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Help-seeking pathways

Andrew McDowell, Neeraj Raizada, Sunil D Khaparde, Raghuram Rao, Sanjay Sarin, Aakshi Kalra, Virender Singh Salhotra, Sreenivas Achuthan Nair, Catharina Boehme, Claudia M Denkinger
BACKGROUND: Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF ('Xpert')-a rapid molecular assay with high sensitivity and specificity-for pediatric presumptive TB patients, as recommended by India's Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers...
2018: PloS One
Michèle Twomey, Ana Šijački, Gert Krummrey, Tyson Welzel, Aristomenis K Exadaktylos, Marko Ercegovac
Emergency center visits are mostly unscheduled, undifferentiated, and unpredictable. A standardized triage process is an opportunity to obtain real-time data that paints a picture of the variation in acuity found in emergency centers. This is particularly pertinent as the influx of people seeking asylum or in transit mostly present with emergency care needs or first seek help at an emergency center. Triage not only reduces the risk of missing or losing a patient that may be deteriorating in the waiting room but also enables a time-critical response in the emergency care service provision...
March 12, 2018: International Journal of Environmental Research and Public Health
N Schnyder, C Michel, R Panczak, S Ochsenbein, B G Schimmelmann, F Schultze-Lutter
BACKGROUND: The stigma of mental illness, especially personal attitudes towards psychiatric patients and mental health help-seeking, is an important barrier in healthcare utilisation. These attitudes are not independent of each other and are also influenced by other factors, such as mental health literacy, especially the public's causal explanations for mental problems. We aimed to disentangle the interrelations between the different aspects of stigma and causal explanations with respect to their association with healthcare utilisation...
March 6, 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
Leopoldo J Cabassa, Sarah Piscitelli, Morgan Haselden, Rufina J Lee, Susan M Essock, Lisa B Dixon
OBJECTIVE: This study aimed to understand the pathways to care from the onset of a first episode of psychosis to entry into a specialized early intervention service (EIS) for individuals with nonaffective psychosis. METHODS: A sample of 20 individuals who participated in an EIS and ten of their family members were enrolled. Semistructured qualitative interviews were used to characterize participants' lives during the onset of psychosis and explore their help-seeking events from the onset of psychosis to entry into the EIS...
March 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Phoebe Dunsmuir, David Smith, A Kate Fairweather-Schmidt, Ben Riley, Malcolm Battersby
Many gambling-specific CBT programs seek to target either gambling-related urge or cognitions or both. However, little is known of the influence of one symptom type on another across time and whether these differ for men and women help-seeking problem gamblers. The aim of this study was threefold: to determine presence of measurement invariance for urge and cognition measures over time; to investigate the effect of baseline urge on end-of-treatment gambling-related cognitions - and the reciprocal relationship; and, identify whether these pathways differ across gender...
February 15, 2018: Psychiatry Research
Karen N Barnett, David Weller, Steve Smith, Robert Jc Steele, Peter Vedsted, Sheina Orbell, Sue M Moss, Jane W Melia, Julietta Patnick, Christine Campbell
BACKGROUND: Colorectal cancer (CRC) screening programmes using a guaiac faecal occult blood test (gFOBt) reduce CRC mortality. Interval cancers are diagnosed between screening rounds: reassurance from a negative gFOBt has the potential to influence the pathway to diagnosis of an interval colorectal cancer. METHODS: Twenty-six semi-structured face-to-face interviews were carried out in Scotland and England, with individuals diagnosed with an interval colorectal cancer following a negative gFOBt result...
February 19, 2018: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
D M Gomez, C Gunarathna, S Gunarathna, K Gnanapragasam, Raveen Hanwella
Background: Mental illness contributes significantly to the global disease burden. There is great diversity in the manner in which mentally ill patients seek help as this is influenced by their beliefs and the opinion of the family-social support unit. The stigma associated with mental illness is a barrier to effective therapy in Sri Lanka where systematic public awareness programmes are minimal. Objective: To study the help-seeking behaviour and its impact on patients attending a psychiatry clinic of the National Hospital of Sri Lanka...
