Mental health, water, and food: Relationships between water and food insecurity and probable depression amongst adults in Mexico.

BACKGROUND: Water and food insecurity often co-occur, and have independently been identified as potential risk factors for poor mental health. Their interlinkages are only just beginning to be explored; even less is known about how the relationships vary by gender. Understanding the independent associations of water and food insecurity with mental health, as well as their joint effects, can help identify which interventions might be most appropriate for improving health. METHODS: We explored how probable depression covaried with water and food insecurity using nationally representative data from the Mexican National Health and Nutrition Survey 2021 (ENSANUT 2021, n = 13,126). Cross-sectional data were collected on household water, food insecurity, and probable depression amongst adults. We used multivariable logistic regression models to examine the association of water insecurity and food insecurity with moderate-to-severe probable depression, and we stratified the models by sex. RESULTS: Household water insecurity was associated with higher odds of probable depression amongst women (1.37 OR, CI: 1.13-1.66) and men (1.30 OR, CI: 0.92-1.83). When controlling for household food insecurity, the association between probable depression and water insecurity was no longer important, however, household food insecurity was associated with higher odds of probable depression. Those experiencing joint water and food insecurity had the highest odds of probable depression (2.70 OR, CI: 2.13-3.40). The associations between water insecurity, food insecurity and mental health did not differ by sex. CONCLUSION: Concurrent water and food insecurity increase the likelihood of probable depression amongst both men and women. Strategies to mitigate both resource insecurities could improve mental health.

Effects of skin-to-skin contact on mental health outcomes in the parents of full-term newborns: A systematic review and meta-analysis of randomized clinical trials.

BACKGROUND: The postpartum period can be emotionally challenging for parents, with documented levels of anxiety, stress, and depression. While the benefits of skin-to-skin contact (SSC) are well-known, its impact on the mental health of parents of full-term newborns has been less studied. OBJECTIVE: We aimed to assess the effects of SSC in mental health outcomes in the parents of full-term newborns. METHODS: In this systematic review, a comprehensive search was conducted to identify randomized clinical trials (RCTs) comparing SSC versus no SSC and assessing mental health outcomes. Meta-analyses were performed whenever possible, and the GRADE approach was used to rate the certainty of evidence. RESULTS: We included 9 RCTs with 1201 participants. Regarding the risk of bias, the most affected domains were selective reporting, blinding, and allocation concealment. Regarding parental anxiety, SSC may reduce it at short-term, while it is unsure its effect at mid-term and it may not have any effect at long-term. Regarding Psychological stress, SSC may not have an impact at mid- and long-term. Regarding delivery-related post-traumatic stress symptoms, SSC may not have an impact at short-, mid-, and long-term. Regarding depressive symptoms, the evidence is uncertain at short- and mid-term. LIMITATIONS: For the assessed outcomes, certainty of the evidence was low or very low. CONCLUSION: SSC may reduce parental anxiety at short-term, while it may not have an impact in psychological stress and delivery-related post-traumatic stress symptoms. Moreover, the evidence is uncertain regarding its effect in long-term anxiety and depressive symptoms.

Peruvian Adolescent Mental Health Across Two Years of the COVID-19 Pandemic: A Four Time-Point Longitudinal Study.

PURPOSE: This study investigated symptoms of anxiety and depression, feelings of loneliness, and life satisfaction among low-to-middle income Peruvian adolescents during 2 years of remote schooling due to the COVID-19 lockdown. METHODS: We used a four-wave longitudinal observational approach. Data were collected in April 2020, October 2020, June 2021, and November 2021 in Perú. A total of 2,392 adolescents (ages 10-15; 57% female) participated in the study. We described longitudinal changes in symptoms of anxiety and depression, feelings of loneliness, and life satisfaction across the four time points and investigated sex and school grade differences. RESULTS: Symptoms of anxiety, depression, and loneliness increased, and life satisfaction decreased over the course of 2 years of remote education. The rate of change was different for each outcome of well-being. We found robust sex differences for all outcomes. In addition, we found school grade differences for anxiety and depression. DISCUSSION: The mental health and well-being of Peruvian adolescents, particularly female adolescents, declined during 2 years of remote education, despite loosening of other pandemic restrictions. Depression appears to have the earliest impacts, with anxiety levels showing even some improvement for male adolescents. School grade differences in levels of anxiety and depression for seventh and eighth graders in 2020 and 2021 provide initial evidence to disentangle pandemic from developmental effects.

