Making a difference: The construction of ethnicity in HIV and STI epidemiological research by the Dutch National Institute for Public Health and the Environment (RIVM)

http://dx.doi.org/10.1016/j.socscimed.2011.03.04

Changes in Physicians’ Practice Using a Cardiologic Tele-expertise network in Mongolia: An Ethnographic Study on Implementation of Technology in Medical Practice

The Luxembourg Government has supported the Mongolian Government in cardiologic care since 2001 through a telemedicine project. The fundamental strategy was to create a centre disseminating knowledge and providing assistance to physicians through a tele-expertise network. To better understand what factors contributed to the successful implementation of the project. This ethnographic study aims to understand how the project has changed doctors’ practice to identify elements that facilitate acceptance of telemedicine.  A qualitative approach based on the central role played by physicians was used. The purpose of this research is to contribute to the development of telemedicine in capitalising on the experience of the Mongolian telemedicine project. We gathered physicians’ insights through participant observation and in-depth interviews of nineteen physicians of the project, added to focus group interviews including nine physicians from the most remote provinces. Our findings show that the technical and social aspects of the project reinforce each other in fostering doctors’ greater autonomy, creating a sense of belonging to a community and promoting ownership of the project, crucial elements for acceptance. The project offers technological support through a tele-expertise network and a dedicated website that help improving professional capacities and participate in increasing physicians’ self-confidence and autonomy. Meanwhile, the technological structure is supported by strong collaboration between  physicians, their participation to the project development and involvement toward new professional activities. It results in structuring a community of cardiologists with a great sense of belonging and ownership that created a social environment for the technology to work

TB STIGMA – MEASUREMENT GUIDANCE

TB is the most deadly infectious disease in the world, and stigma continues to play a significant role in worsening the epidemic. Stigma and discrimination not only stop people from seeking care but also make it more difficult for those on treatment to continue, both of which make the disease more difficult to treat in the long-term and mean those infected are more likely to transmit the disease to those around them. TB Stigma – Measurement Guidance is a manual to help generate enough information about stigma issues to design and monitor and evaluate efforts to reduce TB stigma. It can help in planning TB stigma baseline measurements and monitoring trends to capture the outcomes of TB stigma reduction efforts. This manual is designed for health workers, professional or management staff, people who advocate for those with TB, and all who need to understand and respond to TB stigma

Dark clouds in co-creation, and their silver linings practical challenges we faced in a participatory project in a resource-constrained community in India, and how we overcame (some of) them

BACKGROUND: While any type of field-based research is challenging, building action-oriented, participatory research in resource-constrained settings can be even more so. OBJECTIVE: In this article, we aim to examine and provide insights into some of the practical challenges that were faced during the course of a participatory project based in two non-notified slums in Bangalore, India, aiming to build solutions to indoor air pollution from cooking on traditional cook stoves. METHODS: The article draws upon experiences of the authors as field researchers engaged in a community-based project that adopted an exploratory, iterative design to its planning and implementation, which involved community visits, semi-structured interviews, prioritization workshops, community forums, photo voice activities, chulha-building sessions and cooking trials. RESULTS: The main obstacles to field work were linked to fostering open, continued dialogue with the community, aimed at bridging the gap between the 'scientific' and the 'local' worlds. Language and cultural barriers led to a reliance on interpreters, which affected both the quality of the interaction as well as the relationship between the researchers and the community that was built out of that interaction. The transience in housing and location of members of the community also led to difficulties in following up on incomplete information. Furthermore, facilitating meaningful participation from the people within the context of restricted resources, differing priorities, and socio-cultural diversity was particularly challenging. These were further compounded by the constraints of time and finances brought on by the embeddedness of the project within institutional frameworks and conventional research requirements of a fixed, pre-planned and externally determined focus, timeline, activities and benchmarks for the project. CONCLUSIONS: This article calls for revisiting of scientific conventions and funding prerequisites, in order to create spaces that support flexible, emergent and adaptive field-based research projects which can respond effectively to the needs and priorities of the community

Controlling Access to Sick Leave Programmes: Practices of Physicians in the Netherlands

Policymakers in industrialized countries attempt to contain the costs of sick leave and disability schemes by limiting access to include medically proven cases only. However, a person's incapacity to work cannot be fully deduced by referring to his or her medical condition. It is the question whether using more restrictive eligibility criteria that focus on medical evidence actually reduces the number of benefit recipients and makes access to employee benefit arrangements fairer. This ethnographic study shows that physicians working in Dutch illness certification practices use alternative methods to restrict access to sick leave programmes. Doctors do not control their clients in a restrictive sense of the word. Rather, they exercise control over their clients by inciting them to internalize norms about being active and responsible. While we do not claim that this is good per se, we do contend that this control style may have some advantages over and above more restrictive control mechanisms. Elaborating on policy that supports this alternative notion of control, therefore, seems worthwhile

Post-corona.:Een nieuwe wereld, oude ongelijkheden?

Globalisering van de wereldmarkt heeft welvaart gebracht naar veel landen, maar omdat de meest kwetsbare groepen veel minder hebben kunnen profi teren van de kansen die globalisering biedt, is de kloof tussen arm en rijk intussen verder uitgegroeid. Met de coronacrisis is de mondialisering van de wereldmarkt voorlopig echter sterk ingeperkt. Dat heeft vooral gevolgen voor de meest kwetsbare groepen

Post-corona.: Een nieuwe wereld, oude ongelijkheden?

Globalisering van de wereldmarkt heeft welvaart gebracht naar veel landen, maar omdat de meest kwetsbare groepen veel minder hebben kunnen profi teren van de kansen die globalisering biedt, is de kloof tussen arm en rijk intussen verder uitgegroeid. Met de coronacrisis is de mondialisering van de wereldmarkt voorlopig echter sterk ingeperkt. Dat heeft vooral gevolgen voor de meest kwetsbare groepen