Parenting Stress, Community Support, and Unmet Health Care Needs of Children in the US.

OBJECTIVES: In 2018, approximately 2.3 million children in the United States had unmet healthcare needs (UHCN). To date, studies examining associations between UHCN and parent stress and support have had limited generalizability. This study aimed to investigate the relationship between children's UHCN and parenting stress and support using a nationally representative sample. Additionally, this study aimed to assess associations between unmet mental health needs and these parental well-being measures. METHODS: Households with children ages 0-17 and complete data on UHCN in the combined 2016, 2017, 2018, and 2019 cohorts of the National Survey of Children's Health (NSCH) met inclusion criteria. Logistic regressions were used to evaluate associations between overall UHCN and outcome measures of parental coping, aggravation, emotional support, and neighborhood support. Associations between mental UHCN and these outcome measures were analyzed in a subset limited to children with mental health conditions. Regressions were adjusted for potential confounders, including demographics, household income, medical home status, and health insurance (adequacy/type). RESULTS: In our sample of 131,299 children, overall UHCN were associated with poorer parental coping (aOR = 5.35, 95% CI: [3.60, 7.95]), greater parental aggravation (aOR = 3.35, 95% CI: [2.73, 4.12]), and non-supportive neighborhood (aOR = 2.22, 95% CI: [1.86, 2.65]). Mental UHCN were similarly associated with parental coping and aggravation and neighborhood support in the mental health subset. CONCLUSIONS FOR PRACTICE: Healthcare professionals must address the needs of children with UHCN and collaborate with community organizations and child advocates to promote coordinated and comprehensive care and adequately support caregivers.

Prevalence of Unmet Rehabilitation Needs Among Canadians Living With Long-term Conditions or Disabilities During the First Wave of the COVID-19 Pandemic.

OBJECTIVE: We aimed to describe the prevalence of unmet rehabilitation needs among a sample of Canadians living with long-term conditions or disabilities during the first wave of the COVID-19 pandemic. DESIGN: Cross-sectional survey. SETTING: Individuals residing in Canada during the first wave of the COVID-19 pandemic. PARTICIPANTS: Eligible participants were Canadians living with long-term conditions or disabilities, 15 years or older living in 1 of the 10 provinces or 3 territories (n=13,487). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: We defined unmet rehabilitation needs as those who reported needing rehabilitation (ie, physiotherapy/massage therapy/chiropractic, speech, or occupational therapy, counseling services, support groups) but did not receive it because of the COVID-19 pandemic. We calculated the national, age, gender, and province/territory-specific prevalence and 95% confidence interval of unmet rehabilitation needs. RESULTS: During the first wave of the pandemic, the prevalence of unmet rehabilitation needs among Canadians with long-term conditions or disabilities was 49.3% (95% confidence interval [CI]; 48.3, 50.3]). The age-specific prevalence was higher among individuals 15-49 years old (55.6%; 95% CI [54.2, 57.1]) than those 50 years and older (46.0%; 95% CI [44.5, 47.4]). Females (53.7%; 95% CI [52.6, 54.9]) had higher unmet needs than males (44.1%; 95% CI [42.3, 45.9]). Unmet rehabilitation needs varied across provinces and territories. CONCLUSIONS: In this sample, almost 50% of Canadians living with long-term conditions or disabilities had unmet rehabilitation needs during the first wave of the COVID-19 pandemic. This suggests that a significant gap between the needs for and delivery of rehabilitation care existed during the early phase of the pandemic.

Testicular Cancer: The Unmet Needs of a Younger Generation of Cancer Survivors.

Unmet holistic needs of various cancer populations, with examples including prostate, bladder, gynecologic, kidney, penile, breast, and colorectal, along with holistic impacts of cancer on older adults, have been defined by a growing number of systematic reviews. Unfortunately, there continues to be a lack of clinical insight into the unique needs of younger men with testicular cancer. Survival rate based on low mortality rates and good prognosis if early detection and treatment implementation grows the number of men who need support as long-term survivors with an average life expectancy of approximately 30 to 50 years after treatment. Providers and clinicians need to approach testicular cancer survivors with the tools and strategies that meet these unmet needs for navigation from diagnosis through survivorship. When strategies of specific resources and education are implemented based on the unique needs of these individuals, positive outcomes and increased health care-related quality of life will be prevalent.

"I Think [Western] Healthcare Fails Them": Qualitative Perspectives of State-recognized Women Tribal Members on Elders' Healthcare Access Experiences.