The burden of mental health issues in Behçet's disease: implications for patient quality of life.

INTRODUCTION: Depression and anxiety are among the most prevalent mental health conditions in Brazil. Both are associated with poor quality of life (HRQoL) and challenges in disease management for chronic illnesses, including Behçet's disease (BD). This study aimed to evaluate depression, anxiety, and HRQoL in BD patients from a non-endemic area. RESEARCH DESIGN AND METHODS: This case-control study included adult BD patients from Brazilian tertiary center and healthy controls (HC). All patients fulfilled the ISG and ICBD diagnostic criteria. Depression, anxiety and quality of life were assessed using BDI, HADS, SF-36, and physical capacity with the HAQ. RESULTS: We enrolled 58 BD patients (60% female, mean age 46.1) and 96 HC (74% female, mean age 44). High rates of depression and anxiety were observed in BD patients, correlating with disease activity, younger age, absence of a partner, shorter disease duration, and lower income. BD patients showed significant HRQoL restrictions, particularly in physical and emotional roles, compared to HC. Longer disease duration was correlated with better HRQoL. CONCLUSION: High rates of depression and anxiety were observed in BD patients, negatively impacting HRQoL, particularly in those with higher disease activity. Further study and clinical attention are warranted to enhance patient care and outcomes.

Long-Term Mental Health Outcomes of Bronchopulmonary Dysplasia in Neonates: An 18-Year National Cohort Study.

OBJECTIVE: To evaluate the association between neonatal bronchopulmonary dysplasia and the subsequent development of mental health conditions in children and adolescents. STUDY DESIGN: This was a retrospective cohort study, utilizing data from individuals born in South Korea between 2002 and 2005 and followed up until 2021, using the National Health Insurance Database. The cohort included 1 893 314 participants born during that period, with 927 diagnosed with bronchopulmonary dysplasia during the neonatal period (the exposed cohort). They were matched 1:10 with 9270 unexposed individuals (the unexposed cohort) based on key demographic factors. RESULTS: The median age at the first mental health disorder diagnosis was 9 years (IQR, 5-15 years), with 5698 individuals (55.9%) being male. During an average follow-up of 15.2 years, the incidence rate was 481/10 000 person-years in the exposed and 138 of 10 000 person-years in the unexposed cohort. By the age of 18 years, the cumulative incidence in the exposed cohort was 54% (95% CI; 50%-57%), with an adjusted hazard ratio of 3.18 (95% CI; 2.81-3.60) compared with the unexposed cohort, and adjusted hazard ratios for early- and late-onset mental health disorders of 4.48 (95% CI; 3.84-5.22) and 1.89 (95% CI; 1.61-2.22), respectively. Sensitivity analyses confirmed these findings, and a subgroup analysis revealed a higher risk among individuals with bronchopulmonary dysplasia who required prolonged respiratory support or oxygen. CONCLUSIONS: Half of children with bronchopulmonary dysplasia in our cohort developed mental health disorders by the age of 18 years, emphasizing the need for interventions and support for such individuals.

Degenerateness, Mental Hygiene, and Spiritism: Debates in the Argentine Medical Press (1930-1946).

The disputes between spiritualists and physicians occurred in the context of hygienism and the degeneration theory, where spiritualists were considered agents requiring health care by alienists and psychiatrists. French psychiatry defended this interpretation to isolate and treat "spiritual delirium," which came to have considerable importance in the debates between spiritism and psychiatry. Specifically, pathologization and psychologization became strategies to deal with the disruptive experience of mediumship and the sense of threat from spiritualism. Psychiatrists initiated anti-spiritualist campaigns, inspiring responses from the spiritualist communities and their representatives, along with arguments to refute such diagnostic criteria. The debates between alienists and spiritists are an example of how, the rhetoric of spiritists, physicians, and some philosophers led to hostile positions regarding the designation of limits in the recognition of psychological and religious experiences.

Nonpharmacological Interventions Aimed at Promoting the Mental Health of Children and Adolescents During the COVID-19 Pandemic: A Systematic Review.

