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ABSTRACT Erectile dysfunction is observed in about 50% of men. It has been found that diabetes mellitus increases its prevalence to 19-86.3%, necessitating attention to a therapeutic strategy. Among the available treatment methods, intracavernosal injections of mesenchymal stem cells have proven to be particularly effective. Objective The purpose of study is to assess and analyse the effectiveness of their use in the treatment of erectile dysfunction in patients with diabetes mellitus. Materials and Methods The literature search was conducted using systematic methods and analysis in databases such as Web of Science, Scopus, PubMed, Elsevier, and Springer, with 41 sources included for further review. Results The study highlights microangiopathic and neuropathic links as key factors in erectile dysfunction development in diabetic patients, stemming from endothelial dysfunction and conductivity disturbances. Mesenchymal stem cell therapy from bone marrow, adipose tissue, and umbilical cord mitigates pathogenic impact through regenerative and anti-apoptotic effects. Due to this, most studies indicate high efficacy of the treatment and rapid therapeutic action through intracavernosal administration. Some studies suggest an increase in the body's receptor sensitivity to other drugs, such as sildenafil. Conclusion From the perspective of further research on this issue, standardising the preparation of stem cells and the treatment method using a large sample size is essential to introduce such a method as an extremely promising therapy for this delicate issue in men into practical medicine. The practical value of the study lies in the systematisation of information on different sources of mesenchymal stem cells for treating erectile dysfunction.
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BACKGROUND: Escalating street violence and criminal homicides have an adverse impact on psychological well-being. However, these consequences have been difficult to evaluate. Using a recently validated scale, we aimed to assess the impact of fear of crime on the psychological status of middle-aged and older adults living in a rural setting afflicted by endemic violence. METHODS: Participants were selected from Atahualpa residents included in previous studies targeting psychological distress in the population. A validated scale was used to objectively quantify fear of crime in participants. Differences in symptoms of depression and anxiety between baseline and follow-up were used as distinct dependent variables and the continuous score of the fear of crime scale was used as the independent variable. Linear regression models were fitted to assess the association between the exposure and the outcomes, after adjusting for relevant confounders. RESULTS: A total of 653 participants (mean age = 53.2 ± 11.5 years; 57% women) completed the requested tests. We found a 13% increase in symptoms of depression and anxiety during the peak of violence in the village compared with previous years. Linear regression models showed a significant association between the total score on the fear of crime questionnaire and worsening symptoms of depression (ß = .24; 95% CI = 0.14-0.35) and anxiety (ß = .31; 95% CI = 0.24-0.37), after adjustment for relevant confounders. CONCLUSIONS: This study shows a significant aggravating effect of fear of crime on pre-existing symptoms of depression and anxiety and a deleterious effect of these conditions on overall well-being.
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Ansiedade , Crime , Depressão , Medo , População Rural , Violência , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Medo/psicologia , Depressão/epidemiologia , Depressão/psicologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Crime/psicologia , Crime/estatística & dados numéricos , Idoso , Violência/psicologia , Adulto , Inquéritos e Questionários , Vida Independente/psicologia , Estudos de Coortes , Modelos Lineares , Bem-Estar PsicológicoRESUMO
BACKGROUND: Mental health problems and suicide ideation are common in adolescents. Early detection of these issues could prevent the escalation of mental health-related symptoms in the long term. Moreover, characterizing different profiles of prevalent symptoms in conjunction with emotional regulation strategies could guide the design of specific interventions. The use of web-based screening (WBS) tools has been regarded as a suitable strategy to timely detect symptomatology while improving the appeal, cost, timeliness, and reach of detection in young populations. However, the evidence regarding the accuracy of these approaches is not fully conclusive. OBJECTIVE: The study aims (1) to examine the capability of a WBS to identify adolescents with psychiatric symptoms and suicidality and (2) to characterize the mental health profiles of a large sample of adolescents using WBS. METHODS: A total of 1599 Latin American Spanish-speaking adolescents (mean age 15.56, SD 1.34 years), consisting of 47.3% (n=753) female, 98.5% Chilean (n=1570), and 1.5% Venezuelan (n=24) participants, responded to a mental health WBS. A randomized subsample of participants also responded to the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). McNemar χ2 and receiver-operating characteristic curves tested the detection accuracy of WBS contrasted with the MINI-KID. Latent profile analyses explored the symptomatic and emotional regulation profiles of participants. RESULTS: Both measures showed an adequate level of agreement (area under the curve per symptom domain ranging from 0.70 to 0.89); however, WBS yielded a higher prevalence than MINI-KID for all psychiatric symptoms, except suicide ideation and depression. Latent profile analyses yielded 4 profiles-one of them presented elevated psychopathological symptoms, constituting 11% of the sample (n=175). Rumination (odds ratio [OR] 130.15, 95% CI 51.75-439.89; P<.001), entrapment (OR 96.35, 95% CI 29.21-317.79; P<.001), and defeat (OR 156.79, 95% CI 50.45-487.23; P<.001) contributed significantly to the prediction of latent profile memberships, while cognitive reappraisal did not contribute to the prediction of any latent profile memberships, and expressive suppression was only associated to profile-2 membership. CONCLUSIONS: WBS is acceptable for the timely detection of adolescents at risk of mental health conditions. Findings from the symptomatic and emotional regulation profiles highlight the need for comprehensive assessments and differential interventions.
