Alcohol use disorders and psychiatric diseases in Colombia

Background: An accurate understanding of co-occurrence and comorbidity of alcohol use disorders (AUD) in Colombia is crucial for public health. Objective: A secondary analysis was conducted, using a 2003/2004 government´s population database to determine the lifetime associations between AUD and other mental and addictive disorders in people of Colombia aged 18-65 years. Methods: Several statistical analysis were performed: testing prevalence difference in mental disorders by whether the individual had an AUD; a stratified analysis by gender and logistic regression analyses accounting for differences in demographic, socio-economic, behavioral and self-reported health status variables. Results: People with AUD comprised 9% of the population, of which 88% were males and on average 37 years old. They were more likely to be males, be working, and be current smokers; and less likely to be at home or retired. The population with AUD had greater chance to comply with criteria for all disorders but minor depressive disorder, post-traumatic stress disorder, nicotine dependence, and oppositional defiant disorder. Conclusion: This study demonstrates a high prevalence of mental disorders in the adult population with AUD in Colombia. The findings highlight the importance of comorbidity as a sign of disease severity and impact on public health and supports the need for training of more professionals and developing appropriate interventions and services.

SA HealthPlus : a controlled trial of a statewide application of a generic model of chronic illness care

SA HealthPlus, one of nine national Australian coordinated care trials, addressed chronic illness care by testing whether coordinated care would improve health outcomes at the cost of usual care. SA HealthPlus compared a generic model of coordinated care for 3,115 intervention patients with the usual care for 1,488 controls. Service coordinators and the behavioral and care-planning approach were new. The health status (SF-36) in six of eight projects improved, and those patients who had been hospitalized in the year immediately preceding the trial were the most likely to save on costs. A mid-trial review found that health benefits from coordinated care depended more on patients' self-management than the severity of their illness, a factor leading to the Flinders Model of Self-Management Support.

Isolamento social e indicadores de depressão em adolescentes: Um estudo longitudinal

Tese submetida como requisito parcial para a obtenção do grau de Mestre em Psicologia Aplicada Especialidade em Psicologia Clínica

En jämförelse av upplevd produktivitet samt arbetstillfredsställelse mellan aktivitetsaserade och traditionella kontor.

Purpose: The aim with this study is to compare perceived productivity and job satisfaction between activity based offices and traditional offices. The goal is to investigate, through a quantitative comparison, productivity and job satisfaction between the office types, and if generations perceive this differently. Method: The method used in this study is a quantitative method, in form of a questionnaire. The questionnaire used was taken from a study made by Sahlström and Severin (2015) at the Royal Institute of Technology in Stockholm. The same questionnaire was taken because it had already been quality assured and had good content for the survey. Four IT companies were included in the study. Two of them had activity based offices and two of them had traditional office type. Literature review has also been a method in order to get a deeper understanding of the subject. Findings: The results of the study show that there are differences between the two office types in perceived productivity and job satisfaction. The traditional office type showed the best results. However, this result can be discussed since the two traditional offices differed widely in their responses. The results also show that there are differences between the generations experiencing productivity and job satisfaction of the various offices. The elder generation, Baby boomers, shows better results on the traditional office type and the younger generation, Generation Y, shows better results on the activity based offices. Implications: One conclusion to be drawn from this is that employees at traditional offices are more satisfied with their working place and experience increased productivity than employees on activity based offices. However, these results may be due to other factors than how the office environment affects the employees. Therefore, these results will not be recommended. Another conclusion is that the Baby boomers are experiencing higher productivity and job satisfaction of traditional office and Generation Y experiences higher productivity and job satisfaction on activity based office. These results can be recommended. Limitations: The limitations of this study are to examine only IT companies in Sweden with a maximal amount of employees of 150 persons. The results are, apart from the scattered results in the first issue, generally valid and can be applied to other IT companies. To succeed fully applicable results, a survey with more companies involved had been better. Then, detections of anomaly would easier have been discovered and possible disregards of certain results could have been done. Keywords: Perceived productivity - Self-rated assessment of employees on their own productivity. Traditional offices - In this work traditional offices includes cell offices and shared rooms. Activity based offices - Office where employees have no fixed work place and there are often zones to support different types of working.

