Help seeking and service access

وَجَآءَ رَجُلࣱ مِّنۡ أَقۡصَا ٱلۡمَدِينَةِ يَسۡعَىٰ قَالَ يَٰمُوسَىٰٓ إِنَّ ٱلۡمَلَأَ يَأۡتَمِرُونَ بِكَ لِيَقۡتُلُوكَ فَٱخۡرُجۡ إِنِّي لَكَ مِنَ ٱلنَّٰصِحِينَ

Then a man came running from the furthest part of the city and said, ‘Moses, the authorities are talking about killing you, so leave- this is my sincere advice.’

وَقَاسَمَهُمَآ إِنِّي لَكُمَا لَمِنَ ٱلنَّٰصِحِينَ

and he swore to them, ‘I am giving you sincere advice’

أُبَلِّغُكُمۡ رِسَٰلَٰتِ رَبِّي وَأَنصَحُ لَكُمۡ وَأَعۡلَمُ مِنَ ٱللَّهِ مَا لَا تَعۡلَمُونَ

I am delivering my Lord’s messages to you and giving you sincere advice. I know things from God that you do not

فَتَوَلَّىٰ عَنۡهُمۡ وَقَالَ يَٰقَوۡمِ لَقَدۡ أَبۡلَغۡتُكُمۡ رِسَالَةَ رَبِّي وَنَصَحۡتُ لَكُمۡ وَلَٰكِن لَّا تُحِبُّونَ ٱلنَّٰصِحِينَ

So he turned away from them, saying, ‘My people, I delivered my Lord’s messages to you and gave you sincere advice, but you did not like those who gave sincere advice.’

فَتَوَلَّىٰ عَنۡهُمۡ وَقَالَ يَٰقَوۡمِ لَقَدۡ أَبۡلَغۡتُكُمۡ رِسَٰلَٰتِ رَبِّي وَنَصَحۡتُ لَكُمۡۖ فَكَيۡفَ ءَاسَىٰ عَلَىٰ قَوۡمࣲ كَٰفِرِينَ

so he turned away from them, saying, ‘My people, I delivered my Lord’s messages to you and gave you sincere advice, so why should I grieve for people who refused to believe?’

And he swore to both of them that is he swore to both of them by God ‘Truly I am a sincere adviser to you’ in this matter.

I convey to you read ublighkum or uballighukum the Messages of my Lord and I am advising you I desire good for you for I know from God what you know not.

So he turned his back on them Sālih left them and said ‘O my people I have conveyed to you the Message of my Lord and gave you sincere advice but you do not love sincere advisers’.

"And O Adam! Dwell you and your wife in Paradise, and eat thereof as you both wish, but approach not this tree otherwise you both will be of the wrongdoers (19)Then Shaytan whispered suggestions to them both in order to uncover that which was hidden from them of their private parts (before); he said: "Your Lord did not forbid you this tree save you should become angels or become of the immortals. (20)And he 'Qāsamahuma': "Verily, I am one of the sincere well-wishers for you both. (21) Shaytan's Deceit with Adam and Hawwa' and Their eating from the Forbidden Tree Allah states that He allowed Adam and his wife to dwell in Paradise and to eat from all of its fruits, except one tree. We have already discussed this in Surat Al-Baqarah. Thus, Shaytan envied them and plotted deceitfully, whispering and suggesting treachery. He wished to rid them of the various favors and nice clothes that the

Indeed, We sent Nuh to his people and he said: "O my people! Worship Allah! You have no other god but Him. Certainly, I fear for you the torment of a Great Day! (59)The leaders of his people said: "Verily, we see you in plain error. (60)[Nuh] said: "O my people! There is no error in me, but I am a Messenger from the Lord of all that exists (61)I convey unto you the Messages of my Lord and give sincere advice to you. And I know from Allah what you know not. (62) The Story of Nuh and His People After Allah mentioned the story of Adam in the beginning of this Surah, He started mentioning the stories of the Prophets, the first then the latter of them. Allah mentioned the story of Nuh, because he was the first Messenger Allah sent to the people of the earth after Adam. His name was Nuh bin Lamak bin Matushalakh bin Khanukh. And Khanukh was, as they claim, the Prophet Idris. And Idris was th

Then he [Salih] turned from them, and said: "O my people! I have indeed conveyed to you the Message of my Lord, and have given you good advice, but you like not good advisers. (79) These are the words of admonishment that Salih conveyed to his people after Allah destroyed them for defying Him, rebelling against Him, refusing to accept the truth, avoiding guidance, and preferring misguidance instead. Salih said these words of admonishment and criticism to them after they perished, and they heard him (as a miracle for Prophet Salih from Allah). Similarly, it is recorded in the Two Sahihs that after the Messenger of Allah ﷺ defeated the disbelievers in the battle of Badr, he remained in that area for three days, and then rode his camel, which was prepared for him during the latter part of the night. He went on until he stood by the well of Badr (where the corpses of the disbelievers were t

