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2.
Soc Sci Med ; 287: 114374, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34534779

RESUMO

INTRODUCTION: Amongst its advocates, one of the key arguments for a Universal Basic Income (UBI) is its potential to improve population mental health. However, while previous authors have variously examined the potential effects of UBI on income, employment and labour market demand, the direct mental health consequences of previous pilots have been less frequently examined. The purpose of this paper is therefore to conduct a review of the literature on UBI and to re-examine the existing research with a mental health focus. METHODS: Six electronic databases were used to conduct a review of the literature. We searched for empirical research studies of any design, conducted since the year 2000 in High Income Countries, exploring the effects of interventions similar to a UBI on the mental health of children or working-age adults. Grey literature and government reports were also included. RESULTS: A total of 1566 articles were screened of which seven peer reviewed studies and eight governmental reports were ultimately selected for inclusion. None of the identified studies directly compared the impact of individual payments with those made on a household basis, or the effects of payments which were truly universal. However, several studies evaluated the mental health outcomes associated with payments provided unconditionally, and consistently reported clear and significant improvements in mental wellbeing. Potential mediating factors included improved time with family and friends, a reduction in perceived stigma and a renewed sense of hope for the future. CONCLUSIONS: Our review has produced evidence to suggest that prophesies surrounding the mental health benefits of a UBI are at least partially justified. However, future studies should aim to be conducted at an area level, with an adequately powered sample size, and investigate interventions of a considerable duration using a longitudinal design.


Assuntos
Saúde Mental , Pilotos , Adulto , Criança , Emprego , Humanos , Renda
3.
J Psychiatr Res ; 137: 131-146, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33677217

RESUMO

BACKGROUND: Borderline Personality Disorder (BPD) is a psychiatric disorder associated with significant morbidity and mortality. However, the neurobiological alterations underlying the condition remain poorly understood. As a result, existing treatments remain inadequate. One of the main risk factors for the development of BPD is a history of childhood maltreatment. However, it is considered neither causative nor specific to the condition. Current theory is therefore increasingly moving toward a 'Gene x Environment' (GxE) model of the condition. The purpose of the current work was to conduct a systematic literature review, which comprehensively identifies all published molecular level GxE studies that have explored the role of specific genetic loci, in influencing the risk of BPD following exposure to childhood abuse or neglect. METHODS: Four electronic databases were used to systematically search for molecular level GxE studies of any design, which focused on the development of BPD following exposure to childhood abuse or neglect, without language or date restrictions. Articles were screened independently by two reviewers and results were synthesized narratively. RESULTS: A total of 473 articles were screened of which sixteen were selected for inclusion in our review. Implicated genes were categorised according to their influence on; Neurotransmitter Systems, Neurodevelopment and Neuroendocrine Systems. CONCLUSIONS: The identified studies have produced several relevant and statistically significant results. Of particular note, is the repeated finding that genes involved in HPA axis regulation, may be altered by exposure to childhood maltreatment, influencing subsequent susceptibility to BPD. This is both biologically plausible and of potential clinical significance.


Assuntos
Transtorno da Personalidade Borderline , Maus-Tratos Infantis , Transtorno da Personalidade Borderline/genética , Criança , Humanos , Sistema Hipotálamo-Hipofisário , Sistema Hipófise-Suprarrenal , Fatores de Risco
4.
Transcult Psychiatry ; 58(2): 307-320, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33522455

RESUMO

Exposure to war, conflict and forced migration puts children at risk of mental health problems. The present study examined the levels of psychological distress and resilience factors among 106 Palestinian refugee children aged 11 to 17 in the West Bank. In a cross-sectional, mixed method design along with qualitative interviews, three questionnaires were administered: the Strength and Difficulties Questionnaire and Patient Health Questionnaire-15, assessed the risk of mental health disorders and psychosomatic complaints, and the Child and Youth Resilience Measure assessed the availability of resilience-enhancing factors. Palestinian refugee children were found to be at greater risk for mental disorders and psychosomatic complaints than were children living in non-conflict affected settings. In addition, resilience-enhancing resources were significantly reduced and were negatively correlated with both symptom outcomes. Risk factors identified included poverty, violence and marginalisation. Key protective factors were youth education, supportive relationships and social participation. Our findings support interventions that address the identified protective factors, which may promote the mental health of this vulnerable population.


