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1.
Ann Ist Super Sanita ; 60(3): 197-207, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39269001

RESUMEN

INTRODUCTION: People with substance use disorder (SUD) face challenges like stigma and discrimination, impacting their healthcare experiences. AIM: This study aims to: (i) assess physicians' clinical practices and stigma toward SUD patients among healthcare personnel and (ii) explore the relationship among stigma, psychological well-being, and burnout. METHODS: A survey covering sociodemographic data, physicians' clinical practices, stigmatizing attitudes, psychological well-being, and burnout was completed by 1,796 employees of the Veneto's Local Health Units (Italy). RESULTS: Healthcare professionals reported increased stigma towards SUDs (p-values<0.05). Stigma consistently correlated with variables such as sex, profession, department, and levels of burnout (p-values<0.05). Notably, high burnout levels were associated with increased stigma. Staff in addiction departments displayed lower stigma levels compared to other departments. No significant differences were found in physicians' clinical practices. CONCLUSIONS: Targeted training for healthcare professionals is crucial to reduce stigma, enhance attitudes toward SUDs, and broaden overall knowledge of the condition.


Asunto(s)
Actitud del Personal de Salud , Agotamiento Profesional , Personal de Salud , Estigma Social , Trastornos Relacionados con Sustancias , Humanos , Italia , Masculino , Femenino , Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Persona de Mediana Edad , Personal de Salud/psicología , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Encuestas y Cuestionarios , Médicos/psicología
2.
J Affect Disord ; 326: 249-261, 2023 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-36586617

RESUMEN

BACKGROUND: The Collaborative Outcome study on Health and Functioning during Infection Times (COH-FIT; www.coh-fit.com) is an anonymous and global online survey measuring health and functioning during the COVID-19 pandemic. The aim of this study was to test concurrently the validity of COH-FIT items and the internal validity of the co-primary outcome, a composite psychopathology "P-score". METHODS: The COH-FIT survey has been translated into 30 languages (two blind forward-translations, consensus, one independent English back-translation, final harmonization). To measure mental health, 1-4 items ("COH-FIT items") were extracted from validated questionnaires (e.g. Patient Health Questionnaire 9). COH-FIT items measured anxiety, depressive, post-traumatic, obsessive-compulsive, bipolar and psychotic symptoms, as well as stress, sleep and concentration. COH-FIT Items which correlated r ≥ 0.5 with validated companion questionnaires, were initially retained. A P-score factor structure was then identified from these items using exploratory factor analysis (EFA) and confirmatory factor analyses (CFA) on data split into training and validation sets. Consistency of results across languages, gender and age was assessed. RESULTS: From >150,000 adult responses by May 6th, 2022, a subset of 22,456 completed both COH-FIT items and validated questionnaires. Concurrent validity was consistently demonstrated across different languages for COH-FIT items. CFA confirmed EFA results of five first-order factors (anxiety, depression, post-traumatic, psychotic, psychophysiologic symptoms) and revealed a single second-order factor P-score, with high internal reliability (ω = 0.95). Factor structure was consistent across age and sex. CONCLUSIONS: COH-FIT is a valid instrument to globally measure mental health during infection times. The P-score is a valid measure of multidimensional mental health.


Asunto(s)
COVID-19 , Pandemias , Humanos , Adulto , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Evaluación de Resultado en la Atención de Salud , Análisis Factorial , Psicometría
3.
Artículo en Inglés | MEDLINE | ID: mdl-35055743

RESUMEN

This study aims to determine prevalence and frequency of use of novel psychoactive substances (NPS) and to identify the factors associated with NPS use in an Italian sample of patients diagnosed with substance use disorder (SUD). Prevalence and correlates of NPS knowledge and use were assessed in 185 patients with SUD in three addiction services (Padova, Belluno, Feltre) in the Veneto region with an ad-hoc designed survey. Two thirds of the samples reported knowing NPS and one third reported using them. NPS were considered by them less dangerous than "regular" substances of abuse (t = 6.06 mean 0.78, p < 0.001). Factors associated with NPS use were youth (OR = 4.81; p < 0.001), studentship (OR = 4.99; p = 0.004), subsequent mental disorders diagnosis (OR = 2.49; p = 0.027), suicide attempt history (OR = 11.67; p < 0.001), home detention (OR = 2.30; p = 0.040), residential care (OR = 5.66; p = 0.002), and polysubstance abuse (t = 8.99 mean 2.65 p < 0.001). NPS use in patients with SUD is highly prevalent, particularly in the youngest age group, and associated with psychiatric comorbidity and worse prognosis. It is crucial to systematically assess NPS use and inform addiction service users with SUD of the toxic and potentially lethal side effects. Mental healthcare professionals working in addiction services should receive education and training. Cohort and longitudinal studies are needed.


Asunto(s)
Psicotrópicos , Trastornos Relacionados con Sustancias , Adolescente , Comorbilidad , Humanos , Italia/epidemiología , Prevalencia , Psicotrópicos/uso terapéutico , Trastornos Relacionados con Sustancias/psicología
4.
J Affect Disord ; 299: 367-376, 2022 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-34606810

RESUMEN

BACKGROUND: The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. METHODS: The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT - www.coh-fit.com) is an on-line anonymous survey, available in 30 languages, involving >230 investigators from 49 countries supported by national/international professional associations. COH-FIT has thee waves (until the pandemic is declared over by the WHO, and 6-18 months plus 24-36 months after its end). In addition to adults, COH-FIT also includes adolescents (age 14-17 years), and children (age 6-13 years), recruited via non-probability/snowball and representative sampling and assessed via self-rating and parental rating. Non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to promote health and prevent mental and physical illness in children and adolescents will be generated by COH-FIT. Co-primary outcomes are changes in well-being (WHO-5) and a composite psychopathology P-Score. Multiple behavioral, family, coping strategy and service utilization factors are also assessed, including functioning and quality of life. RESULTS: Up to June 2021, over 13,000 children and adolescents from 59 countries have participated in the COH-FIT project, with representative samples from eleven countries. LIMITATIONS: Cross-sectional and anonymous design. CONCLUSIONS: Evidence generated by COH-FIT will provide an international estimate of the COVID-19 effect on children's, adolescents' and families', mental and physical health, well-being, functioning and quality of life, informing the formulation of present and future evidence-based interventions and policies to minimize adverse effects of the present and future pandemics on youth.


