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J Am Board Fam Med ; 35(4): 793-802, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35896446


INTRODUCTION: Many primary care clinics screen patients for their unmet social needs, such as food insecurity and housing instability, and refer them to community-based organizations (CBOs). However, the ability for patients to have their needs met is difficult to evaluate and address. This study explores patient-reported barriers to accessing referred resources using a conceptual framework that identifies opportunities for intervening to optimize success. METHODS: Patients who participated in a social needs screening and referral intervention at a Federally Qualified Health Center (FQHC) were called 2 weeks after the clinic encounter. We conducted a directed content analysis across 6 domains of access to examine responses from patients who reported barriers. RESULTS: Of the 462 patients that were reached for follow-up, 366 patients reported 537 total barriers. The most frequent challenges related to resource availability (24.6%, eg, patients waiting for submitted application to process) and approachability (23.8%, eg, patients lacking information needed to contact or access resources). Barriers in the domains of acceptability (21.6%, eg, competing life priorities such as medical issues, major life events, or caretaking responsibilities) and appropriateness (17.9%, eg, resource no longer needed) largely represented patient constraints expressed only after the clinical encounter. It was less common for patients to identify accommodation (eg, physical limitations, language barriers, transportation barriers, administrative complexity) or affordability of community resources as barriers (11.2% and 0.9%, respectively). CONCLUSION: Findings suggest opportunities for improvement across the access continuum, from initial referrals from primary care staff during the clinical encounter to patients' attempts to accessing services in the community. Future efforts should consider increased collaboration between health and social service organizations, and advocacy for structural changes that mitigate system-level barriers related to resource availability and administrative complexity.

Encaminhamento e Consulta , Serviço Social , Assistência Ambulatorial , Humanos , Programas de Rastreamento
Investig. desar ; 30(1): 313-331, ene.-jun. 2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1385969


RESUMEN Este artículo presenta una reflexión producida tras una serie de intervenciones realizadas en el sector conocido como "El Bronx" en la ciudad de Bogotá, financiadas por el Gobierno nacional y distrital para, por un lado, comprender el papel que algunas dinámicas territoriales tienen para prevenir el crimen y, por otro lado, diseñar e implementar una estrategia en los entornos escolares locales que ayudara a reducir la vulnerabilidad de los jóvenes del sector. Las propuestas de trabajo desarrollan lineamientos de las políticas sociales articulando elementos propios de la geografía humana, la sociología y la psicología alrededor de propuestas como las Zonas de Orientación Escolar. Entre las conclusiones pueden encontrarse indicios sobre la importancia de considerar el efecto que las dinámicas territoriales tienen para la efectividad del diseño e implementación de políticas sociales, así como también la dificultad que representa la definición de indicadores que permitan la comparabilidad con experiencias similares.

ABSTRACT This paper is a reflection produced after a series of interventions carried out at the sector known as "The Bronx", in the city of Bogotá, financed by the national and district governments. The main aim was, on one hand, to understand the role that some dynamics play in order to prevent crime, and, on the other hand, to design and implement a strategy in local schools that will help to reduce the individual vulnerability of young people in the sector. The work proposals develop social policy guidelines articulating elements of human geography, sociology, and psychology, around proposals such as the Zonas de Orientación Escolar (School Guiding Zones, Indications about the importance of considering the effect that territorial dynamics have on the effectiveness of the design and implementation of social policies, as well as the difficulty of defining indicators that allow comparability with similar experiences, can be found among the conclusions.

Front Genet ; 13: 871820, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35528545


