Mental health literacy

وَقَالُواْ يَٰٓأَيُّهَا ٱلَّذِي نُزِّلَ عَلَيۡهِ ٱلذِّكۡرُ إِنَّكَ لَمَجۡنُونࣱ‏

They say, ‘Receiver of this Quran! You are definitely mad

قَالَ إِنَّ رَسُولَكُمُ ٱلَّذِيٓ أُرۡسِلَ إِلَيۡكُمۡ لَمَجۡنُونࣱ‏

Pharaoh said, ‘This messenger who has been sent to you is truly possessed.’

وَيَقُولُونَ أَئِنَّا لَتَارِكُوٓاْ ءَالِهَتِنَا لِشَاعِرࣲ مَّجۡنُونِۭ

and said, ‘Are we to forsake our gods for a mad poet?’

ثُمَّ تَوَلَّوۡاْ عَنۡهُ وَقَالُواْ مُعَلَّمࣱ مَّجۡنُونٌ

they turned their backs on him, saying, ‘He is tutored! He is possessed!’

فَتَوَلَّىٰ بِرُكۡنِهِۦ وَقَالَ سَٰحِرٌ أَوۡ مَجۡنُونࣱ‏

Pharaoh turned away with his supporters, saying, ‘This is a sorcerer, or maybe a madman,’

كَذَٰلِكَ مَآ أَتَى ٱلَّذِينَ مِن قَبۡلِهِم مِّن رَّسُولٍ إِلَّا قَالُواْ سَاحِرٌ أَوۡ مَجۡنُونٌ

Every previous people to whom a messenger was sent also said, ‘A sor-cerer, or maybe a madman!’

And they that is the disbelievers of Mecca say to the Prophet s ‘O you to whom the Remembrance the Qur’ān — as you claim — has been revealed lo! you are indeed possessed!

He said ‘Verily this messenger of yours sent to you is a madman!’

and would say ‘Are we to abandon our gods for a mad poet?’ that is for the sake of what Muhammad (s) says? as regards the hamzas in a-innā ‘are we’ the same applies as mentioned above.

And they say: "O you (Muhammad) to whom the Dhikr (the Qur'an) has been revealed! Verily, you are a madman (6)"Why do you not bring angels to us if you are of the truthful? (7)We do not send the angels down except with the truth, and in that case, they (the disbelievers) would have no respite (8)Verily, We, it is We Who revealed the Dhikr (i.e. the Qur'an) and surely We will guard it (from corruption)(9) The Accusation that the Prophet (ﷺ) was a Madman and Demands for Him to bring down Angels Allah tells us about the disbelief, arrogance and stubbornness of the disbelievers as reflected in their words: يَا أَيُّهَا الَّذِي نُزِّلَ عَلَيْهِ الذِّكْرُ (O you (Muhammad) to whom the Dhikr (the Qur'an) has been revealed!) i.e., the one who claims to receive it. إِنَّكَ لَمَجْنُونٌ (Verily, you are a mad man!) i.e., by your invitation to us to follow you and leave the way of our forefath

Fir'awn said: "And what is the Lord of Al-'Alamin (23)(Musa) said: "The Lord of the heavens and the earth, and all that is between them, if you seek to be convinced with certainty. (24)(Fir'awn) said to those around: "Do you not hear (what he says)? (25)(Musa) said: "Your Lord and the Lord of your ancient fathers! (26)(Fir'awn) said: "Verily, your Messenger who has been sent to you is a madman! (27)(Musa) said: "Lord of the east and the west, and all that is between them, if you did but understand! (28) Allah tells us about the disbelief, rebellion, oppression and denial of Fir'awn, as He says: وَمَا رَبُّ الْعَالَمِينَ ((Fir'awn said:) "And what is the Lord of the 'Alamin") This is because he used to say to his people: مَا عَلِمْتُ لَكُم مِّنْ إِلَٰهٍ غَيْرِي (I know not that you have a god other than me.)(28:38) فَاسْتَخَفَّ قَوْمَهُ فَأَطَاعُوهُ (Thus he fooled his people, and

