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Research on inequities, especially in health care access among immigrants in Germany, has always reflected some of the disparities between the resident population and the immigrants. However, little attention is always placed on the potential inequalities regarding health care within the immigrants (Arab immigrants). Across Europe, Germany is known to receive the highest immigrant numbers, especially from the Arabic world. Since 2013, Germany has received at least 400,000 to 1500,000 immigrants from the Arab world. For this reason, this study analyses challenges faced by the Arab immigrants in access to healthcare in Germany and the underutilization of the medical care services by the Arab immigrant community. The methodological angle undertaken in this study considers relevant literatures to the topic in analysis the state of the matter in Germany by comparing findings from the considered literatures from previous research on the same topic as the study herein. Upon carrying out the research, this study found out that apart from poor communication between Arab speakers and native German medical practitioners, unimplemented governing policies, inadequate knowledge of the services, discrimination, lack of data for medical preparedness, and financial problems instigated by the slow integration of...

Background: In November 2011, prisoner healthcare in Scotland became the combined responsibility of a partnership between the Scottish Prison Service and the National Health Service. Very little is known about the experience of male prisoners with regard to their health care while in prison and immediately following release. Aim: Against the backdrop of organisational restructure, the purpose of this study was to investigate the experiences of male prisoners in order that future policy developments can be more grounded in their experience. Methodology: The study was conducted from a phenomenological perspective. Data was gathered from semi-structured interviews with male ex-prisoners in the community. Interviews were audio-recorded and transcribed where consent was given; detailed field notes were made in interviews where consent was not given for audio-recording. Transcripts of the recorded interviews and field notes were analysed using inductive phenomenological analysis. Findings: Twenty-nine ex-prisoners participated in semi-structured interviews. Nine consented to being audio-recorded. Analysis revealed the following themes: 1. The meaning of health. Participants experienced their own health predominantly as a physical phenomenon related to their ability to function physically in the world. Mental ill-health had been experienced and was spoken about in terms of stigma and ensuring/maintaining personal safety. Substance misuse was not seen as a health issue but more as an issue of poor service provision. 2. Access to and use of healthcare provisions in prison and the outside community. Problems were experienced regarding medication and the prescribing practices of doctors. Participants’ experience of accessing healthcare services in prison was of a difficult and frustrating process that was controlled by nurses whose attitudes and use of power were perceived as a major factor in prisoners’ ability to access and use the services available. All participants described professionals' high level of mistrust in them and the issues surrounding their health status as a result of the phenomenon known as the credibility gap. This appeared to impact upon their perceived ability to access health care whilst in prison and the outside community. 3. Difficulties in interagency communication of care. Participants expressed experience of an increasingly bureaucratic process of access to health services characterised by form-filling. This was perceived to disadvantage and discourage prisoners with literacy difficulties. Participants expressed that new complaints procedures were not explained and appeared to be designed in a way to deliberately discourage and delay complaints. Participants expressed that the access arrangements for healthcare appointments were also bureaucratic, slow, and perceived to be designed to discourage them from accessing the healthcare services. 4. Vulnerability and hope. The role of the family and the support that they provide following liberation was stated to be important and helpful in preventing relapse into former health threatening behaviours. Such support was also described as helping to prevent participants from becoming embroiled in a revolving door syndrome of release and reoffending. The important mechanisms were identified as a source of accommodation and a permanent address, which was essential to access a number of healthcare services and benefits. Planned, consistent throughcare and opportunities were identified as helpful, especially those from the third sector. Discussion: This study provides a voice to the participants. Healthcare in prison was largely experienced in terms of physical health; mental health is seemingly experienced as stigmatising. Ex-prisoners experience a communication failure among services. Access to healthcare in prison is experienced as overly bureaucratic. Conclusion: Ex-prisoner participants' experiential accounts raise problematic issues relating to the effectiveness of 2011 policy changes that were intended to ensure equity in health services for prisoners and ensure that they received improved opportunities to benefit from NHS care. The changes have not translated into an improved experience for prisoners during and following their incarceration a renewed commitment to providing equivalency of opportunity in healthcare for prisoners is required.