حَدَّثَنِي عَبْدُ اللَّهِ بْنُ مُحَمَّدٍ، حَدَّثَنَا عَبْدُ الْمَلِكِ بْنُ عَمْرٍو، حَدَّثَنَا زُهَيْرُ بْنُ مُحَمَّدٍ، عَنْ مُحَمَّدِ بْنِ عَمْرِو بْنِ حَلْحَلَةَ، عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي سَعِيدٍ الْخُدْرِيِّ، وَعَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ مَا يُصِيبُ الْمُسْلِمَ مِنْ نَصَبٍ وَلاَ وَصَبٍ وَلاَ هَمٍّ وَلاَ حُزْنٍ وَلاَ أَذًى وَلاَ غَمٍّ حَتَّى الشَّوْكَةِ يُشَاكُهَا، إِلاَّ كَفَّرَ اللَّهُ بِهَا مِنْ خَطَايَاهُ ‏"‏‏.‏

Narrated Abu Sa`id Al-Khudri and Abu Huraira:The Prophet (ﷺ) said, "No fatigue, nor disease, nor sorrow, nor sadness, nor hurt, nor distress befalls a Muslim, even if it were the prick he receives from a thorn, but that Allah expiates some of his sins for that

حَدَّثَنَا إِبْرَاهِيمُ بْنُ الْمُنْذِرِ، قَالَ حَدَّثَنِي مُحَمَّدُ بْنُ فُلَيْحٍ، قَالَ حَدَّثَنِي أَبِي، عَنْ هِلاَلِ بْنِ عَلِيٍّ، مِنْ بَنِي عَامِرِ بْنِ لُؤَىٍّ عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي هُرَيْرَةَ ـ رضى الله عنه ـ قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَثَلُ الْمُؤْمِنِ كَمَثَلِ الْخَامَةِ مِنَ الزَّرْعِ مِنْ حَيْثُ أَتَتْهَا الرِّيحُ كَفَأَتْهَا، فَإِذَا اعْتَدَلَتْ تَكَفَّأُ بِالْبَلاَءِ، وَالْفَاجِرُ كَالأَرْزَةِ صَمَّاءَ مُعْتَدِلَةً حَتَّى يَقْصِمَهَا اللَّهُ إِذَا شَاءَ ‏"‏‏.‏

Narrated Abu Huraira:Allah's Messenger (ﷺ) said, "The example of a believer is that of a fresh tender plant; from whatever direction the wind comes, it bends it, but when the wind becomes quiet, it becomes straight again. Similarly, a believer is afflicted with calamities (but he remains patient till Allah removes his difficulties.) And an impious wicked person is like a pine tree which keeps hard and straight till Allah cuts (breaks) it down when He wishes." (See Hadith No. 558, Vol)

حَدَّثَنَا مُحَمَّدُ بْنُ يَحْيَى، قال حَدَّثَنَا إِسْحَاقُ بْنُ مُحَمَّدٍ الْفَرْوِيُّ، قال حَدَّثَنَا إِسْمَاعِيلُ بْنُ جَعْفَرٍ، عَنْ عُمَارَةَ بْنِ غَزِيَّةَ، عَنْ عَاصِمِ بْنِ عُمَرَ بْنِ قَتَادَةَ، عَنْ مَحْمُودِ بْنِ لَبِيدٍ، عَنْ قَتَادَةَ بْنِ النُّعْمَانِ، أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم قَالَ ‏ "‏ إِذَا أَحَبَّ اللَّهُ عَبْدًا حَمَاهُ الدُّنْيَا كَمَا يَظَلُّ أَحَدُكُمْ يَحْمِي سَقِيمَهُ الْمَاءَ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى وَفِي الْبَابِ عَنْ صُهَيْبٍ وَأُمِّ الْمُنْذِرِ ‏.‏ وَهَذَا حَدِيثٌ حَسَنٌ غَرِيبٌ ‏.‏ وَقَدْ رُوِيَ هَذَا الْحَدِيثُ عَنْ مَحْمُودِ بْنِ لَبِيدٍ عَنِ النَّبِيِّ صلى الله عليه وسلم مُرْسَلاً ‏.‏ حَدَّثَنَا عَلِيُّ بْنُ حُجْرٍ، قال أَخْبَرَنَا إِسْمَاعِيلُ بْنُ جَعْفَرٍ، عَنْ عَمْرِو بْنِ أَبِي عَمْرٍو، عَنْ عَاصِمِ بْنِ عُمَرَ بْنِ قَتَادَةَ، عَنْ مَحْمُودِ بْنِ لَبِيدٍ، عَنِ النَّبِيِّ صلى الله عليه وسلم نَحْوَهُ وَلَمْ يَذْكُرْ فِيهِ عَنْ قَتَادَةَ بْنِ النُّعْمَانِ ‏.‏ قَالَ أَبُو عِيسَى وَقَتَادَةُ بْنُ النُّعْمَانِ الظَّفَرِيُّ هُوَ أَخُو أَبِي سَعِيدٍ الْخُدْرِيِّ لأُمِّهِ وَمَحْمُودُ بْنُ لَبِيدٍ قَدْ أَدْرَكَ النَّبِيَّ صلى الله عليه وسلم وَرَآهُ وَهُوَ غُلاَمٌ صَغِيرٌ ‏.‏

