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

Making sense of domestic violence intervention in professional health care.

Intervening in domestic violence in the health care and social service settings is a complex and contested issue. In this qualitative, multidisciplinary study, the barriers to but also the possibilities for health care professionals in encountering victims of violence were scrutinised. The focus was on omissions in service structure and practices. The data consisted of six focus group interviews with nurses, physicians, social workers and psychologists in specialist health care (n = 30) conducted in Finland in 2009. The aim was to explore professionals' processes of making sense of violence interventions and the organisational practices of violence interventions. Four types of framing of the domestic violence issue were identified: (i) practical frame, (ii) medical frame, (iii) individualistic frame and (iv) psychological frame. Each frame consisted of particular features relating to exp…

matched on Patient Acceptance of Health Care (mesh)

Factors affecting voluntary HIV counselling and testing among men in Ethiopia: a cross-sectional survey.

Background: Voluntary HIV counselling and testing (VCT) is one of the key strategies in the HIV/AIDS prevention and control programmes in Ethiopia. However, utilization of this service among adults is very low. The aim of the present study was to investigate factors associated with VCT utilization among adult men since men are less likely than women to be offered and accept routine HIV testing. Methods: The study utilized data from the Ethiopian Demographic Health Survey (EDHS) 2005, which is a cross-sectional survey conducted on a nationally representative sample. Using cluster sampling, 6,778 men aged 15-59 years were selected from all the eleven administrative regions in Ethiopia. Logistic regression was used to analyze potential factors associated with VCT utilization. Results: Overall, 21.9% of urban men and 2.6% of rural men had ever tested for HIV through VCT and most of them had …

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Women's health in urban Mali: social predictors and health itineraries.

Social and marital factors may influence women's health outcomes. This is of particular relevance in sub-Saharan Africa, where women's health indicators lag behind the rest of the world. Our study examines the impact of social mediators of women's health during key events (pregnancy and illness) in urban Mali. In this cross-sectional study, we interviewed 324 women aged 15-80, living in Bamako, the capital city, in 1999. We used mixed quantitative and qualitative methods to obtain detailed histories of pregnancy and illness during specific time periods preceding the survey. We examined the role of marital factors (polygyny, widowhood), social factors (sources of support and scales derived for social network and social power), and household wealth on women's therapeutic itineraries. We compared the sociodemographic characteristics of our sample with those of the 2001 Mali Demographic and …

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Socioeconomic status and child health: what is the role of health care, health conditions, injuries and maternal health?

There is a persistent relationship between socioeconomic status and health that appears to have its roots in childhood. Not only do children in families with lower income and with mothers with lower levels of education have worse health on average than those with greater socioeconomic advantage, but also the gradient appears to steepen with age. This study contributes to the literature on the relationship between socioeconomic status and child health by testing the hypothesis that the increasing effect of family income on children's health with age relates to the children's use of health care services. It also investigates the role of specific health conditions, injuries or maternal health in explaining the steepening gradient. Drawing on a nationally representative survey from Canada, the National Longitudinal Survey of Children and Youth from the period 1994/95-2008/09, this study prov…

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Examining the pathways linking lower socioeconomic status and advanced melanoma.

Background: Low socioeconomic status (SES) is associated with more advanced melanoma at diagnosis and decreased survival. Exploring the pathways linking lower SES and thicker melanoma will help guide public and professional strategies to reduce deaths. Methods: The authors surveyed 566 newly diagnosed patients at Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System, and University of Michigan. SES was assessed by education level (high school/general education degree or less [HS], associate/technical school degree, or ≥college graduate). All data was obtained by self-report among patients within three months of their diagnosis. Results: HS-educated individuals were significantly more likely than college graduates to believe that melanoma was not very serious (odds ratio [OR], 2.90; 95% confidence interval [CI], 1.79-4.71) and were less likely to know the asymm…

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Acculturation and biobehavioral profiles in pregnant women of Hispanic origin: generational differences.

In Hispanics, acculturation may lead to negative health outcomes. This study used a cross-sectional design to investigate the psychosocial and biological risks in acculturating pregnant women of Hispanic origin (n = 470). Psychosocial risks-depressive symptoms, anxiety, and stress-were assessed by self-report, whereas biological measures included stress-related and reproductive hormones. Mental health deteriorated across generations, with worsening depression, anxiety, and stress with successive generations. Stress and reproductive hormone levels decreased across generations, whereas body mass index and number of sexual partners increased. These data provide potential biobehavioral explanations of the relationship between acculturation and declining health among Hispanic women in the United States.

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Referral patterns and proximity to palliative care inpatient services by level of socio-economic disadvantage. A national study using spatial analysis.

