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1.
Arch. argent. pediatr ; 122(3): e202310217, jun. 2024. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1554942

RESUMO

Los problemas de salud mental materna durante el embarazo, parto y puerperio son un desafío para la salud pública. Su falta de reconocimiento atenta contra el diagnóstico y tratamientos oportunos, e impacta en la madre y el establecimiento del vínculo fundamental del binomio. Debemos reconocer los factores de riesgo (edad, situación socioeconómica, antecedentes psicopatológicos, disfunción familiar, entorno desfavorable), las manifestaciones clínicas y las herramientas de detección. Existen evidencias de que el efecto del estrés, la ansiedad y la depresión durante el embarazo afectan negativamente el neurodesarrollo fetal y condicionan los resultados del desarrollo infantil. Describimos el impacto negativo de la depresión puerperal durante los primeros meses de vida, que afecta el vínculo madre-hija/o, el desarrollo posnatal (emocional, conductual, cognitivo, lenguaje) y el mantenimiento de la lactancia materna. También reconocemos factores protectores que atemperan sus efectos. Es fundamental establecer estrategias preventivas y abordajes diagnósticos y terapéuticos interdisciplinarios para minimizar los riesgos sobre la madre y sus hijas/os.


Maternal mental health problems during pregnancy, childbirth, and the postpartum period are a challenge for public health. Not recognizing them hinders a timely diagnosis and treatment and has an impact on the mother and the establishment of the fundamental bond of the mother-child dyad. We must recognize the risk factors (age, socioeconomic status, mental health history, family dysfunction, unfavorable environment), clinical manifestations, and screening tools. There is evidence that the effect of stress, anxiety, and depression during pregnancy negatively affect fetal neurodevelopment and condition child developmental outcomes. Here we describe the negative impact of postpartum depression during the first months of life, which affects mother-child bonding, postnatal development (emotional, behavioral, cognitive, language), and the maintenance of breastfeeding. We also recognize protective factors that mitigate its effects. It is essential to establish preventive strategies and interdisciplinary diagnostic and therapeutic approaches to minimize the risks to the mother and her children.


Assuntos
Humanos , Feminino , Gravidez , Lactente , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/etiologia , Cognição , Parto , Gestantes/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia
2.
BMJ ; 385: q1136, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38830690
3.
J Midwifery Womens Health ; 69(3): 383-393, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38831486

RESUMO

INTRODUCTION: Research on associations between knowledge and health beliefs for women at risk for gestational diabetes mellitus (GDM) has focused on adults at risk for or having GDM. Gaps also exist in examining interpersonal associations with family members or peers. We examined dyadic associations between knowledge and health beliefs about the risk for GDM between and within American Indian and Alaska Native (AIAN) female adolescents and young adults (FAYAs) at risk for GDM and their mothers or adult female caregivers (FCs). METHODS: Grounded in the Expanded Health Belief Model, we employed a cross-sectional design using baseline data from 147 dyads of AIAN FAYAs at risk for GDM and their FCs who participated in the Stopping GDM in Daughters and Mothers trial. FAYAs were 12.0 to 24.5 years of age, and 89.1% were students. FCs had a mean (SD) age of 44.0 (9.3) years, 87.0% were AIAN, 44.9% were college educated, 19.7% had ever had GDM, and 81.0% were the FAYA's mother. FAYAs and FCs completed surveys about knowledge and health beliefs (benefits, barriers, severity, susceptibility) regarding GDM risk and prevention. Bivariate correlational analyses were performed to examine associations between and within dyad members. Dyadic associations were investigated using actor-partner interdependence modeling (APIM) assuming distinguishable dyad members. RESULTS: Compared with their FCs, FAYAs had lower health-related knowledge and perceived benefits of GDM prevention and susceptibility regarding GDM risk. APIM revealed actor and partner effects of health-related knowledge on health beliefs for dyads. In particular, positive actor effects were found for FAYAs and FCs for GDM-related knowledge with perceived benefits (P < .001), and positive partner effects of GDM-related knowledge for FCs were related to perceived susceptibility and severity for FAYAs (P < .05). DISCUSSION: As shown in these AIAN dyads, FAYAs and their FCs, as members of one another's social network, may influence each other's health beliefs regarding GDM risk and prevention.


Assuntos
Nativos do Alasca , Cuidadores , Diabetes Gestacional , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Feminino , Diabetes Gestacional/psicologia , Gravidez , Estudos Transversais , Adolescente , Adulto Jovem , Adulto , Nativos do Alasca/psicologia , Cuidadores/psicologia , Mães/psicologia , Indígenas Norte-Americanos/psicologia , Criança , Fatores de Risco , Modelo de Crenças de Saúde
4.
HIV Res Clin Pract ; 25(1): 2358724, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38831680

RESUMO

BACKGROUND: People living with HIV experience higher rates of cognitive impairment (CI), and at younger ages, than the general population. These individuals report poor health-related quality of life (HRQL), however, interventions aimed at assisting people living with HIV to live well with CI do not currently exist and represent an important un-met need in this population. OBJECTIVE: This study aimed to identify the lived experience research priorities for improving HRQL and identify interventions to support priority areas. METHODS: A Research Advisory Group was established with 15 lived experience, academic, healthcare, and third sector professionals. Additionally, two semi-structured focus groups were undertaken, with health and third sector professionals and people living with HIV with CI. Participants were asked to rank factors impacting HRQL, identified in prior research, in terms of priority and intervention development. Findings were analysed using a combination of conventional and summative content analysis. Study findings were feedback to our Research Advisory Group. RESULTS: Five people living with HIV with CI, recruited through third sector agencies [Male 80%; median age 59 (range 56-78); White British 60%; homosexual 60%], and three healthcare and third sector participants (66% third sector professionals from two local HIV charities; 33% HIV-specific clinical psychologist) took part in two focus groups and ranked interventions targeting improvement in physical function, social connectedness, cognition and perceived control over cognitive health as priority areas. Findings were then fed back to the Research Advisory Group who recommended the development of an illness-specific cognitive rehabilitation programme and improved information provision as important avenues for intervention development. CONCLUSION: Given the absence of meaningful patient and public involvement, intervention, and support guidelines for people living with HIV with CI, this provides a roadmap for future research in this important and growing area of HIV clinical care.


Assuntos
Disfunção Cognitiva , Grupos Focais , Infecções por HIV , Qualidade de Vida , Humanos , Infecções por HIV/psicologia , Infecções por HIV/complicações , Qualidade de Vida/psicologia , Masculino , Pessoa de Meia-Idade , Disfunção Cognitiva/psicologia , Feminino , Idoso , Pesquisa
5.
Disaster Med Public Health Prep ; 18: e98, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38832542

RESUMO

Disasters can cause great physical and financial damage to pet owners in developing countries. These effects lead to severe psychological side effects on individuals and families. With the tendency of families to keep pets in these countries, many challenges have arisen regarding how to manage these pets before, during, and after disasters. Therefore, mitigation, prevention, and preparedness measures for these families should be prioritized in the disaster management cycle to minimize psychological effects such as posttraumatic stress disorder (PTSD) after losing pets.


Assuntos
Comunicação , Países em Desenvolvimento , Animais de Estimação , Humanos , Países em Desenvolvimento/estatística & dados numéricos , Animais de Estimação/psicologia , Animais , Desastres/estatística & dados numéricos , Percepção , Planejamento em Desastres/métodos , Transtornos de Estresse Pós-Traumáticos/psicologia
6.
Lakartidningen ; 1212024 Jun 04.
Artigo em Sueco | MEDLINE | ID: mdl-38832570

RESUMO

Decisions to withdraw life sustaining treatment in the ICU are common, but there is little information about how treatment should be withdrawn. A pilot study showed that doctors withdraw life sustaining treatment in different ways even in identical cases. This variation can cause stress for ICU staff and relatives.  Our study investigated the decisions of doctors working in ICUs in Sweden regarding the withdrawal of life sustaining treatment for two fictitious patients. There was variation in if and how drug treatments should be withdrawn, as well as how ventilatory support should be withdrawn. Less experienced doctors tended to choose to prolong the dying process by weaning, even if it is unclear if that is preferable for the staff or for relatives.  Our study could be used in discussions in ICUs to try to understand how individual doctors make decisions about withdrawing life sustaining treatment.


Assuntos
Unidades de Terapia Intensiva , Suspensão de Tratamento , Humanos , Suspensão de Tratamento/legislação & jurisprudência , Suécia , Projetos Piloto , Cuidados para Prolongar a Vida , Atitude do Pessoal de Saúde , Masculino , Feminino , Tomada de Decisão Clínica , Competência Clínica , Inquéritos e Questionários , Padrões de Prática Médica , Assistência Terminal , Pessoa de Meia-Idade , Médicos/psicologia
7.
JMIR Mhealth Uhealth ; 12: e53964, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38832585

RESUMO

Background: Due to aging of the population, the prevalence of aortic valve stenosis will increase drastically in upcoming years. Consequently, transcatheter aortic valve implantation (TAVI) procedures will also expand worldwide. Optimal selection of patients who benefit with improved symptoms and prognoses is key, since TAVI is not without its risks. Currently, we are not able to adequately predict functional outcomes after TAVI. Quality of life measurement tools and traditional functional assessment tests do not always agree and can depend on factors unrelated to heart disease. Activity tracking using wearable devices might provide a more comprehensive assessment. Objective: This study aimed to identify objective parameters (eg, change in heart rate) associated with improvement after TAVI for severe aortic stenosis from a wearable device. Methods: In total, 100 patients undergoing routine TAVI wore a Philips Health Watch device for 1 week before and after the procedure. Watch data were analyzed offline-before TAVI for 97 patients and after TAVI for 75 patients. Results: Parameters such as the total number of steps and activity time did not change, in contrast to improvements in the 6-minute walking test (6MWT) and physical limitation domain of the transformed WHOQOL-BREF questionnaire. Conclusions: These findings, in an older TAVI population, show that watch-based parameters, such as the number of steps, do not change after TAVI, unlike traditional 6MWT and QoL assessments. Basic wearable device parameters might be less appropriate for measuring treatment effects from TAVI.


Assuntos
Substituição da Valva Aórtica Transcateter , Dispositivos Eletrônicos Vestíveis , Humanos , Substituição da Valva Aórtica Transcateter/instrumentação , Substituição da Valva Aórtica Transcateter/estatística & dados numéricos , Substituição da Valva Aórtica Transcateter/métodos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Masculino , Feminino , Estudos Prospectivos , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos , Dispositivos Eletrônicos Vestíveis/normas , Idoso de 80 Anos ou mais , Idoso , Estenose da Valva Aórtica/cirurgia , Inquéritos e Questionários , Qualidade de Vida/psicologia
8.
BMJ Open ; 14(6): e080022, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834318

RESUMO

OBJECTIVE: Investigating attitudes accepting two categories of violence against women and girls (VAWG) (intimate partner violence-IPV-and other expressions of VAWG) and their association with seven demographic/social determinants and health-seeking behaviours in South Sudan. DESIGN: Cross-sectional study using data from the South Sudan National Household Survey 2020. SETTING: South Sudan. PARTICIPANTS AND METHODS: 1741 South Sudanese women and 1739 men aged 15-49 years; data captured between November 2020 and February 2021 and analysed using binary logistic regression. RESULTS: People with secondary or higher education displayed attitudes rejecting acceptance of IPV (OR 0.631, 95% CI 0.508 to 0.783). Women and men living in states with more numerous internally displaced people (IDP) or political/military violence had attitudes accepting IPV more than residents of less violence-affected regions (OR 1.853, 95% CI 1.587 to 2.164). Women had a higher odd of having attitudes accepting IPV than men (OR 1.195, 95% CI 1.014 to 1.409). People knowing where to receive gender-based violence healthcare and psychological support (OR 0.703, 95% CI 0.596 to 0.830) and with primary (OR 0.613, 95% CI 0.515 to 0.729), secondary or higher education (OR 0.596, 95% CI 0.481 to 0.740) displayed attitudes rejecting acceptance of other expressions of VAWG. People residing in states with proportionately more IDP and who accepted IPV were more likely to have attitudes accepting other expressions of VAWG (OR 1.699, 95% CI 1.459 to 1.978; OR 3.195, 95% CI 2.703 to 3.775, respectively). CONCLUSION: Attitudes towards accepting VAWG in South Sudan are associated with women's and men's education, gender, residence and knowledge about health-seeking behaviour. Prioritising women's empowerment and gender transformative programming in the most conflict-affected areas where rates of VAWG are higher should be prioritised along with increasing girls' access to education. A less feasible strategy to decrease gender inequalities is reducing insecurity, military conflict, and displacement, and increasing economic stability.


Assuntos
Violência por Parceiro Íntimo , Aceitação pelo Paciente de Cuidados de Saúde , Humanos , Feminino , Masculino , Estudos Transversais , Sudão do Sul , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde
9.
BMJ Open ; 14(6): e082481, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834316

RESUMO

OBJECTIVE: To explore and characterise the discrimination and racism experienced in healthcare from the perspective of Dutch patients with a migration background. DESIGN: This was a qualitative phenomenological study incorporating an inductive thematic analysis of the answers provided to a free form online survey. Descriptive and differential analyses were conducted for the closed-ended questions. SETTING: This study used an online survey distributed in Dutch about experiences of discrimination and racism in healthcare to the general population in the Netherlands. PARTICIPANTS: The survey was completed by 188 participants (Mage=39.89, SDage=10.2). Of whom 80 (Mage=37.92, SDage=10.87) met the eligibility criteria for thematic analysis (ie, has a migration background or a relative with a migration background and experienced discrimination in healthcare based on their background) and were thus included in the analysis. RESULTS: From the total sample, women, relative to men, were 2.31 times more likely to report experiencing healthcare discrimination (OR=2.31; 95% CI 1.23 to 4.37). The majority of the participants (60.1%) had a Moroccan or Turkish background. Six themes were identified relating to experienced discrimination in healthcare based on one's migration background: (1) explicit discrimination, (2) prejudice, (3) not being taken seriously, (4) discriminatory behaviour, (5) language barriers and (6) pain attribution to cultural background. Some participants reported that their attire or religion was linked to their migration background, thus contributing to their experiences of discrimination. CONCLUSION: Dutch patients with a migration background may experience discrimination based on their ethnic identity or other factors related to their backgrounds, such as their faith, culture and skin colour. Discrimination manifests as intersectional and may take different forms (eg, discrimination based on the intersection between race and gender). Therefore, healthcare discrimination may increase health inequities and lead to unequal access to healthcare services. Implicitly or explicitly discriminating against patients is immoral, unethical, illegal and hazardous for individual and public health. Further research on the magnitude of discrimination in healthcare and its relation to health is needed.


Assuntos
Pesquisa Qualitativa , Racismo , Humanos , Racismo/psicologia , Feminino , Masculino , Países Baixos , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Emigrantes e Imigrantes/psicologia , Preconceito/psicologia , Idoso , Disparidades em Assistência à Saúde/etnologia , Discriminação Social
10.
BMJ Open ; 14(6): e079304, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834323

RESUMO

OBJECTIVES: Burnout is common among medical personnel in China and may be related to excessive and persistent work-related stressors by different specialties. The aims of this study were to assess the prevalence of burnout, work overload and work-life imbalance according to different specialties and to explore the effect of specialty, work overload and work-life imbalance on burnout among medical personnel. DESIGN: A cross-sectional study. SETTING: This study was conducted in 1 tertiary general public hospital, 2 secondary general hospitals and 10 community health service stations in Liaoning, China. PARTICIPANTS: A total of 3299 medical personnel participated in the study. METHODS: We used the 15-item Chinese version of the Maslach Burnout Inventory General Survey (MBI-GS) to measure burnout. Multivariable logistic regression models were used to explore the association between medical specialty, work overload, work-life imbalance and burnout. RESULTS: 3299 medical personnel were included in this study. The prevalence of burnout, severe burnout, work overload and work-life imbalance were 88.7%, 13.6%, 23.4% and 23.2%, respectively. Compared with medical personnel in internal medicine, working in obstetrics and gynaecology (OR=0.61, 95% CI 0.38, 0.99) and management (OR=0.45, 95% CI 0.28, 0.72) was significantly associated with burnout, and working in ICU (Intensive Care Unit)(OR=2.48, 95% CI 1.07, 5.73), surgery (OR=1.66, 95% CI 1.18, 2.35) and paediatrics (OR=0.24, 95% CI 0.07, 0.81) was significantly associated with severe burnout. Work overload and work-life imbalance were associated with higher ORs for burnout (OR=1.64, 95% CI 1.16, 2.32; OR=2.79, 95% CI 1.84, 4.24) and severe burnout (OR=4.33, 95% CI 3.43, 5.46; OR=3.35, 95% CI 2.64, 4.24). CONCLUSIONS: Burnout, work overload and work-life imbalance were prevalent among Chinese medical personnel but varied considerably by clinical specialty. Burnout may be reduced by decreasing work overload and promoting work-life balance across different specialties.


Assuntos
Esgotamento Profissional , Equilíbrio Trabalho-Vida , Carga de Trabalho , Humanos , Estudos Transversais , China/epidemiologia , Esgotamento Profissional/epidemiologia , Feminino , Masculino , Adulto , Carga de Trabalho/psicologia , Prevalência , Pessoal de Saúde/psicologia , Modelos Logísticos , Pessoa de Meia-Idade , Inquéritos e Questionários , Especialização
11.
BMJ Open ; 14(6): e081281, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834328

RESUMO

INTRODUCTION: Patients with breast cancer often suffer from depressive symptoms throughout various stages of cancer, significantly impacting their quality of life and treatment outcomes. Non-pharmaceutical interventions such as psychotherapy, mind-body therapies and physical exercise have shown effectiveness in addressing cancer-related depression. However, the efficacy and safety of different non-pharmacological interventions remain a topic of debate. Therefore, to provide an objective assessment and comparison of the impact of different non-pharmaceutical interventions on depression, we will conduct a network meta-analysis (NMA) to explore the effects of different non-pharmaceutical interventions on reducing depressive symptoms among patients with breast cancer. METHODS AND ANALYSIS: We will search nine Chinese and English-language databases, from database inception to 31 July 2023, for randomised controlled trials published in Chinese or English. The English-language databases are PubMed, Medline, Embase, Web of Science and Cochrane Central Register of Controlled Trials, and the Chinese databases are CBM, CNKI, VIP and Wanfang. Two independent researchers will perform information extraction from eligible articles. The primary outcome will be the changes in depressive symptoms, while the secondary outcome will include adverse events. STATA V.15.0 will be used to conduct paired meta-analysis and NMA. Grading of Recommendations Assessment, Development and Evaluation will be used to assess the quality of evidence, and the Cochrane tool for assessing the risks of bias in randomised trials V.2 will be used for risk of bias assessment. ETHICS AND DISSEMINATION: The study does not require ethical approval as it will analyse data from existing studies. It is expected that the results of the study will be published in peer-reviewed journals and presented at relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42023450494.


Assuntos
Neoplasias da Mama , Depressão , Metanálise em Rede , Revisões Sistemáticas como Assunto , Humanos , Neoplasias da Mama/complicações , Neoplasias da Mama/psicologia , Feminino , Depressão/terapia , Depressão/etiologia , Metanálise como Assunto , Qualidade de Vida , Projetos de Pesquisa , Psicoterapia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
J Allied Health ; 53(2): 116-121, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38834337

RESUMO

OBJECTIVE: Today's healthcare system requires interprofessional collaborative practice (IPCP) to improve health outcomes. IPCP often begins with interprofessional education (IPE), which should stimulate meaningful idea exchange. This study's purpose was to assess the impact of a photovoice-based IPE experience on the attitudes and beliefs of students in two health professions programs. METHODS: Forty-two Doctor of Physical Therapy students and 13 Radiation Therapy students created photovoice slides representing the most significant "thing" in their professional education. Students discussed their slides in small groups followed by a large-group discussion. A pretest-posttest survey containing researcher-generated questions and the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R2) and a post-activity evaluation were administered. RESULTS: Forty-two students completed the pretest survey; 35 completed the posttest survey. A statistically significant difference was found between pretest (M=4.07, SD=0.91) and posttest (M=4.45, SD=0.70) SPICE-R2 total scores, t(928)=7.22, p<0.001. Statistically significant differences were found for all SPICE-R2 factor scores. Thematic analysis revealed three themes: 1) students learned about the other profession, 2) the IPE experience was meaningful, and 3) the IPE experience could be improved. CONCLUSIONS: The photovoice IPE experience stimulated student reflection, interprofessional collaboration, and new perceptions about the other health profession. Future studies should focus on similar activities offered earlier in the education program.


Assuntos
Comportamento Cooperativo , Educação Interprofissional , Relações Interprofissionais , Fotografação , Estudantes de Ciências da Saúde , Humanos , Educação Interprofissional/organização & administração , Estudantes de Ciências da Saúde/psicologia , Feminino , Masculino , Atitude do Pessoal de Saúde , Ocupações em Saúde/educação , Adulto
14.
J Am Acad Psychiatry Law ; 52(2): 176-185, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834367

RESUMO

The Criminal Sentiments Scale-Modified (CSS-M) has been widely used as a measure of criminal attitudes. This analysis examined CSS-M scores in a large sample of outpatients with serious mental illnesses and a criminal legal system history. We compared total and subscale scores in our sample to scores from two other previously published U.S. studies in which the CSS-M was used, and evaluated associations between total CSS-M score and nine variables (age, educational attainment, gender, race, marital status, employment status, diagnostic category, substance use disorder comorbidity, and adverse childhood experiences (ACE) score). Scores were higher than in two prior U.S. studies involving other types of samples. Independently significant predictors of higher CSS-M scores included being younger (P < .001), having a higher ACE score (P < .001), being male (P = 03), not identifying as White (P < 001), not having a psychotic disorder (P < 001), and having a comorbid substance use disorder (P = 002). Future research should test the hypothesis that these factors increase risk for arrest and that arrest events, and subsequent criminal legal system involvement, are characterized by negative experiences and perceptions of poor procedural justice, which in turn underpin the negative opinions referred to as "criminal sentiments" or criminal attitudes.


Assuntos
Transtornos Mentais , Humanos , Masculino , Feminino , Adulto , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Pacientes Ambulatoriais/psicologia , Pacientes Ambulatoriais/legislação & jurisprudência , Criminosos/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Atitude , Experiências Adversas da Infância/psicologia , Adulto Jovem
15.
Sante Publique ; 36(2): 119-131, 2024.
Artigo em Francês | MEDLINE | ID: mdl-38834518

RESUMO

In Senegal, violent delinquency and illicit drug use are on the increase. This study focuses on two distinct groups: drug users (DUs) undergoing rehabilitation and violent ex-offenders (VEs). The methodology adopted includes a quantitative survey of the general population (n=1009), followed by a qualitative survey of fifteen participants, including eight DUs undergoing treatment at the Centre de prise en charge intégrée des addictions de Dakar (CEPIAD) (Integrated Addictions Management Center of Dakar) and the Centre Jacques Chirac de Thiaroye, and seven former VEs from the Grand Yoff district. This neighborhood, known for its violence, is juxtaposed with the Grand Yoff social housing estate, a residential area also affected by outbreaks of violence. This study aims to establish the link(s) between drug use and criminal violence by analyzing the life stories of young adults who have managed to leave drug use and delinquency behind. It then looks to identify the determinants of resilience in certain young people. The study revealed delinquent violence among young people does not systematically result from drug use. Rather, drug use is a factor conducive to violence. The links between drugs and violence depend on individual predisposition, the type of drugs used, and the level of addiction. Resilience results from a web of individual, sociocultural, and environmental factors. It is not static, but rather the result of a series of successes, failures, and even relapses.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Violência , Humanos , Senegal , Masculino , Adulto , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Feminino , Adulto Jovem , Resiliência Psicológica , Adolescente , Usuários de Drogas/psicologia , Criminosos , Pessoa de Meia-Idade
16.
BMC Public Health ; 24(1): 1492, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834967

RESUMO

OBJECTIVES: To assess the influence of loneliness on the healthy life expectancy of older adults in China and its gender disparities across different health indicators, in order to provide insights for enhancing the health status and subjective well-being of the older population. METHOD: We conducted a cohort analysis using four waves of weighted samples (2008, 2011, 2014, and 2018) from the Chinese Longitudinal Healthy Longevity Survey, encompassing 15,507 respondents aged 65-99. Physical and subjective health were assessed through activity of daily living (ADL) and self-rated health (SRH), respectively. Utilizing loneliness status as a time-variant variable, we employed the multi-state interpolated Markov Chain to explore the associations between loneliness and age-specific life expectancy (LE), healthy life expectancy (HLE), and the proportion of healthy life expectancy in life expectancy (HLE/LE). RESULTS: Compared to the non-lonely population, both LE and HLE were lower among lonely individuals. Regarding gender differences, the HLE/LE for females in the lonely population was consistently lower than that for males. The impact of loneliness on the health of older adults varied by measurement indicators and gender. Specifically, based on ADL results, the decline in HLE/LE was greater for females, with a decline of 53.6% for lonely females compared to 51.7% for non-lonely females between the ages of 65 and 99. For males, the decline was 51.4% for lonely males and 51.5% for non-lonely males. According to SRH, the gender difference in the decline of HLE/LE due to loneliness was less apparent. For males, the change in HLE/LE for non-lonely individuals was 3.4%, compared to 4.2% for lonely individuals, whereas for females, the change was 3.7% for non-lonely individuals and 4.4% for lonely individuals. CONCLUSION: Loneliness exerts varied effects on health across different measurement indicators and gender demographics. Targeted health promotion interventions are imperative to mitigate these negative impacts, particularly emphasizing the enhancement of subjective well-being and physical functioning, especially among older adult females.


Assuntos
Expectativa de Vida , Solidão , Humanos , Solidão/psicologia , Masculino , Feminino , China/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Longitudinais , Atividades Cotidianas/psicologia , Disparidades nos Níveis de Saúde , Fatores Sexuais
17.
J R Soc Interface ; 21(215): 20240038, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38835247

RESUMO

The health and economic impacts of infectious diseases such as COVID-19 affect all levels of a community from the individual to the governing bodies. However, the spread of an infectious disease is intricately linked to the behaviour of the people within a community since crowd behaviour affects individual human behaviour, while human behaviour affects infection spread, and infection spread affects human behaviour. Capturing these feedback loops of behaviour and infection is a well-known challenge in infectious disease modelling. Here, we investigate the interface of behavioural science theory and infectious disease modelling to explore behaviour and disease (BaD) transmission models. Specifically, we incorporate a visible protective behaviour into the susceptible-infectious-recovered-susceptible (SIRS) transmission model using the socio-psychological Health Belief Model to motivate behavioural uptake and abandonment. We characterize the mathematical thresholds for BaD emergence in the BaD SIRS model and the feasible steady states. We also explore, under different infectious disease scenarios, the effects of a fully protective behaviour on long-term disease prevalence in a community, and describe how BaD modelling can investigate non-pharmaceutical interventions that target-specific components of the Health Belief Model. This transdisciplinary BaD modelling approach may reduce the health and economic impacts of future epidemics.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/transmissão , COVID-19/psicologia , COVID-19/epidemiologia , Modelo de Crenças de Saúde , Comportamentos Relacionados com a Saúde
18.
Radiat Oncol ; 19(1): 68, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822369

RESUMO

BACKGROUND: Approximately 25-50% of patients undergoing radiotherapy (RT) experience psychological distress and anxiety, which can detrimentally affect both their quality of life and treatment outcomes. While previous research has demonstrated that relaxation exercises can enhance the tolerability of RT and alleviate associated stress and anxiety, the specific needs for such therapies in radiation oncology remain under-explored. This study aims to investigate the demand for and preferences toward relaxation exercises among radiotherapy patients, addressing a critical gap in patient-centered care. METHODS: A prospective pseudonymized survey study using a one-time paper-based questionnaire was conducted from 2022 to 2023 among patients undergoing curative-intent RT for breast cancer or patients undergoing palliative RT for bone metastases. Patients were asked in a 11-item questionnaire about their anxiety, pre-existing practice of relaxation exercises/interventions, their interest in relaxation exercises, and preferences on the type and format of instruction. Data were analyzed descriptively. RESULTS: 100 patients (74 female and 26 male) responded, of whom 68 received curative-intent adjuvant RT and 32 palliative RT. Median age was 62 years. 78% of patients indicated a desire to be actively involved in their radiotherapy, but only 27% had used relaxation exercises prior to RT. 44.8% of both curatively and palliatively treated patients who wanted to be actively involved in their therapy desired to learn how to best relax. 56.4% of respondents were willing to spend extra time learning offered exercises. CONCLUSION: The survey indicates that patients undergoing RT, both for curative or palliative intent, desire relaxation exercises to relieve stress and anxiety from RT. It is therefore important to assess the need for relaxation interventions in individual patients and to develop suitable programs or collaborate with other healthcare professionals to meet these needs.


Assuntos
Neoplasias da Mama , Terapia de Relaxamento , Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/radioterapia , Neoplasias da Mama/patologia , Neoplasias da Mama/psicologia , Masculino , Estudos Prospectivos , Idoso , Inquéritos e Questionários , Adulto , Qualidade de Vida , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Cuidados Paliativos , Neoplasias Ósseas/secundário , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/psicologia , Terapia por Exercício/métodos
19.
Alzheimers Res Ther ; 16(1): 119, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822365

RESUMO

BACKGROUND: Autopsy work reported that neuronal density in the locus coeruleus (LC) provides neural reserve against cognitive decline in dementia. Recent neuroimaging and pharmacological studies reported that left frontoparietal network functional connectivity (LFPN-FC) confers resilience against beta-amyloid (Aß)-related cognitive decline in preclinical sporadic and autosomal dominant Alzheimer's disease (AD), as well as against LC-related cognitive changes. Given that the LFPN and the LC play important roles in attention, and attention deficits have been observed early in the disease process, we examined whether LFPN-FC and LC structural health attenuate attentional decline in the context of AD pathology. METHODS: 142 participants from the Harvard Aging Brain Study who underwent resting-state functional MRI, LC structural imaging, PiB(Aß)-PET, and up to 5 years of cognitive follow-ups were included (mean age = 74.5 ± 9.9 years, 89 women). Cross-sectional robust linear regression associated LC integrity (measured as the average of five continuous voxels with the highest intensities in the structural LC images) or LFPN-FC with Digit Symbol Substitution Test (DSST) performance at baseline. Longitudinal robust mixed effect analyses examined associations between DSST decline and (i) two-way interactions of baseline LC integrity (or LFPN-FC) and PiB or (ii) the three-way interaction of baseline LC integrity, LFPN-FC, and PiB. Baseline age, sex, and years of education were included as covariates. RESULTS: At baseline, lower LFPN-FC, but not LC integrity, was related to worse DSST performance. Longitudinally, lower baseline LC integrity was associated with a faster DSST decline, especially at PiB > 10.38 CL. Lower baseline LFPN-FC was associated with a steeper decline on the DSST but independent of PiB. At elevated PiB levels (> 46 CL), higher baseline LFPN-FC was associated with an attenuated decline on the DSST, despite the presence of lower LC integrity. CONCLUSIONS: Our findings demonstrate that the LC can provide resilience against Aß-related attention decline. However, when Aß accumulates and the LC's resources may be depleted, the functioning of cortical target regions of the LC, such as the LFPN-FC, can provide additional resilience to sustain attentional performance in preclinical AD. These results provide critical insights into the neural correlates contributing to individual variability at risk versus resilience against Aß-related cognitive decline.


Assuntos
Doença de Alzheimer , Locus Cerúleo , Imageamento por Ressonância Magnética , Lobo Parietal , Humanos , Feminino , Masculino , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/psicologia , Doença de Alzheimer/fisiopatologia , Idoso , Locus Cerúleo/diagnóstico por imagem , Locus Cerúleo/patologia , Imageamento por Ressonância Magnética/métodos , Lobo Parietal/diagnóstico por imagem , Idoso de 80 Anos ou mais , Atenção/fisiologia , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/fisiopatologia , Tomografia por Emissão de Pósitrons , Estudos Transversais , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Testes Neuropsicológicos
20.
Int Breastfeed J ; 19(1): 39, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822371

RESUMO

BACKGROUND: Despite the known benefits of exclusive breastfeeding, global rates remain below recommended targets, with Ireland having one of the lowest rates in the world. This study explores the efficacy of Participatory Action Research (PAR) and Work-Based Learning Groups (WBLGs) to enhance breastfeeding practices within Irish healthcare settings from the perspective of WBLG participants and facilitators. METHODS: Employing a PAR approach, interdisciplinary healthcare professionals across maternity, primary, and community care settings (n = 94) participated in monthly WBLGs facilitated by three research and practice experts. These sessions, conducted over nine months (November 2021 - July 2022), focused on critical reflective and experiential learning to identify and understand existing breastfeeding culture and practices. Data were collected through participant feedback, facilitator notes, and reflective exercises, with analysis centered on participant engagement and the effectiveness of WBLGs. This approach facilitated a comprehensive understanding of breastfeeding support challenges and opportunities, leading to the development of actionable themes and strategies for practice improvement. RESULTS: Data analysis from WBLG participants led to the identification of five key themes: Empowerment, Ethos, Journey, Vision, and Personal Experience. These themes shaped the participants' meta-narrative, emphasising a journey of knowledge-building and empowerment for breastfeeding women and supporting staff, underlining the importance of teamwork and multidisciplinary approaches. The project team's evaluation highlighted four additional themes: Building Momentum, Balancing, Space Matters, and Being Present. These themes reflect the dynamics of the PAR process, highlighting the significance of creating a conducive environment for discussion, ensuring diverse engagement, and maintaining energy and focus to foster meaningful practice changes in breastfeeding support. CONCLUSION: This study highlights the potential of WBLGs and PAR to enhance the understanding and approach of healthcare professionals towards breastfeeding support. By fostering reflective and collaborative learning environments, the study has contributed to a deeper understanding of the challenges in breastfeeding support and identified key areas for improvement. The methodologies and themes identified hold promise to inform future practice and policy development in maternal and child health.


Assuntos
Aleitamento Materno , Humanos , Aleitamento Materno/psicologia , Feminino , Irlanda , Pesquisa sobre Serviços de Saúde , Adulto , Pessoal de Saúde/psicologia , Pessoal de Saúde/educação , Promoção da Saúde , Pesquisa Participativa Baseada na Comunidade , Recém-Nascido
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