Calidad de vida relacionada con la salud y los estados de ánimo en estudiantes de instituciones educativas de Antioquia, Colombia / Quality of life related to the health and mood states of students in educational institutions from Antioquia, Colombia / Qualidade de vida relacionada à saúde e ao humor em estudantes de instituições de ensino em Antioquia, Colômbia

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.

Stress, Anxiety and Coping in Adults With Down Syndrome: An Exploratory Co-Research Study.

BACKGROUND: At least half of children and adults with Down syndrome have a major mental health concern during their life but few studies ask people with Down syndrome directly about their experience. We used a co-research model to explore anxiety, stress, and coping in adults with Down syndrome. METHODS: Our group of researchers and adults with Down syndrome conducted an online survey on mental health for adults with Down syndrome. We analysed quantitative data and thematically grouped coping mechanisms. RESULTS: Sixty adults with Down syndrome completed the survey, mean age was 30 years, and 55% of respondents had some employment. Approximately 80% of respondents reported experiencing stress and 75% reported experiencing anxiety. Employed respondents were more likely to use social coping mechanisms. CONCLUSION: Soliciting responses from adults with Down syndrome about their mental health can provide valuable insights. Mental health is a concern for people with Down syndrome that should be addressed.

Mental Health Services for Adults With Intellectual Disabilities: A Qualitative Study of Patient Characteristics, Associated Factors and Consequent Needs for Adaptation in Assessment and Treatment.

BACKGROUND: Individuals with intellectual disabilities are at increased risk of mental health disorders, but may struggle to access appropriate services. While assessment/treatment may need to be adapted, knowledge is limited about what such adaptations may entail. METHOD: During a service development project, the participants (33 professionals, 13 family members) were asked to identify the characteristics/associated factors of individuals with intellectual disabilities and co-occurring mental health disorders. Using thematic analysis, 1103 participant responses were analyzed to identify the needs for adaptation in assessment/treatment. RESULTS: Three core themes were identified: (1) A broader assessment: Gaining an accurate and comprehensive understanding of the individual's history, abilities and difficulties, (2) Adjusting/modifying existing treatment strategies, (3) Ensuring that the individual's day-to-day needs are met. CONCLUSIONS: According to the participants, assessment/treatment of mental health disorder in this population requires more time and broader assessments are necessary. Family/caregiver involvement and cross-service organisation/collaboration represent other important adaptations.

Acute and chronic response of supervised band-elastic resistance exercise in systemic cytokines levels of bipolar disorders and schizophrenia individuals: A pilot study.

Despite earlier research demonstrating the immunomodulatory effects of acute and chronic exercise in many medical illnesses, there is a lack of literature evaluating the acute and chronic effects of exercise on the cytokine levels in individuals with bipolar disorder (BD) or schizophrenia (SCH). This study aims to examine the acute effects of resistance exercise on cytokines and the chronic effects of resistance exercise by 10 weeks on cytokine levels, symptoms of disease, and muscular strength in individuals with BD and SCH. The included individuals (N=10) performed a single session of band-elastic resistance exercises (six exercises, 3 sets of 12-15 repetitions, 60 seconds of interval between sets). A sub-sample (N=6) of individuals performed a supervised band-elastic resistance exercise program (2 times a week, for 10 weeks, 6 exercises, 3 sets of 12-15 repetitions, 60 seconds of interval). We verified for acute effects: IL-2 (P=0.0085) and IL-4 (P=0.0253) levels increased, while IL-6 decreased (P=0.0435), and for chronic effects: increased IL-2 and IL-4 levels (significant effect size - Pre vs Post), a decrease in disease symptoms, and an increase in muscular strength. This study adds to what is already known about how resistance exercises affect people with BD and SCH in both short-term (systemic cytokines levels) and long-term (symptoms of disease, muscular strength, and systemic cytokines levels).