Introduction: Prenatal environmental exposures have been associated with children's cognitive, behavioral, and mental health problems, and alterations in DNA methylation have been hypothesized as an underlying biological mechanism. However, when testing this hypothesis, it is often difficult to overcome the problem of multiple comparisons in statistical testing when evaluating a large number of developmental outcomes and DNA methylation sites as potential mediators. The objective of this study is to implement a 'meet-in-the-middle' approach with a sequential roadmap to address this concern. Methods: In the Columbia Center for Children's Environmental Health birth cohort study, we implemented a 5-step sequential process for identifying CpG sites that mediate associations between prenatal environmental exposures and cognitive, behavioral, and mental health problems as measured by the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) and the Child Behavior Checklist (CBCL). These steps include 1) the identification of biological pathways that are relevant to each outcome of interest; 2) selection of a set of genes and CpGs on genes that are significantly associated with the outcomes; 3) identification of exposures that are significantly associated with selected CpGs; 4) examination of exposure-outcome relationships among those where significant CpGs were identified; and 5) mediation analysis of the selected exposures and corresponding outcomes. In this study, we considered a spectrum of environmental exposure classes including environmental phenols, pesticides, phthalates, flame retardants and air pollutants. Results: Among all considered exposures and outcomes, we found one CpG site (cg27510182) on gene (DAB1) that potentially mediates the effect of exposure to PAH on CBCL social problems at children aged 7. Conclusion: This 'meet-in-the-middle' approach attenuates concerns regarding multiple comparisons by focusing on genes and pathways that are biologically relevant for the hypothesis.

J Am Board Fam Med ; 35(2): 443-444, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35379734


Despite interacting with a number of other people, doctors are at risk of social isolation. The author shares from his experiences how the use of professional titles may unintentionally hinder the development of meaningful relationships at and away from work. This may increase the risk for physicians to experience isolation, loneliness and burnout.

Esgotamento Profissional , Médicos , Esgotamento Profissional/prevenção & controle , Humanos , Solidão , Isolamento Social
J Anal Psychol ; 67(1): 275-286, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35417574


Latin America is a civilization in transition, a kind of 'in-between', as Rafael López-Pedraza would coin the expression: it is associated not only with various levels of pre-existing consciousness, but also with the emotional life of its inhabitants. This Latin American baroque speaks not only of the cultural complexes which pertain to all of the peoples in this vast territory, but also of why certain emotions - cruelty, intolerance, anxiety, sadness, resentment, joy, rage, envy, suffering, fear, indignation, jealousy, sorrow and shame, to name a few - move these complexes and acquire certain shades in each region and in each inhabitant. Let us remember the relationship that Jung establishes between the emotions and the complexes. For him, although the emotions are the same in their content, they cluster in the complexes of each individual or collective in such a specific, automatic, spontaneous and involuntary way that they possess their own energy, and no one can ignore them. Taking into account these notions of emotion and complex, we analyze some emotions proposed by López-Pedraza (2008) in his book, Emotions: A List, to draw a picture of the collective emotions that predominate among Latin Americans.

L'Amérique Latine est une civilisation en transition, une sorte d' « entre-deux ¼, selon l'expression de Rafael Lopez Pedraza, associée non seulement avec différents niveaux de conscience préexistants, mais aussi avec la vie émotionnelle de ses habitants. Ce « baroque ¼ Latino-Américain évoque non seulement des complexes culturels qui se rapportent à tous les peuples de ce vaste territoire, mais aussi pourquoi certaines émotions - la cruauté, l'intolérance, l'angoisse, la tristesse, la rancœur, la joie, la rage, l'envie, la souffrance, la peur, l'indignation, la jalousie, le chagrin et la honte, pour n'en citer que quelques-unes - animent ces complexes et acquièrent certaines teintes dans chaque région et chaque habitant. Souvenons-nous de la relation que Jung établit entre les émotions et les complexes. Pour lui, bien que les émotions soient les mêmes dans leur contenu, elles se groupent en « clusters ¼ dans les complexes de chaque individu ou collectif d'une manière spécifique, automatique, spontanée et involontaire. Elles possèdent leur propre énergie, et personne ne peut les ignorer. Prenant en compte ces notions d'émotion et de complexe, nous analysons quelques émotions proposées par López-Pedraza dans son livre « Emotions: a List ¼, afin de faire un tableau des émotions collectives qui prédominent chez les Latino-Américains.

Latinoamérica es una civilización en transición, una suerte de 'in between', como acuñaría Rafael López Pedraza, estando asociada no solo a los diversos niveles de consciencia preexistentes sino a la vida emocional de sus habitantes. Ese barroco latinoamericano que somos habla no sólo de los complejos culturales que nos atañen a todos en este vasto territorio, sino también de por qué ciertas emociones -la crueldad, la intolerancia, la ansiedad, la tristeza, el resentimiento, la alegría, la rabia, la envidia, el sufrimiento, el miedo, la indignación, los celos, el duelo y la vergüenza, por nombrar algunas--, mueven esas complejidades y adquieren tintes particulares en cada región y en cada habitante. Recordemos la relación que Jung establece entre las emociones y los complejos. Para él, aunque las emociones son iguales en su contenido se constelan en los complejos de cada individuo o colectividad de manera tan particular, automática, espontánea e involuntaria que poseen su propia energía y nadie puede ser indiferente ante ellas. Teniendo en cuenta estas nociones de emoción y complejo quisiéramos analizar algunas emociones propuestas por López Pedraza en su libro Emociones: una lista, para hacernos una imagen de emociones colectivas que predominan entre nosotros los latinoamericanos.

