Patients' Needs for Care in Public Mental Health: Unity and Diversity of Self-Assessed Needs for Care.

PURPOSE: Needs assessment is recognized to be a key element of mental health care. Patients tend to present heterogeneous profiles of needs. However, there is no consensus in previous research about how patients' needs are organized. This study investigates both general and specific dimensions of patients' needs for care. METHODS: Patients' needs were assessed with ELADEB, an 18-domain self-report scale. The use of a self-assessment scale represents a unique way of obtaining patients' perceptions. A patient-centered psychiatric practice facilitates empowerment as it is based on the patients' personal motivations, needs, and wants. Four seventy-one patients' profiles were analyzed through exploratory factor analysis. RESULTS: A four-factor bifactor model, including one general factor and three specific factors of needs, was most adequate. Specific factors were (a) "finances" and "administrative tasks"; (b) "transports," "public places," "self-care," "housework," and "food"; and (c) "family," "children," "intimate relationships," and "friendship." CONCLUSION: As revealed by the general factor, patients expressing urgent needs in some domains are also more susceptible to report urgent needs in several other domains. This general factor relates to high versus low utilizers of public mental healthcare. Patients also present specific needs in life domains, which are organized in three dimensions: management, functional disabilities, and familial and interpersonal relationships. These dimensions relate to the different types of existing social support described in the literature.

Image guided critical screw placement precision in the cervical spine : important or incidental? : results of a series of 91 consecutive cases using OVEM

Study design: A retrospective study of image guided cervical implant placement precision. Objective: To describe a simple and precise classification of cervical critical screw placement. Summary of Background Data: "Critical" screw placement is defined as implant insertion into a bone corridor which is surrounded circumferentially by neurovascular structures. While the use of image guidance has improved accuracy, there is currently no classification which provides sufficient precision to assess the navigation success of critical cervical screw placement. Methods: Based on postoperative clinical evaluation and CT imaging, the orthogonal view evaluation method (OVEM) is used to classify screw accuracy into grade I (no cortical breach), grade la (screw thread cortical breach), grade II (internal diameter cortical breach) and grade III (major cortical breach causing neural or vascular injury). Grades II and III are considered to be navigation failures, after accounting for bone corridor / screw mismatch (minimal diameter of targeted bone corridor being smaller than an outer screw diameter). Results: A total of 276 screws from 91 patients were classified into grade I (64.9%), grade la (18.1%), and grade II (17.0%). No grade III screw was observed. The overall rate of navigation failure was 13%. Multiple logistic regression indicated that navigational failure was significantly associated with the level of instrumentation and the navigation system used. Navigational failure was rare (1.6%) when the margin around the screw in the bone corridor was larger than 1.5 mm. Conclusions: OVEM evaluation appears to be a useful tool to assess the precision of critical screw placement in the cervical spine. The OVEM validity and reliability need to be addressed. Further correlation with clinical outcomes will be addressed in future studies.

Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions.

BACKGROUND: Literature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age. METHODS: This study examined cross-sectional data from the Canton of Vaud in Switzerland on the health conditions of detainees who were in prison on January 1, 2011 or entered prison in 2011. Health conditions validated by physician examination were reported using the International Classification of Diseases (ICD) version 10. The analyses were descriptive by groups of prisoners: the entire sample (All), Men, Older adults and Women. RESULTS: A total of 1,664 individuals were included in the analysis. Men comprised 91.5 % of the sample and had a mean age of 33 years. The other 8.5 % were women and had an average age of 39. Older adults (i.e., age 50 and older) represented 7 % of the total sample. Overall, 80 % of inmates were non-Swiss citizens, but the proportion of Swiss prisoners was higher among the older adults (51 %) and women (29 %). Overall, 41 % of inmates self-reported substance abuse problems. Of those, 27 % were being treated by psychiatrists for behavioral disorders related to substance abuse. Chronic infectious diseases were found in 9 % of the prison population. In addition, 27 % of detainees suffered from serious mental health conditions. Gender and age had an influence on the disease profile of this sample: compared to the entire prison population, the older inmates were less likely to misuse illegal drugs and to suffer from communicable infections but exhibited more problems with alcohol and a higher burden of chronic health conditions. Female prisoners were more disposed to mental health problems (including drug abuse) and infectious diseases. In terms of chronic diseases, women suffered from the same conditions as men, but the diseases were more prevalent in women. CONCLUSION: It is important to understand the different disease profiles of prisoners by gender and age, as it helps identify the needs of different groups and tailor age-and gender-specific interventions.

