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

Stigma and treatment for alcohol disorders in the United States.

Among a nationally representative sample of adults with an alcohol use disorder, the authors tested whether perceived stigmatization of alcoholism was associated with a lower likelihood of receiving alcohol-related services. Data were drawn from a face-to-face epidemiologic survey of 34,653 adults interviewed in 2004-2005 who were aged 20 years or older and residing in households and group quarters in the United States. Alcohol abuse/dependence was diagnosed by using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, version (AUDADIS-IV). The stigma measure used was the Perceived Devaluation-Discrimination Scale. The main outcome was lifetime intervention including professional services and 12-step groups for alcohol disorders. Individuals with a lifetime diagnosis of an alcohol use disorder were …

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A prospective cohort study of modifiable risk factors for gestational diabetes among Hispanic women: design and baseline characteristics.

Objectives: Women diagnosed with gestational diabetes mellitus (GDM) are at high risk for future diabetes, with rates of GDM consistently higher in Hispanic than non-Hispanic white women. Currently recognized risk factors for GDM are absent in up to half of affected women, and studies addressing modifiable risk factors for GDM in Hispanic women are sparse. Methods: Proyecto Buena Salud is an ongoing prospective cohort study of Hispanic women in Massachusetts designed to assess physical activity, psychosocial stress, and GDM risk. Bilingual interviewers recruit prenatal care patients early in pregnancy and assess activity, trait anxiety, perceived stress, and depressive symptoms using validated questionnaires. Results: Baseline characteristics of the first 632 participants are presented. Women were predominantly young (69% <24 years), were unmarried (87%), and had low levels of education …

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Acculturation and self-reported health among Hispanics using a socio-behavioral model: the North Texas Healthy Heart Study.

Background: Acculturation is a continuous, firsthand contact with other cultures functioning at both group and individual levels and is reflected in our culturally diverse society, calling for a greater understanding of the environmental and cultural impact on health. Self-reported health (SRH), a robust and well validated predictor of future mortality for all racial/ethnic groups, has been differentially reported by Hispanics compared to whites, especially based on their acculturation status. This study investigated the relationship between acculturation and SRH among Hispanics. An adapted Andersen framework was used to develop logistic regression models to assess for an association between acculturation and general health status. Methods: Hispanic participants (n = 135), as part of the North Texas Healthy Heart Study, were administered standardized questionnaires on acculturation, psyc…

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Community participation for malaria elimination in Tafea Province, Vanuatu: Part I. Maintaining motivation for prevention practices in the context of disappearing disease.

Background: In the 1990s, the experience of eliminating malaria from Aneityum Island, Vanuatu is often given as evidence for the potential to eliminate malaria in the south-west Pacific. This experience, however, cannot provide a blueprint for larger islands that represent more complex social and environmental contexts. Community support was a key contributor to success in Aneityum. In the context of disappearing disease, obtaining and maintaining community participation in strategies to eliminate malaria in the rest of Tafea Province, Vanuatu will be significantly more challenging. Method: Nine focus group discussions (FGDs), 12 key informant interviews (KIIs), three transect walks and seven participatory workshops were carried out in three villages across Tanna Island to investigate community perceptions and practices relating to malaria prevention (particularly relating to bed nets); …

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Patients' and providers' perspectives on bibliotherapy in primary care.

Bibliotherapy is a form of self-administered treatment in which structured materials provide a means to alleviate distress. Although the treatment has evidence of effectiveness, evaluations of bibliotherapy have typically focused on outcomes, and the perspectives of both the client and the service provider have been understudied. In the present study, eleven users of a bibliotherapy scheme were interviewed regarding their experiences of bibliotherapy. In addition, five referring practitioners to the scheme were also interviewed. Thematic analyses revealed three super-ordinate themes in the transcripts: participants' personal experiences of the bibliotherapy scheme factors that facilitate change and the influence of the professionals involved. The implications of these findings for bibliotherapy schemes are considered.

