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https://www.readbyqxmd.com/read/28941089/improving-outcomes-of-first-episode-psychosis-an-overview
#1
Paolo Fusar-Poli, Patrick D McGorry, John M Kane
Outcomes of psychotic disorders are associated with high personal, familiar, societal and clinical burden. There is thus an urgent clinical and societal need for improving those outcomes. Recent advances in research knowledge have opened new opportunities for ameliorating outcomes of psychosis during its early clinical stages. This paper critically reviews these opportunities, summarizing the state-of-the-art knowledge and focusing on recent discoveries and future avenues for first episode research and clinical interventions...
October 2017: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
https://www.readbyqxmd.com/read/28940350/urgently-creating-the-better-in-global-health
#2
Richard Marlink
In this issue of the Hastings Center Report, Govind Persad and Ezekiel Emanuel argue that "[t]he provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off." I agree that we should not let the perfect get in the way of the good, but just providing cheaper, less effective treatment for utilitarian or other reasons is not a comprehensive approach to global health. In my experience as an on-the-ground global health practitioner, the choice is never that simple...
September 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28926598/-if-he-could-speak-he-would-be-able-to-point-out-who-does-those-things-to-him-experiences-of-violence-and-access-to-child-protection-among-children-with-disabilities-in-uganda-and-malawi
#3
Lena Morgon Banks, Susan A Kelly, Nambusi Kyegombe, Hannah Kuper, Karen Devries
INTRODUCTION: There is growing evidence that children with disabilities face an increased risk of violence globally. While child protection mechanisms to prevent and respond to violence-including formal government systems and more informal programmes and activities run by local communities or NGOs-are slowly becoming operationalised in low- and- middle-income countries, little is known about whether existing mechanisms are disability-inclusive. The aim of this study is to provide a better understanding of children with disabilities' experiences of violence and their access to available child protection mechanisms in low resource settings...
2017: PloS One
https://www.readbyqxmd.com/read/28923162/food-and-nutrition-programs-for-aboriginal-and-torres-strait-islander-australians-an-overview-of-systematic-reviews
#4
Jennifer Browne, Karen Adams, Petah Atkinson, Deborah Gleeson, Rick Hayes
Objective To provide an overview of previous reviews of programs that aimed to improve nutritional status or diet-related health outcomes for Aboriginal and Torres Strait Islander peoples, in order to determine what programs are effective and why.Methods A systematic search of databases and relevant websites was undertaken to identify reviews of nutrition interventions for Aboriginal and Torres Strait Islander Australians. Pairs of reviewers undertook study selection and data extraction and performed quality assessment using a validated tool...
September 19, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28904815/predictors-help-seeking-behaviour-and-treatment-coverage-for-depression-in-adults-in-sehore-district-india
#5
Rahul Shidhaye, Tanica Lyngdoh, Vaibhav Murhar, Sandesh Samudre, Thomas Krafft
BACKGROUND: National Mental Health Survey found that in India, the point prevalence of major depressive disorder (MDD) was 2.7% and the treatment gap was 85.2%, whereas in Madhya Pradesh the point prevalence of MDD was 1.4% and the treatment gap was 80%. AIMS: To describe the baseline prevalence of depression among adults, association of various demographic and socioeconomic variables with depression and estimation of contact coverage for the same. METHOD: Population-based cross-sectional survey of 3220 adults in Sehore district of Madhya Pradesh, India...
September 2017: BJPsych Open
https://www.readbyqxmd.com/read/28899432/prevalence-and-associations-of-microalbuminuria-in-proteinuria-negative-patients-with-type-2-diabetes-in-two-regional-hospitals-in-cameroon-a-cross-sectional-study
#6
Nelsy T Efundem, Jules Clement N Assob, Vitalis F Feteh, Simeon-Pierre Choukem
BACKGROUND: Microalbuminuria (MA) is the earliest clinical evidence of diabetic nephropathy, but most patients in sub-Saharan Africa (SSA) only have access to much cheaper dipstick proteinuria as a means to screen for diabetic nephropathy. The aim of this study was to determine the prevalence and associations of MA among proteinuria-negative type 2 diabetic patients in a SSA setting. METHODS: In this cross-sectional study, patients with type 2 diabetes screened negative for dipstick proteinuria in a primary healthcare hospital were assessed...
September 12, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28899415/the-experiences-of-caregivers-of-children-living-with-hiv-and-aids-in-uganda-a-qualitative-study
#7
Joseph Osafo, Birthe Loa Knizek, James Mugisha, Eugene Kinyanda
BACKGROUND: Home-based care for HIV patients is popular in contexts severely affected by the epidemic and exacts a heavy toll on caregivers. This study aimed at understanding the experiences of caregivers and their survival strategies. METHODS: A total of 18 caregivers (3 males and 15 females) were interviewed using a semi-structured interview guide, and thematic analysis was used to analyse the data. RESULTS: Analysis suggests that the caregivers are burdened with insecure provisions for food and difficulties in accessing health care...
