My Best Alaskan Life: Addressing Adolescent Mental and Reproductive Health in Alaska.

INTRODUCTION: Since 2020, a multisector research team has coordinated a youth-driven, community-based participatory research project to adapt a reproductive life plan for application in a statewide initiative called My Best Alaskan Life (MBAL). The RLP is adapted for Alaskan youth and is intended to support teens in decision-making processes reflecting cultural priorities, personal goals, and sexual and reproductive health. Background. With 46% of youth in Alaska reporting not having used a condom during their last sexual intercourse and 15% not having used contraception, unintended pregnancy and transmission of STIs will continue. Furthermore, Alaskan youth also cite high rates of hopelessness and suicidality, and research shows that poor mental health among adolescents is correlated with developing and maintaining high-risk sexual behaviors. An intervention focusing on supporting mental wellness and developing personal goals in the context of sexual health decision-making may encourage adolescents to adopt safer sexual health behaviors. METHODS: The MBAL research team completed a statewide pilot assessing the design and implementation of the tool, gathering feedback from over 700 survey responses (youth, ages 14-20); conducted 10 in-depth interviews (adult partners at community organizations and clinics); and hosted two youth-led design review sessions. FINDINGS: Questionnaire respondents were overwhelmingly positive about the tool (91% "liked or loved" the tool) and its potential applicability in their community (86% cited "very applicable"). Project next steps include incorporating design recommendations, a statewide randomized control trial and ultimately, open source access for all interested parties.

Patient-reported outcomes in adults after status epilepticus: A systematic review.

Impairments after status epilepticus have generally been assessed by physicians, using generic scales. Patient-reported outcomes (PROs) directly reflect each patient's experience and are therefore recommended to improve patient-centered care. The objective of this systematic review was to compile the available information on patient-reported outcomes of adults after status epilepticus. We used Medical Subject Headings terms to search PubMed, Embase, and the Cochrane Library from database inception to February 2023. We excluded reviews, case reports, abstract-only reports, editorials, and publications in languages other than English or French. Studies reporting PROs in adults after SE were eligible. Bias in included studies was assessed using the Newcastle-Ottawa Scale (NOS). Given the heterogeneity in assessment tools and outcomes, most of the results are presented separately for each included study. Only three studies met our criteria. All used an observational cohort design. Two were retrospective and one prospective. Of the 141 patients (76 males and 65 females, mean age 43-63 years), 105 (74.4 %) had a history of epilepsy before status epilepticus. The studies used four epilepsy-specific and five generic tools to assess five patient-reported outcomes: quality of life (n = 141), mental health (depression, n = 81, or anxiety, n = 49), physical health including fatigue (n = 130), return to work (n = 49), and side effects of antiepileptic drugs (n = 81). A single study (n = 81) was of good methodological quality. Health-related quality of life (HRQOL) and mental health were the most extensively studied outcomes, and both were impaired. HRQOL scores ranged from 41.7 ±â€¯11.5 to 48.3 ±â€¯24.5. The prevalence of depression and anxiety varied from 30 % to 36 %, and from 22 % to 62 %, respectively. However, data were not collected before the status epilepticus episode, and the possible impact of this last on the outcomes cannot therefore be assessed. Information on PROs of adults after status epilepticus is extremely scant. Patient-reported outcomes should be collected more widely in adults after status epilepticus.

Macro level system mapping of the provision of mental health services to young people living in a conflict context in Colombia.

Colombia has one of the longest running internal armed conflicts, which has significantly impacted the mental health of the population. This article is the first to present a national level mapping of the provision of mental health services to young people living in Colombia, through detailed review of documentation, interviews with key stakeholders and quantitative analysis of existing data on mental health and suicide. It explores the existing public mental health provision in the country, focussing on where mental health resources are concentrated and how these are implemented. We use this mapping to understand how the current mental health system in Colombia fits with international approaches to youth mental health. We show that whilst mental health policy is variously framed (biomedical, biosocial, psychologically or through human rights), Colombian policy clearly focusses on a differential approach. This differential approach shapes service provision to target support at those in need, consequently neglecting whole population level mental health support. This means that not all stakeholders were clearly articulated or included in policy and that key institutional stakeholders, such as the education sector, were not linked to implementation plans or activity. Policy approaches were also over-centralised with little cross-institutional collaboration. Youth were specifically missing from services, as was explicit understanding of the intergenerational effects and impact of conflict. This was exacerbated by unequal distribution of mental health care services concentrated in populous, urban areas away from conflict-affected regions. Suicide is the second most prevalent cause of death with 10% of population who were recorded as dying by violence, dying from completed suicide. Triangulation implies a strong relationship between suicide and poorer access to professional support in conflict-affected areas and suggests that international frameworks and policy approaches to supporting youth mental health have been insufficiently adapted for conflict and post conflict contexts.

