Meredith Stifter, Fiona Grubin, Novalene Goklish
et al.
Abstract Background Adverse childhood experiences (ACEs) are common in many communities. In Native American communities, ACEs are also related to historical trauma. ACEs are correlated with a variety of health problems, among them substance abuse and suicidal behaviors. Despite historical and contemporary efforts to assimilate and eradicate American Indian communities and cultures, these communities are resilient and continue to benefit from unique cultural strengths and values surrounding health today. The White Mountain Apache Tribe (WMAT) leverages tribal sovereignty to implement programs and policies to address health inequities in their community. The Johns Hopkins Center for Indigenous Health supported work toward health equity in the community through developing the My Pathway to Healing intervention aimed at supporting adults struggling with substance abuse and/or suicidal behaviors by addressing trauma, including historical trauma and ACEs. Methods This pilot randomized trial will assess the feasibility and preliminary impacts of the My Pathway to Healing intervention with a two-armed randomized wait-list controlled trial. We will use stratified randomization and 1:1 allocation to assign participants to receive either the intervention or the current standard of care (those randomized to receive standard of care will be offered the intervention upon completion of the study). We aim to enroll N = 30 adults from the WMAT community who are between ages 18 and 65, have engaged in recent (i.e., past 90 days) suicidal, self-harm, or binge substance use behavior, who have experienced at least two ACEs, and who are currently experiencing elevated symptoms of posttraumatic stress. Participants will be recruited through the local community-based suicide surveillance system by community mental health specialists. Analysis will be conducted to assess feasibility of implementing a larger trial in the future and whether the intervention decreases symptoms of posttraumatic stress and increases hopefulness and communal mastery. Discussion The My Pathway to Healing intervention leverages WMA cultural strengths and fills an important gap in programming available to older adults in the WMAT community. This trial will yield results on the utility of a multi-problem approach to addressing similar issues stemming from historical and contemporary trauma. Trial registration ClinicalTrials.gov Identifier: NCT04585906. Registered 14 October 2020, https://classic.clinicaltrials.gov/ct2/show/NCT04585906 .
Growing old is related with all human beings, but for those whose sexualities do not follow the social normative structure of family, growing old is more related to loneliness. This article will refer to such people with a different sexual orientation, in this case, mainly gay men. It will deal with the qualitative queer methodologies used for this particular topic. Queer gerontology has hardly been dealt with anywhere in research in this country; talking about old gay men seems to many that it does not need any methodology to deal with. But when academics try to investigate, interpret and interject many subjects and various areas, it is seen that the ‘queering communications’, ‘queer conversations’ and ’queer(y)ing ethics’ in qualitative methodology are always considered as similar as any social sciences qualitative methodology, or specifically gender qualitative methodology. This article will try to critically analyse how normative gerontology is very different from queer gerontology. This article includes a sample of 50 gay men in five different categories based on age: 30–35, 35–40, 40–45, 45–50 and 50–55 years. The sample includes gay men from different social and cultural backgrounds, various professional fields and several regions and languages, focusing mainly on people, power and place. Beside these, it will also have two broad categories: one who stays single and one who stays with a partner. Being a gay man brings lots of packages along with life—discrimination, violence, rights and privileges as a citizen of India are some of them that this article will also deal with. This article will try to bring the queer methodological structure into focus with the area of growing old gay men in a society where the socio-legal conditions consider them as criminals. The socio-psychological aloofness begins at an early age, and as one grows older, it corrugates the lives of such gay men as lonely, abhorrent human beings in society.
Men are a particularly challenging group when it comes to mental health communication. Non-disclosure of mental distress is quite common among men in general, and even more so among depressed men – despite its detrimental effects on health. Motivating men to share their mental distress with trusted social contacts serves as a vital first step in addressing and improving their mental health – both for those men who are affected by mental illness and those who are not. To overcome the barriers to communicating about mental distress, knowledge about the aspects associated with non-disclosure is indispensable. Bringing together assumptions from interpersonal communication and (mental) health communication literature, we propose a conceptual model of the relationships among depressiveness, loneliness, conformity to masculine norms, number of trusted social contacts, and non-disclosure of mental distress. To empirically test our model, we conducted a cross-sectional online survey with 1,400 men in Germany. Findings largely substantiate our model. They show that a higher depressiveness is positively associated with men's non-disclosure of mental distress – both directly and mediated through several other variables. Loneliness emerged as an important mediating factor, with a higher depressiveness being linked to higher loneliness, which increased the likelihood for men's non-disclosure. Depressiveness was also associated with a higher conformity to traditional masculine norms, again making non-disclosure of mental distress more probable.