A América Latina é uma civilização em transição, uma espécie de "intermediária", como Rafael López-Pedraza cunharia a expressão: está associada não apenas a vários níveis de consciência pré-existente, mas também à vida emocional de seus habitantes. Este barroco latino-americano fala não apenas dos complexos culturais que pertencem a todos os povos deste vasto território, mas também de por que certas emoções - crueldade, intolerância, ansiedade, tristeza, ressentimento, alegria, raiva, inveja, sofrimento, medo, indignação, ciúme, tristeza e vergonha, para citar alguns - movem esses complexos e adquirem certos tons em cada região. Lembremo-nos da relação que Jung estabelece entre as emoções e os complexos, para ele, embora as emoções sejam as mesmas em seu conteúdo, elas se agrupam nos complexos de cada indivíduo ou coletivo de maneira tão específica, automática, espontânea e involuntária que possuem sua própria energia, e ninguém pode ignorá-las. Levando em consideração essas noções de emoção e complexidade, analisamos algumas emoções propostas por López-Pedraza em seu libro Emoções: uma Lista, para traçar um quadro de emoções coletivas que predominam entre os latino-americanos.

Civilização , Emoções , Humanos , América Latina , Masculino
Eur J Gen Pract ; 28(1): 40-47, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35379063


BACKGROUND: Previous studies show an association between a history of abuse and higher care demand. However, studies in general practice regarding help-seeking behaviour by patients (mainly male patients) with a history of abuse are scarce. OBJECTIVES: To analyse help-seeking behaviour in general practice of men and women with a history of abuse. METHODS: A cohort study using data from a Dutch primary care registration network from 2015 to 2019. We included all patients aged ≥ 18 years who indicated on a questionnaire that they did or did not have a history of abuse. We analysed differences in contact frequency, types of contact, reason for encounter and diagnoses between men and women with or without a history of abuse. RESULTS: The questionnaire had a response rate of 59% and resulted in 11,140 patients, of which 1271 indicated a history of abuse. Men and women with a history of abuse contact the general practitioner (GP) 1.5 times (95% CI 1.42-1.60) more often than men and women without a history of abuse, especially for psychological (rate ratio 1.97, 95% CI 1.79-2.17) and social (rate ratio 1.93, 95% CI 1.68-2.22) problems. Moreover, when diagnosed with a psychological or social problem, patients with a history of abuse contact the GP twice more often for these problems. CONCLUSION: Compared to men and women without a history of abuse, men and women with a history of abuse visit their GP more often, particularly for psychological and social problems.

Comportamento de Busca de Ajuda , Adolescente , Estudos de Coortes , Medicina de Família e Comunidade , Feminino , Humanos , Masculino , Atenção Primária à Saúde , Inquéritos e Questionários
J Community Psychol ; 50(7): 2892-2903, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35122690


The Attitudes toward Homelessness Inventory (ATHI) was developed due to a lack of psychometrically sound instruments to measure the nature and change in attitudes toward homelessness. Given inconsistencies in its use and internal reliability, this study evaluates the psychometric properties of the ATHI. Participants (n = 899) were selected using a random-digit-dial telephone survey to complete the ATHI. Results demonstrated that the four-factor solution suggested by the ATHI developers was the best fit for the data, but factor loadings and reliability coefficients were not sufficient for ensuring adequate measurement of attitudes toward homelessness. The poor psychometrics found in this study were likely the result of now outdated items. While the ATHI was developed using well-regarded and rigorous methods, results from this study suggest that it may be necessary to either make edits to the ATHI or to develop a new conceptually and psychometrically-sound measure.

