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The purpose of this study was to assess tuberculosis (TB) treatment outcomes among new smear-positive pulmonary tuberculosis (PTB) patients and identify the risk factors of unsuccessful treatment outcomes in Kepong district, Kuala Lumpur, Malaysia.

A retrospective cohort study was conducted using registry-based data from the Tuberculosis Information System (TBIS) between 2014 and 2018. Simple random sampling was used to select 734 males and 380 females from the TBIS registry. Smear-positive PTB patient's sociodemographic, clinical and behavioral characteristics were extracted and analyzed. Logistic regression was used to find the possible independent risk factors for unsuccessful treatment outcomes.

The treatment success rate was 77.20% (n = 860) which was still below the target set by the WHO (>90%). In total, 254 patients showed an unsuccessful treatment outcome: 106 died, 99 defaulted, 47 not evaluated and 2 showed treatment failure. Unsuccessful treatment outcome was significantly associated with older age, male gender, non-citizen, unemployment and being HIV positive.

The study focuses on all these contributing factors of unsuccessful treatment outcome for a better risk assessment and stratification of TB patients and identify effective surveillance and management strategies to strengthen the control programs of tuberculosis in Kepong district.

The sequence of stress, distress and somatization has occupied much of the late twentieth-century psychological research. The anatomy of stress can be viewed from interactional and hybrid theories that suggest that the individual relates with the surroundings by buffering the harmful effects of stressors. These acts or reactions are called coping strategies and are designed as protection from the stressors and adaptation to them. Failure to successfully adapt to stressors results in psychological distress. In some individuals, elevated levels of distress and failed coping are expressed in physical symptoms, rather than through feelings, words, or actions. Such “somatization” defends against the awareness of the psychological distress, as demonstrated in the psychosocial literature. The progression of behavior resulting from somatic distress moves from a private domain into the public arena, involving an elaborate medicalization process, is however less clear in sociological discourse. The invocation of a medical diagnosis to communicate physical discomfort by way of repeated use of health care services poses a major medical, social and economic problem. The goal of this paper is to clarify this connection by investigating the relevant literature in the area of women with breast cancer. This manuscript focuses on the relationship of psychological stress, the stress response of distress, and the preoccupation with one’s body, and proposes a new theoretical construct.

Hypertension is the most common chronic disease throughout the world. Self-care is the key criteria in determining the final course of the disease. However, the majority of elderly people do not observe self-care behaviors. The purpose of this paper is to analyze the experiences of elderly people with hypertension in order to understand the barriers of their self-care behaviors.

This is a qualitative study with a conventional content analysis approach conducted in Tehran, Iran in 2017. Data collection was done among 23 participants – 14 elderly people; 6 cardiologists, geriatric physicians and nurses working in the cardiovascular ward; and 3 caregivers – who were selected by purposeful sampling. Using semi-structured, face-to-face interviews, data collection was continued until data saturation.

Three main categories, including attitude limitations, inefficient supportive network and desperation, all showed barriers to self-care by the experiences of elderly people with hypertension.

Lack of knowledge of the disease and its treatment process is one of the main barriers to self-care in elderly people with hypertension. Deficient supportive resources along with economic and family problems exacerbate the failure to do self-care behaviors.

The purpose of this paper is to extensively report the implications of the global trend of declining fertility rates and an increasingly ageing population. The experiences of childless men are mostly absent from gerontological, psychological, reproduction, and sociological, research. These disciplines have mainly focussed on family formation and practices, whilst the fertility intentions, history, and experience of men have been overlooked. Not fulfilling the dominant social status of parenthood provides a significant challenge to both individual and cultural identity. Distress levels in both infertile men and women have been recorded as high as those with grave medical conditions.

The aim of this paper is to provide some insight into the affect involuntarily childless has on the lives of older men. This auto/biographical qualitative study used a pluralistic framework drawn from the biographical, feminist, gerontological, and life course approaches. Data were gathered from in-depth semi-structured biographical interviews with 14 self-defined involuntary men aged between 49 and 82 years from across the UK. A broad thematic analysis highlighted the complex intersections between involuntary childlessness and agency, biology, relationships, and socio-cultural structures.

Diverse elements affected the men’s involuntary childlessness: upbringing, economics, timing of events, interpersonal skills, sexual orientation, partner selection, relationship formation and dissolution, bereavement, and the assumption of fertility. The importance of relationship quality was highlighted for all the men: with and without partners. Quality of life was affected by health, relationships, and social networks. Awareness of “outsiderness” and a fear of being viewed a paedophile were widely reported.

