Premium Collection Research Articles

Health net-outcome objectives and approaches for spatial planning and development: a scoping review protocol.

The objective of this scoping review is to review the body of knowledge on net gain and no net loss (net-outcome) objectives and approaches applicable to health in spatial planning and development policies and practice. There is an established body of academic and gray literature addressing environmental net-outcome objectives, such as biodiversity net gain, in spatial planning policies and practice. A "health net gain" objective has recently been proposed as a driver for health protection and the realization of health. Such an objective and approach are yet to be scoped and defined. This review will consider sources in the scientific and gray literature that describe health net-outcome objectives that can be implemented in spatial planning and development policies and practice. Source contexts will not be limited to specific countries, geographical areas, or settings. All types of evidence will be considered. This review will follow the JBI methodology for scoping reviews. Databases to be searched include PsycINFO (APA), Embase, HMIC Health Management Information Consortium, MEDLINE (Ovid), Scopus, and selected databases from the ProQuest Social Science Premium Collection. Sources of gray literature to be searched include ProQuest Dissertations and Theses, TRIP Pro, and BASE. No language or date restrictions will be applied. Two independent reviewers will retrieve and review full-text studies and extract data. The results will be presented in tabular or diagrammatic format with a narrative summary. Open Science Framework https://osf.io/4dbcm.

Assessment of the Viability of Community-Based Health Insurance Schemes in the Ziguinchor Department from 2016 to 2018 in the Context of Universal Health Coverage (Senegal)

<i>Introduction</i>: This study examines the viability of community-based health insurance schemes in the Ziguinchor department of Senegal from 2016 to 2018, within the context of universal health coverage. Health insurance schemes have emerged as a promising solution to extend social health protection to informal sector workers and rural populations. However, despite political support, these structures face persistent challenges in terms of enrollment, member retention, and management. The study aims to assess the viability of these schemes, as well as the perceptions of various stakeholders on mutual health insurance. <i>Methodology</i>: The study adopted a mixed approach, combining quantitative and qualitative methods, based on the theoretical framework developed with the support of the International Labor Office (ILO). This framework evaluates the viability of health insurance schemes according to four dimensions: institutional, technical, functional, and financial/economic. A questionnaire with 87 questions was used to collect quantitative data on these aspects from the seven health insurance schemes in the Ziguinchor department. For the qualitative component, focus groups and individual interviews were conducted with various actors, including beneficiaries, non-beneficiaries, community leaders, scheme managers, and healthcare providers. <i>Results</i>: The study's findings reveal a complex situation for the health insurance schemes in the Ziguinchor department. Institutionally, the schemes have a solid foundation with legal status, internal regulations, and affiliation to a departmental union. Technically, membership is voluntary and family-based, with control mechanisms in place, although their effectiveness is limited. Functional viability shows positive signs with a membership growth rate of 20.18%, but the overall penetration rate remains low at 16.99%, and the premium collection rate is very low, averaging 26.78%. The financial situation is particularly of concern: no scheme can meet its short or long-term debts, and the average claims ratio is excessively high at 282%. As for stakeholder perceptions, they are mixed: while the schemes are generally considered beneficial, significant practical difficulties are identified, including lack of information, funding problems, and procedural complexity. <i>Conclusion</i>: The study highlights the complexity of the role of health insurance schemes in the quest for universal health coverage. Despite undeniable strengths, the schemes face considerable challenges in terms of functional and financial viability. Corrective measures are necessary, including strengthening management capacities, innovating premium collection methods, and improving communication. An evolution of the model is also suggested, potentially towards greater integration into a national social protection system or the development of innovative public-private partnerships.

Scoping Review of Microbiota Dysbiosis and Risk of Preeclampsia.