Background: A range of health outcomes at a population level are related to differences in levels of social disadvantage. Understanding the impact of any such differences in palliative care is important. The aim of this study was to assess, by level of socio-economic disadvantage, referral patterns to specialist palliative care and proximity to inpatient services. Methods: All inpatient and community palliative care services nationally were geocoded (using postcode) to one nationally standardised measure of socio-economic deprivation - Socio-Economic Index for Areas (SEIFA; 2006 census data). Referral to palliative care services and characteristics of referrals were described through data collected routinely at clinical encounters. Inpatient location was measured from each person's home postcode, and stratified by socio-economic disadvantage. Results: This study covered July - December 2…

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Social networks--the future for health care delivery.

With the rapid growth of online social networking for health, health care systems are experiencing an inescapable increase in complexity. This is not necessarily a drawback; self-organising, adaptive networks could become central to future health care delivery. This paper considers whether social networks composed of patients and their social circles can compete with, or complement, professional networks in assembling health-related information of value for improving health and health care. Using the framework of analysis of a two-sided network--patients and providers--with multiple platforms for interaction, we argue that the structure and dynamics of such a network has implications for future health care. Patients are using social networking to access and contribute health information. Among those living with chronic illness and disability and engaging with social networks, there is co…

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[Access to health services: approaches, concepts, policies and analysis model].

Access to health services is a multifaceted and multidimensional issue involving political, economic, social, organizational, technical and symbolic aspects in establishing access to universal healthcare. This theoretical review paper intends to discuss the different approaches, analyze the context and policies for special groups on access, marking an analysis model delineated by the above aspects, from readings on the topic in question. This analysis reveals a diversity of approaches to access the formulation and implementation of public policies and their potential for changing the organization of the health system. We identified progress in reducing inequalities in health and increased access to the network of the Unified Health System (SUS), especially in primary care. There were also limitations related to accessibility, fragmentation, decentralization and regionalization of the ser…

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Environmental factors associated with primary care access among urban older adults.

Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors - in particular, the primary care infrastructure - inform older adults' primary care use. Using geographic data on primary care physician supply and surveys from 1260 senior center attendees in New York City, we examined factors that facilitate and hinder primary care use for individuals living in service areas with different supply levels. Supply quartiles varied in primary care use (visit within the past 12 months), racial and socio-economic composition, and perceived neighborhood safety and social cohesion. Primary care use did not differ significantly after controlling for compositional factors. Individuals who used a community clinic or hos…

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Multilevel analysis of the Be Active Eat Well intervention: environmental and behavioural influences on reductions in child obesity risk.

Background: The Be Active Eat Well (BAEW) community-based child obesity prevention intervention was successful in modestly reducing unhealthy weight gain in primary school children using a multi-strategy and multi-setting approach. Objective: To (1) examine the relationship between changes in obesity-related individual, household and school factors and changes in standardised child body mass index (zBMI), and (2) determine if the BAEW intervention moderated these effects. Methods: The longitudinal relationships between changes in individual, household and school variables and changes in zBMI were explored using multilevel modelling, with measurement time (baseline and follow-up) at level 1, individual (behaviours, n = 1812) at level 2 and households (n = 1318) and schools (n = 18) as higher levels (environments). The effect of the intervention was tested while controlling for child age, …

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Psychometric development and reliability analysis of a patient satisfaction with interpersonal relationship with navigator measure: a multi-site patient navigation research program study.

Background: Patient navigation (PN) is a method for addressing racial-ethnic and socioeconomically based disparities in cancer-related care. Patient navigators provide logistic and emotional support to underserved patients to facilitate successful completion of diagnostic and treatment care. Yet, little is known about patient satisfaction with the relationship with a navigator due to a dearth of instruments measuring satisfaction. Objective: The objective of this study was to validate the Patient Satisfaction with Interpersonal Relationship with Navigator (PSN-I) measure for patients undergoing diagnostic and/or therapeutic cancer care. Methods: We administered the PSN-I to 783 participants from the nine different sites of the National Cancer Institute sponsored Patient Navigation Research Program. We evaluated the latent structure and internal consistency of the PSN-I using principal co…

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Towards universal health coverage: an evaluation of Rwanda Mutuelles in its first eight years.

Background: Mutuelles is a community-based health insurance program, established since 1999 by the Government of Rwanda as a key component of the national health strategy on providing universal health care. The objective of the study was to evaluate the impact of Mutuelles on achieving universal coverage of medical services and financial risk protection in its first eight years of implementation. Methods and findings: We conducted a quantitative impact evaluation of Mutuelles between 2000 and 2008 using nationally-representative surveys. At the national and provincial levels, we traced the evolution of Mutuelles coverage and its impact on child and maternal care coverage from 2000 to 2008, as well as household catastrophic health payments from 2000 to 2006. At the individual level, we investigated the impact of Mutuelles' coverage on enrollees' medical care utilization using logistic reg…

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The influence of therapeutic alliance and insight on medication adherence in schizophrenia.