Assuntos
Sintomas Inexplicáveis , Transtornos Mentais , Refugiados , Adolescente , Árabes , Criança , Estudos Transversais , Humanos , Transtornos Mentais/epidemiologia , Saúde Mental
5.
PLoS One ; 15(12): e0243639, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33290423

RESUMO

BACKGROUND: Studies on the impacts of child maltreatment (CM) have been conducted in diverse areas. Mechanistic understanding of the complex interplay between factors is lacking. Hallmarking is an approach which identifies common factors across studies and highlights the most robust findings. OBJECTIVES: In a review of systematic reviews and meta-analyses, we addressed the following questions: 1) What are the hallmarks associated with exposure to CM across the bio-ecological spectrum? 2) What is the strength of evidence to support each hallmark? 3) What are the gaps that future research should address? METHODS: A comprehensive literature search was carried out to find relevant systematic reviews or meta-analyses. 269 articles were read in full and 178 articles, encompassing more than 6000 original papers, were included in the final synthesis. All reviews were independently rated for quality by at least 2 reviewers using AMSTAR-2. RESULTS: Of 178 review articles, 6 were rated as high quality (all meta-analyses) and 46 were rated as medium quality. Most were from high income countries. CONCLUSIONS: Based on the most commonly reported high-quality research findings we propose that the hallmarks of exposure to child maltreatment are: Increased risk of psychopathology; Increased risk of obesity; Increased risk of high- risk sexual behaviours, Increased risk of smoking; and Increased risk of child maltreatment in children with disabilities. Research gaps include a lack of focus on complexity and resilience. Little can be concluded about directions of causality or mechanisms. Adequately powered prospective studies are required to move the field forward.


Assuntos
Maus-Tratos Infantis , Criança , Humanos , Obesidade/etiologia , Psicopatologia , Fatores de Risco , Assunção de Riscos , Comportamento Sexual , Fumar/epidemiologia
6.
Cell Rep ; 33(5): 108331, 2020 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-33147448

RESUMO

Homeostatic mucosal immune responses are fine-tuned by naturally evolved interactions with native microbes, and integrating these relationships into experimental models can provide new insights into human diseases. Here, we leverage a murine-adapted airway microbe, Bordetella pseudohinzii (Bph), to investigate how chronic colonization impacts mucosal immunity and the development of allergic airway inflammation (AAI). Colonization with Bph induces the differentiation of interleukin-17A (IL-17A)-secreting T-helper cells that aid in controlling bacterial abundance. Bph colonization protects from AAI and is associated with increased production of secretory leukocyte protease inhibitor (SLPI), an antimicrobial peptide with anti-inflammatory properties. These findings are additionally supported by clinical data showing that higher levels of upper respiratory SLPI correlate both with greater asthma control and the presence of Haemophilus, a bacterial genus associated with AAI. We propose that SLPI could be used as a biomarker of beneficial host-commensal relationships in the airway.


Assuntos
Interações entre Hospedeiro e Microrganismos , Hipersensibilidade/microbiologia , Hipersensibilidade/patologia , Inflamação/patologia , Pulmão/microbiologia , Pulmão/patologia , Microbiota , Inibidor Secretado de Peptidases Leucocitárias/metabolismo , Células A549 , Adolescente , Adulto , Animais , Antígenos/metabolismo , Bordetella/fisiologia , Criança , Contagem de Colônia Microbiana , Modelos Animais de Doenças , Interações entre Hospedeiro e Microrganismos/genética , Humanos , Hipersensibilidade/complicações , Hipersensibilidade/imunologia , Imunidade , Inflamação/complicações , Inflamação/imunologia , Inflamação/microbiologia , Pulmão/imunologia , Camundongos Endogâmicos C57BL , Ovalbumina/imunologia , Células Th17/imunologia , Transcriptoma/genética , Adulto Jovem
8.
Psychol Serv ; 16(2): 286-292, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30359074

RESUMO

Financial stress has been frequently identified as a risk factor for suicidal behavior, both in military and civilian groups. However, it remains unclear to what degree financial stress may be associated independently with suicide behavior when accounting for other risk factors. This study examined data on suicide and suicide attempt cases in the Department of Defense Suicide Event Report compared with service members who did not have recent suicide behavior. The resulting multinomial regression analysis found that financial distress had a weak association with suicide, and its relationship to suicide attempts was not statistically significant. Compared with financial distress, relationship problems and substance abuse history appeared to have much stronger associations with suicidal behavior, as did having a diagnosis of a mood disorder, such as major depressive disorder. The major conclusion from these data are that although financial distress may be a risk factor for suicidal behavior, the relationship is likely indirect and considerably less substantial than previously suspected. In addition, its relative influence is significantly less than other identified risk factors. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Status Econômico , Militares/estatística & dados numéricos , Estresse Psicológico/epidemiologia , Suicídio/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , United States Department of Defense/estatística & dados numéricos , Adulto Jovem
9.
Cell Host Microbe ; 24(3): 337-339, 2018 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-30212647

