10 results
Search Results
2. Barriers and delays in access to abortion care: a cross-sectional study of people traveling to obtain care in England and the Netherlands from European countries where abortion is legal on broad grounds.
- Author
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Wollum, Alexandra, De Zordo, Silvia, Zanini, Giulia, Mishtal, Joanna, Garnsey, Camille, and Gerdts, Caitlin
- Subjects
ABORTION laws ,HEALTH policy ,HEALTH services accessibility ,CONFIDENCE intervals ,TRAVEL ,CROSS-sectional method ,FIRST trimester of pregnancy ,MEDICAL care costs ,CLINICS ,COMPARATIVE studies ,DESCRIPTIVE statistics ,SOCIAL classes ,RESEARCH funding ,ODDS ratio ,PROPORTIONAL hazards models - Abstract
Introduction: This study characterized the extent to which (1) financial barriers and (2) abortion care-seeking within a person's country of residence were associated with delays in abortion access among those travelling to England and the Netherlands for abortion care from European countries where abortion is legal on broad grounds in the first trimester but where access past the first trimester is limited to specific circumstances. Methodology: We drew on cross-sectional survey data collected at five abortion clinics in England and the Netherlands from 2017 to 2019 (n = 164). We assessed the relationship between difficulty paying for the abortion/travel, acute financial insecurity, and in-country care seeking on delays to abortion using multivariable discrete-time hazards models. Results: Participants who reported facing both difficulty paying for the abortion procedure and/or travel and difficulty covering basic living costs in the last month reported longer delays in accessing care than those who had no financial difficulty (adjusted hazard odds ratio: 0.39 95% CI 0.21–0.74). This group delayed paying other expenses (39%) or sold something of value (13%) to fund their abortion, resulting in ~ 60% of those with financial difficulty reporting it took them over a week to raise the funds needed for their abortion. Having contacted or visited an abortion provider in the country of residence was associated with delays in presenting abroad for an abortion. Discussion: These findings point to inequities in access to timely abortion care based on socioeconomic status. Legal time limits on abortion may intersect with individuals' interactions with the health care system to delay care. Plain Language Summary: This paper explores delays in accessing abortion care associated with financial and medical system barriers. We focus on residents of countries in Europe where abortion is available on broad grounds in the first trimester seeking abortion care outside of their country of residence. This study demonstrates an association between difficulty covering abortion costs for people facing financial insecurity and in-country care seeking and delays in accessing abortion abroad. Policy barriers, medical system barriers, as well as financial barriers may interact to delay access to care for people in European countries with broad grounds for abortion access in the first trimester but restrictions thereafter, especially for people later in pregnancy. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
3. Cross-country abortion travel to England and Wales: results from a cross-sectional survey exploring people's experiences crossing borders to obtain care.
- Author
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Garnsey, Camille, Zanini, Giulia, De Zordo, Silvia, Mishtal, Joanna, Wollum, Alexandra, and Gerdts, Caitlin
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PREGNANCY & psychology ,HEALTH services accessibility ,RESEARCH methodology ,CROSS-sectional method ,TRAVEL ,ABORTION ,MEDICAL care costs ,SOCIOECONOMIC factors ,MEDICAL tourism - Abstract
Background: The laws governing abortion access vary across Europe. Even in countries with relatively liberal laws, numerous barriers to abortion access exist. In response to these barriers, evidence suggests that people living in countries with both restrictive and liberal laws travel outside of their home country for abortion care. England and Wales are common destinations for those who travel to seek abortions, but little is known about the motivations and experiences of those who undertake cross-country travel to England or Wales to obtain care. This paper aims to describe the abortion seeking and travel experiences of women and pregnant people who traveled to England and Wales for an abortion between 2017 and 2019. Methods: We recruited 97 participants who had traveled cross-country from both liberal and restrictive contexts to seek abortion care at three participating BPAS clinics in England and Wales. Participants completed an electronic survey about their reproductive histories, abortion decision-making, experiences seeking abortion care, and traveling. We conducted a