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Effectiveness of therapies for heroin addiction in retaining patients in treatment: results from the VEdeTTE study.

Treatment is effective in reducing heroin use and clinical and social problems among heroin addicts. The effectiveness is related to the duration of treatment. "VEdeTTE" is an Italian longitudinal study funded by the Ministry of Health to evaluate the effectiveness of treatments provided by the National Health Services. The study involved 115 drug treatment centers and 10,454 heroin users. Clinical and personal information were collected at intake through a structured interview. Treatments were recorded using a standardized form. Survival analysis and Cox Proportional Hazard model were used to evaluate treatment retention. Five thousand four hundred and fifty-seven patients who started a treatment in the 18 months of the study were included in the analysis: 43.2% received methadone maintenance therapy (MMT), 10.5% therapeutic community, and 46.3% abstinence-oriented therapy (AOT). The li…

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The Boston Puerto Rican Health Study, a longitudinal cohort study on health disparities in Puerto Rican adults: challenges and opportunities.

Background: The Boston Puerto Rican Health Study is an ongoing longitudinal cohort study designed to examine the role of psychosocial stress on presence and development of allostatic load and health outcomes in Puerto Ricans, and potential modification by nutritional status, genetic variation, and social support. Methods: Self-identified Puerto Ricans, aged 45-75 years and residing in the Boston, MA metro area, were recruited through door-to-door enumeration and community approaches. Participants completed a comprehensive set of questionnaires and tests. Blood, urine and salivary samples were extracted for biomarker and genetic analysis. Measurements are repeated at a two-year follow-up. Results: A total of 1500 eligible participants completed baseline measurements, with nearly 80% two-year follow-up retention. The majority of the cohort is female (70%), and many have less than 8th grade…

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Stigma and treatment delay in first-episode psychosis: a grounded theory study.

Aim: A longer duration of untreated psychosis (DUP) is associated with greater morbidity in the early course of schizophrenia. This formative, hypothesis-generating study explored the effects of stigma, as perceived by family members, on DUP. Methods: Qualitative interviews were conducted with 12 African American family members directly involved in treatment initiation for a relative with first-episode psychosis. Data analysis relied on a grounded theory approach. A testable model informed by constructs of Link's modified labelling theory was developed. Results: Four main themes were identified, including: (i) society's beliefs about mental illnesses; (ii) families' beliefs about mental illnesses; (iii) fear of the label of a mental illness; and (iv) a raised threshold for the initiation of treatment. A grounded theory model was developed as a schematic representation of the themes and s…

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Women's knowledge of Pap smear test and human papillomavirus: acceptance of HPV vaccination to themselves and their daughters in an Islamic society.

Objective: Cancer of cervix uteri is the second most common cancer among women, and it has been shown to be caused by human papillomavirus (HPV) infection in more than 99% of cases. We surveyed Muslim Turkish women, who mostly accept talking about sex as a taboo, to examine their knowledge about Papanicolaou (Pap) smear test, HPV, HPV vaccine, and their attitude toward vaccination to themselves and their daughters. Methods: We surveyed 525 women aged between 19 and 53 years to examine their knowledge about cervical cancer screening Pap smear test, HPV, HPV vaccine, and their attitude toward vaccination to themselves and their daughters with a questionnaire that is consisted of 5 parts with a total of 31 items. Results: The knowledge of cervical screening was high (70%), and 51% of the subjects were at least once had a Pap smear test, but most respondents (56%) had never heard of HPV. For…

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Health literacy and child health promotion: implications for research, clinical care, and public policy.

