Student and faculty perceptions about mandatory influenza vaccinations on a health sciences campus

Objective: To examine the perceptions among faculty and health professional students regarding mandatory vaccination policies on a health sciences campus. Participants: A total of 296 faculty and 244 students completed surveys during Fall 2015. Methods: The online survey administered to individuals who received the influenza vaccine during the fall 2015 influenza vaccination clinic season included five items evaluating perceptions of employer mandatory vaccination requirements. Results: Chi-square analysis indicated that although faculty and students agree mandatory vaccinations in a health care environment are appropriate, faculty are more likely than students to get vaccinated in the absence of a mandate. Additionally, a small fraction of faculty would consider employment elsewhere when facing this mandate. Conclusions: Overall, faculty and students had favorable perceptions about mandatory influenza vaccine policies. Since students were less likely to be vaccinated in the absence of a mandate, education of students should be improved to support the importance of vaccinations in a health care environment.     

Giving time or giving money? On the relationship between charitable contributions

This paper studies philanthropic behaviour in terms of money and time contributions for charitable organisations. Using a unique dataset, which is representative of the German population, we examine the pure contributions of individuals who give either money or time as well as joint contributions of individuals who give both money and time. We find that the sequential decisions to give to charity and how much to give can be explained by different socio-economic characteristics. We report particularly pronounced gender differences among pure contributions, an interesting pattern of human capital variables such as income and education, and possible differences in the type of philanthropic goods.     

Early Childhood Education Centre Director Perceptions of Challenging Behaviour: Promising Practices and Implications for Professional Development

Given their key role in overall programme quality, it is critical to examine how early childhood programme centre directors in the United States perceive challenging behaviour. Participants completed a survey asking which behaviours they perceive to be most problematic, the number of children dismissed or expelled from the programme during the last year, and the most commonly used strategies for addressing challenging behaviours. Results point to several promising practices and highlight the variability in access to evidence‐based practices based on programme type. Areas that warrant more targeted professional development are discussed, and findings are situated within the larger early childhood context.     

Educational gradient of health in rural China

The aim of this paper is to examine whether and how rural residents’ educational attainment is associated with their self-rated health in China. Taking advantage of the National Exercise Facility Survey that was collected between December 2015 and March 2016, we find that educational attainment has a significant and positive correlation with self-rated health, net of the effects of age, gender, and geographical region. This correlation is mediated by factors such as perceived importance of exercise and healthy lifestyle. Relatively, people’s cognitive knowledge about health-related information and material resource access fail to play a significant mediating role. The findings highlight the non-material and non-cognitive attributes of educational attainment in shaping the gradient of health in the rural setting of China. Interventions that expand formal education to the mass and optimize teaching contents may offer an effective means to balance the health gradient.     

Smoking during pregnancy,stigma and secrets: Visual methods exploration in the UK

BackgroundMoral judgements are commonly directed towards mothers through reference to health behaviour in pregnancy, and working-class mothers are particularly subject to this moral gaze.AimTo gain an in-depth understanding of the health issues affecting 10 low income pregnant women from deprived areas of south Wales, UK.MethodsParticipants completed visual activities (timelines, collaging or thought bubbles and dyad sandboxing) prior to each interview. Participants’ visual representations were used in place of a topic guide, to direct the interview. Guided by feminist principles, 28 interviews were completed with 10 women. Data were analysed thematically.FindingsSmoking was discussed at length during interviews, and this paper focuses on this issue alone. Five of the participants had smoked during pregnancy. Negative reactions were directed towards pregnant women who smoked in public, resulting in maternal smoking being undertaken in private. Participants also reported awkward relationships with midwives and other health professionals, including receipt of public health advice in a judgemental tone.DiscussionSmoking during pregnancy is a particularly demonised and stigmatised activity. This stigma is not always related to the level of risk to the foetus, and instead can be seen as a moral judgement about women. We urgently need to move from individualised neo-liberal discourses about the failure of individual smokers, to a more socio-ecological view which avoids victim blaming.ConclusionStigma from friends, family, strangers and health professionals may lead to hidden smoking. This is a barrier to women obtaining evidence based stop smoking support.     

Multi-objective optimization in partitioning the healthcare system of Parana State in Brazil

Motivated by a proposal of the local authority for improving the existing healthcare system in the Parana State in Brazil, this article presents an optimization-based model for developing a better system for patients by aggregating various health services offered in the municipalities of Parana into some microregions. The problem is formulated as a multi-objective partitioning of the nodes of an undirected graph (or network) with the municipalities as the nodes and the roads connecting them as the edges of the graph. Maximizing the population homogeneity in the microregions, maximizing the variety of medical procedures offered in the microregions, and minimizing the inter-microregion distances to be traveled by patients are considered as three objective functions of the problem. An integer-coded multi-objective genetic algorithm is adopted as the optimization tool, which yields a significant improvement to the existing healthcare system map of the Parana State. The results obtained may have a strong impact on the healthcare system management in Parana. The model proposed here could be a useful tool to aid the decision-making in health management, as well as for better organization of any healthcare system, including those of other Brazilian States.     

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.     

空气污染治理与公众健康———来自“大气十条”政策的证据

为探究《大气污染防治行动计划》 (以下简称“大气十条”)的健康效应,本文基于中国健康与营养调查(CHNS)数据及省级面板数据,利用基于多项Logit模型的双重差分法(Logit-DID),从微观与宏观两个维度考察“大气十条”政策的健康改善效应及其传导机制,并进一步通过异质性分析探讨环境健康不平等的内在原因 研究发现:“大气十条”实施带来显著的健康效应,该政策不仅能有效控制与空气污染高度相关疾病的发病率和死亡占比,还能够间接降低受空气污染影响较小的疾病病情。其作用机理主要通过控制PM2.5浓度改善公众健康,同时该政策对二氧化硫(SO2)、氮氧化物、烟(粉)尘等其 他污染物浓度的下降起到了协同作用。进一步分析显示环境福利不公平的现象依然存在,“大气十条”政 策显著降低了疾病高发人群的发病率,且对女性、城镇居民和低、高年龄段等疾病高发人群的健康影响更显著。本文为政府构建环境健康公平发展路径,推进“健康中国”战略提供了经验证据和政策借鉴。     

Narrating Sustainability in Canadian Health Care Reform Discourse

In Canada, as in other industrialized welfare states, definitions of health system sustainability reflect different goals and correspondingly diverse ways of understanding exactly what is to be sustained and how. In this article, we report on results from a survey of documents and groups involved in and/or concerned about sustainability of the healthcare system. We identify four broad narratives of sustainability in Canadian healthcare reform discourse, and explore what these different sustainability narratives tell us about the character and contours of these often‐fractious debates. We argue that sustainability itself may not be a paradigm shift, as has been suggested, but a plot device that helps to steer the story in a particular direction, ‘black‐boxing’ certain aspects of context and emphasizing others.