IntroductionRoma, the largest minority group in Europe, face widespread racism and health disadvantage. Using qualitative data from Serbia and Macedonia, our objective was to develop a conceptual framework showing how three levels of racism--personal, internalized, and institutional--affect access to maternal health care among Romani women.MethodsEight focus groups of Romani women aged 14-44 (n = 71), as well as in-depth semi-structured interviews with gynecologists (n = 8) and key informants from NGOs and state institutions (n = 11) were conducted on maternal health care seeking, experiences during care, and perceived health care discrimination. Transcripts were coded, and analyzed using a grounded theory approach. Themes were categorized into domains.ResultsTwenty-two emergent themes identified barriers that reflected how racism affects access to maternal health care. The domains into which the themes were classified were perceptions and interactions with health system, psychological factors, social environment and resources, lack of health system accountability, financial needs, and exclusion from education.ConclusionsThe experiences of Romani women demonstrate psychosocial and structural pathways by which racism and discrimination affect access to prenatal and maternity care. Interventions to address maternal health inequalities should target barriers within all three levels of racism.
More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100,000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on expert opinion, retrospective studies, or extrapolation from other tumor sites with similar histology, leading to difficulty in developing guidelines for clinical practice. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different European countries and indeed, worldwide. The GYNOCARE, COST Action CA18117 (European Network for Gynecological Rare Cancer Research) programme aims to address these challenges through the creation of a unique network between key stakeholders covering distinct domains from concept to cure: basic research on RGT, biobanking, bridging with industry, and setting up the legal and regulatory requirements for international innovative clinical trials. On this basis, members of this COST Action, (Working Group 1, “Basic and Translational Research on Rare Gynecological Cancer”) have decided to focus their future efforts on the development of new approaches to improve the diagnosis and treatment of RGT. Here, we provide a brief overview of the current state-of-the-art and describe the goals of this COST Action and its future challenges with the aim to stimulate discussion and promote synergy across scientists engaged in the fight against this rare cancer worldwide.
Introduction: Acne vulgaris is a disorder of the pilosebaceous units. It is a chronic inflammatory dermatosis notable for open/closed comedones, papules, pustules, nodules. It is characterized by open comedones, closed comedones and pustular nodules. Aim of study: To examine factors underlying the quality of life of people with acne. Materials and method: A total of 576 respondents were included in the study. Acne specific Quality of Life questionnaire was used for this purpose. A prospective cross-sectional study was conducted, performed in private dermatological clinic as well as on-line. All analyses were conducted by using the SPSS.26 for Windows. Results and Discussion: 5.7 % were males and 94.3 percent were females. About 69.4% were aged between 15-25; 16.7 % between 26 to 30; 8.8% between 31 to 35 years old. Quality of life and emotional perception towards the social environment is demonstrated by the three components (self-perception of discomfort, functionality, and social factor). The reliability levels for the three components were .858 for self-perception of discomfort, .779 for functionality and .745 for the social factor. The factor analysis discovered three underlying factors: self-perception of discomfort, social factor and functionality in daily life. Conclusion: The findings confirm the general notion that people with acne have problems in quality of life and therefore special attention to psychological intervention should be given in the treatment of acne.
Introduction: This paper examines the factors and approaches the question of patients’ satisfaction in the health care delivery system in North Macedonia. Aim: The study aims to assess how key service quality dimensions relate to an important measure of performance patient satisfaction and to find the elements that are valued by patients and the reasons behind patient satisfaction or dissatisfaction. Materials and method: In this research study, the factor analysis was used to group 12 questions measuring patient satisfaction under certain extent with Promax oblique rotation using the satisfaction responses gauged by importance. We have performed a structural equation model (SEM) to determine the relationships between one or more independent variables (IVs). Results: All component measures were greater than .702 which shows strong internal reliability among components. The reliability levels for the three components were .842 for the hospital environment, .835 for admin and .702 for interaction with health care professionals. Cronbach’s Alpha test of the whole instrument was .903. Conclusions: The explanatory factor analysis (EFA) analysis identified three distinct components or factors of patient satisfaction: (i) hospital environment, (ii) medical administration and (iii) interactions with professionals or staff behaviour. These three factors obtained after exploratory factor analysis have a significant impact on patient satisfaction. This path estimates for our model provide insights into relationships among various constructs.
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