Elder tribal members are important cultural and spiritual leaders and experts among many American Indian and Alaska Native (AI/AN) cultures. AI/AN Elders play a key role in the maintenance and transmission of traditional cultural knowledge and practices and are highly valued members of AI/AN communities. AI/AN populations face disparities in healthcare outcomes, and the healthcare needs of AI/AN Elders remain an understudied area of research, particularly among tribes in the South and for tribes who do not have federal recognition. Qualitative data was collected through semi-structured interviews among 31 women, all of whom are members of a state-recognized Tribe in the Southern United States. While the interview questions were specific to their own reproductive healthcare experiences, repeated concerns were voiced by the women regarding the health of the Elders in their community. Key findings captured several concerns/barriers regarding Elders' healthcare experiences including: (a) Language and communication barriers between Elders and healthcare workers; (b) Prior negative experiences with Western medicine; (c) Lasting impacts of educational discrimination; (d) Concerns over self-invalidation; (e) Transportation barriers; and (f) Need for community programs. Issues related to these barriers have resulted in a concern that Elders are not receiving the full benefit of and access to Western healthcare systems. The purpose of this analysis was to highlight the concerns voiced by women tribal members on the health and wellbeing of Elders in their community. Opportunities related to the importance of prioritizing and improving AI/AN Elders' healthcare experiences and access are also described.

A scoping review of the clinical application of machine learning in data-driven population segmentation analysis.

OBJECTIVE: Data-driven population segmentation is commonly used in clinical settings to separate the heterogeneous population into multiple relatively homogenous groups with similar healthcare features. In recent years, machine learning (ML) based segmentation algorithms have garnered interest for their potential to speed up and improve algorithm development across many phenotypes and healthcare situations. This study evaluates ML-based segmentation with respect to (1) the populations applied, (2) the segmentation details, and (3) the outcome evaluations. MATERIALS AND METHODS: MEDLINE, Embase, Web of Science, and Scopus were used following the PRISMA-ScR criteria. Peer-reviewed studies in the English language that used data-driven population segmentation analysis on structured data from January 2000 to October 2022 were included. RESULTS: We identified 6077 articles and included 79 for the final analysis. Data-driven population segmentation analysis was employed in various clinical settings. K-means clustering is the most prevalent unsupervised ML paradigm. The most common settings were healthcare institutions. The most common targeted population was the general population. DISCUSSION: Although all the studies did internal validation, only 11 papers (13.9%) did external validation, and 23 papers (29.1%) conducted methods comparison. The existing papers discussed little validating the robustness of ML modeling. CONCLUSION: Existing ML applications on population segmentation need more evaluations regarding giving tailored, efficient integrated healthcare solutions compared to traditional segmentation analysis. Future ML applications in the field should emphasize methods' comparisons and external validation and investigate approaches to evaluate individual consistency using different methods.

Psicólogas(os) no sistema educacional de Boa Vista/Roraima: concepções, práticas e desafios / Psychologists in the educational system of Boa Vista/Roraima: conceptions, practices and challenges / Psicólogas(os) en el sistema educativo de Boa Vista/Roraima: concepciones, prácticas y retos

O objeto de estudo deste trabalho é a atuação de psicólogas(os) no campo da educação básica. Tivemos como objetivo investigar as práticas de atuação e os desafios enfrentados pelas(os) psicólogas(os) que trabalham na educação em Boa Vista (RR), com intuito de conhecer a inserção desses profissionais no sistema educacional. Trata-se de pesquisa qualitativa, orientada pelo referencial teórico-metodológico da Psicologia Escolar Crítica. Realizamos o processo de levantamento dos dados entre os meses de março e abril de 2018, por meio de entrevistas semiestruturadas, audiogravadas e transcritas. Encontramos 21 psicólogas e um psicólogo trabalhando em instituições educacionais e de ensino na cidade; a maioria atuava na educação básica; metade dos entrevistados ingressou por concurso público e a outra metade era contratada e comissionada; poucos(as) foram contratados(as) como psicólogos(as) escolares. Para a análise, selecionamos dez psicólogas(os) com mais tempo no cargo. Quanto às práticas de atuação, identificamos que 60% atuavam na modalidade clínica e 40% na modalidade clínica e institucional. Como desafios, encontramos melhoria das condições de trabalho; estabelecimento de relações hierárquicas e a dificuldade de fazer compreender as especificidades desse campo de trabalho; necessidade na melhoria das condições para formação continuada; atuação da(o) psicóloga(o) escolar enquanto ação institucional. Diante do exposto, compreendemos ser necessária uma mudança de paradigma na atuação das(os) psicólogas(os) que trabalham na educação na região, e a apropriação das discussões da área, principalmente, aquelas apresentadas pela Psicologia Escolar Crítica, vez que esta contribui para uma atuação que leve em conta os determinantes sociais, políticos, culturais e pedagógicos que constituem o processo de escolarização.(AU)