Transtornos mentais em profissionais de enfermagem na pré-vacinação da pandemia COVID-19 / Mental disorders in nursing professionals in the pre-vaccination period of the COVID-19 pandemic / Trastornos mentales en profesionales de enfermería antes de la vacunación de la pandemia COVID-19

Objetivo: identificar os fatores associados à ocorrência de transtornos mentais em profissionais de enfermagem atuantes em instituições hospitalares no período de pré-vacinação na pandemia COVID-19. Método: estudo multicêntrico de abordagem quantitativa, transversal, descritivo e analítico, desenvolvido com 859 profissionais de enfermagem, atuantes em três instituições hospitalares de ensino brasileiras, que responderam ao formulário de coleta de dados, entre novembro de 2020 e fevereiro de 2021. Resultados: evidenciou-se a ocorrência de 358 (41,9%) profissionais diagnosticados com COVID-19, sendo que 128 (44,14%) relataram a ocorrência de transtornos mentais (p<0,05). Conclusão: diabetes e doença autoimune, assim como a assistência direta a pacientes com COVID-19, estiveram associadas à ocorrência de sintomas de transtornos mentais em profissionais de enfermagem.

Objective: to identify factors associated with the occurrence of mental disorders in nursing professionals working in hospitals in the pre-vaccination period during the COVID-19 pandemic. Method: multicenter study with a quantitative, cross-sectional, descriptive and analytical approach, developed with 859 nursing professionals, working in three Brazilian teaching hospital institutions, who answered the data collection form, between November 2020 and February 2021. Results: the occurrence of 358 (41.9%) professionals diagnosed with COVID-19 was evidenced, with 128 (44.14%) reporting the occurrence of mental disorders (p<0.05). Conclusion: diabetes and autoimmune disease, as well as direct assistance to patients with COVID-19, were associated with the occurrence of symptoms of mental disorders in nursing professionals.

Objetivo: identificar los factores asociados a la incidencia de trastornos mentales en profesionales de enfermería que trabajan en hospitales en el período previo a la vacunación durante la pandemia de COVID-19. Método: estudio multicéntrico con enfoque cuantitativo, transversal, descriptivo y analítico, desarrollado junto a 859 profesionales de enfermería que trabajan en tres instituciones hospitalarias brasileñas de enseñanza y que respondieron el formulario de recolección de datos, entre noviembre de 2020 y febrero de 2021. Resultados: Se evidenció la incidencia de 358 (41,9%) profesionales diagnosticados con COVID-19, siendo que 128 (44,14%) informaron la aparición de trastornos mentales (p<0,05). Conclusión: la diabetes y las enfermedades autoinmunes, así como la asistencia directa a pacientes con COVID-19, se asociaron con la aparición de síntomas de trastornos mentales en profesionales de enfermería.

Knowledge, confidence, and practices of clinical associates in the management of mental illness.

Background: Additional human resources are needed to provide mental health services in underserved areas in South Africa (SA). Clinical associates, the mid-level medical worker cadre in SA, could potentially be used to deliver these services. Aim: The study explored the self-reported knowledge, confidence, and current practices of clinical associates related to mental health assessment and management. Setting: South Africa. Methods: A cross-sectional study was conducted. The link to the electronic questionnaire was distributed to clinical associates via databases and social media. Data were analysed with Stata v17. Results: Of the 209 participants, 205 (98.1%) indicated they had training on management of patients with mental illness during their undergraduate degree and 192 (91.9%) had a mental health rotation. Few (10.7%) had any additional mental health training. Most participants rated their knowledge of priority mental disorders as 'good' or 'excellent'. Only 43.2% of the participants felt quite or very confident to perform a mental health examination. Participants who felt quite or very confident to manage patients presenting with suicide risk, aggression, and confusion were 44.9%, 46.9% and 53.1%, respectively. Factors associated with a confidence score of 75% and higher were male gendered, working in Gauteng or Northern Cape provinces, and in a rural area. The majority of participants were already involved in mental health assessment and management in their current work. Conclusion: Clinical associates have a contribution to make in mental health service provision, but this may need to be supplemented by additional practical training. Contribution: Potential gaps in training have been identified.

Adolescents' lived experiences of substance abuse in the Greater Giyani Municipality.

BACKGROUND:  Adolescence is a unique and distinct stage of development that involves changes in the physical, psychological and social aspects of adolescents. It is a critical transition into adulthood whereby heightened risk-taking and sensation-seeking takes place, such as substance abuse. In a South African context, this transition sometimes occurs under economic stress, poverty, unemployment, high levels of crime and political instability. This can place adolescents at risk of substance abuse. OBJECTIVES:  To explore and describe the lived experiences of adolescents abusing substances in the Greater Giyani Municipality in the Limpopo province, South Africa. METHOD:  A qualitative, exploratory, descriptive and contextual research design with a phenomenological approach was used. Data were collected through individual, in-depth, phenomenological interviews and field notes. Thematic coding was utilised to analyse the collected data, and literature was reviewed to support the findings. Moreover, measures to ensure trustworthiness and ethical principles were applied throughout the research process. RESULTS:  Five themes were identified: substance abuse behaviour among adolescents, adolescents' motivation for continuing substance abuse, the effects of substance abuse on the lives of adolescents, factors affecting adolescents' discontinuation of substance abuse and a need to discontinue substance abuse. CONCLUSION:  The study concluded that adolescents abusing substances in the Greater Giyani, Limpopo province, experience loss of control, broken relationships, poor academic performance, stigma attached to mental illness and negative emotions. The adolescents foresaw their future as uncertain and without direction. It is recommended that mental healthcare professionals introduce and implement interventions that will assist the adolescents who abuse substances in the Greater Giyani, Limpopo province.Contribution: The findings in this study could add knowledge in developing and implementing of strategies for psychiatric nurses to support adolescents abusing substances in the Greater Giyani, Limpopo province.