This is a study based on a small self-selecting “fortuitous” sample. Consequently care should be taken in applying the findings to the wider population.

Health and social care policy, practice and research have tended to focus on family and women. The ageing childless are absent and excluded from policy, practice, and research. Recognition of those ageing without children or family is urgent given that it is predicted that there will be over two million childless people aged 65 and over by 2030 (approximately 25 per cent of the 65 and over population). The consequences for health and social care of individuals and organisations are catastrophic if this does not happen.

It is common for people to view dropping out of substance misuse treatment as an unsuccessful attempt at recovery. The existing literature emphasises that those who drop out of treatment do worse than those who complete their treatment programme. More recently, however, those who discharge early are faring better than ever before.

In total, 13 service users who discharged early from three residential therapeutic communities were interviewed over the phone to discuss life after treatment. Interview transcripts were analysed using thematic analysis and found four main themes evidencing that “unsuccessful” really can be successful.

The study unearthed significant findings in the area of motivation for continued recovery in that 85 per cent of the sample were actively accessing further substance misuse treatment after leaving the service early. Five participants who had entered treatment as opiate users were all abstaining from Class A drugs at the time of interview; indeed 100 per cent of the sample were opiate free. Furthermore, self-reported psychological health had improved following discharge by 78 per cent.

Recent changes in policy and treatment design within drug treatment services may explain such positive outcomes in that a more responsive programme allows people to gain skills and make changes in a shorter time frame.

Indeed, improved early discharge procedures and increased links to aftercare and follow on treatment may have impacted on this finding.

This study therefore proposes the notion of “right dose of treatment” as opposed to “time in treatment” and highlights the importance of exit procedures and aftercare.

Childbearing via in vitro fertilization (IVF) was taboo for a long time in the Philippines despite being available in the Philippines since 1996 and the signing of the Republic Health Law back in 2013 (Dupont, 2013). In this chapter, the author examines how IVF is imagined, presented, and accepted in the Philippine context by looking at selected case studies of Filipino influencers who opted to bear children via IVF. The author explores these through analyses of selected YouTube videos and Facebook posts through the lens of visibility labor which refers to the activities done by influencers to “the work enacted to flexibly demonstrate gradients of self-conspicuousness in digital or physical spaces depending on intention or circumstance for favourable ends” (Abidin, 2016). The author also examines the comments sections of these selected videos and posts through web scraping to get a glimpse of the reception to the journeys and struggles of these public figures. The author argues that through the visibility labor of influencers, the phenomenon of childbearing via IVF is not only promoted as a viable, if not acceptable procreative process, but also perpetuated as an in/accessible procedure in the Philippines.

The past decade has seen an expansion of psychological treatments available to patients in the NHS. Research into the effectiveness of psychological treatments is also increasing, but this evidence is often not known or used by practitioners. This paper describes the development of a local clinical practice guideline from the research evidence to assist local GPs and psychological practitioners in selecting the most appropriate of three commonly available psychological treatments for adult patients — brief counselling, cognitive behaviour therapy, and psychodynamic psychotherapy. The steps of the guideline development process and difficulties encountered are outlined, and the local dissemination and implementation process described. A survey of GPs and practice counsellors conducted a month following distribution of the guideline found that most recipients reported it useful with many also reporting having used it already in clinical practice. The limitations as well as strengths of this local guideline development process are discussed.

The purpose of this paper is to give an overview of the scientific evidence for reduced drinking in alcohol use disorders. While the aim of alcohol use disorders (AUD) treatment usually focuses on abstinence, only a minority of individuals with AUD enter treatment. Lack of alternative treatment goals, including reduced drinking instead of abstinence, have been identified as a potential barrier for treatment entry. Epidemiological and treatment outcome studies reveal that a large proportion of individuals with AUD are able to substantially reduce their alcohol intake for a prolonged duration of time.

A narrative review of the literature on prevalence rates and health effects as well as evidence-based approaches fostering reduced drinking in individuals with AUD is presented.

Reduced drinking is associated with improvements in both morbidity and mortality. Research has identified evidence-based psychosocial and pharmacological treatment approaches; however, implementation is still scarce.

Target groups for interventions fostering drinking reduction instead of abstinence are defined and desiderata for further research are outlined.