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Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.
Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.
Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.
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Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Saúde , Emoções , Felicidade , HostilidadeRESUMO
Introducción: El yoga es una actividad que trata de un ejercicio el cual contiene una intensidad baja a moderada, la cual no se centra exclusivamente en el entrenamiento físico, sino que también en el desarrollo de la mente y el espíritu de uno mismo. El yoga puede obtener un mayor impacto en el equilibrio y en la ganancia de fuerza de la parte superior del cuerpo, además, demuestra mejora en la aptitud cardiorrespiratoria y flexibilidad. Metodología: El enfoque de desarrollo fue de tipo cuantitativo en donde se realizó una revisión sistemática como metodología de búsqueda de información, relacionada al yoga como una terapia complementaria y los beneficios que éste aportaba al bienestar de las personas mayores. Resultados: En cada uno de los ensayos controlados aleatorizados que fueron recabados para fines de esta revisión sistemática. Se destaca la importancia y los beneficios del yoga en la movilidad, fuerza, flexibilidad y espiritualidad de los usuarios que practican esta terapia. Discusión: Los artículos analizados pertenecen a ensayos clínicos o estudios aleatorizados, los cuales permitieron responder de manera efectiva a nuestra pregunta de investigación, la cual consiste en reconocer si el yoga es efectivo para disminuir el riesgo de dependencia funcional y eliminar hábitos que no son saludables para las personas mayores, además de mejorar la calidad de vida actual. Gracias a ello se pudo evidenciar que esta terapia en adultos mayores genera cambios positivos respecto a estado y condición física, la ejecución de esta práctica mejora la calidad de vida en un 80% Conclusión: La yoga como terapia complementaria si entrega beneficios en la calidad de vida de la población adulta mayor, dado que, que hubo una mejora tanto en la movilidad, calidad de vida y autovalencia de los adultos mayores[AU]
Introduction: Yoga is an activity that deals with a low to moderate intensity exercise, which is not exclusively focused on physical training, but also on the development of the mind and spirit itself. Yoga may have a greater impact on balance and upper body strength gains, and have shown improvements in cardiorespiratory fitness and flexibility. Methodology:the development approach was of a quantitative type where a systematic review was carried out as a methodology for searching for information related to yoga as a complementary therapy and the benefits that it brought to the well-being of the elderly. Results:The importance and benefits of yoga on the mobility, strength, flexibility and spirituality of users who practice this therapy are highlighted in each of the randomized controlled trials that were collected for the purposes of this systematic review. Discussion: The articles analyzed belong to clinical trials or randomized studies, which allowed us to effectively answer our research question. The activity of yoga in older adults generates positive changes regarding state and physical condition, the execution of this practice improves the quality of life by 80% Conclusion: Yoga as a complementary therapy delivers benefits in the quality of life of the adult population elderly, it can be said that there was an improvement in mobility, quality of life and self-valence of the elderly[AU]
Introdução: O Yoga é uma atividade que trata de um exercício de intensidade baixa a moderada, que não se foca exclusivamente no treino físico, mas também no desenvolvimento da mente e do espí-rito. A ioga pode ter um impacto maior no equilíbrio e nos ganhos de força da parte superior do corpo e mostrou melhorias na apti-dão cardiorrespiratória e flexibilidade. Metodologia: a abordagem de desenvolvimento foi do tipo quantitativo onde foi realizada uma revisão sistemática como metodologia de busca de informações re-lacionadas ao yoga como terapia complementar e os benefícios que trouxe para o bem-estar dos idosos. Resultados: A importância e os benefícios do yoga na mobilidade, força, flexibilidade e espiri-tualidade dos usuários que praticam esta terapia são destacados em cada um dos ensaios clínicos randomizados que foram coletados para fins desta revisão sistemática. Discussão: Os artigos analisa-dos pertencem a ensaios clínicos ou estudos randomizados, o que nos permitiu responder de forma eficaz à nossa questão de inves-tigação. A atividade de yoga em idosos gera mudanças positivas quanto ao estado e condição física, a execução desta prática mel-hora a qualidade de vida em 80% Conclusão: o yoga como terapia complementar traz benefícios na qualidade de vida da população adulta idosa, pode-se dizer que houve melhora na mobilidade, qualidade de vida e autovalência dos idosos[AU]
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Humanos , Idoso , Idoso de 80 Anos ou mais , Revisão SistemáticaRESUMO
Introdução: O desenvolvimento da família é influenciado por diversos fatores de sua organização interna e de ordem ambiental, social, cultural, econômica e política. Em contexto de pobreza os riscos são maiores. Fatores de proteção, como boa organização familiar e rede social de apoio podem diminuir as consequências negativas da pobreza. São escassas as pesquisas longitudinais sobre vulnerabilidade e resiliência nas famílias. Objetivo: Este artigo descreve o desenvolvimento de três famílias ao longo de 15 anos, estudadas por meio de entrevistas em casa, parte de uma coorte populacional de um bairro de Porto Alegre (RS). Buscaram-se associações entre a qualidade das relações nessas famílias e sua saúde física e mental, especialmente a do filho, foco da pesquisa. Métodos: Selecionaram-se no arquivo da pesquisa as três primeiras famílias (do total de 148) das quais se tinham os resultados completos das cinco visitas realizadas aos quatro meses e aos dois, quatro, nove e 15 anos de um filho. Realizou-se análise qualitativa dos registros em busca de categorias para compreender a vida e as relações interpessoais nas famílias. O estudo foi realizado em conjunto por duas pesquisadoras, médicas especialistas em desenvolvimento humano. As categorias identificadas na análise e estudadas nas cinco etapas foram: configuração familiar, situação socioeconômica, situações traumáticas, saúde física, saúde relacional e mental, evolução cognitiva e escolar do filho. Resultados: As três famílias, todas de classe C, com filhos sem problemas de saúde física, tiveram evolução suficientemente boa, apesar de todas enfrentarem múltiplos problemas, inclusive separações e mortes precoces. A relação com o sistema de saúde e escola era boa e similar para as três. A jovem com menos problemas de saúde mental foi aquela que sofreu perdas mais importantes: morte dos pais. Tinha uma estrutura familiar multigeracional sólida desde a primeira infância, com relações interpessoais predominantemente colaborativas e amorosas. Conclusões: O artigo busca avançar na compreensão da resiliência nas famílias em situações de vulnerabilidade. Concluímos que essas três famílias, uma delas mais que as outras, foram suficientemente saudáveis na tarefa de educar seus filhos sem desenvolverem problemas mentais graves. Propomos que o bom desenvolvimento se associa com a adequação e amorosidade dos cuidados com a etapa do ciclo vital, mesmo enfrentando situações problemáticas. Essas qualidades precisam estar associadas à estabilidade socioeconômica básica e a bons serviços de saúde e escola.