Associations of screen time with symptoms of stress, anxiety, and depression in adolescents / Associação do tempo de tela com sintomas de estresse, ansiedade e depressão em adolescentes

ABSTRACT Objective: To examine the associations between self-reported screen time and symptoms of stress, anxiety, and depression in adolescents. Methods: A cross-sectional study was conducted with 982 adolescents aged between 12 and 15 years, enrolled in public schools in Jacarezinho (PR), Brazil. Screen time was assessed by the question "Considering a typical day, how much time do you spend watching TV, playing videogame, using computer or smartphone?" The DASS-21 questionnaire (short form) was used to assess symptoms of depression, anxiety, and stress. Crude and adjusted analyses (age, sex, and maternal level of education) between screen time and mental disorders symptoms were performed using general linear regression models, with Poisson distribution, with significance level at p<0.05. Results: Higher depressive symptoms were observed in adolescents who reported screen time of 4-6 hours/day (PR 1.35, 95%CI 1.13-1.61) and ≥6 hours/day (PR 1.88, 95%CI 1.62-2.19), compared with their pairs with <2 hours/day. The same was observed for anxiety symptoms with screen time of 4-6 hours/day (PR 1.23, 95%CI 1.04-1.46) and ≥6 hours/day (PR 1.50, 95%CI 1.28-1.77); and stress, with 4-6 hours/day (PR 1.25, 95%CI 1.08-1.44) and ≥6 hours/day (PR 1.49, 95%CI 1.30-1.71), also compared with their pairs with <2 hours/day. Conclusions: Screen time was positively associated with depressive, anxiety, and stress symptoms in adolescents. Special attention should be given to those who spend more than four hours a day in front of a screen.

RESUMO Objetivo: Examinar a associação entre o tempo de tela autorreportado e os sintomas de estresse, ansiedade e depressão em adolescentes. Métodos: Foi realizado estudo com delineamento transversal com 982 adolescentes entre 12-15 anos, matriculados na rede pública de ensino da cidade de Jacarezinho (PR). Para mensurar o tempo de tela, os adolescentes responderam à pergunta: "Considerando um dia típico, quanto tempo você passa assistindo TV, jogando videogame, usando computador ou smartphone?". O questionário DASS-21 (versão curta) foi utilizado para avaliar os sintomas de depressão, ansiedade e estresse. Análises brutas e ajustadas (idade, sexo e nível de escolaridade materna) entre tempo de tela e indicadores de saúde mental foram realizadas por meio do modelo de regressão linear generalizado, com distribuição de Poisson, adotando a significância de p<0,05. Resultados: Maiores sintomas depressivos foram observados em adolescentes com tempo de tela de 4-6 horas/dia (RP 1,35, IC95% 1,13-1,61) e ≥6 horas/dia (RP 1,88, IC95% 1,62-2,19) quando comparados com seus pares com ≤2 horas/dia. O mesmo foi observado para os sintomas de ansiedade com tempo de tela de 4-6 horas/dia (RP 1,23, IC95% 1,04-1,46) e ≥6 horas/dia (RP 1,50, IC95% 1,28-1,77); e estresse, com 4-6 horas/dia (RP 1,25, IC95% 1,08-1,44) e ≥6 horas/dia (RP 1,49, IC95% 1,30-1,71), também comparados com seus pares com ≤2 horas/dia. Conclusões: O tempo de tela foi associado positivamente com os sintomas de depressão, ansiedade e estresse em adolescentes. Atenção especial deve ser dada àqueles que passam mais de quatro horas por dia em frente a uma tela.

Yoga como terapia complementaria para el Adulto Mayor / Yoga as a complementary therapy for older adult

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]

Estudo longitudinal de famílias / Longitudinal study of families / Estudio longitudinal de familias

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.

Vivência de grupo de apoio em saúde mental na atenção primária: um relato de experiência / Mental health support group in primary health care: an experience report / Grupo de apoyo de salud mental en atención primaria: un informe de experiencia

Problema: Entre os desafios enfrentados na temática de transtornos mentais no Brasil, é pertinente destacar a escassez de recursos e serviços, sua integração e o estigma em torno da doença mental. Apesar das dificuldades, alguns progressos significativos estão sendo inseridos nesse cuidado, como é o exemplo das intervenções em grupo na atenção básica. Método: Este relato de experiência descreve e analisa a implementação de um grupo terapêutico em uma Unidade Básica de Saúde para contribuir com o enriquecimento da intervenção coletiva em pacientes com queixas de saúde mental. A proposta foi trabalhar em conjunto com pacientes com queixa de ansiedade ou depressão após analisar a grande demanda da população adscrita na área por esse cuidado. Resultados: Após dois meses de encontros semanais, foi possível ir além das práticas convencionais oferecidas nos grupos, proporcionando às equipes de saúde a oportunidade de refletir sobre alternativas para promover mudanças nas formas de atenção à saúde mental. Conclusão: Além de estimular a troca de saberes entre universitários, profissionais e comunidade, a implementação de grupos terapêuticos se mostrou promissora no cuidado aos transtornos mentais e como forma de reabilitação psicossocial na atenção básica.

