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Ciencia & Saude Coletiva Apr 2024The present theoretical essay is based on six reports concerning same-sex couples and gay and lesbian people in order to interconnect homoparenting and the adoption of...
The present theoretical essay is based on six reports concerning same-sex couples and gay and lesbian people in order to interconnect homoparenting and the adoption of children with disabilities, through the lenses of human and social sciences in public health. The reports were interpreted in light of studies on same-sex adoption and the adoption of children with disabilities. Feminist approaches related to care and disability were also included in the interpretative perspective, operating as expressive webs of grammars of ableism. It was found that media approaches endorse the right to family formation and the adoption of children with disabilities by homoparental families, but with little critical depth on the category of disability and without highlighting support for the adoption of all adoptee profiles. Moreover, the intersections between homophobia and ableism increase discriminatory and oppressive logics, with the union of social groups considered to be "undesirable" representing a strategy of governmentality that reveals the complexity of grammars of ableism, applied to the sexual and reproductive rights of LGBTQIA+ adopters and to the fundamental rights of children and adolescents with disabilities who are available for adoption.
Topics: Humans; Adoption; Child; Disabled Children; Female; Male; Adolescent; Sexual and Gender Minorities; Homophobia; Human Rights; Feminism
PubMed: 38655973
DOI: 10.1590/1413-81232024294.19772023 -
Animals : An Open Access Journal From... Jun 2021Dog shelters provide a valuable service by housing homeless dogs and seeking subsequent adoption for these dogs. Few studies have aimed to monitor the behavior of...
Dog shelters provide a valuable service by housing homeless dogs and seeking subsequent adoption for these dogs. Few studies have aimed to monitor the behavior of adopted dogs when adoption is successful. The aim of this study was to detect what behavioral modifications, based on their personality, occurred in dogs after their adoption. The personality of 34 healthy dogs was evaluated in the pre-adoption phase by means of a Principal Component Analysis (PCA) of their behavioral patterns. In the post-adoption phase, we analyzed the behavior of the same dogs, completing a questionnaire with their owners. Pre- and post-adoption data were standardized and a PCA was run on the differences between these variables. A k-means cluster analysis was run on the six components, obtaining three groups of dogs: for groups one and two, changes in behavior after adoption seemed to be influenced by dog personality: bolder dogs (1st group) became more active, excitable and playful, showed increased aggressive behavior towards humans, and decreased anxious and submissive behavior towards dogs and humans; shyer dogs (2nd group) went in the opposite direction, displaying increased aggressive behavior. For the 3rd group, personality was not predictive of behavior changes. All the dog adoptions in this study were successful.
PubMed: 34207105
DOI: 10.3390/ani11061816 -
JMIR Formative Research Dec 2022Interest in and funding for digital health interventions have rapidly grown in recent years. Despite the increasing familiarity with mobile health from regulatory...
BACKGROUND
Interest in and funding for digital health interventions have rapidly grown in recent years. Despite the increasing familiarity with mobile health from regulatory bodies, providers, and patients, overarching research on digital health adoption has been primarily limited to morbidity-specific and non-US samples. Consequently, there is a limited understanding of what personal factors hold statistically significant relationships with digital health uptake. Moreover, this limits digital health communities' knowledge of equity along digital health use patterns.
OBJECTIVE
This study aims to identify the social determinants of digital health tool adoption in Georgia.
METHODS
Web-based survey respondents in Georgia 18 years or older were recruited from mTurk to answer primarily closed-ended questions within the following domains: participant demographics and health consumption background, telehealth, digital health education, prescription management tools, digital mental health services, and doctor finder tools. Participants spent around 15 to 20 minutes on a survey to provide demographic and personal health care consumption data. This data was analyzed with multivariate linear and logistic regressions to identify which of these determinants, if any, held statistically significant relationships with the total number of digital health tool categories adopted and which of these determinants had absolute relationships with specific categories.
RESULTS
A total of 362 respondents completed the survey. Private insurance, residence in an urban area, having a primary care provider, fewer urgent emergency room (ER) visits, more ER visits leading to inpatient stays, and chronic condition presence were significantly associated with the number of digital health tool categories adopted. The separate logistic regressions exhibited substantial variability, with 3.5 statistically significant predictors per model, on average. Age, federal poverty level, number of primary care provider visits in the past 12 months, number of nonurgent ER visits in the past 12 months, number of urgent ER visits in the past 12 months, number of ER visits leading to inpatient stays in the past 12 months, race, gender, ethnicity, insurance, education, residential area, access to the internet, difficulty accessing health care, usual source of care, status of primary care provider, and status of chronic condition all had at least one statistically significant relationship with the use of a specific digital health category.
