Search Results (35)

Background/Objectives: Community benefit (CB) obligations by not-for-profit (NFP) hospitals have attracted renewed scrutiny at federal and state levels due to wide variation in CB spending. In 2020, Oregon implemented a CB policy for all NFP hospitals that included requirements to expand patient financial assistance and a hospital-specific minimum CB spending floor. We examined trends in CB spending after the implementation of Oregon’s CB policy. Methods: Interrupted time-series analyses to compare hospital CB spending before and after policy implementation. Results: Overall, Oregon’s CB policy was not associated with changes in CB spending, except for a 0.2% decrease in the Social Determinants of Health spending (−0.0018; p < 0.05). Among hospitals in the first tercile of pre-policy CB spending, Oregon’s policy was associated with a 0.4% decrease in charity care (−0.0041; p < 0.05) and a 0.6% increase in subsidized health services spending (0.0063; p < 0.05). Hospitals in the second tercile of pre-policy CB spending experienced a 0.7% decrease in subsidized health services (−0.0074; p < 0.05). Among frontier hospitals, total CB spending and Medicaid shortfalls increased by 2.9% (0.0292; p < 0.10) and 2.2% (0.0220; p < 0.10) respectively, while non-frontier hospitals experienced a 0.7% decrease in Medicaid shortfall (−0.0068; p < 0.05). Critical access hospitals experienced a 1.3% increase in subsidized health services spending (0.0131; p < 0.05). Conclusions: Although total CB spending did not change in the two years following Oregon’s CB policy implementation, findings suggest that hospitals may be shifting the composition of their CB spending. Oregon’s CB policy encourages proactive CB spending tailored to community needs, but opportunities exist to fine-tune the policy to boost hospital CB spending. Specifically, planned spending in categories such as charity care may alleviate the increasing burden of medical debt and its financial implications for patients. Full article

This paper analyzes the Hindu concept of sevā—selfless service—as a theo-ethical practice that reconfigures the relationship between religion and economy, offering a snapshot of an Indian perspective on the convergence between postsecularism and postcapitalist discourses. Rather than being reducible to acts of charity, sevā integrates spiritual, ethical, and social dimensions that challenge the neoliberal emphasis on individual self-interest and material accumulation. Rooted in the pursuit of liberation and relational well-being, sevā frames economic and moral agency in terms of embeddedness, reciprocity, and care. To illustrate sevā’s unique attributes, the paper engages with two case studies. The first explores Mahatma Gandhi’s philosophy, where sevā is articulated through a non-anthropocentric ethic of nonviolence (ahiṃsā), obliging the reconstruction of eco-economic mechanisms and environmental responsibility. The second examines contemporary guru-bhakti communities in Delhi’s urban peripheries, where sevā functions as spiritual discipline (sādhana), a means for communal uplifting, and the expression of kalyāṇ—holistic well-being that transcends individual boundaries. In both contexts, sevā emerges as a practice that intervenes in and reshapes socio-economic life. By foregrounding sevā as a lived practice, the paper situates Indian religious traditions as a distinctive contribution to broader postcapitalist and postsecular debates. It argues that sevā offers an alternative model of personhood and ethical intentionality—one that contests dominant binaries of spiritual/material, secular/religious, and human/nature, and reimagines human flourishing through the lens of relational ontology and collective responsibility. Full article

Background/Objectives: Understanding health information-seeking behavior is critical in providing effective interventions and improving quality of life for patients, especially those facing complex diagnoses like cancer. The purpose of this study is to understand rural–urban differences in trust levels for various information sources and how trust may differ by cancer status (no cancer, newly diagnosed, survived for six and more years). Methods: We examined 5775 responses from the 2022 Health Information National Trends Survey^®. Using the component analysis, eight sources of information were classified into three domains: structured (doctor, government, scientist, and charity), less structured (family and religion), and semi-structured (health system and social media). Respondents answered questions on a scale of 1–4. Weighted linear regression models were constructed to examine trust level in three domains by rural residency and cancer status, while adjusting for demographic and socioeconomic status. Results: Urban patients reported higher trust in more structured sources of information (2.999 > 2.873, p = 0.005) whereas rural counterparts reported higher trust in less structured sources of information (2.241 > 2.153, p = 0.012). After adjusting for covariates, urban respondents with cancer are more likely to trust doctors (Coeff. = 0.163, p < 0.001) than those without cancer. Rural respondents with cancer are less likely to trust charities (Coeff. = −0.357, p < 0.01) and scientists (Coeff. = −0.374, p < 0.05) than rural respondents without cancer. Conclusions: Newly diagnosed cancer patients in rural areas are less likely to trust structured sources of information even after adjusting for all covariates. Additional studies about misinformation and disinformation being channeled through less structured sources of information are needed to prevent any delay in care among cancer patients, especially rural patients who are more likely to access these sources of information. Full article