Entre o adoecimento e trabalho: ações de qualidade de vida no âmbito de saúde mental / Between illness and work: quality of life actions in the field of mental health / Entre enfermedad y trabajo: acciones de calidad de vida en el campo de la salud mental

Objetivo: descrever sobre o processo de saúde e doença nos profissionais de saúde mental. Metodologia: Trata-se de uma revisão integrativa da literatura, utilizando estratégia PICo e descritores. Consultou-se por meio de descritores bases de dados internacionais, como a National Library of Medicine; Biblioteca Virtual da Saúde (BVS), SCOPUS; e busca livre no Google Acadêmico. Resultados: Foram selecionados 14 estudos que atendiam a questão norteadora, os estudos abordavam sobre os profissionais de saúde mental e fatores que influenciam no desequilíbrio dos processos de saúde e doenças, e as ações e estratégias por parte dos profissionais, dos serviços, e de políticas para enfrentamento dos desafios no ambiente de trabalho e para promover a qualidade de vida dos profissionais de saúde mental. Nota-se que a compreensão da problemática e o uso de estratégias individuais e coletivas tem efeito positivo sobre os profissionais, estimulando a criatividade e autonomia dos mesmos e possibilitando a resolução de problemas que poderiam comprometer o bem estar de trabalhadores e clientes, além de tornar o ambiente de trabalho agradável. Conclusão: O estudo possibilitou expandir os conhecimentos acerca dos profissionais que trabalham com pacientes que apresentam transtornos mentais e os problemas enfrentados por eles. Dessa forma, mais pesquisas devem ser realizadas nesta linha de investigação, a fim de provar a importância de estratégias voltadas à saúde destes profissionais e dissipar preconceitos que envolvem a saúde mental.

Objective: to describe the process of health and illness in mental health professionals. Methodology: This is an integrative literature review, using the PICo strategy and descriptors. International databases were consulted using descriptors, such as the National Library of Medicine; Virtual Health Library (VHL), SCOPUS; and free search on Google Scholar. Results: 14 studies were selected that met the guiding question, the studies addressed mental health professionals and factors that influence the imbalance of health and disease processes, and the actions and strategies on the part of professionals, services, and policies to face challenges in the work environment and to promote the quality of life of mental health professionals. It is noted that the understanding of the problem and the use of individual and collective strategies have a positive effect on professionals, stimulating their creativity and autonomy and enabling the resolution of problems that could compromise the well-being of workers and clients, in addition to making pleasant work environment. Conclusion: The study made it possible to expand knowledge about professionals who work with patients who have mental disorders and the problems they face. Thus, more research should be carried out in this line of investigation, in order to prove the importance of strategies aimed at the health of these professionals and to dispel prejudices involving mental health.

Objetivo: describir el proceso de salud y enfermedad en profesionales de salud mental. Metodología: Se trata de una revisión integrativa de la literatura, utilizando la estrategia y los descriptores PICo. Se consultaron bases de datos internacionales mediante descriptores, como la Biblioteca Nacional de Medicina; Biblioteca Virtual en Salud (BVS), SCOPUS; y búsqueda gratuita en Google Scholar. Resultados: fueron seleccionados 14 estudios que atendieron a la pregunta orientadora, los estudios abordaron los profesionales de la salud mental y los factores que influyen en el desequilibrio de los procesos de salud y enfermedad, y las acciones y estrategias por parte de los profesionales, servicios y políticas para enfrentar los desafíos en la ambiente de trabajo y promover la calidad de vida de los profesionales de la salud mental. Se observa que la comprensión del problema y el uso de estrategias individuales y colectivas tienen un efecto positivo en los profesionales, estimulando su creatividad y autonomía y posibilitando la resolución de problemas que puedan comprometer el bienestar de los trabajadores y clientes, además de haciendo un ambiente de trabajo agradable. Conclusión: El estudio permitió ampliar el conocimiento sobre los profesionales que actúan con pacientes que presentan trastornos mentales y los problemas que enfrentan. Por lo tanto, se deben realizar más investigaciones en esta línea de investigación, con el fin de demostrar la importancia de las estrategias dirigidas a la salud de estos profesionales y disipar los prejuicios que involucran la salud mental.

