求的变化，实施农户自愿前提下的承包地连片重划,争取国家对承包地重划制度的支持,强化农民集体民主决策制度,地方政府也要给予必要的支持。     

Catering to sex,sexual, and gender diversity: An exploratory study on the effects of LGBTI awareness training on aged care staff in Tasmania,Australia

The Australian National LGBTI Ageing and Aged Care Strategy seeks to address the lack of recognition of older lesbian, gay, bisexual, transgender, and intersex (LGBTI) adults living in aged care. Awareness training for aged care staff forms a crucial part of this strategy, but the impact of such educational programs are yet to be examined. In this article, we examine the effects of LGBTI awareness training on staff working in an Australian aged care facility. These staff perceived the awareness training as valuable, but the outcomes from it were limited. Therefore, we indicate changes that are necessary to support the translation of training into practice.     

Bayesian spatial quantile regression for areal count data,with application on substitute care placements in Texas

Quantile regression (QR) allows one to model the effect of covariates across the entire response distribution, rather than only at the mean, but QR methods have been almost exclusively applied to continuous response variables and without considering spatial effects. Of the few studies that have performed QR on count data, none have included random spatial effects, which is an integral facet of the Bayesian spatial QR model for areal counts that we propose. Additionally, we introduce a simplifying alternative to the response variable transformation currently employed in the QR for counts literature. The efficacy of the proposed model is demonstrated via simulation study and on a real data application from the Texas Department of Family and Protective Services (TDFPS). Our model outperforms a comparable non-spatial model in both instances, as evidenced by the deviance information criterion (DIC) and coverage probabilities. With the TDFPS data, we identify one of four covariates, along with the intercept, as having a nonconstant effect across the response distribution.     

Association between sexually explicit messages and sleep health among French sexual minority men

It has been demonstrated that sexual minority men (SMM) participate in sexting. While research has shown that engagement in the exchange of sexually explicit media is associated with poor health outcomes, no previous research has investigated its association with sleep health outcomes. This study sought to examine the association between sexually explicit media and sleep health among SMM, a population that suffers from poor sleep health. A popular geosocial networking application was used to recruit SMM individuals (N?=?580) in the Paris, France, metropolitan area. Multivariate analyses, adjusting for sociodemographics, were used to test the association between the frequency of sexually explicit messaging and three dimensions of sleep health: (1) sleep quality, (2) sleep duration, and (3) two aspects of sleep problems. In multivariate analyses, those who reported engaging in sexually explicit messaging more were more likely to report getting less than seven?hours of sleep (aRR = 1.24; 95% CI = 1.08, 1.43) compared with those who reported engaging in sexually explicit messaging less. No significant associations were found between sexting and sleep quality or reporting sleep problems. Sexually explicit messaging was associated with shorter sleep duration. Intervention targeted at individuals who sext could potentially improve sleep health outcomes.     

Overcoming the ‘tyranny of the urgent’: integrating gender into disease outbreak preparedness and response

ABSTRACT

This article contributes to discussions on the gender dimensions of disease outbreaks, and preparedness policies and responses, by providing a multi-level analysis of gender-related gaps, particularly illustrating how the failure to challenge gender assumptions and incorporate gender as a priority at the global level has national and local impacts. The implications of neglecting gender dynamics, as well as the potential of equity-based approaches to disease outbreak responses, is illustrated through a case study of the Social Enterprise Network for Development (SEND) Sierra Leone, a non-government organisation (NGO) based in Kailahun, during the Ebola outbreak.     

Parents’ perspectives of social support and social cohesion in urban contexts of diversity

Although provisions for young children are increasingly considered as ideal places to foster an inclusive and socially just society by embracing issues of social support and social cohesion, there is no in-depth understanding of the role these provisions can play in enabling supportive and cohesive encounters in contexts of diversity. Even more striking is the absence of parents’ voices in this discussion. Based on an analysis of qualitative interviews with 18 parents who use childcare services in urban contexts of diversity, our findings show the relevance of ephemeral contacts with diverse people that could offer bridging opportunities in terms of social connectedness to familiarise within diversity while decoding the other in urban contexts of diversity. However, neither bonding nor bridging contacts appear as self-evident. Our research shows that the role of childcare services might be vital in creating light and temporal communities as the prerequisite for social cohesion to flourish, in both individual as well as collective dimensions.     

Comfort with discussions about death,religiosity, and attitudes about end‐of‐life care

In end‐of‐life (EOL) care research, death anxiety and religiosity are often overlooked. Terror management theory (TMT) may provide a useful conceptual model with which to examine how comfort discussing death and religiosity influence attitudes related to EOL care. A telephone‐based survey was conducted among community‐dwelling adults in the Unites States. Via random sampling, with over‐sampling of Hispanics/African Americans, 123 completed survey interviews (response rate = 46%) were analyzed. Respondents were more likely to have better attitudes toward EOL care if they were older or white, religiously active, and comfortable with the subject of death. Religiosity and comfort discussing death were correlated with each other and remained significant predictors of attitudes about EOL care even without demographic covariates. Findings suggest that promoting an open dialogue about mortality may improve attitudes about EOL care and utilization of palliative care services. The study also provides evidence about the utility and applicability of TMT for EOL care.     

“健康中国”背景下全民健身与全民健康融合研究

结合我国实际，从全民健身和全民健康的科学理念、科学研究、人才培养、体医融合、设施建设、产业发展、“互联网+”运用等措施，实现全民健身和全民健康的深度融合，保障政府工作落地生根，促进全民健康。