Representações sociais da autoproteção profissional e pessoal para Enfermeiros no contexto da COVID-19 / Social Representations of Professional and Personal Self-Protection for Nurses in the COVID-19 Context / Representaciones sociales de la autoprotección profesional y personal para enfermeros en el contexto del COVID-19

Objetivo: analisar as representações sociais da autoproteção profissional e pessoal dos enfermeiros no contexto da Covid-19. Método: estudo descritivo, com abordagem qualitativa, pautado na Teoria das Representações Sociais, abordagem processual. Participaram 30 enfermeiros que realizaram cuidados de enfermagem a pacientes com Covid-19, no Estado do Rio de Janeiro. A coleta de dados ocorreu por meio de entrevista semiestruturada entre abril e maio 2021, realizada em plataforma online. O tratamento dos dados foi realizado com a técnica de análise de conteúdo temático-categorial. Resultado: a análise resultou em quatro categorias: Representações sociais e práticas relativas a Covid-19; Representações sociais da autoproteção; Desafios no enfrentamento da Covid-19: autoproteção pessoal e profissional; e Estrutura e fluxo de atendimento e sua relação com a autoproteção profissional. Considerações finais: houve engajamento dos profissionais no uso dos EPI na pandemia, o que aponta uma preocupação quanto à autoproteção na prestação de cuidados à pacientes com a Covid-19.

Objective: to analyze the social representations of professional and personal self-protection among nurses in the context of Covid-19. Method: a descriptive study with a qualitative approach, based on the Social Representations Theory, using a procedural approach. Thirty nurses who provided nursing care to Covid-19 patients in the State of Rio de Janeiro participated in the study. Data collection took place through semi-structured interviews between April and May 2021, conducted on an online platform. Data analysis was performed using the thematic-categorical content analysis technique. Results: The analysis resulted in four categories of social representations and practices related to challenges in coping with Covid-19: personal and professional self-protection; Care structure and flow and its relationship with professional self-protection. Final considerations: There was engagement of professionals in the use of PPE during the pandemic, indicating a concern regarding self-protection in providing care to patients with Covid-19.

Objetivo: analizar las representaciones sociales de la autoprotección profesional y personal de los enfermeros en el contexto del Covid-19. Método: estudio descriptivo, con enfoque cualitativo, basado en la Teoría de las Representaciones Sociales, enfoque procesal. Participaron 30 enfermeros que brindaron cuidados de enfermería a pacientes con Covid-19 en el Estado de Río de Janeiro. La recolección de datos se llevó a cabo a través de entrevistas semiestructuradas entre abril y mayo de 2021, realizadas en una plataforma online. El procesamiento de los datos se realizó mediante la técnica de análisis de contenido temático categorial. Resultado: del análisis surgieron cuatro categorías: Representaciones sociales y prácticas relacionadas con el Covid-19; Representaciones sociales de la autoprotección; Desafíos de enfrentar el Covid-19: autoprotección personal y profesional; y Estructura y flujo de atención y su relación con la autoprotección profesional. Consideraciones finales: los profesionales demostraron compromiso en el uso de EPP durante la pandemia, lo que indica que se preocupaban por autoprotegerse durante la atención a pacientes con Covid-19.

Developmental change, bricolage, and how a lot of things develop: Mechanisms and changes in attachment across the lifespan.

Under the leadership of its founding editor, Dante Cicchetti, Development and Psychopathology has been recognized for decades as the foremost journal integrating developmental theory and clinical research programs. Contributors have often highlighted the implications of attachment theory and research for understanding developmental processes and pathways, and as a testing ground for intervention strategies. In this paper we reflect on the strengths and limitations of the traditional developmental perspective. We suggest that behavioral, cognitive, and emotional development are better understood as a process of bricolage (construction within constraints). This perspective is illustrated in an analysis of change mechanisms, and behavioral and representational changes, in attachment development from pre-locomotor infancy to later adulthood. Special emphasis is placed on ordinary learning and cognitive processes, rather than those specific to attachment, and on the roles that socialization pressures and changing circumstances play in shaping the course of attachment development.

Psychiatrists' beliefs, awareness, and attitudes toward gender variance: A French cross-sectional study.