BACKGROUND: Interventions to promote mental health in paediatrics need to be effective, especially in crisis contexts. This systematic review proposes to compile and analyse the findings of nonpharmacological interventions conducted in samples of children and adolescents during the COVID-19 pandemic, focusing on mental health. METHODS: The research was carried out in PsycINFO, PubMed and Web of Science databases for empirical studies, including interventions in which measures of outcome variables were collected at least twice (pre and post). The studies' samples were children and adolescents up to 19 years old, and interventions were developed throughout the COVID-19 pandemic. After eligibility analyses, 16 studies were included in this review. RESULTS: Studies used different theoretical approaches, focusing on the promotion, prevention and treatment of mental health in specific contexts. Some were delivered online, in-person or in hybrid formats. Particularly, depression, the most frequently assessed outcome, demonstrated more favourable results within the interventions than other evaluated outcomes. However, due to the considerable risk of bias, the qualitative analysis of the results of many included studies should be performed with caution. CONCLUSIONS: Most of the interventions necessitate further validation, highlighting the ongoing need for research in this area. However, the emergence of interventions during crises, such as the COVID-19 pandemic, provides an opportunity to expand evidence-based mental health practices, paving the way for their application in other crisis situations. Given that mental health prevention and promotion practices can be integrated into the roles of all healthcare providers, possessing insight into the most suitable evidence-based interventions can elevate the quality of care delivered.

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

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

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

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

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

Introdução: O desenvolvimento da família é influenciado por diversos fatores de sua organização interna e de ordem ambiental, social, cultural, econômica e política. Em contexto de pobreza os riscos são maiores. Fatores de proteção, como boa organização familiar e rede social de apoio podem diminuir as consequências negativas da pobreza. São escassas as pesquisas longitudinais sobre vulnerabilidade e resiliência nas famílias. Objetivo: Este artigo descreve o desenvolvimento de três famílias ao longo de 15 anos, estudadas por meio de entrevistas em casa, parte de uma coorte populacional de um bairro de Porto Alegre (RS). Buscaram-se associações entre a qualidade das relações nessas famílias e sua saúde física e mental, especialmente a do filho, foco da pesquisa. Métodos: Selecionaram-se no arquivo da pesquisa as três primeiras famílias (do total de 148) das quais se tinham os resultados completos das cinco visitas realizadas aos quatro meses e aos dois, quatro, nove e 15 anos de um filho. Realizou-se análise qualitativa dos registros em busca de categorias para compreender a vida e as relações interpessoais nas famílias. O estudo foi realizado em conjunto por duas pesquisadoras, médicas especialistas em desenvolvimento humano. As categorias identificadas na análise e estudadas nas cinco etapas foram: configuração familiar, situação socioeconômica, situações traumáticas, saúde física, saúde relacional e mental, evolução cognitiva e escolar do filho. Resultados: As três famílias, todas de classe C, com filhos sem problemas de saúde física, tiveram evolução suficientemente boa, apesar de todas enfrentarem múltiplos problemas, inclusive separações e mortes precoces. A relação com o sistema de saúde e escola era boa e similar para as três. A jovem com menos problemas de saúde mental foi aquela que sofreu perdas mais importantes: morte dos pais. Tinha uma estrutura familiar multigeracional sólida desde a primeira infância, com relações interpessoais predominantemente colaborativas e amorosas. Conclusões: O artigo busca avançar na compreensão da resiliência nas famílias em situações de vulnerabilidade. Concluímos que essas três famílias, uma delas mais que as outras, foram suficientemente saudáveis na tarefa de educar seus filhos sem desenvolverem problemas mentais graves. Propomos que o bom desenvolvimento se associa com a adequação e amorosidade dos cuidados com a etapa do ciclo vital, mesmo enfrentando situações problemáticas. Essas qualidades precisam estar associadas à estabilidade socioeconômica básica e a bons serviços de saúde e escola.