This work has as object of study the role of psychologists in the field of Basic Education. We aimed to investigate practices and challenges faced by psychologists who work in education in Boa Vista/RR, to know the insertion of these professionals in the educational system. This is a qualitative research, guided by the theoretical-methodological framework of Critical School Psychology. The data collection process was carried out between March and April 2018, with semi-structured, audio-recorded, and transcribed interviews. We found 21 female psychologists and one male psychologist working in educational institutions in the municipality; most worked in Basic Education; half of the interviewees had applied to work as government employee and the other half were hired and commissioned; few were hired as school psychologists. To carry out the analysis, we selected ten psychologists with more time in the position. Regarding the practices, we have identified that 60% worked in the clinical modality and 40% in the clinical and institutional modality. As challenges, we find the improvement in working conditions; the establishment of hierarchical relationships and the difficulty of making the specificities of this field of work understood; the need to improve conditions for continuing education; the practice of the school psychologist as institutional action. In view of the above, we understand that a paradigm shift in the performance of psychologists working in education in that region is necessary, and the appropriation of discussions in the area, especially those presented by Critical School Psychology, contributes to an action that considers social, political, cultural, and pedagogical determinants that constitute the schooling process.(AU)

Este trabajo tiene como objeto de estudio la actuación profesional de las(os) psicólogas(os) en la educación básica. Su objetivo es investigar las prácticas y retos que enfrentan las(os) psicólogas(os) que trabajan en la educación en Boa Vista, en Roraima (Brasil), con la intención de conocer la inserción de estos profesionales en el sistema educativo. Esta es una investigación cualitativa que se guía por el marco teórico-metodológico de la Psicología Escolar Crítica. Se recopilaron los datos entre los meses de marzo y abril de 2018, mediante entrevistas semiestructuradas, grabadas en audio y después transcritas. Las 21 psicólogas y un psicólogo trabajan en instituciones educativas de la ciudad; la mayoría trabajaba en la educación básica; la mitad de los entrevistados ingresaron mediante concurso público y la otra mitad era contratada y de puesto comisionado; pocos fueron contratados como psicólogos escolares. Para el análisis, se seleccionaron diez psicólogas(os) con más tiempo en el cargo. Con respecto a las prácticas, el 60% trabajaba en la modalidad clínica; y el 40%, en la modalidad clínica e institucional. Los retos son mejora de las condiciones laborales; establecimiento de relaciones jerárquicas y dificultad para comprender las especificidades de este campo de trabajo; necesidad de mejorar las condiciones para la educación continua; y actuación dela (del) psicóloga(o) escolar como acción institucional. En vista de lo anterior, es necesario el cambio de paradigma en la práctica profesional de las(os) psicólogas(os) que trabajan en la educación de la región y la apropiación de las discusiones del área, especialmente las presentadas por la Psicología Escolar Crítica, que contribuye a una acción que tiene en cuenta los determinantes sociales, políticos, culturales y pedagógicos que constituyen el proceso de escolarización.(AU)

Plan estratégico nacional multisectorial de VIH e ITS 2022-2026 / National multisectoral strategic plan for HIV and STIs 2022-2026

El Plan Estratégico Nacional Multisectorial de VIH e ITS 2022-2026 (PENM 2022-2026) constituye la síntesis del esfuerzo nacional y multisectorial, el cual responde a las necesidades identificadas y expuestas por los diferentes sectores que trabajan la respuesta nacional al VIH, el presente plan permitirá afrontar la prevalencia e incidencia de casos por el Virus de Inmunodeficiencia humana (VIH) y de otras infecciones de transmisión sexual (ITS). El presente plan cuenta con mecanismos de respuesta en los diferentes momentos de la "Cascada del continuo de la atención": diagnóstico, confirmación, vinculación a una clínica de atención integral, retención en el Sistema Nacional Integrado de Salud, promoción de la adherencia al tratamiento en los servicios de salud y supresión viral. Su elaboración se ha basado en una posición consolidada de los compromisos gubernamentales con la respuesta al VIH, manifestada de diversas formas, tales como la sostenibilidad de la respuesta al VIH, posicionamiento político definido y acciones impulsoras de la participación de la sociedad civil y los diferentes actores de la vida social y económica del país

The National Multisectoral Strategic Plan for HIV and STIs 2022-2026 (PENM 2022-2026) constitutes the synthesis of the national and multisectoral effort, which responds to the needs identified and exposed by the different sectors that work the national response to HIV, the present The plan will make it possible to address the prevalence and incidence of cases of the Human Immunodeficiency Virus (HIV) and other sexually transmitted infections (STIs). This plan has response mechanisms at the different moments of the "Cascade of the continuum of care": diagnosis, confirmation, link to a comprehensive care clinic, retention in the National Integrated Health System, promotion of adherence to treatment in health services and viral suppression. Its preparation has been based on a consolidated position of government commitments to the response to HIV, manifested in various ways, such as the sustainability of the response to HIV, a defined political position and actions that promote the participation of civil society and the different actors of the social and economic life of the country

A Blueprint for Change: Guiding Principles for a System of Services for Children and Youth With Special Health Care Needs and Their Families.

