Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 333
Filtrar
1.
PLoS One ; 16(9): e0255519, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34495951

RESUMEN

Advances in remote sensing and machine learning enable increasingly accurate, inexpensive, and timely estimation of poverty and malnutrition indicators to guide development and humanitarian agencies' programming. However, state of the art models often rely on proprietary data and/or deep or transfer learning methods whose underlying mechanics may be challenging to interpret. We demonstrate how interpretable random forest models can produce estimates of a set of (potentially correlated) malnutrition and poverty prevalence measures using free, open access, regularly updated, georeferenced data. We demonstrate two use cases: contemporaneous prediction, which might be used for poverty mapping, geographic targeting, or monitoring and evaluation tasks, and a sequential nowcasting task that can inform early warning systems. Applied to data from 11 low and lower-middle income countries, we find predictive accuracy broadly comparable for both tasks to prior studies that use proprietary data and/or deep or transfer learning methods.


Asunto(s)
Aprendizaje Automático , Desnutrición/epidemiología , Pobreza/estadística & datos numéricos , Problemas Sociales/estadística & datos numéricos , Países en Desarrollo/economía , Países en Desarrollo/estadística & datos numéricos , Humanos , Desnutrición/economía , Análisis Multivariante , Prevalencia
2.
J Clin Psychopharmacol ; 41(4): 366-369, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34102649

RESUMEN

BACKGROUND: Given the relative lack of psychiatric information and data on the perpetrators of US mass shootings, the aim of our study was to understand who these "mass shooters" were and whether they had a psychiatric illness. If so, were they competently diagnosed, and if so, were they treated with appropriate medication for their diagnoses before the violence? METHODS: Because a prospective study of diagnosis and treatment could not, for obvious reasons, be carried out, we designed a retrospective, observational study of mass shooters, defined as those who killed 4 or more people with firearms between 1982 and 2012 or who killed 3 or more people with firearms between 2013 and 2019 in the United States. We used the Mother Jones database-a database of 115 persons identified as committing a mass shooting in the United States between January 1982 and September 2019. In the vast majority of the incidents identified in the database, the perpetrator died either during or shortly after the crime, leaving little reliable information about their history-especially psychiatric history. We focused on the 35 mass shooters who survived and for which legal proceedings were instituted because these cases presented the most reliable psychiatric information. For each of these 35 mass shootings, we interviewed forensic psychiatrists and forensic psychologists who examined the perpetrator after the crime and/or collected the testimony and reports by psychiatrist(s) at trial or in the postconviction proceedings contained in the court record. In addition, we reviewed available information from the court proceedings, public records, a videotaped interview of assailant by law enforcement, social media postings of the assailant, and writings of the assailant. After collecting the clinical information from multiple sources on each case to make a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis, we also completed a Sheehan Diagnostic Scale. After this, 20 additional cases where the assailant died at the crime were randomly selected form the remaining 80, to determine whether there were differences in psychiatric diagnoses and treatment between such assailants and those who survived. RESULTS: Twenty-eight of 35 cases in which the assailant survived had a psychiatric diagnosis-18 with schizophrenia, 3 with bipolar I disorders, 2 with delusional disorders, persecutory type, 2 with personality disorders (1 paranoid and 1 borderline), 2 with substance-related disorders without other psychiatric diagnoses, and 1 with posttraumatic stress disorder. Four had no psychiatric diagnosis, and in 3, we did not have enough information to make a diagnosis.Of 15 of 20 cases in which the assailant died, 8 had schizophrenia. None of those diagnosed with psychiatric illnesses were treated with medication. CONCLUSIONS: A significant proportion of mass shooters experienced unmedicated and untreated psychiatric disorder.


Asunto(s)
Armas de Fuego , Cumplimiento de la Medicación/estadística & datos numéricos , Trastornos Mentales , Diagnóstico Erróneo/estadística & datos numéricos , Esquizofrenia , Problemas Sociales , Violencia , Adulto , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Psiquiatría Forense/métodos , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Evaluación de Necesidades , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiología , Esquizofrenia/terapia , Problemas Sociales/prevención & control , Problemas Sociales/psicología , Problemas Sociales/estadística & datos numéricos , Apoyo Social/psicología , Apoyo Social/estadística & datos numéricos , Estados Unidos/epidemiología , Violencia/prevención & control , Violencia/psicología , Violencia/estadística & datos numéricos
3.
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 185-190, dic. 2020.
Artículo en Español | LILACS | ID: biblio-1145464

