Equal access to education, as an aspect to serve Mexico vulnerable population, by 2020

Key populations are the future of the African HIV/AIDS pandemic.

Telehealth During COVID-19-Does Everyone Have Equal Access?

Introduction: Globalization and advances in the internet have profoundly transformed social interactions, requiring the creation of new paradigms in communication, including in the field of medicine. In this context, telemedicine has emerged as a crucial tool in the global scenario, characterized by the use of information and communication technologies in the provision of health services, particularly in situations where distance becomes a significant obstacle to adequate care. In this context, the COVID-19 pandemic has intensified the need for and adoption of telemedicine, making it an indispensable alternative for patient care, especially in times of mobility restrictions and overloaded health systems. In Brazil, where the territorial extension presents considerable challenges to access to health, telemedicine has proven to be vital to expand coverage and ensure that the most vulnerable populations can receive adequate care. However, for virtual care to be effective, it is essential that health professionals integrate evidence-based medicine into their practices, ensuring that clinical decisions are based on robust data and adapted to the clinical, social, and economic conditions of each patient. In this way, telemedicine can not only facilitate access but also ensure the quality of care provided in an increasingly digital and interconnected scenario. Objective: To analyze the scientific evidence related to the application of telemedicine, focusing on understanding its effectiveness, benefits, and challenges in health care, especially in scenarios where distance and accessibility are critical factors. Methodology: The study was characterized as qualitative and exploratory in the format of a literature review. For the systematization process of the searches, publications related to the last five years (2019-2024) were considered, and the following databases were used: Scielo, Pubmed, and BVS, using the descriptors: Telemedicine, Information Technology, Health Care, and Digital Health. Results/Discussion: The searches found a total of 848 pieces of evidence, which after going through the screening and evaluation process of abstract titles, the analysis revealed that 35 were suitable for a thorough reading, which resulted in the selection of eight studies as the main results and that were aligned with the proposed objective. Telemedicine, which emerged in the 1960s, evolved as a practice that integrates doctors and patients remotely. In Brazil, the Federal Council of Medicine (CFM) initially limited its use to interactive methodologies for health care, education, and research. However, in 2020, due to the COVID-19 pandemic, the CFM recognized the importance of telemedicine for the continuity of care, marking a significant advance. Studies highlight its benefits, such as reduced consultation time, greater adherence to treatment, and improvements in patients' quality of life, especially in interventions such as digital psychotherapy and teleconsultation. Although telemedicine has overcome geographical and financial barriers, the need for in-person care remains in cases that require more detailed assessments. Conclusion: It is concluded that technology has a profound impact on life and society, offering both benefits and challenges. Responsible use of technology, based on ethical regulations and equal access, is essential to ensure the maintenance of health care. However, technology alone does not solve all problems. Therefore, human collaboration and the implementation of concrete actions in telemedicine are essential to ensure the provision of effective, comprehensive and humanized health care.

Retrospective Review of Care for Black/African American Veterans with Multiple Myeloma at the Orlando VA

The COVID-19 pandemic has caused major catastrophes worldwide. In Indonesia, the pandemic has caused greater barriers for individuals to access mental health services. This article aims to capture the state of public mental health in Indonesia using data from various national surveys. Four main problems were identified: the increase in depression, loneliness, and distress in the general population, disruption in accessing mental health services, mental health problems among vulnerable populations, and the limited scope of available mental health services and facilities in the community. This article provided practical recommendations for the Indonesian government that focuses on preparing a resilient mental healthcare system for future crises, reducing barriers to access mental health services, and expanding the available resources and programs to ensure equal and sustainable access to mental health services in the community.

University of North Carolina at Chapel Hill School of Medicine.

