6 results
Search Results
2. Factors associated with antiretroviral treatment uptake and adherence: a review. Perspectives from Australia, Canada, and the United Kingdom.
- Author
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Bolsewicz, K., Debattista, J., Vallely, A., Whittaker, A., and Fitzgerald, L.
- Subjects
HIV prevention ,ANTIRETROVIRAL agents ,CINAHL database ,DRUGS ,HIV infections ,MEDICAL information storage & retrieval systems ,MEDICAL care use ,MOTIVATION (Psychology) ,PATIENT compliance ,SYSTEMATIC reviews ,ECONOMICS - Abstract
International focus on reducing onward HIV transmission emphasizes the need for routine HIV testing and early uptake of antiretroviral treatment (ART). Strategic targets have been set for 2020 to achieve the goal of 90% of people infected with HIV diagnosed, 90% of identified cases on treatment, and 90% of persons on treatment virally suppressed (90–90–90). It is vital to understand the complexity of factors influencing a person's treatment decisions over time and the context which may enable better adherence. In this paper we present findings from the review of published and gray literature (2003–2013) on the documented factors associated with treatment initiation and adherence in the general adult population of Australia, Canada, and the UK. A framework developed by Begley, McLaws, Ross, and Gold [2008. Cognitive and behavioural correlates of non-adherence to HIV anti-retroviral therapy: Theoretical and practical insight for clinical psychology and health psychology.Clinical Psychologist, 12(1), 9–17] in Australia was adapted to summarize the findings. A systematic database search using keywords and a set of inclusion criteria yielded 17 studies (Australia = 6; Canada = 8; UK = 3). In addition 11 reports were included in the review. We found that a person's abilities and motivations (intrapersonal factors, reported in 7 studies) to start and continue ART are influenced by a host of interconnected factors spanning relationship (interpersonal, 3 studies) and broader structural (extrapersonal, 15 studies) factors that are situated within social determinants of health. People therefore evaluate various costs and benefits of starting and staying on treatment, in which biomedical concerns play an important yet often subsidiary role. In this review the economic barriers to care were found to be significant and under-reported, highlighting the persistent health inequities in terms of access to services. Our understanding of the context around people's use of ART remains poor. Qualitative social research within HIV-positive communities is urgently needed to capture people's lived experiences and may address some of this deficit in understanding. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
3. “So, is that your ‘relative’ or mine?” A political-ecological critique of census-based area deprivation indices.
- Author
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Fu, Mengzhu, Exeter, Daniel J., and Anderson, Anneka
- Subjects
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POVERTY areas , *AGE distribution , *CENSUS , *DEVELOPMENTAL psychobiology , *RESEARCH methodology , *POVERTY , *SEX discrimination , *SEX distribution , *SOCIAL justice , *SOCIOECONOMIC factors , *HEALTH equity , *HEALTH & social status , *STANDARDS - Abstract
Census-based deprivation indices have been widely used in Aotearoa/New Zealand, Canada and UK to measure area-based socio-economic inequalities. This paper examines the indicators used in census-based area deprivation indices using a political ecology approach. We question whether the current indicators of deprivation derived from census data are meaningful for the all age groups and minority groups in the population, with a particular focus on deprivation indicators used in New Zealand, Canada and the United Kingdom. We comparatively reviewed methodological papers and reports that describe the indicators of deprivation in Aotearoa/New Zealand, Canada and the UK from 1975 to 2014. We consider the relationship between the notion of standards of living and measurements of deprivation and explore how hegemonic cultural constructs are implicit in measures of deprivation that privilege a Eurocentric, ageist and gender normative construction of statistics. We argue for more political ecological analyses to studying the relationship between social inequalities, geographies, health inequities and political economy to transform structures of oppression and inequality. This requires turning the analytical gaze on the wealthy and privileged instead of defaulting into deficit models to account for inequality. Studies of deprivation and inequality would benefit from understanding the processes and operations of power in the (re)production of socio-economic and health inequities to inform holistic strategies for social justice. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
4. Regulating health professional scopes of practice: comparing institutional arrangements and approaches in the US, Canada, Australia and the UK.
