Citizens' Perspectives on Disinvestment from Publicly Funded Pathology Tests: A Deliberative Forum.

BACKGROUND: Deliberative forums can be useful tools in policy decision making for balancing citizen voice and community values against dominant interests. OBJECTIVE: To describe the use of a deliberative forum to explore community perspectives on a complex health problem-disinvestment. METHODS: A deliberative forum of citizens was convened in Adelaide, South Australia, to develop criteria to support disinvestment from public funding of ineffective pathology tests. The case study of potential disinvestment from vitamin B12/folate pathology testing was used to shape the debate. The forum was informed by a systematic review of B12/folate pathology test effectiveness and expert testimony. RESULTS: The citizens identified seven criteria: cost of the test, potential impact on individual health/capacity to benefit, potential cost to society, public good, alternatives to testing, severity of the condition, and accuracy of the test. The participants not only saw these criteria as an interdependent network but also questioned "the authority" of policymakers to make these decisions. CONCLUSIONS: Coherence between the criteria devised by the forum and those described by an expert group was considerable, the major differences being that the citizens did not consider equity issues and the experts neglected the "cost" of social and emotional impact of disinvestment on users and the society.

Experiences and perceptions of military and emergency services personnel identifying as LGBTQIA+ and their families: a qualitative systematic review protocol.

OBJECTIVE: The objective of this review is to explore the perceptions and experiences of military and emergency personnel who identify as lesbian, gay, bisexual, transgender, questioning, intersex, asexual, or other (LGBTQIA+), and the perceptions and experiences of their families. INTRODUCTION: LGBTQIA+ military and emergency first response personnel report disproportionately poorer career and personal outcomes than their cisgender and heterosexual counterparts. Research examining the underlying lived experiences and perceptions of people serving who are LGBTQIA+, particularly those of their family members, is sparse. Hence, the aim of this review is to identify, aggregate, and synthesize relevant qualitative research findings. INCLUSION CRITERIA: This review will consider studies of LGBTQIA+ military or emergency first response personnel and their families that include qualitative data capturing their experiences and perceptions of navigating industrial institutions and service communities. Military personnel include those employed in any role within any military organization; emergency first response personnel will include ambulance workers, paramedics, police, firefighters, and other public safety roles. Families will be limited to any configuration of immediate family members of active or retired LGBTQIA+ service personnel. No limits will be applied to the age of service personnel or their family members, nor to duration or chronology of service. METHODS: Databases searched will include PsycINFO, PubMed Central, ProQuest Central, Scopus, MEDLINE, Embase, and PTSDpubs. Domain-specific journals will be manually searched, and gray literature and unpublished studies will be searched via ProQuest Central. Study screening and selection against inclusion criteria will be performed in Covidence. Data extraction and critical appraisal will be performed using the standardized JBI templates and checklists for qualitative research. All stages will be performed by 2 independent reviewers, with conflicts resolved by a third reviewer. REVIEW REGISTRATION: PROSPERO CRD42022323913.

The experience of melanoma follow-up care: an online survey of patients in australia.

Investigating patients' reports on the quality and consistency of melanoma follow-up care in Australia would assist in evaluating if this care is effective and meeting patients' needs. The objective of this study was to obtain and explore the patients' account of the technical and interpersonal aspects of melanoma follow-up care received. An online survey was conducted to acquire details of patients' experience. Participants were patients treated in Australia for primary melanoma. Qualitative and quantitative data about patient perceptions of the nature and quality of their follow-up care were collected, including provision of melanoma specific information, psychosocial support, and imaging tests received. Inconsistencies were reported in the provision and quality of care received. Patient satisfaction was generally low and provision of reassurance from health professionals was construed as an essential element of quality of care. "Gaps" in follow-up care for melanoma patients were identified, particularly provision of adequate psychosocial support and patient education. Focus on strategies for greater consistency in the provision of support, information, and investigations received, may generate a cost dividend which could be reinvested in preventive and supportive care and benefit patient well-being.