OBJECTIVES: The evolution of knowledge and recommendations concerning transgender health has led to various representations, especially for health professionals, that can influence the medical management of transgender individuals. The main objective of this study was to explore the representation of psychiatrists in France regarding gender variance. The secondary objective was to compare these data based on their characteristics. METHODS: This is a cross-sectional observational study based on the distribution in April 2022 of a questionnaire to psychiatrists and psychiatric residents in France. The questionnaire was developed after exploring the results of qualitative studies in the scientific literature. RESULTS: Among 359 respondents, 181 were psychiatric residents and 178 were senior psychiatrists. Ninety percent had already met a transgender person in their professional practice. The representations observed among the respondents were heterogeneous. Most respondents did not consider "transgenderism" a symptom of a psychiatric disorder, and nearly all respondents used the gender and name their patients ask for. About 60% reported insufficient knowledge about "transgenderism", with 86% considering that they had not been trained to adequately support transgender people. CONCLUSIONS: The study reveals that representations, although weakened by a lack of knowledge recognized by psychiatrists, favor a non-pathologizing apprehension of gender variance and recognition of the importance of respecting gender diversity and self-determination. The heterogeneity of representations, as well as the high prevalence of professionals who describe a lack of knowledge, skills, and training, support the need for guidelines and the integration of evidence-based knowledge about gender variance into the psychiatric curriculum.

Protein representations: Encoding biological information for machine learning in biocatalysis.

Enzymes offer a more environmentally friendly and low-impact solution to conventional chemistry, but they often require additional engineering for their application in industrial settings, an endeavour that is challenging and laborious. To address this issue, the power of machine learning can be harnessed to produce predictive models that enable the in silico study and engineering of improved enzymatic properties. Such machine learning models, however, require the conversion the complex biological information to a numerical input, also called protein representations. These inputs demand special attention to ensure the training of accurate and precise models, and, in this review, we therefore examine the critical step of encoding protein information to numeric representations for use in machine learning. We selected the most important approaches for encoding the three distinct biological protein representations - primary sequence, 3D structure, and dynamics - to explore their requirements for employment and inductive biases. Combined representations of proteins and substrates are also introduced as emergent tools in biocatalysis. We propose the division of fixed representations, a collection of rule-based encoding strategies, and learned representations extracted from the latent spaces of large neural networks. To select the most suitable protein representation, we propose two main factors to consider. The first one is the model setup, which is influenced by the size of the training dataset and the choice of architecture. The second factor is the model objectives such as consideration about the assayed property, the difference between wild-type models and mutant predictors, and requirements for explainability. This review is aimed at serving as a source of information and guidance for properly representing enzymes in future machine learning models for biocatalysis.

An In-depth Exploration of the Interplay between fMRI Methods and Theory in Cognitive Neuroscience.

Functional magnetic resonance imaging (fMRI) has been a cornerstone of cognitive neuroscience since its invention in the 1990s. The methods that we use for fMRI data analysis allow us to test different theories of the brain, thus different analyses can lead us to different conclusions about how the brain produces cognition. There has been a centuries-long debate about the nature of neural processing, with some theories arguing for functional specialization or localization (e.g., face and scene processing) while other theories suggest that cognition is implemented in distributed representations across many neurons and brain regions. Importantly, these theories have received support via different types of analyses; therefore, having students implement hands-on data analysis to explore the results of different fMRI analyses can allow them to take a firsthand approach to thinking about highly influential theories in cognitive neuroscience. Moreover, these explorations allow students to see that there are not clearcut "right" or "wrong" answers in cognitive neuroscience, rather we effectively instantiate assumptions within our analytical approaches that can lead us to different conclusions. Here, I provide Python code that uses freely available software and data to teach students how to analyze fMRI data using traditional activation analysis and machine-learning-based multivariate pattern analysis (MVPA). Altogether, these resources help teach students about the paramount importance of methodology in shaping our theories of the brain, and I believe they will be helpful for introductory undergraduate courses, graduate-level courses, and as a first analysis for people working in labs that use fMRI.

Is the Term "Food Consistency" Used Consistently in Consumer Science? An Exploratory Study of Consumer Association and Conceptualization.

