Perception Of Need Research Articles

Genital Cosmetic Surgery in Women of Different Generations: A Qualitative Study.

Individuals from different generations are interacting more and more today, and while each generation exists with its own characteristics, this situation causes intergenerational differences in every issue in social life. Considering the characteristics of different generations, it is predicted that individuals' views on genital cosmetic surgery may differ. This study was conducted to examine the views of women of different generations on genital cosmetic surgery and to determine their perspectives on genital cosmetic surgery. The population of the study consists of women from different generations. The sample of the study was formed using typical case sampling from purposive sampling methods. Data saturation was reached by conducting qualitative interviews with 15 women by selecting the snowball sampling method. Data were collected using a semi-structured individual interview form, and data analysis was performed using MAXQDA 2020. The opinions of women of different generations about genital cosmetic surgery were analysed under four themes and 13 categories as "Perception of Beauty", "Perception of Health", "Perception of Society" and "Perception of Need". The opinions of women of different generations about genital cosmetic surgery differ. It is thought that these differences may be caused by factors such as psychosocial, economic, environment, media, technological developments and culture. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Examining Preceptors’ Perceptions of Need Around Facilitating Clinical Immersion Experiences

Context Clinical immersion experiences allow students to gain firsthand, authentic experiences to help them successfully matriculate into the profession. Preceptors supervise athletic training students during these experiences and are critical in the student’s clinical competence development. It is important to understand their needs to help facilitate a successful experience for the student. Objective To explore the needs of preceptors as they facilitate clinical immersion experiences for their athletic training students. Design Qualitative case study. Setting Athletic training practice settings facilitating clinical immersion. Patients or Other Participants Eight preceptors (6 female, 2 male) who met our inclusion criteria participated in our study. Data Collection and Analysis An exploratory, multiple-case study design was completed with preceptors. Results Four major themes emerged regarding preceptor needs for facilitating a clinical immersion experience: onboarding, communication on individual student needs, professional development as an educator, and relying on social support network. Conclusions Preceptors in our study communicated several needs that would better assist them in facilitating an immersive clinical experience for their students. Understanding these needs as a program administrator can better enhance the relationship between the didactic and clinical components of the educational program. Preceptors must also ask for additional information, resources, and support to help serve their needs in facilitating an immersive clinical experience for a student.

Patient and Provider Perceptions of Barriers and Facilitators to Pre-exposure Prophylaxis Access and Adherence in Black and Latinx Young Men Who Have Sex with Men.

In the United States, the use of pre-exposure prophylaxis (PrEP) has led to a substantial decrease in HIV prevalence and incidence. However, some populations, including young men who have sex with men (YMSM) of color, continue to be disproportionately impacted, highlighting the need for tailored interventions addressing barriers to adequate PrEP access. In collaboration with partner clinics, we recruited 19 PrEP clients and 19 PrEP providers (n = 35) to participate in hour-long in-depth interviews. Although client interviews explored personal experiences with stigma, barriers, and motivators to PrEP and information preferences, provider interviews explored providers' perceived stigma in their clinic, perceived barriers and motivators to meeting clients' PrEP needs, and rapport building with clients. Most participants were affiliated with one of the southern partner clinics. Clients and providers noted similar determinants to PrEP access, uptake, and adherence. Both recognized the impact of personal barriers such as routine adjustments and perception of need, as well as institutional barriers such as transportation and financial difficulties. Clients emphasized the role of the client-provider relationship as part of contributing to willingness to disclose information such as HIV status and sexual practices. Providers noted the importance of sexual health and LGBTQ+ topics in their training. Despite limited geographical scope and the sensitive nature of HIV-related topics, this study has several implications. PrEP clinics may benefit from hiring providers who share identities and experiences with YMSM clients of color and operating with a flexible schedule. Medical provider training should include comprehensive sexual health and LGBTQ+ competencies to reduce bias in care.

