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Adapting and enhancing PAX Good Behavior Game for First Nations communities: a mixed-methods study protocol developed with Swampy Cree Tribal Council communities in Manitoba.

https://arctichealth.org/en/permalink/ahliterature294532
Source
BMJ Open. 2018 02 15; 8(2):e018454
Publication Type
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't
Date
02-15-2018
Author
Janique Fortier
Mariette Chartier
Sarah Turner
Nora Murdock
Frank Turner
Jitender Sareen
Tracie O Afifi
Laurence Y Katz
Marni Brownell
James Bolton
Brenda Elias
Corinne Isaak
Roberta Woodgate
Depeng Jiang
Author Affiliation
Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Source
BMJ Open. 2018 02 15; 8(2):e018454
Date
02-15-2018
Language
English
Publication Type
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Attitude
Child
Child Behavior
Child Behavior Disorders - ethnology - prevention & control
Cultural Competency
Female
Health Promotion - methods
Humans
Indians, North American
Male
Manitoba
Mental health
Play and Playthings
Program Evaluation
Research Design
Residence Characteristics
Reward
School Health Services
Schools
Social Behavior
Social Behavior Disorders - ethnology - prevention & control
Abstract
High rates of mental health problems, such as suicidal behaviours, among First Nations youth in Canada are a major public health concern. The Good Behavior Game (GBG) is a school-based intervention that provides a nurturing environment for children and has been shown to promote positive outcomes. PAX Good Behavior Game (PAX GBG) is an adaptation and enhancement of the GBG. While PAX GBG has been implemented in Indigenous communities, little research exists examining the cultural and contextual appropriateness and effectiveness of the intervention in First Nations communities.
The present paper describes a protocol of the mixed-methods approach guided by an Indigenous ethical engagement model adopted to implement, adapt and evaluate PAX GBG in First Nations communities in Manitoba, Canada. First, implementation outcomes (eg, acceptability, adoption) of PAX GBG will be evaluated using qualitative interviews with teachers, principals and community members from Swampy Cree Tribal Council (SCTC) communities. Second, by linking administrative databases to programme data from schools in 38 First Nations communities, we will compare PAX GBG and control groups to evaluate whether PAX GBG is associated with improved mental health and academic outcomes. Third, the qualitative results will help inform a cultural and contextual adaptation of PAX GBG called First Nations PAX (FN PAX). Fourth, FN PAX will be implemented in a few SCTC communities and evaluated using surveys and qualitative interviews followed by the remaining communities the subsequent year.
Ethical approval was obtained from the University of Manitoba Health Research Ethics Board and will be obtained from the Health Information Privacy Committee and respective data providers for the administrative database linkages. Dissemination and knowledge translation will include community and stakeholder engagement throughout the research process, reports and presentations for policymakers and community members, presentations at scientific conferences and journal publications.
Notes
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PubMed ID
29449291 View in PubMed
Less detail

The associations between health risk behaviours and suicidal ideation and attempts in a nationally representative sample of young adolescents.

https://arctichealth.org/en/permalink/ahliterature160280
Source
Can J Psychiatry. 2007 Oct;52(10):666-74
Publication Type
Article
Date
Oct-2007
Author
Tracie O Afifi
Brian J Cox
Laurence Y Katz
Author Affiliation
Department of Community Health Sciences, University of Manitoba, Winnipeg.
Source
Can J Psychiatry. 2007 Oct;52(10):666-74
Date
Oct-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Canada - epidemiology
Dangerous Behavior
Demography
Female
Health status
Humans
Male
Questionnaires
Risk-Taking
Social Behavior Disorders - epidemiology
Substance-Related Disorders - epidemiology
Suicide, Attempted - statistics & numerical data
Abstract
To examine associations between health risk behaviours and suicidal ideation and attempts in Canadian adolescents aged 12 to 13 years. Young adolescents think about and attempt suicide. However, most existing research on suicide has been conducted on individuals aged 15 years and older.
The present study examined a nationally representative Canadian sample of adolescents aged 12 to 13 years (n=2090). Health risk behaviours included disruptive (shoplifting, physical fighting, damaging property, fighting with a weapon, carrying a knife, and gambling), sexual (petting below the waist and sexual intercourse), and substance use behaviours (smoking cigarettes, consuming alcohol, marijuana or hash, and glue or solvents). Unadjusted and adjusted (for all significant health risk behaviour and psychiatric symptoms) models were tested.
All health risk behaviours were common among male and female adolescents. In unadjusted models, almost all health risk behaviours were associated with suicidal ideation and attempts among adolescent boys. In adjusted models, only damaging property, sexual intercourse, and smoking cigarettes remained statistically associated with suicidal ideation, while smoking cigarettes and using marijuana or hash remained statistically associated with suicide attempts among adolescent boys. All health risk behaviours were statistically associated with suicidal ideation and attempts among female adolescents in unadjusted models. In adjusted models, only carrying a knife remained statistically associated with suicidal ideation, while shoplifting and gambling remained statistically associated with suicide attempts among adolescent girls.
Health risk behaviours among young adolescents are associated with suicidal ideation and attempts among young adolescents. Recognizing health risk behaviours among young adolescents may be one means of understanding who among them is at increased risk of suicidality.
PubMed ID
18020114 View in PubMed
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The associations between peer and parental relationships and suicidal behaviours in early adolescents.

