Nondumiso Dlamini, Siphesihle Hlongwane, Carina Herbst
et al.
In South Africa, many young people relocate from rural to urban areas for education, attending day schools while residing in rented accommodation. Migration exposes them to risk, including alcohol and drug abuse, sexual exploitation and violence. We developed and assessed a support system for young migrants, aged 14-24 in KwaZulu-Natal, South Africa. Five trained peer navigators conducted needs assessments for 283 young internal migrants between June 2021 and October 2022. The intervention included mobile phone support and streamlined referrals through a call centre, connecting young migrants to a study social worker, local healthcare facilities, and peer assistance. To assess the intervention, we conducted repeat in-depth interviews with 20 participants and 5 interviews with peer navigators, in-person and by telephone. Most young migrants rented rooms in unsafe areas to be near their schools, which presented physical, psychological, and mental challenges during the transition from living with parents/carers. The young migrants valued the intervention, including access to sexually transmitted infection treatment, psychosocial support from the social worker, and assistance from peer navigators in tackling general challenges. They appreciated that the peers provided a confidential space to engage and share openly with little fear of being judged. Our findings show that protection for young migrants can be provided through supportive structures such as peer-led interventions.
BackgroundAmerican Indian/Alaska Native (AI/AN) populations have the highest suicide rate in the United States. Research on effective, culturally-centered, multi-level approaches to prevent suicide in AI/AN populations are limited.MethodsThis multi-site longitudinal evaluation employed a retrospective pre-posttest design, utilizing a self-report survey administered daily following the training. Daily surveys included four areas related to suicide prevention, holistic wellness, generational knowledge, behavior change, and legacy impacts. The first objective of this study was to explore how the Good Road of Life training impacted participant knowledge regarding suicide and related risk factors while also exploring protective behaviors and impacts from a culturally-centered, strengths-based lens. A second objective was to present a conceptual model grounded in socioecological and trans-ecological theories of GRL for collective healing targeting the individual, family, community, Tribe, and nation to prevent suicide.ResultsBetween 2019 and 2024, 27 GRL trainings were conducted at 8 Tribal sites in Montana, South Dakota, North Dakota, and Wyoming. Data accumulated across these 27 trainings and 1,810 students represented diverse tribes, locations, and ages. Students were asked to rate different domains of Holistic Wellness: mental (M = 3.25, SD = 1.03), physical (M = 3.33, SD = 1.03), spiritual (M = 3.35, SD = 1.05), and emotional (M = 3.17, SD = 1.12). Students rated 17 generational knowledge domains before and after GRL training; all comparisons were significant at p < 0.001; all differences had moderate or large effect sizes. Middle school students reported larger increases in knowledge from pre to post than high school students.DiscussionFindings from this evaluation underscore the importance of early intervention, culturally-centered approaches, and community-led suicide prevention in AI/AN populations.
This paper presents a qualitative exploration of the representation of the causes, manifestations, and healing strategies of psychiatric conditions in Mari Kushinga, a contemporary Zimbabwean drama. Mental health challenges remain a pressing concern in present-day Zimbabwe, where increasing numbers of individuals exhibit symptoms of psychiatric distress. However, the underlying causes of these conditions often remain undiagnosed or are ambiguously interpreted, leading to uncertainty about appropriate therapeutic interventions. While many families turn to biomedical or postmodern methods of treatment, such as psychotropic medication, clinical counselling, and psychiatric institutionalisation, traditional explanatory models and healing systems continue to exert significant influence within communities. Drawing on Mari Kushinga (2024), a drama performed by ZIYA Cultural Arts Trust, popularly known as Vharazipi, this study interrogates how artistic performance mediates cultural understandings of mental illness. Anchored in the theoretical frameworks of postmodernism, psychiatry, and Afrocentricity, the analysis reveals that greed and the pursuit of ill-got wealth (kuromba/ukuthwala) are dramatised as principal causes of psychic disintegration. The drama further portrays traditional healing systems as central to restoring individual and communal equilibrium. The paper argues that Mari Kushinga serves not only as a mirror of contemporary Zimbabwean society but also as a critical site for negotiating the interface between indigenous epistemologies and modern psychiatric discourse.
