Perceived barriers to accessing mental health services among ethnic minorities: a qualitative study in southeast england

Background: In most European countries, there are significant disparities in the understanding of mental health conditions and access to mental health services among ethnic minority groups. Studies in the UK suggest that individuals from ethnic minorities: have complex pathways to, accessing mental health services, have longer length of inpatient stays, are less likely to take antidepressants, are less likely to contact general practitioners about mental health. It is unclear whether these disparities represent variation in mental health needs, or result from personal/environmental factors and/or relationships between service users and healthcare providers. This qualitative study sought to identify perceived barriers to accessing mental health services among individuals from ethnic minorities in Southeast England to inform the development of effective and culturally acceptable services. Methods: Twenty six adults from ethnic minorities were recruited by community development workers to participate in two focus groups. Discussions were facilitated by researchers trained in cross-cultural communication and the qualitative methodology. Thematic analysis was conducted to identify key emerging themes. Results: Two broad themes were identified: Personal and environmental factors including: inability to recognise symptoms; males being reluctant to seek help; absence of social networks; social networks as an alternative to professional services; cultural identity and stigma; and financial factors. Relationship between service user and healthcare provider including: waiting times; language and communication difficulties; health professionals not listening to concerns or responding to individual needs; power and authority imbalance between healthcare providers and patient; culturally insensitive services; and lack of awareness about services. Conclusion: Members of ethnic minorities require greater mental health literacy and practical support to raise awareness of mental health issues, and provided with appropriate information about the different services and pathways to access these services. Healthcare providers need to be supported in developing effective communication strategies to deliver individually tailored and culturally sensitive care. The engagement of ethnic minorities in the development and delivery of culturally appropriate mental health services could also facilitate better understanding of mental health conditions and improved utilisation of mental health services

Surgical strategies for treatment of malignant pancreatic tumors: extended, standard or local surgery?

Tumor related pancreatic surgery has progressed significantly during recent years. Pancreatoduodenectomy (PD) with lymphadenectomy, including vascular resection, still presents the optimal surgical procedure for carcinomas in the head of pancreas. For patients with small or low-grade malignant neoplasms, as well as small pancreatic metastases located in the mid-portion of pancreas, central pancreatectomy (CP) is emerging as a safe and effective option with a low risk of developing de-novo exocrine and/or endocrine insufficiency. Total pancreatectomy (TP) is not as risky as it was years ago and can nowadays safely be performed, but its indication is limited to locally extended tumors that cannot be removed by PD or distal pancreatectomy (DP) with tumor free surgical margins. Consequently, TP has not been adopted as a routine procedure by most surgeons. On the other hand, an aggressive attitude is required in case of advanced distal pancreatic tumors, provided that safe and experienced surgery is available. Due to the development of modern instruments, laparoscopic operations became more and more successful, even in malignant pancreatic diseases. This review summarizes the recent literature on the abovementioned topics

Policy options for responding to the growing challenge from obesity in the United Kingdom

The aim of this study was to map and analyse how key stakeholders evaluated options for dealing with the rising incidence of obesity in the UK, as part of a wider cross-national study in nine European countries. Multi-criteria mapping was used to capture the ways in which different policy options were evaluated by a variety of key stakeholders. 'Positive societal benefits' was among the criteria most often selected by participants to assess the options and was generally considered more important than costs. Of the seven pre-defined options that all participants appraised, those related to increasing opportunities for physical activity received the highest rankings, and fiscal measures the lowest. Educational measures fared best among the remaining 13 discretionary options while technological measures performed poorly. No one option, or group of options, was considered sufficient to address the obesity problem. Rather, a general consensus was evident in support of mutually reinforcing measures related to education, information, healthier food and physical activity. Although obesity policies are currently emerging in these different areas in the UK, there is a need for them to be better coordinated, and for improved surveillance to estimate their effectiveness in reversing the trend in obesity. © 2007 The Authors

Policy options for responding to the growing challenge from obesity in the United Kingdom

The aim of this study was to map and analyse how key stakeholders evaluated options for dealing with the rising incidence of obesity in the UK, as part of a wider cross-national study in nine European countries. Multi-criteria mapping was used to capture the ways in which different policy options were evaluated by a variety of key stakeholders. 'Positive societal benefits' was among the criteria most often selected by participants to assess the options and was generally considered more important than costs. Of the seven pre-defined options that all participants appraised, those related to increasing opportunities for physical activity received the highest rankings, and fiscal measures the lowest. Educational measures fared best among the remaining 13 discretionary options while technological measures performed poorly. No one option, or group of options, was considered sufficient to address the obesity problem. Rather, a general consensus was evident in support of mutually reinforcing measures related to education, information, healthier food and physical activity. Although obesity policies are currently emerging in these different areas in the UK, there is a need for them to be better coordinated, and for improved surveillance to estimate their effectiveness in reversing the trend in obesity. © 2007 The Authors

Breast is best: Positive mealtime interactions in breastfeeding mothers from Israel and the United Kingdom

We examined mealtime interactions to assess whether they varied according to maternal body mass index, country and mode of feeding in 41 Israeli and UK mother-infant dyads. Feeding behaviours were coded using the Simple Feeding Element Scale. Significantly, more UK mothers breastfed during the filmed meal compared to Israeli mothers. Mealtime interactions did not vary according to maternal body mass index or country. Women who breastfed (as opposed to those who bottle fed or fed solids) provided fewer distractions during the meal, a more ideal feeding environment and fed more responsively

Perceived barriers to quitting smoking among women from deprived communities: a qualitative study in Southeast

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Women’s views on smoking cessation services and national tobacco control measures

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What factors are important in smoking cessation and relapse in women from deprived communities? – A qualitative study

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