External Built Residential Environment Characteristics that Affect Mental Health of Adults

External built residential environment characteristics include aspects of building design such as types of walls, doors and windows, green spaces, density of houses per unit area, and waste disposal facilities. Neighborhoods that are characterized by poor quality external built environment can contribute to psychosocial stress and increase the likelihood of mental health disorders. This study investigated the relationship between characteristics of external built residential environment and mental health disorders in selected residences of Nakuru Municipality, Kenya. External built residential environment characteristics were investigated for 544 residents living in different residential areas that were categorized by their socioeconomic status. Medically validated interview schedules were used to determine mental health of residents in the respective neighborhoods. The relationship between characteristics of the external built residential environment and mental health of residents was determined by multivariable logistic regression analyses and chi-square tests. The results show that walling materials used on buildings, density of dwelling units, state of street lighting, types of doors, states of roofs, and states of windows are some built external residential environment characteristics that affect mental health of adult males and females. Urban residential areas that are characterized by poor quality external built environment substantially expose the population to daily stressors and inconveniences that increase the likelihood of developing mental health disorders.     

Having a Personal Health Care Provider and Receipt of Colorectal Cancer Testing

PURPOSE We wanted to assess the relationship between having a personal health care provider and receiving colorectal cancer testing.     

影响农村老年人身心健康的主要因素及对策研究——安徽省长丰县问卷调查实证分析

采用问卷调查法对长丰县616位农村老年人的基本生活状况进行调查，对影响老年人身心健康状况的因素进行分析，在此基础上提出解决农村老年人身心健康问题的途径和措施。调查结果表明，农村经济条件有限，农村老年人收入不高，“空巢”老人较多，合作医疗制度不完善等因素影响农村老年人的身心健康。各地政府应根据实际情况，积极采取有效措施，改善农村医疗环境，提高医疗服务质量，完善农村合作医疗制度，增设老年娱乐设施，设立老年维权机构等，促进老年人身心全面发展。根据家庭实际情况，子女应明确自己的赡养义务，关心老年人的身心健康状况，确保老年人过好幸福健康的晚年生活。     

影响病人满意度因素研究

"以病人为中心",为患者满意服务和"以工作人员为中心",利用、开发及保护医院人力资源而提供良好的服务,提高病人满意度,已成为众多医院主要竞争策略,反映了现代医院的服务思想,也是现代医院管理思想.     

Toward the Implementation of Mental Health Consumer Provider Services

Encouraged by the New Freedom Commission, mental health systems such as the Veteran Administration (VA) are now becoming more recovery-oriented. Consumer providers (CPs)—those with serious mental illness who are further along in recovery who provide services to others with similar mental health problems—are viewed as a key part of this change. However, organizational change theories suggest that careful consideration of implementation issues is critical when disseminating new and sometimes controversial services into existing organizations. Therefore, to guide the dissemination of CP services, the literature on the effectiveness of CPs was reviewed, and interviews, focus groups, and a brief survey of 110 administrators, providers, and patients were conducted at three large VA clinics in Southern California. Questions focused on their perceptions of feasibility and acceptability of CP services. Using literature and study findings, an organizational change framework and other strategies to overcome potential implementation challenges of CP services are suggested.Alexander S. Young, MD, MSHS, Director, Health Services Unit, VISN 22 MIRECC, West LA VA Healthcare Center, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA.Joseph Hassell, MA, Program Coordinator, Health Services Unit, VISN 22 MIRECC, West LA VA Healthcare Center, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA.Larry Davidson, PhD, Associate Professor and Director, Yale Program for Recovery and Community Health, Yale University School of Medicine, Department of Psychiatry, Erector Square 6W, Suite IC, 319, Peck Street, New Haven, CT 06511, USA.     

Enabling Factors Associated with Receipt of Interconception Health Care

Maternal and Child Health Journal - Preventive health care between pregnancies may benefit future pregnancies and women’s long-term health, yet such care is frequently incomplete. We used...     