Introduction: Family development is influenced by it's internal organization and environmental factors, socioeconomic, cultural and political. In poor contexts there are more risks to development. Protection factors like good family organization and social network may decrease the risks. Longitudinal research about vulnerability and resilience in families is scarse. Objective: This article describes the development of three families over 15 years through interviews at home. The families were part of a populational cohort of a neighborhood in Porto Alegre (RS). We looked for links between the quality of relationships and the physical and mental health of these families, especially of the child focus of the research. Methods: We selected in the research archives the first three families (of a total of 148) for which we had full results of the five interviews at four months and two, four, nine and fifteen years of a child. We did a qualitative analysis of the records looking for parameters to understand the life and interpersonal relationships of these families. This study was done by two researchers, both experts in Human Development. The categories identified in the analysis of the five phases were: family structure, socioeconomic situation, traumatic experiences, physical, mental and relational health and cognitive evolution of the child. Results: All three families belonged to economical class C. The children were in good physical health and had sufficiently good general development, having faced multiple problems, including parental separation and early parental death. The relationship with the health and school systems was good in all of them. The youth with less mental health problems was the one who suffered the heaviest loss: early death of both parents. Her family had strong multigenerational ties since her early days, with predominant collaborative and loving relationships. Conclusions: This article aims to contribute to the comprehension of resilience in families in the context of vulnerability. We can say that these three families were healthy enough in the task of bringing up children without any serious mental health problem. We suggest that healthy development is associated with loving interfamily relationships adequate to each phase of development, notwithstanding dramatic events. This needs to be supported by basic economic stability and adequate school and health systems.

Introducción: El desarrollo de la familia es influenciado por su organización interna y factores ambientales, sociales, culturales, económicos y políticos. En contextos pobres los riesgos son mayores. Factores de protección como buena organización familiar y red social de apoyo pueden disminuir las consecuencias negativas de la pobreza. Son pocas las investigaciones longitudinales de vulnerabilidad y resiliencia de las familias. Objetivo: Este artículo describe el estudio del desarrollo de tres familias a lo largo de 15 años, a través de entrevistas en domicilio, parte de una cohorte poblacional de un barrio de Porto Alegre (RS). Se buscaron correlaciones entre la calidad de las relaciones de esas familias y su salud física y mental, especialmente la del hijo foco de la investigación. Métodos: Fueron seleccionadas en el archivo de la investigación las tres primeras familias (de un total de 148) de las cuales se tenían los resultados completos de las cinco visitas realizadas, a los 4 meses, y a los 2, 4, 9, y 15 años de un hijo. Fue realizado un análisis cualitativo de los registros en busca de categorías para comprender la vida y las relaciones interpersonales en las familias. El estudio fue hecho en conjunto por dos investigadoras, médicas especialistas en desarrollo humano. Las categorías identificadas en el análisis y estudiadas en las cinco etapas fueron: configuración familiar, situación socioeconómica, situaciones traumáticas, salud física, salud relacional y mental, evolución cognitiva y escolar del hijo. Resultados: Las tres familias, todas de clase C, con hijos sin problemas de salud física, tuvieron evolución suficientemente buena, a pesar de que todas enfrentaron múltiples problemas, incluso separaciones y muertes precoces. La relación con el sistema de salud y escuela era buena y similar para las tres. La joven con menos problemas de salud mental fue aquella que sufrió las mayores pérdidas: muerte de los padres. Tenía una estructura familiar multigeneracional sólida desde la primera infancia, con relaciones interpersonales predominantemente colaborativas y amorosas. Conclusiones: El artículo pretende avanzar en la comprensión de la resiliencia en las familias en situaciones de vulnerabilidad. Concluimos que esas tres familias, una de ellas más que las otras, fueron suficientemente saludables en la tarea de educar a sus hijos sin que desarrollaran problemas mentales graves. Proponemos que el buen desarrollo se asocia con el amor y adecuación de los cuidados a la etapa del ciclo vital, aun enfrentando situaciones problemáticas. Esas calidades necesitan estar asociadas a la estabilidad socioeconómica básica y buenos servicios de salud y escuela.

The influence of access to care on the health literacy of families in Mexico.

Health literacy (HL) is essential to understanding health information and achieving health goals. Unfortunately, limited information is available on how parent HL impact child health outcomes. This is critical to understand in areas of the world where access to healthcare services is limited or unavailable. Thus, the purpose of this study was to assess the moderating influence of access to care on the relationship between parent HL and child health outcomes in Mexico. Using a geographically stratified convenience sample survey design, we gathered a sample of 373 parent-child dyads throughout Mexico in August of 2021. Using the HLS-Q12, the Warwick-Edinburgh Mental Wellbeing Scale, healthcare access questions developed by Levy and Janke, a single-item self-report overall health measure, and questions about substance use frequency, we found that parent HL was positively associated with youth mental wellbeing and overall health. Limited healthcare access was associated with increased youth cigarette, marijuana and alcohol use. Our results indicate that efforts to increase parent HL may be effective in improving youth health behaviors and outcomes.