And they will turn to one another and question one another (27)They will say: "It was you who used to come to us from the right side. (28)They will reply: "Nay, you yourselves were not believers. (29)"And we had no authority over you. Nay! But you were a transgressing people. (30)"So now the Word of our Lord has been justified against us, that we shall certainly taste (the torment). (31)"So we led you astray because we were ourselves astray. (32)Then verily, that Day, they will (all) share in the torment (33)Certainly, that is how We deal with the criminals (34)Truly, when it was said to them: "La ilaha illallah," they puffed themselves up with pride (35)And (they) said: "Are we going to abandon our gods for the sake of a mad poet? (36)Nay! he has come with the truth and he confirms the Messengers (37) The arguing of the Idolators on the Day of Resurrection Allah tells us that the disb

ولو كشف الغطاء لرأيت أكثر النفوس البشرية صرعى مع هذه الأرواح الخبيثة وهي في أسرها وقبضتها تسوقها حيث شاءت ولا يمكنها الامتناع عنها ولا مخالفتها وبها الصرع الأعظم الذي لا يفيق صاحبه إلا عند المفارقة والمعاينة فهناك يتحقق أنه كان هو المصروع حقيقة وبالله المستعان وعلاج هذا الصرع باقتران العقل الصحيح إلا الإيمان بما جاءت به الرسل وأن تكون الجنة والنار نصب عينه وقبلة قلبه ويستحرض أهل الدنيا وحلول المثولات والآفات بهم ووقوعها خلال ديارهم كمواقع القطر وهم صرعى لا يفيقون وما أشد أعداء هذا الصرع ولكن لما عمت البلية به بحيث ينظر الإنسان لا يرى إلا مصروعا لم يصر مستغربا ولا مستنكرا بل صار لكثرة المصروعين عين المستنكر المستغرب خلافة فإذا أراد الله بعبد حيرا أفاق من هذه الصرعة ونظر إلى أبناء الدنيا مصروعين حوله يمينا وشمالا على اختلاف طبقاتهم فمنهم من أطبق به الجنون ومنهم من يفيق أحيانا قليلة ويعود إلى جنونه ومنهم من يجن مرة ويفيق أخرى فإذا أفاق عمل عمل أهل الإفاقة والعقل ثم يعاوده الصرع فيقع في التخ

الثاني أن هذا باطل بصور كثيرة منها دخول الماء في العود والسحاب ودخول النار في الحديد ودخول الغذاء في جميع أجزاء البدن ودخول الجن في المصروع فالروح للطافتها لا يمتنع عليها مشابكة البدن والدخول في جميع أجزائه

فالعقل فن واحد وطريقه % أدرى فأرصد و الجنون فنون

هكذا ضعف الدين في قرون سالفة فكيف الظن بزمانك هذا وقد انتهى الأمر إلى أن مظهر الإنكار يستهدف لنسبته إلى الجنون فالأولى أن يشتغل الإنسان بنفسه ويسكت

وأما القسم الثاني، وهو المدح بسبب الجاه والمال، فالفرح بذلك، كالفرح بنبات الأرض الذي يصير عن قريب هشيما، ولا يفرح بذلك إلا من قل عقله، وإن كنت خاليا عن الصفة التي مدحت بها، ففرحك بالمدح غاية الجنون.

قالوا وكيف يمدح أمر يمنع القرار ويسلب المنام ويوله العقل ويحدث الجنون بل هو نفسه جنون كما قال بعض الحكماء الجنون فنون والعشق فن من فنونه كما قال بعض العشاق

The effectiveness of school mental health literacy programs to address knowledge, attitudes and help seeking among youth.: Aim: Conduct a systematic review for the effectiveness of school mental health literacy programs to enhance knowledge, reduce stigmatizing attitudes and improve help-seeking behaviours among youth (12-25 years of age). Methods: Reviewers independently searched PubMed, PsycINFO, Cochrane Library, CINAHL, ERIC, grey literature and reference lists of included studies. They reached a consensus on the included studies, and rated the risk of bias of each study. Studies that reported three outcomes: kn

Is It Possible to "Find Space for Mental Health" in Young People? Effectiveness of a School-Based Mental Health Literacy Promotion Program.: Lack of knowledge regarding, and the stigma associated with, mental disorders have been identified as major obstacles for the promotion of mental health and early intervention. The present study aimed to evaluate the effectiveness of a school-based intervention program focused on the promotion of mental health literacy (MHL) in young people (“Finding Space for Mental Health”). A sample of 543 students (22 classes), aged between 12 and 14 years old, participated in the study. Each class of studen