RESUMEN

Esta revisión narrativa describe el daño colateral de la pandemia de COVID-19, tanto en aspectos de la salud, como también sociales, educativos o económicos. Comunicamos el impacto mundial y local. Consideramos que varias de estas consecuencias eran inevitables, especialmente las sucedidas durante los primeros meses de una pandemia que se difundió a gran velocidad y con graves consecuencias directas en la morbimortalidad de la población. Sin embargo, luego de seis meses de su llegada a la Argentina, es oportuno revaluar la situación y replantearse si no se debería cambiar el enfoque para balancear la minimización del impacto directo de COVID-19 junto con la del daño colateral que las medidas para paliarlo produjeron. Es un desafío que no debe limitarse al sistema de salud. Debe encararse con un abordaje intersectorial amplio y con participación activa de la sociedad. Así como aplanamos la curva de COVID-19, cuanto más nos demoremos en aplanar las otras curvas de problemas sanitarios y sociales que se están generando, mayor será su impacto, tanto en el corto como en el largo plazo. (AU)


This narrative review shows the collateral damage of the COVID-19 pandemic, whether in health, social, educational or economic aspects. We report on the impact at the global and local levels. Many of these consequences were inevitable, especially in the first months of a pandemic that spread at great speed and with serious direct consequences on the morbidity and mortality of the population. However, six months after the arrival in our country, it is an opportunity to reassess the situation and rethink whether the approach should not be changed to balance the minimization of the direct impact of COVID-19 with that of the collateral damage that mitigation measures produced. This is a challenge that should not be limited to the health system. It must be addressed with a broad intersectoral approach and active participation of society. Just as we flatten the COVID-19 curve, the longer we delay in flattening the other curves of health and social problems that are being generated, the greater the impact, both in the short and long term. (AU)


Asunto(s)
Humanos , Neumonía Viral/economía , Infecciones por Coronavirus/economía , Determinantes Sociales de la Salud/estadística & datos numéricos , Argentina , Neumonía Viral/mortalidad , Neumonía Viral/psicología , Calidad de Vida , Aislamiento Social , Problemas Sociales/prevención & control , Problemas Sociales/estadística & datos numéricos , Estrategias de Salud Nacionales , Sistemas de Salud/tendencias , Indicadores de Morbimortalidad , Mortalidad , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/psicología , Impactos de la Polución en la Salud/estadística & datos numéricos , Equidad en el Acceso a los Servicios de Salud , Análisis de las Consecuencias de Desastres , Comunicación en Salud/métodos , Pandemias/estadística & datos numéricos
4.
Pediatrics ; 146(5)2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33097657

RESUMEN

OBJECTIVES: With this study, we seek to understand the relationship between prebirth household challenges and the child's adverse childhood experiences (ACEs) score by age 3 in a statewide-representative birth cohort to inform primary prevention strategies. METHODS: We used a longitudinally linked data set from the Alaska 2009-2011 Pregnancy Risk Assessment Monitoring System, its 3-year follow-up survey, and multiple administrative data sources. Using this linked data set, we predicted an expanded ACEs score by age 3 using maternal reported prebirth household challenges. RESULTS: The number of household challenges reported during the 12 months before or during pregnancy predicted ACEs score in a graded, dose-response manner. On average, reporting 4+ prebirth household challenges was associated with an ACEs score 4.1 times that of those reporting 0 challenges. Homelessness was associated with the greatest increase in ACEs score (relative rate ratio = 3.0). Prebirth household challenges that were independently associated with an elevated ACEs score in our final model included problems paying bills, someone close to the mother having a drinking and/or drug problem, homelessness, mother or husband or partner being in jail, husband or partner losing job, separation or divorce, and being checked or treated for anxiety or depression. CONCLUSIONS: The accumulation and certain prebirth household challenges are strongly associated with the accumulation of childhood ACEs. Addressing and reducing household challenges during the prebirth period may serve as a primary point of ACEs prevention. Many evidence-based, multidisciplinary intervention strategies can and should be implemented in the prebirth period to strengthen the household unit before the introduction of a new child.