Qatadah bin An-Nu'man narrated that the Messenger of Allah (s.a.w) said:"When Allah loves a slave, He prevents him from the world, just as one of you prevents his sick from water." Another chain reports a similar narration

حَدَّثَنَا عَبَّاسُ بْنُ مُحَمَّدٍ الدُّورِيُّ، قال حَدَّثَنَا يُونُسُ بْنُ مُحَمَّدٍ، قال حَدَّثَنَا فُلَيْحُ بْنُ سُلَيْمَانَ، عَنْ عُثْمَانَ بْنِ عَبْدِ الرَّحْمَنِ التَّيْمِيِّ، عَنْ يَعْقُوبَ بْنِ أَبِي يَعْقُوبَ، عَنْ أُمِّ الْمُنْذِرِ، قَالَتْ دَخَلَ عَلَىَّ رَسُولُ اللَّهِ صلى الله عليه وسلم وَمَعَهُ عَلِيٌّ وَلَنَا دَوَالٍ مُعَلَّقَةٌ قَالَتْ فَجَعَلَ رَسُولُ اللَّهِ صلى الله عليه وسلم يَأْكُلُ وَعَلِيٌّ مَعَهُ يَأْكُلُ ‏.‏ فَقَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم لِعَلِيٍّ ‏"‏ مَهْ مَهْ يَا عَلِيُّ فَإِنَّكَ نَاقِهٌ ‏"‏ ‏.‏ قَالَ فَجَلَسَ عَلِيٌّ وَالنَّبِيُّ صلى الله عليه وسلم يَأْكُلُ ‏.‏ قَالَتْ فَجَعَلْتُ لَهُمْ سِلْقًا وَشَعِيرًا فَقَالَ النَّبِيُّ صلى الله عليه وسلم ‏"‏ يَا عَلِيُّ مِنْ هَذَا فَأَصِبْ فَإِنَّهُ أَوْفَقُ لَكَ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ غَرِيبٌ لاَ نَعْرِفُهُ إِلاَّ مِنْ حَدِيثِ فُلَيْحٍ ‏.‏ وَيُرْوَى عَنْ فُلَيْحٍ عَنْ أَيُّوبَ بْنِ عَبْدِ الرَّحْمَنِ ‏.‏ حَدَّثَنَا مُحَمَّدُ بْنُ بَشَّارٍ، قال حَدَّثَنَا أَبُو عَامِرٍ، وَأَبُو دَاوُدَ قَالاَ حَدَّثَنَا فُلَيْحُ بْنُ سُلَيْمَانَ، عَنْ أَيُّوبَ بْنِ عَبْدِ الرَّحْمَنِ، عَنْ يَعْقُوبَ، عَنْ أُمِّ الْمُنْذِرِ الأَنْصَارِيَّةِ، فِي حَدِيثِهِ قَالَتْ دَخَلَ عَلَيْنَا رَسُولُ اللَّهِ صلى الله عليه وسلم فَذَكَرَ نَحْوَ حَدِيثِ يُونُسَ بْنِ مُحَمَّدٍ إِلاَّ أَنَّهُ قَالَ ‏"‏ أَنْفَعُ لَكَ ‏"‏ ‏.‏ وَقَالَ مُحَمَّدُ بْنُ بَشَّارٍ وَحَدَّثَنِيهِ أَيُّوبُ بْنُ عَبْدِ الرَّحْمَنِ ‏.‏ هَذَا حَدِيثٌ جَيِّدٌ غَرِيبٌ ‏.‏

Umm Al-Mundhir said:"The Messenger of Allah (ﷺ) entered upon me, while `Ali was with him, and we had a cluster of unripe dates hanging." She said: "The Messenger of Allah (ﷺ) began eating, and `Ali ate with him. The Messenger of Allah (ﷺ) said to `Ali: 'Stop, stop, for you are still recovering.' So `Ali sat and the Prophet (ﷺ) ate." She said: "I made some chard and barley for them, so the Prophet (ﷺ) said: 'O `Ali eat from this, for indeed it will be more suitable for you." Another chain reports a similar narration