Legislatures are meant to represent the populace but are also racialized institutions capable of perpetuating structural disadvantages against vulnerable populations. It is necessary to periodically test if vulnerable populations are provided with equal access to legislative services. In this manuscript I test for potential ethnic discrimination against Hispanics in US state legislatures. A problem with prior studies is that Hispanicity signals both an ethnic outgroup and non‐citizen stat. I overcome this challenge by comparing migrant Hispanics with migrant whites. I find that Hispanics and whites receive similar constituency service, as measured by reply rate and reply content, but I find that legislators are less likely to acquire information about Hispanic constituents. I advance the existing Hispanic literature by providing a clean comparison between Hispanics and whites with similar nativity backgrounds. I advance the study of discrimination by showcasing best practices for future studies of discrimination.

Vulnerable patient populations include those with chronic diseases, disability, the elderly, minorities and persons with limited health literacy. According to Healthy People 2000, despite recent progress in health care, there is a stagnation or decline in health care outcomes in these vulnerable patient groups. With the world population aging and the number of those over the age of 60 expected to grow to almost 2 billion by 2050 the prevalence of Chronic Disease (CD) will rise. So will the economic cost which currently is substantial and accounts for 46% of the global disease burden. Specifically in the United States, Chronic Diseases (CD’s) will be responsible for 78% of all medical expenses. Unfortunately, the demographic imperatives of an aging society with the concomitant rise in disease burden will coincide with a decreasing provider base (Wooten et al., 2006). This will necessitate the adoption of different patient management models, to ensure cost effective patient monitoring within a continuum of care. Chronic Disease Self Management Programs (CDSMP) based on the Bandura’s self-efficacy theory (Bandura 2004) focuses on teaching patients coping skills to include disease monitoring and understanding, skills to continue with normal living and strategies to improve emotional well being. Based on the Chronic Care Model, optimal care is achieved when a prepared, proactive practice team interacts with an informed, activated patient (Bordenheimer et al.2002). In the new paradigm patients with CDs become their own care givers, with health care providers acting as consultants in a supporting role. The Institutes of Medicine Report “Crossing the Quality Chasm” (1998) advocated continuous healing relationships, customized care with the patient in control, and an information system that flows freely to facilitate evidence based decision making. To achieve this, Healthcare Systems will have to shift from a Provider Centered to a Patient Centered System within the concept of Advanced Patient Centered Medical Homes, where patients are empowered as partners. The question therefore is can Telemedicine (TM) bridge the chasm by empowering patients, improving and supporting equal access, enhancing capacity, improving quality and cost effectiveness, reducing disease burden and supporting decision making, especially in vulnerable patient populations who have the

UNAIDS strategy aligns HIV priorities with development goals

European Union (EU) member states are bound to ensure accessible, good quality healthcare for all of their citizens. In 2018, Bosnia and Herzegovina has been named as a candidate for accession to EU membership as part of the “Strategy for the Western Balkans”. This scoping review identifies healthcare access issues in the country, aiming to inform policy-makers of challenges that may be faced in a possible membership application process and beyond. While the country has seemingly improved citizens’ healthcare access—as measured by the Healthcare Access and Quality Index—various specific problems remain unresolved. The main barrier to equal access appears to lie in the division of the healthcare system between the Federation of Bosnia and Herzegovina, the Republika Srpska, and the Brcko District, which also influences medicine availability and pricing. Although not necessarily systematic, studies further report distance from healthcare providers, alleged widespread corruption, discrimination of minorities and vulnerable populations, as well as vaccination gaps as problems in healthcare access for specific groups. While certainly not easy to realise, this scoping review concludes that possible solutions could include efforts to unify the healthcare and pricing system, and the implementation of the World Health Organization’s Essential Medicines List, as well as investigating and tackling corruption and stigma issues.