Facilitators and Barriers for Advance Care Planning Among Ethnic and Racial Minorities in the U.S.: A Systematic Review of the Current Literature.: Growing evidence suggests a low engagement in advance care planning (ACP) among ethnic minorities in the U.S. The purpose of this study was to synthesize findings from prior research about ACP among ethnic minorities. An extensive literature search was conducted using multiple electronic databases. After applying inclusion criteria, 26 studies were included. Four categories of facilitators and barriers to ACP were identified: (1) Socio-demographic factors, (2) health status, literacy and experie

Adolescent health literacy and health behaviors: A systematic review.: Objectives: To systematically review and synthesize literature on the relationship between health literacy and health behaviors in adolescents. Methods: Searches in PsychInfo, PUBMED/MEDLINE, and Educational Resources Information Center (ERIC) were conducted. Studies were included if they reported original data on the relationship between health literacy and a health behavior in adolescents, were written in English, and the population did not have a chronic illness or disability. Results: Sevent

The effect of a community-based self-help multimodal behavioral intervention in Korean American seniors with high blood pressure.: Background: Great strides have been made in improving heart health in the United States during the last 2 decades, yet these strides have not encompassed many ethnic minority populations. There are significant health disparity gaps stemming from both a paucity of valid research and a lack of culturally sensitive interventions. In particular, many Korean Americans with chronic illnesses encounter difficulty navigating the healthcare system because of limited health literacy. Methods: The effect o

Workplace Interventions Targeting Mental Health Literacy, Stigma, Help-Seeking, and Help-Offering in Male-Dominated Industries: A Systematic Review.: Mental ill-health and suicide represent a significant proportion of the burden of global disease among men. Connell's relational theory of masculinities provides a useful framework to explore how mental health literacy, mental health stigma, and delayed help-seeking and help-offering behaviors are associated with mental ill-health among men, particularly within male-dominated industries. To address the high incidences of mental ill-health in male-dominated industries, several workplace intervent

Epidemiology of HIV and AIDS among adolescents: current status, inequities, and data gaps.

Objectives: To examine levels and patterns of HIV prevalence, knowledge, sexual behavior, and coverage of selected HIV services among adolescents aged 10-19 years and highlight data gaps and challenges. Methods: Data were reviewed from Joint United Nations Programme on HIV/AIDS HIV estimates, nationally representative household surveys, behavioral surveillance surveys, and published literature. Results: A number of gaps exist for adolescent-specific HIV-related data; however, important implications for programming can be drawn. Eighty-two percent of the estimated 2.1 million adolescents aged 10-19 years living with HIV in 2012 were in sub-Saharan Africa, and the majority of these (58%) were females. Comprehensive accurate knowledge about HIV, condom use, HIV testing, and antiretroviral treatment coverage remain low in most countries. Early sexual debut (sex before 15 years of age) is mor…

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'The living death of Alzheimer's' versus 'Take a walk to keep dementia at bay': representations of dementia in print media and carer discourse.

Understanding dementia is a pressing social challenge. This article draws on the 'Dementia talking: care conversation and communication' project which aims to understand how talk about, and to people living with dementia is constructed. In this article I draw on the construction of dementia manifest in two data sets - a corpus of 350 recent UK national newspaper articles and qualitative data derived from in-depth interviews with informal carers. These data were analysed using a thematic discursive approach. A 'panic-blame' framework was evident in much of the print media coverage. Dementia was represented in catastrophic terms as a 'tsunami' and 'worse than death', juxtaposed with coverage of individualistic behavioural change and lifestyle recommendations to 'stave off' the condition. Contrary to this media discourse, in carers' talk there was scant use of hyperbolic metaphor or referen…

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Factors associated with acceptability of HIV self-testing among health care workers in Kenya.

Health care workers (HCWs) in sub-Saharan Africa are at a high risk of HIV infection from both sexual and occupational exposures. However, many do not seek HIV testing. This paper examines the acceptability of an unsupervised facility-based HIV self-testing (HIVST) intervention among HCWs and their partners and factors associated with uptake of HIVST among HCWs. HCWs in seven large Kenyan hospitals were invited to participate in pre-HIVST information sessions during which they were offered HIVST kits to take home for self-testing. A post-intervention survey was conducted among 765 HCWs. Forty-one percent attended the information session; of those, 89% took the HIVST kits and of those, 85% self-tested. Thirty-four percent of surveyed HCWs used the HIVST to test themselves. Of those who took the HIVST kit and had partners, 73% gave the kit to their partner and 86% of them indicated their p…

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Descriptive cross sectional study on prevalence, perceptions, predisposing factors and health seeking behaviour of women with stress urinary incontinence.