descriptive analysis, and include comparisons between participants who traveled from liberal and restrictive contexts. Results: Over a third of participants considered abortion four weeks or more before presenting for care at BPAS, and around two-thirds sought abortion services in their home country before traveling. The majority of participants indicated that they would have preferred to have obtained an abortion earlier and cited reasons including scheduling issues, a dearth of local services, delayed pregnancy recognition, and financial difficulties as causing their delay. About seventy percent of participants reported travel costs between €101–1000 and 75% of participants reported that the cost of the abortion procedure exceeded €500. About half of participants indicated that, overall, their travel was very or somewhat difficult. Conclusions: This analysis documents the burdens associated with cross-country travel for abortion and provides insight into the factors that compel people to travel. Our findings highlight the need for expanded access to abortion care throughout Europe via the removal of legal impediments and other social or procedural barriers. Removing barriers would eliminate the need for cumbersome abortion travel, and ensure that all people can obtain necessary, high-quality healthcare in their own communities. Plain language summary: In Europe, people who live in countries where abortion is severely restricted or illegal altogether lack access to abortion care entirely, but even people who live in countries with more liberal laws face barriers due to gestational age limits, waiting periods, and a lack of trained and willing providers. Existing evidence suggests that restrictions and barriers compel people from both countries with restrictive laws as well as those from countries with more liberal laws to travel outside of their home country for abortion services. England and Wales are common destinations for people traveling within Europe to obtain abortion services, but little is known about the experiences of these travelers. We surveyed individuals who had traveled from another country to seek abortion services in England or Wales. Our analysis documents that many participants contemplated getting an abortion and sought care in their home countries before traveling. Likewise, many participants indicated that they would have preferred to have obtained an abortion earlier in their pregnancy, and referenced scheduling issues, a dearth of local services, delayed pregnancy recognition, and financial difficulties as causing their delay. A majority of participants indicated that covering the costs of their abortion, and the costs of travel was difficult, and that the travel experience in its entirety was difficult. Our findings document the reasons for, and burdens associated with abortion travel and highlight the need to expand access to abortion across Europe via the elimination of all legal restrictions and impediments. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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- View/download PDF
4. Vivendo à margem da lei: histórias de brasileiros em situação irregular no contexto europeu.
- Author
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Proença Lara, Glaucia Muniz
- Subjects
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DISCOURSE analysis , *ENUNCIATION , *SEMANTICS , *VOCABULARY , *SIMILARITY (Psychology) , *MENTAL representation - Abstract
This paper examines and compares, in the light of French Discourse Analysis, four life stories - collected through interviews - that were produced by Brazilian migrants that live illegally in France or in England. The main objective is to find out the discursive representations (of themselves, of the others, of the world) constructed by such individuals in their narratives and, at the same time, verify if and how their irregular situation interferes with their routine in the new country. In order to analyze and compare the four stories, some categories that integrate Maingueneau's Global Semantics (2005) were used: themes, vocabulary, enunciative deixis and enunciation mode. If the results reveal differences in the way of telling and evaluating the migratory experience, they also allow us to apprehend similarities, such as the primarily economic motivation to migrate, the difficulties (cultural, linguistic etc.) faced especially when arriving in the destination country and the precarious working conditions to which Brazilian migrants are submitted due to being in an irregular situation. Even though two of the interviewed subjetcts have preferred to be silent on this issue, their opinions can be implicitly identified. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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5. The Burden of Respiratory Disease from Formaldehyde, Damp and Mould in English Housing.