Asunto(s)
Experiencias Adversas de la Infancia/estadística & datos numéricos , Composición Familiar , Problemas Sociales/estadística & datos numéricos , Alaska , Preescolar , Estudios de Cohortes , Femenino , Predicción , Humanos , Embarazo , Estudios Retrospectivos , Medición de Riesgo
5.
JAMA Netw Open ; 3(9): e2017682, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32960280

RESUMEN

Importance: Although research has examined factors associated with child sexual exploitation (CSE), consensus is lacking in regard to which factors should be prioritized, thereby hindering policy reform, prevention efforts, and development of early detection and intervention. Objective: To provide a meta-analytic synthesis of studies examining factors associated with CSE and to quantify their relative importance. Data Sources: Electronic databases searched to June 2019 included Medline, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Informit, yielding 396 nonduplicative records. Literature search was performed in July 2019. Study Selection: Inclusion criteria were quantitative investigations of sexual exploitation and mean sample age of 18 years or younger. Data Extraction and Synthesis: Literature review and data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Thirty-seven studies met final inclusion criteria. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive odds ratios (ORs) for each factor. Data were analyzed from September 1 to October 28, 2019, and prediction intervals calculated in June 2020. Main Outcomes and Measures: Child sexual exploitation, defined as coerced sexual acts between a child or a young person (aged ≤18 years) and an individual or a group in exchange for money, gifts, substances, or other commodities and associated factors. Results: Thirty-seven unique studies were included with a total of 67 453 unique participants (mean [SD] age of 16.2 [2.5] years; 49.9% female). Fifty-two factors associated with CSE were included in the meta-analysis. The strongest factors significantly associated with exposure to sexual exploitation were engagement in sexual risk behaviors (OR, 6.31 [95% CI, 3.12-12.76]; P < .001), having more than 5 sexual partners (OR, 5.96 [95% CI, 1.63-21.87]; P = .007), a diagnosis of posttraumatic stress disorder (OR, 5.29 [95% CI, 3.40-8.22]; P < .001), historical exposure to child pornography (OR, 5.50 [95% CI, 0.99-30.53]; P = .049), and a history of childhood sexual abuse (OR, 3.80 [95% CI, 3.19-4.52]; P < .001). A number of other potentially modifiable factors had moderate to strong associations. Conclusions and Relevance: In this systematic review and meta-analysis, children and adolescents affected by sexual exploitation showed high levels of sexual risk taking, multiple sexual partners, posttraumatic stress disorder, exposure to child pornography, and childhood trauma. Accurate detection of CSE may prevent this type of sexual violence occurring to adolescents and/or provide opportunities for intervention and recovery. Therefore, prevention and intervention efforts will likely benefit from integrating these factors into screening, assessment, and treatment.


Asunto(s)
Abuso Sexual Infantil/estadística & datos numéricos , Trabajo Sexual/estadística & datos numéricos , Problemas Sociales/estadística & datos numéricos , Adolescente , Niño , Abuso Sexual Infantil/psicología , Demografía , Femenino , Humanos , Masculino , Trabajo Sexual/psicología , Conducta Sexual/psicología , Problemas Sociales/psicología
6.
Biosystems ; 198: 104229, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32860859

RESUMEN

The article presents a methodology for the analysis of political crises meant to assess the current situation of sociopolitical (in)stability of the developing and developed societies in question, provide an inertial forecast of the developing situation in a given period, analyse threats to stability threats, and examine possible measures to counteract such threats and their likely influence on the situation. The methodology is based on modeling sociopolitical stability in the country in question with the help of an elaborate logical-mathematical model.


Asunto(s)
Recolección de Datos/métodos , Predicción/métodos , Sistemas Políticos/estadística & datos numéricos , Problemas Sociales/estadística & datos numéricos , Factores Sociológicos , Algoritmos , Técnica Delphi , Humanos , Modelos Teóricos , Sistemas Políticos/psicología , Reproducibilidad de los Resultados , Problemas Sociales/prevención & control , Problemas Sociales/psicología , Encuestas y Cuestionarios
7.
J Community Psychol ; 48(5): 1603-1619, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32253766

RESUMEN

This exploratory study aimed to identify the dominant cultural narratives on homelessness in Hawai'i-an area of the United States that has seen a precipitous increase in homelessness amid overall national decline. Because media is a primary way in which these narratives are created, solidified, and perpetuated, this study sought to understand the role the local media played in constructing homelessness narratives during this homelessness "crisis." This study used thematic content analysis of a random sample of 648 articles of Hawai'i media coverage between 2012 and 2017. The analysis found that media coverage of homelessness in Hawai'i emphasized structural-level causes and solutions, while simultaneously relying on stereotypes and stigmatizing characteristics. However, coverage became more complex over time and was open to revision based on new information. This study suggests that media could be a viable target of interventions seeking to produce healthy and accurate narratives.