Background: Stress urinary incontinence (SUI) leads to considerable physical and psychological morbidity. The highest prevalence reported was found in Caucasian Americans (range 23% -67%) and the lowest in Singaporean females (4.8%). The study assessed the prevalence, perceptions, predisposing factors and health seeking behaviour of women with SUI in an Asian setting which may have different sociocultural implications. Methods: 400 consecutive women >20 years of age attending the outpatient department of a tertiary care hospital in Sri Lanka, for non-urinary conditions were studied over a 3 week period using an interviewer administered questionnaire. SUI was diagnosed on clinical history alone when leakage of urine occurred either with coughing, sneezing, walking or lifting heavy objects. The severity was graded using the Finnish Gynaecological Society's Urinary Incontinence Severity Sco…

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Perceived outcomes of spiritual healing and explanations--a qualitative study on the perspectives of German healers and their clients.

Background: Limited research has been conducted on contemporary spiritual healing in European countries. The aim of this article is to report how German healers and their clients experienced and perceived the outcomes of spiritual healing and which explanations they use to describe the perceived effects. Methods: Semistructured interviews and participatory observation was used to collect data from spiritual healers and their clients. Analyses were based on the methodological concept of directed qualitative content analysis. Data was analyzed using MAXQDA software, discussed and reviewed by a multidisciplinary research team consisting of medical anthropologists, medical doctors and a religious studies scholar. Results: In total 15 healers and 16 clients participated in this study, 24 interviews with healers, 20 interviews with clients and 8 participatory observations were analyzed. Healer…

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Predictors of help-seeking for suicidal ideation in the community: risks and opportunities for public suicide prevention campaigns.

Help-seeking behaviour for suicidality is low and the reasons for this have not systematically been examined. The aim of the current study was to examine the relationship between suicide stigma, suicide literacy and help-seeking attitudes and intentions. One thousand two hundred seventy-four Australian adults recruited via Facebook completed an online survey assessing a range of mental health outcomes. High suicide literacy and low suicide stigma were significantly associated with more positive help-seeking attitudes and, among a subsample of 534, greater intentions to seek help. Attribution of suicide to isolation was associated with more positive attitudes toward help-seeking and greater intentions to seek help, while respondents experiencing suicidal ideation had more negative attitudes toward help-seeking and lower intentions to seek help. Lower depressive symptoms, older age and fem…

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Developing a scale to measure stigmatizing attitudes and beliefs about women who have abortions: results from Ghana and Zambia.

The objective of this research was to explore the context of abortion stigma in Ghana and Zambia through qualitative research, and develop a quantitative instrument to measure stigmatizing attitudes and beliefs about abortion. Ultimately, we aimed to develop a scale to measure abortion stigma at the individual and community level that can also be used in the evaluation of stigma reduction interventions. Focus group discussions were conducted in both countries to provide information around attitudes and beliefs about abortion. A 57-item instrument was created from these data, pre-tested, and then administered to 531 individuals (n = 250 in Ghana and n = 281 in Zambia). Exploratory factor analyses were conducted on 33 of the original 57 items to identify a statistically and conceptually relevant scale. Items with factor loadings > 0.39 were retained. All analyses were completed using Stata…

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A community-based, environmental chronic disease prevention intervention to improve healthy eating psychosocial factors and behaviors in indigenous populations in the Canadian Arctic.

Diet-related chronic diseases are highly prevalent among indigenous populations in the Canadian Arctic. A community-based, multi-institutional nutritional and lifestyle intervention-Healthy Foods North-was implemented to improve food-related psychosocial factors and behaviors among Inuit and Inuvialuit in four intervention communities (with two comparison communities) in Nunavut and the Northwest Territories, Canada, in 2008. The 12-month program was developed from theory (social cognitive theory and social ecological models), formative research, and a community participatory process. It included an environmental component to increase healthy food availability in local stores and activities consisting of community-wide and point-of-purchase interactive educational taste tests and cooking demonstrations, media (e.g., radio ads, posters, shelf labels), and events held in multiple venues, i…

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How big is my neighborhood? Individual and contextual effects on perceptions of neighborhood scale.