- Author
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Clark, Sierra N., Lam, Holly C. Y., Goode, Emma-Jane, Marczylo, Emma L., Exley, Karen S., and Dimitroulopoulou, Sani
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INDOOR air pollution ,FORMALDEHYDE ,RESPIRATORY diseases ,INDOOR air quality ,OCCUPATIONAL exposure ,ETHNICITY ,ASTHMA in children - Abstract
Quantifying the burden of disease from exposure to poor indoor air pollution can support policy development. In England, there is current regulatory and public attention on the health implications of residential exposure to formaldehyde, damp and mould. However, there is scarce information on these health impacts at the population scale. As such, we assessed the burden of key respiratory diseases from residential formaldehyde, damp and/or mould for the English population aged 0–14 and 15–49. We obtained data on the percentage of dwellings affected by damp and/or mould from the English Housing Survey and estimated the distribution of residential formaldehyde concentrations (annual average (μg/m
3 )) by pooling data from monitoring studies conducted in England. Exposures were combined with epidemiological relationships and national health data to estimate Population Attributable Fractions (PAFs), disease incidence, and Disability Adjusted Life Years (DALYs) lost associated with residential formaldehyde or damp and/or mould exposure in England. We made estimates for the year 2019 but also looked back several years in time. Exposure to formaldehyde was associated with approximately 4000 new cases of childhood asthma (~800 DALYs lost) in 2019, though the estimates were sensitive to the placement of the lower exposure threshold. Exposure to damp and/or mould was associated with approximately 5000 new cases of asthma (~2200 DALYs) and approximately 8500 lower respiratory infections (~600 DALYs) among children and adults in 2019, though the PAFs were unequally distributed across dwellings based on income and ethnicity. Alternative data sources suggest that the percentage of dwellings affected by damp and/or mould may even be higher, resulting in a possible 3–8-fold greater number of cases and DALYs. Our assessment emphasizes a potential respiratory health burden in England associated with residential formaldehyde as well as damp and/or mould, further highlighting the public health importance of good indoor air quality and good quality housing. [ABSTRACT FROM AUTHOR]- Published
- 2023
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6. Batı Avrupa Erken Ortaçağ Tarihinde Kıta Avrupa'sı ve Ada Tarihinde Manor Üzerine Bir Değerlendirme.
- Author
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GÜRSOY, Sultan and Tolga GÜMÜŞ, T.
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UPPER class ,SOCIAL history ,ECONOMIC history ,ROMAN Empire, 30 B.C.-A.D. 476 ,SOCIAL forces ,FEUDALISM - Abstract
Copyright of Celal Bayar University Journal of Social Sciences / Celal Bayar Üniversitesi Sosyal Bilimler Dergisi is the property of Celal Bayar University Journal of Social Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
- Full Text
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7. The European other, the Indo-Iranian self and the discourse of wonder in the earliest Persian travelogues of Europe.
- Author
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Ebrahimian, Mojtaba
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IRANIANS ,SELF ,SOCIAL desirability ,ROMANIES ,EIGHTEENTH century ,EUROPEANS ,TRAVEL writing - Abstract
In the concluding decades of the eighteenth century, as European power was ascending in Asia, Indians and Iranians travelled to Europe and wrote about European society, culture, and politics. This article analyses the earliest Persian travelogues of England by an Indian and an Iranian to show how the Indo-Iranian travellers comprehended European civilisation and envisaged their own status vis-à-vis Europeans. By analysing Shigarfnamah-yi Wilayat (1785) by Mirza I'tisam al-Din (1730–1800), and Hayratnamah-yi Sufara (1810) by Mirza Abu al-Hasan Khan Shirazi (1776–1846), it argues the Indian and Iranian travellers presented the political, social, and military developments in England as wondrous to inform their readers about their desirability, and to critique some undesirable aspects of their own societies and cultures. By analysing these two Persian travelogues, this article also sheds light on some of the commonalities in perceptions of European civilisation circulating in the Persianate world in this period. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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8. A multilevel analysis of the impact of transitioning to grandparenthood on individuals' depression in England, Europe and China.
- Author
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Yang, Yazhen
- Subjects
MENTAL depression risk factors ,RESEARCH ,ECONOMIC impact ,INTERGENERATIONAL relations ,MULTIPLE regression analysis ,GRANDPARENTS ,RISK assessment ,SEX distribution ,PSYCHOSOCIAL factors ,DESCRIPTIVE statistics ,AGING ,MAXIMUM likelihood statistics ,SECONDARY analysis - Abstract
The impact of grandparenting on depression is mediated by both macro- and micro-level factors, however, their combined examination between different country contexts is relatively rare. This study examined whether country level income and grandparents' gender influenced the relationship between the transition to grandparenthood and individuals' depression across England, Europe and China. Multi-level linear regression analyses with restricted maximum likelihood estimation were performed covering 15 countries from the ELSA, the SHARE and the CHARLS 2010-15 in order to understand cross-country differences in this area. This study found significant cross-national variations in the effects of transitioning to grandparenthood on individuals' depression. Transitioning to grandparenthood reduced the depression score among both men and women in lower income countries, but increased it in higher income countries. Moreover, the gender gap in the effects of becoming a grandparent on one's depression was wider in lower income countries than higher income countries. Policymakers should pay attention to the support grandparents need, and systematically integrate childcare provided by grandparents into family policies. Policies supporting older people should take into account the way in which macro-level and micro-level factors combine to affect grandparents' well-being. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
9. Ethnic inequality in choice‐ and performance‐driven education systems: A longitudinal study of educational choices in England, Germany, the Netherlands, and Sweden.