Presence, characteristics and equity of access to breast cancer screening programmes in 27 European countries in 2010 and 2014. Results from an international survey

European Union (EU) member states are bound to ensure accessible, good quality healthcare for all of their citizens. In 2018, Bosnia and Herzegovina has been named as a candidate for accession to EU membership as part of the “Strategy for the Western Balkans”. This scoping review identifies healthcare access issues in the country, aiming to inform policy-makers of challenges that may be faced in a possible membership application process and beyond. While the country has seemingly improved citizens’ healthcare access—as measured by the Healthcare Access and Quality Index—various specific problems remain unresolved. The main barrier to equal access appears to lie in the division of the healthcare system between the Federation of Bosnia and Herzegovina, the Republika Srpska, and the Brcko District, which also influences medicine availability and pricing. Although not necessarily systematic, studies further report distance from healthcare providers, alleged widespread corruption, discrimination of minorities and vulnerable populations, as well as vaccination gaps as problems in healthcare access for specific groups. While certainly not easy to realise, this scoping review concludes that possible solutions could include efforts to unify the healthcare and pricing system, and the implementation of the World Health Organization’s Essential Medicines List, as well as investigating and tackling corruption and stigma issues.

BackgroundThis study aims to evaluate healthcare systems and pandemic responses in relation to marginalized and vulnerable groups, identify populations requiring urgent care, and assess the differential impacts on their health during the pandemic.MethodsData were collected by the Asia-Pacific Observatory on Health Systems and Policies (APO)–National University of Singapore and APO–International Health Policy Program consortium members: Korea, Indonesia, Philippines, and Singapore. Data were collected through a combination of semi-structured interviews, policy document reviews, and analysis of secondary data.ResultsOur findings reveal that the pandemic exacerbated existing health disparities, particularly affecting older adults, women, and children. Additionally, the study identified LGBTI individuals, healthcare workers, slum dwellers, and migrant workers as groups that faced particularly severe challenges during the pandemic. LGBTI individuals encountered heightened discrimination and limited access to health services tailored to their needs. Healthcare workers suffered from immense stress and risk due to prolonged exposure to the virus and critical working conditions. Slum dwellers struggled with healthcare access and social distancing due to high population density and inadequate sanitation. Migrant workers were particularly hard hit by high risks of virus transmission and stringent, often discriminatory, isolation measures that compounded their vulnerability. The study highlights the variation in the extent and nature of vulnerabilities, which were influenced by each country’s specific social environment and healthcare infrastructure. It was observed that public health interventions often lacked the specificity required to effectively address the needs of all vulnerable groups, suggesting a gap in policy and implementation.ConclusionsThe study underscores that vulnerabilities vary greatly depending on the social environment and context of each country, affecting the degree and types of vulnerable groups. It is critical that measures to ensure universal health coverage and equal accessibility to healthcare are specifically designed to address the needs of the most vulnerable. Despite commonalities among groups across different societies, these interventions must be adapted to reflect the unique characteristics of each group within their specific social contexts to effectively mitigate the impact of health disparities.

This study compared University of Missouri child and adolescent telepsychiatry services patients’ specific zip codes to child and adolescent psychiatrists’ practice locations to learn if telehealth was an appropriate option for this group of patients. In demographically and geographically diverse state such as Missouri, patients in rural areas may have limited or no access to timely, affordable and quality care. Many large urban health-care institutions have turned to telehealth as a means of providing equal access to care for all population, no matter where they choose to live. The management analyst system Cognos/Analyzer was used as a data source. Patient- and provider-specific zip codes were processed using GeoKettle software, and ArcGIS explorer was used for map visualization. While patients utilizing child and adolescent telepsychiatry services come from various parts of the state, providers are mostly clustered in urban locations along the Interstate 70. This greatly limits access to specialty care for rural and other vulnerable populations. Telehealth provides adequate and timely access to child and adolescent psychiatry services for the youth that may otherwise not be able to get needed care. Barriers such as mental health crisis and access to care for rural population have been more or less successfully addressed by telehealth for several decades now. However, the shortage of specialty physicians adds an additional layer of complexity to this issue. Health-care organizations with informatics tools such as telemedicine need to focus their efforts on maximizing usage to allow more access for the underserved population.

Opportunities to Improve Care of Hepatocellular Carcinoma in Vulnerable Patient Populations