The well-being of relatives of patients with atrial fibrillation: a critical incident technique analysis

BACKGROUND: The well-being of relatives of patients having chronic heart diseases (CHD) has been found to be negatively affected by the patient's condition. Studies examining relatives of patients with atrial fibrillation (AF) indicate that their well-being may be affected in a similar manner, but further research is needed. AIM: To explore and describe critical incidents in which relatives of patients experience how AF affects their well-being and what actions they take to handle these situations. DESIGN AND METHOD: An explorative, descriptive design based on the critical incident technique (CIT) was used. Interviews were conducted with 19 relatives (14 women and five men) of patients hospitalised in southern Sweden due to acute symptoms of the AF. RESULTS: The well-being of relatives was found to be affected by their worries (patient-related health), as well as the sacri-ficing of their own needs (self-related health). In handling their own well-being, these relatives adjusted to and supported the patient (practical involvement), along with adjusting their own feelings and responding to the mood of the patients (emotional involvement). CONCLUSION: The well-being of relatives of patients with AF was affected depending on the patients' well-being. In their attempt to handle their own well-being, the relatives adjusted to and supported the patients. Further research is needed in order to evaluate the effects of support to relatives and patients respectively and together.

Validez de contenido de un cuestionario para evaluar las etapas del cambio de comportamiento en estilos de vida en escolares, Colombia: Estudio FUPRECOL

Estudio de validación en escolares pertenecientes a instituciones educativas oficiales de la ciudad de Bogotá, Colombia. Se diseñó y aplicó el CCC-FUPRECOL que indagó por las etapas de cambio para la actividad física/ejercicio, consumo de frutas, verduras, drogas, tabaco e ingesta de bebidas alcohólicas, de manera auto-diligenciada por formulario estructurado.

Factores asociados al desplazamiento activo en bicicleta al colegio en el Distrito Bogotá, Colombia. Estudio FUPRECOL

Introducción: El transporte activo (TA) puede ser una oportunidad para incrementar los niveles de actividad física diarios de los niños y adolescentes, además de destacarse como una estrategia práctica, accesible y sostenible a largo plazo. Objetivos: El objetivo del presente estudio es doble: Analizar los patrones de desplazamiento activo en bicicleta al y desde el centro educativo, y b) Identificar los factores asociados al uso de la bicicleta como TA; en una muestra de niños y jóvenes pertenecientes a escuelas oficiales de Bogotá, Colombia. Material y métodos: Se trata de un sub-análisis del estudio FUPRECOL en 8060 niños y adolescentes entre los 9-17 años de edad). El modo de desplazamiento del escolar fue determinado a través de la pregunta: “¿Durante los últimos 7 días, usaste bicicleta para ir al colegio/escuela y volver a la casa?. Dicha respuesta se categorizó en activos “Si” (si se desplazan en bicicleta) y pasivos “No” (si se desplazan en vehículo motorizado). Se midieron parámetros antropométricos de peso, talla y perímetro de cintura. El máximo nivel de estudios alcanzados por la madre/padre (no reporta, primaria o secundaria/técnico o tecnólogo/universitario o postgrado) y la composición del hogar (vive con padre/vive con madre/con ambos padres/con abuelos/otros familiares) se auto-reportó por los padres. Las relaciones entre el TA y los factores anteriormente descritos se analizaron mediante regresión logística binaria. Resultados: El 21,9% del total de la muestra reporta usar la bicicleta como medio de transporte y el 7,9% acumula más de 120 minutos al día. Se observó una mayor probabilidad de usar la bicicleta como medio de desplazamiento activo a la escuela en los varones, en los jóvenes entre 9 y 12 años, y en aquellos cuyo padre/madre reportaron mayor grado académico, es decir, “universitario/postgrado”. 3 Conclusión: Los hallazgos del presente estudio sugieren que es necesario promover el TA desde la niñez, poniendo mayor énfasis en el paso a la adolescencia y en las jóvenes, para así aumentar los niveles diarios de AF de estos.

Au1to-reporte de la condición física relacionada con la salud en una muestra de escolares del distrito Bogotá: estudio FUPRECOL

