Supporting the mental health needs of underserved communities: A qualitative study of barriers to accessing community resources.

This study examined the accessibility of community resources (e.g., welfare programs and afterschool programs) for underserved youth and families with mental health needs. Mental health professionals (n = 52) from a large community mental health and welfare agency serving predominantly low-income, Latinx families completed a semistructured interview that asked about the accessibility of community resources. Participant responses were coded using an inductive thematic analysis. Results showed that 71% of participants endorsed availability barriers (e.g., limited local programs), 37% endorsed logistical barriers (e.g., waitlists), 27% endorsed attitudinal barriers (e.g., stigmatized beliefs about help-seeking), and 23% endorsed knowledge barriers (e.g., lacking awareness about local programs). Professionals' perceived availability barriers were mostly consistent with the actual availability of community resources. Findings highlight the compounding challenges that underserved communities face and point to opportunities for promoting enhanced well-being and functioning for youth and families with mental health needs.

Cultivating hope through creative resistance: Puerto Rican undergraduates surviving the disasters of climate and colonization.

This article details what occurred during a youth participatory action research (YPAR) project involving Puerto Rican undergraduates who at first focused their analysis on how their experiences with Hurricane María could be framed as resiliency and then eventually adopted a framework of resistance to further capture their actions, stances, and practices in response to government neglect. The YPAR generative process facilitated this emergence of resistance by beginning with the presentation of a cultural artifact and then helping students to use creative and artistic means to critically reflect on their experiences and the ways that not just resiliency, but also resistance captured their analysis of the actions of the people and government actors both immediately after the hurricane and in the long recovery that followed.

Rapid expansion of direct-to-consumer telemental health during the COVID-19 pandemic: A case series.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic brought many challenges to patient care delivery. The need for social distancing and relaxing of federal and state telemental health regulations paved the way for widespread adoption of direct-to-consumer (DTC) ambulatory mental health video visits. METHODS: We present cases that demonstrate the use of video visits across 6 clinical areas, each serving a unique population of patients, in a large behavioral health system. The benefits and limitations of this modality are illustrated in children, adults, and older adults with mood disorders, anxiety disorders, intellectual disability, substance use disorders, neurocognitive disorders, and schizophrenia. RESULTS: Although telephone visits were acceptable and necessary to serve some patients, there are many advantages to video visits in providing best patient care. Education and support for telemental health-delivered to both patients and clinicians-is critical to the success of the DTC model. CONCLUSIONS: DTC telemental health is a widespread clinical tool used during the COVID-19 pandemic. Because this model has many strengths and advantages compared with traditional telemental health delivered in a clinic, regulators and insurers should be open to its continued use postpandemic when clinically appropriate.

Community Mental Health Professionals' Perceptions About Engaging Underserved Populations.

This study explored mental health professionals' perceptions about barriers and facilitators to engaging underserved populations. Responses were coded using an iterative thematic analysis based on grounded theory. Results revealed that many professionals endorsed barriers to engaging ethnic minorities and families receiving social services. Client-provider racial and linguistic matching, therapy processes and procedures (e.g., nonjudgmental stance), and implementation supports (e.g., supervision) were commonly nominated as engagement facilitators. Many professionals felt that an organizational culture focused on productivity is detrimental to client engagement. Findings shed light on professionals' perceived barriers to delivering high-quality care to underserved communities and illuminate potential engagement strategies.

Current drug use and lack of HIV virologic suppression: point-of-care urine drug screen versus self-report.

BACKGROUND: There have been inconsistent findings on the association between current drug use and HIV disease progression and virologic suppression. Drug use was often measured using self-report of historical use. Objective measurement of current drug use is preferred. METHODS: In this cross-sectional study, we assessed drug use through Computer-Assisted Self Interviews (CASI) and point-of-care urine drug screen (UDS) among 225 HIV-infected patients, and evaluated the association between current drug use and virologic suppression. RESULTS: About half (54%) of participants had a positive UDS, with a lower self-reported rate by CASI (42%) (Kappa score = 0.59). By UDS, 36.0% were positive for marijuana, 25.8% for cocaine, 7.6% for opiates, and 2.2% for methamphetamine or amphetamine. Factors associated with virologic suppression (plasma HIV RNA <50 copies/mL) were Caucasian race (P = 0.03), higher CD4 count (P < 0.01), current use of antiretroviral therapy (ART) (P < 0.01), and a negative UDS (P < 0.01). Among 178 current ART users, a positive UDS remained significantly associated with lower likelihood of virologic suppression (P = 0.04). CONCLUSIONS: UDS had good agreement with CASI in detecting frequently used drugs such as marijuana and cocaine. UDS at routine clinic visits may provide "real-time" prognostic information to optimize management.

A Perspective on Hormonal Contraception Usage in Central Nervous System Injury.