Limited studies have investigated the role of the microbiota in hypertensive disorders of pregnancy (HDP), particularly preeclampsia, which often results in preterm birth. We evaluated 23 studies that explored the relationship between gut, vaginal, oral, or placental microbiotas and HDP. Scopus, ProQuest Health Research Premium Collection, ProQuest Nursing & Allied Health Database, EBSCO, and Ovid were searched for relevant literature. Majority (18) of studies focused on the gut microbiota, and far fewer examined the oral cavity (3), vagina (3), and placenta (1). One study examined the gut, oral, and vaginal microbiotas. The consensus highlights a potential role for microbiota dysbiosis in preeclampsia and HDP. Especially in the third trimester, preeclampsia is associated with gut dysbiosis-deficient in beneficial species of Akkermansia, Bifidobacterium, and Coprococcus but enriched with pathogenic Campylobacterota and Candidatus Saccharibacteria, with low community α-diversity. Similarly, the preeclamptic vaginal and oral microbiotas are enriched with bacterial vaginosis and periodontal disease-associated species, respectively. The trend is also observed in the placenta, which is colonized by gastrointestinal, respiratory tract, and periodontitis-related pathogens. Consequently, a chronic proinflammatory state that adversely impacts placentation is implicated. These observations however require more mechanistic studies to establish the timing of the preceding immune dysfunction and any causality.

SOCIAL CAPITAL ON THE BROILERS BUSINESS PARTNERSHIP SYSTEM

The role of extension workers in assisting farmers to extend insurance has increased and the level of satisfaction felt by farmers has increased. This study aims to determine the assistance of extension workers in the extension of cattle farmer insurance (AUTS) in Central Sinjai District. The determination of the village sample is determined randomly by determining the sample and population that meets certain characteristics as a barrier with a sample size of 83 respondents. The analysis used in this research is descriptive analysis. The results showed that the role of the extension agent had the highest value of 3.759. The AUTS renewal process participants pay a premium of Rp. 40,000 per year which is included in the government subsidy. The instructor acts as a connector in terms of the fee process at the Indonesia Insurance Service (Jasindo) which must be paid according to the applicable policy. This is in accordance with (Agriculture & Farming, 2021), that farmers are accompanied by livestock officers / UPTD / BPP / Veterinarians in filling out registration forms and premium payments in the AUTS registration or renewal process 3.759. While the lowest value in assisting the extension of AUTS participants is the assistance of subsidy identification data, which is 3.228, because the participant's data already exists in the previous data. Based on the results of the study, it can be concluded that the role of the extension agent is mostly in the good category, and the assistance most felt by farmers is the collection of premiums which has the highest value of 3.759.

Predictive Data Analytics in Telecare and Telehealth: Systematic Scoping Review.

Telecare and telehealth are important care-at-home services used to support individuals to live more independently at home. Historically, these technologies have reactively responded to issues. However, there has been a recent drive to make better use of the data from these services to facilitate more proactive and predictive care. This review seeks to explore the ways in which predictive data analytics techniques have been applied in telecare and telehealth in at-home settings. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist was adhered to alongside Arksey and O'Malley's methodological framework. English language papers published in MEDLINE, Embase, and Social Science Premium Collection between 2012 and 2022 were considered and results were screened against inclusion or exclusion criteria. In total, 86 papers were included in this review. The types of analytics featuring in this review can be categorized as anomaly detection (n=21), diagnosis (n=32), prediction (n=22), and activity recognition (n=11). The most common health conditions represented were Parkinson disease (n=12) and cardiovascular conditions (n=11). The main findings include: a lack of use of routinely collected data; a dominance of diagnostic tools; and barriers and opportunities that exist, such as including patient-reported outcomes, for future predictive analytics in telecare and telehealth. All papers in this review were small-scale pilots and, as such, future research should seek to apply these predictive techniques into larger trials. Additionally, further integration of routinely collected care data and patient-reported outcomes into predictive models in telecare and telehealth offer significant opportunities to improve the analytics being performed and should be explored further. Data sets used must be of suitable size and diversity, ensuring that models are generalizable to a wider population and can be appropriately trained, validated, and tested.

