Mental health of transitional aged youth in Nicaragua: Perceptions and experiences of educators.

Mental illnesses contribute to a large proportion of the disease burden in children and adolescents in low and middle-income countries (LMICs). There is limited research completed in LMICs about paediatric mental health, particularly related to youth. School is a place where many adolescents first seek mental health support. This study examined how educators in Nicaragua view youth mental health and how mental health can be supported in LMIC schools. Focus groups were completed with teachers serving youth from a variety of socioeconomic settings within León, Nicaragua. The study was completed from an Interpretivist theoretical paradigm and coding of qualitative data was completed consistent with Constructivist Grounded Theory. Educators described their roles in as detecting mental health problems and liasing with other supports; they noted barriers as cross-sector integration and social challenges. Educators felt that youth would be better served by improving integration of care, addressing structural factors, and providing more teacher supports. A model for addressing youth mental health in LMICs could include a stepped-care approach with schools providing preventative programming as well as developing within school referral strategies for youth with higher needs. There may be a role for the use of community health promoters.

Tranquility is a child with a full belly: Pathways linking food insecurity and maternal mental distress in Nicaragua.

A growing body of literature identifies food insecurity (FI) as a critical social determinant of mental health. Across settings, quantitative studies report positive correlations between FI and mental distress, especially among women. Less understood are the pathways by which FI undermines women's mental well-being. To address this gap, we conducted six focus group discussions with 45 Nicaraguan mothers. Thematic analysis identified three themes linking the management of FI and maternal mental well-being in this setting. The theme, la lucha, underscored how the chronicity of FI served as a constant mental strain by demanding mothers strategize on a daily basis to resolve it. The themes "tranquility is a child with a full belly" and "the despairing and frustrated mother" emphasized how FI challenged women's abilities to fulfill the responsibilities of motherhood and served as a reminder of social status. Our findings advance earlier quantitative work by identifying how the management of food insecurity undermines maternal mental well-being in a low-middle income setting and indicate that policies aimed at combating food insecurity can concomitantly improve maternal mental well-being if they bolster women's agency and work to reduce the stigma associated with being food insecure.

Maternal resources and household food security: evidence from Nicaragua.

OBJECTIVE: Women (especially mothers) are theorized as critical to reducing household food insecurity through their work and caregiver roles. The present study tests these assumptions, assessing how maternal economic and social resources are associated with food insecurity in households with young children. DESIGN: Data from a population-based sample of households was collected in León, Nicaragua (n 443). Data include a newly validated measure of household food insecurity (ELCSA), maternal resource measures, and household economic status and demographics. Regression analysis tests the statistical associations (P<0·05) of maternal resources with household, adult-specific and child-specific food insecurity. SETTING: Municipality of León, Nicaragua. SUBJECTS: Households with children aged 3-11 years in rural and urban León. RESULTS: Only 25% of households with young children were food secure, with 50% mildly food insecure and 25% moderately/severely food insecure. When mothers contributed substantially to household income, the odds of moderate/severe household food insecurity were 34% lower than when their spouse/partner was the main provider. The odds of food insecurity were 60% lower when mothers managed household money, 48% lower when mothers had a secondary (v. primary) education, 65% higher among single mothers and 16% lower with each indicator of social support. Results were similar for adult- and child-specific food insecurity. CONCLUSIONS: This research provides new evidence that maternal economic and social resources are important for reducing household food insecurity and adult- and child-specific food insecurity. Women's social status, social support and access to economic resources need to be enhanced as a part of policies aimed to reduce food insecurity in high-poverty settings.

Policonsumo simultáneo de drogas en estudiantes de facultades de ciencias de la salud/ciencias médicas en siete universidades de cinco países de América Latina y un país del Caribe: implicaciones de género, legales y sociales / Simultaneous polydrug consuption among undergraduate students of health sciences of seven universities in five Latin American countries and one Caribean country: gender, legal and social implicacions / Policonsumo simultâneo de drogas entre estudantes de graduação de ciências da saúde de sete universidades em cinco países da América Latina e um país do Caribe: implicações de gênero, legal e sociais

El objetivo de este estudio fue comprender los patrones de policonsumo simultáneo de sustancias psicoactivas y sus implicaciones de género, legales y sociales, en estudiantes de primer y segundo año de las facultades de ciencias de la salud/ciencias médicas, en siete universidades de cinco países latinoamericanos, Colombia, Nicaragua, Chile, Brasil y El Salvador, y un país caribeño, Jamaica. El diseño fue un corte transversal. Las combinaciones de alcohol + tabaco y de alcohol + marihuana fueron las mas reportadas en todas las universidades, a excepción de alcohol + tabaco en Jamaica. Los factores asociados al policonsumo más referidos fueron "tener relaciones sexuales inesperada" en la universidad de Brasil, "tener relaciones sexuales sin protección" en las universidades de Chile, Colombia y Nicaragua, "tener problemas con su pareja sentimental" en la universidad de Jamaica, y "ausentarse de clases" en la universidad de El Salvador. Tres entornos se relacionaron, de manera positiva o negativa, con el policonsumo simultáneo de sustancias psicoactivas: estudiantil, familiar y de comportamiento sexual.