[Racism and mental health in indigenous youth living in the Metropolitan Area of Oaxaca, Mexico]. / Racismos y salud mental en jóvenes indígenas residentes en la Zona Metropolitana de Oaxaca, México.

Indigenous populations show high prevalence rates of mental disorders and limited access to mental health services. The aim of this study was to analyze the mental health care trajectories of indigenous youth living in the Metropolitan Area of Oaxaca, Mexico. Between May and August 2023, we conducted a qualitative study involving non-participant observation, in-depth interviews with seven indigenous youth, and semi-structured interviews with nine health professionals, healers, or leaders of mutual support groups. We identified processes, not exempt of tensions, in how these young people perceive themselves as both young and indigenous, in the development of their mental disorders, and in the ways they seek treatment. Their care involved the use of psychological and psychiatric services, mutual support groups, and, to a limited extent, traditional medicine. This study concludes that these dynamics are interwoven and amplified by interpersonal, institutional and epistemic racism, which must be dismantled to improve the mental health of indigenous youth.

Las poblaciones indígenas presentan altas prevalencias de trastornos mentales y limitado acceso a servicios de salud mental. El objetivo del estudio fue analizar las trayectorias de atención a trastornos mentales de jóvenes indígenas residentes en la Zona Metropolitana de Oaxaca, México. Entre mayo y agosto de 2023, se llevó a cabo un estudio cualitativo basado en observación no participante, entrevistas en profundidad a siete personas jóvenes indígenas y entrevistas semiestructuradas a nueve personas profesionales de la salud, curanderas o responsables de grupos de ayuda mutua. Se identificaron procesos de occidentalización, no exentos de tensiones, en la forma de concebirse como jóvenes e indígenas, en el desarrollo de sus trastornos mentales y en la atención de estos, para lo cual utilizaron servicios psicológicos, psiquiátricos, grupos de ayuda mutua y, de manera limitada, medicina tradicional. Se concluye que en estos procesos se articulan y potencian racismos interpersonales, institucionales y epistémicos, que será necesario desarticular para mejorar la salud mental de personas jóvenes indígenas.

Young people's sense of agency and responsibility towards promoting mental health in Brazil: a reflexive thematic analysis.

OBJECTIVES: This study investigated how Brazilian young people perceive their role in promoting and supporting their peer community's mental health and well-being, and the conditions and contexts influencing their engagement. DESIGN: Co-produced qualitative study using in-depth interviews and focus groups with adolescents. The sessions were audio-recorded, transcribed and anonymised. Data were analysed using reflexive thematic analysis. SETTING: Data collection took place remotely across Brazil via audio or video calls conducted by a youth collaborator and a senior researcher. PARTICIPANTS: 46 Brazilian adolescents aged between 15 and 18 years old, recruited primarily via social media. RESULTS: Our analysis generated four overarching themes: (1) young people's sense of responsibility and motivation-many participants felt committed to promoting the mental health and well-being of their friends and community, while also critically emphasising responsibilities of and partnerships with adult stakeholders to make a meaningful difference; (2) strategies for promoting peer mental health-suggested strategies included peer-to-peer support, such as non-judgemental listening, and collective actions such as forming school groups; (3) intrapersonal barriers-key barriers to participation included a lack of necessary skills and self-efficacy; and (4) contextual barriers-young people reported feeling unheard, invalidated, and fearing judgement due to mental health stigma. CONCLUSION: These findings support an ecological view of youth participation in the promotion of mental health as dependent on intrapersonal, interpersonal and contextual factors. Realising young people's potential in advancing mental health in their communities requires fostering youth-adult partnerships, providing peer support training, and combating adultism and mental health stigma.

Recommendations for guidelines for promoting mental health in the workplace: an umbrella review.

OBJECTIVES: to summarize the recommendations of guidelines for promoting mental health in the workplace. METHODS: an umbrella review, according to Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses methodological assumptions. Data collection was carried out in January 2021 and updated in July 2023 in the American Psychological Association, Cochrane Library, EMBASE, National Library of Medicine, and Scopus databases. Systematic reviews that assessed guidelines with recommendations for mental health care for workers were included. PROSPERO registration CRD42023461845. RESULTS: four systematic reviews published between 2015 and 2018 were identified. The abstracts highlighted actions that facilitate and inhibit the recommendations as well as three categories of intervention: primary prevention - worker protection; secondary prevention - promoting workers' mental health; and tertiary prevention - supporting, monitoring and rehabilitating workers upon returning to work. CONCLUSIONS: the interventions are based on prevention, promotion and early recognition, support and rehabilitation of mental health problems.