Atitude , Pessoas em Situação de Rua , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
J Intellect Disabil Res ; 66(6): 533-544, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34498320


BACKGROUND: Numerous studies have proven the significant positive impact of the regular physical activity on general health conditions and quality of life of people with intellectual disability. In practice, various adapted sports activities are used. The current study deals with the effects of the soccer programme. AIM: The purpose of the study is to evaluate the effects of adapted soccer on the motor learning and some psychosocial characteristics in adolescents with Down syndrome. METHODS: Twenty-five participants were recruited and randomised into two groups (exercise and control). Adolescents placed in the exercise group carried out a special soccer programme twice a week during 16 weeks, while adolescents placed in the control group continued with their usual daily regime. Specific motor coordination, level of aggression, attention disorders, level of anxiety and depression, and social problems were measured before and after the training period. Mixed ANOVA were used to evaluate the effects of the experimental treatment. RESULTS: The exercise group had significant improvements (P < 0.05) in one of three motor variables (only in the easiest task) and in all psychosocial variables. There are no one significant change in the control group. The adapted soccer programme influenced more seriously on psychosocial characteristics than on motor learning of adolescent with DS. CONCLUSIONS: The results suggest that adapted soccer training can decrease aggression, anxiety and depression levels, and improve attention, social behaviour and simple motor skills in adolescents with Down syndrome.

Síndrome de Down , Futebol , Adolescente , Exercício Físico , Humanos , Destreza Motora , Qualidade de Vida
Public Health Nurs ; 39(1): 238-250, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-33970521


BACKGROUND: Inequities in maternal mortality in the United States are a form of structural violence against Black women. The concept of reproductive justice has been employed in the social sciences for almost 30 years, yet nursing has been slow to adopt this concept in promoting maternal-child health. OBJECTIVE: To analyze the concept of reproductive justice as used in peer-reviewed publications with the aim of reframing black maternal health in public health nursing scholarship, research, practice, and advocacy. DESIGN: We conducted a systematic review of the social science literature. We analyzed selected articles though a principle-based concept analysis focusing on epistemological, pragmatic, linguistic, and logical principles. SAMPLE: Eight articles were selected from a pool of 377. RESULTS: Race was identified as a source of power for understanding reproductive justice through individual knowledge, collective knowledge, and praxis. Pragmatically, reproductive justice is a social justice-oriented platform that bridges the pro-choice/pro-life divide; aids coalition building; and promotes inclusion. Linguistically, the concept is distinct from both reproductive health and reproductive rights. Reproductive justice is logically situated within intersectionality theory and the cumulative embodiment of oppressions Black women experience based on race, class, and gender. CONCLUSION: Reproductive justice reframes public health nursing actions for Black women by focusing on uncovering systems of oppression, recognizing past historical injustices, and advancing cultural safety in health promotion. Multilevel interventions are needed to simultaneously address these injustices particularly in the areas of preconception health, maternal health, infant and child health, and Black family well-being across the reproductive lifespan.

Enfermagem em Saúde Pública , Justiça Social , Afro-Americanos , Feminino , Humanos , Saúde Reprodutiva , Estados Unidos , Violência
Health Serv Res ; 57(2): 285-293, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34608999


OBJECTIVE: To develop a screening tool to identify emergency department (ED) patients at risk of entering a homeless shelter, which could inform targeting of interventions to prevent future homelessness episodes. DATA SOURCES: Linked data from (1) ED patient baseline questionnaires and (2) citywide administrative homeless shelter database. STUDY DESIGN: Stakeholder-informed predictive modeling utilizing ED patient questionnaires linked with prospective shelter administrative data. The outcome was shelter entry documented in administrative data within 6 months following the baseline ED visit. Exposures were responses to questions on homelessness risk factors from baseline questionnaires. DATA COLLECTION/EXTRACTION METHODS: Research assistants completed questionnaires with randomly sampled ED patients who were medically stable, not in police/prison custody, and spoke English or Spanish. Questionnaires were linked to administrative data using deterministic and probabilistic matching. PRINCIPAL FINDINGS: Of 1993 ED patients who were not homeless at baseline, 5.6% entered a shelter in the next 6 months. A screening tool consisting of two measures of past shelter use and one of past criminal justice involvement had 83.0% sensitivity and 20.4% positive predictive value for future shelter entry. CONCLUSIONS: Our study demonstrates the potential of using cross-sector data to improve hospital initiatives to address patients' social needs.