The objective of this study was to understand patterns of simultaneous polydrug use of psychoactive substances and its gender, legal and social implications, among first and second year undergraduate students in health sciences/medical sciences faculties from six universities in five Latin American countries, Colombia, Nicaragua, Chile, Brazil, and El Salvador, and one Caribbean country, Jamaica. The study design was cross-sectional. The combinations of alcohol + tobacco and alchol + cannabis were the most frequently reported in all universities, with the exception of alcohol + tabaco in Jamaica. The factors associated to polidrug use most frequently mentioned were "to have unexpected sexual relationships" in the Brazilian university, "to have unprotected sex" in the universities of Chile, Colombia and Nicaragua, "to have problems with his o her sentimental partner" in the Jamaican university, and "to skip classes" in the university of El Salvador. Three environments were related, positively or negatively, with simultaneous polydrug use of psychoactive substances: academic, familiar and sexual behavioral.

Estudo de corte transversal que teve por objetivo compreender os padrões de policonsumo simultâneo de substâncias psicoativas e suas implicações de gênero, direitos legais e sociais entre estudantes do primeiro e segundo ano de faculdades de ciencias da saúde/médicas, de sete universidades, em cinco países latinoamericanos e um do Caribe. Os resultados indicam que o uso de múltiplas drogas simultâneas como álcool + tabaco foi maior para as universidades na Colômbia, Nicarágua, Chile, Brasil e El Salvador, com exceção da Jamaica, seguido por policonsumo simultâneo de álcool + maconha. A consequencia mais comum entre os estudantes que usam mais de uma substância psicoativa é o "sexo eventual" na Universidade do Brasil; "ter relações sexuais sem proteção" nas Universidades do Chile, Colômbia e Nicarágua; "ter problemas com seu parceiro sentimental" na Universidade da Jamaica, e ausentar-se das aulas" para a Universidade de El Salvador. Conclui-se que os modelos representam a existência de três ambientes relacionados entre si, positiva ou negativamente, com o uso simultâneo de substâncias psicoativas: ou seja, estudante, família do aluno e comportamento sexual.

Policonsumo simultáneo de drogas en estudiantes de pregrado del área de la salud en una universidad, León - Nicaragua / Simultaneous polydrug use among undergraduate from the health sciences area in one university, León - Nicaragua / Policonsumo simultâneo de drogas entre estudantes de graduação da área de ciências da saúde de uma universidade, León - Nicaragua

Las drogas constituyen una seria amenaza para la salud internacional. Este estudio tuvo como objetivo explorar los patrones de policonsumo simultáneo y sus implicaciones legales y sociales entre estudiante de pregrado. El estudio fue de corte transversal, y en el participaron 357 estudiantes de pregrado del área de la salud de una universidad. El 52.1% de los participantes dijo haber usado sustancias psicoactivas alguna vez en su vida, y el 42.6% dijo haber consumido en los últimos 12 meses. En el último año, un 80.3% refirió haber consumido alcohol, un 34.2% tabaco, un 5.9% drogas de prescripción, un 4.6% cannabis, y un 3.9% cocaína/crack. En relación al consumo simultáneo en los últimos 12 meses, las cifras de reportadas fueron de 14.7% para alcohol + tabaco + cannabis, y de 8.8% para las todas las siguientes combinaciones: alcohol + cannabis, alcohol + cocaína, y cannabis + cocaína. Factores asociados al consumo fueron identificados. Se sugieren programas preventivos e investigación adicional en el tema.

Drug use constitutes a serious threat to health internationally. This study aimed to explore patterns of simultaneous polydrug use and their legal and social implications among undergraduate students. The study was cross-sectional, with a sample size of 357 undergraduate students from health care programs in one university. 52.1% of participants said to have used psychoactive substances somewhere in their lives, and 42.6% referred consumption in the last 12 months. For the year, 80.3% referred to have consumed alcohol, 34.2% tobacco, 5.9% prescription drugs, 4.6% cannabis, and 3.9% cocaine/crack. In relation to the simultaneous consumption in the last 12 months, the report rates were14.7% for alcohol + tobacco + cannabis, and 8.8% for all following combinations: alcohol + cannabis, alcohol + cocaine, and cannabis + cocaine. We explored factors associated with to drug consumption. Preventive programs and further research is suggested.