قال أبو حاتم رضى الله عنه لا أنس آنس من استشارة عاقل ودود ولا وحشة أوحش من مخالفته لأن المشاورة والمناظرة بابا بركة ومفتاحا رحمة من استشير فليشر بالنصيحة وليجتهد بالرأي وليلزم الحق وقصد السبيل وليجعل المستشير كنفسه بترك الخيانه وبذل النصيحه وليكن كما أنشدني على ابن محمد البسامي % ومن الرجال إذا زكت أحلامهم % من يستشار إذا أستشير فيطرق % % حتى يجول بكل واد قلبه % فيرى ويعرف ما يقول وينطق % % إن الحليم إذا تفكر لم يكد % يخفي عليه من الأمور الأوفق % $

ألا قل لهم قول عبد % نصوح وحق النصيحة أن تستمع

فلا أحسن من هذه النصيحة وهذا الإرشاد والتعليم الذي لو أخذ به الناس لم يضع في الأكثر حق أحد ولم يتمكن المبطل من الجحود والنسيان

وحق الله تعالى في الطاعة ستة أمور تقدمت وهي : الإخلاص في العمل والنصيحة لله فيه ومتابعة الرسول فيه وشهود مشهد الإحسان فيه وشهود منة الله عليه وشهود تقصيره فيه بعد ذلك كله

وقيل مجالسة العارف تدعوك من ست إلى ست من الشك إلى اليقين ومن الرياء إلى الإخلاص ومن الغفلة إلى الذكر ومن الرغبة في الدنيا إلى الرغبة في الآخرة ومن الكبر إلى التواضع ومن سوء الطوية إلى النصيحة

وكل قبول في الناس وتعظيم ومحبة له اتصل به خضوع للرب وذل وانكسار ومعرفة بعيب النفس والعمل وبذل النصيحة للخلق فهو منة وإلا فهو حجة

Mental health care utilisation and access among refugees and asylum seekers in Europe: A systematic review.: Background: Refugees and asylum seekers often have increased mental health needs, yet may face barriers in accessing mental health and psychosocial support (MHPSS) services in destination countries. The aim of this systematic review is to examine evidence on MHPSS service utilisation and access among refugees and asylum seekers in European Union Single Market countries. Methods: Four peer-reviewed and eight grey literature databases were searched for quantitative and qualitative literature from

Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review.: Background: Adolescents and young adults frequently experience mental disorders, yet tend not to seek help. This systematic review aims to summarise reported barriers and facilitators of help-seeking in young people using both qualitative research from surveys, focus groups, and interviews and quantitative data from published surveys. It extends previous reviews through its systematic research methodology and by the inclusion of published studies describing what young people themselves perceive

What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review.: Background: Increasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap. Methods: Five databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10-19 years. The search was performed in June 2018 an

Delays in help seeking at the onset of the symptoms of rheumatoid arthritis: a systematic synthesis of qualitative literature.: A systematic review of qualitative peer-reviewed publications was conducted to identify drivers of and barriers to help-seeking behaviour in adults with new-onset rheumatoid arthritis (RA). 1058 abstracts were searched to identify relevant publications. 21 relevant publications were identified assessed for quality and subjected to analysis informed by thematic and grounded theory frameworks. Several interacting themes were identified including the early experience of symptoms in relation to dise

Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: systematic review.: Background: Self-help interventions for psychiatric disorders represent an increasingly popular alternative to therapist-administered psychological therapies, offering the potential of increased access to cost-effective treatment. Aims: To determine the efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders. Method: Randomised controlled trials (RCTs) of self-help interventions for anxiety disorders were identified by searching nine online databases. Stud

Health beliefs and perceived need for mental health care of anxiety and depression--the patients' perspective explored.: Patients' illness representations and beliefs about treatment for depression and anxiety, as well as their perceived needs, are important for treatment. A systematic review was conducted of 71 studies describing the beliefs or perceived needs of patients and non-patients. Patients give multi-dimensional explanations for depression and see both psychological and medication treatment as helpful. People who suffer from depression have more positive beliefs about biological etiology and medication t

Recipients' perspective on breaking bad news: how you put it really makes a difference.

Objective: The goal of this study was to show that physician communication style of breaking bad news affects how the physician is perceived, how satisfied recipients of bad news are with the consultation, and how they feel after the consultation. Method: Female participants (students, N=159) were asked to put themselves in the shoes of a patient receiving the bad news of a breast cancer diagnosis. Participants were randomly assigned to watch one of three prototypical physician communication styles of breaking bad news on videotape: patient-, disease-, or emotion-centered communication. Results: Results showed that these three prototypical communication styles were perceived very differently and they determined how satisfied participants were with the consultation and how they felt after the consultation. Participants exposed to the patient-centered communication perceived the physician …

matched on Attitude to Health (mesh)

Loving-kindness meditation for chronic low back pain: results from a pilot trial.