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While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM's applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients' perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.
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BACKGROUND: Psychological assessment in school settings involves a range of complexities and ethical dilemmas that practitioners must navigate carefully. This paper provides a comprehensive review of common issues faced by school psychologists during assessments, discussing best practices and ethical guidelines based on codes from various professional organizations. METHODS: We examine the entire assessment process, from pre-assessment considerations like informed consent and instrument selection to post-assessment practices involving results communication and confidentiality. Key ethical concerns addressed include fairness in assessment, cultural and linguistic appropriateness of testing materials, and issues surrounding informed consent. RESULTS: Specific challenges discussed include selecting appropriate assessment instruments that reflect the diverse needs and backgrounds of students, ensuring fairness and removing bias in testing, and effectively communicating results to various stakeholders while maintaining confidentiality. We emphasize the importance of multi-source, multi-method assessment approaches and the critical role of ongoing professional development in ethical practice. CONCLUSION: By adhering to established ethical standards and best practices, school psychologists can effectively support the educational and developmental needs of students. This paper outlines actionable recommendations and ethical considerations to help practitioners enhance the accuracy, fairness, and impact of their assessments in educational settings.
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INTRODUCTION: To date, there are no sufficient studies aimed to determine a correlation between personal, academic, and psychological variables with academic achievement, measured with the grade point average (GPA) and intelligence in university students according to each sex. STUDY AIM: To determine the correlation between studying strategies, personal and psychological factors with GPA and intelligence in a sample of health sciences university students. METHODS: Health Sciences university students, were invited to participate, those who accepted were cited in a computer room where they signed an informed consent and filled an electronic questionnaire with sociodemographic, behavioral, psychological variables and studying strategies (from the MLSQ instrument) afterwards they performed a verbal and non-verbal intelligence test (Shipley-2). RESULTS: A total of 439 students were included, from which 297 (67.7%) were women. The mean of age was 20.34 ± 2.61 years old. We found that no differences in GPA where observed between sexes. We detected a higher correlation between combined intelligence and GPA in women than in men. In addition, most studying strategies showed a higher correlation with GPA than intelligence scores in men´s sample. All these findings coincide with the fact that preparatory GPA was the most correlated variable with university GPA in both sexes. Finally, women showed higher levels of the sum of diseases, somatization, anxiety, depression and academic stress than men, and all these variables showed low significant correlations with the combined intelligence score only in women´s sample. CONCLUSION: Verbal and non-verbal intelligence scores show a lower association to GPA in men than in women, while studying strategies showed a higher association with GPA in men than in women.
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Sucesso Acadêmico , Inteligência , Humanos , Masculino , Feminino , Estudos Transversais , Adulto Jovem , Universidades , Fatores Sexuais , Adulto , Inquéritos e Questionários , Adolescente , Estudantes de Ciências da Saúde/psicologia , Estudantes/psicologiaRESUMO
Objective. To determine the predictive role of resilience and hope on adherence to treatment in hemodialysis patients hospitalized in two hospitals affiliated to Shiraz University of Medical Sciences (Shiraz, Iran). Methods. This is a descriptive-analytical study that was conducted in 2021-2022 on 120 patients treated in hemodialysis sections in Namazi and Shahid Faqihi teaching hospitals. Sampling was conducted using a stratified random method. Demographic information questionnaires, Connor and Davidson's resilience, Snyder's hope and adherence to kidney patients' treatment questionnaires were used to collect the data. Results. The finds showed that the levels of resilience, hope, and adherence to treatment had hight level. More specifically, it was indicated that the mean and standard deviation for the total resilience score, the hope variable, and adherence to total treatment was 75.45±14.34, 40.43±3.66, and 80.12±18.20, respectively; which have maximum possible scores of 100, 48 and 100. Thus, it can be said that no correlation was observed between resilience and adherence to treatment variables (p>0.05); hope variable and adherence to treatment (p>0.05), and adherence to treatment with hope and resilience variables (p>0.05). However, hope and resilience variables showed a direct and weak correlation with each other (r=0.36, p<0.05); that is, patients who had more hope indicated better resilience as well. Conclusion. Although in this study we found that the resilience and hope variables were not able to predict the treatment adherence, hope and resilience indicated a direct and weak correlation. It is recommended that nurses should pay more attention to hope and resilience of hemodialysis patients in order to promote their health.