On February 6, 2023, two catastrophic earthquakes hit Turkey on the same day, which was called the biggest disaster of the last century. Following this disaster, some students living in 10 provinces affected by the earthquakes decided to leave their hometowns and continue their education in different cities. In recent years, the concepts of school belonging and school satisfaction have gained prominence in the relevant literature. However, little is known about the mechanisms that mediate the relationship between school satisfaction and school belonging. Therefore, the purpose of this study was to examine the mediating effects of academic grit and subjective vitality on the relationship between students' school belonging and school satisfaction. The study participants consisted of middle school students who moved to another city after the earthquakes and started attending different schools in those cities. A total of 550 students participated in the study, consisting of 312 girls and 238 boys. The age of the participating students ranged from 10 to 15 years (M=12.43, SD=1.07). In the current study, the data collection instruments included a personal information form developed by the researcher, the School Belongingness Scale, the Comprehensive School Satisfaction Scale for Children, the Academic Grit Scale, and the Subjective Vitality Scale. The results of the study indicate that academic grit and subjective vitality play a significant mediating role in the relationship between school belonging and school satisfaction. In addition, all path coefficients in the current study are significantly positive. Based on the results of the study, some suggestions are offered to increase school satisfaction among middle school students.
Karey L. O’Hara, Lindsey M. Knowles, Kate Guastaferro
et al.
Background The public health impact of behavioral and biobehavioral interventions to prevent and treat mental health and substance use problems hinges on developing methods to strategically maximize their effectiveness, affordability, scalability, and efficiency. Methods The multiphase optimization strategy (MOST) is an innovative, principled framework that guides the development of multicomponent interventions. Each phase of MOST ( Preparation , Optimization , Evaluation ) has explicit goals and a range of appropriate research methods to achieve them. Methods for attaining Optimization and Evaluation phase goals are well-developed. However, methods used in the Preparation phase are often highly researcher-specific, and concrete ways to achieve Preparation phase goals are a priority area for further development. Results We propose that the discover, design, build, and test (DDBT) framework provides a theory-driven and methods-rich roadmap for achieving the goals of the Preparation phase of MOST, including specifying the conceptual model, identifying and testing candidate intervention components, and defining the optimization objective. The DDBT framework capitalizes on strategies from the field of human-centered design and implementation science to drive its data collection methods. Conclusions MOST and DDBT share many conceptual features, including an explicit focus on implementation determinants, being iterative and flexible, and designing interventions for the greatest public health impact. The proposed synthesized DDBT/MOST approach integrates DDBT into the Preparation phase of MOST thereby providing a framework for rigorous and efficient intervention development research to bolster the success of intervention optimization. Plain Language Summary 1. What is already known about the topic? Optimizing behavioral interventions to balance effectiveness with affordability, scalability, and efficiency requires a significant investment in intervention development. 2. What does this paper add? This paper provides a structured approach to integrating human-centered design principles into the Preparation phase of the multiphase optimization strategy (MOST). 3. What are the implications for practice, research, or policy? The proposed synthesized model provides a framework for rigorous and efficient intervention development research in the Preparation phase of MOST that will ensure the success of intervention optimization and contribute to improving public health impact of mental health and substance use interventions.