Canadian doctors have historically been an extremely powerful interest group. While there are many variables that account for their political influence, it is widely accepted that much of their power is due to their control over specialized knowledge. To determine whether or not physicians’ control over knowledge is changing, I examine doctors’ position relative to the state, the public and other health professionals. This research finds that, in all three relationships, physicians’ control over knowledge is weakening. Moreover, organized medicine’s response to these developments has largely been a strategy of co-optation, demonstrating that doctors are aware that these changes often cannot be openly fought. This strategy signals that the medical profession recognizes that some changes in its control over knowledge are bound to occur. This study concludes that these changes could contribute to a ‘critical juncture’ signalling the potential for significant change in the physician-state relationship.

Masters of Science - Msc (Physiotherapy) / People with disabilities face many challenges. Some are made to feel inferior by others because of their physical or mental disabilities. Primary healthcare described by the Alma Ata Declaration as "health for all", is a process of care which encompasses a comprehensive approach to meet the basic healthcare needs of all, including people with disabilities. The main focus of the primary healthcare approach is to put people at the centre of healthcare. Primary healthcare utilises rehabilitation as a service. Rehabilitation services worldwide are set to improve the standard that the United Nations Convention of the Rights of People with Disabilities and National Committee of Rights People with Disabilities aims to achieve. There are however, gaps in the delivery of healthcare services at a primary level, as identified by the Western Cape Department of Health in South Africa. The 2030 healthcare plan was developed to fill the gaps at this level of service. The plan builds on the comprehensive service plan of healthcare 2010 which aimed to strengthen community-based services, primary healthcare and district hospitals. The plan also looks at how the Department of Health will operate using this platform. The framework was established to focus on changes inclusive of threats in the environment such as technological advances and the availability of resources, building on lessons learned in the Comprehensive Service Plan 2010 as well as a reimagined future to improve healthcare services for all. Key stakeholders in the Western Cape aim to improve these health services by providing patientcentred care, moving towards a goal orientated outcome, improving services at a district health level, improvement of equity, affordable health services and establishing premeditated partnerships.

The main goal of my thesis is to characterize the conception of "Health in the framework of social discourse" by the means of data analysis and analysis of supporting documentation of explanatory reports of governmental bills regulating the fields of hygiene, preventive measures and health protection within Czech republic, focused mainly on the field of public healthcare system. Theoretical part attempts to picture the above stated matter in a social context of modern society, to point out the ideological connection of how well-being of an individual is perceived in a social system in terms of its function. The main subject of the analysis will be explanatory report regarding a historical First republic law No. 332/1920 Coll., explanatory notes from the communist era - Law. No. 4/1952 Coll. on hygienic and anti-epidemic care and law no. 20/1966 Coll., on public healthcare. The last analyzed era will be the era after year 1989, which will be represented by explanatory notes regarding law no. 258/2000 Coll., on protection of public health and law no. 372/2011 Coll., on healthcare services. The text analysis is based on Analysing discourse method combined with content quantitative method. Text of this thesis is divided to theoretical part, description of the methodology, historical overview of...

This study examines the legitimation of power and knowledge in the struggle of public health and health care agencies in the Lower Congo region of the Democratic Republic of Congo to vanquish chronic tropical diseases. Of particular interest is the creation of alternative institutions following the collapse of state sponsored structures and supply lines in the 1980s and 1990s, and the process by which such alternative structures are legitimized. A review of legitimation theory suggests that new paradigms are required to assess the nature and efficacy of diverse non-state institutions within a fluid global neo-liberal context. The paper argues that these new or newly adapted post-state institutional arrangements, born in the crisis of state failure, may be effective in the lessening of the disease burden that weighs on the region to the extent that they are able to muster the legitimacy of the populace, the professions, the national society, and the wider international community. I thus hope to shed light on the paradox of persistent tropical diseases — e. g., malaria, sleeping sickness, and schistosomiasis, as well as seasonal grippe, typhoid fever, tuberculosis and HIV/AIDS — as endemic or seasonal scourges, despite their being understood by local specialists, with known treatments and public health measures to control them.