Introduction: Family development is influenced by it's internal organization and environmental factors, socioeconomic, cultural and political. In poor contexts there are more risks to development. Protection factors like good family organization and social network may decrease the risks. Longitudinal research about vulnerability and resilience in families is scarse. Objective: This article describes the development of three families over 15 years through interviews at home. The families were part of a populational cohort of a neighborhood in Porto Alegre (RS). We looked for links between the quality of relationships and the physical and mental health of these families, especially of the child focus of the research. Methods: We selected in the research archives the first three families (of a total of 148) for which we had full results of the five interviews at four months and two, four, nine and fifteen years of a child. We did a qualitative analysis of the records looking for parameters to understand the life and interpersonal relationships of these families. This study was done by two researchers, both experts in Human Development. The categories identified in the analysis of the five phases were: family structure, socioeconomic situation, traumatic experiences, physical, mental and relational health and cognitive evolution of the child. Results: All three families belonged to economical class C. The children were in good physical health and had sufficiently good general development, having faced multiple problems, including parental separation and early parental death. The relationship with the health and school systems was good in all of them. The youth with less mental health problems was the one who suffered the heaviest loss: early death of both parents. Her family had strong multigenerational ties since her early days, with predominant collaborative and loving relationships. Conclusions: This article aims to contribute to the comprehension of resilience in families in the context of vulnerability. We can say that these three families were healthy enough in the task of bringing up children without any serious mental health problem. We suggest that healthy development is associated with loving interfamily relationships adequate to each phase of development, notwithstanding dramatic events. This needs to be supported by basic economic stability and adequate school and health systems.
Introducción: El desarrollo de la familia es influenciado por su organización interna y factores ambientales, sociales, culturales, económicos y políticos. En contextos pobres los riesgos son mayores. Factores de protección como buena organización familiar y red social de apoyo pueden disminuir las consecuencias negativas de la pobreza. Son pocas las investigaciones longitudinales de vulnerabilidad y resiliencia de las familias. Objetivo: Este artículo describe el estudio del desarrollo de tres familias a lo largo de 15 años, a través de entrevistas en domicilio, parte de una cohorte poblacional de un barrio de Porto Alegre (RS). Se buscaron correlaciones entre la calidad de las relaciones de esas familias y su salud física y mental, especialmente la del hijo foco de la investigación. Métodos: Fueron seleccionadas en el archivo de la investigación las tres primeras familias (de un total de 148) de las cuales se tenían los resultados completos de las cinco visitas realizadas, a los 4 meses, y a los 2, 4, 9, y 15 años de un hijo. Fue realizado un análisis cualitativo de los registros en busca de categorías para comprender la vida y las relaciones interpersonales en las familias. El estudio fue hecho en conjunto por dos investigadoras, médicas especialistas en desarrollo humano. Las categorías identificadas en el análisis y estudiadas en las cinco etapas fueron: configuración familiar, situación socioeconómica, situaciones traumáticas, salud física, salud relacional y mental, evolución cognitiva y escolar del hijo. Resultados: Las tres familias, todas de clase C, con hijos sin problemas de salud física, tuvieron evolución suficientemente buena, a pesar de que todas enfrentaron múltiples problemas, incluso separaciones y muertes precoces. La relación con el sistema de salud y escuela era buena y similar para las tres. La joven con menos problemas de salud mental fue aquella que sufrió las mayores pérdidas: muerte de los padres. Tenía una estructura familiar multigeneracional sólida desde la primera infancia, con relaciones interpersonales predominantemente colaborativas y amorosas. Conclusiones: El artículo pretende avanzar en la comprensión de la resiliencia en las familias en situaciones de vulnerabilidad. Concluimos que esas tres familias, una de ellas más que las otras, fueron suficientemente saludables en la tarea de educar a sus hijos sin que desarrollaran problemas mentales graves. Proponemos que el buen desarrollo se asocia con el amor y adecuación de los cuidados a la etapa del ciclo vital, aun enfrentando situaciones problemáticas. Esas calidades necesitan estar asociadas a la estabilidad socioeconómica básica y buenos servicios de salud y escuela.
