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The dominant role of the employer regarding the access and use of healthcare services by migrant domestic helpers (MDH) often has a negative impact on healthcare provision for migrants in Cyprus. Research relating to the perceptions of MDH employers remains scarce. The purpose of this paper is to investigate the role of employers on the access and use of healthcare services by their MDH.

Three studies were carried out using semi-structured interviews with MDH (n=13) and employers of MDH (n=12) and structured questionnaires with MDH (n=625). Content analysis for qualitative findings was carried out using QSR Nvivo 10 and for quantitative using Statistical Package for Social Sciences version 17.

Findings provide information about migrant health needs from different views leading to improved documentation via multiple triangulation. Employers play a key gatekeeping role but are not in position to provide sufficient information and guidance to their MDH. MDH reported a need for health services which was not met (18 percent), attributing this to their employers not granting them permission.

The role of the employer is critical and has an impact on the quality of care provided to this migrant group. The involvement of the employer in MDH health matters functions as a barrier. A significant gap exists between employers and MDH regarding the health needs of the latter.

As long as migration is recognized as a public health concern, policies exist to address migrants’ health, and provide comprehensive information on how public and private health care system operates, health rights and what their health care plan does or does not cover. Thereby, responding to patients’ expectations significantly affects overall satisfaction with health care services because this dimension is most strongly associated with patient satisfaction. The purpose of this paper is to constitute the first quantitative large-scale study (n=1,512) in Cyprus and Greece exploring the level of satisfaction among third-country nationals (TCN) in relation to their health care needs.

The questionnaire used in this study has been developed and measured (Cronbach α =0.7) in a similar study in Greece (Galanis et al., 2013) and it has been used by other studies too (Vozikis, 2015).

The authors can conclude that participants’ knowledge of the health system is not good as 70.2 percent that they do not have a good knowledge. The findings suggest that nearly one in two TCN faced problems in accessing clinics or communicating due to various factors.

The findings of this study provide the context for further exploration of different means to improve cultural awareness amongst health and social care professionals, including multicultural training of health and social service providers and medical pluralist approaches that may be closer to migrants’ cultural and health background. Overall, types of interventions to improve cultural competency included training/workshops/programs for health practitioners (e.g. doctors, nurses and community health workers), culturally specific/tailored education or programs for patients/clients, interpreter services, peer education, patient navigators and exchange programs (Truong, 2014). To the above, practices can also be added as multicultural education to all health professionals in order to develop enthusiasm and be able to acknowledge immigrants’ difficulties. Adding to the above recommendation, interdisciplinary education with allied health professionals (psychologists, social workers and nurses) may lead to a more holistic approach of this group’s needs, especially in the forthcoming health system where primary care will play a vital role.

Access to the health system may lead to social inclusion of TCN in the local society and improve their quality of life. It is also important for TCN to feel that the current health system is aware of issues related to their social and cultural background; thus, it will make the health system and those who work look more friendly and approachable.

In an era of crisis and of great debate around a forthcoming National Health System, these findings indicate that healthcare providers in Cyprus will need to address several challenges in managing care for migrants. In order for that to happen, assessing patient satisfaction is thereby important in the process of quality evaluation, especially when dealing with population subgroups at higher risk of inequalities such as immigrants or ethnic minorities. Such studies help systems to develop by measuring their weaknesses and enhancing their strengths. Voicing clients/patients feedback is always helpful to minimize risks.

People with visual impairments or blindness (PwVIB) are mostly excluded from tourism activities. Despite the rise of assistive technology (AT) solutions in Tourism, acceptance remains low because of the difficulty of providing the right functionality, effectiveness and usability. Arguably, it can be said that disability-oriented training can affect the latter two and, therefore, an AT solution’s acceptance. This paper aims to contribute to the theory development and conceptualization of technology acceptance of AT solutions in Tourism by studying, in the context of the Unified Theory of Acceptance and Use of Technology (UTAUT), the effects of training PwVIB on using AT solutions. This study presents the effects of training on the tourism behavior of PwVIB and provides valuable information to the stakeholders.