Pessoas em Situação de Rua , Serviço Hospitalar de Emergência , Habitação , Humanos , Estudos Prospectivos , Inquéritos e Questionários
Eur Child Adolesc Psychiatry ; 31(5): 715-727, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-33415471


Children with attention-deficit/hyperactivity disorder (ADHD) symptoms often experience social and emotional problems. Impaired facial emotion recognition has been suggested as a possible underlying mechanism, although impairments may depend on the type and intensity of emotions. We investigated facial emotion recognition in children with (subthreshold) ADHD and controls using a novel task with children's faces of emotional expressions varying in type and intensity. We further investigated associations between emotion recognition accuracy and social and emotional problems in the ADHD group. 83 children displaying ADHD symptoms and 30 controls (6-12 years) completed the Morphed Facial Emotion Recognition Task (MFERT). The MFERT assesses emotion recognition accuracy on four emotions using five expression intensity levels. Teachers and parents rated social and emotional problems on the Strengths and Difficulties Questionnaire. Repeated measures analysis of variance revealed that the ADHD group showed poorer emotion recognition accuracy compared to controls across emotions (small effect). The significant group by expression intensity interaction (small effect) showed that the increase in accuracy with increasing expression intensity was smaller in the ADHD group compared to controls. Multiple regression analyses within the ADHD group showed that emotion recognition accuracy was inversely related to social and emotional problems, but not prosocial behavior. Not only children with an ADHD diagnosis, but also children with subthreshold ADHD experience impairments in facial emotion recognition. This impairment is predictive for social and emotional problems, which may suggest that emotion recognition may contribute to the development of social and emotional problems in these children.

Transtorno do Deficit de Atenção com Hiperatividade , Disfunção Cognitiva , Reconhecimento Facial , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Emoções , Expressão Facial , Humanos , Análise de Regressão
Cad. Bras. Ter. Ocup ; 30: e2958, 2022. tab, graf
Artigo em Português | LILACS-Express | LILACS, Index Psicologia - Periódicos | ID: biblio-1355952


Resumo Introdução O referencial teórico e o aporte metodológico trazidos pelas obras de Paulo Freire vêm se espraiando por distintas áreas, inclusive na terapia ocupacional. Objetivo Apreender como o referencial freireano vem sendo utilizado em publicações acadêmicas da terapia ocupacional, reunindo e analisando essa literatura, para identificar eixos temáticos e lacunas presentes. Método Revisão de escopo, com levantamento de publicações nas bases de dados CINAHL, Scopus e Web of Science, focalizando artigos acadêmicos que referenciam explicitamente Paulo Freire, num período que, sem recorte inicial, foi até abril de 2020, tendo sido incluídos todos os artigos que referenciavam pelo menos uma obra do autor. Uma planilha desenvolvida no programa Microsoft Excel® reuniu os dados gerais dos artigos, cujos conteúdos foram agrupados, sintetizados e analisados a partir de conjuntos temáticos significativos. Resultados Foram identificados 56 artigos, publicados entre 1993 e abril de 2020. A obra de Freire vem sendo utilizada em publicações acadêmicas da terapia ocupacional, destacando-se o livro "Pedagogia do Oprimido" e as categorias Diálogo/Dialógica e Conscientização/Consciência crítica/política. Foram definidos e discutidos três conjuntos temáticos: 33 (58,9%) artigos que utilizam o referencial freireano para o pensar/fazer da terapia ocupacional; 10 (17,8%) em que ele parametriza a pesquisa na área; 13 (23,2%) cujas análises e proposições envolvendo a formação de terapeutas ocupacionais tomam-no como aporte. Conclusão Paulo Freire informa de diversas maneiras a terapia ocupacional, em prol de uma práxis para a transformação social, embora, em boa parte das vezes, as formulações freireanas não sejam o centro dos esforços de elaboração reflexiva.

