Determinants of Maternal Mortality in Eritrea

Objective: This study was undertaken with a general objective of determining the determinants of maternal mortality in Eritrea. Methods: The study was a case control study which compared 50 women whose pregnancies led to death with 50 individually matched women that survived a severe life threatening obstetric complication in the same community. Findings: From the comparison of maternal deaths (cases) and survivors of severe life threatening obstetric complications (controls), seeking medical care on the part of the survivors was significantly more frequent in both bivariate and multivariate analysis than was the case in those who died and was probably protective. Conclusion: The study concluded that seeking medical care was negatively associated with maternal death and was probably protective. Keywords: maternal deaths, near misses, determinants, antenatal care, delivery, seeking medical care, warning sign

Massive Neurofibroma of the Breast: Late Presentation in a Low Resource Nation

Neurofibromas are benign nerve sheath tumors that are extremely rare in the breast. We report a massive disfiguring neurofibroma of the female breast. It exemplifies a disease presenting late in its natural history, typical of patients seeking medical care in low resource countries.Key words: Neurofibroma, Breast, Presentatio

Young adults seeking medical care: do race and ethnicity matter?

"Health care disparities among different racial and ethnic subgroups in the United States are of national concern. Health insurance is a key factor in the access to medical care services, and young adults in the United States aged 20-29 years are more likely than adults aged 30 years and over to lack health insurance coverage (1-4). A previous report has examined the differences in health insurance and access to health care by gender among young adults aged 20-29 years. This report focuses on the differences in health insurance and access to health care among Hispanic, non-Hispanic white, and non-Hispanic black young adults aged 20-29 years." - p. 1Barbara Bloom and Robin A. Cohen.Also available via the World Wide Web as an Acrobat .pdf file (515 KB, 8 p.).Includes bibliographical references

Improving Healthcare for Coptic Egyptian Migrants

There is very little known about Coptic Egyptian migrant health in the current literature. Exploring health beliefs and behaviors in regard to seeking medical care is important. Additionally, understanding how the Coptic church plays a role in healthcare is essential as many Coptic individuals believe spirituality influences physical health.https://scholarworks.uvm.edu/fmclerk/1988/thumbnail.jp

Predicting attitudes towards seeking medical care among Nigerian immigrants in the UK

This study investigates the relationships between acculturation, religion, and coping styles; as well as their predictive potentials in relation to socio-demographic factors, on access to medical help among Nigerians in the UK. This is a cross-sectional study using questionnaires for data collection (N = 297). Results revealed negative correlations between assimilative behaviours and religious behaviours and between religious behaviours, denial and religious coping. High levels of religiosity and coping through behavioural disengagement and self-blame predicted poor attitudes to medical help; but those who used instrumental support, emotional support, and active coping showed more positive attitudes to medical help-seeking. No gender differences in medical help-seeking were found, but older people sought medical help more than those who were younger; while affiliation to the Christian religion predicted positive attitudes towards medical help seeking. These findings have implications for policy development towards tailored interventions that can enhance healthcare utilization among immigrants

Perceived Discrimination and Adherence to Medical Care in a Racially Integrated Community

BACKGROUND: Past research indicates that access to health care and utilization of services varies by sociodemographic characteristics, but little is known about racial differences in health care utilization within racially integrated communities. OBJECTIVE: To determine whether perceived discrimination was associated with delays in seeking medical care and adherence to medical care recommendations among African Americans and whites living in a socioeconomically homogenous and racially integrated community. DESIGN: A cross-sectional analysis from the Exploring Health Disparities in Integrated Communities Study. PARTICIPANTS: Study participants include 1,408 African-American (59.3%) and white (40.7%) adults (≥18 years) in Baltimore, Md. MEASUREMENTS: An interviewer-administered questionnaire was used to assess the associations of perceived discrimination with help-seeking behavior for and adherence to medical care. RESULTS: For both African Americans and whites, a report of 1–2 and >2 discrimination experiences in one’s lifetime were associated with more medical care delays and nonadherence compared to those with no experiences after adjustment for need, enabling, and predisposing factors (odds ratio [OR] = 1.8, 2.6; OR = 2.2, 3.3, respectively; all P < .05). Results were similar for perceived discrimination occurring in the past year. CONCLUSIONS: Experiences with discrimination were associated with delays in seeking medical care and poor adherence to medical care recommendations INDEPENDENT OF NEED, ENABLING, AND PREDISPOSING FACTORS, INCLUDING MEDICAL MISTRUST; however, a prospective study is needed. Further research in this area should include exploration of other potential mechanisms for the association between perceived discrimination and health service utilization

Prevalence and severity of abscesses and cellulitis, and their associations with other health outcomes, in a community-based study of people who inject drugs in London, UK.

BACKGROUND: Skin and soft tissue infections (SSTI) are a common but preventable cause of morbidity and mortality among people who inject drugs (PWID). They can be severe, and hospitalisations of PWID with SSTI are rising. The most common SSTI presentations are abscesses and cellulitis. METHODS: We used data from Care & Prevent, a cross-sectional community survey of PWID in London. We reported the lifetime prevalence of SSTI, severity of infections, key risk factors, and associated sequelae. Pictorial questions were used to assess SSTI severity. RESULTS: We recruited 455 PWID. SSTI lifetime prevalence was high: 64% reported an abscess and/or cellulitis. Over one-third (37%) reported a severe infection, 137 (47%) reported hospitalisation. SSTIrisk factors were: aged 35+ years, injecting once or more times a day, subcutaneous or intra-muscular injections, and making four or more attempts to achieve an injection. Those who reported having other health conditions were at higher odds of having an abscess or cellulitis, with risk tending to increase with number of reported conditions. Half (46%) employed self-care for their worst SSTI, and 43% waited for ten or more days before seeking medical care or not seeking medical care at all. CONCLUSIONS: Abscess and cellulitis are very common among PWID in London. We corroborate findings indicating SSTIs are associated with risks, e.g. venous access problems, as well as other co-morbid conditions: septicaemia, endocarditis, DVT, and kidney disease. These co-morbidities may impact SSTIs severity and outcomes. Delayed healthcare seeking potentially exacerbates infection severity, which in turn increases poorer health outcomes and complications