Forensic Insights: Unmasking Technology-Assisted Child Sexual Abuse Through the Lens of Child Healthcare Workers

COVID-19 infection prevention measures have enhanced risks of abuse for children, especially in terms of high vulnerability to technology. Despite the rise in technology-assisted child sexual abuse (TA-CSA), little research has been conducted on Child Healthcare Workers’ perceptions beyond reporting on young people’s experiences. This novel study aims to understand how Childcare Workers perceive technology-assisted child sexual abuse, risks, impacts, therapeutics, and perceptions of need. Qualitative research methodology was used for the study. Child healthcare workers volunteering to participate in the study were approached by a purposive sampling strategy and interviewed in person. Field notes were taken to record the conversation. Grounded theory approach was used to analyze the results to eliminate bias associated with presumptive knowledge from literature. Participants reported an exponential rise in cases of TA-CSA during the COVID-19 pandemic. Impacts of TA-CSA such as self-blame, fear of offender, and inability to manage emotions were the most common and peculiar aspects of TA-CSA in this population. Though the childcare workers recognized the risks and impacts of TA-CSA, they were unaware of the need for distinct frameworks and therapeutic approaches essential for handling cases of TA-CSA. Complexities in TA-CSA necessitate an algorithm in addressing TA-CSA as a separate entity. Therapy should be focused on the specific impacts of TA-CSA. Further, the observations of the study stipulate the exigent shift in community perspective from blaming the victim to shaming the offender.

Experiences With Outpatient Nutrition Services Among Caregivers of Youth With Type 1 Diabetes.

Many children with type 1 diabetes do not meet nutritional guidelines. Little is known about how caregivers perceive the necessity of registered dietitian (RD) visits or how satisfied they are with nutrition care. This study aimed to evaluate nutrition experiences and perceptions of care among caregivers of children with type 1 diabetes at an academic medical center. We analyzed 159 survey responses. Using multivariable logistic regression, we assessed factors associated with the perception of need for annual nutrition visits, satisfaction with RD care, and encouragement from a nurse or doctor to meet with an RD. Covariates included age (<13 vs. ≥13 years), type 1 diabetes duration (≤3 vs. >3 years), sex, race/ethnicity, and insulin pump and continuous glucose monitoring use. More than half of caregivers (56%) considered annual visits necessary. Shorter type 1 diabetes duration (odds ratio [OR] 1.92, 95% CI 1.02-3.63) was associated with this finding. Less than half (46.5%) reported satisfaction with nutrition care; higher satisfaction was also correlated with shorter type 1 diabetes duration (OR 2.20, 95% CI 1.17-4.15). Although 42% reported meeting with an RD in the past year, less than two-thirds (62%) reported receiving a medical provider recommendation for nutrition care. Leading reasons for not meeting with an RD were "I am knowledgeable in nutrition and do not need to see an [RD]" (41%) and "I had a past visit with an [RD] that was not helpful" (40%). Our findings suggest that satisfaction with and perceived need for nutrition care may wane with longer type 1 diabetes duration. Improved strategies for therapeutic alliance between caregivers and RDs and engagement of families at later stages of type 1 diabetes are needed.

Who helps whom in times of crisis? An investigation of actual donations to two groups of earthquake victims

This pre-registered study assessed actual donations to two groups of victims of the earthquake in Turkey and Syria in February 2023 while considering various theoretically-relevant contextual and personality factors as determinants of donations. In a diverse German online sample (N = 496), most participants (62.9 %) donated something, and only few (24.0 %) were selective in their donations, donating more to one group of victims than to the other. Dispositional honesty-humility added to the prediction of donation behavior beyond contextual factors. Selective donations, however, were largely driven by (contextual) perceptions of need. Overall, our findings provide novel insights into donation behavior and highlight the importance of personality in understanding individual differences in donations.

Rural broadband usage: analysing satisfaction and internet speed

ABSTRACT Rural access to advanced information communications technology (ICT) lags behind urban areas. ICT availability in rural areas at the household level is understudied. Often, data sources test connectivity at one point in time and then aggregate to a larger geographical region (i.e. county level or census block). Thus, this research collects a high-resolution data set in the midwestern United States through two methods: 1) participants connect a device, recording 1800 readings; and 2) participants take a survey about internet satisfaction. These two methods culminate in a unique high-resolution dataset. Using this data, this article explores how much internet throughput a rural household uses compared to how much a satisfied household consumes, while reviewing the perception of need. Exploratory connections are found between throughput speeds, reliability, and surveyed satisfaction, further validating the research methods. This lends a new perspective to rural broadband usage and the criteria used to set broadband standards.