Dahryn Trivedi, Mahendra Kumar Trivedi, Alice Branton
et al.
Background: In traditional healing systems, life-force energy or subtle human energy fields have been recognized for millennia. Parallel to conventional therapy, its popularity has grown tremendously in recent years. Due to limited scientific research on biofield therapies, the authors investigated the potential impact of distant biofield/blessing energy interventions on individuals with psychological impairments via virtual methods. Methods: A total of 119 participants (56 male, 63 female) with one or more psycho-mental symptoms were enrolled in these randomized, placebo-controlled, double-blind clinical trials. Two remote biofield/blessing energy interventions, each lasting approximately 5 min, were delivered to 38 subjects in the biofield intervention group on days 0 and 90. Subjects were assessed using standardized psychological questionnaires, which employed a validated scoring scale, as well as safety parameters. Results: Participants in the biofield (blessing) intervention group reported significantly lower levels of perceived psychological symptoms (fatigue, sleep disturbances, stress, cognitive impairment, and emotional distress) compared with both naive and sham control groups (p < 0.0001). Biofield intervention was safe and well-tolerated in all three groups. Conclusion: Distant biofield/blessing energy healing sessions were found to significantly improve psychological and mental health, enhance overall well-being, and pose no safety risks. Therefore, further research is needed to identify key variables for a larger scale intervention study on health outcomes and underlying mechanisms. Trial registration: Clinical Trials Registry Number—India (CTRI/2022/07/043633).
Katarina Krizova, Júlia Halamová, Bronislava Strnádelová
et al.
The GAD-7 is a widely used screening tool for the measurement and diagnosis of symptoms of generalized anxiety disorder. It has been translated and validated across more than 20 cultural contexts. However, no study to date examined its psychometric properties in a Slovak sample, despite the fact that a Slovak translation exists. The purpose of the present study was to test psychometric properties and factor structure of GAD-7 in a general sample of Slovak helping professionals. It was hypothesized that a one-dimensional factor structure would be supported by the data, and that construct validity would be demonstrated. A total of 2239 participants (Mage = 42.20, SD = 14.30) from different helping professions (e.g., psychologists, teachers, special educators, medical doctors, nurses, speech-language pathologists) completed an online survey. A confirmatory factor analysis yielded satisfactory factor loadings and acceptable model fit of the tested one-dimensional model. This evidence was invariant by sex. Internal consistency coefficients indicated good reliability. Significant correlations were found between the GAD-7 and both negative and positive adjustment constructs, thus demonstrating convergent and discriminant validity, respectively. The results of this study add to the evidence on the GAD-7 and its applicability across cultures and support the use of a Slovak translation of the instrument.
Muscles and mobility deteriorate with age, and exercising is the only sure countermeasure. It is useful to offer safe and toll-free rehabilitation training, such as the Full-Body In-Bed Gym, easy to learn and perform at home. Based on my own experience, I suggest a 10-20-minute daily routine of easy and safe physical exercises that may improve the main 300 skeletal muscles used for everyday activities. Many of the exercises can be performed in bed (Full-Body In-Bed Gym), so hospital patients can learn this light workout before leaving the hospital. The routine consists of a series of repetitions of bodyweight exercises to be performed one after the other, without time breaks in between. Alternating sequences of arm and leg exercises are followed by moving body parts in lying and sitting positions in bed and by standing and sitting down. Progressive improvements can be tested by a series of push-ups on the bed or the floor. Starting from 3-5, the number of repetitions is increased by adding 5 more every week. To maintain or even shorten the total daily time of workout, each movement is then speeded up. The devoted time every morning (or at least 5 days a week) to train all the major muscles of the body can remain under 15 minutes. Because there are no breaks during and between sets, the final push-ups become very challenging. At the end of the daily workout, heart rate, depth, number of spontaneous ventilations, and frontal perspiration increase for tens of minutes. Here is an example of how to implement the progression of the Full-Body In-Bed Gym, presenting an educational case report of a trained 80-year-old person in stable pharmacological management. Details of the workouts and the related results are presented in the 2024 book, How to Rejuvenate at 80’s. Positive results on quality of life, mental wellness, and persistence in a group of older adults were recently reported in a scientific publication. Although performed in bed, in addition to strengthening the main muscles, ventilatory ones included, Full-Body In-Bed Gym at home is a resistance training equivalent to a short jog. Started in early winter and continued regularly throughout spring and summer, Full-Body In-Bed Gym can help maintain the independence and mental wellness of elderly people. It is a simple approach that deserves further clinical trials.