Physical Comorbidity and Healthcare Utilization in People with Schizophrenia: a systematic review

Introduction. Schizophrenia is a mental health condition that can lead to significant disability and have a major impact on social and occupational functioning. It tends to decrease life expectancy, which could be attributed to a variety of factors, including poor health habits, barriers to healthcare access, and the stigmatization of mental illness. Objective. The main aim of this systematic review is to examine the physical comorbidity of these patients, and their health service utilization. Method. The protocol has been registered with the PROSPERO database (CRD42020139972) and follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of PubMed/MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO, Cochrane Library, and ProQuest Health Research Premium Collection yielded 317 articles, 57 of which were selected. Results. The mortality rate of people with schizophrenia is often at least twice that of the general population. In addition, these individuals may be susceptible to other physical health conditions that can significantly shorten their lifespan: cardiovascular and respiratory diseases, diabetes mellitus, oncologic diseases, and chronic infections. Complications during hospitalization and prolonged length of stay due to comorbidities may impede their access to essential healthcare. Discussion and conclusion. Enhancing the healthcare system is crucial to providing adequate care for these patients. Adopting positive lifestyle choices, reducing substance dependence, and abstaining from unconventional antipsychotics can bolster their life expectancy. It is therefore crucial to implement intervention strategies while training professionals to detect and manage physical comorbidities associated with this disorder.

Effectiveness of interventions for the prevention or management of workplace violence in student nurses during clinical placement: A systematic review.

To systematically investigate the effectiveness of interventions for managing workplace violence experienced by registered nursing students during clinical placement. A systematic review of experimental studies. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The key search concepts such as "Nursing students", "Education", "workplace violence", "clinical placement" and "clinical study" were inspected to identify relevant articles (Appendix A). Two independent reviewers completed screening, critical appraisal and data extraction. Due to heterogeneity among the included studies, results were synthesized narratively. MEDLINE (Ovid), CINAHL (EBSCOhost), Web of Science Core Collection (Clarivate Analytics), Scopus (Elsevier), Embase (Ovid), Cochrane CENTRAL, ERIC (ProQuest), ProQuest Central and ProQuest Social Science Premium Collection were searched from inception to 27th February 2023. A total of 13 studies were included in this review. The predominant intervention for managing workplace violence experienced by registered nursing students during clinical placements was education. Approaches varied among studies and included didactic teaching, e-learning, role-playing and simulation practice. The included studies showed uncertain improvements in registered nursing students' confidence, coping skills, knowledge, competence and self-efficacy in dealing with workplace violence during clinical placements. Only one study assessed the incidence rate of workplace violence and found that a multi-faceted intervention involving both staff and students decreased the incidence. Given the heterogeneity of educational interventions, the effect of interventions for managing workplace violence during students' clinical placement is uncertain. To address this gap, high-quality, proactive and combined interventions at both institutional and organizational levels are needed.

Russian mutual insurance market: Limitations for development

Aim. To assess the practical significance of the possible implementation of some proposals aimed at the development of the insurance market, based on the analysis of statistical data on the activities of insurance organizations and mutual insurance societies, particularly in the field of insurance of civil liability of notaries.Objectives. With the help of statistical data on the activity of insurance organizations and mutual insurance societies to identify the practical significance of the initiative and its impact on the development of mutual insurers in the insurance industry.Methods. The present study is built on the basis of empirical methods such as observation, comparison, generalization, induction, deduction.Results. The authors analyzed the activity of insurance companies in 2023 in the aspect of insurance organizations and mutual insurance societies, including the impact and significance of the type of insurance of civil liability of notaries on the insurance industry. Taking into account the actually full coverage of notaries by insurance services required by law, there are no problems in the conclusion and execution of these insurance contracts, according to the author’s position. The presence of an insignificant number of insurance organizations in this segment and small volumes of premiums in relation to the total premium collections indicate a low interest of insurers in this type of insurance. Today the market of compulsory insurance of notaries is actually covered and closed for new players. The authors believe that admission of mutual insurers to this segment will not practically lead to the development of mutual insurance and improvement of the insurance market as a whole.Conclusions. Despite the tasks set by supervisory and regulatory authorities to strengthen and develop the insurance market, the initiatives put forward to modernize the mutual insurance market are noteworthy and are certainly important, timely, but insufficient for the realization of the set tasks. The authors conclude that the admission of mutual insurers only to the market of notaries’ liability insurance will not be a significant stimulus for the development of mutual insurance and improvement of the Russian insurance market.