Problem: Among the challenges faced in the mental disorders field in Brazil, it is pertinent to highlight the scarcity of resources and services, their integration, and the stigma surrounding mental illness. Despite the difficulties, some significant progress is being achieved in this care such as group interventions in primary health care. Methods: The implementation of a therapeutic group in a Health Center is described and analyzed in this experience report, aiming at contributing to the enrichment of collective intervention in patients with mental health complaints. The aim was to work together with patients complaining about anxiety or depression after analyzing a great demand in the area for this care. Results: After two months of weekly meetings, we could go beyond the conventional practices offered in groups, providing the health teams with the opportunity to reflect on alternatives to promote changes in the forms of mental health care. Conclusions: In addition to stimulating the exchange of knowledge between university students, professionals, and the community, the implementation of therapeutic groups showed to be promising in the care of mental disorders and as a psychosocial rehabilitation method in primary health care.

Problema: entre los desafíos enfrentados en el campo de los trastornos mentales en Brasil, es pertinente destacar la escasez de recursos y servicios, su integración y el estigma que rodea a la enfermedad mental. A pesar de las dificultades, se están insertando algunos avances significativos en esta atención, como es el ejemplo de las intervenciones grupales en la atención primaria. Método: Este relato de experiencia describe y analiza la implementación de un grupo terapéutico en una Unidad Básica de Salud para contribuir al enriquecimiento de la intervención colectiva en pacientes con problemas de salud mental. La propuesta fue trabajar en conjunto con pacientes que se quejan de ansiedad o depresión luego de analizar la gran demanda de la población inscrita en el área para esta atención. Resultados: Después de dos meses de encuentros semanales, fue posible ir más allá de las prácticas convencionales ofrecidas en los grupos, brindando a los equipos de salud la oportunidad de reflexionar sobre alternativas para promover cambios en las formas de atención a la salud mental. Conclusión: además de estimular el intercambio de conocimientos entre universitarios, profesionales y la comunidad, la implementación de grupos terapéuticos se ha mostrado prometedora en la atención de los trastornos mentales y como forma de rehabilitación psicosocial en la atención primaria.

Psico Bot: a robot for psychological assessment of children and adolescents

Chatbots can use fast, and sometimes specialized interactions in different situations, making them an option in the choice of tools to collect information. In the psychological assessment of children and adolescents, they can act as complementary sources, and help to describe, qualify and measure psychological and behavioral characteristics, in its various forms of expression, in different contexts. This study aimed to present Psico Bot, a chatbot developed to assess symptoms of anxiety and depression in children and adolescents. Consisting of 20 questions that map physical and psychological symptoms of the selected constructs, it was developed through the natural language Dialogflow for use in the Google Assistant conversation platform. The design of Psico Bot is based on a neutral representation, with no determined gender or age, facilitating quick identification by the user. Based on the use of multimethod evaluations, the Psico Bot can offer relevant information about the mental health of children and adolescents using language and devices that are easy to understand and handle by this population. For the evaluator, the tool offers quick response and specific information about each construct, enabling more effective interventions in elements of greatest need.

Chatbots podem utilizar-se de interações rápidas, e por vezes, especializada em diferentes situações, tornando-os uma opção na escolha de ferramentas para coletar informações. Na avaliação psicológica de crianças e adolescentes, podem atuar como fontes complementares, e auxiliar a descrever, qualificar e mensurar características psicológicas e comportamentais, nas suas diversas formas de expressão, em diferentes contextos. Este estudo objetivou apresentar o Psico Bot, um chatbot desenvolvido para avaliar sintomas de ansiedade e depressão em crianças e adolescentes. Composto por 20 questões que mapeiam sintomas físicos e psicológicos dos constructos selecionados, sendo desenvolvido por meio da linguagem natural Dialogflow para uso na plataforma de conversação Google Assistente, o design do Psico Bot pauta-se em representação neutra, sem sexo ou idade determinados, facilitando a rápida identificação do usuário. Respaldando-se na utilização de multimétodos avaliativos, o Psico Bot pode oferecer informações relevantes sobre a saúde mental de crianças e adolescentes utilizando linguagem e dispositivos de fácil compreensão e manuseio por essa população. Para o avaliador, a ferramenta oferece resposta rápida e informações específicas sobre cada constructo, possibilitando intervenções mais efetivas em elementos de maior necessidade.