Purpose: Loving-kindness meditation has been used for centuries in the Buddhist tradition to develop love and transform anger into compassion. This pilot study tested an 8-week loving-kindness program for chronic low back pain patients. Method: Patients (N = 43) were randomly assigned to the intervention or standard care. Standardized measures assessed patients' pain, anger, and psychological distress. Findings: Post and follow-up analyses showed significant improvements in pain and psychological distress in the loving-kindness group, but no changes in the usual care group. Multilevel analyses of daily data showed that more loving-kindness practice on a given day was related to lower pain that day and lower anger the next day. Conclusions: Preliminary results suggest that the loving-kindness program can be beneficial in reducing pain, anger, and psychological distress in patients with pe…

matched on Attitude to Health (mesh)

Effects of a social support intervention on health outcomes in residents of a domestic violence shelter: a pilot study.

This pilot study tested the feasibility and effectiveness of a social support intervention with women (n = 24) while they were in a domestic violence shelter. Health outcomes were examined pre and postintervention using a randomized control design. The intervention group had greater improvement (p = .013) in psychological distress symptoms and greater improvement in perceived availability of social support (p = .016) than the control group. The intervention group showed less health care utilization (p = .032) than the control group. Social support interventions for women in shelters are effective in improving health outcomes. Further research should be aimed at testing the effectiveness of different types of interventions on health and abuse outcomes in women who experience interpersonal violence.

matched on Attitude to Health (mesh)

Digital cognitive-behavioural therapy for insomnia compared with digital patient education about insomnia in individuals referred to secondary mental health services in Norway: protocol for a multicentre randomised controlled trial.

Introduction: Insomnia is highly prevalent in outpatients receiving treatment for mental disorders. Cognitive-behavioural therapy for insomnia (CBT-I) is a recommended first-line intervention. However, access is limited and most patients with insomnia who are receiving mental healthcare services are treated using medication. This multicentre randomised controlled trial (RCT) examines additional benefits of a digital adaptation of CBT-I (dCBT-I), compared with an online control intervention of patient education about insomnia (PE), in individuals referred to secondary mental health clinics. Methods and analysis: A parallel group, superiority RCT with a target sample of 800 participants recruited from treatment waiting lists at Norwegian psychiatric services. Individuals awaiting treatment will receive an invitation to the RCT, with potential participants undertaking online screening and c…

matched on Mental Health Services (mesh)

Mental health in refugees and asylum seekers (MEHIRA): study design and methodology of a prospective multicentre randomized controlled trail investigating the effects of a stepped and collaborative care model.

The sudden arrival of culturally diverse asylum seekers and refugees into Germany has created a strong demand for recognizing and appropriately treating those suffering from mental health issues. Due to many systemic, organizational, cultural and socio-linguistic barriers, psychiatric treatment of refugees is posing a major challenge to Germany's mental health care system. Thus, there is a need for alternative models that allow for increased access to adequate, effective and efficient culturally sensitive mental health care services. Here, we describe the Mental Health in Refugees and Asylum Seekers (MEHIRA) project, a multicentre randomized controlled trial investigating a stepped collaborative care model (SCCM) for providing mental health treatment in this vulnerable population. The proposed SCCM aims to decrease the aforementioned barriers. Adult and adolescent participants will be sc…

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Tailored implementation of internet-based cognitive behavioural therapy in the multinational context of the ImpleMentAll project: a study protocol for a stepped wedge cluster randomized trial.

Background: Internet-based Cognitive Behavioural Therapy (iCBT) is found effective in treating common mental disorders. However, the use of these interventions in routine care is limited. The international ImpleMentAll study is funded by the European Union's Horizon 2020 programme. It is concerned with studying and improving methods for implementing evidence-based iCBT services for common mental disorders in routine mental health care. A digitally accessible implementation toolkit (ItFits-toolkit) will be introduced to mental health care organizations with the aim to facilitate the ongoing implementation of iCBT services within local contexts. This study investigates the effectiveness of the ItFits-toolkit by comparing it to implementation-as-usual activities. Methods: A stepped wedge cluster randomized controlled trial (SWT) design will be applied. Over a trial period of 30 months, the …

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Advancing successful implementation of task-shifted mental health care in low-resource settings (BASIC): protocol for a stepped wedge cluster randomized trial.

Background: The mental health treatment gap-the difference between those with mental health need and those who receive treatment-is high in low- and middle-income countries. Task-shifting has been used to address the shortage of mental health professionals, with a growing body of research demonstrating the effectiveness of mental health interventions delivered through task-shifting. However, very little research has focused on how to embed, support, and sustain task-shifting in government-funded systems with potential for scale up. The goal of the Building and Sustaining Interventions for Children (BASIC) study is to examine implementation policies and practices that predict adoption, fidelity, and sustainment of a mental health intervention in the education sector via teacher delivery and the health sector via community health volunteer delivery. Methods: BASIC is a Hybrid Type II Imple…

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Efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL) in early psychosis: study protocol for a multi-centre randomized controlled trial.