Barriers to college student food access: a scoping review examining policies, systems, and the environment.

College student food insecurity (FI) is a public health concern. Programming and policies to support students have expanded but utilisation is often limited. The aim of this study was to summarise the barriers to accessing college FI programming guided by the social ecological model (SEM) framework. A scoping review of peer-reviewed literature included an electronic search conducted in MEDLINE, ERIC, and PubMed databases, with a secondary search in Google Scholar. Of the 138 articles identified, 18 articles met eligibility criteria and were included. Articles primarily encompassed organisational (17/18) level barriers, followed by individual (15/18), relationship (15/18), community (9/18), and policy (6/18) levels. Individual barriers included seven themes: Knowledge of Process, Awareness, Limited Time or Schedules, Personal Transportation, Internal Stigma, Perception of Need, and Type of Student. Four relationship barriers were identified: External Stigma, Comparing Need, Limited Availability Causes Negative Perceptions, and Staff. Ten barrier themes comprised the organisational level: Application Process, Operational Process, Location, Hours of Operation, Food Quality, Food Quantity, Food Desirability or Variety of Food, Marketing Materials, Awareness of the Program, and COVID-19 Restrictions. Two barrier themes were identified at the community level, Public Transportation and Awareness of SNAP, while one barrier theme, SNAP Eligibility and Process, encompassed the policy level. Higher education stakeholders should seek to overcome these barriers to the use of food programmes as a means to address the issue of college FI. This review offers recommendations to overcome these barriers at each SEM level.

Non-adherence to COPD medications and its association with adverse events: A longitudinal population based cohort study of older adults

ObjectiveTo determine the association between non-adherence to long term chronic obstructive pulmonary disease (COPD) medications and COPD related emergency department (ED) visits and hospitalizations in patients with incident COPD, utilizing time varying measures of adherence as well as accounting for time-varying confounding impacted by prior adherence. Study design and settingWe conducted a population-based retrospective cohort study between 2007–2017 among individuals aged 66 years and older with incident COPD using multiple linked administrative health databases from the province of Ontario, Canada. Adherence to COPD medications was measured using time varying proportion of days covered based on insurance claims for medications dispensed at community pharmacies. The parametric g-formula was used to assess the association between time-varying adherence (in the last 90-days) to COPD medications and risk of COPD related hospitalizations and ED visits while accounting for time varying confounding by COPD severity. ResultsOverall, 60,251 individuals with incident COPD were included; mean age was 76 (SD 7) and 59% were male. Mean adherence over the entire follow-up was 23% (SD 0.3). There were 7248 (12%) COPD related ED visits (2.8 events per 100 person years [PY]) and 9188 (15%) COPD related hospitalizations (3.5 events per 100 PY). Compared to those with 0% 90-day adherence, those with adherence between 1–33% had a 19% decreased risk of COPD related ED visits (adjusted risk ratio[aRR]:0.81, 95% confidence interval [CI]:0.78–0.83), those with adherence between 34%−67% had a 18% decreased risk (aRR: 0.82, 95% CI: 0.77–0.85) while those with 68%−100% 90-day adherence had a 63% increased risk of COPD related ED visits (aRR: 1.63, 95% CI: 1.47–1.78). Nearly identical results were obtained for COPD specific hospitalizations. ConclusionAfter accounting for time varying confounding by COPD severity, the highest time varying 90-days adherence was associated with an increased risk of both COPD related ED visits and hospitalizations compared to the lowest adherence categories. Differences in COPD severity between adherence categories, perception of need for medication management in the higher adherence categories, and potential residual confounding makes it difficult to disentangle the independent effects of adherence from the severity of the condition itself.