Abstract Few studies have explored the views of fathers in relation to daughters diagnosed with anorexia nervosa (AN). The aim of this study was to investigate this aspect. This study was part of a larger study. Fourteen fathers (age 46–68 years) of 14 daughters (age 19–29 years) diagnosed with AN were interviewed between 1996 and 2002. The interview consisted of 15 open‐ended questions exploring the views of fathers in relation to their daughters later diagnosed with AN. Following transcription, thematic analysis was used to identify main themes and subthemes based on the data. We identified three themes: “Family dynamic,” “Proximity and distance to the daughter,” and “Commitment and knowledge seeker,” and 10 subthemes. The fathers were involved during the upbringing and the relation to the daughter was important. Different studies show the importance of the paternal role for the daughter's healthy development, and for AN. Not sharing equally, the responsibility of early childcaring, could foster the experience of inadequacy regarding the paternal role in the future. In our study, the fathers considered the mothers to be the experts during the daughters' adolescence. This attitude could have hindered them from understanding their daughters pathological eating problems. This and other studies indicate the importance of viewing the fathers as a resource when planning treatment approaches.
Background: Pregnancy experiences influence fetal and birth outcomes. There is scarcity of locally validated tools to assess pregnancy experiences. We aimed to validate the Pregnancy Experience Scale-Brief (PES-Brief) in pregnant Pakistani women with anxiety symptoms. Methods: A two-step process was used including 1) adaptation via translation/back-translation followed by cognitive interviewing with 10 participants and 2) factor analysis and validation with 605 women in Rawalpindi Pakistan who had mild-moderate symptoms of anxiety, attended the antenatal clinic, and were ≤22 weeks of gestation and ≥18 years old. We calculated internal consistency and reliability and conducted exploratory and confirmatory factor analyses. Results: Cultural adaptation led to inclusion of one item of the hassles subscale and exclusion of one item in the uplifts subscale, resulting in 9 uplifts and 11 hassles. Exploratory factor analysis supported a two-factor structure, with the adapted items exhibiting loading values of ≥0.24 for their respective factors. Internal consistency was demonstrated for uplifts (Cronbach’s alpha = 0.89) and hassles (Cronbach’s alpha = 0.85) subscales. Uplift intensity was moderately correlated with the Hospital Anxiety and Depression Scale anxiety subscale (r = 0.54, 95% CI:0.30–0.77). Conclusion: The Urdu PES-Brief is a reliable and valid tool for use in Pakistani pregnant women with antenatal anxiety. Future studies on its validity are needed on women without symptoms anxiety.
Emily R. George, Lora L. Sabin, Patricia A. Elliott
et al.