Los chatbots pueden utilizar interacciones rápidas y, a veces especializadas, en diferentes situaciones, lo que los convierte en una opción en la elección de herramientas para recopilar información. En la evaluación psicológica de niños y adolescentes pueden actuar como fuentes complementarias y ayudar a describir, calificar y medir las características psicológicas y de comportamiento en sus diversas formas de expresión en diferentes contextos. Este estudio tuvo como objetivo presentar Psico Bot, un chatbot desarrollado para evaluar síntomas de ansiedad y depresión en niños y adolescentes. Compuesto por 20 preguntas que mapean síntomas físicos y psicológicos de los constructos seleccionados, fue desarrollado mediante el lenguaje natural Dialogflow para su uso en la plataforma de conversación Google Assistant. El diseño de Psico Bot se basa en una representación neutra, sin género ni edad determinados, lo que facilita la rápida identificación por parte del usuario. A partir del uso de evaluaciones multimétodo, Psico Bot puede ofrecer información relevante sobre la salud mental de niños y adolescentes utilizando un lenguaje y dispositivos de fácil comprensión y manejo para esta población. Para el evaluador, la herramienta ofrece una respuesta rápida e información específica sobre cada constructo, lo que permite intervenciones más eficaces en los elementos de mayor necesidad.

Influencia de la resiliencia y el afrontamiento en salud mental positiva en jóvenes mexicanos durante la pandemia de COVID-19 / Influence of resilience and coping on positive mental health in young Mexicans during the COVID-19 pandemic

Resumen El objetivo de este estudio consistió en explicar en qué medida la resiliencia y las estrategias de afrontamiento influyeron en la salud mental positiva de jóvenes mexicanos universitarios que vivieron la pandemia de COVID-19. La muestra se conformó por 1042 universitarios mexicanos de 18 a 24 años de edad (M = 20.5 DS = 1.9). El 78.4 % son mujeres (817). Se aplicaron en formato online los instrumentos: Mental Health Continuum-Short Form, Escala de Resiliencia, Escala de Afrontamiento y Escala de miedo al COVID-19. Se obtuvo un modelo con índices de bondad de ajuste satisfactorios (X 2 = 532.913, df = 114, X 2 /df = 4.6, SRMR = .053, RMSEA = .059, CFI = .927, p = .001), en el cual la resiliencia y el afrontamiento funcional son factores importantes que influyen en SMP, por lo que son variables que deben considerarse en los programas de intervención psicológica para la promoción de la salud de los jóvenes universitarios.

Abstract The objective of this study was to explain to what extent resilience and coping strategies influenced the positive mental health of young Mexican university students who have experienced the COVID-19 pandemic. The sample was made up of 1.042 Mexican university students between 18 and 24 years of age (M = 20.5 SD = 1.9). 78.4% are women (817). The instruments: Mental Health Continuum-Short Form, Resilience Scale, Coping Scale and Fear of COVID-19 Scale were applied in online format. A model was obtained with satisfactory goodness-of-fit indices (X2 = 532.913, df = 114), resilience and functional coping are important factors that influence SMP, so they are variables that should be considered in psychological intervention programs to promote the health of university students.

Measuring Hypochondria with Short Health Anxiety Inventory: Psychometric Properties in Colombian University Students / Medición de la hipocondría con el Short Health Anxiety Inventory: propiedades psicométricas en estudiantes universitarios colombianos

Abstract Introduction: The Short Health Anxiety Inventory is a commonly used tool for assessing health anxiety, but its psychometric properties and internal structure have not been examined in a Latin American Spanish-speaking population. This study aimed to establish the psychometric properties among Colombian university students. Method: The goodness of fit of four latent structure models of the Short Health Anxiety Inventory was tested using confirmatory factor analysis in a sample of 1004 Colombian university students. Results: The results show that the original model's structure does not fit well (CFI = .808; RMSEA = .074), and the reliability was .796 and .703 for the original two variables. Conclusions: The findings do not support the utilization of the Colombian version of the Short Health Anxiety Inventory by researchers and clinicians among Colombian university students.