The post-pandemic context has changed the modes for collecting data in sensory and consumer science. The objectives of this research were to analyze consumers' associations of food consistency and to study two virtual modes of the Free Word Association test (FWA). This test was administered to 209 consumers (180 women, 29 men, 18-45 years old) asynchronously (i.e. self-administered) and synchronously (i.e. face to face interviews). The Cognitive Salience Index (CSI) was calculated, and the structure of the social representation was analyzed. Correspondence analysis showed that food consistency was a mixture of concepts related to structure, hardness and several aspects of auditory (e.g., Crunchy, Crispy), tactile (e.g. Smooth, Spreadable) and oral texture (e.g., Creamy, Gummy). Slightly consistent food was associated with something soft, liquid or semisolid, and very consistent food to something hard and resistant. Consistent food was more related to "very" than to "slightly consistent." The CSI depended on the stimulus presented (p < 0.05). Regarding the social representation structure, the central core had the highest CSI for all stimuli (CSI ≥ 0.13, p < 0.05). Consumers defined "very consistent, consistent and slightly consistent food" by naming more foods in the synchronous mode than in the asynchronous one. In the asynchronous mode, consumers took more time to complete the test. The virtual FWA test (asynchronous or synchronous) showed some differences in the associations of term consistency, due to the lack of spontaneity in the first minute. It is important to adjust the methodologies to standardize the times in both modes.

Preliminary Danish Norms for the Odense Child Trauma Screening (OCTS).

The Odense Child Trauma Screening (OCTS) is Danish story stem screening tool applicable for assessment of preschoolers and young children in risk of being traumatized. Having shown initial evidence of validation, Danish norms are needed to strengthen the clinical assessment with the OCTS by serving as a baseline comparison for assessment of potentially traumatized children. We tested 169 children from the Danish general population aged 4-8 with the OCTS and investigated sex and age differences in play-based behavior and narrative representations. Caregivers reported electronically on child demographic information, psychosocial functioning, and history of trauma exposure using The Strengths and Difficulties Questionnaire (SDQ) and The Diagnostic Infant and Preschool Assessment (DIPA) trauma list. Across the 145 scores of the OCTS coding scheme, significant sex and age differences were only found in five and sixteen scores respectively. In the five codes where significant sex differences were observed, boys' normative scores were higher. No significant sex differences were found in the partial story scores or the OCTS total score. Three significant age differences in partial story and OCTS total scores emerged with 4-year-olds scoring higher than 6-8-year-olds. We further found 13 significant age differences in code scores with higher scores among the youngest of the two groups in question suggesting that scores tend to decrease along older age. Few significant sex and age differences were found in children's OCTS play-based behavior and narrative representations. Indicative of few sex and age biases of the OCTS coding scheme and stories, results suggest that the OCTS can be applied across the intended target group of children aged 4 to 8 years. As higher scores were found in the younger age groups, clinicians should be attentive to age in certain codes of the OCTS coding scheme in their assessment of children in clinical practice. The preliminary normative scores must be interpreted and clinically applied with caution due to our non-representative sample and lack of analyses on factors potentially influencing children's responses to the OCTS (e.g., developmental, contextual, cultural factors). Supplementary Information: The online version contains supplementary material available at 10.1007/s40653-024-00616-7.

Comparative analysis of BERT and FastText representations on crowdfunding campaign success prediction.

Crowdfunding has become a popular financing method, attracting investors, businesses, and entrepreneurs. However, many campaigns fail to secure funding, making it crucial to reduce participation risks using artificial intelligence (AI). This study investigates the effectiveness of advanced AI techniques in predicting the success of crowdfunding campaigns on Kickstarter by analyzing campaign blurbs. We compare the performance of two widely used text representation models, bidirectional encoder representations from transformers (BERT) and FastText, in conjunction with long-short term memory (LSTM) and gradient boosting machine (GBM) classifiers. Our analysis involves preprocessing campaign blurbs, extracting features using BERT and FastText, and evaluating the predictive performance of these features with LSTM and GBM models. All experimental results show that BERT representations significantly outperform FastText, with the highest accuracy of 0.745 achieved using a fine-tuned BERT model combined with LSTM. These findings highlight the importance of using deep contextual embeddings and the benefits of fine-tuning pre-trained models for domain-specific applications. The results are benchmarked against existing methods, demonstrating the superiority of our approach. This study provides valuable insights for improving predictive models in the crowdfunding domain, offering practical implications for campaign creators and investors.

Attention-language interface in Multilingual Assessment instrument for Narratives.