Background: Psychotic experiences, social functioning and general psychopathology are important targets for early intervention in individuals with Ultra-High-Risk state (UHR) and a first-episode psychosis (FEP). Acceptance and Commitment Therapy (ACT) is a promising, next-generation Cognitive Behavioural Therapy (CBT) that aims to modify these targets, but evidence on sustainable change and its underlying mechanisms in individuals' daily lives remains limited. The aim of the INTERACT study is to investigate the efficacy of a novel ecological momentary intervention, Acceptance and Commitment Therapy in Daily Life (ACT-DL) in a multi-centre randomised controlled trial of individuals with UHR or FEP. Methods/design: In a multi-centre randomised controlled trial, individuals aged 16-65 years with UHR or FEP will be randomly allocated to ACT-DL in addition to treatment as usual (TAU) as the e…

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Effectiveness of a Stepped, Collaborative, and Coordinated Health Care Network for Somatoform Disorders (Sofu-Net): A Controlled Cluster Cohort Study.

Objective: Stepped, collaborative, and coordinated approaches have been proposed as the optimal treatment strategy for somatic symptom and related disorders, but evidence supporting this strategy is lacking. The aim of this study was to assess the effectiveness of a guideline-based health care network for patients who are at high risk of somatoform disorder (Sofu-Net). Methods: In a controlled, prospective, observer-blinded cluster cohort study, patients who were at high risk of somatoform disorder were recruited at 18 primary care practices in the Sofu-Net and at 15 primary care practices that provided care as usual (CAU). The primary outcome at 6-month follow-up was the rate at which the patients received mental health treatment since the establishment of Sofu-Net. The secondary outcomes included the patients' clinical symptom severity. Results: A total of 119 patients in the Sofu-Net …

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The effectiveness of computerized cognitive behavioural therapy in routine care.

Objectives and design: The efficacy of a Computerized Cognitive Behavioural Therapy (CCBT) package, Beating the Blues, has been demonstrated in a large randomized controlled trial. The current study tests the generalizability of this finding in a naturalistic non-randomized trial. Method: 219 patients with anxiety and/or depression were recruited to receive CCBT in routine care. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) and Work and Social Adjustment scale (WSA) were administered pre-treatment, immediately on completing treatment and at 6 months post-treatment. Single-item self-report measures of anxiety and depression were also collected during each treatment session. Results: Completer and intention-to-treat analysis demonstrated statistically and clinically significant improvements on the CORE-OM, WSA and in self-reported anxiety and depression. Intention-t…

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Help-seeking and receipt of treatment among UK service personnel.

Background: For armed forces personnel, data on help-seeking behaviour and receipt of treatment for mental disorders are important for both research and policy. Aims: To examine mental healthcare service use and receipt of treatment in a sample of the UK military. Method: Participants were drawn from an existing UK military health cohort. The sample was stratified by reserve status and by participation in the main war-fighting period of the Iraq War. Participants completed a telephone-based structured diagnostic interview comprising the Patient Health Questionnaire and Primary Care Post-Traumatic Stress Disorder Screen (PC-PTSD), and a series of questions about service utilisation and treatment receipt. Results: Only 23% of those with common mental disorders and still serving in the military were receiving any form of medical professional help. Non-medical sources of help such as chaplai…

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The influence of social anchorage on the gender difference in the use of mental health services.

Overall, women are more likely than men to seek professional care when they face light or moderate mental health problems. This difference is usually attributed to culture-related factors, but neither women nor men form a homogeneous cultural group. The help-seeking behavior may reflect not only the cultural values and expectations associated with a specific gender but also those associated with specific social roles endorsed by women and men. In addition, the influence of these culture-related factors on the help-seeking behavior is constrained by barriers to care, which apply similarly to women and men. In consequence, the gender difference in the use of mental health services should vary across social roles and types of service. This hypothesis was tested on data from the cycle 1.2 of the Canadian Community Health Survey. Logistic regression analyses show that, although women are more…

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Country-level determinants of healthcare access for refugee populations in a host country: a comparative case study.

Background: Given the unprecedented global volume of forced migration, ensuring equitable access to healthcare for refugees has become a pressing global health priority. This comparative case study examined country-level determinants that influence healthcare access and social determinants of health among refugees in Australia, South Korea, and the United States. Methods: We conducted a comparative case study to identify country-level factors influencing refugee healthcare access in Australia, South Korea, and the United States. Countries were selected to capture diversity in geographic context, immigration and integration policies, and healthcare system structures. Data sources included a comprehensive review of laws, policies, and peer-reviewed literature, as well as in-depth interviews with refugees, healthcare providers, resettlement agency staff, and legal professionals. We used fra…

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Healthcare workers' perspectives on a prescription phone program to meet the health equity needs of patients in the emergency department: a qualitative study.