Resumen Introducción: El Short Health Anxiety Inventory es una herramienta común para evaluar la ansiedad relacionada con la salud, pero sus propiedades psicométricas y estructura interna no han sido evaluadas en una población latinoamericana de habla hispana. Este estudio tuvo como objetivo establecer las propiedades psicométricas en estudiantes universitarios colombianos. Método: Se evaluó la bondad de ajuste de cuatro modelos de estructura latente del Short Health Anxiety Inventory, mediante análisis factorial confirmatorio, en una muestra de 1004 estudiantes universitarios colombianos. Resultados: La estructura no se ajusta al modelo original (CFI = .808; RMSEA = .074) y la confiabilidad fue de .796 y .703 para las dos variables originales. Conclusiones: Los resultados no respaldan el uso de la versión colombiana del Short Health Anxiety Inventory entre estudiantes universitarios colombianos, tanto para investigadores como para clínicos.

Efecto de la sintomatología ansiosa y depresiva sobre los estilos de alimentación de la población chilena / Effect of anxious and depressive symptomatology on eating styles in the chilean population

Resumen Antecedentes: existe una estrecha relación entre salud mental y estilos de alimentación. Indicadores de salud mental como sintomatología ansiosa y depresiva han reportado efectos directos sobre estilos de alimentación que promueven la malnutrición por exceso como la alimentación emocional o restrictiva. Se analizó el efecto de la sintomatología ansiosa y depresiva sobre los estilos de alimentación en mujeres y hombres del norte y centro de Chile. Método: participaron 910 adultos residentes en el norte y centro de Chile; se aplicó el Cuestionario Holandés de Conducta Alimentaria (DEBQ), así como el Inventario de Ansiedad de Beck (BAI) y el Inventario de Depresión de Beck-II (BDI-II). El análisis del modelo global de la relación entre variables se realizó mediante modelos de ecuaciones estructurales. Resultados: el modelo global presentó adecuados indicadores de bondad de ajuste; la sintomatología ansiosa tuvo un efecto directo y significativo sobre la alimentación emocional, alimentación externa y alimentación restrictiva. Por su parte, la sintomatología depresiva no presentó efectos significativos sobre ningún estilo de alimentación. Conclusiones: a medida que aumentan los niveles de ansiedad, aumentan los niveles de todos los estilos de alimentación. La depresión podría interactuar mediando la relación por el contexto emocional que genera la sintomatología depresiva.

Abstract Introduction: There is a close relationship between mental health and eating styles. Mental health indicators such as anxious and depressive symptomatology have reported direct effects on eating styles that promote excess malnutrition such as emotional or restrictive eating. The aim was to analyze the effect of anxious and depressive symptomatology on eating styles in women and men from northern and central Chile. Method: Nine hundred and ten adults living in northern and central Chile participated in the study. The Dutch Eating Behavior Questionnaire (DEBQ), the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory-II (BDI-II) were administered. The analysis of the global model of the relationship between variables was carried out using structural equation modeling. Results: The structural model presented adequate goodness-of-fit indicators, anxious symptomatology had a direct and significant effect on emotional eating, external eating and restrictive eating. On the other hand, depressive symptomatology, did not present significant effects on any eating style. Conclusions: As anxiety levels increase, levels of all eating styles increase. Depression, could interact mediating the relationship by the emotional context that generates the depressive symptomatology.

Medical faculty's perception of students' mental health: a qualitative survey study / Percepción de los profesores de medicina sobre la salud mental de los estudiantes: un estudio cualitativo / Percepção dos docentes de medicina sobre a saúde mental dos estudantes: um estudo qualitativo

This study sought to explore the perspective of medical faculty on the mental health of their students. This qualitative study based on a focus group is part of a longitudinal research that studied the mental health of Brazilian students. One group was conducted with faculty employed at a medical school. Topics discussed covered the concept of mental health and medical education. Six professors participated in one group. The mental health of medical students is a construct that encompasses emotional aspects, ability to solve problems and multiple facets of a human being, according to the participants. Artistic practices, moments of socialization and leisure were perceived as stimulating students' good mental health. Excessive demands generate competitiveness and the teacher's expectation of the student's good performance based on their own experience can harm the student's mental health. Participants also highlighted that a pedagogical reformulation that makes sense for the student's learning process is necessary to update traditional curricula. Medical students' mental health is influenced by experiences and exchanges during the medical school, mainly between professor and student, understood as necessary and inherent to the process of becoming physician. The findings of this study show the need for curriculum changes in the medical education process and updating teacher training for good practices that reinforce good mental health.

