Community care

BACKGROUND: In the global strategy to eliminate leprosy, there remains a need for early case detection to successfully interrupt transmissions. Poor knowledge about leprosy and leprosy-related stigma are key drivers of delayed diagnosis and treatment. Sensitization campaigns to inform and increase awareness among the general population are an integral part of many national neglected tropical disease programs. Despite their importance, the effectiveness of such campaigns has not been rigorously studied in the West African context...

Canada has experienced a steady increase in homicide. Specifically, out of the 10 provinces and 3 territories, Ontario has consistently experienced the highest number of homicides, the majority concentrated within predominantly African, Caribbean, and Black (ACB) communities in the Greater Toronto Area (GTA). Despite this disproportionate reality, there is limited research on the ways in which survivors of homicide victims cope with the murder of their loved ones. This article explores the identification and characterization of coping strategies for ACB survivors of homicide victims residing in five neighbourhoods in the GTA...

BACKGROUND: People with heart failure, particularly those who are physically frail, experience complex needs that can be addressed by palliative care (PC). However, we have a limited understanding of how the intersection of unmet PC needs and physical frailty contributes to health-related quality of life (HRQOL) and risk for hospitalization or mortality. OBJECTIVE: In this study, we sought to examine the association of unmet PC needs and physical frailty with clinical outcomes (baseline HRQOL and hospitalizations or mortality at 6 months)...

Today, population aging is the main trend of population development. Home-based care is mainly adopted in Chinese society, and scholars have paid ample attention to the effect of intergenerational support on the mental health of older people. However, research conclusions differ. This study uses data from the 2018 China Health and Pension Tracking Survey (CHARLS), which we analyzed with STATA software to construct least squares regression and two-stage least squares regression models. The regression model included 6,647 respondents to investigate the mental health status of older people based on depression status...

BACKGROUND: Antenatal care (ANC) is one of the recommended interventions to reduce stillbirth, maternal, neonatal, and child mortality through early identification and management of pregnancy complications or pre-existing conditions. Although increasing number of ANC is a key priority of the 2016 WHO recommendations, ANC uptake in Low and Middle Income Countries (LMICs) is insufficient. Therefore, this study aimed to investigate factors associated with the number of ANC contacts in LMICs...

Integrating the voices of service users and providers in the design and delivery of health services increases the acceptability, relevance, and effectiveness of services. Such efforts are particularly important for youth opioid use treatments and services, which have failed to consider the unique needs of youth and families. Applying community-based participatory research (CBPR) and co-design can facilitate this process by contextualizing service user experiences at individual and community levels and supporting the collaborative design of innovative solutions for improving care...

OBJECTIVES: Preventative services are required to address the risk factors for chronic conditions such as cardiovascular disease. The National Health Service Health Checks in England were introduced to provide such services. One School of Pharmacy established a student-led clinic to provide this service to the local community. The clinic was provided by undergraduate pharmacy students and delivered free of charge within a central city locality. The aim was to explore the impact of the clinic on user thoughts and motivations around healthy living and investigate user experience...

This study explores how bereaved families of organ donors become participants in an 'imagined epistemic community' of organ donor families, amidst a national conflict between Jews and Arabs in Israel. Utilizing a media case study approach, we identified factors contributing to the creation of this bi-national community and examined what the families received in return for their part. Additionally, we explored the reasons behind the community splitting into two separate entities. Based on the media reports, we suggest that entry into the community is conditional on donating organs during wartime, granting these families a special moral status in return, resonating messages of altruism, solidarity and coexistence...

Human Papilloma Virus (HPV) is a preventable cause of cervical cancer, the commonest cancer among women in Uganda. The Uganda Ministry of Health included the HPV vaccine in the free routine immunization schedule since 2015. Five years after this policy, we assessed the uptake of the HPV vaccine and associated socio-demographic factors among young women living in fishing communities in Central Uganda in 2020. We analyzed secondary data from 94 young women aged 9-25 years who were recruited from the two fishing communities (Kasenyi landing site and Koome Island) in a primary study that aimed to promote awareness of maternal and childhood vaccines...

BACKGROUND: Coronavirus disease 2019 (COVID-19) continues to pose a global public health threat. The pandemic overstretched already weak health systems in low- and low-middle-income countries, including Ethiopia. There is a paucity of studies on the impact of COVID-19 on antenatal care access, uptake, and provision in Ethiopia. This study examines the impact of COVID-19 on antenatal care provision in the Sidama region, Ethiopia. METHODS: A concurrent mixed-methods study was conducted between 14 February and 10 May 2022 at 15 public hospitals in the Sidama region...