CONCLUSIONS
The results demonstrate that persons who are socioeconomically disadvantaged may not adopt digital health tools at disproportionately higher rates. Instead, digital health tools may be adopted along social determinants of health, providing strong evidence for the digital health divide. The variability of digital health adoption necessitates investing in and building a common framework to increase mobile health access. With a common framework and a paradigm shift in the design, evaluation, and implementation strategies around digital health, disparities can be further mitigated and addressed. This likely will begin with a coordinated effort to determine barriers to adopting digital health solutions.
PubMed: 36472905
DOI: 10.2196/39647 -
Heliyon Dec 2023The penetration of digital technologies to enhance market participation by farmers, and intensify farmers' access to support services such as finance, farm inputs, and...
The penetration of digital technologies to enhance market participation by farmers, and intensify farmers' access to support services such as finance, farm inputs, and agricultural production information is on the rise in developing countries. However, the drivers and intensity of the adoption of these technologies by Ghanaian farmers have received little attention in policy and academic circles. This study analyzed the factors that drive the adoption and intensity of adoption of digital agricultural solutions by smallholder farmers in the Bono East Region of Ghana. The study used a survey questionnaire to collect data from 1199 randomly selected smallholder farmers in 2023. The multivariate probit model and the Heckpoisson regression model were used to analyze the drivers of different digital agricultural solutions and the intensity of adoption of these solutions, respectively. The results show that there is a joint demand for technologies that enhance access to extension services and those that accelerate access to inputs. Market-oriented solutions and agricultural extension solutions exhibited a complementary relationship. In addition to selected socio-demographic factors, the study found that membership in farmer-based organizations, access to credit, and participation in agronomic training increased farmers' propensity to adopt different digital agricultural solutions and increased the number of solutions adopted by farmers. Receiving visits from extension officers reduced the likelihood and intensity of adopting digital agricultural solutions. The results suggest that government and development partners should enhance access to credit and promote capacity development programmes among farmers. This will capacitate them to adopt digital agricultural solutions.
PubMed: 38125414
DOI: 10.1016/j.heliyon.2023.e23023 -
Nutrients Jan 2021Since 1955, international adoption has been a way of finding homes for children who have been orphaned or abandoned. We aimed to describe the nutritional status of... (Review)
Review
Since 1955, international adoption has been a way of finding homes for children who have been orphaned or abandoned. We aimed to describe the nutritional status of individuals adopted internationally and their long-term nutritional and health outcomes. We searched four databases for articles published from January 1995 to June 2020, which included information on anthropometric or micronutrient status of children adopted internationally (CAI). Mean Z-scores on arrival to adoptive country ranged from -2.04 to -0.31 for weight for age; -0.94 to 0.39 for weight for height; -0.7 to 0 for body mass index; -1.89 to -0.03 for height for age; -1.43 to 0.80 for head circumference for age. Older children, those adopted from institutionalized care or with underlying disability, were more likely to be malnourished. Though long-term data was scarce, mean Z-scores post-adoption ranged from -0.59 to 0.53 for weight for age; -0.31 to 1.04 for weight for height; 0.39 to 1.04 for body mass index; -1.09 to 0.58 for height for age; -0.06 to 1.23 for head circumference for age. We conclude that though CAI are at high risk of malnutrition at baseline, marked catch-up growth is possible, including for those older than two years of age on arrival. This has implications not only for CAI but for the wider population of malnourished children worldwide. Research on how to optimize catch-up growth is a priority.
Topics: Adolescent; Adoption; Age Factors; Body Constitution; Child; Child Development; Child Nutrition Disorders; Child Nutritional Physiological Phenomena; Child, Adopted; Child, Preschool; Databases as Topic; Female; Humans; Infant; Internationality; Male; Nutritional Status; Time Factors
PubMed: 33467102
DOI: 10.3390/nu13010245 -
Animals : An Open Access Journal From... Nov 2019Some domestic dogs aggressively guard resources. Canine resource guarding impacts public health through dog bites and affects dog welfare through adoption and euthanasia...
Some domestic dogs aggressively guard resources. Canine resource guarding impacts public health through dog bites and affects dog welfare through adoption and euthanasia policies at animal shelters. However, little is known about the demographic characteristics and adoption success of dogs assessed as resource guarders during shelter behavioral evaluations. I reviewed nearly five years of records from a New York (NY) SPCA and categorized 1016 dogs by sex; age; size; reproductive status; and resource guarding. I then examined how these characteristics influenced the returns of dogs by adopters. The prevalence of resource guarding in this shelter dog population was 15%. Resource guarding was more common in adult and senior dogs than in juvenile dogs; and it was more common in small and large dogs than medium-sized dogs. Spayed females were more likely than intact females to guard food; neutered males and intact males did not differ in their likelihood of food guarding. Most dogs identified as resource guarders showed mild to moderate guarding. Severe guarders were more likely to be returned by adopters; although almost all were eventually re-adopted and not returned to the shelter. Data presented here provide the most comprehensive description of resource guarders in a shelter dog population and show the successful re-homing of most.