Exploring the complexities and challenges of healthcare access for transgender people in Minas Gerais state: a qualitative study a decade following the implementation of the transsexualization process in the Brazilian National Health System.

OBJECTIVE: This article explores the complexities and challenges of healthcare access for transgender people in Minas Gerais. METHODS: : This study is based on a subsample from the Manas Survey, comprised of 15 semi-structured interviews with transgender people, conducted between May 2018 and May 2020, analyzed using the content analysis method and organized into a thematic network. RESULTS: : The results highlight the need for adequate structures, specific training for healthcare professionals, the influence of support networks and challenges in mental health. CONCLUSIONS: : Despite advances in transgender health policies, access barriers persist, underscoring the importance of training strategies, accurate record-keeping and the expansion of specialized services and the role of primary health care. The study makes progress by including the perceptions from residents of small and medium-sized cities across different regions of the state, aiming to improve access and care for the transgender population via the Brazilian National Health System in Minas Gerais. MAIN RESULTS: The findings underscore the need for adequate structures, specific training for healthcare professionals, the influence of support networks and challenges in mental health, in addition to including the perceptions of residents from small and medium-sized cities. IMPLICATIONS FOR SERVICES: Improving the use of social name and gender identity in records. There is a need for training healthcare professionals in gender identity, expanding transgender-specific services and the role of primary health care (PHC) in this topic. PERSPECTIVES: Expansion of specialized services and the role of PHC for this population, in order to improve access and care for the transgender population via the Brazilian National Health System in Minas Gerais state.

Chikungunya chronic arthralgia: impact on general and mental health and absenteeism from work.

BACKGROUND: This study investigated the self-rated general health, mental health, and work absenteeism among patients with laboratory-confirmed chikungunya. METHODS: Telephone interviews were conducted with 63 patients ≥22 months after infection. RESULTS: Patients who reported (N=42) or did not report (N=21) chronic arthralgia, defined by duration ≥90 days, had different frequencies for low scores for general health (68.3% vs. 30.0%, respectively; prevalence ratio, 95% confidence interval: 2.3, 1.1-4.6), symptoms of depression (31.7% vs. 15.0%; 2.1, 0.7-6.6), symptoms of anxiety (43.9% vs. 35.0%; 1.3, 0.6-2.5), and work absenteeism (76.5% and 40.0%; 1.9, 0.9-4.2). CONCLUSIONS: Chikungunya chronic arthralgia impacts long-term health and work.

Factors associated with HIV viremia in transgender women and transvestites in five Brazilian capitals, 2019-2021: a multicenter study.

OBJECTIVE: To analyze factors associated with detectable HIV viremia among transgender women/transvestites (TWT) in five Brazilian capitals. METHODS: : This was a cross-sectional study using data from a sample of TWT with HIV-positive serology and detectable viral load (VL), between 2019 and 2021. The dependent and independent variables were, respectively: viral load measurement, socioeconomic/demographic characteristics; alcohol/drug use; and self-perceived mental health. Poisson regression with robust variance was used. RESULTS: : A total of 425 TWT tested positive for HIV and underwent VL measurement, 179 (42.0%) presented detectable viremia. Factors positively associated with detectability were: younger age (PR=2.26; 95%CI 1.13;4.51), poorer housing conditions (PR=2.72; 95%CI 1.30;5.68) and poor/very poor mental health (PR=1.70; 95%CI 1.08;2.66). The use of antiretroviral drugs was a protective factor against detectability (PR=0.29; 95%CI 0.30;0.61). CONCLUSION: The factors associated with unsuppressed viral load highlight vulnerability related to gender identity that have a negative impact, despite the majority of participants being on antiretroviral therapy (ART). MAIN RESULTS: People aged 20-29 who were homeless or unstable and those who reported poor or very poor mental health were more likely to have a detectable viral load. ARV drug use was a protective factor. IMPLICATIONS FOR SERVICES: The identification of predictors for detectable viral load enables the design of appropriate strategies for monitoring and linking vulnerable people to health services, ensuring effective implementation. PERSPECTIVES: It is necessary to develop educational strategies that take into account important social issues to improve awareness about undetectable viral load in HIV prevention among the transgender population, especially among younger people.