What about Insurance Law Principles? A Comment on the South African Case of African Unity Life Limited v Prosper Funeral Solutions Case No 2021/55922

This article discusses the legal implications of an insurance net premium. A net premium refers not only to a single premium but also to premiums in the aggregate, commonly referred to as a loss ratio calculation. This calculation is relevant to a specific agent of an insurance company, namely a binder holder, the equivalent of which as regards Lloyd’s of London is a cover holder. A binder holder is a South African approach to a cover holder and acts as an insurance company without an insurance company licence in order to, for example, draft policy wordings, and accept or reject claims. The article discusses an instance where the court did not consider the importance of a binder holder and a net premium, nor the importance of a bordereau and how it related to the business activities of Prosper Funeral Solutions. Keywords: cover holder; binder holder; net premium; loss ratio; acknowledgment of debt; bordereau; premium collection company.

Sustainable employability in supported employment and Individual Placement and Support interventions in the context of the characteristics of work and perspectives of the employers: A scoping review

BACKGROUND: In Supported Employment (SE) and Individual Placement and Support (IPS) research, less attention has been paid to employers’ interests and the quality and opportunities of jobs or the work itself for sustainable working careers. OBJECTIVE: To explore what is known about sustainable employability in SE and IPS interventions in the context of the characteristics of work and perspectives of employers. METHODS: A systematic literature search was conducted in the Medline, Scopus, PsycINFO, CINAHL, and Social Science Premium Collection (ProQuest) databases. The scoping review process was carried out in accordance with the methodological guidelines. The analysis included numerical summary, qualitative content, and thematic analysis processes. RESULTS: From the total of 2,729 articles, 20 studies were included. The majority of the jobs were entry-level, part-time and on fixed-term basis. There were only few descriptions of interaction at work. From the themes arising from the reviewed studies, “Productivity in the job performance”, “Making a job-person match” and “Workplaces strategies for integrating work, recovery and wellness” contained the most data. CONCLUSION: Research from the point of view of the employers and other workplace actors is scarce. More research is needed also about interactions at work and the meaningfulness of work for people with disabilities.

Barriers to Enrollment of National Health Insurance Scheme in Uttargaya Rural Municipality, Rasuwa

The Social Health Security Program (SHSP) is a social protection program of the Government of Nepal that aims to enable all citizens to access quality and effective healthcare services without any financial burden. A cross-sectional household-based and quantitative in-nature study was conducted in Rasuwa district. This study's population was residents of Uttargaya rural municipality wards no 4 and 5. How different factors are related to SHI enrolment. Ethnicity (p=<0.001), religion (p=<0.001), IWI grade (p=0.010), know about health insurance (p=<0.001), the behavior of service providers (p=<0.001), neighbors enrollment (p=<0.001), discussed SHI with neighbors (p=0.001), and family members agreed to enroll (p=0.002) were significantly associated with enrollment in SHI whereas others factors did not show any significant association with enrollment in social health insurance. This study found that enrollment was significantly associated with different independent variables. Poor knowledge of SHI, unfriendly behaviors of service providers, lack of trust, and unaffordability of premium costs were identified as barriers. Furthermore, Inappropriate timing of premium collection, limited services point, feeling that enrollment was not necessary, long queue, inadequate number of enrollment assistant and mandatory refer card were also reasons for not enrolling in SHI.