Naturally occurring life stages in women are associated with changes in the milieu of endogenous ovarian hormones. Women of childbearing age may be exposed to exogenous ovarian hormone(s) because of their use of varying combinations of estrogen and progesterone hormones-containing oral contraceptives (OC; also known as "the pill"). If women have central nervous system (CNS) injury such as spinal cord injury (SCI) and traumatic brain injury (TBI) during their childbearing age, they are likely to retain their reproductive capabilities and may use OC. Many deleterious side effects of long-term OC use have been reported, such as aberrant blood clotting and endothelial dysfunction that consequently increase the risk of myocardial infarction, venous thromboembolism, and ischemic brain injury. Although controversial, studies have suggested that OC use is associated with neuropsychiatric ramifications, including uncontrollable mood swings and poorer cognitive performance. Our understanding about how the combination of endogenous hormones and OC-conferred exogenous hormones affect outcomes after CNS injuries remains limited. Therefore, understanding the impact of OC use on CNS injury outcomes needs further investigation to reveal underlying mechanisms, promote reporting in clinical or epidemiological studies, and raise awareness of possible compounded consequences. The goal of the current review is to discuss the impacts of CNS injury on endogenous ovarian hormones and vice-versa, as well as the putative consequences of exogenous ovarian hormones (OC) on the CNS to identify potential gaps in our knowledge to consider for future laboratory, epidemiological, and clinical studies.

Impact of menopause-associated frailty on traumatic brain injury.

Navigating menopause involves traversing a complex terrain of hormonal changes that extend far beyond reproductive consequences. Menopausal transition is characterized by a decrease in estradiol-17ß (E2), and the impact of menopause resonates not only in the reproductive system but also through the central nervous system, musculoskeletal, and gastrointestinal domains. As women undergo menopausal transition, they become more susceptible to frailty, amplifying the risk and severity of injuries, including traumatic brain injury (TBI). Menopause triggers a cascade of changes leading to a decline in muscle mass, accompanied by diminished tone and excitability, thereby restricting the availability of irisin, a crucial hormone derived from muscles. Concurrently, bone mass undergoes reduction, culminating in the onset of osteoporosis and altering the dynamics of osteocalcin, a hormone originating from bones. The diminishing levels of E2 during menopause extend their influence on the gut microbiota, resulting in a reduction in the availability of tyrosine, tryptophan, and serotonin metabolites, affecting neurotransmitter synthesis and function. Understanding the interplay between menopause, frailty, E2 decline, and the intricate metabolisms of bone, gut, and muscle is imperative when unraveling the nuances of TBI after menopause. The current review underscores the significance of accounting for menopause-associated frailty in the incidence and consequences of TBI. The review also explores potential mechanisms to enhance gut, bone, and muscle health in menopausal women, aiming to mitigate frailty and improve TBI outcomes.

Editorial: Transition to Telehealth for Mental Health Clinics: Future Considerations.

The acute mental health demands during the COVID-19 pandemic galvanized early adoption of telehealth for care delivery in all medical settings. This is even more so for the field of psychiatry.1 Whether an established telehealth program existed or not, the abrupt lifting of regulations and urgent need for access to care opened the telehealth flood gates. While video visits and telephone visits improved immediate access to care, they simultaneously challenged our ability to structure, organize, educate, operationalize, and track such visits.1 This swift shift in health care delivery forced providers, health care systems, and patients into a nationwide experiment to learn what works well via telehealth and what does not. The ground-breaking article by Folk et al.2 focuses on challenges and successes for a new shared phenomenon: the sudden pivot from in-person to video/telephone care. We examine the data collected by this consortium and compare it with our own experience at UPMC Western Psychiatric behavioral health outpatient settings, both academic and rural.

Synchronization of occurrence of the ovarian philometrid, Philometra carolinensis, with the spawning season of its fish host, the spotted seatrout, Cynoscion nebulosus.

The philometrid Philometra carolinensis inhabits the ovaries of the spotted seatrout, Cynoscion nebulosus. A 2-year study in estuaries of South Carolina showed that each year adult female worms were present only during the spawning season of the host and that only sexually mature fish were infected. Overall prevalence was 13.1%. Young-of-the-year fish were uninfected and mature 1-year-old fish were less frequently infected than older fish. Abundance of the philometrid was significantly different in age-1 and -2 spotted seatrout. Prevalence, mean abundance, and intensity peaked during the first 2 months of the host's 4-month spawning season, which then declined abruptly. Occurrence of the philometrid in the fish host was unaffected by water temperature, salinity, and dissolved oxygen. Histological studies revealed that the worms were hematophagous. Worms induced disruption of the ovarian lamellar walls resulting in the interruption of development and the loss of host eggs into the ovarian lumen prior to their maturation. The data show that development of this parasite is linked to the host's reproductive status and suggest that paratenesis plays an important role in the maintenance of the parasite's life cycle.