Children and youth with special health care needs (CYSHCN) and their families continue to face challenges in accessing health care and other services in an integrated, family-centered, evidence-informed, culturally responsive system. More than 12 million, or almost 86%, of CYSHCN ages 1-17 years do not have access to a well-functioning system of services. Further, the inequities experienced by CYSHCN and their families, particularly those in under-resourced communities, highlight the critical need to address social determinants of health and our nation's approach to delivering health care. To advance the system and prioritize well-being and optimal health for CYSHCN, the Health Resources and Services Administration's Maternal and Child Health Bureau, with input from diverse stakeholders, developed a set of core principles and actionable strategies for the field. This article presents principles and strategies in the Blueprint for Change: Guiding Principles for a System of Services for CYSHCN and Their Families (Blueprint for Change), which acknowledges the comprehensive needs of CYSHCN, a changing health care system, and the disparities experienced by many CYSHCN. Four critical areas drive the Blueprint for Change: health equity, family and child well-being and quality of life, access to services, and financing of services. Although discussed separately, these critical areas are inherently interconnected and intend to move the field forward at the community, state, and federal levels. Addressing these critical areas requires a concerted, holistic, and integrated approach that will help us achieve the goal that CYSHCN enjoy a full life from childhood through adulthood and thrive in a system that supports their families and their social, health, and emotional needs, ensuring their dignity, autonomy, independence, and active participation in their communities.

Pregnancy planning health information and service needs of women with chronic non-communicable conditions: a systematic review and narrative synthesis.

BACKGROUND: Preparing for pregnancy and being in the best possible health before conception improves reproductive outcomes. For women living with a chronic non-communicable disease (NCD), pregnancy planning is essential to allow optimal disease control in preparation for pregnancy. AIM: The aim was to review the literature relating to the pregnancy planning health information and service needs of women with NCDs. METHOD: The MEDLINE (Ovid), Embase (Ovid), Emcare (Ovid), PsycINFO (Ovid), CINAHL and Scopus databases were searched. Studies were included if they were published in peer-reviewed English language journals between January 2010 and June 2020 and reported on the pregnancy planning health information and service needs of women with rheumatic diseases, asthma, cystic fibrosis, depression and/or anxiety, type 1 diabetes mellitus, epilepsy, or multiple sclerosis. Risk of bias was assessed using QualSyst. The characteristics of the studies were tabulated and summarised. Key findings of the included studies were analysed thematically using an inductive approach, where the study findings determined the themes. Findings are reported in a narrative synthesis. RESULTS: The database searches yielded 8291 results, of which 4304 remained after duplicates were removed. After abstract screening 104 full-text papers were reviewed. Of these 15 met inclusion criteria and were included in analysis. The narrative synthesis of the included studies revealed six themes: 'Women with chronic conditions have unmet preconception health information needs', 'Women with chronic conditions want personalised preconception health information', 'Preferred sources of preconception health information', 'Learning from the experiences of other women', 'Improving preconception health discussions with health care professionals', and 'Women want holistic care'. These themes were consistent across all studies, highlighting the similarity of experiences and needs of women with different chronic conditions. CONCLUSION: To improve pregnancy outcomes for women living with NCDs, health care providers need to ask women of reproductive age proactively and routinely about their pregnancy intentions and provide them with personalised advice on how to avoid unplanned pregnancy and be in optimal health when they wish to conceive. PROSPERO registration number CRD42020176308.

Factors Influencing Demand for Medical Cannabis Use among Cancer Patients in the North of Thailand.

OBJECTIVE: Cancer treatments often cause side effects. Cannabis is a plant that has been studied and used to treat and relieve side effects from modern medicine. Medical cannabis (MC) was legalized in Thailand in 2019 with limited research on demand for its use. Therefore, this study aimed to identify factors associated with demand for MC use among cancer patients in the North of Thailand. METHODS: This analytical cross-sectional study administered a multistage random sampling to recruit 1,284 cancer patients in northern Thailand to response a self-administered structured questionnaire. Generalized Linear Mixed Model (GLMM) was used to identify the determinants of demand for MC use among the population, presented adjusted odds ratios (adj.OR), 95% confidence intervals (95% CI), and p-values. RESULT: Nearly half of the respondents reported demand to use MC (44.0%). The factors that were significantly associated with demand to use MC included had high levels of health literacy about MC (adj.OR = 5.70; 95% CI: 4.08 to 7.96), higher levels of social support (adj.OR =5.50; 95% CI: 3.60 to 8.39), positive attitudes toward MC use (adj.OR = 2.56; 95% CI: 1.83 to 3.56), aged less than 30 (adj.OR =1.89; 95% CI: 1.21 to 2.93), diagnosis with cancerfor more than 12 months ago (adj.OR =1.73; 95% CI: 1.19 to 2.52) when controlling effect of other covariates. CONCLUSION: We found substantial demand for MC use among cancer patients. Health literacy,social support, attitudes about MC, age, and duration of having cancer were significantly associated with demand for MC use. Therefore, improving health literacy and social support, especially among older cancer patients, could help increasing demand for MC as a complementary medicine to treat cancers.