Asunto(s)
COVID-19 , Adolescente , Adulto , Niño , Estudios Transversales , Promoción de la Salud , Humanos , Salud Mental , Pandemias , Calidad de Vida , SARS-CoV-2
5.
J Affect Disord ; 299: 393-407, 2022 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-34949568

RESUMEN

BACKGROUND: . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed. METHODS: . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/regions, endorsed by national/international professional associations. COH-FIT is a multi-wave, on-line anonymous, cross-sectional survey [wave 1: 04/2020 until the end of the pandemic, 12 months waves 2/3 starting 6/24 months threreafter] for adults, adolescents (14-17), and children (6-13), utilizing non-probability/snowball and representative sampling. COH-FIT aims to identify non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to improve social/health outcomes in the general population/vulnerable subgrous during/after COVID-19. In adults, co-primary outcomes are change from pre-COVID-19 to intra-COVID-19 in well-being (WHO-5) and a composite psychopathology P-Score. Key secondary outcomes are a P-extended score, global mental and physical health. Secondary outcomes include health-service utilization/functioning, treatment adherence, functioning, symptoms/behaviors/emotions, substance use, violence, among others. RESULTS: . Starting 04/26/2020, up to 14/07/2021 >151,000 people from 155 countries/territories/regions and six continents have participated. Representative samples of ≥1,000 adults have been collected in 15 countries. Overall, 43.0% had prior physical disorders, 16.3% had prior mental disorders, 26.5% were health care workers, 8.2% were aged ≥65 years, 19.3% were exposed to someone infected with COVID-19, 76.1% had been in quarantine, and 2.1% had been COVID 19-positive. LIMITATIONS: . Cross-sectional survey, preponderance of non-representative participants. CONCLUSIONS: . Results from COH-FIT will comprehensively quantify the impact of COVID-19, seeking to identify high-risk groups in need for acute and long-term intervention, and inform evidence-based health policies/strategies during this/future pandemics.


Asunto(s)
COVID-19 , Pandemias , Adolescente , Adulto , Ansiedad , Niño , Estudios Transversales , Depresión , Humanos , Salud Mental , Evaluación de Resultado en la Atención de Salud , SARS-CoV-2
6.
Plant Cell ; 21(11): 3473-92, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19897671

RESUMEN

We hypothesized that chloroplast energy imbalance sensed through alterations in the redox state of the photosynthetic electron transport chain, measured as excitation pressure, governs the extent of variegation in the immutans mutant of Arabidopsis thaliana. To test this hypothesis, we developed a nondestructive imaging technique and used it to quantify the extent of variegation in vivo as a function of growth temperature and irradiance. The extent of variegation was positively correlated (R(2) = 0.750) with an increase in excitation pressure irrespective of whether high light, low temperature, or continuous illumination was used to induce increased excitation pressure. Similar trends were observed with the variegated mutants spotty, var1, and var2. Measurements of greening of etiolated wild-type and immutans cotyledons indicated that the absence of IMMUTANS increased excitation pressure twofold during the first 6 to 12 h of greening, which led to impaired biogenesis of thylakoid membranes. In contrast with IMMUTANS, the expression of its mitochondrial analog, AOX1a, was transiently upregulated in the wild type but permanently upregulated in immutans, indicating that the effects of excitation pressure during greening were also detectable in mitochondria. We conclude that mutations involving components of the photosynthetic electron transport chain, such as those present in immutans, spotty, var1, and var2, predispose Arabidopsis chloroplasts to photooxidation under high excitation pressure, resulting in the variegated phenotype.


Asunto(s)
Proteínas de Arabidopsis/metabolismo , Arabidopsis/metabolismo , Proteínas del Complejo de Cadena de Transporte de Electrón/metabolismo , Mutación/fisiología , Fotosíntesis/fisiología , Hojas de la Planta/metabolismo , Proteasas ATP-Dependientes/genética , Proteasas ATP-Dependientes/metabolismo , Arabidopsis/genética , Arabidopsis/crecimiento & desarrollo , Proteínas de Arabidopsis/genética , Cloroplastos/genética , Cloroplastos/metabolismo , Cotiledón/genética , Cotiledón/crecimiento & desarrollo , Cotiledón/metabolismo , Proteínas del Complejo de Cadena de Transporte de Electrón/genética , Metabolismo Energético/genética , Regulación de la Expresión Génica de las Plantas/genética , Variación Genética/fisiología , Luz , Proteínas de la Membrana/genética , Proteínas de la Membrana/metabolismo , Metaloproteasas/genética , Metaloproteasas/metabolismo , Mitocondrias/genética , Mitocondrias/metabolismo , Proteínas Mitocondriales , Oxidación-Reducción , Oxidorreductasas/genética , Oxidorreductasas/metabolismo , Fenotipo , Estimulación Luminosa , Hojas de la Planta/genética , Hojas de la Planta/crecimiento & desarrollo , Proteínas de Plantas , Temperatura , Tilacoides/genética , Tilacoides/metabolismo
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