Asunto(s)
Personas con Mala Vivienda/estadística & datos numéricos , Medios de Comunicación de Masas/estadística & datos numéricos , Hawaii , Personas con Mala Vivienda/legislación & jurisprudencia , Humanos , Problemas Sociales/estadística & datos numéricos
8.
PLoS One ; 15(4): e0231758, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32298388

RESUMEN

BACKGROUND: Homelessness is one of the most disabling and precarious living conditions. The objective of this Delphi consensus study was to identify priority needs and at-risk population subgroups among homeless and vulnerably housed people to guide the development of a more responsive and person-centred clinical practice guideline. METHODS: We used a literature review and expert working group to produce an initial list of needs and at-risk subgroups of homeless and vulnerably housed populations. We then followed a modified Delphi consensus method, asking expert health professionals, using electronic surveys, and persons with lived experience of homelessness, using oral surveys, to prioritize needs and at-risk sub-populations across Canada. Criteria for ranking included potential for impact, extent of inequities and burden of illness. We set ratings of ≥ 60% to determine consensus over three rounds of surveys. FINDINGS: Eighty four health professionals and 76 persons with lived experience of homelessness participated from across Canada, achieving an overall 73% response rate. The participants identified priority needs including mental health and addiction care, facilitating access to permanent housing, facilitating access to income support and case management/care coordination. Participants also ranked specific homeless sub-populations in need of additional research including: Indigenous Peoples (First Nations, Métis, and Inuit); youth, women and families; people with acquired brain injury, intellectual or physical disabilities; and refugees and other migrants. INTERPRETATION: The inclusion of the perspectives of both expert health professionals and people with lived experience of homelessness provided validity in identifying real-world needs to guide systematic reviews in four key areas according to priority needs, as well as launch a number of working groups to explore how to adapt interventions for specific at-risk populations, to create evidence-based guidelines.


Asunto(s)
Vivienda/estadística & datos numéricos , Personas con Mala Vivienda/estadística & datos numéricos , Salud Mental/estadística & datos numéricos , Problemas Sociales/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Canadá/epidemiología , Consenso , Técnica Delphi , Demografía , Personas con Discapacidad/estadística & datos numéricos , Femenino , Personal de Salud , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Pueblos Indígenas/psicología , Pueblos Indígenas/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Refugiados/estadística & datos numéricos , Factores de Riesgo , Problemas Sociales/psicología , Trastornos Relacionados con Sustancias/diagnóstico , Encuestas y Cuestionarios , Migrantes/estadística & datos numéricos , Adulto Joven
9.
PLoS One ; 15(2): e0229385, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32106225

RESUMEN

Stigma and discrimination toward individuals experiencing homelessness and mental disorders remain pervasive across societies. However, there are few longitudinal studies of stigma and discrimination among homeless adults with mental illness. This study aimed to identify the two-year group trajectories of stigma and discrimination and examine the predictive role of mental health characteristics among 414 homeless adults with mental illness participating in the extended follow-up phase of the Toronto At Home/Chez Soi (AH/CS) randomized trial site. Mental health-related perceived stigma and discrimination were measured at baseline, one, and two years using validated scales. Group-based-trajectory modelling was used to identify stigma and discrimination group trajectory memberships and the effect of the Housing First treatment (rent supplements and mental health support services) vs treatment as usual on these trajectories. The associations between mental health-related characteristics and trajectory group memberships were also assessed using multinomial logistic regression. Over two-years, three group trajectories of stigma and discrimination were identified. For discrimination, participants followed a low, moderate, or increasingly high discrimination group trajectory, while for stigma, participants followed a low, moderate or high stigma group trajectory. The Housing First treatment had no significant effect on discrimination or stigma trajectories groups. For the discrimination trajectories, major depressive episode, mood disorder with psychotic features, alcohol abuse, suicidality, severity of mental health symptoms, and substance use severity in the previous year were predictors of moderate and increasingly high discrimination trajectories. History of discrimination within healthcare setting was also positively associated with following a moderate or high discrimination trajectory. For the stigma trajectories, substance dependence, high mental health symptoms severity, substance use severity, and discrimination experiences within healthcare settings were the main predictors for the moderate trajectory group; while substance dependence, suicidality, mental health symptom severity, substance use severity and discrimination experiences within health care setting were also positive predictors for the high stigma trajectory group. Ethno-racial status modified the association between having a major depression episode, alcohol dependence, and the likelihood of being a member of the high stigma trajectory group. This study showed that adults experiencing mental illness and homelessness followed distinct stigma and discrimination group trajectories based on their mental health-problems. There is an urgent need to increase focus on strategies and policies to reduce stigma and discrimination in this population.