The nation's leading sources of morbidity and health disparities (eg, preterm birth, obesity, chronic lung disease, cardiovascular disease, type 2 diabetes, mental health disorders, and cancer) require an evidence-based approach to the delivery of effective preventive care across the life course (eg, prenatal care, primary preventive care, immunizations, physical activity, nutrition, smoking cessation, and early diagnostic screening). Health literacy may be a critical and modifiable factor for improving preventive care and reducing health disparities. Recent studies among adults have established an independent association between lower health literacy and poorer understanding of preventive care information and poor access to preventive care services. Children of parents with higher literacy skills are more likely to have better outcomes in child health promotion and disease prevention. A…

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A national review of mandibular orthognathic surgery activity in the National Health Service in England over a nine year period: part 2--patient factors.

We aimed to investigate patients who had mandibular orthognathic surgery in England for the period 1 April 1997-30 March 2006. Data on hospital inpatient activity were extracted from the NHS Hospital Episode Statistics (HES) database for all mandibular orthognathic surgical procedures between these dates. Details of patients were investigated in relation to clinical details, socioeconomic status, other diagnoses, and clinical outcomes. Mandibular orthognathic operations were done for 8941 patients in England over the 9-year period, and the ratio of women: men was 1.7:1. The mean (SD) age at operation was 24 (9) years with no difference between sexes. There was a socioeconomic gradient in patients requesting treatment, most of whom lived in relatively affluent areas. The most common other diagnosis was "additional dentofacial anomalies" (8% of episodes). Mental or behavioural diagnoses we…

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Diabetes self-management in a Latino social environment.

Purpose: The purpose of this qualitative descriptive study was to explore the sociocultural influences and social context associated with living with type 2 diabetes among migrant Latino adults. Methods: A qualitative descriptive study using grounded theory techniques was conducted. In-depth semistructured interviews were completed with 10 participants (6 female and 4 male) ranging in age from 46 to 65 years and with a duration of diabetes diagnosis ranging from 1.5 to 40 years. Results: An overarching meta-theme of self-management in a social environment emerged. Every aspect of the process of self-management, as described in the 4 major themes-(1) family cohesion, (2) social stigma of disease, (3) social expectations/perception of "illness," and (4) disease knowledge and understanding-was influenced by the social context. Conclusions: The familist traditions, central to the Mexican cul…

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Prejudice and the medical profession: a five-year update.

Over the past decades the mortality rate in the United States has decreased, and life expectancy has increased. Yet a number of recent studies have drawn Americans' attention to the fact that racial and ethnic disparities persist in health care. It is clear that the U.S. health care system, which is the envy of the world, is not only flawed by basic injustices, but may be the cause of both injury and death for members of racial and ethnic minorities. Progress has been made in several areas since the original Institute of Medicine 2002 report. However, five years later, the 2007 National Healthcare Disparities Report (NHDR) reported that overall, disparities in quality and access for minority groups and poor populations have not been reduced since the original report. The three key themes that have emerged from this report are the following: (1) overall, disparities in health care quality…

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Association between general practice referral rates and patients' socioeconomic status and access to specialised health care a population-based nationwide study.

Objectives: To explore the association between patients' socioeconomic status and their referral from general practice to specialised health care. Methods: Multiple regression analysis was used on cross-sectional data on general practice referral rates for all Danish general practices in year 2006. Results: Our models explained between 26% and 45% of the variation in general practice referral to specialised care. Adjusting for access to specialised care (local supply of hospitals and practicing specialists) reduced the association between socioeconomic factors and referral rates. The results suggest that persons with high socioeconomic status are referred more to practicing specialist than persons with low socioeconomic status and that the latter are referred more to hospital care than the former. Conclusions: Our results indicate that the influence of socioeconomic factors may be overst…

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Unmet healthcare need, gender, and health inequalities in Canada.

Unmet healthcare need should be rare in nations with a universally accessible publicly funded healthcare system such as Canada. This however is not the case. This study examines the extent to which predictors of such need are consistent with various paradigmatic approaches (e.g., structural-critical, social capital, social support, and lifestyle) that consider such issues. Analyses of data from a probability sample of 2536 urban residents in British Columbia specified the relationship of unmet need with socioeconomic issues such as income, gender, and housing tenure, community issues such as social networks and social support, and traditional lifestyle or behavioural risk factors. The structural-critical model concerned with socio-demographics provided the most parsimonious explanation for having an unmet healthcare need. Consistent with a structural-critical approach, gender was found t…

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Gender differences in jail inmates' symptoms of mental illness, treatment history and treatment seeking.