Questionnaire data collected from 128 PwVIB after evaluating an AT were subjected to exploratory and confirmatory factor analysis and structural equation modeling followed by post-evaluation interviews. The used application, called BlindMuseumTourer, enables high-precision autonomous indoor navigation for PwVIB in tourist places like museums and places of health care.

The results of this study indicate the partial satisfaction of the extended model validating the importance of performance expectancy and training (the new factor) in predicting the behavioral intention of PwVIB tourists toward using ATs during their tourist activities. This suggests that practitioners have to provide performant technological solutions accompanied by special training sessions for improved engagement and satisfaction.

This study contributes to the UTAUT theory in the context of Tourism for PwVIB by adding a new factor and replacing two moderator variables. To the best of the authors’ knowledge, no similar work is studying AT acceptance by PwVIB in the tourism literature. Furthermore, the validation process used a novel indoor navigation application, demonstrating its effectiveness in the Tactual Museum of Greece.

视障或失明人士（PwVIB）大多被排除在旅游活动之外。尽管辅助技术（AT）解决方案在旅游业中兴起, 但由于难以提供适当的功能、有效性和可用性, 接受度仍然很低。可以说, 以残疾为导向的培训会影响后两者, 从而影响对辅助技术解决方案的接受程度。本文旨在通过在技术接受和使用统一理论（UTAUT）的背景下, 研究培训 PwVIB 对使用 AT 解决方案的影响, 为旅游行业对 AT 解决方案的技术接受的理论发展和概念化做出贡献。本研究将介绍培训对 PwVIB 旅游行为的影响, 并为利益相关者提供有价值的信息。

对 128 名无身份者在评估了辅助设施后收集的问卷数据进行了探索性因素分析、确认性因素分析和结构方程模型分析, 然后进行了评估后访谈。所采用的应用程序名为 “BlindMuseumTourer”, 可在博物馆和医疗场所等旅游景点为 PwVIB 提供高精度的自主室内导航。

结果表明, 扩展模型的部分结果验证了性能预期和培训（新因素）在预测无障碍游客在旅游活动中使用自动视听设备的行为意向方面的重要性。这表明, 从业人员必须提供性能优越的技术解决方案, 并辅以专门的培训课程, 以提高参与度和满意度。

本研究通过增加一个新因素和替换两个调节变量, 为UTAUT 理论在无障碍游客旅游方面的应用做出了贡献。据我们所知, 在旅游文献中, 还没有类似的工作是研究 PwVIB 对 AT 的接受程度。此外, 在验证过程中还使用了一个新颖的室内导航应用程序, 并在希腊触觉博物馆展示了其有效性。

Las personas con discapacidad visual o ceguera (PwVIB) están excluidas en su mayoría de las actividades turísticas. A pesar del auge de las soluciones de tecnología de asistencia (TA) en el turismo, su aceptación sigue siendo baja debido a la dificultad de proporcionar la funcionalidad, eficacia y usabilidad adecuadas. Podría decirse que la formación orientada a la discapacidad puede afectar a las dos últimas y, por tanto, a la aceptación de una solución de TA. Este artículo pretende contribuir al desarrollo teórico y a la conceptualización de la aceptación de las soluciones de tecnología de apoyo en el turismo estudiando, en el contexto de la Teoría Unificada de la Aceptación y el Uso de la Tecnología (UTAUT), los efectos de la formación de las PwVIB en la utilización de las soluciones de tecnología de apoyo. El estudio presentará los efectos de la formación en el comportamiento turístico de las PwVIB y proporcionará información valiosa a las partes interesadas.

Los datos del cuestionario recogidos de 128 PwVIB tras la evaluación de una TA se sometieron a un Análisis Factorial Exploratorio y Confirmatorio y a un Modelado de Ecuaciones Estructurales, seguidos de entrevistas posteriores a la evaluación. La aplicación empleada, denominada BlindMuseumTourer, permite la navegación autónoma en interiores de alta precisión para PwVIB en lugares turísticos como museos y lugares de asistencia sanitaria.