Background: Many strategies may be used by external consultants (such as treatment developers and trainers) and internal program leaders to support evidence-based practice (EBP) implementation. The goal of this study was to identify which educational implementation strategies are considered by therapists to be most helpful, through which mechanisms, and whether these strategies are linked to EBP use. Methods: Semi-structured interviews were conducted with 60 therapists, and 826 therapists completed surveys regarding their perceptions of educational implementation strategies and reported delivery of EBPs within a system-driven, multiple-EBP implementation effort. Using sequential QUAL → QUAN mixed methods, we first identified qualitative themes. Next, we conducted a multilevel logistic regression to examine how quantitative survey items corresponding with qualitative themes predicted EBP use. Results: Initial qualitative thematic analyses revealed four implementation strategies perceived as essential for EBP delivery: connection to a community of trained therapists, ongoing consultation/supervision, availability of internal supervisors trained in the EBP, and access to EBP materials and resources. Quantitative results showed strategies related to connections with a community of trained therapists (i.e., percentage of other therapists at an agency with EBP training and delivery experience as opposed to those who are only trained in the EBP), ongoing consultation/supervision, and having an internal supervisor trained in the EBP (receiving EBP-specific in-house supervision) were significantly associated with EBP use while receiving EBP boosters was not. The closest quantitative indicator corresponding to access to EBP resources, EBP web-based training, was not associated with EBP use. Therapist reported these strategies supported EBP delivery through exposure to other therapists’ cases, guidance/feedback, emotional support, and removing logistic barriers to EBP use. Conclusions: These findings demonstrate how considering therapist perspectives and creating a network of EBP support via supervisors, consultants, and a community of therapists experienced in the EBP may be particularly critical to EBP delivery. Plain language abstract: Public mental health systems are increasingly implementing multiple evidence-based practices (EBPs). There are many strategies that may be used by external consultants (such as treatment developers and trainers) and internal program leaders to support EBP implementation. The goal of this study was to identify which of these internal and external implementation strategies are considered by therapists to be most helpful and how these strategies are linked with continued use of EBPs. First, qualitative interviews with therapists revealed the following strategies are key for supporting their delivery of EBPs: (1) connections to a community of trained therapists, (2) ongoing consultation/supervision, (3) having an internal supervisor at their program who was trained in the EBP, and (4) access to EBP materials and logistic resources. Next, quantitative analyses of survey data examined whether any of the strategies therapists identified as most helpful predicted the continued delivery of EBPs by therapists after initial training. Results confirmed that strategies involving connections with a community of therapists trained in and experienced with the EBP, ongoing consultation/supervision, and having an internal supervisor trained in the EBP were each significantly associated with EBP use. Therapist reported these strategies supported EBP delivery through exposure to other therapists’ cases, guidance/feedback, emotional support, and removing logistic barriers to EBP use. These findings can assist systems and programs in prioritizing implementation strategies to support the sustained delivery of EBPs.
Fallon R. Goodman, Katharine E. Daniel, Lameese Eldesouky
et al.
Background: Emotion regulation flexibility is a person's tendency to shift their use of emotion regulation strategies in response to contextual demands. A lack of flexibility is thought to underlie affective disorders, yet conceptualizations of “flexibility” vary widely, and few studies have empirically assessed flexibility. In this study, we outline methods for measuring emotion regulation flexibility and then examine evidence for inflexibility in people with a common affective disorder: social anxiety disorder (SAD). Methods: Participants were community adults diagnosed with SAD and a psychologically healthy control group who completed a 14-day experience-sampling study. Participants recorded their most anxiety-provoking event each day, how they evaluated contextual demands (i.e., perceived controllability, emotional intensity) of these events, and their use of seven emotion regulation strategies to manage anxiety. Hypotheses and analyses were preregistered with the Open Science Framework (https://osf.io/s7kqj/). Results: Participants with SAD demonstrated some evidence of inflexibility. They used three disengagement strategies (rumination, thought suppression, expressive suppression) more often than controls and did so independently of contextual demands (specifically, perceived controllability). Nonetheless, participants with SAD largely demonstrated similar regulatory patterns as controls, most notably in their use of engagement strategies (acceptance, cognitive, reappraisal, problem-solving). Limitations: We measured two of many possible contextual demands, did not compare to a mixed clinical group or other affective disorders (e.g., depression), and did not assess temporal sequences of strategy use. Conclusions: People with SAD demonstrate some inflexibility in their use of disengagement regulation strategies.