December 26, 2017: Ceylon Medical Journal
Deborah A Goebert, Fumiaki Hamagami, Earl S Hishinuma, Jane J Chung-Do, Jeanelle J Sugimoto-Matsuda
Multivariate dynamic relationships among suicide attempts, anxiety and/or depressive symptoms, hope, and help-seeking were examined across time in Native Hawaiian and non-Hawaiian adolescents, using data from a 5-year longitudinal cohort study (N = 7,317). The rate of suicide attempts decreased over time, but this reduction was significantly less among Native Hawaiian youth than their non-Hawaiian peers. There were also significant differences between groups in hope and help-seeking, with Native Hawaiian youth increasing help-seeking and decreasing hope to a greater degree...
January 22, 2018: Suicide & Life-threatening Behavior
Mariarita Caroleo, Amedeo Primerano, Marianna Rania, Matteo Aloi, Valentina Pugliese, Fabio Magliocco, Gilda Fazia, Andrea Filippo, Flora Sinopoli, Marco Ricchio, Franco Arturi, Susana Jimenez-Murcia, Fernando Fernandez-Aranda, Pasquale De Fazio, Cristina Segura-Garcia
BACKGROUND: Considering that specific genetic profiles, psychopathological conditions and neurobiological systems underlie human behaviours, the phenotypic differentiation of obese patients according to eating behaviours should be investigated. The aim of this study was to classify obese patients according to their eating behaviours and to compare these clusters in regard to psychopathology, personality traits, neurocognitive patterns and genetic profiles. METHODS: A total of 201 obese outpatients seeking weight reduction treatment underwent a dietetic visit, psychological and psychiatric assessment and genotyping for SCL6A2 polymorphisms...
December 14, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
Anna Sansom, Rohini Terry, Emily Fletcher, Chris Salisbury, Linda Long, Suzanne H Richards, Alex Aylward, Jo Welsman, Laura Sims, John L Campbell, Sarah G Dean
OBJECTIVE: To identify factors influencing general practitioners' (GPs') decisions about whether or not to remain in direct patient care in general practice and what might help to retain them in that role. DESIGN: Qualitative, in-depth, individual interviews exploring factors related to GPs leaving, remaining in and returning to direct patient care. SETTING: South West England, UK. PARTICIPANTS: 41 GPs: 7 retired; 8 intending to take early retirement; 11 who were on or intending to take a career break; 9 aged under 50 years who had left or were intending to leave direct patient care and 6 who were not intending to leave or to take a career break...
January 10, 2018: BMJ Open
Marta G Novelle, Carlos Diéguez
The feeding process is required for basic life, influenced by environment cues and tightly regulated according to demands of the internal milieu by regulatory brain circuits. Although eating behaviour cannot be considered "addictive" under normal circumstances, people can become "addicted" to this behaviour, similarly to how some people are addicted to drugs. The symptoms, cravings and causes of "eating addiction" are remarkably similar to those experienced by drug addicts, and both drug-seeking behaviour as eating addiction share the same neural pathways...
January 11, 2018: Nutrients
Kumudha Aruldas, Aastha Kant, P S Mohanan
BACKGROUND: India has made large strides in reducing maternal mortality ratio and neonatal mortality rate, yet care-seeking behavior for appropriate care is still a challenge. We conducted a qualitative study to understand the process of recognition and care-seeking for maternal and newborn illnesses in rural India where a health intervention through women's self-help groups (SHG) to improve maternal and newborn health behaviors is implemented by a non-governmental organization, the Rajiv Gandhi Mahila Vikas Pariyojana...
December 21, 2017: Journal of Health, Population, and Nutrition
Judith Maher, Catherine Robichaud, Elizabeth Swanepoel
BACKGROUND: optimal nutrition in pregnancy is crucial for short and long term health in both mother and child. While a large proportion of pregnant women utilise the internet for informational support during pregnancy, little is known about online practices relating to food and nutrition in pregnancy. METHODS: a qualitative study; Semi-structured interviews were undertaken with 16 primigravid women to explore their approaches and preferences when accessing and engaging with pregnancy-related nutrition information online...