Este estudio buscó explorar la perspectiva de los profesores de medicina sobre la salud mental de sus estudiantes. Este estudio cualitativo basado en un grupo focal es parte de una investigación longitudinal que estudió la salud mental de estudiantes brasileños. Un grupo se llevó a cabo con profesores empleados en una escuela de medicina. Los temas tratados abarcaron el concepto de salud mental y educación médica. Seis docentes participaron en un grupo. La salud mental de los estudiantes de medicina es un constructo que abarca aspectos emocionales, capacidad de resolución de problemas y múltiples facetas del ser humano, según los participantes. Las prácticas artísticas, los momentos de socialización y el ocio fueron percibidos como estimulantes de la buena salud mental de los estudiantes. Las exigencias excesivas generan competitividad y la expectativa del docente sobre el buen desempeño del estudiante basándose en su propia experiencia puede perjudicar la salud mental del estudiante. Los participantes también resaltaron que es necesaria una reformulación pedagógica que tenga sentido para el proceso de aprendizaje del estudiante para actualizar los currículos tradicionales. La salud mental de los estudiantes de medicina está influenciada por las experiencias y los intercambios durante la carrera de medicina, principalmente entre profesor y estudiante, entendidos como necesarios e inherentes al proceso de convertirse en médico. Los hallazgos de este estudio muestran la necesidad de cambios curriculares en el proceso de formación médica y de actualización de la formación docente hacia buenas prácticas que refuercen la buena salud mental.

Este estudo buscou explorar a perspectiva dos docentes de medicina sobre a saúde mental de seus alunos. Este estudo qualitativo baseado em grupo focal faz parte de uma pesquisa longitudinal que estudou a saúde mental de estudantes brasileiros. Um grupo foi conduzido com professores empregados em uma faculdade de medicina. Os temas discutidos abrangeram o conceito de saúde mental e educação médica. Seis professores participaram de um grupo. A saúde mental dos estudantes de medicina é um construto que engloba aspectos emocionais, capacidade de resolução de problemas e múltiplas facetas do ser humano, segundo os participantes. As práticas artísticas, os momentos de socialização e de lazer foram percebidos como estimuladores da boa saúde mental dos estudantes. Exigências excessivas geram competitividade e a expectativa do professor pelo bom desempenho do aluno com base na própria experiência pode prejudicar a saúde mental do aluno. Os participantes destacaram também que é necessária uma reformulação pedagógica que faça sentido para o processo de aprendizagem do aluno para atualizar os currículos tradicionais. A saúde mental dos estudantes de medicina é influenciada pelas experiências e trocas durante o curso de medicina, principalmente entre professor e aluno, entendidas como necessárias e inerentes ao processo de tornar-se médico. Os achados deste estudo mostram a necessidade de mudanças curriculares no processo de formação médica e de atualização da formação docente para boas práticas que reforcem a boa saúde mental.

Conceptualizing Domestic Violence Within Clinical Documentation.

Domestic and family violence (DFV) is a global issue with significant impacts on victim-survivors. The emergency department (ED) serves as the initial point of contact for victim-survivors. Given the significant role that clinical notes play in the management of patients and the communication between healthcare professionals, understanding how healthcare practitioners describe and document abuse reported in emergency settings is crucial. Yet, there remains a gap in understanding how health professional document DFV in the medical records of women presenting to the ED. Therefore, this qualitative descriptive study explored how DFV is documented in patient records of women presenting to the ED. Clinical notes from healthcare workers, including medical practitioners, nurses, social workers, mental health clinicians and ambulance officers, were qualitatively analyzed. Overall, the study included 43 presentations from 32 women (aged 18-56 years old) who visited a regional ED, during which instances of DFV were noted. An inductive content analysis resulted in the identification of four categories, including (a) DFV articulated in direct speech, (b) Unambiguous DFV, (c) Unconfirmed DFV, and (d) Problematic relationship. Although most references to DFV in the clinical notes included direct quotations from the patient's descriptions of abuse or were documented unambiguously by healthcare professionals, a notable number of clinical notes exhibited a degree of caution or reluctance to acknowledge DFV dynamics when describing these events. These findings support the need for sustained and consistent professional training among healthcare professionals concerning the identification, documentation, and response to disclosures, suspicions, and allegations of DFV to better support victim-survivors presenting to the ED and other hospital settings.

The Intersection of Ultra-Processed Foods, Neuropsychiatric Disorders, and Neurolaw: Implications for Criminal Justice.