Introducción y objetivo: La escala de auto-reporte de la condición física (IFIS) “The International FItness Scale”, fue creada como parte del proyecto financiado por la unión europea HELENA Study “Healthy Lifestyle in Europe by Nutrition in Adolescence”. A la fecha, no se conoce ningún estudio que haya examinado el auto-reporte de la condición física en un contexto distinto al Europeo. Este trabajo evalúa por auto-reporte la condición física relacionada con la salud (CFRS) en una muestra de niños y adolescentes del distrito de Bogotá pertenecientes al grupo FUPRECOL. Materiales y Método: Estudio transversal en 1.922 escolares (54.3% mujeres). Se aplicó de manera auto-administrada la escala “IFIS”. Se midió el peso, talla, circunferencia de cintura y se calculó el índice de masa corporal (IMC) en kg/m2. La capacidad aeróbica, el índice general de fuerza (z-score fuerza prensil + z-score salto de longitud), la velocidad/agilidad y la flexibilidad fueron como indicadores objetivos de la CFRS objetiva y directa. Resultados: La muestra estuvo conformada por 1.922 escolares, de los cuales 1.045 fueron mujeres (54.3%) y 877 hombres (45.6%). El análisis ANOVA mostró que los varones tenían mayores valores de peso (p<0.003), estatura (p<0.001), CC (p<0.001), capacidad aeróbica (p<0.001), velocidad/agilidad (p<0.001) e índice general de fuerza (p<0.001), mientras que las mujeres presentaron exceso de peso por IMC (sobrepeso y obesidad). En el componente de condición física general, las puntuaciones más altas en la escala “IFIS” se encontraron en la categoría buena (40%), seguido de aceptable (34%), mientras que la puntuación más baja se encontró en la categoría muy mala/mala (6%). En población general, relaciones lineales fueron observadas entre el auto-reporte de la CFRS por la escala “IFIS” y la mayoría de los indicadores del fitness evaluado objetivamente. El análisis post-hoc ajustado por sexo, edad y etapa de maduración reveló que los escolares que acusaron mejores valores en la auto-percepción de los dominios del “IFIS”, presentaron mejor desempeño en los indicadores de CFRS objetivos. Conclusión: Este trabajo describe por primera vez en población Latina, que el auto-reporte con la escala “IFIS”, es un instrumento válido para evaluar la CFRS, y además posee una adecuada capacidad para clasificar la aptitud física en población escolar de Bogotá, Colombia. Esta escala se encuentra disponible para otros investigadores interesados en evaluar la condición física muscular en América Latina.

Health-related quality of life in Huntington’s Disease patients: a comparison of proxy assessment and patient self-rating using the disease-specific Huntington’s Disease health-related quality of life questionnaire (HDQoL)

Huntington’s disease (HD) is a fatal, neurodegenerative disease for which there is no known cure. Proxy evaluation is relevant for HD as its manifestation might limit the ability of persons to report their health-related quality of life (HrQoL). This study explored patient–proxy ratings of HrQoL of persons at different stages of HD, and examined factors that may affect proxy ratings. A total of 105 patient–proxy pairs completed the Huntington’s disease health-related quality of life questionnaire (HDQoL) and other established HrQoL measures (EQ-5D and SF-12v2). Proxy–patient agreement was assessed in terms of absolute level (mean ratings) and intraclass correlation. Proxies’ ratings were at a similar level to patients’ self-ratings on an overall Summary Score and on most of the six Specific Scales of the HDQoL. On the Specific Hopes and Worries Scale, proxies on average rated HrQoL as better than patients’ self-ratings, while on both the Specific Cognitive Scale and Specific Physical and Functional Scale proxies tended to rate HrQoL more poorly than patients themselves. The patient’s disease stage and mental wellbeing (SF-12 Mental Component scale) were the two factors that primarily affected proxy assessment. Proxy scores were strongly correlated with patients’ self-ratings of HrQoL, on the Summary Scale and all Specific Scales. The patient–proxy correlation was lower for patients at moderate stages of HD compared to patients at early and advanced stages. The proxy report version of the HDQoL is a useful complementary tool to self-assessment, and a promising alternative when individual patients with advanced HD are unable to self-report.

Agreement between adolescent self-report and parent reports of health and well-being: results of an epidemiological study.

Objective To examine parent and adolescent agreement on physical, emotional, mental and social health and well-being in a representative population.
Methodology An epidemiological design was used to obtain parent–child/adolescent dyad data on comparable items and scales of a generic measure of health and well-being, the Child Health Questionnaire (parent/proxy report 50 item, self-report 80 item). Scale analysis included intraclass correlations (ICCs) to examine strength of parent–child associations and independent t-tests for differences between adolescents (with or without an illness). Where there were significant differences in scale scores, analysis of variance and two sample t-tests were used to examine the influence of social, demographic, health concern and school variables. Single items were examined for trends in response categories.
Results 2096 parent–adolescent dyads (adolescent mean age of 15.1 years, males 50%, maternal parent 83.2%, biological parent 93.5%). ICCs were strong. Overall, adolescents reported poorer emotional and social health, and clinically significant differences were observed for perceptions of general health (mean difference 8.1/100), frequency and amount of body pain (5.94/100), experience of mental health (5.14/100), and impact of health on family activities (12.43/100), which widen significantly for adolescents with illness. Social, health and school enjoyment and performance significantly widened parent–child differences.
Conclusions All adolescents were much less optimistic about their health and well-being than their parents, and were only in close agreement on aspects of health and well-being they rated highly. Adolescent reports are more likely to be sensitive to pain, mental health problems, health in general and the impact of their health on family activities.