Asunto(s)
Personas con Mala Vivienda/psicología , Trastornos Mentales/psicología , Servicios de Salud Mental/normas , Salud Mental , Discriminación Social/estadística & datos numéricos , Problemas Sociales/estadística & datos numéricos , Estigma Social , Adulto , Femenino , Personas con Mala Vivienda/estadística & datos numéricos , Vivienda , Humanos , Masculino , Trastornos Mentales/fisiopatología
11.
Am J Psychiatry ; 177(1): 47-57, 2020 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-31509004

RESUMEN

OBJECTIVE: Adverse childhood experiences (ACEs) are associated with mental and physical health risks that, through biological and psychosocial pathways, likely span generations. Within an individual, telomere length (TL), an established marker of cellular stress and aging, is associated with both ACE exposure and psychopathology, providing the basis for an emerging literature suggesting that TL is a biomarker of the health risks linked to early-life adversity both within and across generations. The authors tested the effect of maternal ACEs on both the trajectory of infant TL and infant social-emotional problems at 18 months of age. METHODS: Pregnant women were recruited, and maternal scores on the Adverse Childhood Experience questionnaire were obtained, along with demographic and prenatal stress measures. Postnatal visits with 155 mother-infant dyads occurred when infants were 4, 12, and 18 months of age. At each visit, infant buccal swabs were collected for TL measurement, and mothers completed measures of maternal depression. Mothers also completed the Child Behavior Checklist at the 18-month visit. Mixed-effects modeling was used to test how maternal ACEs influenced infant TL trajectory. Linear regression was used to test the association between maternal ACEs and infant internalizing and externalizing behaviors. Finally, the interaction between telomere attrition from 4 to 18 months and maternal ACEs was examined as a predictor of infant scores on the Child Behavior Checklist. RESULTS: Higher maternal ACEs were associated with shorter infant TL across infancy and higher infant externalizing behavioral problems at 18 months. No associations were found with internalizing behavioral problems. Telomere attrition from 4 to 18 months interacted with maternal ACEs to predict externalizing behaviors. In infants whose mothers reported higher scores on the Adverse Childhood Experience questionnaire, greater telomere attrition predicted higher externalizing problems, even when accounting for maternal postnatal depression and prenatal stress. CONCLUSIONS: These data demonstrate an interactive pathway between maternal early-life adversity and infant TL that predicts emerging behavioral problems in the next generations.


Asunto(s)
Síntomas Afectivos/epidemiología , Hijo de Padres Discapacitados/psicología , Problemas Sociales/estadística & datos numéricos , Acortamiento del Telómero , Adulto , Biomarcadores/metabolismo , Maltrato a los Niños , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Estudios Prospectivos , Psicopatología
12.
Adv Gerontol ; 32(4): 664-667, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31800198

RESUMEN

The article presents the results of the analysis of the needs of long-lived people with disabilities in medical and social care, reflects the problems that arise in this contingent of persons when it is necessary to address the issues of medical and social rehabilitation. A medical and social examination of 238 long-lived patients undergoing inpatient treatment in a geriatric medical organization was carried out. The most frequent deviations from the norm in laboratory and instrumental methods of research are revealed. Screening of «Age is no obstacle¼, which revealed the presence of cognitive disorders and depression in a significant number of investigated and their dependence on others. Emphasized the importance of participation of bodies of social protection of the population in solving the problems of the aged.


Asunto(s)
Personas con Discapacidad , Problemas Sociales , Anciano , Disfunción Cognitiva/epidemiología , Disfunción Cognitiva/rehabilitación , Depresión/epidemiología , Depresión/rehabilitación , Personas con Discapacidad/estadística & datos numéricos , Humanos , Problemas Sociales/estadística & datos numéricos
13.
Am J Mens Health ; 13(6): 1557988319882589, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31779511