Perception and performance of the nursing team in caring for patients with suicide behavior

Objective: to understand the perception and performance of the Nursing team in a hospital emergency service in the care of patients after attempting suicide. Methods: exploratorystudy, with a qualitative approach, carried out through semi-structured interviews with Nursing professionals who work in an Emergency Service. The interviews were transcribed and analyzed as to their content following Bardin's thematic model. Results: seven nurses and four Nursing technicians participated in the study, with an average age of 36 years, most of them female. Suicide attempts are often associated with 'psychic pain' that is opposed to the principles of life preservation; such an attitude has caused suicidal behavior to be misinterpreted by health professionals. Conclusion: most professionals demonstrated a stereotyped 'pre-concept' and full of taboos about patients who attempted suicide, which triggered a service more directed to physical needs and protocol formalities. Few professionals reported carrying out holistic and empathic care, which is so necessary for these people. In this sense, the importance and urgency of training the team in the identification of suicide risks and in the continuity of treatment of surviving individuals is emphasized.

Exploring patient's experience and unmet needs on pregnancy and family planning in rare and complex connective tissue diseases: a narrative medicine approach.

OBJECTIVE: The aim of this work is to explore patient' unmet needs of rare and complex rheumatic tissue diseases (rCTDs) patients during pregnancy and its planning by means of the narrative-based medicine (NBM) approach. METHODS: A panel of nine rCTDs patients' representatives was identified to codesign a survey aimed at collecting the stories of rCTD patients who had one or more pregnancies/miscarriages. The results of the survey and the stories collected were analysed and discussed with a panel of patients' representatives to identify unmet needs, challenges and possible strategies to improve the care of rCTD patients. RESULTS: 129 replies were collected, and 112 stories were analysed. Several unmet needs in the management of pregnancy in rCTDs were identified, such as fragmentation of care among different centres, lack of education and awareness on rCTD pregnancies among midwifes, obstetricians and gynaecologists. The lack of receiving appropriate information and education on rCTDs pregnancy was also highlighted by patients and their families. The need for a holistic approach and the availability specialised pregnancy clinics with a multidisciplinary organisation as well as the provision of psychological support during all the phases around pregnancy was considered also a priority. CONCLUSION: The adoption of the NBM approach enabled a direct identification of unmet needs, and a list of possible actions was elaborated to improve the care of rCTD patients and their families in future initiatives.

Factors associated with the comprehensive needs of caregivers of childhood cancer survivors in Korea.

PURPOSE: Caregivers of childhood cancer survivors (CCS) have diverse needs, which should be addressed to provide comprehensive cancer care. We aimed to evaluate the unmet needs of caregivers of CCS. METHODS: The subjects were 700 caregivers recruited at three major hospitals in South Korea. We collected study data using self-administered questionnaires and a thorough review of medical records. We assessed the unmet needs of caregivers using the comprehensive needs assessment tool for cancer caregivers and evaluated factors associated with the highest tertile range of unmet needs by multiple logistic regression analysis. RESULTS: The greatest unmet needs of caregivers had to do with healthcare staff, followed by information. Compared with father-caregivers, mother-caregivers had greater unmet needs related to health and psychological problems, family/social support, and religious/spiritual support, with odds ratios (95% confidence interval) of 3.79 (2.52-5.69), 3.17 (2.09-4.81), and 1.69 (1.14-2.50), respectively. Compared with caregivers of the youngest CCS (< 6 years), caregivers of CCS aged 12-18 years and caregivers of the oldest CCS (≥ 19 years) respectively showed 2.62 (1.24-5.52) and 3.18 (1.34-7.55) times greater unmet needs for information. Caregivers of CCS who received haematopoietic stem-cell transplantation had a 2.01-fold (1.14-3.57) greater need for practical support. CONCLUSION: Caregivers of CCS had substantial unmet needs required for comprehensive care for CCS. Several individual characteristics of caregivers and their children were significantly associated with greater unmet needs of the caregivers. IMPLICATIONS FOR CANCER SURVIVORS: Personalized support based on the characteristics of both CCS and their caregivers is required to provide comprehensive care for CCS.

Colorectal cancer survival: prevalence of psychosocial distress and unmet supportive care needs.