Abstract Introduction Paulo Freire's theoretical references and methodological propositions are spread over different study areas, including occupational therapy. Objective To understand how the Freirean framework has been used in academic publications on occupational therapy, gathering and analyzing this literature to identify thematic axes and gaps. Method A scoping review conducted through an open-period search until April 2020 for all academic articles that explicitly referenced at least one work by Paulo Freire. Data from the retrieved articles were gathered, synthesized, and organized on a Microsoft Excel® spreadsheet and then analyzed from significant thematic axes. Results The search identified 56 articles published between 1993 and April 2020. Freire's work has been used in occupational therapy academic publications, with emphasis on the book "Pedagogy of the Oppressed" and the concepts of Dialogue/dialogics and Critical and political consciousness/conscientization. Three thematic axes were defined and discussed: 33 (58.9%) studies used Paulo Freire as a theoretical-methodological framework for thinking/practicing occupational therapy, 10 (17.8%) used Freire as a framework to assist with research in the area, and 13 (23.2%) used Freire's contributions in analyses and propositions involving the education of occupational therapists. Conclusions Paulo Freire contributes to occupational therapy in different ways, favoring a praxis for social transformation; however, in most cases, the Freirean propositions are not the center of reflexive development efforts.

Afr Health Sci ; 21(2): 775-781, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34795735


BACKGROUND: Sickle-cell disease comprises a group of genetic disorders characterized by the inheritance of sickle haemoglobin from both parents. Sickle-cell disease carries a huge psycho-social burden which has impacts on the physical, psychological, social and occupational well-being as well as levels of independence on adolescents. OBJECTIVE: To investigate the psycho-social problems of adolescents with sickle-cell anaemia in Ekiti State. The study also examined whether the variables of age and educational level would influence the psycho-social problems of adolescents with sickle-cell anaemia in Ekiti State. METHODS: Descriptive survey design was adopted for the study. Purposive sampling technique was adopted to draw a total of 121 respondents. A questionnaire was used to collect data for the study. Mean and rank order was used to answer the research question while Analysis of Variance was used to test the hypotheses at 0.05 level of significance. RESULTS: Findings revealed that psycho-social problems of adolescents with sickle-cell anaemia are limited in the choice of career, find it difficult to get suitable partner in marriage and SCD adolescents usually manifest emotional upset, misbehaviour, and have learning problems. Findings also revealed that there were significant differences in the psycho-social problems of adolescents with sickle-cell anaemia based on age and educational level. CONCLUSION: Majority of the respondents attested to the psycho-social problems facing adolescents with sickle-cell anaemia. Based on the findings of the study, it was recommended that social workers should be employed in health sectors; government should offered standard health care for all adolescents with sickle cell disease.

Anemia Falciforme/psicologia , Problemas Sociais , Adolescente , Humanos , Nigéria , Inquéritos e Questionários , Adulto Jovem
Front Pediatr ; 9: 707648, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34631612


Objective: To identify psychosocial problems and self-esteem in children with growth hormone deficiency (GHD) and define the role of some clinical and sociodemographic determinants in the conceptualization of internalizing and externalizing problems as criteria for psychosocial functioning. Materials and Methods: A GHD sample (46 prepubescent children) was selected and compared to a matched control group (80 healthy children). Psychosocial functioning in children with GHD was investigated using Goodman's "Strengths and Difficulties Questionnaire (SDQ)." The study of children's self-esteem was carried out by the Dembo-Rubinstein method. Results: This study reveals that the GHD sample has more internalizing problems and lower self-esteem. Higher score and frequency of assessment in the abnormal score for "total difficulties," "emotional problem," and "peer problem" were found in children with GHD. The SDQ score and the frequency of assessment in the abnormal score for all SDQ scales in children with more pronounced growth deficit (height SDS < -3) did not exceed the same indicators in children with less growth retardation (-3 < height SDS < -2). A comparison of psychosocial features in children with isolated growth hormone deficiency and multiple pituitary hormones deficiency did not reveal differences in SDQ score and the frequency of assessment in the abnormal score for all SDQ scales. It was found that children with GHD have a reduced level of assertions, low self-esteem, and a weak discrepancy between the level of assertions and self-esteem. Some sociodemographic determinants (male gender, age < 9 years, and low family income) and clinical determinants (low compliance and suboptimal growth response after 1 year of rGHh therapy) have an impact on the overall assessment of psychological problems in children with GHD. The internalizing difficulties are associated with certain clinical determinants (growth status and treatment status) and sociodemographic determinants (female gender, age < 9 years). Conclusions: The identification of low self-esteem and the high SDQ score for scales "total difficulties," "emotional problems," and "peer problems" indicates psychosocial maladjustment and conceptualization of internalizing problems in children with GHD.