Over the last decade there has been increasing interest in the links between the consumption of ultra-processed foods and various neuropsychiatric disorders, aggression, and antisocial behavior. Neurolaw is an interdisciplinary field that seeks to translate the rapid and voluminous advances in brain science into legal decisions and policy. An enhanced understanding of biophysiological mechanisms by which ultra-processed foods influence brain and behavior allows for a historical reexamination of one of forensic neuropsychiatry's most famous cases-The People v. White and its associated 'Twinkie Defense'. Here in this Viewpoint article, we pair original court transcripts with emergent research in neurolaw, including nutritional neuroscience, microbiome sciences (legalome), pre-clinical mechanistic research, and clinical intervention trials. Advances in neuroscience, and related fields such as the microbiome, are challenging basic assumptions in the criminal justice system, including notions of universal free will. Recent dismissals of criminal charges related to auto-brewery syndrome demonstrate that courts are open to advances at the intersection of neuromicrobiology and nutritional neuroscience, including those that relate to criminal intent and diminished capacity. As such, it is our contention that experts in the neurosciences will play an increasing role in shaping research that underpins 21st-century courtroom discourse, policy, and decision-making.

Decreasing the Anxiety and Shame of Medical Students Not Placing into a Residency Using an Innovative Fifth-Year Educational Intervention.

US medical students, even before the COVID-19 pandemic, exhibited higher rates of mental health challenges than age-matched cohorts. The National Resident Matching Program (NRMP) match process, which places medical students into residency, is the culmination of medical school training and a well-recognized stressor that amplifies anxiety levels and the mental strain that accompanies medical school. Facing an unprecedented year with a decrease in 2021 NRMP placement percentages, Rocky Vista University College of Osteopathic Medicine (RVUCOM) introduced an innovative new program, the predoctoral internship (PDI), to support students who did not match into a residency program. At no extra expense to the student, this program offers a year-long opportunity to customize experiences in both clinical and academic settings, along with leadership training, aimed at bolstering their residency applications. Alternatively, students could participate in a Master's PDI (MPDI), which allowed students to concurrently pursue a master's degree of their choosing with an external program. RVUCOM achieved 100% placement for students completing the PDI or MPDI program, aligning with the institution's historical graduate trends. Perhaps equally important, students in the program reported feeling supported and less ashamed, fostering loyalty to RVUCOM. Transparency in communication and leaning into institutional values reinforced trust within community partners. The intentional balance of rigor and support, coupled with faculty investment, proved crucial for success. The experience held students accountable, allowing personal and professional growth and fostering the development of a deeper professional identity. RVUCOM's innovative approach to unplaced students not only addresses the challenges faced by RVUCOM students not achieving a residency placement, but also transforms an unforeseen circumstance into an opportunity for growth, resilience, and the development of more competitive and accountable medical graduates.

Loneliness, online learning and student outcomes in college students living with disabilities: results from the National College Health Assessment Spring 2022.

Background: People with disabilities face many health, economic and social disparities. Loneliness is recognized as a significant issue for this group however, its impact on students with disabilities (SWDs) remains a critically underexplored area of research. Importantly, as higher education continues its transition to the digital space, the potential to entrench social isolation and loneliness within this population has not been examined. This research seeks to explore the associations between SWDs, loneliness, online learning, and academic outcomes in a national survey of university students. Methods: Using the National College Health Assessment from Spring 2022, this study compared multiple outcomes between different groups of SWDs and students without disabilities. Two ordinal regression models were used to estimate associations between loneliness, disability type and learning mode (online vs. in-person), as well as cumulative grade average (CGA) with disability type. Results: All disability types included within this study were positively associated with increased odds of loneliness for those engaged in online learning compared to students without disabilities. Interactions indicate a significant effect of in-person learning compared with online learning for deaf or hard of hearing students, and those with multiple disabilities. Several disability groups reported decreased odds of higher CGA compared to students without disabilities. Conclusion: Loneliness is a significant issue for all SWD groups reported in this study. The impact of disability on academic outcomes is reported herein; however, its impact on medium-to-long term outcomes for these individuals remains unknown. To address inequities in higher education for SWDs, universities must invest more resources to holistically support these students.

Participatory logic model for a precision child and youth mental health start-up: scoping review, case study, and lessons learned.