A comparative study of Venezuelan immigrants' pre- and post-migration concerns for their children in the United States and Colombia.

Research suggests that forced migration may lead to cultural stress and psychological distress. However, little is known about immigrant parents' pre- and post-migration concerns for their children's welfare. The present study examined the concerns of Venezuelan parents who migrated to the United States versus those who migrated to Colombia, and whether post-migration concerns were related to cultural stressors, mental health, and cultural identity. A sample of 609 Venezuelan immigrants completed surveys and responded to an open-ended prompt asking about pre- and post-migration concerns for children's welfare. Lack of safety was the most common pre-migration concern for Venezuelans in the U.S., whereas lack of food was the most common pre-migration concern for Venezuelans in Colombia. More years in the destination country since arrival were linked to heightened economic concerns and reduced worries about family separation. A positive link emerged between national identity and health-related concerns for children following migration. This knowledge can inform policies and programs to better support immigrant families as they navigate the challenges of forced migration.

Factorial validation and invariance of the Academic Procrastination Scale in Colombian students.

BACKGROUND: Academic procrastination is an increasingly pertinent issue among university students, impacting their academic performance, interpersonal relationships, and emotional well-being. However, brief assessment tools for timely intervention are scarce, especially in the Colombian context. Therefore, this study aims to evaluate the psychometric properties of the academic procrastination scale and analyze its relationship with mental health and life satisfaction. METHODS: A total of 805 Colombian university students were selected through convenience sampling. Their ages ranged from 17 to 35 years, with an average age of 20.4 years (SD = 3.0).  RESULTS: The findings reveal a modified two-factor structure of the scale, with adequate fit indices (χ2 = 65.65, df = 13, p < .001; CFI = .96, TLI = .93, RMSEA = .07 (90% CI .06 - .09), SRMR = .03) and loadings above .50. Furthermore, both factors of the scale exhibited high reliability, with Cronbach's alpha and McDonald's omega coefficients greater than .80. The scale was also found to be gender invariant. Lastly, academic procrastination correlates positively with mental health and negatively with life satisfaction, while mental health relates negatively to life satisfaction. CONCLUSION: The Modified Academic Procrastination Scale (EPA-C) demonstrates adequate psychometric properties and is gender-invariant for assessing academic procrastination among Colombian university students. Moreover, it has an impact on the mental health and life satisfaction of these students.

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

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

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

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

Does work modify the relationship between violence and mental health among young people? Evidence from the Violence Against Children Surveys in Uganda, Nigeria and Colombia.

Background: Considering the well-established link between experiencing violence in childhood and poor mental health, it is important to understand the role of contextual factors in which young people live, learn, work, and play. Evidence has highlighted the importance of work as a contextual factor in the lives of young people, but it is unclear whether being in work mitigates, entrenches, or exacerbates the association between violence against children and poor mental health. Methods: This study is based on nationally representative data of males and females aged 13-24 years who completed the Violence Against Children Surveys in Nigeria, Uganda, and Colombia. We used multivariable logistic regression models to explore the association between lifetime violence and past 30-day mental distress, and explored whether working in the past year modified this association. All analyses were age- and sex-stratified and conducted separately in each country. Results: We found a high prevalence of lifetime violence among young people in all three countries and strong associations between violence and mental distress. In Colombia, there was strong evidence (P-value for interaction = 0.014) that work in the past year (adjusted odds ratio (aOR) = 0.42; 95% confidence interval (CI) = 0.07-2.57) reduced the risk of mental distress among girls who had experienced violence compared to not working in the past year (aOR = 6.12; 95% CI = 2.60-14.41). There was also evidence among boys in Nigeria (P-value for interaction = 0.045), where there was a reduction in risk of mental distress among those not in work in the past year (aOR = 0.99; 95% CI = 0.46-2.13) compared to those in work in the past year (aOR = 2.10; 95% CI = 1.32-3.33). There was also a pattern of effect modification by work in the association between childhood violence and mental health in other population groups, with variation by country, sex, and age groups. Conclusions: Our findings suggest that work can mitigate, entrench, or exacerbate risk of mental distress among young people who have experienced violence, depending on their age, sex, and country of residence. While additional research is needed to explore these mechanisms, this highlights the importance of work as a contextual factor in the lives of young people and points to the need for safe and secure workplaces and the integration of context-specific interventions into workplaces for young people.