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Introducción: El suicidio es la tercera causa de muerte de jóvenes entre 15 y 19 años. Ante esto, los ambientes escolares pueden favorecer el fomento de la salud mental de los adolescentes, permitir la identificación temprana de factores de riesgo y aportar en la prevención de conductas suicidas. Una de las estrategias de prevención es el entrenamiento de "gatekeepers". Objetivo: Determinar el efecto del programa "Abriendo Puertas para la Vida" sobre conocimientos, actitudes y prácticas en prevención de conductas suicidas en un grupo de profesores de secundaria de una institución educativa de San Juan de Pasto, Colombia. Materiales y métodos: Estudio preexperimental, con un grupo de intervención y medidas pre y pos-seguimiento. Participaron nueve docentes voluntarios durante dos jornadas de formación. Resultados: Se identificaron cambios positivos en conocimientos, actitudes y prácticas de los participantes entre pretest y postest, en la mayoría de las subdimensiones evaluadas; sin embargo, tres años después, estos cambios se mantuvieron tan solo en conocimientos sobre las conductas suicidas y en actitudes hacia la prevención. Conclusión: El programa "Abriendo Puertas para la Vida" evidenció efectividad y pertinencia, sin embargo, el mantenimiento de sus efectos requiere de acciones de seguimiento y acompañamiento a los docentes formados.
Introduction: Suicide is the third cause of death in young people aged between 15 to 19 years. Thus, school environments can promote mental health of adolescents through early identification of risk factors and prevention of suicidal behaviors. One prevention strategy is the training of "gatekeepers". Objective: To determine the impact of the "Opening Doors to Life" program on the knowledge, attitudes, and practices regarding prevention of suicidal behavior in a set of high school teachers from an educational institution in San Juan de Pasto, Colombia. Materials and methods: A pre-experimental study with an intervention group and pre- and post-follow-up measurements. Nine volunteer teachers participated during two training sessions. Results: Positive changes regarding knowledge, attitudes, and practices of the participants during pretest and posttest were observed for the majority of evaluated sub-dimensions. However, after three years, the positive measures prevailed only for knowledge about suicidal behavior and attitudes toward prevention. Conclusion: The "Opening Doors to Life" program showed effectiveness and relevance. However, maintaining its impact requires follow-up actions and support of trained teachers.
Introdução: O suicídio é a terceira causa de morte de jovens entre 15 e 19 anos. Diante disso, os ambientes escolares podem promover a promoção da saúde mental em adolescentes, permitir a identificação precoce de fatores de risco e contribuir para a prevenção do comportamento suicida. Uma das estratégias de prevenção é a formação de "gatekeepers". Objetivo: Determinar o efeito do programa "Abrindo Portas para a Vida" nos conhecimentos, atitudes e práticas na prevenção do comportamento suicida em um grupo de professores do ensino médio de uma instituição educacional em San Juan de Pasto, Colômbia. Materiais e métodos: Estudo pré-experimental, com grupo de intervenção e medidas pré e pós-acompanhamento. Nove professores voluntários participaram durante dois dias de treinamento. Resultados: Foram identificadas mudanças positivas nos conhecimentos, atitudes e práticas dos participantes entre o pré-teste e o pós-teste, na maioria das subdimensões avaliadas; porém, três anos depois, essas mudanças se mantiveram apenas no conhecimento sobre comportamentos suicidas e atitudes frente à prevenção. Conclusão: O programa "Abrindo Portas para a Vida" mostrou efetividade e relevância, porém, a manutenção de seus efeitos requer ações de acompanhamento e apoio a professores capacitados.
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Humanos , Masculino , Feminino , Suicídio , PsicologiaRESUMO
Disclosing one's HIV status can involve complex individual and interpersonal processes interacting with discriminatory societal norms and institutionalized biases. To support disclosure decision-making among young men who have sex with men (YMSM) living with HIV, we developed Tough Talks™, an mHealth intervention that uses artificially intelligent-facilitated role-playing disclosure scenarios and informational activities that build disclosure skills and self-efficacy. Qualitative interviews were conducted with 30 YMSM living with HIV (mean age 24 years, 50% Black) who were enrolled in a randomized controlled trial assessing Tough Talks™ to understand their experiences with HIV status disclosure. Interviews were recorded, transcribed, and thematically coded. Barriers to disclosure focused on fear, anxiety, stigma, and trauma. Facilitators to disclosure are described in the context of these barriers including how participants built comfort and confidence in disclosure decisions and ways the Tough Talks™ intervention helped them. Participants' narratives identified meaning-making within disclosure conversations including opportunities for educating others and advocacy. Findings revealed ongoing challenges to HIV status disclosure among YMSM and a need for clinical providers and others to support disclosure decision-making and affirm individuals' autonomy over their decisions to disclose. Considering disclosure as a process rather than discrete events could inform future intervention approaches.
