950 resultados para mental health services


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Canada and Australia share many similarities in terms of demographics and the structure of their health systems; however, there has been a divergence in policy approaches to public funding of psychological care. Recent policy reforms in Australia have substantially increased community access to psychologists for evidence-based treatment for high prevalence disorders. In Canada, access remains limited with the vast majority of consultations occurring in the private sector, which is beyond the reach of many individuals due to cost considerations. With the recent launch of the Mental Health Commission of Canada, it is timely to reflect on the context of the current Canadian and Australian systems of psychological care. We argue that integrating psychologists into the publicly-funded primary care system in Canada would be feasible, beneficial for consumers, and cost-effective.

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Objective
Diet quality is related to the risk for depression and anxiety in adults and adolescents; however, the possible impact of maternal and early postnatal nutritional exposures on children’s subsequent mental health is unexplored.

Method
The large prospective Norwegian Mother and Child Cohort Study recruited pregnant women between 1999 and 2008. Data were collected from mothers during pregnancy and when children were 6 months and 1.5, 3, and 5 years of age. Latent growth curve models were used to model linear development in children’s internalizing and externalizing problems from 1.5 to 5 years of age as a function of diet quality during pregnancy and at 1.5 and 3 years. Diet quality was evaluated by dietary pattern extraction and characterized as “healthy” or “unhealthy.” The sample comprised 23,020 eligible women and their children. Adjustments were made for variables including sex of the child, maternal depression, maternal and paternal age, maternal educational attainment, household income, maternal smoking before and during pregnancy, mothers’ parental locus of control, and marital status.

Results
Higher intakes of unhealthy foods during pregnancy predicted externalizing problems among children, independently of other potential confounding factors and childhood diet. Children with a high level of unhealthy diet postnatally had higher levels of both internalizing and externalizing problems. Moreover, children with a low level of postnatal healthy diet also had higher levels of both internalizing and externalizing problems.

Conclusion
Among this large cohort of mothers and children, early nutritional exposures were independently related to the risk for behavioral and emotional problems in children.

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Objectives

In this study, we assess the importance of area-based partnerships in an initiative to improve access to Maternal and Child Health (MCH) services (known as Best Start) in socially disadvantaged communities in Victoria, Australia.

Methods:
The study assessed changes in MCH attendance rates, parental attitudes and local partnership formation before and after the introduction of Best Start projects. Partners involved in Best Start projects were surveyed regarding the extent of local partnership formation (before 54; after 84). Data was collected for MCH attendance using routine records for Best Start with MCH projects (before 1,739; after 1437) and the rest of the State (before 45,497; after 45,953). Two cross-sectional surveys of parents of 3-year old children were used to assess changes in parent’s knowledge about, and confidence in using relevant services as well as parental confidence more generally (before 1666; after 1838).

Results:
Best Start was significantly associated with improving:
- levels of partnership formation (5 of 7 relevant factors)
- attendance at the 3.5 year MCH visit in Best Start Sites with MCH projects between 2001/02-2004/05.
- parent’s access to information (partnership effect);
- confidence about attending the 3.5 year MCH visits (partnership effect); and
- overall parental confidence (project effect only).

Conclusion:
Best Start improves participation in the MCH attendance. This is related most directly to improving parent’s access to information and overall parental confidence either through local partnership or direct project effects.