The use of COOP/WONCA charts as a screen for mental disorders in the immigrant community in primary care in primary care

Aim. To evaluate the usefulness of COOP/WONCA charts as a screening tool for mental disorders in primary care in the immigrant healthcare users in Salt. To measure self-rated health of Salt immigration population using the COOP / WONCA charts and to assess its associated factorsDesign. Descriptive and transversal study, Participants. 370 non-EU immigrants seniors selected by consecutive sampling stratified by sexMain measures. Personal information will be collected (age, sex, country of origin, years of residency in Spain, number of people living in the household and associated comorbidities). Each participant will complete the COOP/WONCA charts. An analysis of the validity of the diagnostic test will be done: sensibility, specificity, positive predictive value, negative predictive value, ROC curve and area under the curve (AUC). All variables will be subjected to descriptive analysis. Bivariate and multivariate analysis between the variables collected (sex, years of residency in Spain... ) and the results of COOP / WONCA charts will be performedResults. Preliminary results are available on a pilot test with 30 patients. The mental disorder prevalence is around 30%. Sensibility (0,89), specificity (0,89), VPP (0,80), VPN (0,94) cutoff score (3.5) and AUC (0,941). Women, people with 10 or more years of residency in Spain and unemployed people have worse self-rated healthConclusions. Based on the preliminary results, is possible to conclude that COOP/WONCA charts could be an useful, valid and applicable screening test for mental disorders in primary care with immigrant population

Un análisis comparativo del papel del bucle fonológico versus la agenda visoespacial en el cálculo en niños de 7-8 años = A comparative analysis of the phonological loop versus the visuo-spatial sketchpad in mental arithmetic tasks in 7-8 y.o. children

En esta investigación se ha estudiado la relación entre dos subsistemas de la memoria de trabajo (buclefonológico y agenda viso-espacial) y el rendimiento en cálculo con una muestra de 94 niños españolesde 7-8 años. Hemos administrado dos pruebas de cálculo diseñadas para este estudio y seis medidassimples de memoria de trabajo (de contenido verbal, numérico y espacial) de la «Batería de Testsde Memoria de Treball» de Pickering, Baqués y Gathercole (1999), y dos pruebas visuales complementarias.Los resultados muestran una correlación importante entre las medidas de contenido verbaly numérico y el rendimiento en cálculo. En cambio, no hemos encontrado ninguna relación con las medidasespaciales. Se concluye, por lo tanto, que en escolares españoles existe una relación importanteentre el bucle fonológico y el rendimiento en tareas de cálculo. En cambio, el rol de la agenda viso-espaciales nulo

El papel de la memoria de trabajo en el cálculo mental un cuarto de siglo después de Hitch = The role of working memory in mental arithmetic a quarter of century after Hitch

Desde que Hitch (1978) publicó el primer estudio sobre el rol de la memoria de trabajo en el cálculo han idoaumentando las investigaciones en este campo. Muchos trabajos han estudiado un único subsistema, pero nuestroobjetivo es identificar qué subsistema de la memoria de trabajo (bucle fonológico, agenda viso-espacial o ejecutivocentral) está más implicado en el cálculo mental. Para ello hemos realizado un estudio correlacional en el quehemos administrado dos pruebas aritméticas y nueve pruebas de la “Bateria de Test de Memòria de Treball” dePickering, Baqués y Gathercole (1999) a una muestra de 94 niños españoles de 7-8 años. Nuestros resultadosindican que el bucle fonológico y sobretodo el ejecutivo central inciden de forma estadísticamente significativa enel rendimiento aritmético