Contextual Factors Influencing the Implementation of a Multifaceted Intervention to Improve Teamwork and Quality for Hospitalized Patients: A Multisite Qualitative Comparative Case Study

Many hospitals have begun to implement models that combine interventions to redesign care for medical patients. These models include localization of physicians to specific units, nurse-physician co-leadership, and interprofessional rounds. Understanding contextual factors, the circumstances surrounding an implementation effort that influence its success, is essential to provide guidance to leaders implementing similar models of care. A multisite qualitative comparative case study was conducted with four hospitals in the REdesigning SystEms to Improve Teamwork and Quality for Hospitalized Patients (RESET) study. Researchers conducted observations and semistructured interviews with 40 health care professionals and four implementation mentors. Researchers used inductive qualitative content analysis, reviewed fidelity of implementation trends, and performed cross-case analysis to identify contextual factors and their influence on implementation. Four contextual factors were associated with implementation success: (1) senior hospital leader involvement and organizational support; (2) alignment of RESET with organizational, hospital, and professional group priorities; (3) site leaders' engagement in RESET and relationship with one another; and (4) perceptions of need and intervention benefits among professionals. Implementation was optimal when senior leadership was stable and tangibly involved; organizational, hospital, and group goals were aligned; site leaders were committed and collaborated well; and nurses and physicians perceived a need for and benefits from the interventions. Four interrelated contextual factors are associated with the implementation of combined interventions to redesign care for hospitalized medical patients. Hospital leaders should consider these findings prior to implementing similar interventions and be prepared to address challenges related to these factors during implementation.

Psychological barriers to take-up of healthcare and child support benefits in the Netherlands

We empirically test an integral model for healthcare and child support benefits take-up using a probability sample of the Dutch population ( N = 905). To examine how different psychological factors, in conjunction, explain take-up, we apply model averaging with Akaike’s Information Criterion (AICC). For both types of benefits, people’s perceptions of eligibility best explain take-up. For healthcare benefits, take-up also relates to perceptions of need. Exploratory analyses suggest that for healthcare benefits but not for child support benefits, executive functions, self-efficacy, fear of reclaims, financial stress, and welfare stigma explain perceived eligibility. We find no support for knowledge, support, and administrative burden as explanatory factors in take-up. We discuss the results in relation to the Capability Opportunity Motivation Behaviour (COM-B) model for developing behavioural change interventions.

Safety training in context: technical, cultural and political factors affecting its design, delivery and transfer

Introduction: Safety training is integral to modern safety management systems. However, what is trained in the classroom is not always adopted and applied in the workplace, creating the training transfer problem. Taking an alternative ontological stance, the aims of this study were to conceptualize this problem as one of ‘fit’ between what is trained and the contextual factors in the work environment of the adopting organization. Method: Twelve semi-structured interviews were conducted with experienced health andsafety trainers having diverse backgrounds and experience. Data were thematically coded ‘bottom-up’ to capture reasons for safety training and where consideration of context occurs in the design and delivery of training. Then, the codes were thematically grouped against a pre-existing framework to categorize contextual factors that affect ‘fit’ into technical, cultural, and political factors each operating at different levels of analysis. Results: Safety training occurs to satisfy external stakeholder expectations and meet internal perceptions of need. Consideration of contextual factors can occur both in the design and delivery of training. A range of technical, cultural, and political factors were identified, which can operate at individual, organizational, or supra-organizational levels to influence safety training transfer. Conclusions: The study draws particular attention to the influence of political factors and the impact of supra-organizational factors on the successful transfer of training, areas not consistently considered in safety training design and delivery. Practical Application: The application of the framework adopted in this study provides a useful tool for discriminating between different contextual factors and the level at which they operate. This could enable more effective management of these factors to improve the potential for transfer of safety training from the classroom to the workplace.

Staffing transformation following Patient-Centered Medical Home recognition among Health Resources & Services Administration-funded health centers.