The current study employed the Multilingual Assessment Instrument for Narratives (MAIN) to test comprehension of narrative macrostructure in Russian in a visual world eye-tracking paradigm. The four MAIN visual narratives are structurally similar and question referents' goals and internal states (IS). Previous research revealed that children's MAIN comprehension differed among the four narratives in German, Swedish, Russian, and Turkish, but it is not clear why. We tested whether the difference in comprehension was (a) present, (b) caused by complicated inferences in understanding IS compared with goals, and (c) ameliorated by orienting visual attention to the referents whose IS was critical for accurate comprehension. Our findings confirmed (a) and (b) but found no effect of attentional cues on accuracy for (c). The multidimensional theory of narrative organization of children's knowledge of macrostructure needs to consider the type of inferences necessary for IS that are influenced by subjective interpretation and reasoning.

Norm learning, teaching, and change.

We present a broad notion of norms that can accommodate many of its interdisciplinary variants and offers a framework to ask questions about norm change. Rather than examining community norm change, we focus on changes in the individual's norm representations. These representations can be characterized by six properties (including as context specificity, deontic force, prevalence), and we examine which of the properties change as a result of norm learning and norm teaching. We first review research insights into norm learning based on observation, imitation, and various forms of inference. Then we examine norm learning that results from teaching, specifically teaching by modeling and demonstration, communication and instruction, and evaluative feedback. We finally speculate about how different kinds of norm change in a given community foster different kinds of norm learning in the individual community member.

Commutative avatars of representations of semisimple Lie groups.

Here we announce the construction and properties of a big commutative subalgebra of the Kirillov algebra attached to a finite dimensional irreducible representation of a complex semisimple Lie group. They are commutative finite flat algebras over the cohomology of the classifying space of the group. They are isomorphic with the equivariant intersection cohomology of affine Schubert varieties, endowing the latter with a new ring structure. Study of the finer aspects of the structure of the big algebras will also furnish the stalks of the intersection cohomology with ring structure, thus ringifying Lusztig's q-weight multiplicity polynomials i.e., certain affine Kazhdan-Lusztig polynomials.

Spaces of mathematical chemistry.

In an effort to expand the domain of mathematical chemistry and inspire research beyond the realms of graph theory and quantum chemistry, we explore five mathematical chemistry spaces and their interconnectedness. These spaces comprise the chemical space, which encompasses substances and reactions; the space of reaction conditions, spanning the physical and chemical aspects involved in chemical reactions; the space of reaction grammars, which encapsulates the rules for creating and breaking chemical bonds; the space of substance properties, covering all documented measurements regarding substances; and the space of substance representations, composed of the various ontologies for characterising substances.

Illness representation in patients with multiple sclerosis: A preliminary narrative medicine study.

Background: The development of personalized interventions aimed at coping with multiple sclerosis is enriched by the understanding of patients' representations of the illness. Objective: The aim of this study was to investigate the association between patients' illness representations versus contextual factors (i.e. presence/absence and type of caregiver, engagement, frequency and type of rehabilitation), fatigue, pain, and neurological impairment. Methods: Interviews of 28 patients were analysed through an automated text analysis procedure. After a systematic labelling procedure four illness representations were identified: daily life, search for meaning of the disease, relationship to people and the diagnosis, coping and physical growth. Results: Findings showed that the representation of the relational aspects of the illness was associated with the caregiver's presence, while the representation related to coping and growth tended to be associated with participation in rehabilitation programs. Moreover, the representation related to daily life was associated with lower levels of fatigue compared to the representation related to coping and growth, and with higher levels of neurological impairment compared to the representations related to coping and growth and the relational aspects of the illness. Conclusion: Exploring illness representations is a key step that can help health professionals to get an integrated perspective that could be useful in designing and calibrating interventions according to specific patient needs.

Eyes and hand are both reliable at localizing somatosensory targets.