BACKGROUND: It is crucial to deliver a child at nearby primary healthcare facilities to prevent subsequent maternal or neonatal complications. In low-resource settings, such as Nepal, it is customary to forgo the neighboring primary healthcare facilities for child delivery. Reports are scanty about the extent and reasons for bypassing local health centers in Nepal. This study sought to determine the prevalence and contributing factors among women bypassing primary healthcare facilities for childbirth...

This article memorializes Héctor Fernández-Álvarez (1944-2023). Héctor was an exceptional mentor, therapist, supervisor, professor, researcher, author, and leader, as well as a beloved brother, partner, father, and grandfather. The consummate renaissance person who embraced all manners of cultural expressions through an intentional wanderlust, he sought to understand all forms of human suffering and to alleviate senseless ones. Héctor's career spanned well over 5 decades. He received a licenciatura degree in 1967 from the University of Buenos Aires and a PhD in 1995 from the National University of San Luis, Argentina...

While the COVID-19 pandemic disproportionately impacted Black American communities, there is a lack of empirical research examining mental health experiences during the COVID-19 pandemic among this population. This report examines the relationship between the COVID-19 pandemic and stress, depression, and anxiety among Black women. A cohort study with supplementary data was conducted among 45 Black American women with depressive symptoms participating in an ongoing randomized controlled trial of a mindfulness-based intervention (M-Body) at a Federally Qualified Health Center...

The current study was designed to describe usual clinical care for youth with primary anxiety problems in community mental health centers. The observer-rated Therapy Process Observational Coding System for Child Psychotherapy - Revised Strategies scale (TPOCS-RS), designed to assess therapeutic techniques from five theory-based domains, was used to code sessions (N = 403) from the usual clinical care group of two randomized effectiveness trials: (a) Youth Anxiety Study (YAS) with 21 youth (M age = 10...

Research shows that, in mental healthcare, empathy and active listening skills play a fundamental role in the therapeutic relationship. Despite this, clinicians receive little training in cultivating these qualities, and there is a dearth of training in therapeutic relationships and relational care in this field more generally. In response to this paucity of training, a new intensive three-day training programme has been developed called Compassionate and Relational Enquiry (CARE). The CARE training programme has recently been delivered to a number of mental health teams in different boroughs of an NHS Trust and has undergone several rounds of redevelopment...

Issue:  A significant component of health professions education is focussed on students' exposure to the social determinants of health and the challenges that patients within the health care system face. An appropriate way to provide such exposure is through distributed clinical training. This usually entails students training in smaller groups along the continuum of care, away from tertiary academic hospitals. This also means students are away from their existing academic and social support systems. It is evident that knowledge and clinical skills alone are not sufficient to prepare students, they also need to be taught to critically reflect on how their own values and attitudes traverse their knowledge and skills to influence their practice as healthcare professionals...

Recent studies show that Traditional Ecological Knowledge (TEK) of Indigenous Peoples' food systems and the transfer of that knowledge to their children are critical to physical and mental health, promote the transfer of language and culture, and further resilience. The aim of this exploratory, medical ecological study was to document TEK about foraging and plant use among the Dukha, a small, semi-nomadic reindeer herding community in Northern Mongolia. Field research was conducted at multiple remote camps in 2019 and 2023...

BACKGROUND: Bisphosphonates are a class of medication commonly used to treat osteoporosis. Alendronate is recommended as the first-line treatment; however, long-term adherence (both treatment compliance and persistence) is poor. Alternative bisphosphonates are available, which can be given intravenously and have been shown to improve long-term adherence. However, the most clinically effective and cost-effective alternative bisphosphonate regimen remains unclear. What is the most cost-effective bisphosphonate in clinical trials may not be the most cost-effective or acceptable to patients in everyday clinical practice...

BACKGROUND AND AIM: Long Covid is often stigmatised, particularly in people who are disadvantaged within society. This may prevent them from seeking help and could lead to widening health inequalities. This coproduced study with a Community Advisory Board (CAB) of people with Long Covid aimed to understand healthcare and wider barriers and stigma experienced by people with probable Long Covid. METHODS: An active case finding approach was employed to find adults with probable, but not yet clinically diagnosed, Long Covid in two localities in London (Camden and Merton) and Derbyshire, England...

BACKGROUND: Aligning cost of mental health care with expected clinical and functional benefits of that care would incentivize the delivery of high value treatments and services. In turn, ineffective or untested care could still be offered but at costs high enough to offset the delivery of high value care. AIMS: The authors comment on Benson and Fendrick's paper on Value-Based Insurance Design (VBID) for mental health in the September 2023 special issue of this journal...