Background: The human secondary sex ratio has been the subject of long-standing medical, environmental and social scientific curiosity and research. A decline in male birth proportion in some industrialised countries is linked to endocrine disruption and is validated by some empirical studies. Increasing parental age and population stress and associated decreases in sex ratio have also been demonstrated. A thorough literature review of 123 relevant and diverse studies provides context for these assessments. Methods: A spatial-temporal investigation of birth sex ratio in Scotland and potential determinants of endocrine disruptor pollution, socio-economic factors including neighbourhood stress, deprivation, smoking, and maternal age, was conducted. This involved review of national and regional sex ratio time trends, and stratified/spatial analysis of such factors, including the use of GIS tools. Secondary data were sourced from Scottish Government web portals including Scottish Neighbourhood Statistics and the Scottish Environmental Protection Agency. Results: Regional differences in sex ratio between 1973 and 2010 are observed which likely lever the national male birth proportion downwards, with the region of poorest air quality from industrial emissions, the Forth Valley, displaying the greatest sex ratio reduction. Further analysis shows significant upwards skewing in sex ratio for the population cohort experiencing the least and 2nd most deprivation. Localised reductions in sex ratio for areas of high modelled endocrine disruptor pollution within the Central Region in Scotland are also displayed. Discussion: Limitations of the analyses include the danger of ecological fallacy in interpreting from area-based measurement and the simplified pollution modelling adopted. Despite this, and given elevated incidence of testicular cancer in Scottish regions mirrors the study’s results, tentative confirmation of the endocrine disruptor hypothesis can be substantiated. Further, elucidation on advanced parental age as a contributory factor to secondary sex ratio change is also given. Recommendations are made with respect to environmental monitoring and health protection, and preventative health strategies in Scotland.

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Införandet av elektorniska patientjournaler har bidragit till flera fördelar men trots det arbetar vårdpersonal fortfarande i hektiska och stressiga miljöer. Därmed har taligenkänning blivit ett allt vanligare arbetssätt kopplat till dokumentation, detta med anledning av att underlätta främst dokumentationsprocesser. Med denna studie kommer möjligheter och utmaningar kopplat till anvädning av taligenkänning att identidieras. Syftet med studien är att inhämta kunskap och skapa en bredare förståelse för anvädning av taligenkänning inom sjukvården. Resultatet av studien har lett till en bredare förståelse för vårdprocessen med taligenkänning inom hälso- och sjukvård, främst kopplat till dokumentation och elektronsika patientjournaler. Studiens bidrag kommer med förhoppning att kunna användas som stöd för använding av taligenkänning inom vården. Studien har utförts med en kvalitativ ansats där möjligheter och utmaningar identidierats, både från litteratur och från vårdpersonal. Detta kring hur väl taligenkänning integrerar och fungerar vårdmottanginar emellan. / Despite the many advantages of implementing electronic patient records, healthcare straff are still working in a hectic and stressful environment. Speech recognition has therefore become a more common way of working with documentation, mostly to facilitate the documentation process. In this study, possibilities and challanges with speech recognition will be identified. The main purpose of the study is to gather knowledge and create a greater understanding for the usage of speech recognition in healthcare. The result of the study has led to a greater understanding for the process of speech recogotion in healthcare, mostly connected to documentation and electronic patient records. The contribution of the study could optimistically be used as support for speech recognition in healthcare. The study was executed with a qualitative approach where possibilities and challenges have been identified from both literature and healthcare staff. This was carried out regaring how well speech recognition integrates and works healthcare clinics between.