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Introduction: The online study investigated the sleep, psychological conditions, and risk factors during the wave of transmission of COVID-19 since December 7, 2022. Methods: We distributed questionnaires through networking mediums to residents to gather information about COVID-19 infection, sleep, and mental status. Results: During the extraordinary period in China, 91.9% of 1094 participants claimed to be infected with COVID-19, 36.8% reported poor sleep quality, 75.9% reported anxiety, and 65.5% reported depression. In retrospect, people have experienced lower sleep quality, longer sleep latency, enhanced rising time, and decreased sleep efficiency after the infection wave. After adjusting confounding factors, the elderly, women, urban residents, people with comorbidity, anxiety, depression, stress state, and COVID-19 infection have high risks for sleep disorders during the period. Discussion: The survey indicates that sleep disturbance caused by COVID-19 involves multiple dimensions, such as physiology, psychology, and society. The COVID-19 infection-related sleep problem should be taken seriously. Apart from conventional treatment, psychological issues of insomnia can not be ignored.
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Background: Social prescribing involves connecting individuals to community groups and activities, often to support their mental health and well-being. It has received increasing support in recent years across the NHS. There is a strong evidence base for the benefits of different types of community activities, including exercise groups, arts groups and nature interventions, on mental health outcomes, however, less is known about how these groups impact mental health and well-being. This study explores through what individual-level mechanisms (the 'how') these groups support psychosocial well-being. Methods: An ethnographic study was conducted over 12-months to explore key shared, individual-level mechanisms across 4 social prescribing community groups: football, singing, gardening and reading. This study focused mostly on those with severe mental illness, whereas previously most social prescribing studies have focused on mild to moderate mental health problems. To frame the findings, a 'multi-level theoretical framework of mechanisms of action' of leisure activities was used. Results: Key shared psychological mechanisms were: increased self-confidence and self-esteem, increased purpose/meaning, increased sense of achievement, experience of pleasure; social mechanisms included: increased social support, formation of friendships and reduced loneliness, enhanced sense of community and belonging; behavioural mechanisms were: increased independence and openness to experience, reduction in addictive behaviours and building healthier habits, increased work-seeking behaviour, and provision of structure & routine. Conclusions: It is hoped that the findings of this study can help referring professionals increase their understanding of exactly how such groups support individuals' mental health, thus enhancing referring practices.
This study uses ethnographic methods, wherein the lead researcher spent over a year participating in 4 different community groups, using interviews, conversations and observation to explore the mental health impact of such groups on individuals' lives. The participants had moderate to severe mental health conditions, and the groups consisted of a reading, gardening, singing and football group. The study explored 'mechanisms' underlying the mental health benefits of these groups. Key shared psychological mechanisms were: increased self-confidence and self-esteem, increased purpose/meaning, increased sense of achievement, experience of pleasure; social mechanisms included: increased social support, formation of friendships and reduced loneliness, enhanced sense of community and belonging; behavioural mechanisms were: increased independence and openness to experience, reduction in addictive behaviours and building healthier habits, increased work-seeking behaviour, and provision of structure & routine. It is hoped that the findings of this study can help referring professionals (e.g. GPs, social workers, link workers) increase their understanding of exactly how such groups support individuals' mental health, thus improving referring skills.
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This narrative review study seeks to consolidate the existing knowledge on motivational factors that influence marathon and ultramarathon runners. The primary aim is to collect and summarize the understanding of the factors that drive both marathon and ultramarathon runners. Furthermore the review seeks to explore how variables like gender, age and experience impact motivational drivers within these running communities to highlight the intricate nature of factors, in endurance running and stress the significance of tailored training approaches and community backing to enhance participation and achievement. The study aimed to thoroughly review research papers using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. After the evaluation of 302 publications that could potentially be relevant, 61 papers were selected for inclusion in the review. The investigation uncovers unique motivating patterns within these endurance sports communities. The desire for good health, physical fitness, and social interaction drives marathon runners. Their motivations develop as they train and become more involved in the running community. On the other hand, ultramarathon runners are motivated by internal psychological variables like self-esteem and personal exploration, which are significantly shaped by the ultramarathon community's impact on their identity and running approach. Additional research indicates that gender, age, and experience affect the motivational elements in both groups differently. Specifically, experienced ultramarathon runners prioritize personal achievements and health more than time. This review underscores the intricacy of motivating elements in endurance running, highlighting the necessity for tailored methodologies in training and communal assistance to cultivate involvement and achievement.
This organized study aims to add to what is already known about what motivates marathon and ultramarathon runners. The study aimed to use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) structure to review research papers carefully. Following a review of 302 publications that might be relevant, 61 papers were chosen to be included in the study. The study finds unique patterns of what drives people in these endurance sports communities. People who run marathons do it because they want to be healthy, fit, and socialize. Their motivation grows as they train and get more active in the running community.Ultramarathon runners, on the other hand, are driven by things like self-esteem and personal discovery that are inside of them. The ultramarathon community dramatically affects who they are and how they run. More studies show that gender, age, and experience have different effects on what motivates each group. In particular, experienced ultramarathon runners care more about their goals and health than time. This review shows how complicated it is to find things that motivate people to do endurance running. It shows how important it is to use customized training methods and community support to encourage participation and success.