As drogas constituem uma séria ameaça para a saúde internacional. Este estudo teve como objetivo explorar o policonsumo simultâneo de drogas e suas consequências legais e sociais entre estudantes de graduação da área de ciências da saúde. Este estudo é de corte transversal com a participação de 357 estudantes de graduação da área da saúde de uma universidade. 52,1% disseram ter usado substância psicoactiva alguma vez em sua vida e 42,6% tinham consumido nos últimos 12 meses. Nos último ano, 80,3% dos estudantes tinha consumido álcool, 34,2% tabaco, 5,9% drogas prescritas, 4,6% maconha, e 3,9% cocaína/crack. Em relação ao consumo simultâneo nos últimos 12 meses, foram álcool + tabaco + maconha (14,7%); e álcool + maconha, álcool + cocaína, e maconha + cocaína, todos com 8,8%. Fatores associados ao uso de drogas foram identificados. Sugere-se programas de prevenção e pesquisa adicional sobre o assunto.

Comorbilidad entre el distrés psicologico y el abuso de drogas en pacientes en centros de tratamiento, en la ciudad de Leon - Nicaragua: implicaciones para políticas y programas / Comorbidity between psychological distress and abuse of drugs in patients in treatment centers in the city of Leon - Nicaragua: implications for policies and programs / Comorbidade entre sofrimento psíquico e abuso de drogas em pacientes nos centros de tratamento na cidade de León - Nicaragua: implicações para as políticas e programas

La presencia de trastornos de salud mental y consumo de drogas ambos se conocen como comorbilidad. Este estudio tuvo como objetivo determinar la prevalencia de la comorbilidad entre el distrés psicológico y el abuso/dependencia de drogas en pacientes de Centros de tratamiento en León, Nicaragua. La mayoría de participantes del estudio eran hombres y 68.5% eran menor de 40 años, solteros (58.5%), con bajo nivel de educación, trabajo de forma autónoma (51.2%), y 41.5% viven con su madre biológica. El 65.9% de los pacientes llegaron al centro por cuenta propia. Las drogas más consumida fueron alcohol, marihuana y crack (59.7%, 58.2% y 53.7%). Los trastornos concurrente más comunes fueron, ansiedad (29.3%), depresión (24.1%), esquizofrenia 9.8% y trastorno bipolar 2,4% y según la escala de Kessler K-10, el 56% de los participantes fueron diagnosticados con distrés psicológico severo. Según la escala de APGAR-familiar, el 26% percibieron familias como disfuncionales.

This study aimed to determine the prevalence of comorbidity between psychological distrés and abuse/dependence in patients on drug treatment centers in Leon, Nicaragua. We performed a cross-sectional study, aimed at people who were in treatment for abuse/dependence of drugs in specialized centers with a total of 41 participants. Most study participants were men and 68.5% were under 40 years old, single (58.5%), low education level, work independently (51.2%), 41.5% live with their biological mother. The 65.9% of patients arrived at the center on their own. The drugs most consumed were alcohol, marijuana and crack (59.7%, 58.2% and 53.7%). We conclude that the most common concurrent disorders were anxiety (29.3%), depression (24.1%), schizophrenia (9.8%) and bipolar disorder (2.4%) and according to the scale of the Kessler K-10 56.0% of participants were diagnosed with severe psychological distrés. And according to the family APGAR scale, 26% had severe family dysfunction.

Este estudo teve como objetivo determinar a prevalência de comorbidade entre a sofrimento psíquico e o abuso nos pacientes em centros de tratamento de toxicodependência em Leon, na Nicarágua. Estudo transversal, destinado a pessoas que estavam em tratamento para abuso de drogas em centros especializados com um total de 41 participantes. A maioria dos participantes eram homens, 68,5% tinham menos de 40 anos, solteiros (58,5%), baixa escolaridade, trabalham de forma independente (51,2%), 41,5% moram com a mãe biológica, 65,9% dos pacientes procuraram o centro por conta própria, 48,8% responderam que não tinham recebido qualquer tratamento. As drogas mais consumidas pelos participantes foram álcool, maconha e crack (59,7%, 58,2% e 53,7%). Conclui-se que os distúrbios mais comuns foram ansiedade (29,3%), depressão (24,1%), esquizofrenia (9,8%) e transtorno bipolar (2,4%). De acordo com a escala do K-10 Kessler, 56,0% dos participantes foram diagnosticados com sofrimento psíquico grave, e de acordo com a escala APGAR da família, 26% tinham disfunção familiar grave.