Suchergebnisse

Male infant circumcision is a controversial and debated topic in both scientific and public discourses in parts of Western Europe. Debates are heated and it is not always entirely clear what is in the best interest of the male infant. In this article, we discuss the importance of returning to core principles of evidence-based, patient-centred care that may help move the discussion away from the current, increasingly polarised positions. According to principles of evidence-based medicine, systematic retrieval and critical appraisal of the best evidence available should be a core consideration in all decisions regarding healthcare policy and practice. Applying this principle to male infant circumcision, we need a careful, dispassionate critique of the evidence in relation to the benefits and risks associated with the procedure and an assessment of the potential health gains and adverse effects of any interventions (such as legislation) that may be introduced. Currently, the more robust evidence-base has tended to focus on biomedical aspects of male infant circumcision and this shows consistent evidence of important benefits of this practice, but also some risks. However, health is multi-dimensional and when considering male infant circumcision, there is therefore a need to broaden the perspective to also include psycho-social considerations. It is also imperative that those striving to deliver patient-centred care keep the best interests of the patient/family at the heart of their decision-making, promote autonomy and do not inadvertently exceed the fine line between beneficence and medical paternalism.In summary, we argue that a more comprehensive and robust evidence-base is needed to enable evidence-based policy-making and that these uncertainties are communicated to patients/families so they can in the light of this evidence make an informed choice.

Migrants are especially susceptible to inequitable access to health care services and their access to health care may be further compromised by the tradition of informal patient payments in the Western Balkan countries. As a particularly vulnerable group, this study focused on the asylum-seeking migrants and the role of informal patient payments as an avenue for migrants' health care access in Serbia. Qualitative interviews were conducted in August and September of 2018 with civil servants (intercultural mediators and information workers, n = 8) and asylum-seeking migrants ( n = 6). Data was analyzed using the phenomenological hermeneutical approach. The study showed that intercultural mediators had a pivotal role in shaping better and quicker access to health care services for asylum-seeking migrants in Serbia, which also lowered their exposure to informal patient payments. A commonness in paying informally was found in Serbia, especially due to the high value put into doctors and the lacking resources of the health care system. The asylum-seeking migrants seemed exempted from such payments. Reducing these informal patient payments for health care is highly important to facilitate equity in access to health care

This article presents provider experiences with the Cultural Formulation Interview (CFI) in Danish mental healthcare for migrant patients. Semi-structured interviews with 17 providers and 20 recorded CFI sessions were analyzed with a constructivist grounded theory approach. Based on our empirical material, we endorse the CFI's ability to facilitate working alliance and a profound and contextually situated understanding of the patient. Further, the CFI supported less-experienced providers in investigating cultural issues. Conversely, we found that CFI questions about cultural identity and background evoked notions of distance and 'othering' in the encounter. Nine providers had felt discomfort and professional insecurity when the CFI compelled them to introduce explanatory frameworks of culture in the mental health assessment. Eleven providers had experienced that the abstract nature of the questions inhibited patient responses or led to short and stereotypical descriptions, which had limited analytical value. We describe the contradictory CFI experiences of alliance versus distance at three levels: 1) at the CFI instrument level; 2) at the organizational level; and 3) at the contextual and structural level. We demonstrate benefits and pitfalls of using the CFI with migrants in Denmark, which is an example of a European healthcare context where cultural consultation is not an integrated concept in health education programs and where the notion of culture is contentious due to negative political rhetoric on multiculturalism. We suggest that the CFI should be introduced with thorough training; focus on fidelity; and supervision in the clinical application and understanding of the concept of culture.

This collection charts the lives and times of Muslims living in contemporary ScotlandBetween the 2001 and 2011, the Muslim population of Scotland increased by nearly eighty percent. The youthfulness of Scotland's Muslim community means this population is likely to continue to grow in size. Yet, Scotland's Muslim community does not feature much at all in research about 'Muslims in Britain': at best, Scotland is mentioned in passing, and at worst, generalisations are made about 'British Muslims' based on the assumption that Muslims in Scotland have the same experiences to Muslims in England.However, in the last ten years or so, research has started to give specific attention to the everyday lives, identities and experiences of Scotland's Muslims. This collection brings together a lot of this research and, with contributions from leading and emerging scholars in the field, explores the lives, political engagements and social practices of Scotland's Muslim communities.Key featuresThemes include: health, education, gender, sexuality, politics, integration, family and the mediaExplores the political participation of Muslims and their engagements with multicultural nationalismProvides different examples of Muslim and ethnic minority citizenship practices and integration strategiesCharts the changing size, composition and practices of Muslims in Scotland ContributorsFayaz Alibhai, University of EdinburghHengameh Ashraf-Emami, University of NorthumbriaReza Bagheri, University of TehranStefano Bonino University of BirminghamKatherine Botterill, Edinburgh Napier UniversityRobin Finlay, Newcastle UniversityPeter Hopkins, Newcastle UniversityMaria Kristiansen, University of CopenhagenNasar Meer, Strathclyde UniversityMichael B. Munnik, Cardiff UniversitySheila Riddell, University of EdinburghGurchathen Sanghera, University of St AndrewsOmar Shaikh, Colourful Heritage Project, GlasgowAziz Sheikh, University of EdinburghAsifa Siraj, Independent ResearcherRebecca Syswerda, University of St AndrewsElisabet Weedon, University of Edinburgh

A new introduction to a timeless dynamic: how the movement of humans affects health everywhere. International migrants compose more than three percent of the world's population, and internal migrants—those migrating within countries—are more than triple that number. Population migration has long been, and remains today, one of the central demographic shifts shaping the world around us. The world's history—and its health—is shaped and colored by stories of migration patterns, the policies and political events that drive these movements, and narratives of individual migrants. Migration and Health offers the most expansive framework to date for understanding and reckoning with human migration's implications for public health and its determinants. It interrogates this complex relationship by considering not only the welfare of migrants, but also that of the source, destination, and ensuing-generation populations. The result is an elevated, interdisciplinary resource for understanding what is known—and the considerable territory of what is not known—at an intersection that promises to grow in importance and influence as the century unfolds