Health Promot Perspect ; 11(3): 267-270, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34660220


The coronavirus disease 2019 (COVID-19) pandemic has subjected the mental health and well-being of Filipino children under drastic conditions. While children are more vulnerable to these detriments, there remains the absence of unified and comprehensive strategies in mitigating the deterioration of the mental health of Filipino children. Existing interventions focus on more general solutions that fail to acknowledge the circumstances that a Filipino child is subjected under. Moreover, these strategies also fail to address the multilayered issues faced by a lower-middle-income country, such as the Philippines. As the mental well-being of Filipino children continues to be neglected, a subsequent and enduring mental health epidemic can only be expected for years to come.

Rev. crim ; 63(2): 155-174, mayo-ago. 2021. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1365782


Resumen El artículo presenta los resultados de un estudio de caso de tipo descriptivo que se ejecutó en el municipio de Barrancabermeja, departamento de Santander, Colombia. El mismo asumió como objetivo central describir la utilidad que tuvo la aplicación de una estrategia de aprendizaje experiencial (clubes juveniles), como método o maniobra para la prevención del consumo de drogas y la violencia juvenil. El programa se puso en marcha mediante el diseño metodológico de estudio de caso, lo cual permitió sistematizar por 12 meses la experiencia de clubes juveniles que buscaron desarrollar valores, habilidades para la vida y competencias prelaborales en 100 adolescentes o jóvenes en edades entre los 12 y los 21 años de edad, de estrato uno en situación de vulnerabilidad y riesgo frente al consumo de drogas y la delincuencia juvenil. Los resultados del trabajo investigativo revelaron que la implementación de programas preventivos que involucran metodologías experienciales, activas o participativas son una estrategia pedagógica que mantiene motivados a los adolescentes o jóvenes. Igualmente se evidenció que el club juvenil lleva la prevención de consumo de drogas y delincuencia juvenil a un nivel que va más allá de la información, generando procesos de metacognición o reflexión que permiten ejercer las habilidades para la vida. Como conclusión general de la investigación es posible afirmar que las metodologías participativas que involucran la acción/reflexión como principio pedagógico logran un mayor estímulo en los jóvenes y garantizan una mayor expectativa frente al cambio de conductas.

Abstract The article presents the results of a descriptive case study, which was developed in the Municipality of Barrancabermeja Department of Santander-Colombia. It assumed as a central objective to describe the usefulness of the application of an experiential learning strategy (youth clubs), as a method and / or maneuver for the prevention of drug use and youth violence. The program was developed through the methodological design of a case study, which allowed to systematize for 12 months the experience of development of youth clubs that sought to develop values, life skills and pre-work competence in 100 adolescents and / or young people between the ages of 12 and 21 years, from stratum one in a situation of vulnerability and risk in the face of drug use and juvenile delinquency. The results of the research work revealed that the implementation of preventive programs that involve experienced, active and/or participatory methodologies are a pedagogical strategy that keeps adolescents and/or young people motivated. It was also evidenced that the youth club takes the prevention of drug use and juvenile delinquency to a level that goes beyond information, generating processes of metacognition and / or reflection that allow the exercise of life skills. As a general conclusion of the work, it is possible to affirm that participatory methodologies that involve action/reflection as a pedagogical principle achieve greater motivation in young people and guarantee a greater expectation in the face of behavior change.

Resumo O artigo apresenta os resultados de um estudo de caso descritivo, desenvolvido no Departamento de Barrancabermeja do Santander-Colômbia. Assumiu como objetivo central descrever a utilidade da aplicação de uma estratégia de aprendizagem experiencial (clubes juvenis), como método e/ou manobra para a prevenção do uso de drogas e violência juvenil. O programa foi desenvolvido por meio do desenho metodológico de um estudo de caso, que permitiu sistematizar por 12 meses a experiência de desenvolvimento de clubes juvenis que buscaram desenvolver valores, habilidades de vida e competência pré-laboral em 100 adolescentes e/ou jovens entre 12 e 21 anos, a partir de um estrato em situação de vulnerabilidade e risco diante do uso de drogas e de delinquência juvenil. Os resultados do trabalho de pesquisa revelaram que a implementação de programas preventivos que envolvem metodologias experientes, ativas e/ou participativas são uma estratégia pedagógica que mantém os adolescentes e/ou jovens motivados. Também foi evidenciado que o clube juvenil leva a prevenção do uso de drogas e delinquência juvenil a um nível que vai além da informação, gerando processos de metacognição e/ou reflexão que permitem o exercício de habilidades de vida. Como conclusão geral do trabalho, é possível afirmar que metodologias participativas que envolvem ação/reflexão como princípio pedagógico alcançam maior motivação nos jovens e garantem maior expectativa diante da mudança de comportamento.