The role of accounting information systems characteristics in improving the quality of insurance services An applied study for the National Insurance Company

Our modern world is experiencing rapid development at various levels of information and social systems, and it is natural for this development to be reflected in people and organizations. This development was in the information system and the field of its application. The characteristics of accounting information systems are a fundamental goal in the success or failure of the organization, because this information is used to support and coordinate administrative operations. In addition to using it as a tool for coordination and communication within the organization and its external environment on the other hand. It is considered one of the most important information that the organization needs, and the accounting information system used within the insurance company is specific to it and is compatible with the nature of its work. This is because it is used to process the collection of insurance premiums in addition to paying compensation. The accounting information system collects, classifies and communicates information to the company's management. Therefore, the use of accounting information shows us the financial reality of the insurance company because it depends on the collection of premiums and compensation.

Insurance Based on Waqf and Blockchain Technology: A Strong Social Impact & Efficiency

We surveyed to measure the satisfaction of policyholders in Morocco, and the results clearly show that the majority of customers do not appreciate the current services. They suffer from the ambiguity of contracts, and delays in reimbursement and do not feel the real impact of insurance in society. To solve this problem, we propose an innovative insurance based on blockchain and waqf. We suggest in this paper, to use smart contracts to create an efficient and automatic process in the collection of premiums and reimbursement of policyholders. The goal of this paper is to build insurance that reflects the true meaning of solidarity through Waqf while integrating transparency and speed through Fintech. This insurance model is supposed to be resilient in times of crisis, have a strong social impact, and be attractive to customers. Many advantages of the proposed model are discussed in the paper. In addition, the suggested insurance model will be represented through simulations on the NetLogo platform. We carry out the analysis in normal times and evaluate the behavior of policyholders in choosing a specific type of insurance, depending on some decision-making tools. We also analyze the impact of insurance during a time of crisis, as a particular example, the crisis experienced during the coronavirus pandemic. The simulations aim to evaluate the model in different situations and prove its efficiency.

Factors that influence the implementation of innovation in aged care: a scoping review.

The objective of this scoping review is to identify factors that influence the implementation of innovation in aged care. Aged care is a dynamic sector experiencing rapid change. Implementation of innovations in aged care has received relatively little research attention compared to health care. This review included studies of any design, that examined the implementation of innovations in aged care settings. Searches were conducted in MEDLINE, CINAHL, AgeLine, and ProQuest Social Sciences Premium Collection for studies published between January 1, 2012 and December 31, 2022. The titles and abstracts of retrieved citations were screened by two independent reviewers. Full-text articles were screened by one reviewer to determine inclusion. Data were extracted in NVivo using a tool developed by the research team. Factors that influenced implementation were inductively coded, interpreted, and grouped into categories in a series of workshops. Of the 2530 studies that were screened, 193 were included. Of the included papers, the majority (74%) related to residential aged care, 28% used an implementation theory or framework, and 15% involved consumers. Five key categories of factors influencing implementation were identified: organizational context including resourcing and culture; people's attitudes and capabilities; relationships between people; the intervention and its appropriateness; and implementation actions such as stakeholder engagement and implementation strategies. Our findings can be used to develop practical resources to support implementation efforts, and highlight the importance of resourcing for successful implementation. Attention to community-based aged care, and greater engagement with theory and community is needed to promote research rigor, relevance and applicability.