Patient-Centered Medical Home (PCMH) recognition is designed to promote whole-person team-based and integrated care. Our goal was to assess changes in staffing infrastructure that promoted team-based and integrated care delivery before and after PCMH recognition in Health Resources & Services Administration (HRSA)-funded health centers (HCs). We identified changes in staffing 2 years before and 3 years after PCMH recognition using 2010-2019 Uniform Data System data among three cohorts of HCs that received PCMH recognition in 2013 ( n = 346), 2014 ( n = 207), and 2015 ( n = 115). Our outcomes were team-based ratio (full-time equivalent medical and nonmedical providers and staff to one primary care physician) and a multidisciplinary staff ratio (allied medical and nonmedical staff to 1,000 patients). We used mixed-effects Poisson regression models. The earlier cohorts served fewer complex patients and were larger before PCMH recognition. Three years following recognition, the 2013 and 2014 cohorts had significantly larger team-based ratios, and all three cohorts had significantly larger multidisciplinary staff ratios. Cohorts varied, however, in the type of staff that drove this change. Both ratios increased in the longer term. Our study suggests that growth in team-based and multidisciplinary staff ratios in each cohort may have been due to a combination of HCs' perceptions of need for specific services, HRSA funding, and technical assistance opportunities. Further research is needed to understand barriers such as costs of employing a multidisciplinary staff, particularly those that cannot directly bill for services as well as whether such changes lead to practice transformation and improved quality of care.

Comparison of Self-Perception of Esthetics and Orthodontic Treatment Needs among Dental and Non-Dental Students with Assessment by Orthodontist

Objectives: The present study was conducted to compare the self-perception of esthetics and wish for seeking orthodontic treatment among dental and non-dental students. The realistic orthodontic treatment needs were confirmed by expert orthodontist. Methods: A cross-sectional study was conducted among 255 male students (Dental—75, Medical—93 and Pharmacy—87 students). The questionnaire included 20 items covering dental esthetics self-perception (10 questions), self-confidence and psychological impact (5 questions), and the need for seeking orthodontic treatment (5 questions) on a five-point Likert scale. The realistic orthodontic treatment needs were confirmed by photographs using aesthetic component of IOTN and clinical examination for the participants and analysis of jaw models using Dental aesthetic index (DAI). Kruskal-Wallis ANOVA was used to check the significant difference between groups. Results: The overall average esthetic self-perception score for total sample was 3.83. The overall average psychological impact score for the whole sample was 2.67. The total percentage of participants who either agree or strongly agree with the question related to their perception of need for seeking orthodontic treatment was 70%. According to the assessment of orthodontic needs using AC-IOTN, 19.8% required definitive treatment. According to the assessment of orthodontic treatment needs based on DAI, 20.3% and 9.9% needed highly desirable (DAI 31 - 35) and definite need of treatment (DAI ≥ 36) respectively. Conclusion: It can be concluded that there was no difference between the esthetic perception of dental and non-dental students. The self-perception for seeking orthodontic treatment was over-reported by participants compared to real requirement as assessed by orthodontic specialist. Dental esthetics has no psychological impact on academic performance and self-confidence as perceived by study participants.

Religion as a barrier to the use of student loans for higher education: A community‐based participatory study with Somalis living in England

AbstractThe unwillingness of the Somali community to finance higher education has largely gone unnoticed within the academic literature and government policy documents. This study explores the role of religion and the influence of Shari'ah scholars on the use of interest‐bearing student loans within the Somali community. In the absence of any theoretical framework on this topic, we explore the multiple socioeconomic factors that may influence the attitude, perception of need, motivation and action of using student loans for higher education, by proposing the UK Somali Muslims Acceptance of Interest‐bearing Student Loan Model. This is also a community‐based participatory study that actively involved Somali community members in exploring and interpreting the results. This was achieved through regular consultations with the sampled Somali Muslim communities within the UK. Our results contribute to the broader debate on the effect of cultural, religious and social values of marginalised communities on inclusion and widening access policies for higher education. The findings reemphasise that people sharing the same location do not necessarily share the same level of opportunities for higher education because of the intersectionality of race, religion, gender and class. The results also show the complexity of the issue of exclusion and the atheoretical nature of student loans as a financial instrument for improving financial inclusion and widening access to higher education among Somali residents in England.

Social Disparities in Mental Health Service Use Among Children and Youth in Ontario: Evidence From a General, Population-Based Survey.