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Preschool childcare is considered an important policy for reducing inequalities in children's cognitive and socio-emotional development, although the population-level benefits for children under three years, is less clear. We examined the potential for childcare across the whole early years' period to benefit mental health and reduce inequalities, under different hypothetical policy scenarios, in the Growing Up in Scotland study. Marginal structural logistic regression models estimated odds ratios (ORs) to quantify inequalities in mental health and consider how these would be altered under different hypothetical scenarios. Mental health (the outcome) was measured using the total Strengths and Difficulties Questionnaire score at the start of primary school. Socioeconomic circumstances (the exposure) were represented by maternal educational measured in infancy. Sequence analysis identified common patterns of childcare usage from 10 months to four years (the mediator). Confounders were adjusted for using inverse probability of treatment weights and analyses accounted for sampling design and attrition (complete case sample, n = 3205). With virtually universal uptake of government-funded childcare at 3-4 years, most variation was seen before age three. Four groups were identified: 'Parents, family & friends' (35.8%), 'Grandparents' (32.7%), 'Private group childcare' (e.g. nurseries 23.5%), 'Single professional care' (e.g. childminders 8.1%). Children whose mothers had low, compared to high, educational qualifications were 3.18 times more likely to have mental health problems (95% CI: 1.88-5.37). In a hypothetical scenario where everyone received private group childcare, inequalities increased slightly to 3.78 (95%CI: 1.46-9.76). In an alternative scenario, where everyone received single professional childcare, inequalities in mental health reduced to 2.42 (95% CI: 0.20-28.76), albeit with wide confidence intervals. Universal childcare provision before three years may widen or narrow socioeconomic inequalities in children's mental health, depending on the childcare type provided. Further research is required to understand the role of childcare quality, which we were unable to account for.
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Background: There is an urgent need for culturally and contextually relevant mental health support for First Nations, Inuit and Métis youth. Objective: Our aim was to identify mental health and wellness services that are currently available to Indigenous youth across Canada. Methodology: As a first step, we conducted a web-based environmental scan of services tailored to Indigenous youth. Specific factors were examined for each program, including organization type and mission, types of services, and who provides services. Results: One hundred and seventeen programs were found, with 54% being non-profits and 34% being on-reserve. Four core features were identified. The first was a strengths-based focus, rather than a pathology/deficit-focus, in programs' vision and mission statements, reflected in words like wellness and resilience. The second (87% of included programs) was the integration of mental health services with a range of other services and supports (e.g., health, employment, housing). The third was the provision of land-based programming (in 34% of programs) such as camps or hunting. Such programs were framed as promoting wellness and healing and strengthening identity. The fourth was the role of community members without formal mental health professional training (in 42% of programs), for example, as youth workers or knowledge keepers. This stems not only from the dearth of specialists in many Indigenous settings, but also a valuing of Indigenous knowledge. Conclusion: These core features in mental health services for Indigenous youth may be promising avenues for communities seeking to strengthen the services they offer to First Nations, Inuit and Métis youth.
Contexte: Il y a un besoin urgent de soutien en santé mentale adapté à la culture et au contexte pour les jeunes des Premières Nations, Inuits et Métis. Objectif: Nous cherchions à identifier les services de santé mentale et de bien-être actuellement disponibles pour les jeunes autochtones du Canada. Méthodologie: Dans un premier temps, nous avons mené une analyse environnementale en ligne des services adaptés aux jeunes autochtones. Des facteurs spécifiques ont été examinés pour chaque programme, notamment le type et la mission de l'organisation, les types de services offerts, et les prestataires de ces services. Résultats: Cent dix-sept programmes ont été recensés, dont 54 % étaient sans but lucratif et 34 % situés dans une réserve. Quatre caractéristiques principales ont été identifiées. La première était l'accent mis sur les forces plutôt que sur la pathologie ou le déficit, reflété dans les énoncés de vision et de mission des programmes, où des termes comme bien-être et résilience étaient utilisés. La deuxième caractéristique (présente dans 87 % des programmes) était l'intégration des services de santé mentale avec une gamme d'autres services et soutiens (p.ex., santé, emploi, logement). La troisième était l'offre de programmes liés au territoire (dans 34 % des programmes) comme des camps ou des activités de chasse, conçus pour promouvoir le bien-être, la guérison et le renforcement de l'identité. La quatrième caractéristique était le rôle des membres de la communauté sans formation professionnelle officielle en santé mentale (dans 42 % des programmes), par exemple en tant que travailleurs auprès des jeunes ou gardiens du savoir. Cela découle non seulement du manque de spécialistes dans de nombreux contextes autochtones, mais aussi de la valorisation des connaissances autochtones. Conclusion: Ces principales caractéristiques des services de santé mentale pour les jeunes autochtones peuvent constituer des avenues prometteuses pour les communautés cherchant à consolider les services qu'elles offrent aux jeunes des Premières Nations, Inuits et Métis.
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Background: Youth involved in child welfare have high rates of mental health problems and are known to receive mental health services from multiple settings. Still, gaps remain in our understanding of service use patterns across settings over the course of youth's involvement with child welfare. Objective: To examine the settings, reasons for contact, persons involved in initiating care, and timing of each mental health service contact for individuals over their involvement with the child welfare system, and to identify factors that predict multi-setting use. Methods: Data on mental health service contacts were collected retrospectively from charts for youth aged 11-18 (n=226) during their involvement with child welfare services in Montreal, Quebec. Logistic regression analysis was conducted to determine predictors of multi-setting mental health services use (defined as ≥3 settings). Results: 83% of youth had at least one mental health service contact over the course of their child welfare services follow-up, with 45% having multi-setting use. Emergency Departments were the top setting for mental health services. Youth with a higher number of placements and from neighborhoods with greater social and material deprivation were significantly likelier to use ≥3 mental health service settings over the course of their follow-up. Conclusion: These findings suggest a need for enhanced collaboration between youth-serving sectors to ensure that continuous and appropriate mental health care is being offered to youth followed by child welfare systems. The relationship between placement instability and multi-setting mental health service use calls for specific policies to ensure that young people do not experience multiple discontinuities of care.
