scholarly journals Socio-Sexual Experiences and Access to Healthcare Among Informal PrEP Users in the Netherlands

2020 ◽  
Author(s):  
Mart van Dijk ◽  
John B. F. de Wit ◽  
Rebecca Kamps ◽  
Thomas E. Guadamuz ◽  
Joel E. Martinez ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Qualitative Study ◽  
The Netherlands ◽  
Healthcare Providers ◽  
Well Being ◽  
Healthcare Services ◽  
Interpretive Description ◽  
Sex Partners ◽  
Sex With Men ◽  
Incorrect Information

AbstractThe aim of this qualitative study was to explore the experiences of informal PrEP users regarding access to PrEP and PrEP-related healthcare, community responses, sexual behavior and well-being. We interviewed 30 men who have sex with men (MSM) in semi-structured online interviews between March and August 2018. Interviews were analyzed using interpretive description. Informal PrEP users were well informed about the use of PrEP, but sometimes did not make use of renal testing. Participants reported a lack of PrEP knowledge among healthcare providers, which limited their access to PrEP and put them at risk, as they received incorrect information. Although some participants reported negative reactions from potential sex partners, most received positive reactions and were sometimes seen as more desirable sex partners. PrEP healthcare services should not only be accessible to formal PrEP users, but also to PrEP users who procure PrEP informally.

scholarly journals Implementation of Primary Healthcare Services in Community Health Stations in Highly Urbanized City

2021 ◽  
Vol 4 (3) ◽  
pp. 123-132
Author(s):  
Hanna B. Gella ◽  
Merlita V. Caelian
Keyword(s):  
Community Health ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Well Being ◽  
Healthcare Services ◽  
Health Improvement ◽  
Patient Centeredness ◽  
Sustainable Development Goal ◽  
The Sustainable Development ◽  
Child Healthcare

Primary healthcare is integral to the Sustainable Development Goal (SDG) of ensuring healthy lives and promoting well-being.  A descriptive study assessed the implementation of primary healthcare services in community health stations through a researcher-made questionnaire among healthcare providers and beneficiaries of 30 community health stations.  The results revealed that, as a whole, the implementation of primary healthcare services in community health stations is great, with maternal and child healthcare implemented to a very great extent while the treatment of non-communicable diseases to a great extent only.  The major challenges encountered are the lack of medical drugs, supplies and equipment, and medical professionals.  Primary healthcare has made contributions to the community's health improvement; however, challenges imply that the quality and efficiency of the services need improvement. The study contributed to new knowledge on implementing healthcare at the lowest level of government, emphasizing patient-centeredness.

scholarly journals Trends in antimicrobial susceptibility for azithromycin and ceftriaxone in Neisseria gonorrhoeae isolates in Amsterdam, the Netherlands, between 2012 and 2015

2017 ◽  
Vol 22 (1) ◽  
Author(s):  
Carolien M Wind ◽  
Maarten F Schim van der Loeff ◽  
Alje P van Dam ◽  
Henry JC de Vries ◽  
Jannie J van der Helm
Keyword(s):  
The Netherlands ◽  
Neisseria Gonorrhoeae ◽  
Treatment Strategies ◽  
Sex Partners ◽  
Hiv Status ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
New Treatment ◽  
Sex With Men ◽  
Infection Clinic

Resistance of Neisseria gonorrhoeae to azithromycin and ceftriaxone has been increasing in the past years. This is of concern since the combination of these antimicrobials is recommended as the first-line treatment option in most guidelines. To analyse trends in antimicrobial resistance, we retrospectively selected all consultations with a positive N. gonorrhoeae culture at the sexually transmitted infection clinic, Amsterdam, the Netherlands, from January 2012 through September 2015. Minimum inhibitory concentrations (MICs) for azithromycin and ceftriaxone were analysed per year, and determinants associated with decreased susceptibility to azithromycin (MIC > 0.25 mg/L) or ceftriaxone (MIC > 0.032 mg/L) were assessed. Between 2012 and 2015 azithromycin resistance (MIC > 0.5 mg/L) was around 1.2%, the percentage of isolates with intermediate MICs (> 0.25 and ≤ 0.5 mg/L) increased from 3.7% in 2012, to 8.6% in 2015. Determinants associated with decreased azithromycin susceptibility were, for men who have sex with men (MSM), infections diagnosed in the year 2014, two infected sites, and HIV status (HIV; associated with less decreased susceptibility); for heterosexuals this was having ≥ 10 sex partners (in previous six months). Although no ceftriaxone resistance (MIC > 0.125 mg/L) was observed during the study period, the proportion of isolates with decreased ceftriaxone susceptibility increased from 3.6% in 2012, to 8.4% in 2015. Determinants associated with decreased ceftriaxone susceptibility were, for MSM, infections diagnosed in 2014, and pharyngeal infections; and for heterosexuals, infections diagnosed in 2014 or 2015, being of female sex, and having ≥ 10 sex partners. Continued decrease of azithromycin and ceftriaxone susceptibility will threaten future treatment of gonorrhoea. Therefore, new treatment strategies are warranted.