Asertividad y fomento de la salud mental

La asertividad es un modelo de relación interpersonal que permite la obtención de relaciones más satisfactorias, tanto socialmente como con uno mismo. El entrenamiento asertivo intenta modificar la falta de capacidad autoafirmativa, entendida como una excesiva sumisión o como una incapacidad de expresar emociones positivas. La utilización de un estilo de conducta asertiva capacita al individuo para influir en su entorno de forma tal que le permita conseguir sus objetivos básicos proporcionándole satisfacción y fomentando, por lo tanto, su salud mental

Self-reported sitting time and physical activity: interactive associations with mental well-being and productivity in office employees

Abstract Background: Little is known about how sitting time, alone or in combination with markers of physical activity (PA), influences mental well-being and work productivity. Given the need to develop workplace PA interventions that target employees’ health related efficiency outcomes; this study examined the associations between self-reported sitting time, PA, mental well-being and work productivity in office employees. Methods: Descriptive cross-sectional study. Spanish university office employees (n = 557) completed a survey measuring socio-demographics, total and domain specific (work and travel) self-reported sitting time, PA (International Physical Activity Questionnaire short version), mental well-being (Warwick-Edinburg Mental Well-Being Scale) and work productivity (Work Limitations Questionnaire). Multivariate linear regression analyses determined associations between the main variables adjusted for gender, age, body mass index and occupation. PA levels (low, moderate and high) were introduced into the model to examine interactive associations. Results: Higher volumes of PA were related to higher mental well-being, work productivity and spending less time sitting at work, throughout the working day and travelling during the week, including the weekends (p < 0.05). Greater levels of sitting during weekends was associated with lower mental well-being (p < 0.05). Similarly, more sitting while travelling at weekends was linked to lower work productivity (p < 0.05). In highly active employees, higher sitting times on work days and occupational sitting were associated with decreased mental well-being (p < 0.05). Higher sitting times while travelling on weekend days was also linked to lower work productivity in the highly active (p < 0.05). No significant associations were observed in low active employees. Conclusions: Employees’ PA levels exerts different influences on the associations between sitting time, mental well-being and work productivity. The specific associations and the broad sweep of evidence in the current study suggest that workplace PA strategies to improve the mental well-being and productivity of all employees should focus on reducing sitting time alongside efforts to increase PA.

Intervención de enfermería en Salud Mental desde los centros escolares

Con la promoción de la salud mental y la prevención de las enfermedades mentales se hace frente a factores determinantesrelacionados con la salud del individuo, familia, comunidad y la sociedad en general reforzando los factores de protección ydisminuyendo los factores de riesgo. Los centros escolares junto con los centros de trabajo son un escenario de actuacionesfundamentales, debido a la cantidad de tiempo que pasan en ellos las personas. Sabemos que la salud mental estádeterminada en gran parte por los primeros años de vida, de ahí la importancia de la promoción de la salud mental en lainfancia y en la adolescencia. En esta línea en la comunidad autónoma de Cataluña se ha diseñado y implementado unprograma “Salud y Escuela” que pretende: Mejorar la salud de los adolescentes a través de acciones de promoción de lasalud, prevención de las situaciones de riesgo y atención precoz de los problemas de salud relacionados con: • La saludafectivo-sexual • El consumo de drogas, alcohol y tabaco • Los trastornos relacionados con la alimentación • La salud mentalEn este programa el profesional de enfermería es el referente en el centro educativo de secundaria, y por tanto es el queinterviene orientando, informando, enseñando o derivando a los adolescentes a los servicios de salud, en función de lasconsultas que recibe. También asesora a los profesores y a las familias

Habilidades terapéuticas de salud mental en enfermería

La salud mental (SM) de los ciudadanos pasará a ser en los años venideros una de las principales necesidades deatención en la asistencia sanitaria, debido al incremento progresivo que se está observando en los problemas deSM, destacando entre estos los trastornos depresivos i de ansiedad. En este nuevo siglo, entre las accionesprioritarias en la atención sanitaria van a destacar el trabajo preventivo en SM, el diagnóstico precoz en esteámbito y el aumento de los cuidados en estas alteraciones, lo que precisará de una mayor preparación enhabilidades terapéuticas en SM de todos los profesionales sanitarios y entre ellos de los profesionales deenfermería