Contexte: Les jeunes impliqués dans le système de la protection de la jeunesse ont des taux élevés de problèmes de santé mentale et il et ils reçoivent souvent des services de santé mentale dans plusieurs types d'établissements. Pourtant, des lacunes subsistent dans notre compréhension des trajectoires d'utilisation des services à travers divers contextes au cours du suivi d'un jeune dans le système de protection de la jeunesse. Objectif: Examiner les contextes, les raisons pour les contacts, les personnes impliquées dans l'initiation des soins, et le moment de chaque contact avec les services de santé mentale pour les personnes pendant la durée de leur suivi en protection de la jeunesse et identifier les facteurs qui prédisent une trajectoire impliquant de multiples établissements. Méthodes: Des données sur les contacts avec les services de santé mentale ont été recueillies rétrospectivement des dossiers de jeunes de 11 à 18 ans (n=226) leur suivi en protection de la jeunesse à Montréal, Québec. Une analyse de régression logistique a été menée pour déterminer les prédicteurs de l'utilisation des services de santé mentale multi-établissements (définie à ≥3 établissements). Résultats: Quatre-vingt-trois pour cent des jeunes avaient au moins un contact avec un service de santé mentale au cours de leur suivi en protection de la jeunesse, et 45 % avaient une trajectoire impliquant de multiples établissements. Les services d'urgence étaient l'établissement le plus fréquenté pour les services de santé mentale. Les jeunes ayant un nombre plus élevé de placements et provenant de quartiers d'une plus grande défavorisation sociale et matérielle étaient significativement plus susceptibles d'utiliser ≥3 établissements de services de santé mentale au cours de leur suivi. Conclusion: Ces résultats démontrent le besoin d'une collaboration améliorée entre les secteurs des services aux jeunes pour faire en sorte que les jeunes en protection de la jeunesse reçoivent des soins de santé mentale continus et appropriés. La relation entre l'instabilité de placement et les trajectoires complexes à travers les services de santé mentale exige de politiques spécifiques afin d'assurer que les jeunes ne connaissent pas de multiples discontinuités de soins.
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Background: Overweight and obesity now affect more than a third of the world's population. They are strongly associated with somatic diseases, in particular increasing the risk of many metabolic and cardiovascular diseases, but also with mental disorders. In particular, there is a strong association between obesity and depression. As a result, more attention is paid to the neurobiological, behavioural, and psychological mechanisms involved in eating. One of these is food addiction (FA). Research comparing lifestyle elements, physical and mental health problems of excess body weight and individuals with FA is limited and has focused on younger people, mainly students. There is also a lack of studies that relate actual metabolic parameters to FA. To better understand the problem of FA also in older adults, it is important to understand the specific relationships between these variables. Methods: A cross-sectional survey was conducted with 172 adults with overweight and obesity (82% female) aged 23-85 years. The mean age of all subjects was M = 59.97 years (SD = 11.93), the mean BMI was M = 32.05 kg/m2 (SD = 4.84), and the mean body fat was M = 39.12% (SD = 6.48). The following questionnaires were used: Food Frequency Questionnaire-6 (FFQ-6), Global Physical Activity Questionnaire (GPAQ), Three Factor Eating Questionnaire-R18 (TFEQ-R18), Yale Food Addiction Scale 2. 0 (YFAS 2.0), Zung Self-Rating Depression Scale (SDS). Body composition, anthropometry, fasting glucose, lipid profile, and blood pressure were measured. Results: A total of 22.7% of participants with overweight and obesity had symptoms of depression according to the SDS, and 18.6% met the criteria for FA according to YFAS 2.0. FA was statistically significantly more common among people up to 50 years. BMI, body fat mass, diastolic blood pressure and sedentary behaviour were statistically significantly higher in people with FA symptoms. Those who were sedentary for 301-450 min per day were significantly more likely to have depressive symptoms, and those who were sedentary for more than 450 min per day were significantly more likely to have FA symptoms. Conclusions: Our findings complement the current literature on FA, particularly in older adults and metabolic parameters, and suggest further research directions. Although our cross-sectional study design does not allow causal interpretations, increasing physical activity appears to be particularly important in the management of people with overweight or obesity and FA. This may be even more important than for people with depression alone, but future research is needed to explore these relationships further.