https://arctichealth.org/en/permalink/ahliterature166394
Source
Can J Psychiatry. 2006 Oct;51(11):698-703
Publication Type
Article
Date
Oct-2006
Author
Sarah A Fotti
Laurence Y Katz
Tracie O Afifi
Brian J Cox
Author Affiliation
Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba.
Source
Can J Psychiatry. 2006 Oct;51(11):698-703
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior - psychology
Age Factors
Age of Onset
Canada - epidemiology
Child
Cross-Sectional Studies
Depression - epidemiology - psychology
Female
Follow-Up Studies
Humans
Male
Parent-Child Relations
Parents
Peer Group
Prevalence
Questionnaires
Suicide, Attempted - psychology - statistics & numerical data
Abstract
To investigate associations between suicidal behaviours, including suicidal ideation and attempts, and poor peer and parental relationships in a nationally representative sample of Canadian adolescents aged 12 to 13 years.
We used Statistics Canada's National Longitudinal Survey of Children and Youth as the dataset. This cross-sectional sample included 1049 girls and 1041 boys aged 12 to 13 years. We obtained answers to self-report questionnaires that included measures of peer relationships, parental nurturance, and parental rejection, as well as information regarding suicidal ideation and attempts. Unadjusted and adjusted logistic regression models were used for the analysis. We included depression in the multiple logistic regression analysis. Analyses were run separately for boys and girls.
The unadjusted logistic regression models found that, among early adolescent boys and girls, depression, poor peer relationships, decreased parental nurturance, and increased parental rejection were all significantly associated with suicidal ideation and attempts. However, after adjusting for all other variables in the multiple logistic regression models, poor peer relationships were no longer significantly associated with suicidal ideation among early adolescent boys and were only weakly associated among early adolescent girls.
Poor parental relationships and depression were more powerfully associated with suicidal ideation and attempts than were peer relationships in a nationally representative sample of boys and girls aged 12 to 13 years, and these factors may be important early intervention targets.
PubMed ID
17121168 View in PubMed
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Canadian military personnel's population attributable fractions of mental disorders and mental health service use associated with combat and peacekeeping operations.

https://arctichealth.org/en/permalink/ahliterature154695
Source
Am J Public Health. 2008 Dec;98(12):2191-8
Publication Type
Article
Date
Dec-2008
Author
Jitender Sareen
Shay-Lee Belik
Tracie O Afifi
Gordon J G Asmundson
Brian J Cox
Murray B Stein
Author Affiliation
Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada. sareen@cc.umanitoba.ca
Source
Am J Public Health. 2008 Dec;98(12):2191-8
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Attitude to Health
Canada - epidemiology
Cross-Sectional Studies
Female
Health Surveys
Humans
Logistic Models
Male
Mental Disorders - epidemiology
Mental Health Services - utilization
Middle Aged
Military Personnel - education - psychology - statistics & numerical data
Needs Assessment
Patient Education as Topic
Population Surveillance
Prevalence
Questionnaires
Relief Work
Stress Disorders, Post-Traumatic - epidemiology
Suicide, Attempted - psychology - statistics & numerical data
Young Adult
Abstract
We investigated mental disorders, suicidal ideation, self-perceived need for treatment, and mental health service utilization attributable to exposure to peacekeeping and combat operations among Canadian military personnel.
With data from the Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement, a cross-sectional population-based survey of active Canadian military personnel (N = 8441), we estimated population attributable fractions (PAFs) of adverse mental health outcomes.
Exposure to either combat or peacekeeping operations was associated with posttraumatic stress disorder (men: PAF = 46.6%; 95% confidence interval [CI] = 27.3, 62.7; women: PAF = 23.6%; 95% CI = 9.2, 40.1), 1 or more mental disorder assessed in the survey (men: PAF = 9.3%; 95% CI = 0.4, 18.1; women: PAF = 6.1%; 95% CI = 0.0, 13.4), and a perceived need for information (men: PAF = 12.3%; 95% CI = 4.1, 20.6; women: PAF = 7.9%; 95% CI = 1.3, 15.5).
A substantial proportion, but not the majority, of mental health-related outcomes were attributable to combat or peacekeeping deployment. Future studies should assess traumatic events and their association with physical injury during deployment, premilitary factors, and postdeployment psychosocial factors that may influence soldiers' mental health.
Notes
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PubMed ID
18923111 View in PubMed
Less detail