First- and second-language phonological representations in the mental lexicon

Performance-based studies on the psychological nature of linguistic competence can conceal significant differences in the brain processes that underlie native versus nonnative knowledge of language. Here we report results from the brain activity of very proficient early bilinguals making a lexical decision task that illustrates this point. Two groups of SpanishCatalan early bilinguals (Spanish-dominant and Catalan-dominant) were asked to decide whether a given form was a Catalan word or not. The nonwords were based on real words, with one vowel changed. In the experimental stimuli, the vowel change involved a Catalan-specific contrast that previous research had shown to be difficult for Spanish natives to perceive. In the control stimuli, the vowel switch involved contrasts common to Spanish and Catalan. The results indicated that the groups of bilinguals did not differ in their behavioral and event-related brain potential measurements for the control stimuli; both groups made very few errors and showed a larger N400 component for control nonwords than for control words. However, significant differences were observed for the experimental stimuli across groups: Specifically, Spanish-dominant bilinguals showed great difficulty in rejecting experimental nonwords. Indeed, these participants not only showed very high error rates for these stimuli, but also did not show an error-related negativity effect in their erroneous nonword decisions. However, both groups of bilinguals showed a larger correctrelated negativity when making correct decisions about the experimental nonwords. The results suggest that although some aspects of a second language system may show a remarkable lack of plasticity (like the acquisition of some foreign contrasts), first-language representations seem to be more dynamic in their capacity of adapting and incorporating new information. &

La inclusión laboral de personas con trastorno mental grave mediante Empleo con Apoyo : elementos clave a partir de los professionals

Supported Employment (SE) is a clear alternative to the work inclusion of people with severe mental disorder (SMD). This article has two purposes: first, to show the possibilities of application of the SE with people with SMD, secondly, to establish the main lines that are configured as elements favoring the inclusion processes of this group work by SE. A piece of research has been carried out based on interviews of professionals with experience in supporting the work inclusion of people with SMD, focusing on the key factors that these professionals perceive as key elements for successful work inclusion processes. The awareness of the disease by the worker with SMD, the organization of the support processes throughout the insertion process, the relationship with the company as well as with the family and the characteristics of the health network are among the factors that, according to the research results, appear to be key factors for successful and less successful work inclusion processes. The information obtained provides insight into how people with SMD develop work inclusion processes with supported employment and help us to suggest some strategies to improve these processes

Mental Health of Expatriates in Finnish Enterprises in Brazil

Expatriation has become increasingly common due to the global trade expansion. Many large companies base their production facilities in far-flung countries, where experts are sent from their own countries to launch the operations. Working in a foreign environment demands from so-called expatriates considerable adaptability. This study aimed to investigate if following expatriation mental health difficulties were experienced by the employees themselves or their family members. This study investigated by a questionnaire and interviews how expatriate employees in Finnish companies operating in different regions of Brazil and their families adjusted. Investigated employees were required to be at least 6 months in expatriation. Data were collected in Brazil during their stay at least 3 months after the arrival. The survey covered 121 expatriate employees, that operated in 17 different companies, from which 71 employees from 10 different companies responded to the questionnaire. All the employees from the two largest enterprises and their spouses were invited to focus groups; in total 43 persons (22 employees and 21 employees’ spouses) participated in a group or individual interviews. No significant mental health difficulties were found among the expatriate employees. Only a tenth of the expatriate employees reported strain. The experience of strain symptoms was found to be related to long working days, intense working rhythm and lack of friends. Work satisfaction seemed to be an important mediator in the coping process. While abroad, the expatriate employees were highly recognized for their work. Due to the immature organization of work they could often use their creative capacities to improve the work flow. The opportunity to see the effects of their own contribution with their own eyes to the development of the enterprise made them feel good. The association between the expatriate employees’ adjustment and that of their spouses’ was evident. The spouses’ situation was markedly different than that of the expatriate employees’ themselves. Expatriation changed the family members’ previous division of tasks considerably. The expatriate spouses had to change their roles more than the expatriate employees themselves; since most of them were highly educated women, who were leaded through an identity crisis due to at least temporary renunciation of own work and career.