Development of mental health first aid guidelines for deliberate non-suicidal self-injury: a Delphi study

BACKGROUND: It is estimated that around 4% of the population engages, or has engaged, in deliberate non-suicidal self-injury. In clinical samples, the figures rise as high as 21%. There is also evidence to suggest that these figures may be increasing. A family member or friend may suspect that a person is injuring themselves, but very few people know how to respond if this is the case. Simple first aid guidelines may help members of the public assist people to seek and receive the professional help they require to overcome self-injury.

METHODS: This research was conducted using the Delphi methodology, a method of reaching consensus in a panel of experts. Experts recruited to the panels included 26 professionals, 16 people who had engaged in self-injurious behaviour in the past and 3 carers of people who had engaged in self-injurious behaviour in the past. Statements about providing first aid to a person engaged in self-injurious behaviour were sought from the medical and lay literature, but little was found. Panel members were asked to respond to general questions about first aid for NSSI in a variety of domains and statements were extracted from their responses. The guidelines were written using the items most consistently endorsed by the consumer and professional panels.

RESULTS: Of 79 statements rated by the panels, 18 were accepted. These statements were used to develop the guidelines appended to this paper.

CONCLUSION: There are a number of actions which are considered to be useful for members of the public when they encounter someone who is engaging in deliberate, non-suicidal self-injury. These guidelines will be useful in revising curricula for mental health first aid and NSSI first aid training programs. They can also be used by members of the public who want immediate information about how to assist a person who is engaging in such behaviour.

Should mental health issues be addressed in primary care, and can it be done? Views of rural general practitioners in Queensland

Objective: The aim of this paper was to examine self-efficacy and perceived appropriateness among rural general practitioners (GPs) in regards to screening and intervention for physical, lifestyle and mental health issues. ----- Method: Fifty GPs from 25 practices in eight rural Queensland towns completed a written survey designed for the study. ----- Results: General practitioners rated opportunistic screening or assessment for smoking and for detection of relapse of mental disorders as the most appropriate, with even cardiovascular and diabetes risk falling behind these. Self-efficacy was highest for medical disorders for smoking assessment. It was significantly lower for alcohol, mental health issues, and addressing risks of physical disorder in people with mental disorders. ----- Conclusions: High appropriateness ratings suggest that current strategies to boost self-efficacy of GPs in addressing mental health issues are timely.

Trends in demographic, health behaviour factors, and self-perceived weight status : influences on obesity in Australia from 1995 to 2005

Overweight and obesity are two of the most important emerging public health issues in our time and regarded by the World Health Organisation [WHO] (1998) as a worldwide epidemic. The prevalence of obesity in the USA is the highest in the world, and Australian obesity rates fall into second place. Currently, about 60% of Australian adults are overweight (BMI „d 25kg/m2). The socio-demographic factors associated with overweight and/or obesity have been well demonstrated, but many of the existing studies only examined these relationships at one point of time, and did not examine whether significant relationships changed over time. Furthermore, only limited previous research has examined the issue of the relationship between perception of weight status and actual weight status, as well as factors that may impact on people¡¦s perception of their body weight status. Aims: The aims of the proposed research are to analyse the discrepancy between perceptions of weight status and actual weight status in Australian adults; to examine if there are trends in perceptions of weight status in adults between 1995 to 2004/5; and to propose a range of health promotion strategies and furth er research that may be useful in managing physical activity, healthy diet, and weight reduction. Hypotheses: Four alternate hypotheses are examined by the research: (1) there are associations between independent variables (e.g. socio -demographic factors, physical activity and dietary habits) and overweight and/or obesity; (2) there are associations between the same independent variables and the perception of overweight; (3) there are associations between the same independent variables and the discrepancy between weight status and perception of weight status; and (4) there are trends in overweight and/or obesity, perception of overweight, and the discrepancy in Australian adults from 1995 to 2004/5. Conceptual Framework and Methods: A conceptual framework is developed that shows the associations identified among socio -demographic factors, physical activity and dietary habits with actual weight status, as well as examining perception of weight status. The three latest National Health Survey data bases (1995 , 2001 and 2004/5) were used as the primary data sources. A total of 74,114 Australian adults aged 20 years and over were recruited from these databases. Descriptive statistics, bivariate analyses (One -Way ANOVA tests, unpaired t-tests and Pearson chi-square tests), and multinomial logistic regression modelling were used to analyse the data. Findings: This research reveals that gender, main language spoken at home, occupation status, household structure, private health insurance status, and exercise are related to the discrepancy between actual weight status and perception of weight status, but only gender and exercise are related to the discrepancy across the three time point s. The current research provides more knowledge about perception of weight status independently. Factors which affect perception of overweight are gender, age, language spoken at home, private health insurance status, and diet ary habits. The study also finds that many factors that impact overweight and/or obesity also have an effect on perception of overweight, such as age, language spoken at home, household structure, and exercise. However, some factors (i.e. private health insurance status and milk consumption) only impact on perception of overweight. Furthermore, factors that are rel ated to people’s overweight are not totally related to people’s underestimation of their body weight status in the study results. Thus, there are unknown factors which can affect people’s underestimation of their body weight status. Conclusions: Health promotion and education activities should provide education about population health education and promotion and education for particular at risk sub -groups. Further research should take the form of a longitudinal study design ed to examine the causal relationship between overweight and/or obesity and underestimation of body weight status, it should also place more attention on the relationships between overweight and/or obesity and dietary habits, with a more comprehensive representation of SES. Moreover, further research that deals with identification of characteristics about perception of weight status, in particular the underestimation of body weight status should be undertaken.