Los resultados indican la satisfacción parcial del modelo ampliado validando la importancia de la expectativa de rendimiento y la formación en la predicción de la intención conductual de los turistas PwVIB por lo que sugieren a los profesionales que las sesiones especiales de formación son esenciales para el compromiso y la satisfacción de los usuarios.

Este estudio contribuye a la teoría UTAUT en el contexto del turismo para PwVIB añadiendo un nuevo factor y sustituyendo dos variables moderadoras. Hasta donde se sabe, no existe ningún trabajo similar que estudie la aceptación de la TA por parte de las PwVIB en la literatura sobre turismo. Además, en el proceso de validación se utilizó una novedosa aplicación de navegación en interiores que ha demostrado su eficacia en el Museo Táctico de Grecia.

The ultimate aim of this study is to investigate how health information needs’ satisfaction actually makes a difference to the patients' management of a chronic clinical condition. The literature falls short of providing evidence on the interaction between patients' health information seeking behaviour and the successful management of a clinical condition. On the other hand, patient education and good information seeking practices are deemed necessary for hypertension management daily decisions.

A specially designed questionnaire study was developed: The survey design was informed by the information seeking behaviour model of Wilson for studying hypertension patients' information needs, information resources and obstacles patients face while seeking hypertension-related information. Moreover, clinical information was collected in order to make associations and inference on the impact of information seeking on patients' clinical outcomes.

The study included 111 patients submitted to the outpatient hypertension clinic of a university hospital in Athens for a 24-h ambulatory blood pressure measurement (ABPM). The analysis showed that those reporting higher satisfaction level of their information needs achieved lower values in ABPM (ABPM<130/80mmHg, p = 0.049). Stepwise the logistic regression analysis revealed three independent factors to predict the possibility of being optimally treated (ABPM<130/80mmHg). Dipping status (OR: 14.052, 95% CI: 4.229–46.688, p = 0.0001) patients with high satisfaction level of their disease (OR: 13.450, 95% CI: 1.364–132.627, p = 0.026) and interpersonal relationships were used as the main source of information (OR: 1.762, 95% CI: 1.024–3.031, p = 0.41).

Hypertensive patients with high satisfaction level of information achieve better disease control. Among different sources of information, interpersonal relationships emerge as the most appropriate factor for patients' disease control.

Informal payments (IPs) for healthcare are a serious obstacle to equitable access and universal health coverage in developing countries. Policy makers need to know more about the hidden nature of informal patient payments (IPPs) before any policy adoption and implementation. The purpose of this paper is to systematically review the main factors affecting IPPs.

This systematic review was conducted in 2018 using the standard guideline of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses. All English original articles on the determinants of IPPs published in the scientific journals, whose full text was available through Scopus, PubMed and Web of Science databases, which were given consideration for review.

The results showed that IPPs were greatly dependent on the characteristics of healthcare consumers, providers, healthcare system and services. Among healthcare consumers’ characteristics affecting IPPs, the income, age, education, gender, employment and health status were more cited factors, respectively. Among healthcare providers’ characteristics affecting IPPs, the providers’ experience, reputation, and salary satisfaction were better known, respectively. Among healthcare services features, the hospitalization, service specialty and the level of treatment urgency were more noted, respectively.

Policy making against IPs in the health sector requires precise attention to all components of healthcare market, including healthcare consumers, providers, healthcare system and services characteristics.

The purpose of this paper is to evaluate which groups of the self-employed engage in the informal economy. Until now, self-employed people participating in the informal economy have been predominantly viewed as marginalised populations such as those on a lower income and living in deprived regions (i.e. the “marginalisation thesis”). However, an alternative emergent “reinforcement thesis” conversely views the marginalised self-employed as less likely to do so. Until now, no known studies have evaluated these competing perspectives.

To do this, the author report a 2013 survey conducted across 28 countries involving 1,969 face-to-face interviews with the self-employed about their participation in the informal economy.