September 12, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28880355/-mental-health-as-a-front-line-service-for-bewildered-persons
#8
C L Mulder, J van Weeghel, A Wierdsma, J Zoeteman, A Schene
'Bewildered persons' have often been in the news over the last few years. There has been much discussion about the meaning of the term 'bewildered persons', the number of people involved, the way the problem should be tackled and the role of the mental health services.<br/> AIM: To look critically at the term 'bewildered persons' and to discuss the suspected increase in numbers and the role of mental health services.<br/> METHOD: Review and discussion of the relevant literature relating to 'bewildered persons' which has been published in the last 25 years...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28861551/access-to-medical-and-mental-health-services-across-the-hiv-care-continuum-among-young-transgender-women-a-qualitative-study
#9
Nadia Dowshen, Susan Lee, Joshua Franklin, Marné Castillo, Frances Barg
Purpose: (1) To describe psychosocial, medical, and mental health outcomes of young transgender women (YTW) living with or at risk for HIV infection and (2) to explore barriers and facilitators to medical and mental health services across the HIV care continuum. Methods: We conducted a cross-sectional observational study of YTW aged 16-24 years who were at risk for contracting or living with HIV. Participants were recruited from an adolescent HIV clinic and local community-based organizations that serve YTW...
2017: Transgender Health
https://www.readbyqxmd.com/read/28855231/inequalities-in-the-dental-health-needs-and-access-to-dental-services-among-looked-after-children-in-scotland-a-population-data-linkage-study
#10
Alex D McMahon, Lawrie Elliott, Lorna Md Macpherson, Katharine H Sharpe, Graham Connelly, Ian Milligan, Philip Wilson, David Clark, Albert King, Rachael Wood, David I Conway
BACKGROUND: There is limited evidence on the health needs and service access among children and young people who are looked after by the state. The aim of this study was to compare dental treatment needs and access to dental services (as an exemplar of wider health and well-being concerns) among children and young people who are looked after with the general child population. METHODS: Population data linkage study utilising national datasets of social work referrals for 'looked after' placements, the Scottish census of children in local authority schools, and national health service's dental health and service datasets...
August 30, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28844783/doctors-opinions-on-clinical-coordination-between-primary-and-secondary-care-in-the-catalan-healthcare-system
#11
Marta-Beatriz Aller, Ingrid Vargas, Jordi Coderch, Sebastià Calero, Francesc Cots, Mercè Abizanda, Lluís Colomés, Joan Farré, María-Luisa Vázquez-Navarrete
OBJECTIVE: To analyse doctors' opinions on clinical coordination between primary and secondary care in different healthcare networks and on the factors influencing it. METHODS: A qualitative descriptive-interpretative study was conducted, based on semi-structured interviews. A two-stage theoretical sample was designed: 1) healthcare networks with different management models; 2) primary care and secondary care doctors in each network. Final sample size (n = 50) was reached by saturation...
August 24, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28840255/-appropriate-treatment-of-acute-stroke-at-all-times-and-in-all-places-organizational-concepts-and-new-approaches
#12
REVIEW
J E Weber, H J Audebert
Stroke is one of the most common neurological diseases in acute care. The introduction of new organizational concepts in the rescue chain and in acute inpatient services can significantly reduce time to treatment and patients can receive specific therapeutic options that have been shown to improve acute stroke prognosis. This review provides an overview of organizational structures that lead to improved medical care and outlines the evidence-based therapeutic options. This is intended to give the reader a decision support on provision of specific treatment in acute ischemic stroke...
August 24, 2017: Der Internist
https://www.readbyqxmd.com/read/28838969/acquired-heart-disease-in-low-income-and-middle-income-countries
#13
Chris Curry, Liesl Zuhlke, Ana Mocumbi, Neil Kennedy
The burden of illness associated with acquired cardiac disease in children in low-income and middle-income countries (LMIC) is significant and may be equivalent to that of congenital heart disease. Rheumatic heart disease, endomyocardial fibrosis, cardiomyopathy (including HIV cardiomyopathy) and tuberculosis are the most important causes. All are associated with poverty with the neediest children having the least access to care. The associated mortality and morbidity is high. There is an urgent need to improve cardiac care in LMIC, particularly in sub-Saharan Africa and parts of Southeast Asia where the burden is highest...
August 24, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28837574/beyond-form-and-functioning-understanding-how-contextual-factors-influence-village-health-committees-in-northern-india
#14
Kerry Scott, Asha S George, Steven A Harvey, Shinjini Mondal, Gupteswar Patel, Rajani Ved, Surekha Garimella, Kabir Sheikh
Health committees are a common strategy to foster community participation in health. Efforts to strengthen committees often focus on technical inputs to improve committee form (e.g. representative membership) and functioning (e.g. meeting procedures). However, porous and interconnected contextual spheres also mediate committee effectiveness. Using a framework for contextual analysis, we explored the contextual features that facilitated or hindered Village Health, Sanitation and Nutrition Committee (VHSNC) functionality in rural north India...