Neighborhood is a social and geographic concept that plays an increasingly important role in research and practice that address disparities in health and well-being of populations. However, most studies of neighborhoods, as well as community initiatives geared toward neighborhood improvement, make simplifying assumptions about boundaries, often relying on census geography to operationalize the neighborhood units. This study used geographic information system (GIS) tools to gather and analyze neighborhood maps drawn by residents of low-income communities in 10 cities. The median resident map size was approximately 30 percent smaller than the median census tract, but 25 percent of residents viewed their neighborhood as quite small (less than one-fifth of the typical census tract). Multi-level modeling showed significant within context variation in perceived neighborhood scale. Longer term …

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Breaking bad news in clinical setting - health professionals' experience and perceived competence in Southwestern Nigeria: a cross sectional study.

Background: Communication skills are vital in clinical settings because the manner in which bad news is delivered could be a huge determinant of responses to such news; as well as compliance with beneficial treatment option. Information on training, institutional guidelines and protocols for breaking bad news (BBN) is scarce in Nigeria. We assessed the training, experience and perceived competence of BBN among medical personnel in southwestern Nigeria. Materials and methods: The study was a cross-sectional descriptive study conducted out among doctors and nurses in two healthcare institutions in southwestern Nigeria using an anonymous questionnaire (adapted from the survey by Horwitz et al.), which focused on the respondents training, awareness of protocols in BBN; and perceived competence (using a Five-Point Likert Scale) in five clinical scenarios. We equally asked the respondents abou…

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Caring for a child with type 1 diabetes: links between family cohesion, perceived impact, and parental adjustment.

This study analyzed the psychological adjustment of parents of children and adolescents with type 1 diabetes (T1D) and examined whether family cohesion and parental adjustment were connected through the perceived impact of this condition on family functioning, as well as whether these links varied according to the child's age. In total, 104 parents of children (8-12 years old) and adolescents (13-18 years old) with T1D and 142 parents of healthy children and adolescents completed self-report measures of family cohesion, parental stress, quality of life (QOL), anxious and depressive symptoms, and perceived impact of chronic illness. The results indicated that the parents of children and adolescents with T1D were more anxious and perceived less family cohesion than the parents of healthy children and adolescents. No significant differences were found on depressive symptoms, QOL, and parent…

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Mothers' perspectives on the delivery of childhood injury messages: a qualitative study from the growing up in Wales, environments for healthy living study (EHL).

Background: Childhood injury is the second leading cause of death for infants aged 1-5 years in the United Kingdom (UK) and most unintentional injuries occur in the home. We explored mothers' knowledge and awareness of child injury prevention and sought to discover mothers' views about the best method of designing interventions to deliver appropriate child safety messages to prevent injury in the home. Methods: Qualitative study based on 21 semi-structured interviews with prospective mothers and mothers of young children. Mothers were selected according to neighbourhood deprivation status. Results: There was no difference in awareness of safety devices according to mothers' deprivation status. Social networks were important in raising awareness and adherence to child safety advice. Mothers who were recent migrants had not always encountered safety messages or safety equipment commonly us…

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Barriers and facilitating factors for disease self-management: a qualitative analysis of perceptions of patients receiving care for type 2 diabetes and/or hypertension in San José, Costa Rica and Tuxtla Gutiérrez, Mexico.

Background: The burden of cardiovascular disease is growing in the Mesoamerican region. Patients' disease self-management is an important contributor to control of cardiovascular disease. Few studies have explored factors that facilitate and inhibit disease self-management in patients with type 2 diabetes and hypertension in urban settings in the region. This article presents patients' perceptions of barriers and facilitating factors to disease self-management, and offers considerations for health care professionals in how to support them. Methods: In 2011, 12 focus groups were conducted with a total of 70 adults with type 2 diabetes and/or hypertension who attended urban public health centers in San José, Costa Rica and Tuxtla Gutiérrez, Chiapas, Mexico. Focus group discussions were transcribed and coded using a content analysis approach to identify themes. Themes were organized using t…

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Arabic-speaking religious leaders' perceptions of the causes of mental illness and the use of medication for treatment.

Objectives: The Arabic-speaking clergy is highly revered and considered the first point of contact for people who suffer from mental illness within their community. The current study aimed to explore the beliefs of Arabic-speaking religious leaders regarding the causes of mental illness and the use of medication for their treatment. Method: Participants consisted of 170 Arabic-speaking clerics of Muslim (n = 85) and Christian (n = 85) denominations residing in Sydney, Australia. A questionnaire was administered during face-to-face interviews and included items regarding the causes of mental illness and beliefs about whether psychiatric medications were viewed as helpful or harmful. Results: Most of the Arabic-speaking clerics viewed drug and alcohol addiction and psychosocial factors as the most important causes of mental illness. Biological causes such as a chemical imbalance in the bra…

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Associations between health communication behaviors, neighborhood social capital, vaccine knowledge, and parents' H1N1 vaccination of their children.