RESUMEN

Globally, rape is regarded as the most demoralizing type of trauma, and it has negative implications for victims and their families. Although rape affects the community in general, there is a paucity of literature on rape victimization of men. As a result, the types of rape experienced by them are not understood, and thus it is often difficult to develop contextually relevant interventions to prevent male rape and to support male rape victims. The objective of this study was to first determine and then describe, the types of rape experienced by men. An interpretative phenomenological analysis (IPA) qualitative approach was used to collect and analyze data from a purposive sample of 11 participants, using semistructured individual interviews. The findings of the study reveal six themes and related subthemes as six types and related subtypes of rape experienced by men as follows: acquaintance rape, including familial rape; stranger rape; gang rape, including corrective-gang rape, drug-facilitated gang rape, pack-hunting rape, women retributive rape (or women vengeance) for violence experienced from men; homophobic rape; prison rape, including transactional rape and gang initiation rape; and armed rape. The findings reveal the different contexts or settings where men are vulnerable to rape. This highlights the possibilities for the development of context-specific sexual violence prevention interventions for men, which include self-defense training and awareness campaigns specific to rape victimization of men. Furthermore, future studies are recommended to expose this pandemic. Activism is advocated to stop the silence around this public and social health issue.


Asunto(s)
Víctimas de Crimen/estadística & datos numéricos , Prevención Primaria/organización & administración , Violación/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Problemas Sociales/ética , Adolescente , Adulto , Víctimas de Crimen/psicología , Humanos , Incidencia , Masculino , Narración , Evaluación de Necesidades , Violación/prevención & control , Violación/psicología , Delitos Sexuales/prevención & control , Delitos Sexuales/estadística & datos numéricos , Conducta Sexual/ética , Problemas Sociales/estadística & datos numéricos , Sudáfrica , Adulto Joven
14.
Int J Equity Health ; 18(1): 101, 2019 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-31262310

RESUMEN

BACKGROUND: People experiencing homelessness are often marginalized and are known to face barriers to accessing acceptable and respectful healthcare services. This study examines the experience of accessing hospital-based services of persons experiencing homelessness or vulnerable housing in southeastern Ontario and considers the potential of Equity-Oriented Health Care (EOHC) as an approach to improving care. METHODS: Focus groups and in-depth interviews with people with lived experience of homelessness (n=31), as well as in-depth interviews of health and social service provider key informants (n=10) were combined with qualitative data from a survey of health and social service providers (n=136). Interview transcripts and written survey responses were analyzed using directed content analysis to examine experiences of people with lived experience of homelessness within the healthcare system. RESULTS: Healthcare services were experienced as stigmatizing and shaming particularly for patients with concurrent substance use. These negative experiences could lead to avoidance or abandonment of care. Despite supposed universality, participants felt that the healthcare system was not accountable to them or to other equity-seeking populations. Participants identified a system that was inflexible, designed for a perceived middle-class population, and that failed to take into account the needs and realities of equity-seeking groups. Finally, participants did identify positive healthcare interactions, highlighting the importance of care delivered with dignity, trust, and compassion. CONCLUSIONS: The experiences of healthcare services among the homeless and vulnerably housed do not meet the standards of universally accessible patient-centered care. EOHC could provide a framework for changes to the healthcare system, creating a system that is more trauma-informed, equity-enhancing, and accessible to people experiencing homelessness, thus limiting identified barriers and negative experiences of care.


Asunto(s)
Atención a la Salud/estadística & datos numéricos , Equidad en Salud/estadística & datos numéricos , Personas con Mala Vivienda/estadística & datos numéricos , Problemas Sociales/estadística & datos numéricos , Servicio Social/estadística & datos numéricos , Poblaciones Vulnerables/estadística & datos numéricos , Grupos Focales , Humanos , Ontario , Encuestas y Cuestionarios
15.
Am J Addict ; 28(2): 111-118, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30701620

RESUMEN

BACKGROUND AND OBJECTIVES: Prescription opioid misuse has not been well examined in the context of comorbid substance use in representative samples of substance users. Past 30-day comorbid prescription opioid misuse and recreational substance use (eg, alcohol, marijuana, cocaine, etc.) was studied in a representative sample of substance users in the United States using the 2016 National Survey on Drug Use and Health (NSDUH). METHODS: Prevalence of prescription opioid misuse with and without comorbid substance use was estimated with the 2016 NSDUH. Generalized linear modeling was used to describe demographic correlates of opioid and comorbid substance use and explore the relation of opioid and comorbid substance use with social and behavioral health indicators. RESULTS: The majority of past month prescription opioid misusers reported use of other substances including cigarettes, alcohol, marijuana, or hard drugs (cocaine, methamphetamine, etc.). Males and younger respondents had a significantly higher risk of reporting past month prescription opioid misuse with illicit drug or polydrug use (p's < .01). Prescription opioid and polydrug users had the greatest odds of stealing property, selling drugs, having suicidal ideations, major depressive episode, and perceived treatment need in the past year compared to all other categories of prescription opioid misuse categories. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Prescription opioid misuse is likely a part of a larger set of psychological, behavioral, and mental health problems. More attention should be given to the profiles of recreational (non-medical) substance use involving prescription opioids to curtail the current opioid crisis and prevent other similar epidemics in the future. (Am J Addict 2019;XX:1-8).


