Determinants in the process of seeking help for urinary incontinence in the Chilean health system

Objective: To analyze via the Andersen model what leads women with urinary incontinence (UI) to seek help and remain in the healthcare system. Methods: An interpretative phenomenologic study enrolling women aged 18 years or older who were diagnosed with UI at a tertiary care hospital in Chile between January and March 2016. Data were collected by semi‐structured interview. The categories explored experience with UI and reasons for seeking health care, and included the dimensions of the Andersen model. Results: Ten women were enrolled. Characteristics that eased or hindered healthcare seeking were identified to come from the women (frequency and quantity of symptoms, coping strategies, and beliefs about its causes) and from their environment (reaction of partner, family, or coworkers to her condition). Some were associated with primary care (human and/or technical resources) and some with secondary care (pelvic floor units). Conclusion: The results reflect the complexities of asking for health care for women with UI, especially in a country such as Chile with different healthcare levels. Raising awareness of this complexity and developing an approach that includes all stakeholders (institution, community, and family) is crucial for professionals who want to offer both medical therapy and wellness‐focused healthcare

Stop smoking practitioner consensus on barriers and facilitators to smoking cessation in pregnancy and how to address these: A modified Delphi survey.

Introduction Pregnant women can experience barriers and facilitators towards achieving smoking cessation. We sought consensus from smoking cessation practitioners on how influential pre-identified barriers and facilitators can be on pregnant women's smoking behaviour, and how difficult these might be to manage. Suggestions for techniques that could help overcome the barriers or enhance the facilitators were elicited and consensus sought on the appropriateness for their use in practice. Methods Forty-four practitioners who provided cessation support to pregnant women completed a three-round modified Delphi survey. Round one sought consensus on the ‘influence’ and ‘difficulty’ of the barriers and facilitators, and gathered respondents' suggestions on ways to address these. Rounds two and three sought further consensus on the barriers and facilitators and on ‘appropriateness’ of the respondent-suggested techniques. The techniques were coded for behaviour change techniques (BCTs) content using existing taxonomies. Results Barriers and facilitators considered to be the most important mainly related to the influence of significant others and the women's motivation & self-efficacy. Having a supportive partner was considered the most influential, whereas lack of support from partner was the only barrier that reached consensus as being difficult to manage. Barriers relating to social norms were also considered influential, however these received poor coverage of respondent-suggested techniques. Those considered the easiest to address mainly related to aspects of cessation support, including misconceptions surrounding the use of nicotine replacement therapy (NRT). Barriers and facilitators relating to the women's motivation & self-efficacy, such as the want to protect the baby, were also considered as being particularly easy to address. Fifty of the 54 respondent-suggested techniques reached consensus as being appropriate. Those considered the most appropriate ranged from providing support early, giving correct information on NRT, highlighting risks and benefits and reinforcing motivating beliefs. Thirty-three BCTs were identified from the respondent-suggested techniques. ‘Social support (unspecified)’, ‘Tailor interactions appropriately’ and ‘Problem solving’ were the most frequently coded BCTs. Conclusions Involving partners in quit attempts was advocated. Existing support could be potentially improved by establishing appropriate ways to address barriers relating to pregnant smokers' ‘social norms’. In general, providing consistent and motivating support seemed favourable

Including the religious viewpoints and experiences of Muslim students in an environment that is both plural and secular

This paper sets out the context and some main lines of argument about the education of Muslim children in England, including concern over low attainment, over segregation and violent extremism. Three approaches to inclusion of Muslims in mainstream educational settings are identified. The paper describes and assesses the identity-based approach to inclusion common to many English schools using a distinction between permissive and affirmative stances to analyse practice. It proceeds to argue for an epistemology-based approach that makes room for students’ experiential and theological perspectives on the content of their learning

Awareness of islamic banking products among muslims: The case of Australia

© The Editor(s) (if applicable) and the Author(s) 2016. The concept of interest-free financing was practiced by Arabs prior to the advent of Islam, and was later adopted by Muslims as an acceptable form of trade financing. While the system had been used on a small scale for centuries, its commercial application began in the 1970s.1 Since then Islamic financing has experienced worldwide acceptance, and by early 2003 there were at least 176 Islamic banks around the world, with deposits in excess of $147bn