scholarly journals Families of victims of homicide: qualitative study of their experiences with mental health inquiries

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Lillian Ng ◽  
Alan F. Merry ◽  
Ron Paterson ◽  
Sally N. Merry
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Qualitative Study ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Interpretive Description ◽  
Structured Interviews ◽  
Mental Health Patient ◽  
Loved One ◽  
Inquiry Process

Background Investigations may be undertaken into mental healthcare related homicides to ascertain if lessons can be learned to prevent the chance of recurrence. Families of victims are variably involved in serious incident reviews. Their perspectives on the inquiry process have rarely been studied. Aims To explore the experiences of investigative processes from the perspectives of family members of homicide victims killed by a mental health patient to better inform the process of conducting inquiries. Method The study design was informed by interpretive description methodology. Semi-structured interviews were conducted with five families whose loved one had been killed by a mental health patient and where there had been a subsequent inquiry process in New Zealand. Data were analysed using an inductive approach. Results Families in this study felt excluded, marginalised and disempowered by mental health inquires. The data highlight these families’ perspectives, particularly on the importance of a clear process of inquiry, and of actions by healthcare providers that indicate restorative intent. Conclusions Families in this study were united in reporting that they felt excluded from mental health inquiries. We suggest that the inclusion of families’ perspectives should be a key consideration in the conduct of mental health inquiries. There may be benefit from inquiries that communicate a clear process of investigation that reflects restorative intent, acknowledges victims, provides appropriate apologies and gives families opportunities to contribute.

scholarly journals Qualitative study on mental health and well-being of Syrian refugees and their coping mechanisms towards integration in the UK

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046065
Author(s):  
Priyamvada Paudyal ◽  
Mais Tattan ◽  
Maxwell J F Cooper
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Cultural Difference ◽  
Mental Health Problems ◽  
Community Support ◽  
Well Being ◽  
Healthcare Services ◽  
Coping Mechanisms ◽  
Syrian Refugees ◽  
Structured Interviews

ObjectiveThis study aimed to explore the mental well-being of Syrian refugees and identify their coping mechanisms and pathways towards integration into new communities.DesignQualitative study using in-depth semi-structured interviews.Setting and participantsAdult Syrian refugees (>18 years old) currently residing in South East of England.Results12 participants (3 women and 9 men) took part in the study, all were born in Syria and the majority (n=9) were over 45 years of age. Our findings show that Syrian refugees face constant challenges as they try to integrate into a new society. Loss of and separation from loved ones as well as the nostalgia for the homeland were often cited as a source of psychological distress that created an overwhelming sense of sadness. Participants reported that they struggled for connectedness due to cultural difference and the problematic nature of rapidly formed migrant communities in their new setting. They believed in ‘being their own doctor’ and turning to faith, ritual and nature for healing and comfort. Taboo and stigma around mental health and language barriers were cited as barriers to accessing mental healthcare services.ConclusionPast experiences and present challenges frame Syrian refugees’ sense of well-being, impact use of healthcare and risk future mental health problems. It is hoped that this study will act as a catalyst for further research on this vulnerable group to promote integration, community support and culturally sensitive mental health services.

scholarly journals An insight on initiation of same sex behavior among men who have sex with men in Agra district of India: A Qualitative study

2020 ◽  
Vol 32 (4) ◽  
pp. 624-630
Author(s):  
Iqbal Aqeel Khan ◽  
Shailendra Singh Chaudhary ◽  
Sunil Kumar Misra ◽  
Geetu Singh ◽  
Tej Pal Singh ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Qualitative Study ◽  
Sex Behavior ◽  
Sexual Encounter ◽  
Education Curriculum ◽  
Same Sex ◽  
Data Saturation ◽  
Sex With Men ◽  
Almost All ◽  
Depth Interviews