Objetivo. Determinar el papel predictivo de la resiliencia y la esperanza en la adherencia al tratamiento en pacientes en hemodiálisis internados en dos hospitales afiliados a la Universidad de Ciencias Médicas de Shiraz (Shiraz, Irán). Métodos. Se trata de un estudio descriptivo-analítico que se realizó en 2021-2022 con la participación de 120 pacientes tratados en secciones de hemodiálisis en los hospitales docentes Namazi y Shahid Faqihi. El muestreo se realizó mediante un método aleatorio estratificado. Para la recogida de datos se utilizaron datos demográficos y las escalas de resiliencia de Connor y Davidson, de esperanza de Snyder y de adherencia al tratamiento de pacientes renales. Resultados. Los hallazgos mostraron que los niveles de resiliencia, esperanza y adherencia al tratamiento se encontraban en niveles altos. Más concretamente, se indicó que la media y la desviación estándar para la puntuación total de resiliencia, la variable esperanza y la adherencia al tratamiento total fueron 75.45±14.34, 40,43±3.66 y 80.12±18.20, respectivamente; las cuales tienen como puntajes máximos posibles 100, 48 y 100. No se observó correlación entre las variables: resiliencia y adherencia al tratamiento (p>0.05), esperanza y la adherencia al tratamiento (p>0.05), y adherencia al tratamiento y las variables esperanza y resiliencia (p>0.05). Sin embargo, las variables esperanza y resiliencia mostraron una correlación directa y débil entre sí (r=0.36, p<0.05); es decir, los pacientes que tenían más esperanza indicaron también mejor resiliencia. Conclusión. Aunque en este estudio encontramos que las variables resiliencia y esperanza no fueron capaces de predecir la adherencia al tratamiento, la esperanza y la resiliencia indicaron una correlación directa y débil. Se recomienda que el personal de enfermería preste más atención a la esperanza y la resiliencia de los pacientes en hemodiálisis para promover su salud.
Objetivo. Determinar o papel preditivo da resiliência e da esperança na adesão ao tratamento em pacientes em hemodiálise internados em dois hospitais afiliados à Universidade de Ciências Médicas de Shiraz (Shiraz, Irã). Métodos. Trata-se de um estudo descritivo-analítico realizado em 2021-2022 com a participação de 120 pacientes atendidos nas seções de hemodiálise dos hospitais universitários Namazi e Shahid Faqihi. A amostragem foi realizada por método aleatório estratificado. Para a coleta de dados foram utilizados dados demográficos e as escalas de resiliência de Connor e Davidson, escalas de esperança de Snyder e adesão ao tratamento de pacientes renais. Resultados As descobertas mostraram que os níveis de resiliência, esperança e adesão ao tratamento estavam em níveis elevados. Mais especificamente, foi indicado que a média e o desvio padrão do escore de resiliência total, da variável esperança e da adesão total ao tratamento foram 75.45±14.34, 40.43±3.66 e 80.12±18.20, respectivamente; que possuem as pontuações máximas possíveis de 100, 48 e 100. Não foi observada correlação entre as variáveis: resiliência e adesão ao tratamento (p>0.05), esperança e adesão ao tratamento (p>0.05), e adesão ao tratamento e esperança e variáveis de resiliência (p>0.05). Contudo, as variáveis esperança e resiliência apresentaram correlação direta e fraca entre si (r=0.36, p<0.05); Ou seja, os pacientes mais esperançosos também indicaram melhor resiliência. Conclusão. Embora neste estudo tenhamos constatado que as variáveis resiliência e esperança não foram capazes de predizer a adesão ao tratamento, a esperança e a resiliência indicaram uma correlação direta e fraca. Recomenda-se que a equipe de enfermagem preste mais atenção à esperança e à resiliência dos pacientes em hemodiálise para promover sua saúde.
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Humanos , Masculino , Feminino , Insuficiência Renal Crônica , Resiliência Psicológica , Esperança , Cooperação e Adesão ao Tratamento , Unidades Hospitalares de HemodiáliseRESUMO
As condições de trabalho às quais os professores são submetidos levam, muitas vezes, ao seu desgaste físico e mental. Uma consequência desse desgaste é o número crescente de casos de síndrome de burnout entre esses profissionais. Este trabalho objetiva, então, apresentar e discutir a produção científica sobre a percepção das causas da síndrome de burnout em professores. Trata-se de uma revisão integrativa de literatura, realizada em junho de 2023. A questão norteadora foi baseada na estratégia de população, interesse e contexto (PICo). A busca pelos artigos foi realizada nas bases de dados: Medical Literature Analysis and Retrieval System Online (Medline), via PubMed, e SciELO, utilizando os termos de busca: "School Teachers" AND "Burnout, Professional". O processo de seleção dos estudos foi seguido conforme as recomendações do PRISMA. Na busca, foi recuperado o quantitativo de 72 publicações e, ao final, foram selecionados sete estudos para a amostra. Os estudos evidenciaram como as principais causas da síndrome de burnout em professores: a desvalorização dos profissionais; violência; exaustão emocional; conflitos com alunos; assédio; sobrecarga; falta de suporte organizacional; e a pandemia de covid-19. Observou-se que os professores são submetidos diariamente a vários fatores que podem desencadear a síndrome de burnout. Desse modo, fica evidente a necessidade de intervenções para atenuar a problemática. Compreende-se o fortalecimento das políticas públicas como uma estratégia resolutiva, levando em consideração a importância da saúde mental dos professores.