PURPOSE: The aim of this study was to determine the prevalence of distress and unmet supportive care needs in post-treatment colorectal cancer (CRC) survivors. Also, to explore the association between both variables and to identify potential associated sociodemographic and cancer-related risk factors. METHODS: A cross-sectional study of 200 CRC survivors who at least 1 month before had completed the primary treatment for CRC was conducted. The Brief Symptom Inventory-18 (BSI-18) and the Spanish version of Cancer Survivors' Unmet Needs (S-CaSUN) were used. RESULTS: One in five CRC survivors showed clinical distress and 86% expressed at least one unmet need. Distress was positively associated with the prevalence of needs in all domains. All comprehensive care and information needs were expressed by at least 20% of survivors and some by more than 50%. Other needs also mentioned by 20% of survivors were financial support, ongoing case manager, and concerns about cancer recurrence. The risk factors associated were lower socioeconomic status, younger age, and a primary treatment that includes more than surgery. CONCLUSIONS: The findings highlight the relevance of extending psychosocial care beyond the CRC primary medical treatment. A person-centered approach that addresses informational, emotional, social, and physical needs can increase satisfaction with care and also prevent psychological morbidity in CRC survivors.

Identifying the unmet supportive care needs of people affected by kidney cancer: a systematic review.

PURPOSE: To synthesize existing evidence on the unmet supportive care needs of people affected by kidney cancer, across the cancer care continuum. METHODS: A systematic review was conducted according to the PRISMA Statement Guidelines. Electronic databases (CINAHL, MEDLINE, and PsychINFO) were searched using key search terms. Articles were assessed according to pre-specified eligibility criteria. Data extraction and quality appraisal were conducted. The findings were integrated in a narrative synthesis. RESULTS: One thousand sixty-three publications were screened, and 18 publications met the inclusion criteria. The following domains of unmet needs in order of frequency included psychological/emotional needs (17/18: 94%), physical needs (10/18: 56%), social needs (4/18: 22%), interpersonal/intimacy needs (4/18: 22%), patient-clinician communication needs (3/18: 17%), family-related needs (3/18: 17%), health system/information needs (3/18: 17%), spiritual needs (3/18: 17%), daily living needs (2/18: 11%), practical needs (1/18: 6%), and cognitive needs (1/18: 6%). CONCLUSIONS: There was a wide range of unmet supportive care needs experienced by people diagnosed with kidney cancer. A prominent focus was on psychological and physical needs. Further research is needed to understand how clinical (stage/treatment) and demographic (age/socio-economic/ethnicity) variables may moderate or mediate the relationship with unmet needs over time. With many unmet needs identified, this review provides a starting place to inform future work to address the complex unmet supportive care needs of people affected by kidney cancer. IMPLICATIONS FOR CANCER SURVIVORS: Individuals living with kidney cancer have many unmet supportive care needs, and future research is needed to learn about what are the most pressing needs and how to best address these concerns to ensure holistic person-centered care is delivered.

Práticas educativas em saúde junto aos familiares de crianças com necessidades especiais de saúde: revisão integrativa / Educational practices in health with families of children with special health nedds: integrative review / Prácticas educativas em salud con familias de niños con necesidades especiales de salud: revisión integrativa

Objetivo: identificar a produção científica sobre práticas educativas em saúde junto aos familiares de crianças com necessidades especiais de saúde. Métodos: revisão integrativa da literatura desenvolvida em cinco recursos informacionais nos meses de janeiro e fevereiro de 2021. Resultados: incluíram-se nove artigos na síntese qualitativa, dentre os quais a maioria foi nacional, com delineamento metodológico descritivo e com nível VI de evidência. As práticas educativas em saúde encontradas foram: atividades grupais como rodas de conversa e grupos de diálogo, tecnologias educacionais em formato de cartilha, além de práticas integrativas como massagem e atividades musicais. Conclusão: a literatura científica sobre a adoção de práticas educativas em saúde que auxiliem o cuidado domiciliar às crianças com necessidades especiais e suas famílias ainda é limitada, indicando-se a necessidade de produções que potencializem esta modalidade de assistência. Assim, sugere-se o desenvolvimento de novas pesquisas e desenvolvimento de tecnologias educacionais voltadas para essa temática

Objective: to identify the scientific production on educational practices in health with the families of children with special health needs. Methods: integrative literature review developed in five informational resources in January and February 2021. Results:nine articles were included in the qualitative synthesis, among which the majority were national, with descriptive methodological design and level VI of evidence. The health educational practices found were: group activities such as conversation circles and dialogue groups, educational technologies in booklet format, in addition to integrative practices such as massage and musical activities. Conclusion: the scientific literature on the adoption of educational practices in health that help home care for children with special needs and their families is still limited, indicating the need for productions that enhance this type of care. Thus, the development of new research and development of educational technologies aimed at this theme is suggested