To examine differences in mental health-related service contacts between immigrant, refugee, racial and ethnic minoritized children and youth, and the extent to which social, and economic characteristics account for group differences. The sample for analyses includes 10,441 children and youth aged 4-17 years participating in the 2014 Ontario Child Health Study. The primary caregiver completed assessments of their child's mental health symptoms, perceptions of need for professional help, mental health-related service contacts, experiences of discrimination and sociodemographic and economic characteristics. Adjusting for mental health symptoms and perceptions of need for professional help, children and youth from immigrant, refugee and racial and ethnic minoritized backgrounds were less likely to have mental health-related service contacts (adjusted odds ratios ranged from 0.54 to 0.79), compared to their non-immigrant peers and those who identified as White. Group differences generally remained the same or widened after adjusting for social and economic characteristics. Large differences in levels of perceived need were evident across non-migrant and migrant children and youth. Lower estimates of mental health-related service contacts among immigrant, refugee and racial and ethnic minoritized children and youth underscore the importance and urgency of addressing barriers to recognition and treatment of mental ill-health among children and youth from minoritized backgrounds.

Perception of Need for Further Refinement in a Clear Aligner Treatment among Orthodontists, Dentists and Laypeople: A Retrospective Study

Clear aligner treatment often requires further refinement to improve the orthodontic treatment outcome. However, the perceptions of treatment outcomes evaluated by orthodontists and dentists are sparse, and laypeople's perceptions have yet to be explored. Here, we explore the perceptions of orthodontists, dentists, and laypeople concerning the treatment outcomes achieved after completing the first sequence of aligners. This cross-sectional study involved 37 orthodontists, 67 dentists, and 93 laypeople. We administered an online questionnaire containing intra-oral photographs of nine completed cases with pre- and post-first sequences of aligners. As a control, we used a digital prediction system for the treatment outcome. Self-perception was reported using a visual analog scale. Both orthodontists and dentists had similar perceptions about treatment outcomes (p = 0.363) but significantly differed from laypeople (p ≤ 0.0001). Both orthodontists and dentists recommended further treatment; orthodontists were more critical than dentists (p ≤ 0.001). Orthodontists were more critical than dentists in their evaluations of the need for further treatments; however, their perceptions of treatment outcomes were similar. Laypeople were more satisfied with the treatment outcomes, were less concerned with occlusion, and were more focused on the aesthetic results of the treatment.

Examining socioeconomic status disparities in facility-based childbirth in Kenya: role of perceived need, accessibility, and quality of care

BackgroundGiving birth in health facilities with skilled birth attendants (SBAs) is one of the key efforts promoted to reduce preventable maternal deaths in sub-Saharan Africa. However, research has revealed large socioeconomic status (SES) disparities in facility-based childbirth. We seek to extend the literature on the factors underlying these SES disparities. Drawing on the Disparities in Skilled Birth Attendance (DiSBA) framework, we examined the contribution of three proximal factors—perceived need, accessibility, and quality of care—that influence the use of SBAs.MethodsWe used data from a survey conducted in Migori County, Kenya in 2016, among women aged 15–49 years who gave birth nine weeks before the survey (N = 1020). The primary outcome is facility-based childbirth. The primary predictors are wealth, measured in quintiles calculated from a wealth index based on principal component analysis of household assets, and highest education level attained. Proposed mediating variables include maternal perceptions of need, accessibility (physical and financial), and quality of care (antenatal services received and experience of care). Logistic regression with mediation analysis was used to investigate the mediating effects.ResultsOverall, 85% of women in the sample gave birth in a health facility. Women in the highest wealth quintile were more likely to give birth in a facility than women in the lowest quintile, controlling for demographic factors (adjusted odds ratio [aOR]: 2.97, 95% CI: 1.69–5.22). College-educated women were five times more likely than women with no formal education or primary education to give birth in a health facility (aOR: 4.96; 95% CI: 1.43–17.3). Women who gave birth in health facilities had higher perceived accessibility and quality of care than those who gave birth at home. The five mediators were estimated to account for between 15% and 48% of the differences in facility births between women in the lowest and higher wealth quintiles.ConclusionOur results confirm SES disparities in facility-based childbirth, with the proximal factors accounting for some of these differences. These proximal factors – particularly perceived accessibility and quality of care – warrant attention due to their relationship with facility-birth overall, and their impact on inequities in this care.