- Subjects
RACIAL inequality ,CHILDREN of immigrants ,IMMIGRANT children ,STUDENT aspirations ,EDUCATIONAL equalization ,ACADEMIC achievement - Abstract
The motivation for this article was the main finding of an earlier study, which concludes that choice‐driven education systems—in the study represented by England and Sweden—are particularly beneficial for immigrants in that they provide them with many opportunities to pursue their generally high educational ambitions. We extend this analysis by including two countries with performance‐driven education systems: Germany and the Netherlands. Our study specifically aims to explore whether it is true that choice‐driven systems are more beneficial for immigrants or whether immigrants can also succeed in more stratified and selective education systems. Using longitudinal data from the Children of Immigrants Longitudinal Survey in Four European Countries (CILS4EU), we show that there are no differences in (gross) transition rates between immigrants and natives in Germany, the Netherlands, and Sweden, but immigrants' optimistic choices are more pronounced in England. However, these differences diminish once we account for achievement and students' socioeconomic background in the analyses. Regarding the underlying mechanisms, we find that educational aspirations have an (equally) strong, universal impact, while anticipated discrimination plays a minor role. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
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10. Large differences in the organization of palliative care in nursing homes in six European countries: findings from the PACE cross-sectional study.
- Author
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Honinx, E., Van den Block, L., Piers, R., Onwuteaka-Philipsen, B. D., Payne, S., Szczerbińska, K., Gambassi, G., Kylänen, M., Deliens, L., Smets, T., on behalf of PACE, Gatsolaeva, Yuliana, Miranda, Rose, Pivodic, Lara, Tanghe, Marc, van Hout, Hein, Pasman, Roeline H. R. W., Oosterveld-Vlug, Mariska, Piers, Ruth, and Wichmann, Anne B.
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MEDICAL quality control ,MEETINGS ,HEALTH services administration ,HEALTH services accessibility ,MEDICAL care ,NURSING care facilities ,QUALITY assurance ,HEALTH care teams ,DESCRIPTIVE statistics ,CHI-squared test ,QUESTIONNAIRES ,STATISTICAL sampling ,STATISTICAL correlation ,PALLIATIVE treatment ,SECONDARY analysis - Abstract
Background: To be able to provide high-quality palliative care, there need to be a number of organizational structures available in the nursing homes. It is unclear to what extent such structures are actually present in nursing homes in Europe. We aim to examine structural indicators for quality of palliative care in nursing homes in Europe and to evaluate the differences in terms of availability of and access to palliative care, infrastructure for residents and families, multidisciplinary meetings and quality improvement initiatives. Methods: A PACE cross-sectional study (2015) of nursing homes in Belgium, England, Finland, Italy, the Netherlands and Poland. Nursing homes (N = 322) were selected in each country via proportional stratified random sampling. Nursing home administrators (N = 305) filled in structured questionnaires on nursing home characteristics. Organization of palliative care was measured using 13 of the previously defined IMPACT structural indicators for quality of palliative care covering four domains: availability of and access to palliative care, infrastructure for residents and families, multidisciplinary meetings and quality improvement initiatives. We calculated structural indicator scores for each country and computed differences in indicator scores between the six countries. Pearson's Chi-square test was used to compute the p-value of each difference. Results: The availability of specialist palliative care teams in nursing homes was limited (6.1–48.7%). In Finland, Poland and Italy, specialist advice was also less often available (35.6–46.9%). Up to 49% of the nursing homes did not provide a dedicated contact person who maintained regular contact with the resident and relatives. The 24/7 availability of opioids for all nursing home residents was low in Poland (37.5%). Conclusions: This study found a large heterogeneity between countries in the organization of palliative care in nursing homes, although a common challenge is ensuring sufficient structural access to specialist palliative care services. Policymakers and health and palliative care organizations can use these structural indicators to identify areas for improvement in the organization of palliative care. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
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