The unfavorable working conditions faculty members are subjected to often lead to their physical and mental exhaustion, consequently increasing the prevalence of burnout syndrome among these professionals. Thus, this study presents and discusses the scientific literature on the perceived causes of burnout syndrome among faculty members. An integrative literature review was conducted in June 2023 based on a question formulated using the population, interest and context (PICo) strategy. The Medline via PubMed and Scielo databases were consulted using the search terms "School Teachers" AND "Burnout, Professional". Selection followed the PRISMA recommendations. From the 72 publications identified, seven studies were included in the final sample. According to the studies, professional devaluation, violence, emotional exhaustion, conflicts with students, harassment, overload, lack of organizational support, and the COVID-19 pandemic are the main causes of burnout among teachers. Faculty members are daily exposed to various factors that can trigger burnout syndrome evancing the need for interventions to mitigate this problem. Strengthening public policies is as a solution strategy, considering the importance of teachers' mental health.
Las condiciones laborales que enfrentan los docentes generan, muchas veces, agotamiento físico y mental en esta población. Una consecuencia de este estrés es el aumento de la prevalencia del síndrome de burnout entre estos profesionales. Este estudio tiene por objetivo presentar y discutir la producción científica sobre la percepción de las causas del síndrome de burnout entre los docentes. Este estudio es una revisión integradora de la literatura realizada en junio de 2023. La pregunta orientadora se formuló basándose en la estrategia de población, interés y contexto (PICo). Se buscaron artículos en las bases de datos Medline a través de PubMed y SciELO utilizando el término de búsqueda: "School Teachers" AND "Burnout, Professional". El proceso de selección de estudios siguió las recomendaciones de PRISMA. La búsqueda arrojó un total de 72 publicaciones, y se seleccionaron siete estudios para la muestra final. Los estudios revelaron que las principales causas del burnout entre los docentes fueron la desvalorización profesional, la violencia, el agotamiento emocional, los conflictos con los estudiantes, el acoso, la sobrecarga, la falta de apoyo organizacional y la pandemia del covid-19. Se observó que los docentes están expuestos diariamente a diversos factores que pueden desencadenar el síndrome de burnout. Por lo tanto, se hace evidente la necesidad de intervenciones para mitigar este problema. El fortalecimiento de las políticas públicas es una estrategia de solución teniendo en cuenta la importancia de la salud mental de estos profesionales.
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As disfunções temporomandibulares são uma série de alterações que afetam os músculos mastigatórios, a articulação temporomandibular e as estruturas associadas. Sua etiologia é multifatorial e inclui fatores como hábitos parafuncionais desencadeados ou intensificados por condições psicológicas como o estresse emocional. Este artigo tem como objetivo investigar a frequência de sintomas de disfunções temporomandibulares e de hábitos parafuncionais e sua associação com estresse percebido em estudantes de uma universidade pública da cidade de Salvador. Os dados primários foram coletados por meio de um questionário sociodemográfico, do questionário anamnésico de Fonseca, da Lista de Verificação dos Comportamentos Orais e da Escala de estresse Percebido. Os dados foram analisados de forma descritiva e a análise estatística realizada por meio do teste qui-quadrado de Pearson e do teste exato de Fisher. Participaram do estudo 149 estudantes de Fisioterapia. A frequência de sintomas de disfunções temporomandibulares foi elevada (83,9%), como também uma maior prática de hábitos parafuncionais (55%). Observou-se associação positiva entre os hábitos parafuncionais e os sintomas temporomandibulares. Um alto nível de estresse foi encontrado em 92,8% dos estudantes com a presença de disfunção e em 71% dos alunos com maior prática de hábitos parafuncionais, sendo ambas as associações estatisticamente significativas. Assim, as frequências de sintomas de disfunções temporomandibulares e de hábitos parafuncionais foram elevadas e estão associadas ao estresse percebido em estudantes universitários. Sugere-se a realização de estudos com amostras mais robustas que busquem estabelecer relações de causalidade entre as variáveis estudadas.