Right hemispheric reversible cerebral vasoconstriction syndrome in a patient with left hemispheric partial seizures.

We report a right-handed 19-year-old girl who developed reversible cerebral vasoconstriction syndrome (RCVS) lateralized to the right hemisphere with simultaneous new-onset left hemispheric seizures. RCVS, typically more diffuse, was lateralized to one of the cerebral hemispheres.

Del dualismo cartesiano a la psiconeuroinmunología: Nuevos horizontes de ayuda a pacientes oncológicos a partir de la intervención del psicólogo de la salud

La revisión teórica que se desarrolló pretende brindar nuevos horizontes de ayuda a pacientes oncológicos desde la Psicología de la Salud, en respuesta a los escenarios multidisciplinarios emergentes en la actualidad como es el caso de la Psiconeuroinmunología y su contribución para el abordaje del cáncer junto al despliegue de nuevos profesionales que desde distintas disciplinas trabajan aplicando las nuevas tecnologías desarrolladas en este ámbito para el tema del cáncer. Desde esta perspectiva, se presentan desde la psicología, propuestas concretas como la Terapia Cognitiva Comportamental del Mindfulness o Atención Plena para el control y la superación del estrés crónico, el poder terapéutico de la Expresión Emocional Escrita como una herramienta fundamental para estimular la fluidez de las emociones reprimidas y por último se presentan algunas Técnicas de Afrontamiento Cognitivo para el Manejo del Dolor por cáncer como alternativas puntuales para el trabajo del psicólogo con los pacientes que sufren a causa de esta enfermedad tan devastadora en el mundo.

The theoretical review that was developed intends to offer new horizons of help to oncological patients from the Psychology of Health, in response to the multidisciplinary scenarios that are emerging today, such as the case of Psychoneuroimmunology and its contribution to the approach to cancer along with the deployment of new professionals from different disciplines working applying the newtechnologies developed in this field to the topic of cancer. From this perspective, specific proposals such as Cognitive Behavioral Therapy of Mindfulness or Mindfulness for the control and overcoming of chronic stress, the therapeutic power of Written Emotional Expression as a fundamental tool to stimulate the flow of repressed emotions and finally some Cognitive Coping Techniques for the Management of Pain due to cancer as specific alternatives for the work of the psychologist with patients suffering from this devastating disease in the world.

A revisão teórica que foi desenvolvido visa proporcionar novos horizontes ajuda pacientes com câncer a partir da Psicologia da Saúde, em resposta ao emergente cenários multidisciplinares hoje como no caso da psiconeuroimunologia ea sua contribuição para a luta contra o cancro com a implantação de novos profissionais de diferentes disciplinas trabalhando aplicando as novas tecnologias desenvolvidas neste campo ao tema do câncer. A partir desta perspectiva, são apresentados a partir de psicologia, propostas concretas, como a terapia cognitivo-comportamental Mindfulness ou Mindfulness para controlare superar o estresse crônico, o poder terapêutico da expressão emocional escrita como uma ferramenta fundamental para estimular o fluxo de emoções reprimidas e finalmente algumas Técnicas de Enfrentamento Cognitivo para o Tratamento da Dor devido ao câncer como alternativas específicas para o trabalho do psicólogo com pacientes que sofrem desta doença devastadora no mundo.

Aportes desde la psicología educativa para el desarrollo de los valores y ética profesional

El objetivo de este proyecto estuvo centrado en trabajar desde la psicología educa­tiva, para el desarrollo de la calidad humana a través de la educación en valores y ética profesional dirigido a estudiantes de la Carrera de Psicología de la Universi­dad Mayor de San Andrés La investigación estuvo centrada en un enfoque cuanti y cualitativo, se trabajó bajo un diseño pre test post test, y se utilizaron entrevistas cerradas y cuestionario pre y post test Los resultados del post test muestran cambios significativos de los estudiantes en la concepción valórica y conocimiento de la deontología psicológica.

The objective of this project was focused on working from the educational psychology, for the development of human quality through the education in values and professional ethics directed to students of the career of psychology of Umsa. The research was focused on a qualitative approach, working under a quasi-experimental design, pre-test post test, and closed interviews, pre and post test questionnaires and focus groups were used. The results of the post test show significant changes of students in the valuation conception, knowledge of psychological deontology.

O objetivo deste projeto foi centrarse no trabalho desde a psicología educacional, para o desenvolvimento da qualidade humana através da educação em valores e ética profissional dirigida a estudantes da carreira de psicología da UMSA. A pesquisa foi focada em urna abordagem qualitativa, trabalhando sob um desenho quase-experimental, pós-teste pré-tes-te, entrevistas fechadas, questionários pré e pós-teste e grupos focais foram utilizados. Os resultados do pós-teste mostram mudanças significativas de alunos na concepção de valoração e no conhecimento da deontologia psicológica.