Breadwinners and Homemakers: Migration and Changing Conjugal Expectations in Rural Bangladesh

The literature on marriage norms and aspirations across societies largely sees the institution as static – a tool for the assertion of masculinities and subordination of women. The changing meanings of marriage and conjugality in the contemporary context of globalisation have received scant attention. Based on research in rural Bangladesh, this article questions the usefulness of notions of autonomy and dependence in understanding conjugal relations and expectations in a context of widespread migration for extended periods, especially to overseas destinations, where mutuality is crucial for social reproduction, though in clearly genderdemarcated domains

Climate-influenced migration in Bangladesh: the need for a policy realignment

Recent research into migration in Bangladesh has highlighted that people migrate for better livelihoods, not necessarily in response to climatic stresses and shocks. If facilitated appropriately, internal and international migration can help build adaptive capacity to future environmental and climatic hazards. In this framing, migration happens in the context of a growing city-centred economy that promotes remittances to villages. However, a textual analysis of current and recent policies concerning climate change, development and poverty alleviation, and disaster management shows that the economic and adaptive roles of internal migration are often not included in policy framing. We argue that if migration works as a positive step towards adaptation, then the key challenge is to align the policies with this new understanding

Contemporary midwifery practice: Art, science or both?

Current midwifery practice is regulated by the Nursing and Midwifery Council (NMC), whose primary role is to safeguard the public through setting standards for education and practice and regulating fitness to practise, conduct and performance through rules and codes (NMC, 2012; 2015a). Practice is informed by evidence-based guidelines developed and implemented by the National Institute for Health and Care Excellence based on hierarchies of evidence, with meta-analyses and systematic reviews being identified as the ‘gold standard’. This positivist epistemological approach as developed by Auguste Comte (1798–1857), with scientific evidence at the top of a knowledge hierarchy, fails to acknowledge the ‘art of midwifery’, where a constructivist paradigm of experiential, intuitive and tacit knowledge is used by reflective practitioners to provide high-quality care. As midwifery pre-registration education is now degree-level, is the essence of midwifery practice being ‘with woman’ providing holistic care under threat, as the drive for a systematic and analytical approach to decision-making gathers momentum

How the field of infectious diseases can leverage digital strategy and social media use during a pandemic

Rapid information dissemination is critical in a world changing rapidly due to global threats. Ubiquitous internet access has created new methods of information dissemination that are rapid, far-reaching, and universally accessible. However, inaccuracies may accompany rapid information dissemination, and rigorous evaluation of primary data through various forms of peer review is crucial. In an era in which high-quality information can save lives, it is critical that infectious diseases specialists are well versed in digital strategy to effectively disseminate information to colleagues and the community and diminish voices spreading misinformation. In this study, we review how social media can be used for rapid dissemination of quality information, benefits and pitfalls of social media use, and general recommendations for developing a digital strategy as an infectious diseases specialist. We will describe how the Infectious Diseases Society of America has leveraged digital strategy and social media and how individuals can amplify these resources to disseminate information, provide clinical knowledge, community guidance, and build their own person brand. We conclude in providing guidance to infectious diseases specialists in aiming to build and preserve public trust, consider their audience and specific goals, and use social media to highlight the value of the field of infectious diseases

Honor-Based Abuse in England and Wales: Who Does What to Whom?

Key findings are presented from an empirical study profiling 1,474 cases of honor-based abuse (HBA) known to police and victim services in England and Wales. Thematic and quantitative (regression) analyses were used to investigate whether and how HBA differed from other forms of domestic abuse and forced marriage. A new typology of HBA is proposed, based principally on the relationship(s) between victim and perpetrator(s). Interpreted within an overarching lens of gender-based violence, it is argued that Type 1 (partner abuse) and Type 3 (partner plus family abuse) are culturally specific forms of domestic abuse, whereas Type 2 (family abuse) is distinct