Artigo em Inglês | MEDLINE | ID: mdl-34299782


(1) Background: The aim of this study was (i) to analyze problems faced by informal caregivers in three areas of their life: health, work and finances, and family and social relationships, (ii) to investigate the main determinants of these problems, and (iii) to explore differences between men and women. (2) Methods: The study population consisted of people aged ≥18 years living in a family home who were providing unpaid care to a dependent person in the same or another home and who were registered as caregivers with the Primary Health Care District of Granada or the Provincial Council of Gipuzkoa. Several logistic regression models were built to analyze the likelihood of caregivers experiencing health, work-related, or social problems as a result of their caregiving responsibilities. (3) Results: Informal female caregivers were more likely to experience problems attributed to caregiving than their male counterparts, particularly in the areas of health and work. Additional factors associated with an increased likelihood of problems were low perceived social support, performance of ungratifying tasks, and fewer years as a caregiver. (4) Conclusions: Informal caregivers in Spain face significant problems as a result of their caregiving duties, and the impact on men and women is different. Policies and interventions to mitigate the negative effects of unpaid caregiving should incorporate differential strategies to meet the specific needs of male and female caregivers in different caregiving contexts.

Cuidadores , Apoio Social , Adolescente , Adulto , Feminino , Identidade de Gênero , Humanos , Masculino , Problemas Sociais , Espanha
J Am Board Fam Med ; 34(4): 688-697, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34312262


PURPOSE: Social determinants of health (SDoH) including insecure access to food, housing, and financial resources are critical threats to overall health. We sought to examine this relationship among adult primary care patients with multiple chronic conditions. METHODS: We obtained cross-sectional data on 2763 adults with chronic medical and behavioral conditions or greater than 2 chronic medical conditions from a survey of participants in Integrating Behavioral Health and Primary Care, a multicenter randomized trial. RESULTS: The prevalence of 1 or more insecurities was reported in 29% of participants, including food (13%), housing (3%), or financial (25%). Functional capacity ranged from 2.74 to 9.89 metabolic equivalents (METs) (median, 6.05). The distribution of functional capacity was significantly lower for those with any 1 or more SDoH than for those without. Each insecurity independently affected the functional capacity in multivariable analysis. CONCLUSIONS: Among primary care patients with chronic conditions, SDoH are associated with poorer functional capacity, independent of other social and demographic factors. Primary care offers a promising, if underused, opportunity to intervene in SDoH. There is a need for future studies to explore the role of screening and intervention by primary care providers to mitigate or prevent SDoH.

Múltiplas Afecções Crônicas , Adulto , Estudos Transversais , Humanos , Atenção Primária à Saúde , Determinantes Sociais da Saúde
Artigo em Inglês | MEDLINE | ID: mdl-34076800


The DSM-5 alternative model for the diagnosis of personality disorders (AMPD) states that self- and interpersonal (Criterion A) dysfunction is necessary to diagnose a personality disorder, qualified by maladaptive personality trait profiles (Criterion B). This study tested whether childhood maladaptive personality traits predict interpersonal dysfunction during adolescence, which further predicts lower self-functioning in young adulthood. A mixed clinical-community sample of 157 10-year-olds participated for ten years. Social problems and personality traits were rated by parents at age 10 and 12. At age 20, young adults completed 14 daily ratings of self-functioning. Traits of emotional instability and disagreeableness predicted social problems and self-problems. Social problems predicted worse self-functioning in adulthood. An indirect effect of childhood narcissistic traits on higher levels of self-functioning via lower levels of social problems was found. Results are discussed in terms of their contribution to our understanding of the AMPD from a developmental perspective.