(Self-) Reflection / Reflexivity in Sensitive, Qualitative Research: A Scoping Review

This scoping review offers insight into researcher well-being when working with sensitive and traumatic topics in a qualitative research context. The study identified existing empirical research concerning researcher well-being and mental health. The databases included SSCI, ASSIA < IBISS, Scopus, Social Policy and Practice, PsycInfo, Social Science Database/Social Science Premium Collection (Proquest), and Open Grey. An international search was conducted, with no time constraints on publication dates to gather as wide a selection as possible. 55 papers met the criteria. We found that the terminology used within the papers was not consistent which necessitated grouping the (self-) reflection/reflexive practices researchers used and categorizing them under the umbrella term SRR practices. The research questions were: 1. Which disciplines or fields are conducting SRR practices on sensitive topics? 2. What SRR practices do researchers employ in the context of sensitive research? 3. What were the self-reported outcomes from using SRR practices as a tool of researchers working on sensitive research? A key finding of the scoping review is that many researchers who work on sensitive topics feel unprepared and receive little or no training or support for SRR practices. This poses particular challenges for early career researchers. We also identified that qualitative researchers have developed a range of SRR practices to manage the emotional impact of their sensitive research work. Many authors of the scoped papers stress the importance of peer-support as well as formal and informal debriefing meetings. Another key SRR practice discussed by many researchers is reflexive journaling. Our scoping review suggests that if it is combined with other activities, self-reflexive journaling can be an excellent way to acknowledge and assess the emotional impact of sensitive research.

Arts Premium Collection

ProQuest’s Arts Premium Collection database provides access to three cross-searchable databases across thousands of journals in specialized subject areas of the arts. The primary audience of this resource comprises academic scholars and students. Access to these resources is provided by the standardized search bar layout, which is consistent across ProQuest products. A robust Advanced Search tool allows users to construct Boolean searches, apply facets, and recombine searches to efficiently access the available resources. All search results have a Details display, which provides hyperlinked metadata to help users expand their discovery. Full text and PDFs are provided, and real-time translation is available for full-text resources. Each item also has suggested resources and citation counts/bibliography for works cited in other ProQuest collections.

Interventions to prevent or manage workplace violence against student nurses during clinical placement: a systematic review protocol.

The objective of this review is to investigate the effectiveness of workplace violence management or prevention interventions, including strategies, protocols, and policies, to address violence against, and provide support to, registered nursing students (RNS) following incidents of violence during clinical placement. Workplace violence is a global issue that affects victims' physical and mental health. RNS are especially vulnerable to workplace violence because of their limited work experience and confidence. These students often feel shocked and unprepared when experiencing workplace violence due to limited education and support provided by educational institutions or clinical sites. Workplace violence can lead to anxiety, decreased confidence, and professional attrition. There is a need to systematically synthesize the evidence on workplace violence management and prevention to support nursing students during clinical placement. The review will consider studies assessing the effectiveness of interventions to address workplace violence or improve support for RNS. Studies that report on educational interventions or pre-clinical placement strategies and measure the preparedness of students will also be considered. Study designs will be limited to quantitative methods that evaluate intervention effectiveness. Databases to be searched include MEDLINE (Ovid), CINAHL (EBSCOhost), Web of Science Core Collection, Scopus, Embase (Ovid), Cochrane Central, ERIC (ProQuest), ProQuest Central, ProQuest Social Science Premium Collection, and ProQuest Dissertations and Theses Global. Two independent reviewers will screen, review, appraise, and extract data from eligible articles. For data synthesis, studies will be pooled using JBI SUMARI. The GRADE approach for grading the certainty of evidence will be followed and a Summary of Findings will be created. PROSPERO CRD42022377318.

Salivary and gingival crevicular fluid biomarkers of periodontal health and/or obesity among children and adolescents: A systematic review and meta-analysis