2017: PloS One
https://www.readbyqxmd.com/read/28835850/risk-based-triage-for-nephrology-referrals-using-the-kidney-failure-risk-equation
#15
Jay Hingwala, Peter Wojciechowski, Brett Hiebert, Joe Bueti, Claudio Rigatto, Paul Komenda, Navdeep Tangri
BACKGROUND: In some jurisdictions, routine reporting of the estimated glomerular filtration rate (eGFR) has led to an increase in nephrology referrals and wait times. OBJECTIVE: We describe the use of the Kidney Failure Risk Equation (KFRE) as part of a triage process for new nephrology referrals for patients with chronic kidney disease stages 3 to 5 in a Canadian province. DESIGN: A quasi-experimental study design was used. SETTING: This study took place in Manitoba, Canada...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28831671/opportunistic-invasive-mycoses-in-aids-cryptococcosis-histoplasmosis-coccidiodomycosis-and-talaromycosis
#16
REVIEW
Daniel B Chastain, Andrés F Henao-Martínez, Carlos Franco-Paredes
PURPOSE OF REVIEW: The goal of this review is to provide an update on the epidemiology, diagnosis, and treatment of opportunistic fungal infections in patients with human immunodeficiency virus (HIV) infection including Cryptococcus spp., Histoplasma spp., Coccidioides spp., and Talaromyces marneffei, formerly Penicillium marneffei. RECENT FINDINGS: In many settings, despite increasing roll out of antiretroviral therapy (ART), opportunistic invasive mycoses produce a substantial burden of disease...
August 22, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28831441/pain-management-and-use-of-opioids-in-pediatric-oncology-in-india-a-qualitative-approach
#17
Paola Angelini, Katherine M Boydell, Vicky Breakey, Purna A Kurkure, Marian A Muckaden, Eric Bouffet, Brijesh Arora
PURPOSE: Consumption of medical opium for pain relief in India is low, despite the country being one of the main world producers of the substance. We investigated obstacles to opioid use and physician perceptions about optimal pain management in pediatric oncology patients in India. METHODS: Semistructured interviews were conducted with oncologists who work in pediatric oncology settings. A mixed sampling strategy was used, including maximum variation and confirmation and disconfirmation of cases, as well as snowball sampling...
August 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28831275/beneficiaries-of-conflict-a-qualitative-study-of-people-s-trust-in-the-private-health-care-system-in-mogadishu-somalia
#18
Abdi A Gele, Mohamed Yusuf Ahmed, Prabhjot Kour, Sadiyo Ali Moallim, Abdulwahab Moallim Salad, Bernadette Kumar
BACKGROUND: In 2005, the World Health Conference called for all nations to move toward universal health coverage, which is defined as "access to adequate health care for all at an affordable price". Despite this, an estimated 90% of Somalia's largely impoverished population use private health care. Therefore, considering that the private health care system is the dominant health care system in Mogadishu, Somalia, exploring the accessibility to, as well as people's trust in, the private sector is essential to help contribute an equitable and affordable health care system in the country...
2017: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/28828871/why-seek-a-second-consultation-at-an-emergency-centre-a-qualitative-study
#19
Lize Crafford, Louis S Jenkins
BACKGROUND: The inappropriate use of emergency centres (ECs) is an expanding problem globally. The high attendance of non-urgent return presentations to ECs is recognised as part of the problem, placing an unnecessary demand on limited staff and resources. Of unscheduled returns 34% of cases had no change to diagnosis or treatment with the conclusion that 80% of re-attendance could be attributed to deficiencies in the initial consultation. This study aimed to evaluate the reasons why patients sought an early second consultation for the same complaint at a hospital EC in South Africa, by exploring the patient's experience and shortcomings in the first consultation...
July 27, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28827247/comparing-provision-and-appropriateness-of-health-care-between-immigrants-and-non-immigrants-in-germany-using-the-example-of-neuraxial-anaesthesia-during-labour-cross-sectional-study
#20
Oliver Razum, Katharina Reiss, Jürgen Breckenkamp, Lutz Kaufner, Silke Brenne, Kayvan Bozorgmehr, Theda Borde, Matthias David
OBJECTIVE: Research on health services for immigrants has mostly been concerned with access barriers but rarely with appropriateness and responsiveness of care. We assessed whether appropriateness and responsiveness of care depend on migration status, using provision of neuraxial anaesthesia (NA) during labour as indicator. In relation to their migration status, we analysed whether (1) women undergoing elective or secondary/urgent secondary caesarean sections (ESCS) appropriately receive NA (instead of general anaesthesia), (2) women delivering vaginally appropriately receive NA and (3) women objecting to NA, for example, for religious reasons, may deliver vaginally without receiving NA (provider responsiveness)...
August 21, 2017: BMJ Open
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