Why College Students Don't Access Resources for Food Insecurity: Stigma and Perceptions of Need

AbstractAttempts to understand college student food insecurity have primarily focused on demographic characteristics associated with higher rates of food insecurity, and have recommended improving awareness of and access to resources such as campus food pantries. We argue in this article that this emphasis on individual‐level factors and efforts can lead to stigma or shame for many of those using pantries and other programs. Our survey and interview data collected from 2016 to 2019 show that many college students see hunger as tied to their individual failures. We find that an individualistic perspective on the experience of student food insecurity neglects the larger institutional and social contexts, including changes to financial aid, college funding options, food assistance policies, and discrimination. We propose an alternative model for understanding the stigma of student food insecurity that connects language and stereotypes to power differentials affecting access beyond the individual, and thus better addresses the root causes of student food insecurity.Intentos de comprender la inseguridad alimentaria de estudiantes universitarios suelen enfocarse en las características demográficas asociadas con incidencias altas de inseguridad alimentaria y han recomendado mejorar la información sobre y el acceso a recursos como las despensas de alimentos universitarias. En este artículo proponemos que este énfasis en factores y esfuerzos a nivel del individuo pueden conducir a que muchos quienes usan despensas y otros programas de asistencia sientan estigma o vergüenza por ello. Los datos que recopilamos entre 2016 y 2019 por medio de encuestas y entrevistas demuestran que muchos estudiantes universitarios consideran que el hambre está ligado a fracasos del individuo mismo. Concluimos que al tomar una perspectiva individualista sobre la experiencia de la inseguridad alimentaria estudiantil se ignoran contextos institucionales y sociales más amplios que afectan al problema, incluyendo los cambios en la ayuda financiera universitaria, las opciones de financiación universitaria, las políticas de asistencia alimentaria, y la discriminación. Proponemos un modelo alternativo para comprender el estigma de la inseguridad alimentaria de los estudiantes que conecta el lenguaje y los estereotipos con las diferencias de poder que afectan el acceso más allá del individuo y, por lo tanto, mejor aborda las causas fundamentales de la inseguridad alimentaria de los estudiantes.

Women’s access to health care for non-communicable diseases in South Africa: A scoping review.

Background: Non-communicable diseases (NCDs) such as obesity, hypertension (HPT), and type II diabetes (T2D) are of increasing concern in South Africa (SA), with women being more at risk. Authors conducted a scoping review to identify and map the evidence available about the barriers of access to obesity, HPT, and T2D care among women in SA. Methods: Arksey and O'Malley's framework for scoping review was used. The search of the literature was completed in the Scopus, Web of Science, and PubMed databases between April and May 2022. Only studies conducted among women in SA were eligible for inclusion. Identified barriers were mapped onto Levesque’s framework of access to health care to determine which points along the chain of accessing NCD health care among women are mostly impacted. Results: Seven articles were included in the review: qualitative (n=2), quantitative (n=2), mixed methods (n=2), and grey literature (n=1). The included studies reported barriers of access to HPT and T2D care only, and no study reported barriers to obesity care. Supply-side barriers included lack of knowledge about available services, physician heavy workloads, medicine stock-outs, limited availability of testing equipment, unaffordable transport costs, travelling longer distances, inefficiently longer waiting times, and delayed referral. Demand-side barriers included women having low self-awareness of NCD status, concerns about confidentiality, perceived discrimination, and poverty. Conclusions: Access to HPT and T2D services is impacted from perception of need to benefitting from care. Articles included identified barriers affecting the availability and accommodation dimension of access to care, suggesting that HPT and T2D care is often unavailable or that women are unable to reach health facilities or service providers. There is need for more and better-quality research about access to NCD health care in SA, especially among women having a disproportionately high burden of obesity, T2D, and HPT.