Veterinary and charity teams are frequently involved in equine end-of-life decisions. These can cause ethical dilemmas and emotional burdens and complicate communication with owners. Semi-structured focus groups explored experiences of making decisions about end-of-life care and euthanasia at three UK equine veterinary practices and one charity. There were 26 participants in a mix of roles. Inductive coding was conducted during thematic analysis. Major themes generated were ‘Equine Welfare’, ‘Relationships’, ‘Decision-Making’, and ‘Emotional Toll and Coping Strategies’. Communication, finances, and chronic vs. acute cases were key issues featured within multiple themes. The individual horse’s welfare was the participants’ priority during decision-making. However, there were barriers to coming to a decision about treatment or euthanasia, and conflict caused by these barriers could detrimentally affect participants’ mental health. Preferred style of decision-making varied depending on the situation. Examples given included shared decision-making, participants steering the decision, and attempts by participants or owners to shift decisional responsibility onto the other party. Some owners sought additional input into decisions from veterinary nurses and receptionists. Participants found aspects of their roles emotionally challenging. This could be mitigated by supportive relationships and communication with colleagues. Involving veterinary team members in varying roles in end-of-life care planning and euthanasia decision-making with owners contributes a range of skills and expertise and helps to share the burden of responsibility. Full article

In this paper, I will argue that Aquinas provides a framework for why and how religious communities, specifically Christian religious communities, can minister to those who struggle with suicide. Aquinas thinks that charity makes us friends of God, and to be God’s friend is to love one’s neighbor and care for his needs. After examining what Aquinas has to say about suicide, I consider in some detail what he has to say about charity. In light of recent psychological research, I use what Aquinas has to say about charity to suggest ways in which the church should help those struggling with suicidal ideation. Full article

Declining student mental health is a global public health issue. Campus-based animal-assisted interventions (AAIs) are popular and effective interventions to prevent and alleviate symptoms. How to design, implement and evaluate evidence-based, student-centred interventions that enjoy sustained stakeholder buy-in and support is less known. This paper presents the procedures and results of a three-stage co-production method and the resulting curriculum of a novel AAI aimed at university students experiencing serious mental health problems. Stage 1 shaped the focus and structure of the intervention based on online student surveying (N = 204) and consultations with stakeholders (N = 10), including representatives of Student Well-being Services leadership, veterinarians, animal welfare charities and Therapets volunteers. In Stage 2, we conducted co-production workshops with post-graduate students (N = 6), developing the curriculum based on Stage 1 insights. In Stage 3, through iterative prototyping and student feedback (N = 22) the Paws on Campus programme was finalised, resulting in a series of four, one-hour themed sessions: (1) Thoughts and Feelings, (2) Well-being and Welfare, (3) Care and Compassion and (4) Problem Solving and Help Seeking. We describe the co-production method and resulting programme characteristics and provide considerations for others interested in developing effective and sustainable AAIs for their respective populations and contexts. Full article

Background and Objectives: We previously reported on the impact of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) on the QoL of persons with ME/CFS and their family members. Here, we present the findings of the impact on the QoL of individuals with ME/CFS whose family members did not participate in the survey. Materials and Methods: A prospective multinational online survey was disseminated via patient charities, support groups and social media. Persons with ME/CFS completed the EuroQoL questionnaire (EQ-5D-3L). Results: Data were analysed from 876 participants from 26 countries who reported a health care professional diagnosis of ME/CFS. In total, 742 participants identified as female, 124 male and 10 preferred not to say. The mean age of the participants was 47 years (range 18–82), and the mean time to diagnosis was 14 years. The mean overall health status on a visual analogue scale for people with ME/CFS was 36.4 (100 = best health). People with ME/CFS were most often affected by inability to perform usual activities (n = 852, 97%), followed by pain (n = 809, 92%), impaired mobility (n = 724, 83%), difficulty in self-care (n = 561, 64%) and least often affected by anxiety and depression (n = 540, 62%). Conclusions: The QoL of people with ME/CFS is significantly affected globally. There was no significant difference in quality of life compared with previously published data on those with ME/CFS who did have a family member complete the family member quality of life questionnaire (FROM16). Contrary to popular misconception, anxiety and depression are the least often affected areas in persons with ME/CFS who are most impacted by their inability to perform usual activities. Full article