PubMed: 31744263
DOI: 10.3390/ani9110982 -
BMJ Open Jan 2022To identify the key individual-level (demographics, attitudes, mobility) and contextual (COVID-19 case numbers, tiers of mobility restrictions, urban districts)...
OBJECTIVE
To identify the key individual-level (demographics, attitudes, mobility) and contextual (COVID-19 case numbers, tiers of mobility restrictions, urban districts) determinants of adopting the NHS COVID-19 contact tracing app and continued use overtime.
DESIGN AND SETTING
A three-wave panel survey conducted in England in July 2020 (background survey), November 2020 (first measure of app adoption) and March 2021 (continued use of app and new adopters) linked with official data.
PARTICIPANTS
N=2500 adults living in England, representative of England's population in terms of regional distribution, age and gender (2011 census).
PRIMARY OUTCOME
Repeated measures of self-reported app usage.
ANALYTICAL APPROACH
Multilevel logistic regression linking a range of individual level (from survey) and contextual (from linked data) determinants to app usage.
RESULTS
We observe initial app uptake at 41%, 95% CI (0.39% to 0.43%), and a 12% drop-out rate by March 2021, 95% CI (0.10% to 0.14%). We also found that 7% of nonusers as of wave 2 became new adopters by wave 3, 95% CI (0.05% to 0.08%). Initial uptake (or failure to use) of the app associated with social norms, privacy concerns and misinformation about third-party data access, with those living in postal districts with restrictions on mobility less likely to use the app. Perceived lack of transparent evidence of effectiveness was associated with drop-out of use. In addition, those who trusted the government were more likely to adopt in wave 3 as new adopters.
CONCLUSIONS
Successful uptake of the contact tracing app should be evaluated within the wider context of the UK Government's response to the crisis. Trust in government is key to adoption of the app in wave 3 while continued use is linked to perceptions of transparent evidence. Providing clear information to address privacy concerns could increase uptake, however, the disparities in continued use among ethnic minority participants needs further investigation.
Topics: Adult; COVID-19; Contact Tracing; Ethnic and Racial Minorities; Ethnicity; Humans; Minority Groups; Mobile Applications; SARS-CoV-2; Semantic Web
PubMed: 35039293
DOI: 10.1136/bmjopen-2021-053327 -
Healthcare (Amsterdam, Netherlands) Mar 2018Little is known about physicians' approaches to adopting new cardiovascular drugs and how adoption varies between drugs of differing novelty.
BACKGROUND
Little is known about physicians' approaches to adopting new cardiovascular drugs and how adoption varies between drugs of differing novelty.
METHODS
Using data on dispensed prescriptions from IMS Health's Xponent™ database, we created a cohort of all primary care physicians (PCPs) and cardiologists in Pennsylvania who regularly prescribed anticoagulants, antihypertensives and statins from 2007 to 2011. We examined prescribing of three new cardiovascular drugs of differing novelty: dabigatran, aliskiren and pitavastatin. Outcomes were rapid adoption of each new drug, defined by early and sustained monthly prescribing detected by group-based trajectory models, by physicians within the first 15 months of marketplace introduction.
RESULTS
5953 physicians regularly prescribed each drug class. The majority of physicians (63.8%) adopted zero new drugs in the first 15 months, 35.0% rapidly adopted one or two, and 1.2% rapidly adopted all three. Physicians were more likely to rapidly adopt the most novel drug, dabigatran (27.3%), than aliskiren (10.5%) or pitavastatin (8.0%). Physician specialty and sex were the most consistent predictors of adoption. Compared to PCPs, cardiologists were more likely to rapidly adopt dabigatran (Adjusted Odds Ratio 8.90, 95% confidence interval 7.42-10.67; P<0.001) aliskerin (2.05, CI 1.56-2.69; P<0.001) and pitavastatin (3.44, CI 2.60-4.57; P<0.001). Female physicians were less likely to adopt dabigatran (0.71, CI 0.59-0.85; P <0.001) and aliskiren (0.64, CI 0.49-0.83; P <0.001).
CONCLUSIONS
Physicians vary in their prescribing of recently-introduced cardiovascular drugs. Though most physicians did not rapidly adopt any new cardiovascular drugs, drug novelty and cardiology training were associated with greater adoption.