ObjectivesTo investigate the association of salivary and gingival crevicular fluid (GCF) biomarkers with periodontal status and obesity in children and adolescents. Data/sourcesA literature search up to July 2023 was conducted through PubMed, Web of Science, Embase, ProQuest Medical Database, ProQuest SciTech Premium Collection, and the Cochrane Library. Observational studies comparing salivary and GCF biomarkers in children and adolescents with compromised periodontal status and/or obesity were included for data extraction. A meta-analysis was performed to estimate the overall standardised mean difference. Study selectionFifteen observational studies met the inclusion criteria and were included in this systematic review. Meta-analysis was only applicable in synthesising the dyadic relationship between GCF biomarkers and obesity. The results demonstrated that children and adolescents with obesity had significantly higher GCF levels of tumour necrosis factor-alpha (SMD:0.56; 95% CI:0.07, 1.04), adiponectin (SMD:0.33; 95% CI:0.06, 0.60), leptin (SMD:0.52; 95% CI:0.15, 0.90), and interleukin-1 beta (SMD:0.71; 95% CI:0.44, 0.99) than those with normal weight. ConclusionTo date, no study has well addressed the triadic association between salivary or GCF biomarkers, periodontal status, and obesity among children and adolescents. Further in-depth, high-quality studies are required to investigate these associations. Clinical significancePeriodontal disease and obesity are growing public health crises worldwide. Their relationship has been intensively studied. Investigating the salivary or GCF biomarkers alterations could help better understand the relationship between periodontal disease and obesity, which would assist in tailoring future oral health promotion programs.

Precision cancer medicine and the doctor-patient relationship: a systematic review and narrative synthesis

BackgroundThe implementation of precision medicine is likely to have a huge impact on clinical cancer care, while the doctor-patient relationship is a crucial aspect of cancer care that needs to be preserved. This systematic review aimed to map out perceptions and concerns regarding how the implementation of precision medicine will impact the doctor-patient relationship in cancer care so that threats against the doctor-patient relationship can be addressed.MethodsElectronic databases (Pubmed, Scopus, Web of Science, Social Science Premium Collection) were searched for articles published from January 2010 to December 2021, including qualitative, quantitative, and theoretical methods. Two reviewers completed title and abstract screening, full-text screening, and data extraction. Findings were summarized and explained using narrative synthesis.ResultsFour themes were generated from the included articles (n = 35). Providing information addresses issues of information transmission and needs, and of complex concepts such as genetics and uncertainty. Making decisions in a trustful relationship addresses opacity issues, the role of trust, and and physicians’ attitude towards the role of precision medicine tools in decision-making. Managing negative reactions of non-eligible patients addresses patients’ unmet expectations of precision medicine. Conflicting roles in the blurry line between clinic and research addresses issues stemming from physicians’ double role as doctors and researchers.ConclusionsMany findings have previously been addressed in doctor-patient communication and clinical genetics. However, precision medicine adds complexity to these fields and further emphasizes the importance of clear communication on specific themes like the distinction between genomic and gene expression and patients’ expectations about access, eligibility, effectiveness, and side effects of targeted therapies.

Health insurance uptake, poverty and financial inclusion in the Democratic Republic of Congo

AbstractThis study estimates the prevalence of health insurance coverage and associated socioeconomic factors in the Democratic Republic of Congo (DRC). Using the nationally representative household survey of the 2017/2018 DRC Multiple Indicator Cluster Survey (MICS), we applied weighted logistic regression models to identify regions and subgroups with low health insurance coverage. The study's findings revealed a low insurance coverage of less than 5%, with significant disparities across provinces and socioeconomic status. Additionally, three factors were strongly associated with the low health insurance coverage rates: education, wealth, and financial inclusion proxied by bank account ownership. Consequently, we recommend that the government, the private sector, and donors prioritize programs targeting provinces with less coverage and individuals without formal education to increase health insurance coverage. This study encourages the government to establish national programs to improve financial inclusion, which could positively impact poverty reduction and health insurance coverage. We also propose that the government initiates pilot projects for premium exemptions and through subsidies for vulnerable populations in the short term, and ensure formal employment for the majority of the population in the long term to facilitate the proper collection of premiums for individuals. Overall, this study contributes to the literature on health insurance in the DRC and sub‐Saharan Africa by identifying the socioeconomic factors that explain the prevalence of health insurance coverage. The findings of this study have important policy implications for the government, the private sector, and donors to promote health insurance coverage and achieve universal health coverage.