Objectives: People experiencing homelessness and marginalization face considerable barriers to accessing healthcare services. Increased reliance on technology within healthcare has exacerbated these inequities. We evaluated a hospital-based prescription phone program aimed to reduce digital health inequities and improve access to services among marginalized patients in Emergency Departments. We examined the perceived outcomes of the program and the contextual barriers and facilitators affecting outcomes. Methods: We conducted a constructivist qualitative program evaluation at two urban, academic hospitals in Toronto, Ontario. We interviewed 12 healthcare workers about their perspectives on program implementation and outcomes and analyzed the interview data using reflexive thematic analysis. Results: Our analyses generated five interrelated program outcomes: building trust with patients, …

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Association of Social Isolation With Disability Burden and 1-Year Mortality Among Older Adults With Critical Illness.

Importance: Disability and mortality are common among older adults with critical illness. Older adults who are socially isolated may be more vulnerable to adverse outcomes for various reasons, including fewer supports to access services needed for optimal recovery; however, whether social isolation is associated with post-intensive care unit (ICU) disability and mortality is not known. Objectives: To evaluate whether social isolation is associated with disability and with 1-year mortality after critical illness. Design, setting, and participants: This observational cohort study included community-dwelling older adults who participated in the National Health and Aging Trends Study (NHATS) from May 2011 through November 2018. Hospitalization data were collected through 2017 and interview data through 2018. Data analysis was conducted from February 2020 through February 2021. The mortality …

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A Comparison of Low-Income Versus Higher-Income Individuals Seeking an Online Relationship Intervention.

Compared to higher-income couples, low-income couples experience higher rates of relationship disruption, including divorce and breakup of cohabiting relationships. In recognition of this disparity in relationship outcomes, relationship interventions have increasingly been targeted at this population. However, these interventions have had limited impacts on the relationships of low-income couples. Developing interventions that are effective and responsive to the needs of low-income couples requires descriptive data on the challenges those couples perceive in their own relationships and an assessment of how their needs compare to the more affluent couples typically served by relationship interventions. The current study sampled over 5,000 individuals at the time they were seeking an online relationship intervention and compared the relationship functioning and life circumstances reported …

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Factors predicting first-time hepatitis C virus testing uptake among men who have sex with men in China: an observational prospective cohort study.

Objectives: Men who have sex with men (MSM) are at high risk of hepatitis C virus (HCV). This study investigated predictors of first-time HCV testing uptake during a 6-month period among a sample of MSM in Hong Kong. Methods: Participants were 351 Chinese-speaking MSM who had never received HCV testing. Participants completed two telephone surveys 6 months apart. At baseline, participants reported on sociodemographics, sexual behaviours, risk perception, depressive symptoms and anxiety symptoms. Illness representations, which refers to how people think about HCV, was measured by the Brief Illness Perception Questionnaire (BIPQ) at baseline. The BIPQ assessed identity (identifying symptoms of HCV), timeline (whether HCV is acute/chronic), consequences (severity of HCV), personal control and treatment control (whether HCV is under volitional control), concern, emotions (anger, guilt or sha…

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Distinct Trauma Types in Military Service Members Seeking Treatment for Posttraumatic Stress Disorder.

We examined the frequency of trauma types reported in a cohort of service members seeking treatment for posttraumatic stress disorder (PTSD) and compared symptom profiles between types. In this observational study, 999 service members (9.2% women; Mage = 32.91 years; 55.6% White) were evaluated using a standardized assessment procedure to determine eligibility for clinical trials. Participants were evaluated for DSM-IV-TR-defined PTSD using the PTSD Symptom Scale-Interview; all participants reported a Criterion A event. Independent evaluators rated descriptions of Criterion A events as belonging to trauma types at a high degree of reliability, κ = 0.80. Aggregated non-life-threat primary trauma types were more frequently endorsed than aggregated life-threat types, 95% CI [17.10%, 29.20%]. Participants who endorsed moral injury-self traumas had a higher level of reexperiencing (d = 0.39),…

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WOMEN'S EDUCATION AND UTILIZATION OF MATERNAL HEALTH SERVICES IN AFRICA: A MULTI-COUNTRY AND SOCIOECONOMIC STATUS ANALYSIS.

There is an abundant literature on the relationship between women's education and maternal and child outcomes, including antenatal and postnatal care, onset of antenatal care and skilled birth attendance. However, few studies have adopted the 'equity' lens, despite increasing evidence that inequities between rich and poor are increasing although maternal and child mortality is declining. This study examined the differential effects of women's education within different socioeconomic strata in Africa. The most recent Demographic and Health Surveys (DHS) conducted in the Democratic Republic of the Congo, Egypt, Ghana, Nigeria and Zimbabwe were used. In each country, the original sample was stratified into three socioeconomic groups: poor, middle and rich. For each maternal health service utilization variable, the gross and net effects of women's education, controlling for age, parity, reli…

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Performance characteristics and clinical utility of diagnostic criteria proposals in bereaved treatment-seeking patients.