Background: Considering the role of lifestyle in promoting, maintaining, continuity health and the importance of paying attention to the veterans and their families who have suffered a lot in order to sacrifice for the homeland, the present study intends to compare the lifestyle among veterans and non-veterans in Mashhad city.
Methods: This study was conducted using a survey method. The statistical population included the veteran and non-veteran families of Mashhad. A total of 360 questionnaires were filled out in this city. The research instruments were Lifestyle Questionnaire (LSQ) and All Aspects of Health Literacy Scale. The data were analyzed by SPSS v.24.
Results: There is not a significant difference between the mean scores of lifestyle in the two groups of veteran and non-veteran in Mashhad (p > 0.05). The comparison of mean lifestyle scores also showed that there was no significant difference between the lifestyle scores of men and women in the non-veteran group and the mean scores of the single and married lifestyle in the veteran and non-veteran group (p > 0.05). There is a significant relationship between education level and health literacy of veteran and non-veteran families with their lifestyle, age, and employment status. They are also related to the lifestyle of their life because of the status they provide for the sacrifices.
Conclusion: Comparison of the two groups in terms of lifestyle indicates that the veterans are in a less favorable position than non-veterans in terms of some aspects of lifestyle such as physical health, exercise and health, disease prevention and mental health.
Communities. Classes. Races, Social pathology. Social and public welfare. Criminology
Hallucinations are absorption (perception) of the five senses without any stimulation from outside. The way to control hallucinations is by conducting therapeutic communication. Therapeutic Communication is communication done by nurses during nursing interventions to help the patient's healing process and help patients overcome the problems they face through communication. Nurse's therapeutic communication has four phases of communication namely the phase of pre-interaction, orientation or introduction, work and termination. This study aims to improve the ability of schizophrenia patients in controlling hallucinations in Menur Mental Hospital Surabaya. The method in this research was a case study using two subjects. The results of this study indicate that after doing therapeutic communication with a frequency of 6 sessions in 6 days both subjects experienced an increase in the ability to control hallucinations. Therapeutic communication can improve the ability to control the hallucinations of the subject if it is done in stages according to the process that can be used.
Context: As sexual intercourse is a known risk factor for recurrent urinary tract infection (UTI) in women, we decided to evaluate a novel method of sex education using sexually explicit materials (SEM) to reduce the number of recurrences of UTI in sexually active women, when the other preventive measures fail to reduce the number of recurrences of UTI in these women. Methods: After obtaining written informed consent and ethical committee approval, sexually active women with a single sexual partner, who presented for recurrent symptomatic UTI following sexual intercourse, were included in this study. The absence of recurrence for 6 months, successful postcoital drug prophylaxis, the presence of comorbidities, anatomical abnormalities of the genitourinary tract (GUT), history of instrumentation of GUT, and use of contraception were exclusion criteria. Their demographic profile, socioeconomic status, imaging studies, pre- and post-intervention urine culture profile and pre- and post-intervention sexual practices were recorded. During every visit, all these women along with their male partners were given sex education sessions about healthy sexual practices using SEM. Data is analyzed. Results: Study period was January 2012 to June 2018. A total of 107 women with the mean age of 30.11 years were included in the study. A total of 82% of UTI were due to Escherichia coli , whereas the other cases were attributable to Klebsiella, Proteus, and Staphylococcus saprophyticus . Their preintervention yearly incidence of documented UTI was 4.04 episodes which reduced to 1.91 episodes post intervention. Conclusions: Sex education with SEM can be an option to treat recurrent UTI in sexually active women.
A. Cheikhyoussef, Martin K. Shapi, K. Matengu
et al.