- Author
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Leslie, Kathleen, Moore, Jean, Robertson, Chris, Bilton, Douglas, Hirschkorn, Kristine, Langelier, Margaret H., and Bourgeault, Ivy Lynn
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MEDICAL personnel ,PROFESSIONAL practice ,SWOT analysis ,PUBLIC interest ,POLICY analysis - Abstract
Background: Fundamentally, the goal of health professional regulatory regimes is to ensure the highest quality of care to the public. Part of that task is to control what health professionals do, or their scope of practice. Ideally, this involves the application of evidence-based professional standards of practice to the tasks for which health professional have received training. There are different jurisdictional approaches to achieving these goals.Methods: Using a comparative case study approach and similar systems policy analysis design, we present and discuss four different regulatory approaches from the US, Canada, Australia and the UK. For each case, we highlight the jurisdictional differences in how these countries regulate health professional scopes of practice in the interest of the public. Our comparative Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis is based on archival research carried out by the authors wherein we describe the evolution of the institutional arrangements for form of regulatory approach, with specific reference to scope of practice.Results/conclusions: Our comparative examination finds that the different regulatory approaches in these countries have emerged in response to similar challenges. In some cases, 'tasks' or 'activities' are the basis of regulation, whereas in other contexts protected 'titles' are regulated, and in some cases both. From our results and the jurisdiction-specific SWOT analyses, we have conceptualized a synthesized table of leading practices related to regulating scopes of practice mapped to specific regulatory principles. We discuss the implications for how these different approaches achieve positive outcomes for the public, but also for health professionals and the system more broadly in terms of workforce optimization. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
5. Factors impacting HIV testing: a review – perspectives from Australia, Canada, and the UK.
- Author
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Bolsewicz, K., Vallely, A., Debattista, J., Whittaker, A., and Fitzgerald, L.
- Subjects
HIV prevention ,MEDICAL screening ,HIV infection epidemiology ,HEALTH services accessibility ,HEALTH policy - Abstract
With the current global focus on strengthening HIV prevention through greater testing and treatment uptake, it is increasingly salient to identify and address barriers to testing. A review of the published, peer-reviewed literature and national reports from Australia, Canada, and the UK (2003–2013) on barriers to HIV testing was conducted to provide new information relevant to Australia and to complement earlier reviews from Canada and the UK. A systematic database search using keywords and a set of inclusion criteria yielded 36 studies (Australia = 13; Canada = 6; and the UK = 17). In addition 17 unpublished reports were included in the review. Our study uses a novel, comprehensive framework to describe barriers to HIV testing, and thus contributes to moving beyond the traditional patient–provider–system categorization. Within that framework, barriers are categorized as either intrapersonal (reported in 15 studies), interpersonal (21), or extrapersonal (16) and conceptualized within wider sociocultural and structural contexts. People's abilities and motivations to test (intrapersonal factors) are influenced by a host of interconnected factors spanning relationship (interpersonal) and broader socioeconomic, political and cultural (extrapersonal) factors. We suggest that the relative effects of interventions targeting barriers to HIV testing at the intrapersonal and interpersonal levels are limited by the extent to which the social determinants of health are addressed. The framework may also lend itself to thinking about the enabling factors for HIV testing, and future research may investigate the application of that framework for strategizing the most effective response. Future studies should also capture the lived experiences of barriers to HIV testing experienced by patients, especially in populations which are hard to reach based on social and geographic distance. Context-specific studies to evaluate the feasibility and effectiveness of various interventions proposed in the literature to address barriers to HIV testing are needed. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
6. Director education programs in Canada, Australia and the UK: a comparative study.
- Author
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McIntyre, Michael L. and Murphy, Steven A.
- Subjects
RESEARCH & development ,CORPORATE directors ,BOARDS of directors ,TRAINING - Abstract
In this paper, the authors examine the details of the board of director (BOD) education programs currently offered in Canada, the UK and Australia. The authors analyse the program patterns relative to an integrated model of BOD education and present recommendations for change. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
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