Objetivo: identificar la producción científica sobre prácticas educativas en salud con las familias de niños con necesidades especiales de salud. Métodos: revisión integradora de la literatura desarrollada en cinco recursos informativos en enero y febrero de 2021. Resultados: se incluyeron nueve artículos en la síntesis cualitativa, entre los cuales la mayoría fueron nacionales, con diseño metodológico descriptivo y nivel de evidencia VI. Las prácticas educativas en salud encontradas fueron: actividades grupales como círculos de conversación y grupos de diálogo, tecnologías educativas en formato folleto, además de prácticas integradoras como masajes y actividades musicales. Conclusión: la literatura científica sobre la adopción de prácticas educativas en salud que ayuden a la atención domiciliaria de los niños con necesidades especiales y sus familias es aún limitada, lo que indica la necesidad de producciones que potencien este tipo de atención. Así, se sugiere el desarrollo de nuevas investigaciones y desarrollo de tecnologías educativas orientadas a esta temática

Perfil epidemiológico da clientela que busca atendimento em práticas integrativas e complementares / Epidemiological profile of the clientele that seeks assistance in integrative and complementary practices / Perfil epidemiológico de la clientela que busca asistencia en prácticas integradoras y complementarias

Objetivo: descrever o perfil epidemiológico da clientela que busca atendimento em Práticas Integrativas e Complementares. Método: pesquisa descritiva, tipo corte transversal e abordagem quantitativa, realizado com 104 indivíduos que buscaram atendimento em Práticas Integrativas e Complementares na Universidade Federal Fluminense. Resultados: houve predomínio de jovens de 19 a 30 anos com alta escolaridade. Apesar de 57 (76%) ingerem regularmente a água e 14 (79%) praticam atividade física três ou mais vezes/semana, 14 (18,9%) eram etilistas, sete (9,3%) tabagistas, três (4,2%) consumiam drogas ilícitas e 27 (39,6%) dedicavam-se "nada" ou "muito pouco" ao lazer. Apenas 29 (37,1%) possuíam boa disposição geral, nove (11,8%) bom humor e 10 (9,3%) sentiam-se tranquilos a maior parte do tempo. Apetite e sede normal foram relatados em 43 (56,5%) e 38 (49,3%) respectivamente e 59 (90,7%) exibiram problemas com o sono. Conclusão: o atendimento tem sido buscado pela população que manifesta certo grau de sofrimento mental

Objective: describe the epidemiological profile of the clientele that seeks assistance in Integrative and Complementary Practices. Method: descriptive, cross-sectional research and quantitative approach, conducted with 104 individuals who sought assistance in Integrative and Complementary Practices at Universidade Federal Fluminense. Results: there was a predominance of young people from 19 to 30 years old with high schooling. Although 57 (76%) regularly drink water and 14 (79%) practice physical activity three or more times/week, 14 (18,9%) were alcoholics, seven (9,3%) smokers, three (4,2%) used illicit drugs and 27 (39,6%) devoted "nothing" or "very little" to leisure. Only 29 (37,1%) had good general disposition, nine (11,8%) good mood and 10 (9,3%) felt calm most of the time. Normal appetite and thirst were reported in 43 (56,5%) and 38 (49,3%) respectively and 59 (90,7%) exhibited problems with sleep. Conclusion: care has been sought by the population that manifests a certain degree of mental suffering

Objetivo: describir el perfil epidemiológico de la clientela que busca asistencia en Prácticas Integrativas y Complementarias. Método: enfoque descriptivo, transversal y cuantitativo, realizado con 104 personas que buscaron asistencia en Prácticas Integrativas y Complementarias en la Universidad Federal Fluminense. Resultados: predominó la juventud de 19 a 30 años con estudios secundarios. Aunque 57 (76%) beben regularmente agua y 14 (79%) practican actividad física tres o más veces/semana, 14 (18,9%) eran alcohólicos, siete (9,3%) fumadores, tres (4,2%) usaron drogas ilícitas y 27 (39,6%) dedicaron "nada" o "muy poco" al ocio. Solo 29 (37,1%) tenían buen humor general, nueve (11,8%) estaban de buen humor y 10 (9,3%) se sentían tranquilos la mayor parte del tiempo. Se informaron apetito y sed normales en 43 (56,5%) y 38 (49,3%) respectivamente y 59 (90,7%) exhibieron problemas con el sueño. Conclusión: la población ha buscado atención que manifieste cierto grado de sufrimiento mental

Plan Provincial Integral de salud mental: hacia un sistema solidario e integrado de salud 2022-2027 / Comprehensive Provincial Mental Health Plan: towards a supportive and integrated health system