Topics: Adult; Anticoagulants; Antihypertensive Agents; Cardiovascular Agents; Cohort Studies; Drug Prescriptions; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Middle Aged; Pennsylvania; Physicians; Practice Patterns, Physicians'
PubMed: 29066168
DOI: 10.1016/j.hjdsi.2017.09.004 -
Exploratory Research in Clinical and... Mar 2022Community pharmacies across the nation have adopted medication synchronization (Med Sync) services with the aim of improving medication adherence. To help incorporate...
BACKGROUND
Community pharmacies across the nation have adopted medication synchronization (Med Sync) services with the aim of improving medication adherence. To help incorporate Med Sync into a pharmacy's workflow, pharmacy associations and organizations developed implementation guides for community pharmacies. However, considerable variability in the adoption of this service exists as pharmacies struggle to implement Med Sync into traditional workflow. Researchers identified early adopters of Med Sync who dispense majority of their prescriptions as part of a Med Sync program. An exploratory study was undertaken with the aim to reveal themes surrounding facilitators and barriers to adoption of Med Sync in community pharmacies.
OBJECTIVES
The objective of this study was to explore the barriers and facilitators associated with Med Sync adoption in community pharmacies and generate practical solutions for service adoption. Methods Community pharmacies participating in the North Carolina's Community Pharmacy Enhanced Services Network (CPESNsm) who were early adopters of Med Sync and had greater than 50% of their prescription volume being dispensed as part of a Med Sync program were recruited to participate in semi-structured interviews. Interviews were conducted, recorded, and transcribed verbatim with representatives who led the adoption of Med Sync in their pharmacy. Inductive coding and summary analysis were used to analyze the interview data and determine themes associated with facilitators and barriers.
RESULTS
Analysis of the interviews revealed four key themes: program organization, staff engagement, patient engagement, and provider engagements for Med Sync adoption. Each of these themes had several sub-themes, contributing to facilitators and barriers to Med Sync adoption. Subthemes of program organization included having organizational infrastructure, including a pharmacy software system, a dedicated area, and a consistent enrollment process. Subthemes of staff engagement included having a team-based approach, job training, and staff incentives. Patient engagement's subthemes included communication, finances, health literacy, and transportation. Provider engagement resulted with subthemes including lack of communication and provider-pharmacist relationships.
CONCLUSION
To ensure successful adoption of Med Sync into traditional workflow, community pharmacies should employ a multi-factorial approach that includes internal and external components to the community pharmacy. This study identified facilitators associated with successful Med Sync adoption such as adequate staff engagement and requisite program organization. Barriers hindering successful Med Sync adoption resulted from challenges with provider and patient engagement. This study also makes an important contribution by providing practical solutions to Med Sync adoption based on participant responses and identified themes and sub-themes.
PubMed: 35478527
DOI: 10.1016/j.rcsop.2022.100111 -
International Journal of Population... Oct 2020The long-term health and wellbeing of adoptees is under-researched. One reason for this has been limited data accessibility regarding the adoption process, and another...
INTRODUCTION
The long-term health and wellbeing of adoptees is under-researched. One reason for this has been limited data accessibility regarding the adoption process, and another is a practice common in some UK jurisdictions of changing the National Health Service (NHS) number (or equivalent) at adoption, as part of creating the new identity. The SAIL Databank holds data on child and family court cases from Cafcass Cymru, together with children's social care data, and can link these with routine health and administrative data in anonymised form. However, because the linkage key at SAIL is based on an encryption of the NHS number, working with pre- and post-adoption records for longitudinal research remains a major challenge. We set out to explore the legal implications of, and social support for, linking these records for use in anonymised form for longitudinal research.
METHODS
We reviewed the main legislation and regulations governing the use of data about adoptees in England and Wales. We gauged support for a social licence in Wales by carrying out interviews with individuals who had been involved in the adoptions process, and by engaging with general public groups for their views. We drew out the main emerging themes and, in combination with the review, propose a way forward.
RESULTS
The legal review indicated that there are provisions in the Family Procedure Rules (England and Wales) and the General Data Protection Regulation that can be relied upon for the lawful processing of adoption data into anonymised form for research. The main points of concern about linking pre- and post-adoption records were privacy, data security, the need to limit the number of organisations involved in data sharing, and re-identification risk. The over-riding message was favourable with longitudinal research seen as strongly beneficial.
CONCLUSION
This study has indicated that in Wales, there is no legal impediment, nor major objection from individuals involved in the adoptions process, or members of the general public, for the use of adoption data in anonymised form in a data safe haven. This includes the linkage of pre- and post-adoption records to enable novel longitudinal research to take place. The provisos were that robust safeguards must be in place, and that the research should aim to benefit adoptees and to improve policy and practice. We conclude that it is reasonable to proceed with caution to develop practical ways to link pre- and post-adoption records in a data safe haven.
PubMed: 34007888
DOI: 10.23889/ijpds.v5i3.1370