Estratégias de promoção à saúde mental no trabalho de enfermagem hospitalar: revisão integrativa* / Estrategias de promoción de la salud mental em el trabajo de enfermería hospitalaria: revisión integrativa / Strategies for promoting mental health in hospital nursing work: integrative review

Objetivo: identificar estratégias de promoção à saúde mental dos trabalhadores de enfermagem hospitalar disponíveis na literatura. Método: revisão integrativa desenvolvida por meio de acesso a fontes de informação online. Foram incluídos estudos disponíveis na íntegra entre 2012 e 2022 em português, inglês ou espanhol. Realizada seleção em duplo-cego, apresentação descritiva dos resultados e interpretação à luz do referencial teórico-conceitual. Resultados: onze artigos apontam estratégias individuais focadas no treinamento de habilidades, teleassistência e programas de fortalecimento da resiliência que reduziram sintomas de depressão, ansiedade, estresse, burnout, rotatividade e elevaram satisfação no trabalho, estilos de vida saudáveis, bem-estar e saúde geral. Conclusão: as estratégias para promoção da saúde mental no trabalho mantêm o seu enfoque no indivíduo, e não envolvem aspectos organizacionais e coletivos do trabalho, denotando insuficiência ao não enfocar causas centrais do problema. As intervenções devem ser direcionadas a sanar tal lacuna para promover ambientes de trabalho mais saudáveis.

Objective: identify strategies for promoting the mental health of hospital nursing workers available in the literature. Method: integrative review developed through access to online information sources. Studies available entirely between 2012 and 2022 in Portuguese, English or Spanish were included. Double-blind selection was carried out, as well as descriptive presentation of results and interpretation in light of the theoretical-conceptual framework. Results: eleven articles point to individual strategies focused on skills training, teleassistance and resilience-building programs that reduced symptoms of depression, anxiety, stress, burnout and turnover, and increased job satisfaction, healthy lifestyles, well-being and general health. Conclusion: strategies for promoting mental health at work maintain their focus on the individual, and do not involve organizational and collective aspects of work, denoting insufficiency by not concentrating on the central causes of the problem. Interventions should be aimed at closing this gap to promote healthier work environments.

Objetivo: identificar estrategias de promoción de la salud mental para trabajadores de enfermería hospitalaria disponibles en la literatura. Método: revisión integrativa de la literatura en las bases de datos Lilacs, Scopus, Web of Science, Cochrane Library y Medline. Se incluyeron en la muestra estudios primarios publicados en portugués, inglés o español, disponibles en su totalidad en los últimos diez años (2012 - 2022). La selección se realizó de manera doble ciego, y los resultados se presentan de forma descriptiva e interpretados a la luz del marco teórico-conceptual adoptado. Resultados: once artículos señalan estrategias individuales centradas en la formación de habilidades, la teleasistencia y los programas de desarrollo de la resiliencia, que redujeron los síntomas de depresión, ansiedad, estrés, agotamiento y rotación, y aumentaron la satisfacción laboral, los estilos de vida saludables, el bienestar y la salud general. Conclusión: las estrategias de promoción de la salud mental en el trabajo mantienen su enfoque en lo individual, y no involucran aspectos organizativos y colectivos del trabajo, denotando insuficiencia al no concentrarse en las causas centrales del problema. Las intervenciones deberían estar encaminadas a cerrar esta brecha para promover entornos de trabajo más saludables.

Adolescents' lived experiences of substance abuse in the Greater Giyani Municipality

Background: Adolescence is a unique and distinct stage of development that involves changes in the physical, psychological and social aspects of adolescents. It is a critical transition into adulthood whereby heightened risk-taking and sensation-seeking takes place, such as substance abuse. In a South African context, this transition sometimes occurs under economic stress, poverty, unemployment, high levels of crime and political instability. This can place adolescents at risk of substance abuse. Objectives: To explore and describe the lived experiences of adolescents abusing substances in the Greater Giyani Municipality in the Limpopo province, South Africa. Method: A qualitative, exploratory, descriptive and contextual research design with a phenomenological approach was used. Data were collected through individual, in-depth, phenomenological interviews and field notes. Thematic coding was utilised to analyse the collected data, and literature was reviewed to support the findings. Moreover, measures to ensure trustworthiness and ethical principles were applied throughout the research process. Results: Five themes were identified: substance abuse behaviour among adolescents, adolescents' motivation for continuing substance abuse, the effects of substance abuse on the lives of adolescents, factors affecting adolescents' discontinuation of substance abuse and a need to discontinue substance abuse. Conclusion: The study concluded that adolescents abusing substances in the Greater Giyani, Limpopo province, experience loss of control, broken relationships, poor academic performance, stigma attached to mental illness and negative emotions. The adolescents foresaw their future as uncertain and without direction. It is recommended that mental healthcare professionals introduce and implement interventions that will assist the adolescents who abuse substances in the Greater Giyani, Limpopo province. Contribution: The findings in this study could add knowledge in developing and implementing of strategies for psychiatric nurses to support adolescents abusing substances in the Greater Giyani, Limpopo province.

Emotional distress symptoms and their determinants: screening of non-clinical hospital staff in an Egyptian University hospital.