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Dependência de Alimentos , Obesidade , Sobrepeso , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Adulto , Estudos Transversais , Obesidade/psicologia , Obesidade/epidemiologia , Idoso , Dependência de Alimentos/epidemiologia , Dependência de Alimentos/psicologia , Sobrepeso/psicologia , Sobrepeso/epidemiologia , Idoso de 80 Anos ou mais , Adulto Jovem , Nível de Saúde , Saúde Mental , Depressão/epidemiologia , Inquéritos e Questionários , Índice de Massa CorporalRESUMO
Background: The Sars-CoV-2 pandemic imposed unprecedented and drastic changes in health care organizations all over the world. Purpose: To evaluate the impact of the pandemic on hospitalizations in an acute psychiatric ward. Patients and Methods: We retrospectively identified and compared acute psychiatric hospitalizations in the Service for Psychiatric Diagnosis and Care (SPDC) of AUSL-Modena during the pre-pandemic (n = 1858) and pandemic period (n = 1095), from 01/01/2017 to 31/12/2022. Data were statistically analyzed using STATA12. Results: We collected 1858 hospitalizations in the pre-pandemic and 1095 in the pandemic. During the pandemic, we observed a progressively sharp reduction in voluntary hospitalizations, whereas involuntary ones remained stable with an increase in 2022 (p < 0.001), longer hospital stays (12.32 mean days vs 10.03; p < 0.001), longer periods of involuntary hospitalizations (8.45 mean days vs 5.72; p < 0.001), more frequent aggressive behaviour (16.10% vs 9.12%; p < 0.001) and referral to psychiatric communities at discharge (11.04% vs 6.13%; p < 0.001); non-Italians (p = 0.001), people with disability pension (p < 0.001) and Support Administrator (p < 0.001) were more frequently hospitalized. Conclusion: During the pandemic, voluntary psychiatric hospitalizations decreased, but not involuntary ones, and the most vulnerable people in serious clinical conditions were hospitalized.
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Post-intensive care syndrome (PICS) is the term used to describe the decline in the physical, cognitive, and/or mental condition of individuals who have been discharged from the intensive care unit (ICU). This complication could result in a significant reduction in quality of life, with some patients experiencing symptoms of prolonged weakness, depression, anxiety, and post-traumatic stress disorder (PTSD). Intensive care advancement over the years has resulted in an increase in ICU survival rates and a proportional increase in PICS, creating a need for more in-depth research into the prevention and management of the disease. Hence, this study aims to examine the present body of literature on PICS, encompassing its underlying physiological processes and elements that contribute to its development, methods for evaluating and diagnosing the condition, current treatment choices as well as potential new approaches, and the constraints in managing PICS and the necessity for further investigation. In this article, studies were compiled from several databases, including, but not limited to, Google Scholar, PubMed, and Cochrane Library. These studies were reviewed, and their data were used to highlight important aspects regarding the efficacy of current PICS screening tools, the optimization and limitations of both pharmacologic and non-pharmacologic treatment methods, and the feasibility and safety of emerging treatments and technologies. The major conclusions of this review were centered around the need for multidisciplinary management of PICS. From pharmacological management using analgesia to non-pharmacological management using early mobilization and exercise therapy, the effective treatment of PICS requires a multifaceted approach. Patient follow-up and its importance were touched upon, including strategies and policies to bolster proper follow-up, thereby increasing favorable outcomes. Lastly, the importance of family involvement and the increased need for research into this topic were highlighted.
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BACKGROUND: A substantial proportion of children have a physical illness; these children commonly experience physical-mental comorbidity. To assess child mental health, brief scales that can be used in clinical and research settings are needed. This study assessed the validity and reliability of parent-reported Ontario Child Health Study Emotional Behavioural Scale-Brief Version (OCHS-EBS-B) scores. METHODS: Data come from a longitudinal study of children aged 2-16 years with a physical illness recruited from outpatient clinics at a pediatric hospital. Confirmatory factor analysis and McDonald's coefficient assessed the factor structure and internal consistency reliability of the OCHS-EBS-B, respectively. Point biserial correlations assessed agreement between the OCHS-EBS-B and Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), a structured diagnostic interview. The Wilcoxon rank sum test compared OCHS-EBS-B scores between children with versus without physical-mental comorbidity (known-group validity). RESULTS: The three-factor structure of the OCHS-EBS-B was replicated in this sample of children with physical illness (χ2 = 196.23(272), p < 0.001; CFI = 0.98; TLI = 0.98; SRMR = 0.06; RMSEA [90% CI] = 0.034 [0.027, 0.044]). It had excellent internal consistency reliability (ω = 0.86-0.92) and was moderately correlated with the MINI-KID (baseline: rpb = 0.43-0.51; 6 months: rpb = 0.55-0.65). OCHS-EBS-B scores were significantly higher among children with versus without physical-mental comorbidity. CONCLUSIONS: Findings confirm psychometric evidence that the OCHS-EBS-B is a valid and reliable measure of mental health in children with chronic physical illness. Its brevity and robust psychometric properties make the OCHS-EBS-B a strong candidate for routine use in integrated pediatric physical and mental health services.
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Psicometria , Humanos , Criança , Masculino , Feminino , Reprodutibilidade dos Testes , Pré-Escolar , Doença Crônica/psicologia , Adolescente , Ontário , Estudos Longitudinais , Análise Fatorial , Transtornos Mentais/psicologia , Escalas de Graduação Psiquiátrica/normas , Comorbidade , Saúde MentalRESUMO
To examine the association between scope-of-practice (SoP) regulations and racial disparities in pediatric mental health services. We used the National Survey of Children's Health (2016-2020; n = 33,790) to examine racial disparities in unmet mental health care needs and receipt of mental health medication between states with and without SoP expansions for psychologists and nurse practitioners (NP). Our primary outcomes were (1) unmet mental health care needs and (2) receipt of mental health medication. We examined heterogeneous treatment effects of SoP expansion on the outcomes using logistic regression with interaction terms between SoP expansion and race/ethnicity. We estimated population-level racial disparities for both outcomes stratified by SoP expansion to identify differences in racial disparities. The psychologist SoP expansion-associated reduction in unmet need was 15.8 percentage-points (CI= -25.3, -6.2) larger for Other-race children than for White children. The psychologist SoP expansion-associated increase in medication was 5.1%-points (CI=. 0.8, 9.4) larger for Black children and 5.6%-points (CI = 0.5, 10.8) for Other-race children. No differences were found for NP SoP expansion. Racial disparities in both outcomes were lower in psychologist SoP expansion states but varied in NP SoP states. Expanded SoP was generally associated with lower racial disparities in pediatric mental health care access.