Temporomandibular disorders constitute a series of changes that affect the masticatory muscles, the temporomandibular joint, and their associated structures. Its multifactorial etiology includes factors such as parafunctional habits triggered or intensified by psychological conditions such as emotional stress. The purpose is to investigate the frequency of symptoms of temporomandibular disorders and parafunctional habits and their association with perceived stress in students at a public university in the municipality of Salvador. Primary data collected by a sociodemographic questionnaire, the Fonseca anamnestic questionnaire, the Oral Behaviors Checklist, and the Perceived Stress Scale. Data were descriptively analyzed, and a statistical analysis was performed using the Pearson's chi-squared and Fisher's exact tests. Overall, 149 physical therapy students participated in this study. They showed a high frequency of temporomandibular disorder symptoms (83.9%) and more frequent parafunctional habits (55.0%). This study found a positive association between parafunctional habits and temporomandibular symptoms. It also observed a high level of stress in 92.8% of students with the dysfunction and in 71.0% of students with more common practice of parafunctional habits, statistically significant associations. This study found a high frequency of temporomandibular disorder and parafunctional habit symptoms, which are associated with perceived stress in college students. It is suggested to carry out studies with more robust samples that seek to establish causal relationships between the studied variables.
Los trastornos temporomandibulares son una serie de cambios que afectan a los músculos masticatorios, la articulación temporomandibular y estructuras asociadas. Su etiología es multifactorial e incluye factores como hábitos parafuncionales desencadenados o intensificados por condiciones psicológicas como el estrés emocional. el objetivo es determinar la frecuencia de los síntomas de trastornos temporomandibulares y de hábitos parafuncionales y su asociación con el estrés percibido en estudiantes de una universidad pública de la ciudad de Salvador (Brasil). Los datos primarios se recolectaron de un cuestionario sociodemográfico, del cuestionario anamnésico de Fonseca, de la Lista de Comportamientos Orales y de la Escala de Estrés Percibido. Los datos se analizaron de forma descriptiva, y el análisis estadístico se realizó mediante la prueba de chi-cuadrado de Pearson y la prueba exacta de Fisher. Participaron en el estudio 149 estudiantes de fisioterapia. La frecuencia de los síntomas de trastornos temporomandibulares fue alta (83,9%), así como una mayor práctica de hábitos parafuncionales (55,0%). Se observó una asociación positiva entre hábitos parafuncionales y síntomas temporomandibulares. Se encontró un alto nivel de estrés en el 92,8% de los estudiantes con presencia de disfunción y en el 71,0% de los estudiantes con mayor práctica de hábitos parafuncionales, y ambas asociaciones fueron estadísticamente significativas. La frecuencia de los síntomas de trastornos temporomandibulares y de los hábitos parafuncionales fue alta, y estuvo asociada con el estrés percibido en estudiantes universitarios. Se sugiere realizar estudios con muestras más robustas para establecer relaciones causales entre las variables estudiadas.
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BACKGROUND: Diabetes mellitus is a chronic disease that can cause psychological stress. This study was conducted to perform the translation and cross-cultural adaptation of the QSD-R for diabetic patients into Portuguese (Brazil). METHODS: This study was a cross-cultural adaptation process carried out in a public university in São Paulo, Brazil, in three stages: translation and backtranslation by two native-speaking independent professionals, analysis by a committee of specialists, and a pre-test phase. RESULTS: The final version was created by seven experts after making semantic, idiomatic, and cultural changes to eighteen items. The results indicated a satisfactory content validation index (CVI ≥ 0.80). This version was applied to 30 patients. No item was excluded from the instrument. CONCLUSION: The translated version of the QSD-R was considered adequate and culturally adapted for use in Brazil to enable the psychometric validation of the instrument.
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BACKGROUND: The Confusion, Hubbub, and Order Scale (CHAOS in English Version) was originally developed in the USA by Matheny et al (Bringing order out of chaos: psychometric characteristics of the confusion, hubbub, and order scale. Journal of Applied Developmental Psychology 16(3):429-444, 1995) to measure chaos in the family environment, characterized by confusion, lack of routine, and organization. OBJECTIVE: To present evidence of content validity, internal structure validity, and validity based on relationships with external measures of an adapted version of the CHAOS into Brasilian Portuguese with adolescents sample in São Paulo - Brasil. METHOD: Study 1 involved the translation/back-translation and adaptation of the scale into Brazilian Portuguese [here named "Escala de Confusão, Alvoroço e Ordem no Sistema familiar" (CAOS)], assessed by 5 judges. In Study 2, we conducted an exploratory factor analyses (EFA) to determine the scale's factor structure (N = 180 adults). In Study 3, we carried out confirmatory factor analyses (CFA) to confirm the internal validity of the scale, along with complete structural equation modeling to explore convergent validity in another sample (N = 239 adolescents). RESULTS: The CAOS scale displayed content validity, and the EFA and CFA showed a unifactorial structure (with some scale adjustments) with an acceptable fit. The family chaos latent factor was associated with externalizing symptoms and perceived stress in adolescents. CONCLUSION: Overall, the Brazilian version of the scale presented evidence of construct, internal, and concurrent validity that indicate its usefulness in Brazil.