Background: The precision child and youth mental health (PCYMH) paradigm has great potential to transform CYMH care and research, but there are numerous concerns about feasibility, sustainablity, and equity. Implementation science and evaluation methodology, particularly participatory logic models created with stakeholders, may help catalyze PCYMH-driven system transformation. This paper aims to: (1) report results of a PCYMH logic model scoping review; (2) present a case study illustrating creation of a participatory logic model for a PCYMH start-up; and (3) share the final model plus lessons learned. Methods: Phase 1: Preparation for the logic model comprised several steps to develop a preliminary draft: scoping review of PCYMH logic models; two literature reviews (PCYMH and implementation science research); an environmental scan of our organization's PCYMH research; a gap analysis of our technological capability to support PCYMH research; and 57 stakeholder interviews assessing PCYMH perspectives and readiness. Phase 2: Participatory creation of the logic model integrated Phase 1 information into a draft from which the final logic model was completed through iterative stakeholder co-creation. Results: Phase 1: The scoping review identified 0 documents. The PCYMH literature review informed our Problem and Impact Statements. Reviewing implementation and evaluation literature resulted in selection of the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) and Behavior Change Wheel (BCW) frameworks to guide model development. Only 1.2% (5/414) of the organization's research projects involved PCYMH. Three technological infrastructure gaps were identified as barriers to developing PCYMH research. Stakeholder readiness interviews identified three themes that were incorporated into the draft. Phase 2: Eight co-creation cycles with 36 stakeholders representing 13 groups and a consensus decision-making process were used to produce the final participatory logic model. Conclusions: This is the first study to report the development of a participatory logic model for a PCYMH program, detailing involvement of stakeholders from initial planning stages to the final consensus-based product. We learned that creating a participatory logic model is time- and labour-intensive and requires a multi-disciplinary team, but the process produced stakeholder-program relationships that enabled us to quickly build and implement the PCYMH start-up. Our processes and final model can inform similar efforts at other sites.

Protocol for an implementation study of group metacognitive therapy for anxiety and depression in NHS cardiac rehabilitation services in England (PATHWAY-Beacons).

Background: Cardiac rehabilitation (CR) services aim to improve heart disease patients' health and quality of life and reduce the risk of further cardiac events. Depression and anxiety are common among CR patients but psychological treatments have usually had small effects. In contrast, the recent NIHR-funded PATHWAY trial found that group Metacognitive Therapy (MCT) was associated with improvements in anxiety and depression when added to CR and was more effective than usual CR alone. The next stage is to test implementation of MCT within the National Health Service through the creation of a network of CR beacon sites. The study will test the quality of data capture following addition of a new MCT data-field to the national audit of cardiac rehabilitation (NACR), examine level of adoption at sites, examine mental health outcomes benchmarked against usual CR and the PATHWAY data, examine the enablers and barriers to implementation and the expected resource requirements. The study has been registered: NCT05956912 (13th July, 2023). Methods: Beacon sites will be recruited as preliminary adopters of group MCT from NHS CR services in England. A national invitation for expressions of interest from CR services will be issued and those meeting eligibility criteria will be considered for inclusion. Two staff at each site will receive training in MCT, and mixed-methods will be used to address questions concerning the quality of patient data recorded, level of adoption at sites, the characteristics of patients attending MCT, the impact of adding MCT to CR on mental health outcomes, and patient, healthcare staff and commissioner views of barriers/enablers to implementation. Exploration of implementation will be informed by Normalisation Process Theory. Discussion: The study will support development of an NHS roll-out strategy, assess the mental health outcomes associated with MCT, examine treatment fidelity in real-world settings, and evaluate revised data collection structures that can be used to assess the impact of national-level implementation. Trial Registration: NCT05956912; 13th July 2023.

Pharmaceutical Telemonitoring for Patients With Psychiatric Disorders: Implementation Description.

Telecare has exhibited efficacy in managing various chronic clinical conditions and presents potential in the surveillance of patients with psychiatric disorders, an area necessitating further investigation. Herein, we delineate an adjunct for pharmacotherapeutic oversight of individuals with psychiatric disorders receiving care at a public mental health outpatient facility. This manuscript serves as an implementation dossier detailing the progression of a preliminary trial. The non-probabilistic sample consisted of 21 patients, monitored between January 2022 and October 2022. Predominantly, schizophrenia constituted the primary psychiatric disorder among the cohort, accounting for 61.9% of cases. Across 79 remote consultations, averaging 3.8 consultations per patient, text messages constituted 52% (41/79) of the interactions. Throughout the telemonitoring process, diligent monitoring of patients' self-reported concerns was facilitated, permitting pharmaceutical interventions encompassing health advisories (52.7%) and recommendations for therapeutic adjustments (34.4%). Consequently, telemonitoring yielded an augmented pharmaceutical support framework for psychiatric patients, thereby presenting a plausible avenue for enhancing accessibility within public healthcare institutions.