During the H1N1 pandemic in 2009-10, the vaccination behavior of parents played a critical role in preventing and containing the spread of the disease and the subsequent health outcomes among children. Several studies have examined the relationship between parents' health communication behaviors and vaccinations for children in general. Little is known, however, about the link between parents' health communication behaviors and the vaccination of their children against the H1N1 virus, and their level of vaccine-related knowledge. We drew on a national survey among parents with at least one child less than 18 years of age (n=639) to investigate Parents' H1N1-related health communication behaviors including sources of information, media exposure, information-seeking behaviors, H1N1-related knowledge, and neighborhood social capital, as well as the H1N1 vaccination rates of their children. …

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Medical students' knowledge and attitudes toward organ donation: results of a Dutch survey.

Background: In the Netherlands, as in many other countries, a paucity of research exists on the attitudes and intentions of medical students toward organ donation. These students are of interest for the effect that increasing medical knowledge might have on the willingness to register as a donor. Objective: To examine which factors determine medical students' willingness to register as donors. Methods: We conducted a cross-sectional survey among medical students at the University of Amsterdam. Our questionnaire included questions on actual donor registration, motives, knowledge, and attitudes toward donation. To assess which factors were related to self-reported donor registration status, we conducted multivariate logistic regression analyses. Results: We received 506 questionnaires (response rate at least 84%). The majority of respondents (80%) intended to donate organs, while 59% were …

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Parental vaccine concerns, information source, and choice of alternative immunization schedules.

Alternative immunization schedules increase the time a child is unvaccinated and require greater resources from providers. Understanding what drives interest in alternative immunization schedules can potentially inform the design of effective, targeted messages that help to reduce time spent counseling and decrease requests for alternative immunization schedules. This study used the Theory of Planned Behavior to explore associations between sources of vaccine information, parental vaccine concerns, peer norms for vaccine behavior and intentions to follow an alternative immunization schedule. We performed logistic regression using medical record data from a private pediatric practice in a large northeastern city. Routine data were recorded in the EMR by the pediatrician during an initial vaccine counseling conversation with the parent(s). Parents who received vaccine information from doct…

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Parents' information needs, self-efficacy and influences on consulting for childhood respiratory tract infections: a qualitative study.

Background: Acute respiratory tract infection (RTI) is the most common reason why parents consult primary care in the UK. Little is known about parents' perceptions of what may help them to make an appropriate decision to consult when their child is ill and how to improve self-care. Using qualitative methods, this study aimed to explore parents' views on support and information needs prior to consulting when children have RTIs with cough, and identify the triggers and barriers to consulting primary care. Methods: 7 focus groups and 30 semi-structured interviews were held with 60 parents (with children aged 5 months - 17 years) from a range of socio-economic backgrounds. Topics discussed were informed by the Health Belief Model, and explored parents' concerns and beliefs about susceptibility and severity of RTIs, beliefs about the triggers and barriers to consulting, and information and s…

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Training in and implementation of Acceptance and Commitment Therapy for depression in the Veterans Health Administration: therapist and patient outcomes.

Objective: The U.S. Department of Veterans Affairs has implemented a national dissemination and training initiative to promote the availability of Acceptance and Commitment Therapy for depression (ACT-D). This paper reports on therapist and patient outcomes associated with competency-based training in and implementation of ACT-D. Method: Therapist and patient outcomes were assessed on eleven cohorts of therapists (n = 391) and their patients (n = 745). Results: Three-hundred thirty four therapists successfully completed all requirements of the Training Program. Ninety-six percent of therapists achieved competency by the end of training, compared to 21% at the outset of training. Mixed effects model analysis indicated therapists' overall ACT-D competency scores increased from 76 to 112 (conditional SD = 6.6), p < 0.001. Moreover, training was associated with significantly increased therap…

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Shaping legal abortion provision in Ghana: using policy theory to understand provider-related obstacles to policy implementation.