Background: Poor adherence is one of the leading problems affecting the effectiveness of treatment in schizophrenia. It is an identified factor for relapse and hospitalizations with major social and economic consequences. Various determinants of poor adherence have been identified but few studies investigate the role of therapeutic alliance on medication adherence in routine mental healthcare. Aims: To investigate links between therapeutic alliance insight and medication adherence in routine care and community psychiatry. Methods: In this cross-sectional study, 38 inpatients that met ICD-10 criteria for schizophrenia or schizoaffective disorder were recruited and independently interviewed just before discharge. Various rating scales were used: the self-reported 4-Point ordinal Alliance Scale (4PAS), the Medication Adherence Rating Scale (MARS) and the Scale to assess Unawareness of Menta…

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What makes adults with hearing impairment take up hearing AIDS or communication programs and achieve successful outcomes?

Objectives: Client involvement in health decision making, or shared decision making, is increasingly being advocated. For example, rehabilitation interventions such as hearing aids and communication programs can be presented as options to adults with hearing impairment seeking help for the first time. Our previous research focused on the predictors of intervention decisions when options were presented with a decision aid. However, not all participants took up the intervention they initially decided upon. Although it is interesting to understand what informs adults with hearing impairment's intervention decisions, it is their intervention uptake and outcomes which best represent the ultimate end result of the rehabilitation process. This prospective study investigated the predictors of uptake and of successful outcomes of hearing aids and communication programs in middle-aged and older ad…

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The lifetime impact of attention deficit hyperactivity disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

Background: The aim of the study was to present nationally representative data on the lifetime independent association between attention deficit hyperactivity disorder (ADHD) and psychiatric co-morbidity, correlates, quality of life and treatment seeking in the USA. Method: Data were derived from a large national sample of the US population. Face-to-face surveys of more than 34 000 adults aged 18 years and older residing in households were conducted during the 2004-2005 period. Diagnoses of ADHD, Axis I and II disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version. Results: ADHD was associated independently of the effects of other psychiatric co-morbidity with increased risk of bipolar disorder, generalized anxiety disorder, post-traumatic stress disorder, specific phobia, and narcissistic, histrionic, borderline, antisocial and sch…

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WFH: closing the global gap--achieving optimal care.

For 50 years, the World Federation of Hemophilia (WFH) has been working globally to close the gap in care and to achieve Treatment for All patients, men and women, with haemophilia and other inherited bleeding disorders, regardless of where they might live. The WFH estimates that more than one in 1000 men and women has a bleeding disorder equating to 6,900,000 worldwide. To close the gap in care between developed and developing nations a continued focus on the successful strategies deployed heretofore will be required. However, in response to the rapid advances in treatment and emerging therapeutic advances on the horizon it will also require fresh approaches and renewed strategic thinking. It is difficult to predict what each therapeutic advance on the horizon will mean for the future, but there is no doubt that we are in a golden age of research and development, which has the prospect …

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Women's sexual empowerment and contraceptive use in Ghana.

Pervasive gendered inequities and norms regarding the subordination of women give Ghanaian men disproportionately more power than women, particularly in relation to sex. We hypothesize that lack of sexual empowerment may pose an important barrier to reproductive health and adoption of family planning methods. Using the 2008 Ghana Demographic Health Survey, we examine the association between women's sexual empowerment and contraceptive use in Ghana among nonpregnant married and partnered women not desiring to conceive in the next three months. Increasing levels of sexual empowerment are found to be associated with use of contraceptives, even after adjusting for demographic predictors of contraceptive use. This association is moderated by wealth. Formal education, increasing wealth, and being in an unmarried partnership are associated with contraceptive use, whereas women who identify as b…

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Comparing the predictive capacity of observed in-session resistance to self-reported motivation in cognitive behavioral therapy.

Self-report measures of motivation for changing anxiety have been weakly and inconsistently related to outcome in cognitive behavioral therapy (CBT). While clients may not be able to accurately report their motivation, ambivalence about change may nonetheless be expressed in actual therapy sessions as opposition to the direction set by the therapist (i.e., resistance). In the context of CBT for generalized anxiety disorder, the present study compared the ability of observed in-session resistance in CBT session 1 and two self-report measures of motivation for changing anxiety (the Change Questionnaire & the Client Motivational for Therapy Scale) to (1) predict client and therapist rated homework compliance (2) predict post-CBT and one-year post-treatment worry reduction, and (3) differentiate those who received motivational interviewing prior to CBT from those who received no pre-treatmen…

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Neighbourhood deprivation, health inequalities and service access by adults with intellectual disabilities: a cross-sectional study.

