scholarly journals Therapeutic alliance: satisfaction and attrition of patients from a mental health clinic in Ayacucho, Peru

2014 ◽  
Vol 11 (4) ◽  
pp. 95-97
Author(s):  
Maria C. Prom ◽  
Jeffrey Stovall ◽  
Luis E. Bedregal ◽  
James Phillips ◽  
Mario A. Davidson
Keyword(s):  
Mental Health ◽  
Low Income ◽  
Drop Out ◽  
Low Income Countries ◽  
Health Clinic ◽  
Early Withdrawal ◽  
Working Alliance Inventory ◽  
Prospective Comparison ◽  
Patient Withdrawal

This study examines the role of the patient–provider relationship (alliance) and patient satisfaction in early patient withdrawal from mental health therapy in rural Peru. A prospective comparison of 60 patients demonstrated that early withdrawal was associated with the clinician's, but not the patient's, evaluation of the patient–provider alliance. This suggests that the satisfaction and alliance questionnaires typically used in high-income countries may not be effective in evaluating patient attitudes in this population, but may be useful for clinician evaluations of the alliance. Clinicians can use the Working Alliance Inventory to indicate the need for early intervention to prevent patient drop-out in middle- and low-income countries.

scholarly journals The multiplier role of psychiatrists in low income settings

2014 ◽  
Vol 23 (2) ◽  
pp. 123-127 ◽  
Author(s):  
F. Kigozi ◽  
J. Ssebunnya
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Low Income ◽  
Health Workers ◽  
Developed Countries ◽  
Low Income Countries ◽  
Wide Range

Mental health care is receiving increased attention in low-income countries with the availability of a wide range of effective evidence-based treatments for acute and chronic mental disorders amidst scarce resources. Availability of these treatments and competent human resources enables the use of a variety of interventions at several levels of care for persons with mental illness and makes it feasible to ensure observance of quality in the treatment approaches that go beyond institutionalisation. However, unlike developed countries which are endowed with many and relatively well-paid mental health specialists, low-income countries face a dire shortage of highly trained mental health professionals in addition to several other challenges. In light of this, there is need to re-assess the role of the few available psychiatrists, with a shift to new core tasks such as designing mental health care programmes that can be delivered by non-specialists, building their health system's capacity for delivering care, including supporting front-line health workers through support supervision, raising awareness on mental health and patients’ rights in addition to promoting essential research. This requires a fundamental paradigm shift from the current training for mental health specialists to a public health oriented approach and providing incentives for community engagement.

scholarly journals Prevalence and Associated Factors of Metabolic Syndrome among Patients with Severe Mental Illness Attending a Tertiary Hospital in Southwest Uganda

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
David Collins Agaba ◽  
Richard Migisha ◽  
Rosemary Namayanja ◽  
Godfrey Katamba ◽  
Henry Mark Lugobe ◽  
...  
Keyword(s):  
Mental Health ◽  
Metabolic Syndrome ◽  
Mental Illness ◽  
Logistic Regression ◽  
Severe Mental Illness ◽  
Low Income ◽  
Associated Factors ◽  
Tertiary Hospital ◽  
Low Income Countries ◽  
Health Clinic

Globally, the prevalence of metabolic syndrome (MetS) and its components which are the major cardiovascular disease (CVD) risk factors, is higher among patients with severe mental illness (SMI) compared to the general population. This is mainly due to the deleterious lifestyles characterized by physical inactivity, excessive alcohol consumption, smoking, and unhealthy diets common among patients with SMI as well as due to cardiometabolic effects of psychotropic medications. Despite these conditions being highly prevalent among patients with SMI, little attention is given to these conditions during routine reviews in the mental health clinics in most low-income countries including Uganda. The main objective of this study was to determine the prevalence and associated factors of MetS among patients with SMI at Mbarara Regional Referral Hospital (MRRH), a tertiary hospital in southwestern Uganda. Through a cross-sectional study at the mental health clinic of the hospital, we recruited 304 patients with SMI and evaluated them for MetS using the National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria. We defined the prevalence of MetS as the proportion of patients meeting the NCEP ATP III criteria. We used logistic regression to evaluate associations between MetS and independent variables. We included a total of 302 (44.37% male, 55.63% female) patients with a diagnosis of SMI in the analysis. The prevalence of MetS was 23.51% (95% CI 18.84–28.71). At multivariable logistic regression, age >40 years and long duration of mental illness (>10 years) were significantly associated with MetS. The prevalence of MetS is high among patients with psychiatric disorders, and thus metabolic screening, especially among the high-risk groups, is critical.