Body representations (BR) for action are critical to perform accurate movements. Yet, behavioral measures suggest that BR are distorted even in healthy people. However, the upper limb has mostly been used as a probe so far, making difficult to decide whether BR are truly distorted or whether this depends on the effector used as a readout. Here, we aimed to assess in healthy humans the accuracy of the eye and hand effectors in localizing somatosensory targets, to determine whether they may probe BR similarly. Twenty-six participants completed two localization tasks in which they had to localize an unseen target (proprioceptive or tactile) with either their eyes or hand. Linear mixed model revealed in both tasks a larger horizontal (but not vertical) localization error for the ocular than for the manual localization performance. However, despite better hand mean accuracy, manual and ocular localization performance positively correlated to each other in both tasks. Moreover, target position also affected localization performance for both eye and hand responses: accuracy was higher for the more flexed position of the elbow in the proprioceptive task and for the thumb than for the index finger in the tactile task, thus confirming previous results of better performance for the thumb. These findings indicate that the hand seems to beat the eyes along the horizontal axis when localizing somatosensory targets, but the localization patterns revealed by the two effectors seemed to be related and characterized by the same target effect, opening the way to assess BR with the eyes when upper limb motor control is disturbed.

Processing of Short-Form Content in Clinical Narratives: Systematic Scoping Review.

BACKGROUND: Clinical narratives are essential components of electronic health records. The adoption of electronic health records has increased documentation time for hospital staff, leading to the use of abbreviations and acronyms more frequently. This brevity can potentially hinder comprehension for both professionals and patients. OBJECTIVE: This review aims to provide an overview of the types of short forms found in clinical narratives, as well as the natural language processing (NLP) techniques used for their identification, expansion, and disambiguation. METHODS: In the databases Web of Science, Embase, MEDLINE, EBMR (Evidence-Based Medicine Reviews), and ACL Anthology, publications that met the inclusion criteria were searched according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for a systematic scoping review. Original, peer-reviewed publications focusing on short-form processing in human clinical narratives were included, covering the period from January 2018 to February 2023. Short-form types were extracted, and multidimensional research methodologies were assigned to each target objective (identification, expansion, and disambiguation). NLP study recommendations and study characteristics were systematically assigned occurrence rates for evaluation. RESULTS: Out of a total of 6639 records, only 19 articles were included in the final analysis. Rule-based approaches were predominantly used for identifying short forms, while string similarity and vector representations were applied for expansion. Embeddings and deep learning approaches were used for disambiguation. CONCLUSIONS: The scope and types of what constitutes a clinical short form were often not explicitly defined by the authors. This lack of definition poses challenges for reproducibility and for determining whether specific methodologies are suitable for different types of short forms. Analysis of a subset of NLP recommendations for assessing quality and reproducibility revealed only partial adherence to these recommendations. Single-character abbreviations were underrepresented in studies on clinical narrative processing, as were investigations in languages other than English. Future research should focus on these 2 areas, and each paper should include descriptions of the types of content analyzed.

The Most Effective Interventions for Classification Model Development to Predict Chat Outcomes Based on the Conversation Content in Online Suicide Prevention Chats: Machine Learning Approach.

BACKGROUND: For the provision of optimal care in a suicide prevention helpline, it is important to know what contributes to positive or negative effects on help seekers. Helplines can often be contacted through text-based chat services, which produce large amounts of text data for use in large-scale analysis. OBJECTIVE: We trained a machine learning classification model to predict chat outcomes based on the content of the chat conversations in suicide helplines and identified the counsellor utterances that had the most impact on its outputs. METHODS: From August 2021 until January 2023, help seekers (N=6903) scored themselves on factors known to be associated with suicidality (eg, hopelessness, feeling entrapped, will to live) before and after a chat conversation with the suicide prevention helpline in the Netherlands (113 Suicide Prevention). Machine learning text analysis was used to predict help seeker scores on these factors. Using 2 approaches for interpreting machine learning models, we identified text messages from helpers in a chat that contributed the most to the prediction of the model. RESULTS: According to the machine learning model, helpers' positive affirmations and expressing involvement contributed to improved scores of the help seekers. Use of macros and ending the chat prematurely due to the help seeker being in an unsafe situation had negative effects on help seekers. CONCLUSIONS: This study reveals insights for improving helpline chats, emphasizing the value of an evocative style with questions, positive affirmations, and practical advice. It also underscores the potential of machine learning in helpline chat analysis.

Parallel maturation of rodent hippocampal memory and CA1 task representations.