December 14, 2017: Midwifery
Susana Vacas, Barbara Van de Wiele
Background: Craniotomy is a relatively common surgical procedure with a high incidence of postoperative pain. Development of standardized pain management and enhanced recovery after surgery (ERAS) protocols are necessary and crucial to optimize outcomes and patient satisfaction and reduce health care costs. Methods: This work is based upon a literature search of published manuscripts (between 1996 and 2017) from Pubmed, Cochrane Central Register, and Google Scholar...
2017: Surgical Neurology International
Lovney Kanguru, Annemieke Bikker, Debbie Cavers, Karen Barnett, David H Brewster, David Weller, Christine Campbell
INTRODUCTION: As cancer survivors continue to live longer, the incidence of second primary cancers (SPCs) will also rise. Relatively little is understood about the diagnostic pathway for SPCs, how people appraise, interpret symptoms and seek help for a second different cancer and the experiences (including challenges) of healthcare providers relating to SPCs. This study aims to systematically appraise and synthesise the literature on the pathways to diagnosis of an SPC and the associated patient and healthcare provider experiences...
December 21, 2017: BMJ Open
Christina Müller, Stefan Remy
The septo-hippocampal pathway adjusts CA1 network excitability to different behavioral states and is crucially involved in theta rhythmogenesis. In the medial septum, cholinergic, glutamatergic and GABAergic neurons form a highly interconnected local network. Neurons of these three classes project to glutamatergic pyramidal neurons and different subsets of GABAergic neurons in the hippocampal CA1 region. From there, GABAergic neurons project back to the medial septum and form a feedback loop between the two remote brain areas...
December 18, 2017: Cell and Tissue Research
Harinder Singh Chahal, Jeffrey S Murray, Martin Shimer, Peter Capella, Ryan Presto, Mary Lou Valdez, Peter G Lurie
INTRODUCTION: In 2004, the US government began to utilize the Food and Drug Administration's (USFDA) tentative approval process (tFDA) as a basis to determine which HIV drugs are appropriate to be purchased and used in resource-constrained settings. This process permits products that are not approved for marketing in the US, including medicines with active patents or marketing restrictions in the US, to be purchased and distributed in resource-constrained settings. Although the tFDA was originally intended to support the United States' President's Emergency Plan for AIDS Relief (PEPFAR), the USFDA list has become a cornerstone of international HIV programmes that support procurement of ARVs, such as the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria...
December 2017: Journal of the International AIDS Society
Harriet Mellotte, Dominic Murphy, Laura Rafferty, Neil Greenberg
Background : It is well established that veterans suffering from mental health difficulties under use mental health services. Objective : This study aimed to understand more about the barriers that prevent veterans from seeking professional help and the enablers that assist veterans in seeking professional help. It also aimed to explore potential mechanisms to improve veterans' help-seeking and pathways to care. Method : The study employed a qualitative design whereby 17 veterans who had recently attended specialist veteran mental health services took part in semi-structured interviews...
2017: European Journal of Psychotraumatology
Leon J Broom, Michael H Kogut
Inflammation is an essential immune response that seeks to contain microbial infection and repair damaged tissue. Increased pro-inflammatory mediators have been associated with enhanced resistance to a range of important poultry and pig pathogens. However, inflammation may also have undesirable consequences, including potentially exacerbating tissue damage and diverting nutrients away from productive purposes. The negative effects of inflammation have led to the active pursuit of anti-inflammatory feed additives and/or strategies...
November 4, 2017: Poultry Science
Christy Hanson, Mike Osberg, Jessie Brown, George Durham, Daniel P Chin
Background: Despite significant progress in diagnosis and treatment of tuberculosis over the past 2 decades, millions of patients with tuberculosis go unreported every year. The patient-pathway analysis (PPA) is designed to assess the alignment between tuberculosis care-seeking patterns and the availability of tuberculosis services. The PPA can help programs understand where they might find the missing patients with tuberculosis. Methods: This analysis aggregates and compares the PPAs from case studies in Kenya, Ethiopia, Indonesia, the Philippines, and Pakistan...
November 6, 2017: Journal of Infectious Diseases
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