Factors Influencing the Choice of a New Dental Service Provider

This research investigated the influence of demographic characteristics, the importance of risk consequences, likelishood of using a variety of risk reduction techniques, and the reduction of perceived risk upon the selection of a new tradional or nontradiaional dental service provider. The findings suggest that there is a unique market segment for traditional providers and for nontraditional providers. Each of the variable categories was found to differentiate patrons of the two provider types.     

Factors that Influenced Adoption of a School-Based Trauma-Informed Universal Mental Health Intervention

Prevention Science - We know little about why school administrators choose to adopt preventive mental health interventions within the context of school-based prevention trials. This study used a...     

影响新医疗技术使用的决定因素分析

近年来,新医疗技术的引进和使用被认为是医疗费用持续增加的主要原因之一。过去国内外有关控制医疗费用政策的研究,多数探讨引进新医疗技术的影响因素与医疗费用之间的关系,很少从医生使用新医疗技术影响因素的角度来分析。文章通过文献综述的方式,讨论影响新医疗技术使用的决定因素,借此帮助政府及卫生部门设计控制医疗费用的策略。     

儿童心理健康教育在儿童保健门诊中的作用

为满足广大儿童对心理卫生服务的需求 ,同时探索本地区儿童心理问题的现状 ,自 2 0 0 2年 9月份起宁波市镇海区妇幼保健院儿童保健科开展了儿童心理保健工作 ,并且开设了儿童心理门诊 ,有计划、有步骤、有针对性地进行三级心理健康教育 ,取得了良好的效果。对象与方法1 对象　 2 0 0 3年 2～ 5月来本区妇幼保健院儿童保健门诊体检的 5～ 7岁儿童 2 88人 ,其中男 1 60人 ,女 1 2 8人 ,男女之比为 1 5∶1。2 方法　选择整群抽样方法 ,采用美国Achen back (4～ 1 6岁家长用 )量表 ,可归纳为 9个因子。自行设计环境因素调查表 ,包括 :孕期情…     

Disparities in Assessment,Treatment, and Recommendations for Specialty Mental Health Care: Patient Reports of Medical Provider Behavior

ObjectiveTo examine perceptions of medical doctor behavior in mental health (MH) utilization disparities.ConclusionsPerceptions of provider behavior might contribute to documented disparities in MH utilization. Further research is needed to determine other points in the treatment utilization process that might account for racial/ethnic disparities.     

影响尿液检测结果的若干因素分析

了解影响尿液检验质量的因素,认识其对临床诊断的重要性,采取相应的措施和建议。采用大量实验结果和相关文献证实,尿液标本检验受多种因素（包括肉眼血尿、药物、尿液pH、标本放置时间、尿液试纸带）的影响。其结果直接影响尿液检验的各项指标,造成不同程度的误诊,对这些干扰因素的分析和排除在理论和实践上对临床诊断、治疗有很重要的意义。     

影响尿液检测结果的若干因素分析

了解影响尿液检验质量的因素,认识其对临床诊断的重要性,采取相应的措施和建议。采用大量实验结果和相关文献证实,尿液标本检验受多种因素(包括肉眼血尿、药物、尿液pH、标本放置时间、尿液试纸带)的影响。其结果直接影响尿液检验的各项指标,造成不同程度的误诊,对这些干扰因素的分析和排除在理论和实践上对临床诊断、治疗有很重要的意义。     

Mental Health of Prisoners: Identifying Barriers to Mental Health Treatment and Medication Continuity