Self-management of cancer treatment-related fatigue, nausea, vomiting and oral mucositis in Chinese cancer patients

Background: Treatment-related symptoms continue to place a significant burden on many cancer patients. Many side effects require patients to engage in a range of self-management actions. While some studies have explored self-management of treatment-related side effects in Western settings, very few studies were identified that described the self-management practices of cancer patients in China. Objective: The purposes of this study are to: (1) Investigate Chinese cancer patients. self-management behaviours in dealing with the fatigue, nausea/vomiting and oral mucositis that result from treatment, as well as the perceived effectiveness of these behaviours and related self-efficacy in performing them. (2) Explore factors influencing symptom self-management behaviours using the Cancer Symptom Self-management Framework based on Grey, Knafl and McCorkle.s (2006) self-management framework as a guide. Methods: This study was divided into two phases. Phase One consisted of the translation and modification of two instruments. The adaptation of these instruments to ensure applicability in the Chinese context was achieved through semi-structured interviews with six cancer patients, and content evaluation with eight experienced oncology nurses. A pilot study was conducted with nine cancer patients to trial the questionnaire set in the Chinese context. Based on the results of Phase One, Phase Two involved a cross-sectional survey of Chinese cancer patients undergoing cancer treatment using these instruments. A total of 277 chemotherapy patients with fatigue and/or nausea and vomiting, and 100 radiotherapy patients with oral mucositis were surveyed. Results: Participants in this study reported a variety of self-management behaviours to cope with fatigue, nausea, vomiting and oral mucositis. There are some consistencies as well disparities between strategies that are frequently used and those rated as effective. For fatigue self-management, participants were more likely to use strategies related to rest and sleep, while activity enhancement strategies were rated as achieving higher relief. For nausea and vomiting self-management, dietary modification and taking medication were most frequently used and rated as moderately effective. Psychological strategies were used by more than a third of participants and were rated as mildly effective. Some other infrequently used strategies, such as distraction by keeping busy and acupressure, were rated as moderately effective. For oral mucositis self-management, having soft, bland food and keeping the mouth moisturised were most frequently reported and they were rated as achieving moderate relief. A prescribed mouthwash was used by most but not all participants and brought moderate relief. In general, patients had low-to-moderate self-efficacy in nausea and vomiting self-management behaviours, moderate self-efficacy in fatigue self-management behaviours, and low-to-moderate self-efficacy in oral mucositis self-management behaviours. In terms of the factors influencing symptom self-management, different predictors were identified affecting engagement in fatigue, nausea/vomiting and oral mucositis self-management behaviours. Self-efficacy scores of different behaviours were consistently found to be a positive predictor of the relief level from corresponding behaviours, after controlling for other variables. Perceived social support from health care professionals was identified as an important factor influencing nausea and vomiting self-management behaviours, while neighbourhood support was important for fatigue self-management. In addition, symptom distress was identified as an important factor influencing nausea and vomiting self-management. Conclusion: Similar to reports from overseas, Chinese cancer patients initiate a wide range of self-management behaviours in response to treatment-related side effects. While some behaviours were reported to provide relief, many did not. Given these results, this study has a number of practical implications for health care professionals, particularly in relation to developing tailored self-management programs for fatigue, nausea, vomiting and oral mucositis. Additionally, this study suggests a number of theoretical implications and directions for future research. It is envisaged that these recommendations may pave the way for further studies understanding and promoting cancer symptom self-management in Chinese people affected by cancer.