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Background: The COVID-19 pandemic has impacted the residency experience for physicians across all specialties. There have been studies examining resident perspectives on changes in curriculum and clinical experiences due to the pandemic; however, little research has been conducted on how residents in different specialties interpreted their educational experience and rates of burnout during the pandemic. Methods: We extended surveys to 281 residents across 15 separate residency programs between November 17, 2020, and December 20, 2020. The questions pertained to burnout and the effects of the pandemic on their careers. Differences between general and specialty medicine resident responses were analyzed using descriptive statistics and the Mann-Whitney U test. Results: The final analysis included 105 responses (40% response rate). We received 62 surveys (59%) from general medicine residents and 43 surveys (41%) from specialty medicine residents, with a higher response rate from junior level trainees in both groups. We found no significant differences between general and specialty residents on the level of burnout, impact on clinical experience, or future career due to COVID-19, though there was a significant difference between resident groups on the perceived impact of COVID-19 on learning. Conclusion: Specialty medicine residents reported a negative perception of the pandemic's impact on their learning during residency suggesting a greater impact on training than was perceived by the general medicine residents. Residents from general and specialty medicine programs reported similar levels of burnout and similar perceptions of the pandemic's impact on their clinical experience and future career prospects. Understanding the impacts of the COVID-19 pandemic on resident education and well-being should serve graduate medical education administrators well and prepare them for future interruptions in the traditional learning process.
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Objectives: To explore speaking up behaviours, barriers to openly expressing patient safety concerns, and perceived psychological safety climate in the clinical setting in which healthcare trainees from Ibero-America were receiving their practical training. Methods: Cross-sectional survey of healthcare trainees from Colombia, Mexico, and Spain (N = 1,152). Before the field study, the Speaking Up About Patient Safety Questionnaire (SUPS-Q) was translated into Spanish and assessed for face validity. A confirmatory factor analysis was conducted to establish the construct validity of the instrument, and the reliability was assessed. The SUPS-Q was used to evaluate voice behaviours and the perceived psychological safety climate among Ibero-American trainees. Descriptive and frequency analyses, tests for contrasting means and proportions, and logistic regression analyses were performed. Results: Seven hundred and seventy-one trainees had experience in clinical settings. In the previous month, 88.3% had experienced patient safety concerns, and 68.9% had prevented a colleague from making an error. More than a third had remained silent in a risky situation. Perceiving concerns, being male or nursing student, and higher scores on the encouraging environment scale were associated with speaking up. Conclusion: Patient safety concerns were frequent among Ibero-American healthcare trainees and often silenced by personal and cultural barriers. Training in speaking up and fostering safe interprofessional spaces is crucial.
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Segurança do Paciente , Humanos , Estudos Transversais , Masculino , Feminino , Adulto , Inquéritos e Questionários , Espanha , México , Colômbia , Adulto Jovem , Reprodutibilidade dos Testes , Atitude do Pessoal de SaúdeRESUMO
OBJECTIVE: To identify the relationship between the degree of anxiety and the capacity for resilience in palliative care physicians. METHODS: Cross-sectional analytical study with non-probability sampling. We included 42 Colombian Palliative Care Physicians and administered a sociodemographic questionnaire, the Zung Anxiety Scale and the Resilience Scale. RESULTS: 42 palliative care physicians with an average age of 41 participated in the study. Anxious symptoms were present in 100% of the physicians evaluated. Mild or moderate anxiety was identified in 93.7% of the population and 6.3% of people with severe anxiety symptoms. Less than half of the participants considered demonstrated high levels of resilience. We found an inverse and significant correlation between the factors that make up the Resilience Scale and the manifestation of psychological and physical symptoms of anxiety. CONCLUSION: Our results reflect that the population of palliative care physicians has a higher risk and exposure to developing anxiety and its adverse outcomes. We found higher anxiety levels compared with other studies so this population requires greater vigilance and intervention in treating and preventing mental health difficulties.
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Background: The health crisis associated with COVID-19 led to a period of increased demand on the operational and social organization of healthcare centers, which often had a negative impact on the psychological and social wellbeing of healthcare workers. In order to tackle this issue, an intervention plan was designed to develop collective competences through various participatory strategies. This study sought to determine the effect of this intervention on the variables collective efficacy, psychological wellbeing, and social wellbeing in healthcare workers by performing a pretest and posttest comparison with a control group. Method: The variables were evaluated using a non-probability, purposive sample of 80 healthcare workers from three Family Healthcare Centers (CESFAM) located in the Coquimbo Region, Chile, within health crisis context. The intervention group was composed of voluntary participants, while the control group only completed the evaluations. The intervention consisted in 6 training workshops focused on improving collective management, group synergy, collaborative problem-solving, communicative strategies, and overall team care. Results: The analysis shows that the collective competence intervention had a positive effect on the collective efficacy, psychological wellbeing, and social wellbeing of the participating healthcare workers during the COVID-19 crisis. Only specific factors of these variables did not undergo a significant impact. Conclusion: The results of this study suggest that interventions aimed at improving collective organizational competences, apart from increasing collective efficacy, can have a positive impact on healthcare workers' psychological and social wellbeing in a context of occupational adversity.