BACKGROUND: Non-clinical hospital staff were rarely studied despite their potential exposure to workplace stressors. We aimed to measure the prevalence of depression, anxiety, and stress (emotional distress symptoms) and determine their association with perceived job stress level and socioeconomic factors among non-clinical hospital staff. METHODS: This cross-sectional study was conducted in Ain-Shams University Hospitals from March to May 2019. Tools were the Arabic Depression, Anxiety, and Stress Scale-21, Workplace Stress Scale, and Socioeconomic status scale. Independent correlates were determined using multivariable ordinal regression. RESULTS: Out of 462 participants, 72.5% reported receiving insufficient income and 54.8% showed Effort-reward imbalance. Job stress was scored as severe/potentially dangerous by 30.1%. The prevalence of depression, anxiety, and stress were 67.5, 69.0, and 51.7%; and the severe/extremely severe levels were 20.8, 34.6, and 17.6% respectively. Across all the severity levels, the likelihood of depression, anxiety, and stress were progressively higher with more serious levels of income insufficiency [in debt versus able to save, OR:5.82 (95%CI:2.35-14.43), OR:3.84 (95%CI:1.66-8.91), and OR:3.01 (95%CI:1.20-7.55) respectively] and with higher job stress levels. Specifically, the likelihood of depression, anxiety, and stress increased by 74, 56, and 53% respectively with feelings of unpleasant/unsafe work conditions and by 64, 38, and 62% respectively with the presence of work-life conflict; while the likelihood of depression and stress increased by 32 and 33% respectively when there was difficult communication with superiors; and only the likelihood of depression increased by 23% with underutilization of skills. CONCLUSION: Non-clinical hospital staff were commonly affected by emotional distress symptoms with high rates of severe/very severe levels, and they often considered their workplace stress as severe/potentially dangerous. Workplace stress and income insufficiency were strong correlates with emotional distress symptoms. Decreasing work-life conflict, enhancing leadership skills, and mitigation of the economic hardship are needed.

Escuta terapêutica no processo de atendimento à saúde do idoso / Therapeutic listening in the process of health care for the elderly / Escucha terapéutica en el proceso de atención médica anciana

Objetivo: descrever os efeitos da escuta terapêutica domiciliar junto a idosos com indicativo de depressão utilizando a técnica de solução de problemas. Método: estudo descritivo, intervencional de cunho qualitativo, com idosos de 60 anos ou mais e com indicativo de depressão. Os dados foram coletados entre outubro de 2017 a abril de 2018 e foi realizada em três etapas: seleção da amostra, intervenção domiciliar e avaliação final. Utilizou-se para análise o Discurso do Sujeito Coletivo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos. Resultados: foram elaborados três discursos utilizando as ideias centrais: acolhimento; crescimento pessoal e reflexão sobre a vida. Conclusão: a escuta terapêutica no domicílio favoreceu o acolhimento, fortalecimento do vínculo profissional/paciente e reforçou de modo positivo os mecanismos assertivos das idosas. A Técnica de Solução de Problemas possibilitou o desenvolvimento de uma estratégia sistematizada e adequada para a aplicação da escuta terapêutica.

Objective: to describe the effects of therapeutic listening, using the problem-solving technique, in home visits to elderly people with signs of depression. Method: this qualitative, descriptive, interventional study with elderly people aged 60 years and over with an indication of depression proceeded in three stages: sample selection, home intervention, and final evaluation. Data were collected between October 2017 and April 2018 and analyzed using Collective Subject Discourse. The study was approved by the human research ethics committee. Results: three discourses were formulated using the central ideas: reception; personal growth and reflection on life. Conclusion: therapeutic listening at home favored receptiveness, a stronger bond with the patients and reinforced the elderly women's assertive mechanisms positively. The Problem-Solving Technique made it possible to develop a systematic strategy suited to applying therapeutic listening.

Objetivo: describir los efectos de la escucha terapéutica domiciliaria junto a personas mayores con signos de depresión, utilizando la técnica de resolución de problemas. Método: estudio descriptivo, intervencionista, de tipo cualitativo, junto a personas mayores de 60 años y con indicios de depresión. La recolección de datos se realizó entre octubre de 2017 y abril de 2018 y se llevó a cabo en tres etapas: selección de la muestra, intervención domiciliaria y evaluación final. Para el análisis, se utilizó el Discurso del Sujeto Colectivo. El estudio fue sometido al Comité de Ética en Investigación con Seres Humanos. Resultados: se han elaborado tres discursos utilizando las ideas centrales: acogimiento; crecimiento personal y reflexión sobre la vida. Conclusión: la escucha terapéutica en el domicilio favoreció la recepción, fortaleció el vínculo profesional/paciente y reforzó positivamente los mecanismos asertivos de las ancianas. La Técnica de Resolución de Problemas permitió desarrollar una estrategia sistematizada y adecuada a la aplicación de la escucha terapéutica.