RESUMO

In this issue of Cell Host & Microbe, Teo et al. (2018) explore the development of the upper airway microbiota over the first 5 years of life and provide evidence for a "critical window" of microbial exposure that contributes to chronic wheezing, a precursor to asthma.


Assuntos
Asma/microbiologia , Hipersensibilidade , Microbiota , Bactérias , Criança , Humanos , Sons Respiratórios
10.
Dialogues Clin Neurosci ; 20(4): 327-339, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30936771

RESUMO

Adults presenting to maxillofacial surgery services are at high risk of psychological morbidity. This study examined the prevalence of depression, post-traumatic stress disorder (PTSD), anxiety, drug and alcohol use, and appearance-related distress among maxillofacial trauma outpatients over medium-term follow-up. It also explored socio-demographic and injury-related variables associated with psychological distress to inform targeted psychological screening protocols for maxillofacial trauma services. Significant associations were found between level of distress at time of injury and number of traumatic life events with levels of depression at 3 months. No significant associations were found between predictor variables and PTSD at 3 months, or with any psychiatric diagnosis at 6 months. The lack of evidence for an identifiable subgroup of patients who were at higher risk of psychological distress indicated that routine screening of all maxillofacial trauma outpatients should be offered in order to best respond to their mental health needs. The feasibility of the medical team facilitating this is challenging and should ideally be undertaken by psychologists integrated within the MDT. This study led to the funding of a clinical psychologist to provide collaborative care with the maxillofacial surgeons, resulting in brief assessment and treatment to over 600 patients in the first year of the service.


Los adultos que consultan en los servicios de cirugía máxilo-facial tienen un alto riesgo de presentar morbilidad psicológica. Este estudio examinó la prevalencia de depresión, trastorno por estrés postraumático (TEPT), ansiedad, uso de alcohol y drogas, y distrés relacionado con la apariencia entre los pacientes con trauma máxilofacial en un seguimiento ambulatorio de mediano plazo. También se exploraron variables socio-demográficas y otras relacionadas con las lesiones que se asocian con distrés psicológico para contar con protocolos de evaluación psicológica orientados a los servicios de trauma máxilo-facial. Se encontraron asociaciones significativas entre el nivel de distrés al momento de la lesión y el número de acontecimientos traumáticos con los niveles de depresión a los tres meses. En cambio, no hubo asociaciones significativas entre las variables predictoras y el TEPT a los tres meses, o con algún diagnóstico psiquiátrico a los seis meses. La falta de evidencia de un subgrupo identificable de pacientes que estuvieron en alto riesgo de distrés psicológico indicaron que se debe ofrecer la evaluación de rutina a todos los pacientes ambulatorios con trauma máxilo-facial para responder mejor a sus necesidades de salud mental. Constituye un desafío configurar un equipo médico que permita esto y lo ideal es que se forme un equipo multidisciplinario en que estén integrados psicólogos. Este estudio permitió el financiamiento de un psicólogo clínico, quien aportó atención en colaboración con los cirujanos máxilo-faciales, lo que se tradujo en una evaluación breve y el tratamiento de más de 600 pacientes durante el primer año de funcionamiento del servicio.