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Background: Despite its popularity, evidence of the effectiveness of Psychological First Aid (PFA) is scarce.Objective: To assess whether PFA, compared to psychoeducation (PsyEd), an attention placebo control, reduces PTSD and depressive symptoms three months post-intervention.Methods: In two emergency departments, 166 recent-trauma adult survivors were randomised to a single session of PFA (n = 78) (active listening, breathing retraining, categorisation of needs, assisted referral to social networks, and PsyEd) or stand-alone PsyEd (n = 88). PTSD and depressive symptoms were assessed at baseline (T0), one (T1), and three months post-intervention (T2) with the PTSD Checklist (PCL-C at T0 and PCL-S at T1/T2) and the Beck Depression Inventory-II (BDI-II). Self-reported side effects, post-trauma increased alcohol/substance consumption and interpersonal conflicts, and use of psychotropics, psychotherapy, sick leave, and complementary/alternative medicine were also explored.Results: 86 participants (51.81% of those randomised) dropped out at T2. A significant proportion of participants in the PsyEd group also received PFA components (i.e. contamination). From T0 to T2, we did not find a significant advantage of PFA in reducing PTSD (p = .148) or depressive symptoms (p = .201). However, we found a significant dose-response effect between the number of delivered components, session duration, and PTSD symptom reduction. No significant difference in self-reported adverse effects was found. At T2, a smaller proportion of participants assigned to PFA reported increased consumption of alcohol/substances (OR = 0.09, p = .003), interpersonal conflicts (OR = 0.27, p = .014), and having used psychotropics (OR = 0.23, p = .013) or sick leave (OR = 0.11, p = .047).Conclusions: Three months post-intervention, we did not find evidence that PFA outperforms PsyEd in reducing PTSD or depressive symptoms. Contamination may have affected our results. PFA, nonetheless, appears to be promising in modifying some post-trauma behaviours. Further research is needed.
Psychological First Aid (PFA) is widely recommended early after trauma.We assessed PFA's effectiveness for decreasing PTSD symptoms and other problems 3 months post-trauma.We didn't find definitive evidence of PFA's effectiveness. Still, it seems to be a safe intervention.
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Depressão , Serviço Hospitalar de Emergência , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/terapia , Masculino , Feminino , Adulto , Depressão/terapia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Primeiros Socorros , Sobreviventes/psicologia , Psicoterapia , Pessoa de Meia-Idade , Resultado do Tratamento , Escalas de Graduação PsiquiátricaRESUMO
Irritable bowel syndrome (IBS), a disorder of gut-brain interaction, is often comorbid with somatic pain and psychological disorders. Dysregulated signaling of brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin-related kinase B (TrkB), has been implicated in somatic-psychological symptoms in individuals with IBS. We investigated the association of 10 single-nucleotide polymorphisms (SNPs) in the regulatory 3' untranslated region of neurotrophic receptor tyrosine kinase-2 (NTRK2) kinase domain-deficient truncated isoform (TrkB.T1) and BDNF Val66Met SNP with somatic and psychological symptoms and quality-of-life (QoL) in a cohort from the United States (IBS, n = 464; healthy controls, n = 156). We found that the homozygous recessive genotype (G/G) of rs2013566 in individuals with IBS is associated with worsened somatic symptoms, including headache, back pain, joint pain, muscle pain, and somatization as well as diminished sleep quality, energy level, and overall QoL. Validation using United Kingdom BioBank data confirmed the association of rs2013566 with an increased likelihood of headache. Several SNPs (rs1627784, rs1624327, and rs1147198) showed significant associations with muscle pain in our U.S. cohort. These 4 SNPs are predominantly located in H3K4Me1-enriched regions, suggesting their enhancer and/or transcription regulation potential. Our findings suggest that genetic variation within the 3' untranslated region region of the TrkB.T1 isoform may contribute to comorbid conditions in individuals with IBS, resulting in a spectrum of somatic and psychological symptoms impacting their QoL. These findings advance our understanding of the genetic interaction between BDNF/TrkB pathways and somatic-psychological symptoms in IBS, highlighting the importance of further exploring this interaction for potential clinical applications. PERSPECTIVE: This study aims to understand the genetic effects on IBS-related symptoms across somatic, psychological, and quality-of-life (QoL) domains, validated by United Kingdom BioBank data. The rs2013566 homozygous recessive genotype correlates with worsened somatic symptoms and reduced QoL, emphasizing its clinical significance.