In 2016, a localisation agenda was set across the international aid industry with the understanding that humanitarian interventions need to be led by local actors and local communities. Despite international agreements, the localisation efforts are largely failing. This paper demonstrates the challenges that prevent effective collaboration between international humanitarian agencies and crisis-affected communities. It draws on evaluation reports to highlight an inability to learn lessons or follow recommendations from previous crises. Based on the authors’ experiences, we present a novel framework for effectively collaborating with crisis-affected communities. The Communities Framework provides a pathway to establishing effective community collaboration and locally owned and led humanitarian interventions. The importance of local leadership, trust building, and local context are at the heart of the framework. In light of the need for a more localised and decolonial humanitarian response, this framework supports humanitarian actors and the affected communities in moving from a charity-led approach to one of mutual aid. The paper draws on alternative notions of compassion from the Global South of contemporary humanitarian interventions as a philosophical foundation for the framework. Caring for others and the world is central to implementing an appropriate and effective humanitarian response. There remains a largely unexplored scope regarding the outcome of resolving crises when both humanitarian actors and affected communities work as equal partners and how that will shape modern humanitarianism as we understand it today. Full article

Considering the intermingling of problems in today’s multi-crisis environment, this text explores the possibilities of intertwining social work and pastoral care. In the search for effective approaches, we find dynamic patterns in the activities of the Royová (Roy) sisters. Their diaconal work is an important source for social work history illustrating how social work took the form of diaconal (charity) work with a rich pastoral reach at the time. Their activities represent a natural link between Christian anthropology and social work. This study mainly investigates the Christian (spiritual) basis of the social and charitable activities of the Royová sisters, the beginnings of the institutionalisation of social and charitable work in Slovakia and Serbia through the organisations founded by the Royová sisters, the Christian-social interpersonal contribution of the Roy sisters to the development of Slovak and European social work personified by their cooperation with several personalities of social and charitable work at the international, national, and local levels, and the contribution of the Roy sisters in the creation of women’s, volunteer, and international roots of social and charitable work in Slovakia and Europe. In their responses to the needs of their environment, we find significant stimuli for pastoral theology, which is supposed to respond to the needs of the multi-crisis environment of today. Full article

Prehabilitation and rehabilitation will be essential services in an ageing population to support patients with cancer to live well through their life spans. Active Together is a novel evidence-based service embedded within existing healthcare pathways in an innovative collaboration between health, academic, and charity organisations. Designed to improve outcomes for cancer patients and reduce the demand on healthcare resources, it offers physical, nutritional, and psychological prehabilitation and rehabilitation support to patients undergoing cancer treatment. The service is underpinned by behaviour change theories and an individualised and personalised approach to care, addressing the health inequalities that might come about through age, poverty, ethnicity, or culture. Meeting the challenge of delivering high-quality services across multiple stakeholders, while addressing the complexity of patient need, has required skilled leadership, flexibility, and innovation. To support patients equally, regardless of geography or demographics, future services will need to be scaled regionally and be available in locations amenable to the populations they serve. To deliver these services across wide geographic regions, involving multiple providers and complex patient pathways, will require a systems approach. This means embracing and addressing the complexity of the contexts within which these services are delivered, to ensure efficient, high-quality provision of care, while supporting staff well-being and meeting the needs of patients. Full article

This article centers on the nonprofit landscape in Vancouver, Canada, a city that occupies the territories of the xʷməθkʷəy̓əm (Musqueam), sḵwx̱wú7mesh (Squamish), and səlilwətaɬ (Tsleil-Waututh) nations, which have never been ceded to the colonial occupation of Canada. Vancouver has a competitive nonprofit field, with an estimated 1600+ nonprofits operating within city limits. This descriptive review starts by defining what a nonprofit industrial complex (NPIC) is, then outlines an abbreviated history of the nonprofit sector on the aforementioned lands. The article then explores issues related to colonialism, anti-poor legislation, neoliberal governance, the fusing of the public and private sectors, and the bureaucratization of social movements and care work as mechanisms to uphold the status quo social order and organization of power. Focusing on under-examined issues related to the business imperatives of nonprofit organizations in the sectors of housing, health and social services, community policing, and research, this work challenges the positive default framing of nonprofits and charities. Instead, we contend that Vancouver’s NPIC allows the government and the wealthy to shirk responsibility for deepening health and social inequities, while shaping nonprofits’ revenue-generating objectives and weakening their accountability to the community. Full article

Many people are keen to be actively involved in social life and activities, but even at an early stage, dementia can have a negative impact on social participation and access to leisure activities. As part of the IDoService project, this study has investigated people’s needs and wishes, barriers and facilitators to identify opportunities for improving access to meaningful activities. Individual and focus group interviews were conducted with 5 people living with mild to moderate dementia, 2 familial and 2 professional care partners, as well as 12 people working in the field of dementia and/or community activities. Thematic analysis has highlighted the benefits of participating in meaningful activities, such as empowerment and pride, social contacts, and feeling useful to others. A number of barriers to participation relating to individual and environmental factors were reported. Even where participants praised dementia-friendly activities and facilities, they advocated activities inclusive for all and mentioned that some people might be reluctant to participate in dementia-labelled activities because they may not be suitable for their needs. These results indicate the need for developing tailored opportunities for people with mild to moderate dementia and provide valuable insights for researchers, service providers, policymakers and charities wanting to improve access. Full article