Background Champions are widely recognized as playing a key role in the successful implementation of evidence-based interventions within the health care sector; however, little is known about which characteristics and skills enable them to play that role. Furthermore, previous studies have measured only individual champions’ responses to personal attributes without incorporating input from other observers. A mixed-methods study was conducted to identify, analyze, and group the behaviors and characteristics of champions who have successfully promoted the adoption of new initiatives within the health care delivery system, taking into consideration self and peer perspectives. Methods Using a mixed-methods, cross-sectional triangulation design with a convergence model, quantitative data were collected and analyzed from health care champions (n = 30) and their colleagues (n = 58) from 11 countries using a survey. Every champion and a subset of colleagues (n = 14) also participated in in-depth interviews. Descriptive statistics were used to explore the relationship between champion and colleague responses to survey items; chi-squared tests and Kruskal–Wallis tests were used to compare the differences. Thematic content analysis of qualitative data was used to explore champion-like behaviors and features. Characteristics of champions were categorized using the Transformational Leadership Theory framework. Results Champions exhibited characteristics that facilitated trust and encouraged motivation among their colleagues to adopt innovations, such as being intrinsically motivated, persistent, enthusiastic, and highly effective communicators. Champions were described by their colleagues as empathetic, curious, physically present, approachable, and often soliciting feedback from others. Although there was a high degree of agreement between champion and colleague survey responses, champions were more likely to underrate their skills and abilities to instigate change compared to their colleagues. Conclusion Both champions and colleagues described key champion-like characteristics, but champions often downplayed the characteristics and behaviors that make champions uniquely effective at facilitating the adoption of evidence-based interventions. Plan language abstract Health care champions are people who promote the adoption of new initiatives to improve the quality of patient care among their colleagues within health care settings. Champions are often viewed by organizational leaders and researchers as critical for the successful implementation of new ideas; however, little is known about what specific skills or characteristics make them effective at promoting the adoption of new ideas among their colleagues. Most studies on champions’ behaviors have only included the perspectives of champions, and not perspectives from others within the organization. The goal of our study was to not only explore champions’ perspectives of themselves, but also the views of champions’ colleagues to understand why and how champions motivated and influenced their colleagues to try new things. Findings from this study could lead to more accurate identification of health care champions, which in turn could lead to more efficient and effective adoption of new initiatives to improve the quality of patient care.
Alexandra Brewis, Kedir Teji Roba, Amber Wutich
et al.
Elevated levels of mental health symptoms – especially related to depression and anxiety – are observed in water-insecure communities. A small set of ethnographic studies have suggested that inadequate safe and sufficient water does not in itself well explain observed patterns; rather the social contexts of water is critical. The most commonly theorized explanatory mechanism is the distress of perceived unfairness acting as a psychosocial stressor, although direct empirical tests of this are currently lacking. Another theorized and untested mechanism is the stress of social interactions around household water (like participation with neighbors in water sharing systems). Based on a sample of N = 1543 women ages 18–49 years (all with young children in the home) collected in Eastern Hararghe, Oromia, Eastern Ethiopia from June to September 2019, we tested the effects of two theorized mechanisms potentially implicated in why water causes psychosocial distress: perceived unfairness in the water system and level of participation in informal water sharing systems. In these predominantly smallholder agricultural households, and taking into account expected covariates like role-responsibility for water and household food insecurity, we find that perceived unfairness accounted for two-thirds of the effect of household water insecurity on individual depression/anxiety symptom levels. Even taking all these factors into account, high (and assumably predictable) levels of participation in water borrowing were associated with better mental health. However, less frequent (and assumably less predictable) borrowing was associated with worse outcomes. Together these findings provide needed empirical support for the propositions that the negative mental health effects of water insecurity are fundamentally tied to the dynamic social mechanisms around and meanings of water in water insecure communities, much more so than water access in itself.
One of the most burdensome and profound complaint among parents of children with autism is disrupted sleep, with more than 40-80% of the children experiencing sleep problems compared with 25-40% in typically developing children. Consequence of disrupted sleep is potentially serious; it may exacerbate core ASD symptoms. Research is limited on sleep and its relation with behavioural problems and parental distress in low functioning autism. The main aim of the study is to assess the sleep problems and its relation with severity of autism, day time problem behavior and parental distress in children with low functioning autism. A descriptive cross sectional design was adopted for the study among 40 children aged between 6-16 years of age, recruited from selected special schools and autism centres in Kerala. Sleep problems, autism severity, problematic behavior and parental distress were assessed using Children’s sleep habit questionnaire (CSHQ), Social responsive scale (SRS), The Disruptive Behaviour Disorder Rating Scale, Parenting stress index respectively. Prevalence of sleep problems were more among children with low functioning autism. All the children in the study met the cut off score of sleep problems in CSHQ .But sleep problem was not correlated with severity of autism, problematic behaviours and parental distress. Findings showed that autism severity is related with parental stress (p=0.046) and problem behaviour (p<0.01) in children with autism. It was also observed that problematic behaviours in children is correlated with parental stress (p=0.019) .Study results emphasize the need for implementing interventions to reduce sleep problems, problematic behaviours and parental distress.