Self-inflicted injuries: The intersection of mental health and traumatic injury in Malawi

2021 ◽  
pp. 004947552110131
Author(s):  
Brittney M Williams ◽  
Linda Kayange ◽  
Laura Purcell ◽  
Jared Gallaher ◽  
Anthony Charles
Keyword(s):  
Mental Health ◽  
Hospital Mortality ◽  
Low Income ◽  
Retrospective Review ◽  
Primary Outcome ◽  
Trauma Registry ◽  
Traumatic Injury ◽  
Low Income Countries ◽  
Intentional Injury ◽  
Fall From Height

Self-inflicted injury, the most common form of intentional injury, disproportionately affects low-income countries, but is poorly described in this setting. This retrospective review of the 2008–2018 trauma registry at a referral hospital in Malawi included all victims of intentional injury ≥10 years. Self-inflicted injuries were compared to assaults. The primary outcome was in-hospital mortality. Common mechanisms of self-inflicted injuries were fall from height, poisoning, and penetrating injury. In-hospital mortality from self-inflicted injury was 8.8% vs. 1.9% for assault. Those who died from self-inflicted injury were more often older (median 34 vs. 26 years, p < 0.001), male (91.9% vs. 67.8%, p < 0.001), unemployed (32.8% vs. 6.4%, p < 0.001), and most commonly died by hanging (60%). The odds of in-hospital mortality after self-inflicted injury was four times assault (OR 4.0 [95% CI 1.4–11.5], p = 0.01). The trauma registry proved useful for describing self-inflicted injury in this setting.

Presence through absence? Understanding the role of capital in the African Human Rights Action Plan

2020 ◽  
Vol 58 (4) ◽  
pp. 579-600
Author(s):  
Obiora Chinedu Okafor ◽  
Sanaa Ahmed ◽  
Sylvia Bawa ◽  
Ibironke Odumosu-Ayanu
Keyword(s):  
Human Rights ◽  
Low Income ◽  
Action Plan ◽  
Significant Degree ◽  
Universal Declaration ◽  
Low Income Countries ◽  
Significant Extent ◽  
Global Capital ◽  
Market Practices

AbstractThis study examines the African Human Rights Action Plan (AHRAP) through the lens of Upendra Baxi's germinal theory on the emergence in our time of a ‘trade-related, market-friendly human rights’ (TREMF) thesis that is challenging the specific understandings of ‘people-centric’ human rights that are predicated in the letter and spirit of the Universal Declaration of Human Rights (UDH). Baxi contends, instead, that the dominant strands of the contemporary understandings of human rights are – for the most part – designed to protect the interests of global capital. That said, human rights frameworks in low-income countries need to be studied with a view to what they say and don't say about global capital. Despite its attempt to facilitate a progressive realisation of human rights in Africa, the AHRAP does not rise far enough above the TREMF paradigm to re-locate itself within the UDH one. This is due to the AHRAP not adequately theorising and analysing the role of capital in the (non)realisation of human rights in Africa. By allowing trade and market practices to slip to a significant extent beyond its purview, the AHRAP privileges – to a significant degree – the needs/interests of capital over the human rights of ordinary Africans. That is, the victims of the excesses of capital in Africa are reincarnated in the AHRAP document by the fact of their exclusion from it.

scholarly journals Three models of community mental health services In low-income countries

2011 ◽  
Vol 5 (1) ◽  
pp. 3 ◽  
Author(s):  
Alex Cohen ◽  
Julian Eaton ◽  
Birgit Radtke ◽  
Christina George ◽  
Bro Manuel ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Low Income ◽  
Community Mental Health Services ◽  
Low Income Countries

scholarly journals Next generation sequencing of RB1gene for the molecular diagnosis of ethnic minority with retinoblastoma in Yunnan

2020 ◽  
Author(s):  
Huaiyu Gu ◽  
Zhen Zhang ◽  
Yi-shuang Xiao ◽  
Ru Shen ◽  
Hong-chao Jiang ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Next Generation Sequencing ◽  
Low Income ◽  
Eastern China ◽  
Low Income Countries ◽  
Next Generation ◽  
Single Nucleotide Variants ◽  
Bioinformatics Pipeline ◽  
Generation Sequencing

Abstract Background: Retinoblastoma is a rare intraocular malignancy and typically initiated by inactivating biallelic mutations of RB1 gene. Each year, ~8,000 children worldwide are diagnosed for retinoblastoma. In high-income countries, patient survival is over 95% while low-income countries is ~30%.If disease is diagnosed early and treated in centers specializing in retinoblastoma, the survival might exceed 95% and many eyes could be safely treated and support a lifetime of good vision. In China, approximate 1,100 newly diagnosed cases are expected annually and 28 hospitals covering 25 provinces established centers classified by expertise and resources for better treatment options and follow-up. Comparing with other province of eastern China, Yunnan province is remote geographically. This might result that healthcare staff have low awareness of the role of genetic testing in management and screening in families.Methods: The patients with retinoblastoma were selected in Yunnan. DNA from blood was used for targeted gene sequencing. Then, an in-house bioinformatics pipeline was done to detect both single nucleotide variants and small insertions/deletions. The pathogenic mutations were identified and further confirmed by conventional methods and cosegregation in families.Results: Using our approach, targeted next generation sequencing was used to detect the mutation of these 12 probands. Bioinformatic predictions showed that nine mutations were found in our study and four were novel pathogenic variants in these nine mutations.Conclusions: It’s the first report to describe RB1 mutations in Yunnan children with retinoblastoma. This study would improve role of genetic testing for management and family screening.

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