Though the average employee spends a third of their day inside an office, designing a productive workspace can be challenging for designers. However, lighting design is a critical factor for the wellbeing of the employee. With the increasing number of local and international companies opening in Saudi Arabia, it is important to study the effect of natural and artificial lighting on the productivity of employees in the office environment. It is essential to consider that employee productivity leads to economic productivity. A questionnaire was shared with the employees of the head office of Ensan Charity for Orphans Care to collect data on the preferences of staff on the current lighting design in their offices. Office design is one of the most important aspects in need of special attention, since employees spend more than eight hours daily at their offices. Lighting design is one of the key aspects of office design that has a direct impact on employees’ satisfaction and productivity. The aim of this study was to discover employees’ preferences for office design in Saudi Arabia. The collected data are analyzed to uncover employee preferences as well as to predict two key design aspects using machine-learning techniques. The two design aspects of concern are direct sunlight in the office environment and manual control of light intensity. This research aimed to help improve the design of the office environment according to employees’ preferences and international standards through investigating sustainable lighting design elements. A further challenge to be overcome was the need for further data collection as it relates to the two design aspects mentioned above. This paper demonstrates relatively high prediction accuracies of the mentioned design considerations using a variety of machine-learning algorithms. Full article

The increasing presence of documented and undocumented migrants increases the commitment of the Italian National Health Service to their health needs, following its founding principle of equity. In particular, chronic diseases, such as diabetes, represent a crucial area where patients’ health is affected by their adherence to care pathways, for which the recent literature has reported alarming low levels. In the case of migrants, obstacles to adherence, such as language or organizational barriers, could be overcome thanks also to charitable organizations providing healthcare services. In this study, we aimed to compare the adherence among documented and undocumented migrants who received healthcare services in Milan, Italy, either from the National Health Service (NHS) or from a charitable organization. We identified a cohort of newly taken into care diabetic patients composed of two groups: (i) documented migrants that attend the NHS; and (ii) undocumented migrants that attend a charity. Information was tracked by merging two datasets: the regional healthcare information system of Lombardy, and a unique dataset that collects data on specialistic visits and pharmaceutical prescriptions for all people visiting one of the most prominent charitable organizations in Italy. The annual diabetologist visit was used as the measure of adherence. The probability of being adherent was compared among the two groups by using a multivariate log-binomial regression model, considering a set of personal characteristics that may impact health behaviors. The cohort comprised 6429 subjects. The percentage of adherence was 52% among the documented migrants, and 74% among the undocumented. Regression results confirmed this pattern: undocumented patients have an increased probability of being adherent by 1.19 times (95% CI: 1.12 to 1.26) compared to documented ones. Our study revealed the potentiality of charitable organizations in guaranteeing continuity of care to undocumented migrants. We argue that this mechanism would benefit from central coordination by the government. Full article

According to the American College of Cardiology/American Heart Association (ACC/AHA) new cholesterol management guidelines in 2019, statin regimen was prescribed to only about 46.4% and 30% of diabetes (DM) patients and patients with atherosclerotic cardiovascular disease (ASCVD), respectively. Atherosclerotic cardiovascular disease accounts for most deaths and disabilities in North America. This study argues that a systematic approach to identifying targeted interventions to adhere to the statin regimen for ASCVD is sparse in previous studies. This study seeks to address the research gap. Besides, the study argues that the statin regimen could improve cholesterol management with the enablers of pharmacy, providers, electronic medical records (E.M.R.), and patients. It paves the way for future research on cardiovascular and statin regimens from different perspectives. Current study has adopted the Qualitative observation method. Accordingly, the study approached the charity care primary clinic serving a large population in the northeastern part of the United States, which constitutes the project’s setting. The facility has 51 internal medicine residents. The facility has E.H.R., which is used by the clinical staff. Besides, providers use electronic medication prescribing (E-Scribe). Four PDSA cycles were run in six months. Here, the interventions were intensified during each subsequent cycle. The interventions were then incorporated into routine clinical practice. Based on the observation, the study found a 25% relative improvement by six months based on the baseline data of the appropriate intensity statin prescription for patients with ASCVD or DM by medical resident trainees in our single-center primary care clinic. A total of 77% of cardiovascular disease patients were found to be on an appropriate statin dose at baseline. On the other hand, the proportion of patients with DM who were on proper dose statin was 80.4%. According to the study’s findings, PDSA could result in a faster uptake and support of the ACC/AHA guidelines. Evidence indicates that overmedication of persons at low risk and time constraints are some of the most significant impediments to the greater use of prescription medications. Proactive panel management can help improve statins’ use by ensuring they are used appropriately. Full article