Desinstitucionalização como conceito em disputa: compreensão dos profissionais de um Centro de Atenção Psicossocial / Deinstitutionalization as a disputed concept: understanding of professionals from a mental health service / Desinstitucionalización como concepto en disputa: comprensión de los profesionales en una Unidad de Atención Psicosocial

Objetivo: identificar e analisar a compreensão dos trabalhadores de um Centro de Atenção Psicossocial acerca da desinstitucionalização. Método: estudo exploratório de abordagem qualitativa, realizado em um Centro de Atenção Psicossocial do município do Rio de Janeiro. A coleta de dados foi realizada em 2019, por meio de entrevista semiestruturada com dez trabalhadores do serviço. Utilizou-se análise temática de conteúdo para análise dos dados. O protocolo de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: os profissionais do serviço compreendem a desinstitucionalização alinhada à desconstrução de paradigmas, possibilitando mudanças nas práticas dos trabalhadores. No entanto, há profissionais que compreendem a desinstitucionalização como sinônimo de desospitalização de pessoas que passaram por longas internações em hospital psiquiátrico, o que pode contribuir para a persistência de práticas manicomiais no cotidiano do serviço. Considerações finais: a desinstitucionalização apresentou-se como um conceito-ferramenta que coloca em ação modos de cuidado produtores de vida em liberdade.

Objective: to identify and analyze the understanding of workers from a Psychosocial Care Center about deinstitutionalization. Method: exploratory study with a qualitative approach, carried out in a Psychosocial Care Center in the city of Rio de Janeiro. Data collection was carried out in 2019, through a semi-structured interview with ten service workers. Thematic content analysis was used for data analysis. The research protocol was approved by the Research Ethics Committee. Results: professionals from the service understand deinstitutionalization aligned with the deconstruction of paradigms, enabling changes in workers' practices. However, there are professionals who understand deinstitutionalization as synonymous with dehospitalization of people who have been hospitalized for long periods in a psychiatric hospital, which can contribute to the persistence of asylum practices in the daily routine of the service. Final considerations: deinstitutionalization was presented as a concept-tool that puts into action modes of care that produce life in freedom.

Objetivo: identificar y analizar la comprensión de los trabajadores de una Unidad de Atención Psicosocial sobre la desinstitucionalización. Método: estudio exploratorio con enfoque cualitativo, realizado en una Unidad de Atención Psicosocial de la ciudad de Río de Janeiro. La recolección de datos se realizó en 2019, mediante una entrevista semiestructurada con diez trabajadores de ese servicio. Para el análisis de los datos se utilizó el análisis de contenido temático. El Comité de Ética en Investigación aprobó el protocolo de investigación. Resultados: los profesionales del servicio comprenden la desinstitucionalización acorde con la deconstrucción de paradigmas, posibilitando cambios en las prácticas de los trabajadores. Sin embargo, hay profesionales que entienden la desinstitucionalización como sinónimo de deshospitalización de personas internadas durante largos períodos en un hospital psiquiátrico, lo que puede contribuir a la persistencia de prácticas típicas de manicomios en el cotidiano del servicio. Consideraciones finales: la desinstitucionalización se presentó como un concepto-herramienta que pone en acción modos de cuidado que producen vida en libertad.

A Golden Thread approach to transforming Maternal and Child Health in Singapore.

Maternal and child health (MCH) in Singapore is entering a new phase, with challenges different to those faced 50 years ago. The advancement of medical technologies and access to MCH resources have led to a dramatic fall in maternal and infant mortality rates. However, there has been a steep rise in the rates of obesity and related metabolic diseases. Alongside this is an emerging mental wellness challenge, with one in ten women experience depression across pre-, during and post-pregnancy. Maternal obesity and mental disorders before and during pregnancy not only increase a woman's risk of pregnancy complications, but also result in increased risks in the offspring of childhood obesity, behavioral disorders and later life metabolic disease, catalyzing vicious cycles of disease. Thus, there is a pressing need to transform the current MCH system to address a burgeoning metabolic and mental health challenge for Singapore. Initiating interventions during preconception and continuing into the postpartum has the potential to confer long-term maternal-child benefits, promoting virtuous cycles of health. However, the current MCH system emphasizes antenatal care and lacks focus on the equally, if not more important, preconception, postpartum and inter-pregnancy stages. We describe a new model-of-care framework that integrates a life-course approach to health across preconception, pregnancy and postpartum phases, with the social-ecological model comprising individual, interpersonal, institutional, community and policy as the major targets for health promotion interventions. This "golden thread" approach is being established at the Singapore KK Women's and Children's Hospital (KKH), to address both metabolic and mental health challenges to achieve the goal of a thriving, healthy nation. This new model-of-care is set up in KKH as a pilot program known as Healthy Early Life Moments in Singapore (HELMS). HELMS will reach out to women planning to conceive through coordinated interventions across preconception, pregnancy and postpartum periods. A mobile health platform is being developed to facilitate interventions and engage participants in the program through a digital, personalized and interactive approach. This new model-of-care is designed to secure a population with healthy life cycles, by influencing each life-course, early-in-life, to provide the best start for generations to come.

Impact of COVID-19 pandemic on physical activity level and screen time is associated with decreased mental health in Brazillian adults: A cross-sectional epidemiological study.

The objective was to verify whether the impact of COVID-19 on physical activity and screen time was associated with the impact on quality of life and symptoms of anxiety and depression in a sample of Brazilian adults. The invitation was made through social networks and the collection was carried out through electronic research. There was a decrease in quality of life and physical activity, and an increase in symptoms of anxiety and depression and screen time. These findings are important for new strategies that promote physically active habits during the pandemic .