Background: Adults with intellectual disabilities (IDs) experience health inequalities and are more likely to live in deprived areas. The aim of this study was to determine whether the extent of deprivation of the area a person lives in affects their access to services, hence contributing to health inequalities. Method: A cross-sectional study design was used. Interviews were conducted with all adults with IDs within a defined location (n = 1023), and their medical records were reviewed. The extent of area deprivation was defined by postcode, using Carstairs scores. Results: Area deprivation did not influence access to social supports, daytime primary health-care services or hospital admissions, but people in more deprived areas made less use of secondary outpatient health care [first contacts (P = 0.0007); follow-ups (P = 0.0002)], and more use of accident and emergency care (P = 0.02).…

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Assessing family-provider partnerships and satisfaction with care among US children with special health care needs.

Objectives: Family-provider partnerships and satisfaction with services together are one of the Health Resources and Services Administration's (HRSA) Maternal and Child Health Bureau's (MCHB) 6 core outcomes for children with special health care needs (CSHCN) and are tracked using the 2005-2006 National Survey of Children with Special Health Care Needs. Our objectives were to examine demographic, health, and other correlates/associations, with the perception of family-provider partnership and satisfaction with care; determine the associations between these perceptions and other child/family outcomes; and evaluate differences in the perception of partnership and satisfaction between the families of CSHCN and other children. Methods: We analyzed data for 40,723 CSHCN from the 2005-2006 National Survey of CSHCN and assessed the prevalence of family-provider partnerships and satisfaction wit…

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Prevalence and factors associated with knowledge of and willingness for male circumcision in rural Zimbabwe.

Objective: To explore male circumcision (MC) prevalence, knowledge, attitudes and intentions among rural Zimbabweans. Methods: Representative survey of 18-44 year olds in two provinces, as part of an evaluation of the Zimbabwe National Behaviour Change Programme. We conducted univariate, bivariate and multivariate analyses. Linear regression was employed to predict knowledge of MC (composite index) and logistic regression to predict knowledge that MC prevents HIV, willingness (oneself or one's partner) to undergo MC, and willingness to have son circumcised. Results: Two thousand seven hundred and forty-six individuals participated in the survey (87% of eligibles). About two-thirds were women (64%). Twenty per cent of men reported being circumcised, while 17% of women reported having a circumcised partner. Knowledge of MC and its health benefits was low. Attitudes towards MC were relative…

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Impact of children's migration on health and health care-seeking behavior of elderly left behind.

Background: Many countries are facing the burden of accelerated population aging and a lack of institutional support to meet the needs of older individuals. In developing countries, adult children are primarily responsible for the care of their elderly parents. However, out-migration of adult children is common in these countries. This study aims to explore the impact of migration on the health of the elderly left behind and their health care-seeking behavior. Methods: This paper uses data from a national survey of older persons in Thailand conducted in 2007. The analysis is confined to those who were aged 60 years or above and who had at least one child (biological or step/adopted) (n = 28,677). Logistic regression was used to assess the net effect of migration of adult children on the health of the elderly left behind and their health care-seeking behavior, after controlling for other …

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A youth-focused case management intervention to engage and retain young gay men of color in HIV care.

HIV-positive Latino and African-American young men who have sex with men (YMSM) have low rates of engagement and retention in HIV care. An evaluation of a youth-focused case management intervention (YCM) designed to improve retention in HIV care is presented. HIV-positive Latino and African-American YMSM, ages 18-24, who were newly diagnosed with HIV or in intermittent HIV care, were enrolled into a psychosocial case management intervention administered by Bachelor-level peer case managers at two HIV clinics in Los Angeles County, California. Participants met weekly with a case manager for the first two months and monthly for the next 22 months. Retention in HIV primary care at three and six months of follow-up was evaluated as were factors associated with retention in care. From April 2006 to April 2009, 61 HIV-positive participants were enrolled into the intervention (54% African-Ameri…

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'It's leaflet, leaflet, leaflet then, "see you later"': black Caribbean women's perceptions of perinatal mental health care.

Background: Despite high levels of psychosocial risks, black women of Caribbean origin rarely consult health professionals regarding symptoms of perinatal depression. Reasons for this are unclear as there has been little perinatal mental health research among this ethnic group. Aim: To examine stakeholder perspectives on what might account for low levels of consultation for perinatal depression among a group of women who are, theoretically, vulnerable. Design of study: A qualitative study using focus group interviews. Setting: Community settings in the northwest of England. Method: A purposive sample of black Caribbean women (n = 42) was split into focus groups and interviewed. This sample was drawn from a larger study. Interviews were digitally recorded and transcribed verbatim. Framework analysis was used to generate themes. Results: Perceptions of practitioners' lack of compassion in …

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