Objectives. We assessed mental health screening and medication continuity in a nationally representative sample of US prisoners.Methods. We obtained data from 18 185 prisoners interviewed in the 2004 Survey of Inmates in State and Federal Correctional Facilities. We conducted survey logistic regressions with Stata version 13.Results. About 26% of the inmates were diagnosed with a mental health condition at some point during their lifetime, and a very small proportion (18%) were taking medication for their condition(s) on admission to prison. In prison, more than 50% of those who were medicated for mental health conditions at admission did not receive pharmacotherapy in prison. Inmates with schizophrenia were most likely to receive pharmacotherapy compared with those presenting with less overt conditions (e.g., depression). This lack of treatment continuity is partially attributable to screening procedures that do not result in treatment by a medical professional in prison.Conclusions. A substantial portion of the prison population is not receiving treatment for mental health conditions. This treatment discontinuity has the potential to affect both recidivism and health care costs on release from prison.Mental health disorders among prisoners have consistently exceeded rates of such disorders in the general population, and correctional facilities in the United States are often considered to be the largest provider of mental health services.1–3 Despite court mandates for access to adequate health care in prisons (these mandates are even further limited to “severe” and “serious” mental illness treatment requirements in prison settings), inmate access to health and mental health care has been sporadic.4,5 Treatment decisions often depend on the limited available resources, public support of correctional treatment, and correctional management decision-making.4,5 Some studies report that at least half of male inmates and up to three quarters of female inmates reported symptoms of mental health conditions in the prior year (compared with 9% or fewer in the general population).3,6–8 These rates underscore the importance of access to mental health treatment for inmates, because lack of access to treatment can have important policy implications, particularly when financial resources are limited for correctional intervention and treatment.Individuals with untreated mental health conditions may be at higher risk for correctional rehabilitation treatment failure and future recidivism on release from prison.2,9,10 In fact, Baillargeon et al.10 found that after release from prison, former inmates who received a professional diagnosis of any Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, mental health disorder were 70% more likely to return to prison at least once than were those who were not given a diagnosis. Furthermore, among those who have been previously incarcerated, the rates of recidivism are between 50% and 230% higher for persons with mental health conditions than for those without any mental health conditions, regardless of the diagnosis.The limited treatment options in many prison settings are directly reflected in the greater number of disciplinary problems, rule violations, and physical assaults among those who have mental health disorders,11 often compounded by the resulting solitary confinement as punishment for these behaviors.1 Although all prisons are required to provide some level of health care, we know very little about whether mental health treatment is actually available to inmates on a case-by-case basis.3,9 In fact, Wilper et al. found that most prisoners, even those who have chronic medical conditions (such as diabetes or hypertension), had limited access to health care in prison.3 Therefore, we used a nationally representative sample of US prisoners to assess whether all persons with a history of mental health conditions were screened and evaluated by a medical professional for these conditions and whether medication use was continuous from the community setting to the prison setting.Mental health conditions represent a different level of need when compared with physical health needs among prisoners. For instance, tuberculosis transmission is a physical health hazard to all inmates and staff. Therefore, correctional administrators ensure that individuals suspected of having tuberculosis obtain proper assessment and subsequent access to health care. Symptoms inherent to many mental health disorders, however, may be less obvious to prison staff, especially without assessment by trained mental health professionals. In addition, a report on mental health care in prison emphasized the need for screening and treatment of mental health conditions among inmates from both a legal and a humanitarian perspective.12 Specifically, several US Supreme Court decisions have supported the rights of prisoners to receive health care, including mental health care (see Bowring v Godiva, 551 F2d 44 [4th Cir 1977]; Laamon v. Helgemoe, 437 F Supp 269 [DNH 1977]; and Ruiz v Estelle, 503 F Supp 1265 [SD Tex 1980]). To date, however, a great deal of variation remains in screening for and treatment of mental health disorders in prison settings.13,14 The use of pharmacotherapy, in conjunction with counseling and self-help groups, to treat mental health conditions in correctional settings has been largely accepted in the correctional community; however, many medications are expensive and, therefore, not offered widely within institutions.4,12,13,15Several practical issues might explain why an individual in the correctional system would have difficulty receiving (or continuing to receive) pharmacotherapy for mental health conditions. First, psychologists and psychiatrists who may properly diagnose disorders are in short supply,12 and the screening tools that are typically used in prison settings are not diagnostic tests. Instead, the purpose of these tools is to gauge the security risk of a new inmate at the institution.4 Second, the continuously declining correctional budget may limit treatment access to those with only the most serious mental health conditions.5 In an ideal situation in which a licensed professional properly diagnoses inmates, specialized treatment programs (rarely located inside of prison facilities) are available. Unfortunately, the use of these outside treatment programs is limited, because correctional budgets do not have the extensive resources necessary to manage inmates enrolled in off-site treatment or to handle the logistics (such as secure transport) involved.15The incarceration experience itself poses a challenge to mental health treatment. Untreated mental health (and physical health) conditions are known to result in poor adjustment to life in prison.12 Furthermore, crowded living quarters, lack of privacy, increased risk of victimization, and solitary confinement within the institution have been identified as strong correlates for self-harm and adaptation challenges for those with mental health conditions in prison settings.16,17Given the strong relation between mental health and criminal behavior,18 the public health system has a great deal to gain from better mental health treatment among inmates, particularly in reducing the costs associated with high recidivism rates.5,10,19 Therefore, this study extends previous research on prisoner health conducted by Wilper et al.3 by assessing the continuity of pharmacotherapy (e.g., medication used to treat a mental health condition in prison), beyond the prevalence rates of pharmacotherapy in prison. Furthermore, we examined potential explanations for both continuity and discontinuity of treatment in the inmate population. Specifically, this study will contribute to the literature by evaluating 3 specific aims: (1) to assess medication continuity for a mental health condition since admission to prison; (2) to assess the correlates of medication continuity, medical screening, and receipt of examinations by medical personnel; and (3) to assess the degree to which medication continuity is predicted by screening prisoners for mental health conditions at intake to prison.     