Background: Unsafe abortion is a major public health problem in Ghana; despite its liberal abortion law, access to safe, legal abortion in public health facilities is limited. Theory is often neglected as a tool for providing evidence to inform better practice; in this study we investigated the reasons for poor implementation of the policy in Ghana using Lipsky's theory of street-level bureaucracy to better understand how providers shape and implement policy and how provider-level barriers might be overcome. Methods: In-depth interviews were conducted with 43 health professionals of different levels (managers, obstetricians, midwives) at three hospitals in Accra, as well as staff from smaller and private sector facilities. Relevant policy and related documents were also analysed. Results: Findings confirm that health providers' views shape provision of safe-abortion services. Most promin…

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Community collectivization and its association with consistent condom use and STI treatment-seeking behaviors among female sex workers and high-risk men who have sex with men/transgenders in Andhra Pradesh, India.

We examine community collectivization among female sex workers (FSWs) and high-risk men who have sex with men and transgenders (HR-MSM) following several years of HIV prevention programming with these populations, and its association with selected outcome indicators measuring individual behaviors (condom use with different partners and sexually transmitted infection [STI] treatment-seeking from government health facilities). Data for this study were collected from a large-scale cross-sectional survey conducted in 2010-2011 among FSWs (sample size: 3557) and HR-MSM (sample size: 2399) in Andhra Pradesh, India. We measured collectivization among FSWs in terms of three binary (low, high) indices of collective efficacy, collective agency, and collective action. Collectivization among HR-MSM was measured by participation in a public event (no, yes), and a binary (low, high) index of collectiv…

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Child maltreatment severity and adult trauma symptoms: does perceived social support play a buffering role?

Objectives: The current study investigates the moderating effect of perceived social support on associations between child maltreatment severity and adult trauma symptoms. We extend the existing literature by examining the roles of severity of multiple maltreatment types (i.e., sexual, physical, and emotional abuse; physical and emotional neglect) and gender in this process. Methods: The sample included 372 newlywed individuals recruited from marriage license records. Participants completed a number of self-report questionnaires measuring the nature and severity of child maltreatment history, perceived social support from friends and family, and trauma-related symptoms. These questionnaires were part of a larger study, investigating marital and intrapersonal functioning. We conducted separate, two-step hierarchical multiple regression models for perceived social support from family and p…

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Do negative beliefs about exposure therapy cause its suboptimal delivery? An experimental investigation.

Despite its effectiveness, exposure therapy is underutilized and frequently implemented in suboptimal fashion. Research has shown negative beliefs about exposure are related to its underutilization, and these beliefs are held by exposure therapists and may play a causal role in its suboptimal delivery. This study examined the effect of negative beliefs about exposure on treatment delivery. Participants (n=53) received training in basic exposure implementation and were given additional information intended to elicit either positive or negative beliefs about the treatment's safety, tolerability, and ethicality prior to conducting an exposure session with a confederate client. Results indicated that participants with experimentally induced negative beliefs about exposure delivered the treatment more cautiously (e.g. creation of a less ambitious exposure hierarchy, selection of a less anxiet…

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Is it bullying or sexual harassment? Knowledge, attitudes, and professional development experiences of middle school staff.

Background: This study fills a gap in the literature by examining how school staff members view bullying and sexual harassment and their role in preventing both. Given recent legislation, increasingly more attention is paid to bully prevention; however, student-on-student sexual harassment is less addressed. Methods: Four focus groups were conducted with 32 staff members from 4 midwestern public middle schools. Questions assessed professional development opportunities on bullying and sexual harassment prevention/intervention, personal definitions of these behaviors, and their perceptions of school norms regarding such behavior. Results: Staff members recalled receiving more professional development on bullying than sexual harassment. They tended to define sexual harassment as something that occurs between adults and/or adults and students and did perceive their role in enforcing a "sexua…

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Public knowledge, attitudes and behaviour regarding people with mental illness in England 2009-2012.

Background: Public stigma against people with mental health problems is damaging to individuals with mental illness and is associated with substantial societal burden. Aims: To investigate whether public knowledge, attitudes and behaviour in relation to people with mental health problems have improved among the English population since the inception of the Time To Change programme in 2009. Method: We analysed longitudinal trends in public knowledge, attitudes and behaviour between 2009 and 2012 among a nationally representative sample of English adults. Results: There were improvements in intended behaviour (0.07 standard deviation units, 95% CI 0.01-0.14) and a non-significant trend for improvement in attitudes (P = 0.08) among the English population. There was, however, no significant improvement in knowledge or reported behaviour. Conclusions: The findings provide support for effectiv…

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