Using multilevel mixed-effects logistic regression analysis, the finding is that the marginalisation thesis applies when examining characteristics such as the age, marital status, tax morality, occupation and household financial circumstances of the self-employed engaged in the informal economy. However, when gender and regional variations are analysed, the reinforcement thesis is valid. When characteristics such as the urban-rural divide and educational level are analysed, no evidence is found to support either the marginalisation or reinforcement thesis.

The outcome is a call for a more nuanced understanding of the marginalisation thesis that the self-employed participating in the informal economy are largely marginalised populations.

This is the first extensive evaluation of which self-employed groups participate in the informal economy.

This paper aims at understanding how clinical guidelines' use in the labour process relates to clinical autonomy, that is, the self-control medical professionals exercise over medical practice.

Drawing on a qualitative case study research strategy, this paper explores how medical professionals use clinical guidelines in the labour process in one public general hospital of the Greek National Health System. Supplemented by an extensive study of documents, semi-structured interviews were conducted with 33 doctors of several specialties.

The analysis shows (1) how clinical autonomy, as a self-control structure, mediates the use of clinical guidelines as a knowledge tool in the labour process, and (2) how employing clinical guidelines as a means towards coordinating medical work, but also towards regulating and standardising medical practice, is exercising pressure on the individualistic character of clinical autonomy.

Advancing the analytic value of workplace control structures, this paper contributes novel theoretical understanding of emerging tendencies characterising medical work organisation and clinical autonomy, and explains how medical professionals' non-adherence to clinical practice guidelines (CPGs) relates to CPGs' role as a resource to medical practice. Finally, this research proposes a more critical approach to health policy towards addressing the challenges associated with centrally introducing clinical guidelines in healthcare organisations.

Reducing informal payments (IPs) for health services has always been a top priority for health policymakers all over the world. As the newest attempts to reduce IPs, Iran’s Government applied a set of reforms in the health care system in 2014 called “Health Sector Evolution Plan” (HSEP). The purpose of this paper is to investigate the prevalence and nature of IPs one year after implementing this plan.

This descriptive and cross-sectional study was a nationwide survey on Iran's health sector informal payments carried out in 2016. To do this, a sample of 1,112 Iranain households was selected from all over the country using a multistage cluster-stratified sampling method. The prevalence and nature of IPs were determined through conducting face-to-face interviews using a standard questionnaire.

One year after implementing the HSEP, about 27.7 percent of sampled Iranians had at least one experience of IPs for health services. The prevalences of compulsory and voluntary IPs were 21.4 and 11.5 percent, respectively. IPs were reported by 26.1 and 12.5 percent in the inpatient and outpatient services, respectively.

According to the results, compulsory IPs are still prevalent in both the outpatient and inpatient services of Iran’s health system and it seems that the HSEP has not been completely successful in achieving the goal of eradicating IPs. It can be said that the HSEP has been the first step toward eradicating IPs in Iran and should not be the last one. The study provides useful results of the prevalence and nature of IPs after implementing the HSEP, which should be considered in designing the next steps.

To better meet people's information needs under the public health crisis, this study explored the information needs and seeking behavior of college students in the context of the COVID-19 pandemic.

This research utilized a survey and the convenience snowball sampling method. A sample of 400 college students was obtained.

The results revealed that college students have paid great attention to COVID-19-related information. They sought the information mainly for personal protection, obtaining the latest information and seeking information for family and friends. Their COVID-19-related information needs were diverse; at different stages, the concerns were different. Social media and mass media were both found to be the most useful tools for seeking COVID-19 information. Too much repetitive information, unclear authoritative and reliable informational sources, and difficulties in judging the authenticity of the information were the most common obstacles for them in information seeking. Nevertheless, the majority of the students agreed that they were very satisfied and somewhat satisfied with the current information services. This did not affect the students' understanding of the importance of health services provided by libraries.

Insights into the people's information needs and information-seeking behavior of this study could help the information providers to offer appropriate information in better ways to improve the public's virus protection capabilities and maintain the stability of social order.