Background: Persistent complex bereavement disorder (PCBD) is a protracted form of grief included in DSM Section 3 indicating a need for more research. Two other criteria sets [prolonged grief disorder (PGD) and complicated grief (CG) disorder] are also currently in use by researchers. This study evaluates rates of diagnosis of each proposed criteria set in a clinical sample of bereaved individuals participating in clinical research. Method: Two groups in which persistent grief was judged to be present or absent completed an assessment instrument that included items needed to diagnose PCBD as well as PGD and CG. One group included grief treatment-seeking participants in our multicenter National Institute of Mental Health (NIMH)-sponsored study who scored ⩾30 on the Inventory of Complicated Grief (ICG) and the other comprised bereaved adults enrolled in clinical research studies who score…

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Patients' and Parents' Needs, Attitudes, and Perceptions About Early Palliative Care Integration in Pediatric Oncology.

Importance: Early palliative care integration for cancer patients is now touted as the optimal care model, yet significant barriers often prevent its implementation. A perceived barrier, especially for pediatric oncology patients, is the notion that patients and their families may not need or want palliative care involvement early in the disease trajectory. Objective: To determine the perception of symptom burden early in treatment and assess attitudes toward early integration of palliative care in pediatric oncology patient-parent pairs. Design, setting, and participants: Novel but pretested survey tools were administered to 129 patient-parent dyads of hospital-based pediatric oncology ambulatory clinics and inpatient units between September 2011 and January 2015. All patient participants were aged between 10 and 17 years and were diagnosed as having an oncologic condition 1 month to 1 …

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Determinants of stage at diagnosis of breast cancer in Nigerian women: sociodemographic, breast cancer awareness, health care access and clinical factors.

Purpose: Advanced stage at diagnosis is a common feature of breast cancer in Sub-Saharan Africa (SSA), contributing to poor survival rates. Understanding its determinants is key to preventing deaths from this cancer in SSA. Methods: Within the Nigerian Integrative Epidemiology of Breast Cancer Study, a multicentred case-control study on breast cancer, we studied factors affecting stage at diagnosis of cases, i.e. women diagnosed with histologically confirmed invasive breast cancer between January 2014 and July 2016 at six secondary and tertiary hospitals in Nigeria. Stage was assessed using clinical and imaging methods. Ordinal logistic regression was used to examine associations of sociodemographic, breast cancer awareness, health care access and clinical factors with odds of later stage (I, II, III or IV) at diagnosis. Results: A total of 316 women were included, with a mean age (SD) o…

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Stigma, explanatory models and unmet needs of caregivers of children with developmental disorders in a low-income African country: a cross-sectional facility-based survey.

Background: Understanding the perspectives of caregivers of children with developmental disorders living in low-income countries is important to inform intervention programmes. The purpose of this study was to examine the stigma experiences, explanatory models, unmet needs, preferred interventions and coping mechanisms of caregivers of children with developmental disorders in Ethiopia. Methods: Participants comprised caregivers (n = 102) of children with developmental disorders attending two child mental health clinics in Addis Ababa. The majority (66.7%; n = 68) had a diagnosis of intellectual disability (ID); 34 children (33.3%) had autism spectrum disorder (ASD) as their primary diagnosis. All caregivers were administered a structured questionnaire via a face-to-face interview, which included an adaptation of the Family Interview Schedule, closed questions about socio-demographic char…

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Marijuana use trajectories during college predict health outcomes nine years post-matriculation.

Background: Several studies have linked marijuana use with a variety of health outcomes among young adults. Information about marijuana's long-term health effects is critically needed. Methods: Data are from a ten-year study of 1253 young adults originally recruited as first-year college students and assessed annually thereafter. Six trajectories of marijuana use during college (Non-Use, Low-Stable, Early-Decline, College-Peak, Late-Increase, Chronic) were previously derived using latent variable growth mixture modeling. Nine health outcomes assessed in Year 10 (modal age 27) were regressed on a group membership variable for the six group trajectories, holding constant demographics, baseline health status, and alcohol and tobacco trajectory group membership. Results: Marijuana trajectory groups differed significantly on seven of the nine outcomes (functional impairment due to injury, ill…

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Correlates of PrEP Indication in a Multi-Site Cohort of Young HIV-Uninfected Transgender Women.

Transgender women are at high risk of HIV infection, with younger transgender women (YTW) particularly vulnerable. Pre-Exposure Prophylaxis (PrEP) has shown efficacy in reducing HIV acquisition, but little is known about PrEP indication or initiation among YTW. Baseline data from 180 YTW age 18-29 years enrolled in Project LifeSkills, an on-going HIV prevention intervention for YTW, were analyzed to examine factors associated with PrEP indication. The sample (mean age = 23.4, SD = 3.2) was comprised largely of women of color (69 %) and of low socioeconomic status (71 % unemployed). Overall, 62 % met criteria for PrEP indication, but only 5 % reported ever taking PrEP. Factors associated with increased odds of PrEP indication were: PrEP interest (aOR 3.24; 95 % CI 1.44, 7.33), number of recent anal sex partners (aOR 1.23; 95 % CI 1.04, 1.46), and lower collective self-esteem scores (aOR 0…

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