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Síndrome do Intestino Irritável , Polimorfismo de Nucleotídeo Único , Receptor trkB , Humanos , Masculino , Feminino , Receptor trkB/genética , Adulto , Pessoa de Meia-Idade , Síndrome do Intestino Irritável/genética , Fator Neurotrófico Derivado do Encéfalo/genética , Qualidade de Vida , Glicoproteínas de Membrana/genética , Isoformas de Proteínas/genética , Estudos de CoortesRESUMO
Introduction: The PERMA model of well-being has gained prominence in the study of well-being by the Positive Psychology movement. However, the model has been little studied regarding its applicability in different populations, such as adolescents. This study sought to evaluate the psychometric properties of the PERMA-Profiler instrument for Brazilian adolescents, as well as the measurement invariance for different age groups and gender, and investigate the relation with external variables. Methods: Confirmatory Factor Analysis and Multigroup Confirmatory Factor Analysis were used to test the internal structure and invariance of the PERMA-Profiler. Reliability was determined with McDonald's Omega and composite reliability. A total of 1,197 adolescents between 11 and 19 years old from different regions of Brazil participated. Results: The results of the confirmatory factor analysis indicated that the five correlated factors model was the most appropriate, presenting good factor loadings and adequate reliability. The scale proved to be invariant for adolescents of different age groups and gender. Correlations with associated variables were significant and moderate to strong, showing positive relations between positive emotions and well-being, and negative relations with negative affects and depressive and anxiety symptoms. Discussion: These results contribute to the understanding of well-being in adolescence and highlight the importance of promoting different components of well-being for adolescents' mental health.
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Objective: To determine the predictive role of resilience and hope on adherence to treatment in hemodialysis patients hospitalized in two hospitals affiliated to Shiraz University of Medical Sciences (Shiraz, Iran). Methods: This is a descriptive-analytical study that was conducted in 2021-2022 on 120 patients treated in hemodialysis sections in Namazi and Shahid Faqihi teaching hospitals. Sampling was conducted using a stratified random method. Demographic information questionnaires, Connor and Davidson's resilience, Snyder's hope and adherence to kidney patients' treatment questionnaires were used to collect the data. Results: The finds showed that the levels of resilience, hope, and adherence to treatment had hight level. More specifically, it was indicated that the mean and standard deviation for the total resilience score, the hope variable, and adherence to total treatment was 75.45±14.34, 40.43±3.66, and 80.12±18.20, respectively; which have maximum possible scores of 100, 48 and 100. Thus, it can be said that no correlation was observed between resilience and adherence to treatment variables (p>0.05); hope variable and adherence to treatment (p>0.05), and adherence to treatment with hope and resilience variables (p>0.05). However, hope and resilience variables showed a direct and weak correlation with each other (r=0.36, p<0.05); that is, patients who had more hope indicated better resilience as well. Conclusion: Although in this study we found that the resilience and hope variables were not able to predict the treatment adherence, hope and resilience indicated a direct and weak correlation. It is recommended that nurses should pay more attention to hope and resilience of hemodialysis patients in order to promote their health.
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Esperança , Cooperação do Paciente , Diálise Renal , Resiliência Psicológica , Humanos , Diálise Renal/psicologia , Masculino , Feminino , Pessoa de Meia-Idade , Irã (Geográfico) , Inquéritos e Questionários , Adulto , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , IdosoRESUMO
BACKGROUND: Intimate partner violence (IPV) is prevalent in low and middle-income countries, such as Haiti. However, there is little research on its association with mental health problems such as psychological distress and depression. Although there is evidence that men may experience IPV, few studies have investigated mental health difficulties among Haitian men and women. The present study aims to 1) assess the prevalence of depressive symptoms and psychological distress in this population and 2) examine the association between IPV, psychological distress, and depression while considering potential risk and protective factors. METHOD: A representative sample of 3,586 adolescents and young adults aged 15 to 24 living in Haiti was recruited. Structural equation modeling was used to examine the association between IPV, depressive symptoms, and psychological distress. RESULTS: Almost half of the sample reported depressive symptoms and psychological distress, with high rates among both genders. IPV was found to be an independent predictor of both depressive symptoms and psychological distress after accounting for risk and protective factors. LIMITATION: This study is the first step in understanding the interplay between IPV victimization, risk and protective factors, and psychological difficulties in this population. However, because of the cross-sectional design, causality should not be inferred. Furthermore, this study did not measure community violence, which could have affected participants' mental health. CONCLUSION: This study highlights the importance of considering the occurrence of IPV victimization when evaluating depression and psychological distress among adolescents and young adults.