BackgroundThe objective of this study was to establish a regional profile of the indigenous knowledge system (IKS) for medicinal plant use and cultural practices associated with the healing process of these plants by traditional healers in the Oshikoto region, Namibia.MethodsAn ethnobotanical survey was undertaken to collect information from traditional healers during September and October 2008. Data was collected through the use of questionnaires and personal interviews during field trips in the ten constituencies of the Oshikoto region. A total of 47 respondents were interviewed with most of them aged 66 and above.ResultsThe traditional healers in Oshikoto region use 61 medicinal plant species that belong to 25 families for the treatment of various diseases and disorders with the highest number of species being used for mental diseases followed by skin infection and external injuries. Trees (28 species) were found to be the most used plants followed by herbs (15 species), shrubs (10 species) and climbers (4 species). The average of the informant consensus factor (FIC) value for all ailment categories was 0.75. High FIC values were obtained for Pergularia daemia, and Tragia okanyua, which were reported to treat weakness and dizziness problems, snake bite, swelling and cardiovascular problems indicating that these species traditionally used to treat these ailments are worth examining for bioactive compounds.ConclusionsThe traditional healers in Oshikoto possess rich ethno-pharmacological knowledge. This study allows for identifying many high value medicinal plant species, indicating high potential for economic development through sustainable collection of these medicinal plants.
A turizmus szektorát markánsan meghatározza a nyújtott szolgáltatások minősége: a turisztikai vállalkozások fejlődésének velejárója a permanens tanulás és a folyamatos megújulás. A regionális kutatásunkra a turizmus szektorában, szálláshelynyújtók körében került sor, online kérdőíves megkérdezés keretében. Fő kutatási kérdéseink: hogyan jelenik meg a gyakorlatban az egész életen át tartó tanulás, és milyen módon korszerűsítik és bővítik tudásukat a nevezett szektor dolgozói. Munkánkban az élethosszig tartó tanulás gyakorlati implementációjához és a folyamatos szakmai megújuláshoz kötődően a tanulásról alkotott válaszokból egy példákkal alátámasztott strukturált véleményösszegzést is készítettünk.
Flávia de Souza Barbosa Dias, Renata Cristina Gasparino, Elenice Valentim Carmona
et al.
RESUMO Objetivo Avaliar a confiabilidade e a validade da versão brasileira da Échelle Douleur Inconfort Nouveau-Né, que mensura a dor prolongada em recém-nascidos. Método Estudo metodológico realizado junto com recém-nascidos. Para a coleta foram utilizadas as versões brasileiras da Échelle Douleur Inconfort Nouveau-Né e da Children’s and Infants’ Postoperative Pain Scale. Para a confiabilidade, foram consideradas a equivalência, mensurada pela concordância entre observadores, e a homogeneidade. Para avaliar a validade, foi considerada a abordagem de construto convergente correlacionando as versões brasileiras da Échelle Douleur Inconfort Nouveau-Né e da Children’s and Infants’ Postoperative Pain Scale. Resultados Compuseram a amostra final 96 recém-nascidos. Na avaliação da confiabilidade, o coeficiente de concordância entre observadores variou entre 0,64 e 0,85 para os itens que compõem o instrumento e 0,96 para o escore total. O alfa de Cronbach foi de 0,82. Na avaliação da validade convergente, o coeficiente de correlação de Spearman entre os valores encontrados para as duas escalas foi de 0,79 (p< 0,0001). Conclusão A versão brasileira da Échelle Douleur Inconfort Nouveau-Né é um instrumento confiável e válido para avaliar a dor prolongada em recém-nascidos.
Priscila Alencar Mendes Reis, Zuila Maria de Figueiredo Carvalho, Juan José Tirado Darder
et al.
OBJECTIVE To translate and culturally adapt to Portuguese the Ferrans and Powers Quality of Life Index Spinal Cord Injury - Version III and characterize the sample in relation to sociodemographic and clinical aspects. METHOD A methodological study with view to cross-cultural adaptation, following the particular steps of this method: initial translation, translation synthesis, back-translation (translation back to the original language), review by a committee of judges and pretest of the final version. The pretest was carried out with 30 patients with spinal cord injury. RESULTS An index of 74 items divided into two parts (satisfaction/importance) was obtained. The criteria of semantic equivalence were evaluated as very adequate translation, higher than 87%, and vocabulary and were grammar higher than 86%. Idiomatic equivalence was higher than 74%, experimental greater than 78% and conceptual was greater than 70%. CONCLUSION After cross-cultural adaptation, the instrument proved semantic, idiomatic, experimental and conceptual adequacy, in addition to helping the evaluation of the quality of life of people with spinal cord injury.