Hippocampal-dependent memory is known to emerge late in ontogeny, and its full development is protracted. Yet the changes in hippocampal neuronal function that underlie this delayed and gradual maturation remain relatively unexplored. To address this gap, we recorded ensembles of CA1 neurons while charting the development of hippocampal-dependent spatial working memory (WM) in rat pups (∼2-4 weeks of age). We found a sharp transition in WM development, with age of inflection varying considerably between individual animals. In parallel with the sudden emergence of WM, hippocampal spatial representations became abruptly task specific, remapping between encoding and retrieval phases of the task. Further, we show how the development of task-phase remapping could partly be explained by changes in place-field size during this developmental period as well as the onset of precise temporal coordination of CA1 excitatory input. Together, these results suggest that a hallmark of hippocampal memory development may be the emergence of contextually specific CA1 representations driven by the maturation of CA1 micro-circuits.

Reality Cheque: Different Methods of Eliciting Fear-Related Beliefs Reveal Multiple Representations of Threat.

Influential models of fears and phobias suggest that irrational threat beliefs underpin excessive fear. Yet, many fearful individuals recognize their fear is not justified. Drawing on memory competition/multiple representations theory, we developed a novel, fear-relevant procedure, which reveals conflicting representations of threat. In three experiments (Experiment 1, N = 49, Experiment 2, N = 47, Experiment 3, N = 75), fearful and non-fearful participants not only provided Probability Ratings for fear-related outcomes in a fear-relevant exposure task, but placed Bets, with payoffs depending on what happened in reality. Fearful participants displayed much higher Probability Ratings than Low fear participants. However, Bets revealed far less consistent group differences, even when proximal to threat (Experiments 1 and 2), and differences between High and Low fear participants' Bets disappeared when they could not be anchored to previous Probability Ratings (Experiment 3). A Neutral Betting task also showed that general betting strategies were comparable between groups. We suggest that these findings may reflect the multi-representational nature of belief, in which both adaptive and maladaptive representations of a feared object may exist in parallel, with personal and contextual factors determining which form of representation is retrieved or expressed. This perspective can provide insights into the complex interplay of adaptive and maladaptive beliefs that is a central focus of currently dominant therapies.

Illness perceptions in cochlear implant users - a longitudinal study.

PURPOSE: 'Illness perceptions' refers to the thoughts and ideas a person has about an illness. According to Leventhal's Self-Regulatory Model (SRM), changing the threatening illness perceptions of cochlear implant (CI) recipients can be a further step in optimizing hearing outcomes with the CI. The aims of the present study were to assess users' illness perceptions and to determine whether perceptions change during six months of CI rehabilitation. METHODS: One hundred and thirty-eight participants completed the Brief Illness Perception Questionnaire (Brief IPQ), assessing their illness perceptions on nine scales. Data were collected at a German CI center at first CI fitting and six-month follow-up. After first fitting, participants underwent intensive rehabilitation including auditory training, medical, audiological and psychological treatments. RESULTS: At both assessments, participants tended to view their hearing impairment as a severe threat. On the Brief IPQ, the 'consequences' assessment improved during CI rehabilitation, which can be explained by the CI-induced hearing improvement. However, 'understanding' and 'identity' assessments worsened. This could be because CI recipients only come to realize the full complexity of their hearing impairment during rehabilitation. The other scales and the total score remained unaffected. CONCLUSIONS: Current practice in CI rehabilitation seems to be insufficient to improve threatening illness perceptions (except for perceived consequences). This may be because standard information often fails to reach the patients. The development and empirical validation of an intervention program to address individual illness perceptions in CI recipients could be helpful in this context. Further research will be needed to confirm the results.

Creating communities that care: social representation of mental health in two urban poor communities in Ghana.

Building caring communities is fundamental to achieving a community-based approach to mental health. Understanding how communities perceive mental illness provides critical insight into fostering mental health awareness and care. We explored the perceptions of mental illness among members of two urban poor communities in Accra, Ghana. Qualitative data were collected from 77 participants through key informant interviews, focus group discussions, and situated conversations. Using theory-driven thematic analysis based on social representations theory, findings revealed cognitive-emotional representations of mental illness. The communities demonstrated high awareness of the multilevel factors contributing to mental illness risk and experiences, drawing on five sources of knowledge: embodied, common sense, medical, cultural, and religious. Mental illness representations informed the classification and legitimization of mental illness based on the severity of conditions and the identity of sufferers. These findings provide valuable insights for planning community mental health interventions that address both social and institutional care needs.