Child abuse and mental disorders in Canada.

https://arctichealth.org/en/permalink/ahliterature104424
Source
CMAJ. 2014 Jun 10;186(9):E324-32
Publication Type
Article
Date
Jun-10-2014
Author
Tracie O Afifi
Harriet L MacMillan
Michael Boyle
Tamara Taillieu
Kristene Cheung
Jitender Sareen
Author Affiliation
Departments of Community Health Sciences (Afifi, Sareen), Psychiatry (Afifi, Sareen), Family Social Sciences (Afifi), Applied Health Sciences (Taillieu), Psychology (Cheung, Sareen). University of Manitoba, Winnipeg, Man.; Department of Psychiatry and Behavioural Neurosciences (MacMillan, Boyle), Department of Pediatrics (MacMillan), McMaster University, Hamilton, Ont. tracie.afifi@med.umanitoba.ca.
Source
CMAJ. 2014 Jun 10;186(9):E324-32
Date
Jun-10-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Canada
Child
Child Abuse - statistics & numerical data
Cross-Sectional Studies
Female
Humans
Male
Mental Disorders - epidemiology
Mental health
Odds Ratio
Prevalence
Retrospective Studies
Risk factors
Sex Offenses - statistics & numerical data
Young Adult
Abstract
Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts.
We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23,395). The survey had a multistage stratified cluster design (household response rate 79.8%).
The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose-response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men.
We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts.
Notes
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PubMed ID
24756625 View in PubMed
Less detail

Childhood adversity and personality disorders: results from a nationally representative population-based study.

https://arctichealth.org/en/permalink/ahliterature138710
Source
J Psychiatr Res. 2011 Jun;45(6):814-22
Publication Type
Article
Date
Jun-2011
Author
Tracie O Afifi
Amber Mather
Jonathon Boman
William Fleisher
Murray W Enns
Harriet Macmillan
Jitender Sareen
Author Affiliation
Department of Community Health Sciences, University of Manitoba, S113 Medical Services Building, 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3, Canada. t_afifi@umanitoba.ca
Source
J Psychiatr Res. 2011 Jun;45(6):814-22
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Antisocial Personality Disorder - psychology
Anxiety Disorders - psychology
Borderline Personality Disorder - psychology
Canada - epidemiology
Child
Child Abuse - psychology
Female
Health Surveys
Humans
Male
Mental Disorders - epidemiology - psychology
Mood Disorders - psychology
Personality Disorders - epidemiology - psychology
Risk factors
Sampling Studies
Schizotypal Personality Disorder - psychology
Stress, Psychological - psychology
Substance-Related Disorders - psychology
Abstract
Although, a large population-based literature exists on the relationship between childhood adversity and Axis I mental disorders, research on the link between childhood adversity and Axis II personality disorders (PDs) relies mainly on clinical samples. The purpose of the current study was to examine the relationship between a range of childhood adversities and PDs in a nationally representative sample while adjusting for Axis I mental disorders.
Data were from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n=34,653; data collection 2004-2005); a nationally representative sample of the United States population aged 20 years and older.
The results indicated that many types of childhood adversity were highly prevalent among individuals with PDs in the general population and childhood adversity was most consistently associated with schizotypal, antisocial, borderline, and narcissistic PDs. The most robust childhood adversity findings were for child abuse and neglect with cluster A and cluster B PDs after adjusting for all other types of childhood adversity, mood disorders, anxiety disorders, substance use disorders, other PD clusters, and sociodemographic variables (Odd Ratios ranging from 1.22 to 1.63). In these models, mood disorders, anxiety disorders, and substance use disorders also remained significantly associated with PD clusters (Odds Ratios ranging from 1.26 to 2.38).
Further research is necessary to understand whether such exposure has a causal role in the association with PDs. In addition to preventing child maltreatment, it is important to determine ways to prevent impairment among those exposed to adversity, as this may reduce the development of PDs.
PubMed ID
21146190 View in PubMed
Less detail

Child maltreatment in Canada: an understudied public health problem.

https://arctichealth.org/en/permalink/ahliterature128870
Source
Can J Public Health. 2011 Nov-Dec;102(6):459-61
Publication Type
Article
Author
Tracie O Afifi
Author Affiliation
Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, MB R3E 0W3. T_Afifi@umanitoba.ca
Source
Can J Public Health. 2011 Nov-Dec;102(6):459-61
Language
English
Publication Type
Article
Keywords
Adolescent
Canada - epidemiology
Child
Child Abuse - statistics & numerical data
Data Collection - methods
Epidemiologic Research Design
Humans
Needs Assessment
Prevalence
Abstract
Child maltreatment is a major public health problem associated with impairment in childhood, adolescence, and extending throughout the lifespan. Within Canada, high-quality child maltreatment studies have been conducted and are critical for informing prevention and intervention efforts. However, compared to other parts of the world (e.g., United States, United Kingdom, the Netherlands, and Mexico), the number of studies conducted in Canada is far fewer and the data used to study this important public health problem are less diverse. Importantly, to date, representative data on child maltreatment from the general population at the national level in Canada do not exist. This means that many questions regarding child maltreatment in Canada remain unanswered. To advance our understanding of child maltreatment in Canada and to make significant strides towards protecting Canadian children and families, research using Canadian data is essential. To begin to meet these important public health goals, we need to invest in collecting high-quality, nationally representative Canadian data on child maltreatment. Solutions for the barriers and challenges for the inclusion of child maltreatment data into nationally representative Canadian surveys are provided.
Notes
Comment In: Can J Public Health. 2012 Mar-Apr;103(2):16022530544
PubMed ID
22164559 View in PubMed
Less detail

Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: findings from a large representative sample of military personnel.

https://arctichealth.org/en/permalink/ahliterature162700
Source
Arch Gen Psychiatry. 2007 Jul;64(7):843-52
Publication Type
Article
Date
Jul-2007
Author
Jitender Sareen
Brian J Cox
Tracie O Afifi
Murray B Stein
Shay-Lee Belik
Graham Meadows
Gordon J G Asmundson
Author Affiliation
Department of Psychiatry, University of Manitoba, 771 Bannatyne Ave, Winnipeg, MB PZ430, Canada R3E 3N4. sareen@cc.umanitoba.ca
Source
Arch Gen Psychiatry. 2007 Jul;64(7):843-52
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Attitude to Health
Canada - epidemiology
Combat Disorders - diagnosis - epidemiology - psychology
Diagnostic and Statistical Manual of Mental Disorders
Health Services Accessibility
Health services needs and demand
Health Surveys
Humans
Life Change Events
Male
Mental Disorders - diagnosis - epidemiology - therapy
Mental Health Services - supply & distribution - utilization
Military Personnel - psychology - statistics & numerical data
Patient Acceptance of Health Care
Prevalence
Psychiatric Status Rating Scales
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Suicide - psychology
Violence - psychology
War
Abstract
Although military personnel are trained for combat and peacekeeping operations, accumulating evidence indicates that deployment-related exposure to traumatic events is associated with mental health problems and mental health service use.
To examine the relationships between combat and peacekeeping operations and the prevalence of mental disorders, self-perceived need for mental health care, mental health service use, and suicidality.
Cross-sectional, population-based survey.
Canadian military.
A total of 8441 currently active military personnel (aged 16-54 years).
The DSM-IV mental disorders (major depressive disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social phobia, and alcohol dependence) were assessed using the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, a fully structured lay-administered psychiatric interview. The survey included validated measures of self-perceived need for mental health treatment, mental health service use, and suicidal ideation. Lifetime exposure to peacekeeping and combat operations and witnessing atrocities or massacres (ie, mutilated bodies or mass killings) were assessed.
The prevalences of any past-year mental disorder assessed in the survey and self-perceived need for care were 14.9% and 23.2%, respectively. Most individuals meeting the criteria for a mental disorder diagnosis did not use any mental health services. Deployment to combat operations and witnessing atrocities were associated with increased prevalence of mental disorders and perceived need for care. After adjusting for the effects of exposure to combat and witnessing atrocities, deployment to peacekeeping operations was not associated with increased prevalence of mental disorders.
This is the first study to use a representative sample of active military personnel to examine the relationship between deployment-related experiences and mental health problems. It provides evidence of a positive association between combat exposure and witnessing atrocities and mental disorders and self-perceived need for treatment.
PubMed ID
17606818 View in PubMed
Less detail

Demographic and social variables associated with problem gambling among men and women in Canada.

https://arctichealth.org/en/permalink/ahliterature142868
Source
Psychiatry Res. 2010 Jul 30;178(2):395-400
Publication Type
Article
Date
Jul-30-2010
Author
Tracie O Afifi
Brian J Cox
Patricia J Martens
Jitender Sareen
Murray W Enns
Author Affiliation
Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. toafifi@hsc.mb.ca
Source
Psychiatry Res. 2010 Jul 30;178(2):395-400
Date
Jul-30-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Canada - epidemiology
Economics
Educational Status
Female
Gambling - psychology
Health Surveys
Humans
Impulse Control Disorders - epidemiology
Logistic Models
Male
Middle Aged
Sex Characteristics
Social Support
Young Adult
Abstract
Knowledge of demographic and social correlates of problem gambling among men and women in general population samples is limited. Such research is important for identifying individuals who may become problem gamblers. The current research used a gender-stratified analysis using logistic regression models in a nationally representative sample to identify correlates of problem gambling among men and women. Data were from the Canadian Community Health Survey Cycle 1.2 (CCHS 1.2; data collected in 2002; response rate 77%). The 12-month prevalence of problem gambling among men and women who endorsed gambling in the past year was 4.9% and 2.7%, respectively. For women, increased odds of problem gambling was associated with middle age, middle to low levels of income, a high school diploma or less, being never-married, higher levels of life stress, and negative coping abilities. For men, being aged 70 or greater decreased the odds of problem gambling, while being separated, widowed, or divorced, lower levels of social support, and negative coping abilities increased the odds of problem gambling. These findings have important public health implications for identifying men and women who may be more likely to become problem gamblers in the general population.
PubMed ID
20546926 View in PubMed
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Does co-morbid depressive illness magnify the impact of chronic physical illness? A population-based perspective.

https://arctichealth.org/en/permalink/ahliterature169845
Source
Psychol Med. 2006 May;36(5):587-96
Publication Type
Article
Date
May-2006
Author
Murray B Stein
Brian J Cox
Tracie O Afifi
Shay-Lee Belik
Jitender Sareen
Author Affiliation
Department of Psychiatry, University of California San Diego, La Jolla, CA 92093-0985, USA. mstein@ucsd.edu
Source
Psychol Med. 2006 May;36(5):587-96
Date
May-2006
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adolescent
Adult
Canada - epidemiology
Child
Chronic Disease - economics - epidemiology
Comorbidity
Cost of Illness
Cross-Sectional Studies
Depressive Disorder - economics - epidemiology
Female
Health Services - utilization
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Sick Leave
Abstract
To examine the relative and combined impact of depressive and chronic physical conditions on functional status and health-care use in the general population.
Canadian, representative, population-based cross-sectional survey (n=130,880). Major depressive disorder (MDD) in the past 12 months was assessed by structured interview, and physical disorders, activity reduction, role impairment and work absence by self-report. The relative impact of MDD and six common chronic physical illnesses (asthma, arthritis, back problems, chronic obstructive pulmonary disease, heart disease and diabetes) was estimated using multivariate regression, adjusting for sociodemographic characteristics and overall chronic physical illness burden.
After adjusting for sociodemographic characteristics, alcohol dependence and chronic physical illness burden, the presence of co-morbid MDD was associated with significantly greater (approximately double the) likelihood of health-care utilization and increased functional disability and work absence compared to the presence of a chronic physical illness without co-morbid MDD. This impact of MDD was seen across each of the six chronic physical illnesses examined in this study, with the strongest associations seen for work absence.
These observations confirm prior findings of a strong association at the population level between major depression and health-care use and role impairment among persons with chronic physical disorders. They also point to the significant impact of co-morbid major depression on health-care seeking, disability and work absence in persons with chronic physical illness, underscoring the need for greater efforts to design and test the impact of detection and treatment programs for such individuals.
PubMed ID
16608557 View in PubMed
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