Asunto(s)
Trastorno Depresivo Mayor/epidemiología , Diagnóstico Dual (Psiquiatría)/estadística & datos numéricos , Drogas Ilícitas , Mal Uso de Medicamentos de Venta con Receta , Trastornos Relacionados con Sustancias , Adulto , Analgésicos Opioides/uso terapéutico , Comorbilidad , Consumidores de Drogas/psicología , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Mal Uso de Medicamentos de Venta con Receta/psicología , Mal Uso de Medicamentos de Venta con Receta/estadística & datos numéricos , Prevalencia , Problemas Sociales/prevención & control , Problemas Sociales/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Estados Unidos/epidemiología
16.
S Afr Med J ; 109(11b): 69-76, 2019 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-32252872

RESUMEN

For several decades, researchers from the South African Medical Research Council have made invaluable contributions towards improving the health of the population through the analysis and interpretation of cause of death data. This article reflects the mortality trends in pre-and post-apartheid South Africa (SA), and describes efforts to improve vital statistics, innovations to fill data gaps, and studies to estimate the burden of disease after adjusting for data deficiencies. The profound impact of HIV/AIDS, particularly among black African children and young adults, is striking, within a protracted epidemiological transition and the current reversals of multiple epidemics. Over the next 20 years, it will be important to sustain and enhance the country's capacity to collect, analyse and utilise cause of death data. SA needs to support development in the region, harnessing new data platforms and approaches such as including verbal autopsy tools in the official system and improving data linkage.


Asunto(s)
Causas de Muerte/tendencias , Epidemias , Mortalidad/tendencias , Problemas Sociales/estadística & datos numéricos , Estadísticas Vitales , Síndrome de Inmunodeficiencia Adquirida/etnología , Síndrome de Inmunodeficiencia Adquirida/mortalidad , Adolescente , Adulto , Anciano , Apartheid , Población Negra , Enfermedades Cardiovasculares/etnología , Enfermedades Cardiovasculares/mortalidad , Niño , Preescolar , Enfermedades Transmisibles/etnología , Enfermedades Transmisibles/mortalidad , Recolección de Datos , Diabetes Mellitus/etnología , Diabetes Mellitus/mortalidad , Carga Global de Enfermedades , Infecciones por VIH/etnología , Infecciones por VIH/mortalidad , Humanos , Lactante , Persona de Mediana Edad , Mortalidad/etnología , Neoplasias/etnología , Neoplasias/mortalidad , Sudáfrica/epidemiología , Población Blanca , Adulto Joven
17.
Acta Paediatr ; 108(6): 1087-1095, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30496622

RESUMEN

AIM: The aim of this study was to investigate mental health with respect to social-emotional problems among three-year-olds in relation to their gender, custody arrangements and place of residence. METHODS: A cross-sectional population-based design was used, encompassing 7179 three-year-olds in northern Sweden during the period 2014-2017 from the regional Salut Register. Descriptive and comparative analyses were performed based on parents' responses on the Ages and Stages Questionnaires: Social-Emotional, supplemented with items on gender, custody arrangement and place of residence. RESULTS: Parental-reported social-emotional problems were found in almost 10% of the children. Boys were reported to have more problems (12.3%) than girls (5.6%; p < 0.001). Parents were most concerned about children's eating habits and interactions at mealtimes. Parents not living together reported more problems among their children than those living together (p < 0.001). When stratifying by custody arrangement, girls in rural areas living alternately with each parent had more problems compared to those in urban areas (p < 0.008). CONCLUSION: Gender and custody arrangements appear to be important factors for social-emotional problems among three-year-olds. Thus, such conditions should receive attention during preschool age, preferably by a systematic preventive strategy within Child Health Care.