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Although the need to train clinicians to provide effective mental health care to individuals from diverse backgrounds has been recognized worldwide, a bulk of what we know about training in cultural competence (CC) is based on research conducted in the United States. Research on CC in mental health training from different world populations is needed due to the context-dependent nature of CC. Focusing on India and USA, two diverse countries that provide complementary contexts to examine CC, we explored graduate students', practicing clinicians', and faculty members' perspectives regarding CC training they received/provided and future training needs using mixed-methods. The data were collected using focus groups (n = 25 groups total: 15 in India, 11 in USA), and a survey (n = 800: 450 in India, 350 in USA). Our data highlight the salient social identities in these countries, and the corresponding constituents of CC training. Participants in India described a practical emphasis to their CC training (e.g., learning about CC through life experiences and clinical practice experiences) more so than through coursework, whereas participants in USA described varying levels of coursework related to CC along with practice. Participants in both countries considered enormity of CC as a challenge, while those in the US also identified CC training limited to a white, straight, male perspective, hesitancy in engaging with diversity topics, and limited time and competence of the faculty. Strengths of CC training in India and USA are mutually informative in generating recommendations for enhancing the training in both countries.
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OBJECTIVES: Previous studies have examined the psychological burden of caregivers of patients with dementia. However, although many caregivers struggle to assist patients with dementia with medication management, the relationship between assisting such patients with taking their medicines and the caregiver psychological burden is understudied. Therefore, this study identified the association between caregivers' psychological burden and assisting patients with dementia with taking medication. METHODS: A cross-sectional survey was conducted among caregivers of patients with dementia in Japan. The survey questionnaire included questions that assessed the symptoms of patients with dementia, their status of taking medication through medication assistance from caregivers, and caregivers' psychological burden using the Kessler Psychological Distress Scale and the Japanese version of the Perceived Stress Scale. KEY FINDINGS: A total of 57 caregivers participated in the study. Higher Kessler Psychological Distress Scale scores were significantly associated with unsuccessful assistance with taking regular medication (ß = 0.35, 95% confidence interval [CI]: 2.23-12.0, P < .05), depressive symptoms (ß = 0.26, 95% CI: 0.10-8.53, P < .05), and irritability (ß = 0.38, 95% CI: 2.71-11.5, P < .05). Likewise, higher scores on the Japanese version of the Perceived Stress Scale were significantly associated with irritability (ß = 0.37, 95% CI: 1.87-12.5, P < .05) among patients with dementia. CONCLUSION: The findings suggest that caregiver psychological burden is associated with unsuccessful assistance with taking regular medication for patients with dementia.
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Mounting evidence indicates the worsening of maternal mental health conditions during the COVID-19 pandemic. Mental health conditions are the leading cause of preventable death during the perinatal and postpartum periods. Our study sought to detect space-time patterns in the distribution of maternal mental health conditions in pregnant women before (2016-2019) and during (2020-2021) the COVID-19 pandemic in North Carolina, USA. Using the space-time Poisson model in SaTScan, we performed univariate and multivariate cluster analysis of emergency department (ED) visits for perinatal mood and anxiety disorders (PMAD), severe mental illness (SMI), maternal mental disorders of pregnancy (MDP), suicidal thoughts, and suicide attempts during the pre-pandemic and pandemic periods. Clusters were adjusted for age, race, and insurance type. Significant multivariate and univariate PMAD, SMI, and MDP clustering persisted across both periods in North Carolina, while univariate clustering for both suicide outcomes decreased during the pandemic. Local relative risk (RR) for all conditions increased drastically in select locations. The number of zip code tabulation areas (ZCTAs) included in clusters decreased, while the proportion of urban locations included in clusters increased for non-suicide outcomes. Average yearly case counts for all maternal mental health outcomes increased during the pandemic. Results provide contextual and spatial information concerning at-risk maternal populations with a high burden of perinatal mental health disorders before and during the pandemic and emphasize the necessity of urgent and targeted expansion of mental health resources in select communities.
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There is growing evidence suggesting an increased perception of control is associated with reduced psychological distress among survivors of sexual trauma. The current study advances the extant literature by investigating the association between depressive symptoms, sexual trauma, and an external locus of control or the perception life events are outside one's own control. To do so, we analyze data from the New Family Structures Study, a nationally representative survey of U.S. adults ages 18-39. Results from ordinary least square regression analyses suggest sexual trauma and an external locus of control are associated with significantly greater depressive symptoms and that external control exacerbates the association between sexual trauma and depression. Such findings suggest future research should investigate environmental control for sexual trauma survivors in areas such as prenatal care and the justice system.