Background: Rates of mental illness among prisoners are substantial, but little is known about the unique mental health needs of women in jail, those under pre-trial custodial remand or serving short sentences. Aims: To compare male and female jail inmates along a wide range of symptoms of mental illness using identical assessment methods, and to examine gender differences in treatment seeking before and during incarceration. Methods: Soon after incarceration in a county jail, 360 male and 154 female pre-trial and post-trial inmates completed the Personality Assessment Inventory, a wide-ranging measure of psychiatric symptoms. Treatment seeking information was taken from official jail records. Results: Women were more likely to report clinically significant symptoms of anxiety, borderline personality features, somatic concerns and trauma-related symptoms; however, trauma-related symptoms…

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Understanding, beliefs and perspectives of Aboriginal people in Western Australia about cancer and its impact on access to cancer services.

Background: Despite a lower overall incidence, Aboriginal Australians experience poorer outcomes from cancer compared with the non-Aboriginal population as manifested by higher mortality and lower 5-year survival rates. Lower participation in screening, later diagnosis of cancer, poor continuity of care, and poorer compliance with treatment are known factors contributing to this poor outcome. Nevertheless, many deficits remain in understanding the underlying reasons, with the recommendation of further exploration of Aboriginal beliefs and perceptions of cancer to help understand their care-seeking behavior. This could assist with planning and delivery of more effective interventions and better services for the Aboriginal population. This research explored Western Australian (WA) Aboriginal peoples' perceptions, beliefs and understanding of cancer. Methods: A total of 37 Aboriginal people…

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"Women's autonomy and pregnancy care in rural India: a contextual analysis".

Studies in low-income countries have shown that women's autonomy (i.e. the freedom of women to exercise their judgment in order to act for their own interests) influences a number of reproductive and child health outcomes, including the use of pregnancy care services. However, studies have not examined the full spectrum of pregnancy care services needed for safe motherhood and have not accounted for community context. This study analyzed data on women and their villages from the cross-sectional population-based National Family Health Survey-2 (1998-1999) of rural India to investigate whether women's autonomy (measured in the 3 dimensions of decision-making autonomy, permission to go out, and financial autonomy) was associated with the use of adequate prenatal, delivery and postnatal care. The findings indicate women's autonomy was associated with greater use of pregnancy care services, p…

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Understanding advance care planning as a process of health behavior change.

Objectives: To explore whether models of health behavior change can help to inform interventions for advance care planning (ACP). Design: Qualitative cross-sectional study. Setting: Community. Participants: Sixty-three community-dwelling persons aged 65 and older and 30 caregivers with experience as surrogate decision-makers. Measurements: In focus groups conducted separately with older persons and caregivers, participants were asked to discuss ways they had planned for future declines in health and why they had or had not engaged in such planning. Transcripts were analyzed using grounded theory. Results: Four themes illustrated the potential of applying models of health behavior change to improve ACP. (1) Participants demonstrated variable readiness to engage in ACP and could be in different stages of readiness for different components of ACP, including consideration of treatment goals,…

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Healthcare barriers of refugees post-resettlement.

The majority of refugees spend the greater part of their lives in refugee camps before repatriation or resettlement to a host country. Limited resources and stress during residence in refugee camps can lead to a variety of acute and chronic diseases which often persist upon resettlement. However, for most resettled refugees little is known about their health needs beyond a health assessment completed upon entry. We conducted a qualitative pilot-study in San Diego County, the third largest area in California, USA for resettling refugees, to explore health care access issues of refugees after governmental assistance has ended. A total of 40 guided in-depth interviews were conducted with a targeted sample of informants (health care practitioners, employees of refugee serving organizations, and recent refugee arrivals) familiar with the health needs of refugees. Interviews revealed that the …

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Economic hardship associated with managing chronic illness: a qualitative inquiry.

Background: Chronic illness and disability can have damaging, even catastrophic, socioeconomic effects on individuals and their households. We examined the experiences of people affected by chronic heart failure, complicated diabetes and chronic obstructive pulmonary disease to inform patient centred policy development. This paper provides a first level, qualitative understanding of the economic impact of chronic illness. Methods: Interviews were conducted with patients aged between 45 and 85 years who had one or more of the index conditions and family carers from the Australian Capital Territory and Western Sydney, Australia (n = 66). Content analysis guided the interpretation of data. Results: The affordability of medical treatments and care required to manage illness were identified as the key aspects of economic hardship, which compromised patients' capacity to proactively engage in …

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The health literacy of parents in the United States: a nationally representative study.

Objective: To assess the health literacy of US parents and explore the role of health literacy in mediating child health disparities. Methods: A cross-sectional study was performed for a nationally representative sample of US parents from the 2003 National Assessment of Adult Literacy. Parent performance on 13 child health-related tasks was assessed by simple weighted analyses. Logistic regression analyses were performed to describe factors associated with low parent health literacy and to explore the relationship between health literacy and self-reported child health insurance status, difficulty understanding over-the-counter medication labeling, and use of food labels. Results: More than 6100 parents made up the sample (representing 72600098 US parents); 28.7% of the parents had below-basic/basic health literacy, 68.4% were unable to enter names and birth dates correctly on a health in…

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Influence of socioeconomic and cultural factors on rural health.

Objective: To provide a framework for investigating the influence of socioeconomic and cultural factors on rural health. Design: Discussion paper. Results: Socioeconomic and cultural factors have long been thought to influence an individual's health. We suggest a framework for characterising these factors that comprises individual-level (e.g. individual socioeconomic status, sex, race) and neighbourhood-level dimensions (population composition, social environment, physical environment) operating both independently and through interaction. Recent spatial research suggests that in rural communities, socioeconomic disadvantage and indigenous status are two of the greatest underlying influences on health status. However, rural communities also face additional challenges associated with access to, and utilisation of, health care. The example is given of procedural angiography for individuals …

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Update on disparities in oral health and access to dental care for America's children.

This contribution updates federal survey findings on children's oral health and dental care since release of Oral Health in America: A Report of the Surgeon General in 2000. Dental caries experience continued at high levels, impacting 40% of all children aged 2 to 11 years, with greater disease and untreated disease burden borne by poor and low-income children and racial/ethnic minorities. Caries rates increased for young children (to 28% of 2- to 5-year-olds in the period 1999-2004) and remained flat for most other ages. The total volume of caries and untreated caries increased as the numbers of children increased. The proportion of US children with a dental visit increased modestly (from 42% to 45% between 1996 and 2004), with the greatest increases occurring among children newly covered by the State Children's Health Insurance Program (SCHIP). Disparities in dental visits continued to…

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Health care seeking among pulmonary tuberculosis suspects and patients in rural Ethiopia: a community-based study.

Background: Health care seeking is a dynamic process that is influenced by socio-demographic, cultural and other factors. In Ethiopia, there are limited studies regarding the health seeking behaviour of tuberculosis (TB) suspects and TB patients. However, a thorough understanding of patients' motivation and actions is crucial to understanding TB and the treatment of disease. Such insights would conceivably help to reduce delay in diagnosis, improve treatment adherence and thereby reduce transmission of TB in the community. The objective of this study was to describe and analyze health care seeking among TB suspects and pulmonary TB (PTB) cases in a rural district of the Amhara Region in Ethiopia. Methods: Study kebeles were randomly selected in a cross-sectional study design. House-to-house visits were conducted in which individuals aged 15 years and above in all households of the kebele…

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