Asunto(s)
Custodia del Niño , Emociones , Trastornos Mentales/epidemiología , Características de la Residencia , Problemas Sociales/estadística & datos numéricos , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Factores Sexuales , Suecia
18.
Ital J Pediatr ; 44(1): 146, 2018 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-30514334

RESUMEN

Gambling disorder (GD) is a psychiatric condition and it is characterized by a maladaptive pattern of gambling behavior that persists despite negative consequences in major areas of life functioning. In Italy, CNR (National Research Council) underlined how over 17 million, 42.8% of the population aged 15-64 have a gambling behavior. Among them, there are over one million students, aged 15-19, equal to 44.2% of Italian students; the number of minors in Italy with GD in 2017 was 580,000, equal to 33.6%. Various psychosocial treatment models have been adapted for GD; on the other hand no drug has received regulatory approval in any jurisdiction as a specific psychopharmacological treatment for GD. Family therapy interventions for treatment of substance abuse problems have been adapted for adolescents GD. Given the increasing overall prevalence of adolescent gambling, it is imperative that Pediatricians appreciate that gambling problems can also afflict adolescents. In conclusion underage gambling appears to be associated positively with alcohol, tobacco and other substance use, as well as with other individual behaviors, therefore we need that collaborative efforts between scientific societies, government and stake holders can influence the uptake of research findings necessary to implement social policies and design effective public health intervention options. Educational-based problem gambling prevention programs are important avenues in targeting at-risk behaviors among adolescents to prevent an escalation of problematic behaviors into adulthood.


Asunto(s)
Conducta del Adolescente/psicología , Juego de Azar/epidemiología , Juego de Azar/terapia , Problemas Sociales/prevención & control , Adolescente , Juego de Azar/psicología , Humanos , Italia , Asunción de Riesgos , Problemas Sociales/estadística & datos numéricos , Adulto Joven
19.
Child Psychiatry Hum Dev ; 49(5): 757-765, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29508120

RESUMEN

Since after the second world war there has been an increasing number of studies investigating secular changes in adolescent mental health. Although no general trends could be outlined, the majority of studies show at least partial deterioration of psychological wellbeing from year 2000 on. Our study adds to this knowledge by exploring changes in self-declared emotional and behavioral problems in Poland, which is a part of post-communist Europe. In this paper, we compared responses on the Youth Self-Report by Polish 16-year-olds from 2000 and those from 2011. Two independent samples consisted of 259 (year 2000) and 185 (year 2011) 16-year-olds of both genders, drawn from randomized, normative, school-based groups. We analyzed linear, ordinal and binary logistic regression models. The results revealed that teenagers from 2011 reported more self-rated internalizing and total problems. Social and thought problems also rose significantly. Gender related time trends hint at a male increase in externalizing, aggressive behaviors and anxiety/depression. Caseness rose significantly in most scales with female gender being an additional risk factor for internalizing and total problems. No reduction in self-reported emotional and behavioral problems was detected.


Asunto(s)
Síntomas Afectivos/psicología , Salud Mental/estadística & datos numéricos , Problema de Conducta/psicología , Adolescente , Agresión , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Factor F , Femenino , Humanos , Masculino , Polonia/epidemiología , Factores de Riesgo , Autoinforme , Problemas Sociales/psicología , Problemas Sociales/estadística & datos numéricos
20.
Am Psychol ; 73(2): 157-168, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29369661

RESUMEN

Income inequality has become one of the more widely debated social issues today. The current article explores the role of progressive taxation in income inequality and happiness. Using historical data in the United States from 1962 to 2014, we found that income inequality was substantially smaller in years when the income tax was more progressive (i.e., a higher tax rate for higher income brackets), even when controlling for variables like stock market performance and unemployment rate. Time lag analyses further showed that higher progressive taxation predicted increasingly lower income inequality up to 5 years later. Data from the General Social Survey (1972-2014; N = 59,599) with U.S. residents (hereafter referred to as "Americans") showed that during years with higher progressive taxation rates, less wealthy Americans-those in the lowest 40% of the income distribution-tended to be happier, whereas the richest 20% were not significantly less happy. Mediational analyses confirmed that the association of progressive taxation with the happiness of less wealthy Americans can be explained by lower income inequality in years with higher progressive taxation. A separate sample of Americans polled online (N = 373) correctly predicted the positive association between progressive taxation and the happiness of poorer Americans but incorrectly expected a strong negative association between progressive taxation and the happiness of richer Americans. (PsycINFO Database Record


Asunto(s)
Felicidad , Impuesto a la Renta/estadística & datos numéricos , Renta/estadística & datos numéricos , Problemas Sociales/psicología , Problemas Sociales/estadística & datos numéricos , Factores Socioeconómicos , Humanos , Pobreza/psicología , Pobreza/estadística & datos numéricos , Estados Unidos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA