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Every year, millions of Americans do not receive needed mental health (MH) services. Although Pacific Islanders (PI) have a high need for MH services, this group has the lowest rate of MH care help seeking. This is especially concerning as the rate of suicide has been increasing within the PI community. This study explored how Pacific Islanders think about MH supports, including their attitudes toward and perceptions of barriers to receiving MH services. An interpretative phenomenological analysis focus group study was conducted with cross-generational Pacific Islanders residing in one western state. The findings include (a) PI perceptions that MH help seeking results in family burdensomeness, stigma, and shame; (b) negotiating PI social customs and beliefs related to MH help seeking, care, and support; and (c) PI mistrust of institutional resources. These themes seemed to interact with each other and create perpetuate barriers which prevent help-seeking behaviors. Clinical and research implications will be provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Cultura , Serviços de Saúde Mental , Humanos , Bases de Dados Factuais , Vergonha , População das Ilhas do PacíficoRESUMO
Background: Two Way Prayer Meditation (TWPM) is a spiritual intervention that holds promise for improving the psychospiritual well-being of individuals in recovery from substance use disorders (SUD). This study aimed to identify moderators of TWPM's treatment effects. Moderators tested included gender, race/ethnicity, age, education, religious/spiritual affiliation, and most often used substance. Methods: This study employed a randomized controlled trial design with pretest and posttest. In total, 134 adults in four residential recovery programs participated in the study and were randomly assigned to the TWPM group or the treatment as usual control group. Linear mixed modeling was used to assess the moderating effect of each hypothesized moderator in the form of interaction tests. Sensitivity analyses were conducted by excluding cases with more than a minimum number of missing items. Results: There were no significant moderators for psychological distress, self-esteem, and most of the spiritual well-being outcomes. Both the primary and sensitivity analyses showed education significantly moderated TWPM's effect on overall spirituality self-ranking. Specifically, TWPM's positive effect on overall spirituality self-ranking was greater in the master's degree subgroup than in the less than high school subgroup. Conclusion: TWPM's treatment effects on most outcomes were not found to vary by the tested participant characteristics. The only statistically significant finding suggests clinicians may need to adjust TWPM workshop/teaching content, delivery style, or language used to reach clients with lower levels of education. Future better-powered studies are recommended to continue exploring the potential moderating effects of race/ethnicity, education, spiritual/religious affiliation, and most often used substance.
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Meditação , Transtornos Relacionados ao Uso de Substâncias , Adulto , Humanos , Projetos Piloto , Religião , Espiritualidade , Transtornos Relacionados ao Uso de Substâncias/terapiaRESUMO
Background: The study goal was to conduct a preliminary evaluation of a spiritual intervention called Two Way Prayer Meditation's (TWPM) effectiveness on the psychological distress, self-esteem, and spiritual well-being of people with substance use disorders. Methods: This study employed a randomized controlled trial design with pretest and posttest. In total, 134 adults in four residential recovery programs participated in the study and were randomly assigned to either the TWPM group or the treatment as usual group. Primary and sensitivity analyses were conducted using linear mixed modeling. Hedges's g was used to estimate treatment effect sizes. Results: Both primary and sensitivity analyses found significant treatment effects on daily spiritual experiences (Hedges's g = 0.62), reliance on God (g = 0.49), private religious practice (g = 0.36), and positive religious/spiritual coping (g = 0.68). Treatment effects on psychological distress (g = 0.33), self-esteem (g = 0.41), and overall spirituality self-ranking (g = 0.32) reached significance in the primary analysis but not in the sensitivity analysis. Conclusions: This study found evidence of TWPM's effectiveness in improving some aspects of the spiritual well-being of adults with substance use disorders. TWPM was also found to be promising in decreasing psychological distress and increasing self-esteem.
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Meditação , Transtornos Relacionados ao Uso de Substâncias , Adaptação Psicológica , Adulto , Humanos , Projetos Piloto , Religião , Espiritualidade , Transtornos Relacionados ao Uso de Substâncias/terapiaRESUMO
Substance use is a prevalent public health issue. Most social workers may encounter substance use in their work with clients and need effective therapeutic strategies for this issue. Since the 1980s, solution-focused brief therapy (SFBT) has been practiced with clients who have substance use problems, and clinical training materials have been developed to help practitioners learn and use SFBT in substance use treatment. Despite the longevity of the use of SFBT in practice, there are no published reviews of outcome studies to guide practitioners using SFBT. This article fills a gap in current literature on SFBT and substance use treatment by reviewing the published studies on SFBT where the focus was on substance use treatment. Five databases were searched to identify eligible studies. Experts and reference lists of relevant studies were also consulted. Nine studies were identified and included in the review. All studies reviewed found promising evidence on SFBT's effectiveness in improving substance use behaviors and related psychosocial problems. Five of the nine studies reviewed showed that SFBT can change substance use and comorbid mental health and psychosocial problems such as depression, trauma, and school- and work-related behavior problems. The article concludes with a discussion of the study results' implications for clinical practice and future research.
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Psicoterapia Breve , Transtornos Relacionados ao Uso de Substâncias , Humanos , Aprendizagem , Transtornos Relacionados ao Uso de Substâncias/terapiaRESUMO
The COVID-19 pandemic has exposed the systemic inequities in our health care system and society has called for actions to meet the clinical, psychosocial and educational needs in health care settings and communities. In this paper we describe how an organized Department of Health Social Work in a medical school played a unique role in responding to the challenges of a pandemic with community, clinical, and educational initiatives that were integral to our community's health.
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COVID-19/epidemiologia , Liderança , Faculdades de Medicina/organização & administração , Serviço Social/organização & administração , Fadiga de Compaixão/epidemiologia , Abastecimento de Alimentos/métodos , Nível de Saúde , Linhas Diretas/organização & administração , Humanos , Capacitação em Serviço/organização & administração , Saúde Mental , Cuidados Paliativos/organização & administração , Pandemias , SARS-CoV-2 , Telemedicina/organização & administração , Estados Unidos/epidemiologiaRESUMO
The original version of this article unfortunately contained a typo in the second author surname. The author surname was incorrectly listed as Borhneimer. The correct name should be Bornheimer.
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Cognitive-behavioral therapy (CBT) is well supported for treating depressive and anxiety disorders. Trials of CBT for anxiety and depression in primary care have increased over the past decade, yet only one meta-analysis, published in 2015, examined this topic and the scope of that review is relatively narrow. This study conducted a systematic review and meta-analysis of primary care based CBT for depression and anxiety. A search of seven electronic databases, six professional websites, and reference lists from articles meeting inclusion criteria was conducted for studies published between 1900 and November 2018. Fifty-seven eligible studies (including 10,701 participants; 221 effect sizes) of randomized controlled trials were eligible and included for meta-analysis using robust variance estimation in meta-regression. Outcome indicators were depression and anxiety measures. An overall significant treatment effect, d = 0.400, 95% CI (0.235, 0.566), p < 0.001, of CBT for depression and anxiety disorders in primary care was identified. Subgroup analyses indicated significant treatment effect for: (1) depressive (d = 0.425, p < 0.001) and anxiety (d = 0.393, p < 0.01) outcomes, (2) studies conducted inside primary care (d = 0.412, p < 0.001), (3) studies using individual-based CBT (d = 0.412, p < 0.001), (4) studies without primary care physician involvement (d = 0.395, p < 0.001), and (5) studies using both tele-health (d = 0.563, p < 0.001) and in-person CBT (d = 0.363, p < 0.001). The percentage of White participants, treatment composition (CBT only versus CBT + other approaches), and treatment duration were significant moderators. Implications for clinical practice are discussed based on both moderator and subgroup analysis results.
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Transtornos de Ansiedade/terapia , Ansiedade/terapia , Terapia Cognitivo-Comportamental , Depressão/terapia , Transtorno Depressivo/terapia , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Bases de Dados Factuais , Depressão/psicologia , Transtorno Depressivo/psicologia , Humanos , Atenção Primária à Saúde , Resultado do TratamentoRESUMO
Solution-focused brief therapy (SFBT) is a resource-based, future-oriented therapeutic approach that focuses on finding exceptions to problems and identifying coping strategies to build solutions. SFBT has been efficacious with individuals with alcohol use disorders. Chile experiences high levels of alcohol consumption and alcohol-related health consequences. Despite the international dissemination of SFBT, this is the first study to attempt a linguistic adaptation of SFBT in a Latin American country. We conducted 9 cognitive interviews to examine 13 translated main SFBT tools and 3 focus groups to gather information on cultural aspects of alcohol use in primary care. Results suggest that Chileans understood most SFBT tools, albeit with some linguistic modifications of original translations, and that family, gender, and meaningful issues should be considered when working with individuals with alcohol use disorders.
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Consumo de Bebidas Alcoólicas/prevenção & controle , Alcoolismo/reabilitação , Psicoterapia Breve/métodos , Adaptação Psicológica , Adulto , Chile , Grupos Focais , Humanos , Entrevistas como Assunto , Atenção Primária à Saúde/métodosRESUMO
PURPOSE: Given the critical role of parental care for pediatric cancer patients, this pilot study evaluated the feasibility and effectiveness of a hospital-based solution-focused brief therapy (SFBT) intervention for reducing psychological distress among parents of pediatric cancer patients in China. Differences between treatment and active control (AC) groups were assessed on dimensions of psychological distress. Parents' level of hope was also assessed. METHODS: Participants (N = 44) were randomly assigned to SFBT or AC. Parents received four sessions of SFBT twice a week delivered by graduate-level hospital social workers. Pre- and post-intervention assessments measured change in distress (depression, anxiety, and somatization symptoms) of parents as well as their level of hope. RESULTS: Analysis of covariance (ANCOVA) indicated the SFBT group had better outcomes than the AC group on overall distress of somatic, anxiety, depression symptoms and level of hope. Within- and between-group treatment effects reported significantly greater effect of the SFBT group than of the AC group. CONCLUSIONS: Considering the inherent limits of a pilot feasibility study, results suggest that SFBT is a feasible, culturally compatible, and promising intervention for alleviating distress among Chinese parents of children with cancer. Additional comprehensive trials are needed to draw more definitive conclusions. RELEVANCE: SFBT may be beneficial for improving the critical support systems of parents of pediatric cancer patients. Thus, SFBT may have the potential to enhance children's well-being during cancer treatment and recovery.
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Neoplasias/psicologia , Pais/psicologia , Psicoterapia Breve/métodos , Estresse Psicológico/terapia , Adulto , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Adulto JovemRESUMO
This meta-analysis synthesized randomized controlled trials of solution focused brief therapy (SFBT) in medical settings for patients' health-related psychosocial (e.g., depression, psychosocial adjustment to illness), behavioral (e.g., physical activity, nutrition score), and functional health (e.g., BMI, individual strength) outcomes. Medical setting is defined in this study as any healthcare setting that primarily focuses on patients' physical wellbeing. A comprehensive search strategy across five electronic databases, four academic journals, three professional websites, and reference lists of included articles resulted in a final sample of nine studies for meta-analytic synthesis. Combining outcomes indicated an overall significant effect of SFBT for health-related psychosocial outcomes (d = 0.34, p < .05.) and a nearly significant outcome for health-related behavioral outcomes (d = 0.28, p = .06), but not for functional health outcomes. Results indicated SFBT being an effective intervention for psychosocial outcomes and a promising approach for behavioral outcomes in medical settings.
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Transtorno Depressivo/terapia , Psicoterapia Breve , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtorno Depressivo/psicologia , Exercício Físico , Humanos , Resultado do TratamentoRESUMO
Bereavement is prevalent among college students and spirituality/religiosity may play an important role in their bereavement adjustment. This is the first systematic review to investigate the spirituality/religiosity's relationship with bereavement among college students. We searched 10 databases and screened 598 studies. Eight studies met the inclusion criteria. Findings suggested a favorable association of spirituality/religiosity with desirable bereavement adjustment outcomes (growth, spiritual wellbeing, and psychological wellbeing), but mixed association with undesirable bereavement outcomes (distress). We provided directions for future research to further investigate the complex relationship between spirituality/religiosity and bereavement and to refine the meaning-making coping model for the college student population.
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Luto , Religião e Psicologia , Estudantes/psicologia , Universidades , Adulto , Humanos , Adulto JovemRESUMO
In an effort to develop new fluoroquinolones, we synthesized eight compounds and tested them against a panel of bacteria. The design of these compounds was guided by the introduction of the isothiazoloquinolone motif. The three most active compounds in this series, 8-10, demonstrated good antibacterial activity against methicillin-sensitive Staphylococcus aureus and healthcare-acquired methicillin-resistant Staphylococcus aureus (MIC 0.62-6.3 µg/mL). Further, when these three active compounds were tested for their inhibitory effects on bacterial enzymes, compound 9 was the most effective agent exhibiting IC50 values of 33.9 and 116.5 µM in the S. aureus deoxyribonucleic acid (DNA) gyrase supercoiling and topoisomerase IV decatenation assays, respectively.
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Amidas/farmacologia , Antibacterianos/farmacologia , Fluoroquinolonas/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Tiazóis/farmacologia , Tiazolidinas/farmacologia , Amidas/síntese química , Amidas/química , Antibacterianos/síntese química , Antibacterianos/química , Relação Dose-Resposta a Droga , Fluoroquinolonas/síntese química , Fluoroquinolonas/química , Testes de Sensibilidade Microbiana , Estrutura Molecular , Relação Estrutura-Atividade , Tiazóis/síntese química , Tiazóis/química , Tiazolidinas/síntese química , Tiazolidinas/químicaRESUMO
Our objective was to study hypertension induced by chronic administration of synthetic glucocorticoid, dexamethasone (DEX), under nonstressful conditions and examine the role of catecholamine biosynthesis. To achieve this, we did the following: 1) used radiotelemetry to record mean arterial pressure (MAP) and heart rate (HR) in freely moving rats, and 2) administered different doses of DEX in drinking water. To evaluate the involvement of tyrosine hydroxylase (TH), the rate-limiting step in catecholamine biosynthesis, we treated rats with the TH inhibitor, α-methyl-para-tyrosine (α-MPT), for 3 days prior to administration of DEX and assessed TH mRNA and protein expression by quantitative real-time polymerase chain reaction and Western blot in the adrenal medulla. We observed a dose-dependent elevation in blood pressure with a DEX dose of 0.3 mg/kg administered for 10 days, significantly increasing MAP by +15.0 ± 1.1 mm Hg, while concomitantly reducing HR. Although this DEX treatment also significantly decreased body weight, pair-fed animals that showed similar decreases in body weight due to lowered food intake were not hypertensive, suggesting that body weight changes may not account for DEX-induced hypertension. Chronic DEX treatment significantly increased the TH mRNA and protein levels in the adrenal medulla, and α-MPT administration not only reduced DEX pressor effects, but also inhibited TH (serine(40)) phosphorylation. Our study thus validates a novel model to study hypertension induced by chronic intake of DEX in freely moving rats not subject to the confounding factors of previous models and establishes its dependence on concomitant activation of peripheral catecholamine biosynthesis.
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Dexametasona/farmacologia , Modelos Animais de Doenças , Hipertensão/induzido quimicamente , Hipertensão/enzimologia , Tirosina 3-Mono-Oxigenase/metabolismo , Medula Suprarrenal/efeitos dos fármacos , Medula Suprarrenal/metabolismo , Animais , Pressão Sanguínea/efeitos dos fármacos , Relação Dose-Resposta a Droga , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Masculino , Fosforilação/efeitos dos fármacos , Ratos , Serina/metabolismo , Tirosina 3-Mono-Oxigenase/antagonistas & inibidores , Tirosina 3-Mono-Oxigenase/química , Tirosina 3-Mono-Oxigenase/genética , alfa-Metiltirosina/farmacologiaRESUMO
The impact of suicidal ideation on college students' academic performance has yet to be examined, yet mental health is often linked with academic performance. Underclassmen and upperclassmen were compared on behavioral health outcomes related to academic success (N = 26,457). Ideation (b = -0.05, p < .05), increased mental health (b = -0.03, p < .01) or substance use severity (b = -0.02, p < .01) was associated with lower GPAs. Underclassmen's behavioral health severity was related to lower GPA. Students reported higher GPAs when participating in extracurricular activities during the past year. Ideation, beyond mental health, is an important when assessing academic performance. Increasing students' connections benefits students experiencing behavioral concerns but also aids in suicide prevention initiatives and improves academic outcomes. Creating integrated health care systems on campus where physical, mental health and academic support services is crucial to offer solutions for students with severe or co-morbid mental health histories.
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Escolaridade , Saúde Mental , Ideação Suicida , Feminino , Humanos , Masculino , Saúde Mental/estatística & dados numéricos , Fatores de Risco , Serviços de Saúde para Estudantes , Estudantes/psicologia , Adulto JovemRESUMO
School social workers are integral to the school mental health workforce and the leading social service providers in educational settings. In recent decades, school social work practice has been largely influenced by the multi-tiered systems of support (MTSS) approach, ecological systems views, and the promotion of evidence-based practice. However, none of the existing school social work reviews have examined the latest characteristics and outcomes of school social work services. This scoping review analyzed and synthesized the focuses and functions of school social workers and the state-of-the-art social and mental/behavioral health services they provide. Findings showed that in the past two decades, school social workers in different parts of the world shared a common understanding of practice models and interests. Most school social work interventions and services targeted high-needs students to improve their social, mental/behavioral health, and academic outcomes, followed by primary and secondary prevention activities to promote school climate, school culture, teacher, student, and parent interactions, and parents' wellbeing. The synthesis also supports the multiple roles of school social workers and their collaborative, cross-systems approach to serving students, families, and staff in education settings. Implications and directions for future school social work research are discussed.
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Background: Community-based youth mentoring programs are popular interventions that serve a large number of Black youths throughout the country. Interestingly, the majority of mentors who volunteer their time for mentoring organizations identify as non-Hispanic White. This study examines how White mentors address topics acknowledging ethnic/racial identity and issues centered around social justice and recognize their own privileges when mentoring Black youth in community-based youth mentoring programs. Objective: The aims of the current study were to examine: (a) whether and how White volunteer mentors address ethnic/racial identity, racial socialization, and oppression in the mentoring relationship and (b) how White mentors' awareness of their own positionality and privilege impacted how they addressed ethnic/racial identity, racial socialization, and oppression in the mentoring relationship with Black youth. Method: Utilizing a constructivist grounded theory approach, in-depth semi-structured interviews were conducted with 26 current and former mentors from six different Big Brothers Big Sisters community-based mentoring programs across the United States. Results: Findings reveal that some mentors felt uncomfortable discussing issues centered around race and others do not think it is relevant at all. Further, findings demonstrated that mentoring Black youth significantly impacts mentors' perceived awareness of social issues and acknowledgment of privileges they hold. Conclusions: Current findings highlight the need for youth mentoring programs to provide training and resources to help White mentors discuss implications of race and broader social justice issues with the Black youth they mentor.
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Objective: Simultaneous alcohol and marijuana (SAM) use exposes college students to a myriad of adverse consequences. However, there is no recent nationally representative study on SAM use among college students in the United States (US). To provide an update to the literature, the present study aimed to examine the trends, prevalence, and correlates of SAM use among US college students between 2006 and 2019, using nationally representative data. Method: We used data from the 2006-2019 National Survey on Drug Use and Health (NSDUH) and the analytic sample was limited to the 55,669 full-time college student respondents (ages 18-22). Using logistic regression analysis, we assessed trends in SAM use prevalence and examined sociodemographic and psycho-social-behavioral correlates of SAM use. Results: The proportion of US college students who reported SAM use increased significantly from 8.13% (2006-2010) to 8.44% (2015-2019). However, examination by race/ethnicity revealed that the increasing trend was largely driven by Black college students, whose SAM use prevalence increased significantly from 5.50% (2006-2010) to 9.30% (2015-2019), reflecting a 69.09% increase. SAM use rates did not change significantly among other racial/ethnic groups. Conclusions: This study uncovered an upward trend and prevalence of SAM use among US college students, calling for more research and public health interventions in this area. At-risk subgroups that warrant more attention include college students who are Black, female, above the legal drinking age, have a lower than $20,000 household income, and reside in small metropolitan areas.
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Successful formulation development hinges on the ability to screen and identify excipients that stabilize drug products during long-term storage. Biophysical and accelerated stability studies are used to screen for excipients that stabilize protein drug products. However, these studies are not always predictive of aggregation during long-term storage. In this study, we used multivariate experimentation to compare the effectiveness of intrinsic fluorescence and size exclusion chromatography accelerated stability parameters to predict excipients that stabilized bovine serum albumin (BSA) against aggregation on long-term storage at 4 °C. Emission intensity ratio (IR330/350) data was more sensitive than emission maxima (λmax) or intensity measurements in identifying significant factors and interactions. We observed the expected inverse correlation between the mid-points of fluorescence thermal transitions (Tms) and insoluble aggregates at 4 and 40 °C. However, there were positive correlations between Tms and % aggregates at 4 °C, indicating that if Tm was used as a predictive tool, it would select formulations that promoted soluble aggregates on long-term storage. Ambient temperature IR330/350 measurements identified excipients that reduced BSA soluble aggregates on long-term storage. The results show ambient temperature emission ratio measurements can be useful for protein formulation development.
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Excipientes , Soroalbumina Bovina , Cromatografia em Gel , Estabilidade de Medicamentos , TemperaturaRESUMO
Working on What Works (WOWW) is a manualized, 10-week classroom intervention based on solution-focused brief therapy. This study evaluates WOWW using a randomized experimental, posttest-only design. The study included 30 fourth and fifth grade classrooms, containing 30 teachers and 413 students. Results indicate no significant differences between WOWW and control groups for student internalizing and externalizing behaviors, student-teacher relationships, student academic performance, or teacher sense of efficacy. However, students in the WOWW group had significantly fewer days absent from school compared with the control group. Additionally, teachers' ratings on WOWW classrooms' performance improved significantly more than teachers' ratings on the control classrooms. Results from this study show that WOWW is a feasible intervention for therapists to use in schools and can be implemented across classrooms in both public and private schools. WOWW has potential to improve student attendance and classroom performance, both of which are important areas of concern for schools.
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Desempenho Acadêmico , Avaliação de Processos e Resultados em Cuidados de Saúde , Psicoterapia Breve , Professores Escolares , Instituições Acadêmicas , Estudantes , Criança , Feminino , Humanos , Masculino , Projetos de PesquisaRESUMO
BACKGROUND: Spiritual/religious (S/R) interventions are commonly used to treat substance use problems, but this is the first systematic review and meta-analysis to examine their efficacy for these problems. METHODS: Ten electronic databases were searched to identify eligible studies (i.e., randomized controlled trials) published between January 1990 and February 2018 that examined S/R interventions' efficacy for substance use or psycho-social-spiritual outcomes. Two reviewers independently screened studies, extracted data, and assessed risks of bias. Robust variance estimation in meta-regression was used to estimate effect sizes and conduct moderator analysis. RESULTS: Twenty studies comprising 3700 participants met inclusion criteria. Four studies used inactive controls, 14 used active controls, and two used both inactive and active controls and were therefore included in estimating both absolute and relative effect sizes. The absolute effect of S/R interventions (compared with inactive controls such as no treatment) was moderate but non-significant (six studies, dâ¯=â¯.537, 95% confidence interval [CI]â¯=â¯-.316, 1.390), possibly due to low power. The relative effect of S/R interventions (compared with other interventions) was statistically significant (16 studies, dâ¯=â¯.176, 95% CIâ¯=â¯.001, .358). Because only 12-step-oriented interventions were compared with other interventions, this finding does not apply to the relative effect of non-12-step-oriented S/R interventions. Moderator analysis showed that relative effect sizes differ significantly by country. CONCLUSION: We found evidence of S/R interventions' efficacy in helping people with substance use problems. More high-quality efficacy studies of non-12-step-oriented S/R interventions for substance use problems are needed.