A survey of violence and vulgarity in children television programmes: A content analysis, and assessment of perceptions of parents and children (ViCTiM study).

OBJECTIVE: To quantify the depiction of violence and vulgarity in television programmes for children, and to assess the perception and practices of parents and children about television programmes meant for children. METHODS: We conducted this mixed-methods cross-sectional study in Karachi, Pakistan in the months of August-September 2018, after approval from the ethics review board of Dow University of Health Sciences, Karachi. First, a content analysis of over 102 hours of various television programmes meant for children was performed in the light of the guidelines set out by the World Health Organisation, the United States Federal Communication Commission and the Pakistan Electronic Media Regulatory Authority. Seven trained researchers sampled the children prime time throughout a week, including the weekends, using a structured tally sheet. Subsequently, interviews were conducted with dyad of parent-children from the employees' list of a public-sector university. A questionnaire was also administered to assess the practices and perceptions of the parents-children dyad about the programmes. Data was analysed using SPSS 24. RESULTS: Of the 173 subjects, 84(48.6%) were parents and 89(51.4%) were children. The mean age of the children was 9.8±3.7 years. Content analysis comprised 6130 minutes, of which 5442(88.8%) had depictions of violence and vulgarity. Depiction of violence and vulgarity was prevalent on television channels that were watched the most, but there was no significant difference in this regard (p=0.238). Of the parents, 68(81%) expressed concern over the effect of screen time and content on the mental health of their children. CONCLUSIONS: Television programmes meant for children were found to be inappropriate with seriously high proportion of violence and vulgarity in their contents.

Analysis of influencing factors of quality of life of patients with pneumoconiosis in Chongqing based on a structural equation model / 中国职业医学

@#Objective To analyze the influencing factors of quality of life of patients with occupational pneumoconiosis in Methods Chongqing using a structural equation model. A total of 1 181 pneumoconiosis patients in Chongqing were selected - as the research subjects using convenient sampling method. The Chinese version of the SF 36 Scale was used to investigate the quality of life of the patients. Amos 24.0 software was used to construct a structural equation model reflecting the quality of life of Results ， （ ），（ ） （ ）， patients. The scores of physical health mental health and quality of life were 61.7±18.5 68.7±20.5 and 64.7±16.8 respectively. The scores of the eight dimensions of the quality of life of the research subjects were lower than that of the （ P ） Chongqing City municipal and national norms all <0.01 . Multiple linear regression results showed that personal monthly ， ， ， income pneumoconiosis stage complications employment status and smoking were the influencing factors of the quality of life （ P ） ， of pneumoconiosis patients all <0.05 . The results of the structural equation model showed that the stage of pneumoconiosis ， ， complications personal monthly income and pulmonary rehabilitation treatment could directly affect the physical and mental （ P ） ， health of the research subjects all <0.05 . In addition the stage of pneumoconiosis and complications indirectly affected the （ P ）Conclusion physical and mental health of patients by affecting pulmonary rehabilitation treatment all <0.05 . The structural equation model can be used to verify the influencing factors of the quality of life of patients with occupational pneumoconiosis. ， Complications personal monthly income and pneumoconiosis stage are the main factors affecting the quality of life of patients with occupational pneumoconiosis.

Acolhimento como tecnologia do cuidado emancipatório em Centros de Atenção Psicossocial / Welcoming as an emancipatory care technology in Psychosocial Care Centers / Acogida como tecnología de la asistencia emancipatoria en los Centros de Atención Psicosocial

Objetivo: analisar os componentes que caracterizam o potencial emancipatório do acolhimento realizado em Centros de Atenção Psicossocial, destacados por cidadania, consciência crítica, liberdade e autonomia. Método: Pesquisa Convergente Assistencial, cujos dados foram provenientes de entrevistas com roteiro semiestruturado e grupos de integração pesquisa-serviço com quatro enfermeiros, uma psicóloga e três assistentes sociais, no período de novembro de 2018 a julho de 2019. A análise compreendeu quatro processos conforme atribuídos pela Pesquisa Convergente Assistencial. Resultados: à luz do constructo teórico de Nietsche em sua classificação tecnológica, o acolhimento apresenta potencial emancipatório pleno ao revelar componentes emancipatórios relacionados à liberdade, cidadania, autonomia e consciência crítica, favorecendo o processo de emancipação, tanto de profissionais quanto de usuários. Conclusão: acolhimento como tecnologia de potencial emancipatório pleno possibilita aos enfermeiros a apreensão do conceito de tecnologia emancipatória e de reflexão dos saberes e práticas que a esta são intrínsecos.

Objective: to analyze the components that characterize the emancipatory potential of welcoming at Psychosocial Care Centers, highlighted as citizenship, critical awareness, freedom and autonomy. Method: Convergent Care Research was performed with data from interviews using a semi-structured script and research-service integration groups with four nurses, a psychologist and three social workers, held from November 2018 to July 2019. The analysis comprised four processes as per Convergent Care Research. Results: in the light of Nietzsche's theoretical construct in his classification of technologies, welcoming has full emancipatory potential in that it displays emancipatory components relating to freedom, citizenship, autonomy and critical awareness and thus favors the emancipation process, for both professionals and users. Conclusion: as a technology with full emancipatory potential, welcoming enables nurses to grasp the concept of emancipatory technology and to reflect on the knowledge and practices intrinsic to it.