Behavioral Health Treatment Receipt Among a Community Sample of Young Adult Veterans

Young adult veterans are at risk for behavioral health problems such as depression, posttraumatic stress disorder (PTSD), and substance misuse. Despite this, studies of veterans within the Veterans Affairs Healthcare System (VA) indicate that about half of those warranting treatment receive it in any form, with few receiving an adequate dose of care. For this study, the behavioral health screening status and behavioral health usage (including care outside of VA settings) among a community sample of 812 young adult veterans recruited from the Internet is described. Although approximately 70% of the sample screened positive for behavioral health problems, only one fifth to three fifths of those screening positive reported any mental health or substance use treatment in the past year, with one third or less receiving a dose of minimally adequate psychotherapy or psychotropic care. Findings expand on prior work and suggest that more effort is necessary to engage young veterans in behavioral health services.     

A Preferred Provider Organization (PPO) Case Study for Mental Health and Substance Abuse

No abstract available for this article.     

儿童心理健康的影响因素及对策浅论

本文从遗传、社会、家庭等方面综合分析了儿童心理健康的影响因素及其作用,从而有助于探索一套有效的预防策略。     

Association between Women Veterans' Experiences with VA Outpatient Health Care and Designation as a Women's Health Provider in Primary Care Clinics

BackgroundWomen veterans comprise a small percentage of Department of Veterans Affairs (VA) health care users. Prior research on women veterans' experiences with primary care has focused on VA site differences and not individual provider characteristics. In 2010, the VA established policy requiring the provision of comprehensive women's health care by designated women's health providers (DWHPs). Little is known about the quality of health care delivered by DWHPs and women veterans' experience with care from these providers.MethodsSecondary data were obtained from the VA Survey of Healthcare Experience of Patients (SHEP) using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient-centered medical home (PCMH) survey from March 2012 through February 2013, a survey designed to measure patient experience with care and the DWHPs Assessment of Workforce Capacity that discerns between DWHPs versus non-DWHPs.FindingsOf the 28,994 surveys mailed to women veterans, 24,789 were seen by primary care providers and 8,151 women responded to the survey (response rate, 32%). A total of 3,147 providers were evaluated by the SHEP-CAHPS-PCMH survey (40%; n = 1,267 were DWHPs). In a multivariable model, patients seen by DWHPs (relative risk, 1.02; 95% CI, 1.01–1.04) reported higher overall experiences with care compared with patients seen by non-DWHPs.ConclusionsThe main finding is that women veterans' overall experiences with outpatient health care are slightly better for those receiving care from DWHPs compared with those receiving care from non-DWHPs. Our findings have important policy implications for how to continue to improve women veterans' experiences. Our work provides support to increase access to DWHPs at VA primary care clinics.