La integración del sistema de salud de la Provincia de Buenos Aires implica, entre muchas otras cosas, la firme decisión de la integración de la salud mental a la salud en lo que hace a su definición política, comprensión problemática y organización de respuestas frente a las demandas y necesidades. No hay salud sin salud mental, y no es una frase vacía. El Plan Provincial de Salud Mental condensa la decisión y el compromiso del Ministerio de Salud para cuidar la salud mental de nuestra población, conociendo que las formas de sufrimiento y padecimiento mental, entendidas desde su determinación social, obstaculizan la vida de las personas y su necesario aporte a una sociedad inclusiva. Representa a su vez un hito histórico, por ser la primera vez que una gestión provincial elabora un documento de estas características, en donde se plasma la voluntad política de transformar el modelo de atención en salud mental. El plan pretende ser un instrumento que formalice, desencadene y estructure procesos de trabajo colectivos, que requerirán de la participación del conjunto de actores, que en vinculación puedan garantizar más salud y más comunidad. Este Plan ha sido construido receptando un conjunto de necesidades, demandas y vacancias históricas de la política pública. Ha sido producto del diálogo e intercambio con el conjunto de actores que componen el campo de la salud mental. Refleja principios, valores y formas de concebir a la salud mental y, a la vez, convoca a otros actores a sumarse a la tarea de garantizar una atención en salud mental y consumos problemáticos digna y de calidad para los y las bonaerenses.

The integration of the health system of the Province of Buenos Aires implies, among many other things, the firm decision to integrate mental health into health in terms of its political definition, problematic understanding and organization of responses to the demands and needs. There is no health without mental health, and it is not an empty phrase. The Provincial Mental Health Plan condenses the decision and commitment of the Ministry of Health to take care of the mental health of our population, knowing that the forms of suffering and mental illness, understood from its social determination, hinder the lives of people and their necessary contribution to an inclusive society. It also represents a historical milestone, as it is the first time that a provincial administration has prepared a document of these characteristics, where the political will to transform the mental health care model is reflected. The plan intends to be an instrument that formalizes, triggers and structures collective work processes, which will require the participation of all the actors, who in connection can guarantee more health and more community. This Plan has been built by accepting a set of historical needs, demands and vacancies in public policy. It has been the product of dialogue and exchange with the group of actors that make up the field of mental health. It reflects principles, values ​​and ways of conceiving mental health and, at the same time, summons other actors to join in the task of guaranteeing decent and quality mental health care and problematic consumption for the people of Buenos Aires.

A integração do sistema de saúde da Província de Buenos Aires implica, entre muitas outras coisas, a firme decisão de integrar a saúde mental à saúde em sua definição política, compreensão problemática e organização das respostas às demandas e necessidades. Não há saúde sem saúde mental, e não é uma frase vazia. O Plano Provincial de Saúde Mental condensa a decisão e o compromisso do Ministério da Saúde em cuidar da saúde mental de nossa população, sabendo que as formas de sofrimento e doença mental, compreendidas a partir de sua determinação social, dificultam a vida das pessoas e suas necessidades contribuição para uma sociedade inclusiva. Também representa um marco histórico, pois é a primeira vez que uma administração provincial elabora um documento com essas características, onde se reflete a vontade política de transformar o modelo de atenção à saúde mental. O plano pretende ser um instrumento que formalize, acione e estruture processos de trabalho coletivo, que exigirão a participação de todos os atores, que em conexão podem garantir mais saúde e mais comunidade. Este Plano foi construído acolhendo um conjunto histórico de necessidades, demandas e vagas nas políticas públicas. Tem sido produto do diálogo e da troca com o conjunto de atores que compõem o campo da saúde mental. Reflete princípios, valores e formas de conceber a saúde mental e, ao mesmo tempo, convoca outros atores a se unirem na tarefa de garantir cuidados de saúde mental dignos e de qualidade e consumo problemático para os portenhos.

Spiritual Care Needs of Terminal Ill Cancer Patients.

OBJECTIVE: Terminal ill cancer patients experience spiritual distress and need spiritual care. They are in need of palliative care in the long term to alleviate suffering. The aim of the study was to investigate spiritual needs of terminal ill cancer patients. METHODS: This study is a cross-sectional study. The participants were Thai terminal ill cancer patients from seven hospitals in northern, northeast, central, and southern regions of Thailand. Three-hundred-and-twenty-two participants were purposively selected. The instrument used in this study was a spiritual needs scale, consisting of 41 items with 4-point rating scale. Statistical analysis was F-test for one-way analysis of variance. RESULTS: The majority of terminal ill cancer patients aged fifty-one years old. Most of them were females with end stage cancer status that did not respond to treatment. The overall spiritual needs of terminal ill cancer patients were at the moderate level (M = 18.21, SD = 2.56). The highest mean was found in the 'prepare for death' dimension, followed by the 'have meaning, values, and life purposes' and the 'have opportunity to pursue most important things in life' dimensions respectively and had different spiritual needs among status (F(3,318) = 3.66, p < 0.05), number of family members (F(8,313) = 5.07,  p < 0.05), living with family (F(2,319) = 3.91, p < 0.05), and spiritual anchor (F(2,319) = 4.13, p < 0.05). CONCLUSION: The study results provide insight into spiritual needs of terminal ill cancer patients which assists in improving the provision of holistic care to let the patients be happy at end-of-life phase.