Objetivo: analizar los componentes que caracterizan el potencial emancipatorio de la acogida que se realiza en los Centros de Atención Psicosocial, destacando la ciudadanía, la conciencia crítica, la libertad y la autonomía. Método: Investigación Convergente Asistencial, cuyos datos provienen de entrevistas con guión semiestructurado y grupos de integración investigación-servicio con cuatro enfermeros, una psicóloga y tres asistentes sociales, de noviembre de 2018 a julio de 2019. El análisis comprendió cuatro procesos según lo asignado por la Investigación Convergente Asistencial. Resultados: a la luz del constructo teórico de Nietsche en su clasificación tecnológica, la acogida presenta potencial emancipatorio pleno al revelar componentes emancipatorios relacionados con la libertad, la ciudadanía, la autonomía y la conciencia crítica, favoreciendo el proceso de emancipación, tanto para los profesionales como para los usuarios. Conclusión: la acogida como tecnología con potencial emancipatorio pleno les permite a los enfermeros captar el concepto de tecnología emancipatoria y reflexionar sobre los saberes y prácticas que le son intrínsecos.

Ideação suicida em mulheres e violência por parceiro íntimo / Suicidal ideation in women and intimate partner violence / Ideación suicida en mujeres y violencia de pareja

Objetivo: investigar a associação entre ideação suicida e violência por parceiro íntimo em mulheres. Método: estudo analítico e transversal, desenvolvido em Unidades Básicas de Saúde do Piauí-Brasil, com 369 mulheres adultas e com histórico de relacionamento. Os dados foram coletados de agosto de 2015 a março de 2016, por meio do Revised Conflict Tactics Scales e Self-Reporting Questionnaire, e analisados no software Statistical Package for the Social Science, versão 20.0. Resultados: verificou-se que 65,3% das mulheres sofreram violência por parceiro íntimo, 61,0% foi vítima de violência psicológica, 32,2% física, 18,7% moral e 17,1% sexual. Identificou-se associação entre ideação suicida e violência por parceiro íntimo (p=0,000), violência psicológica (p=0,001) e moral (p=0,000). Ser vítima de violência por parceiro íntimo aumenta 4,35 vezes as chances de as mulheres pensarem em cometer atos contra a própria vida. Conclusão: a ideação suicida está associada a violência por parceiro íntimo, violência psicológica e moral.

Objective: to investigate the association between suicidal ideation and intimate partner violence in women. Method: analytical and cross-sectional study carried out in Basic Health Units in Piauí, Brazil, with 369 adult women and with a relationship history. Data were collected from August 2015 to March 2016 using the Revised Conflict Tactics Scales and Self-Reporting Questionnaire, and analyzed using the Statistical Package for the Social Science software, version 20.0. Results: 65.3% of the women were found to have suffered intimate partner violence; 61.0%, psychological violence, 32.2%, physical violence, 18.7%, moral violence, and 17.1%, sexual violence. An association was identified between suicidal ideation and intimate partner violence (p = 0.000), psychological violence (p = 0.001), and moral violence (p = 0.000). Victims of intimate partner violence were 4.35 times more likely to think of committing acts against their own lives. Conclusion: suicidal ideation is associated with intimate partner violence, psychological and moral violence.

Objetivo: investigar la asociación entre ideación suicida y violencia de pareja en mujeres. Método: estudio analítico y transversal, realizado en Unidades Básicas de Salud de Piauí-Brasil, con 369 mujeres adultas y con antecedentes de parentesco. Los datos se recopilaron desde agosto de 2015 hasta marzo de 2016, utilizando el Revised Conflict Tactics Scales y Self-Reporting Questionnaire, y se analizaron utilizando el software Statistical Package for the Social Science, versión 20.0. Resultados: se encontró que el 65,3% de las mujeres sufrió violencia de pareja íntima, el 61,0% fue víctima de violencia psicológica, 32,2% física, 18,7% moral y 17,1% sexual. Se identificó asociación entre ideación suicida y violencia de pareja íntima (p = 0,000), violencia psicológica (p = 0,001) y violencia moral (p = 0,000). Ser víctima de violencia de pareja aumenta 4,35 veces las posibilidades de que las mujeres piensen en cometer actos contra su propia vida. Conclusión: la ideación suicida está asociada con la violencia de pareja, violencia psicológica y moral.

Mobile Mental Health Apps from the National Center for PTSD: Digital Self-Management Tools for Co-Occurring Disorders.

Mobile mental health apps can help bridge gaps in access to care for those with substance use disorders and dual diagnoses. The authors describe a portfolio of free, publicly available mobile mental health apps developed by the National Center for PTSD. The authors also demonstrate how this suite of primarily non-substance use disorder-specific mobile mental health apps may support the active ingredients of substance use disorder treatment or be used for self-management of substance use disorder and related issues. The potential advantages of these apps, as well as limitations and considerations for future app development, are discussed.