Les adultes hospitalisés des services de chirurgie maxillo-faciale sont à risque élevé de morbidité psychologique. Cette étude analyse la prévalence de la dépression, du syndrome de stress post-traumatique (SSPT), de l'anxiété, de la consommation de drogues et d'alcool ainsi que de la détresse liée à l'apparence chez des patients ayant subi un traumatisme maxillo-facial, avec un suivi à moyen terme en ambulatoire. Les variables socio-démographiques et liées à la lésion ainsi que la détresse psychologique sont également examinées afin de renseigner des protocoles ciblés de dépistage psychologique pour les services de chirurgie maxillo-faciale. Le niveau de détresse au moment de la lésion et le nombre d'événements traumatiques de la vie sont significativement associés aux niveaux de dépression à 3 mois. Aucune association significative n'a été trouvée entre les variables prédictives et le SSPT à 3 mois ou un diagnostic psychiatrique quel qu'il soit à 6 mois. L'identification d'un sous-groupe de patients à risque élevé de détresse psychologique est difficile : le dépistage de routine de tous les patients suivis en ambulatoire après chirurgie maxillo-faciale devrait donc être proposé afin de mieux répondre à leurs besoins en santé mentale. Créer l'équipe médicale qui le permettrait est compliqué ; idéalement, cette tâche devrait être confiée à des psychologues au sein d'une équipe pluridisciplinaire. Grâce à l'étude, le poste d'un psychologue clinicien a été financé, qui travaille en collaboration avec les chirurgiens maxillo-faciaux. C'est ainsi que plus de 600 patients ont été évalués et traités au cours de la première année.


Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , Traumatismos Faciais/epidemiologia , Traumatismos Faciais/psicologia , Valor Preditivo dos Testes , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/fisiopatologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Depressão/epidemiologia , Depressão/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Reino Unido
11.
Cell Biol Int ; 39(2): 210-6, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25196852

RESUMO

Gamma delta (γδ) T cells contribute to both innate and acquired immune responses during infection. In this pilot study, we measured the in vitro responses of γδT cell populations from patients with sepsis compared to cells from healthy subjects. We also measured production of interferon (IFN)γ. Mononuclear cells were isolated from 10 healthy control subjects and 20 patients with sepsis. Cells were cultured for 7 days with interleukin (IL)-2 plus the bisphosphonate zoledronic acid which results in indirect cell activation. Flow cytometry was used to characterise the γδT cells and enzyme immunoassay was used to measure IFNγ production. The median [range] proportion of γδT cells in healthy controls after activation was 19.2% [2.0-55.9%], compared to only 0.61% [0.1-3.6%] (P < 0.0001) in patients with sepsis. However, IFNγ levels in culture supernatants were similar in both the patients and healthy subjects. We therefore characterised the cells further by CD27 and CD45RA expression in a additional group of patients and found that the population of γδT cells was mainly CD27 negative which characterised these cells as non-proliferating effector cells. Our results suggest predominance of a non-proliferative effector subset of γδT cells in patients with sepsis, which retain functional activity and may contribute towards the host response to inflammation and infection.


Assuntos
Sepse/patologia , Linfócitos T/citologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Células Cultivadas , Difosfonatos/farmacologia , Feminino , Humanos , Imidazóis/farmacologia , Interferon gama/metabolismo , Interleucina-2/farmacologia , Antígenos Comuns de Leucócito/metabolismo , Masculino , Pessoa de Meia-Idade , Sepse/metabolismo , Índice de Gravidade de Doença , Linfócitos T/efeitos dos fármacos , Linfócitos T/metabolismo , Membro 7 da Superfamília de Receptores de Fatores de Necrose Tumoral/metabolismo , Ácido Zoledrônico
12.
Clin Child Psychol Psychiatry ; 20(4): 570-84, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24928278

RESUMO

'Disruptive behaviour disorders' are the most common reason for referral to Child and Adolescent Mental Health Services (CAMHS). Current treatment guidelines focus on parent-training programmes. Difficulties are often reported when engaging families, with parental attributions and attitudes towards help-seeking proposed as influential factors. Previous research has tended to privilege pre-existing frameworks; this study utilised qualitative methods to add to the current understanding of the ways in which parents make sense of their children's behaviour. Semi-structured interviews were carried out with six mothers, recruited through CAMHS. Interpretative Phenomenological Analysis (IPA) revealed four master themes: 'Understanding the Emotional Child', 'The Emotional Parent', 'Getting Help' and 'The Journey'. Participants used a variety of explanations in order to make sense of their children's behaviour, including the impact of loss and trauma. Help-seeking was associated with feelings of shame, and services were often viewed as inconsistent and stigmatising. In contrast, positive experiences were those which were characterised as being non-judgemental, normalising and took into account the wider family context, including mothers' own emotional needs. These findings were discussed in relation to existing research and implications for clinical practice.


Assuntos
Comportamento do Adolescente/psicologia , Comportamento Infantil/psicologia , Transtorno da Conduta/psicologia , Emoções/fisiologia , Mães/psicologia , Adolescente , Criança , Feminino , Humanos , Masculino , Vergonha
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