Background: Men who have sex with men (MSM) refer to all males (of any age) who engage in sexual relations with other males. The gross stigmatization and discrimination of homosexuals have affected the life and health of MSM. Aims & objective: To get an insight on circumstances of initiation and continuation of same sex behavior among MSM. Material & Methods: This qualitative study was conducted in MSM population in Agra district in India. Audio recorded in-depth interviews were transcribed into verbatim. Potential themes were extracted as a part of analysis as per relevant experiences of the participants. Data saturation achieved after 13 In-depth interviews. Results: The initiation of same sex behavior among MSM was at a young age and was mostly without their consent. Almost all participants were below the legal age of giving consent for sex and their first homosexual partner was a familiar, elderly in position of authority. They played a passive role in their initial sexual encounter and none of them was able to discuss it freely with their family members or friends. They mostly felt depressed after their first homosexual encounter. They had continued this sexual behavior as they have accepted their attraction towards same sex. Conclusion: There is a need to include concepts of sexuality in education curriculum and sensitize parents also and counseling of those exposed to homosexuality at a tender age is imperative.

scholarly journals The future of rehabilitation in the United Kingdom National Health Service: Using the COVID-19 crisis to promote change, increasing efficiency and effectiveness

2020 ◽  
pp. 026921552097114
Author(s):  
Derick T Wade
Keyword(s):  
Healthcare Providers ◽  
Organisational Change ◽  
Well Being ◽  
Healthcare Services ◽  
Rehabilitation Services ◽  
Complex Needs ◽  
Cord Injury ◽  
Palliative Care Services ◽  
The Uk ◽  
Rehabilitation Needs

The problem: Rehabilitation services in the UK are inadequate, with insufficient capacity or flexibility to meet the needs of patients after Covid-19. History: Rehabilitation developed in a piecemeal way, focused on specific problems: spinal cord injury, burns, polio, stroke, back pain, equipment and adaptations etc. Rehabilitation is also provided using other names (e.g. intermediate care). Patients with complex needs do not fit easily within this system. System failure: After Covid-19, patients have problems that cross existing condition-specific and/or treatment-specific services. Covid-19 has exposed the lack of any coherent organisational principle underlying development or commissioning of rehabilitation services. Consequently, in order to have their needs met, patients either have to engage with two or more separate services or they receive good management for some problems and sub-optimal management for other problems. The goals: The multitude of small specific services need to coalesce into an integrated service able to meet all the needs of any patient referred. Second, rehabilitation needs to be fully integrated into all healthcare services. A solution: The purpose of healthcare is to ‘ improve our health and well-being . . . to stay as well as we can to the end of our lives’. (NHS constitution) All healthcare services need to consider patients holistically, giving equal attention to disease, disability, and distress. Rehabilitation, acute care, mental health and palliative care services need to work in parallel to achieve this purpose. Healthcare providers, supported by commissioners and rehabilitation experts, could achieve structural and organisational change, meeting the needs of patients.

scholarly journals Factors influencing utilization and perception of health care: a qualitative study among traumatized Yazidi refugees in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Virginia M. Tran ◽  
Laila Fozouni ◽  
Jana K. Denkinger ◽  
Caroline Rometsch ◽  
Florian Junne ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Traumatic Experience ◽  
Theory Approach ◽  
Islamic State ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Utilization Of Healthcare ◽  
The Impact

Abstract Background Ensuring adequate utilization of healthcare services for displaced populations is critical, yet there are well-documented treatment gaps. Yazidi women captured by the Islamic State (IS) were subjected to extreme trauma and violence. This study aims to understand perceptions of healthcare providers and utilization of these services among women who experienced extreme trauma. Methods This is a qualitative study with voluntary participation offered to approximately 400 women resettled through the Special Quota Program. An empirical approach was used to collect data and a grounded theory approach was used for content analysis. Participants ranked their interactions with providers on a Likert scale. Posttraumatic stress disorder (PTSD) symptoms were assessed using the impact of event scale-revised questionnaire. Results A total of 116 Yazidi women participated in this study. The women experienced an average of 6.8 months of captivity by IS and 93% met criteria for probable PTSD. Eighty-three percent of the women interacted with a physician; 80% found this interaction helpful. Sixty-nine percent interacted with psychologists; 61% found this interaction helpful. Six themes emerged: “reminders of trauma” and “hopelessness” in relation to the traumatic experience; “immediate relief” and “healing through pharmaceutical treatment” in relation to provider interventions, and “support” and “cultural differences” in relation to interactions with providers. Conclusions There exist major barriers to care for Yazidi women who experienced extreme trauma, particularly in regards to psychiatric care. Perceptions of healthcare providers and perceived effectiveness of therapy are critical factors that must be taken into consideration to improve healthcare utilization and outcomes.

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