Dulce Maria Pereira Garcia Galvão, Isília Aparecida Silva
Para analisar os currículos e os livros escolares adotados nos primeiros cinco anos do Ensino Fundamental na disciplina de Ciências quanto à presença ou não de termos relacionados à prática da amamentação, realizamos um estudo descritivo analisando o currículo e 16 manuais de 25 escolas públicas de três municípios do interior paulista, de setembro/2010 a fevereiro/2011. Definimos previamente alguns conceitos considerados imprescindíveis para ensinar e explicar à criança noções de amamentação. Verificamos que nenhum bloco temático do currículo aborda explicitamente a temática amamentação. Nove dos 16 conteúdos definidos estavam presentes em oito dos 16 livros. Da análise emergiu a categoria apoio e ajuda da família. Três obras utilizavam ilustrações associadas à alimentação artificial. No programa e nos manuais escolares existem diversas oportunidades de incluir este tema. Aconselha-se a integração dos conteúdos em todos os manuais de Ciências dos primeiros anos do ensino fundamental.<br>Para analizar los programas y libros escolares adoptados en los primeros cinco años de Enseñanza Primaria en la materia de Ciencias respecto de la presencia o ausencia de términos relacionados a la práctica de la lactancia, realizamos un estudio descriptivo, analizando el programa y 16 manuales de 25 escuelas públicas en tres municipios del interior paulista, entre setiembre 2010 y febrero 2012. Definimos previamente algunos conceptos considerados imprescindibles para enseñar y explicar al niño nociones de lactancia. Verificamos que ninguna unidad temática del programa aborda explícitamente la cuestión. Nueve de los dieciséis contenidos definidos estaban presentes en ocho de los dieciséis libros. Del análisis surgió la categoría apoyo y ayuda familiar. Tres obras utilizaban ilustraciones asociadas a la alimentación artificial. En el programa y manuales escolares existe oportunidad de incluir el tema. Se aconseja integración de contenidos en todos los manuales de Ciencias de los primeros años de enseñanza primaria.<br>To review the curricula and content of 1st- through 5th-year elementary school science textbooks with respect to the presence or absence of terms related to breastfeeding, we conducted a descriptive study analyzing the curricula and 16 textbooks of 25 public schools in 03 municipalities of São Paulo between September 2010 and February 2011. In particular, we defined essential concepts to teach and explain breastfeeding to children. We found that no block themed curriculum explicitly addressed the theme of breastfeeding. Nine of the sixteen predefined concepts were present in eight of the sixteen textbooks adopted. From the analysis, we identified a new category: Support and help the family. Three textbooks used illustrations associated with artificial feeding. In the program and textbooks, there are several opportunities to introduce this topic. We advise integrating this content into all science textbooks in the early years of elementary school.
Esse trabalho teve como objetivos caracterizar o perfil sociodemográfico e clínico, os comportamentos em saúde, crenças e atitudes sobre a doença e o tratamento de mulheres com HIV/AIDS atendidas no serviço ambulatorial de um hospital universitário do interior de São Paulo, bem como identificar fatores que interferem na adesão à terapêutica antirretroviral. Os sujeitos do estudo foram 60 mulheres acompanhadas no serviço. Os dados foram colhidos por meio de entrevista semiestruturada. As mulheres tinham idade média de 39,8 (desvio padrão 9,1) anos, baixa escolaridade, condições socioeconômicas insatisfatórias e mantinham relacionamento estável. A relação heterossexual foi a forma mais frequente de infecção; 55% das mulheres já abandonaram o tratamento e alegavam como principais motivos os esquemas terapêuticos impostos, os efeitos colaterais dos antirretrovirais, o enfrentamento psicológico da doença e o pesar iminente da morte; 35% delas não atingiram critérios de adesão considerando-se o uso de 95% da terapêutica antirretroviral prescrita.