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Kidman R, Hossain S, Hou W, Violari A. Pathways between adverse childhood experiences and viral suppression among male HIV-infected adolescents in South Africa. AIDS Care 2024; 36:36-44. [PMID: 38555604 PMCID: PMC11283965 DOI: 10.1080/09540121.2024.2332451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/14/2024] [Indexed: 04/02/2024]
Abstract
Fewer adolescents achieve viral suppression compared to adults. One impediment may be a history of adverse childhood experiences (ACEs). To better develop targets and timeframes for intervention, this study created more robust estimates of the impact of cumulative adversity on viral suppression, tested whether the association is sensitive to the timing of adversity, and simultaneously tested several potential mechanisms. We focus on males, who have lower viral suppression than females and who may contribute to disproportionate incidence among young women. We recruited 251 male perinatally HIV-infected adolescents aged 15-19 from HIV clinics in Soweto, South Africa. Adversity was captured using the Adverse Childhood Experience - International Questionnaire (ACE-IQ). Viral load was measured using blood samples; viral suppression was defined as <20 copies/mL. Indicators of medication adherence, depression, post-traumatic stress disorder (, and substance misuse were captured. A series of pathway analysis were performed. Our sample experienced a median of 7 lifetime and 4 past-year adversities. Less than half (44%) exhibited viral suppression. Adversity demonstrated a significant association with suppression; depression mediated the association. Primary prevention of adversity among children living with HIV is paramount, as is addressing the subsequent mental and behavioral health challenges that impede viral suppression among adolescents.
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Affiliation(s)
- Rachel Kidman
- Program in Public Health and Department of Family, Population and Preventive Medicine, State University of New York at Stony Brook, Stony Brook, NY, USA
| | - Sabera Hossain
- State University of New York at Stony Brook, Stony Brook, NY, USA
| | - Wei Hou
- Work completed while with the Department of Family, Population and Preventive Medicine, State University of New York at Stony Brook, Stony Brook, NY, USA
| | - Avy Violari
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Kidman R, Mwera J, Rui YT, Breton E, Zulu A, Behrman J, Kohler HP. Cohort profile: the Adverse Childhood Experiences cohort of the Malawi Longitudinal Study of Families and Health. BMJ Open 2024; 14:e079631. [PMID: 38719291 PMCID: PMC11086369 DOI: 10.1136/bmjopen-2023-079631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
PURPOSE The Adverse Childhood Experiences (ACE) cohort of the Malawi Longitudinal Study of Families and Health (MLSFH-ACE) is a study of adolescents surveyed during 2017-2021. It provides an important opportunity to examine the longitudinal impact of ACEs on health and development across the early life course. The MLSFH-ACE cohort provides rich data on adolescents, their children and adult caregivers in a low-income, high-HIV-prevalence context in sub-Saharan Africa (SSA). PARTICIPANTS The MLSFH-ACE cohort is a population-based study of adolescents living in three districts in rural Malawi. Wave 1 enrolment took place in 2017-2018 and included 2061 adolescents aged 10-16 years and 1438 caregivers. Wave 2 took place in 2021 and included data on 1878 adolescents and 208 offspring. Survey instruments captured ACEs during childhood and adolescence, HIV-related behavioural risk, mental and physical health, cognitive development and education, intimate partner violence (IPV), marriage and aspirations, early transitions to adulthood and protective factors. Biological indicators included HIV, herpes simplex virus and anthropometric measurements. FINDINGS TO DATE Key findings include a high prevalence of ACEs among adolescents in Malawi, a low incidence of HIV and positive associations between ACE scores and composite HIV risk scores. There were also strong associations between ACEs and both IPV victimisation and perpetration. FUTURE PLANS MLSFH-ACE data will be publicly released and will provide a wealth of information on ACEs and adolescent outcomes in low-income, HIV-endemic SSA contexts. Future expansions of the cohort are planned to capture data during early adulthood.
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Affiliation(s)
- Rachel Kidman
- Program in Public Health and Department of Family Population and Preventive Medicine, Stony Brook University (The State University of New York), Stony Brook, New York, USA
| | - James Mwera
- Compelling Works, Blantyre, Malawi
- Invest in Knowledge (IKI), Zomba, Malawi
| | - Yang Tingting Rui
- Department of Sociology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Etienne Breton
- Department of Sociology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Andrew Zulu
- Compelling Works, Blantyre, Malawi
- Invest in Knowledge (IKI), Zomba, Malawi
| | - Jere Behrman
- Departments of Economics and Sociology, Population Aging Research Center and Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hans-Peter Kohler
- Department of Sociology and Population Aging Research Center and Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Silima M, Christofides N, Franchino-Olsen H, Woollett N, Meinck F. "I've accepted it because at the end of the day there is nothing, I can do about it": A qualitative study exploring the experiences of women living with the HIV, intimate partner violence and mental health syndemic in Mpumalanga, South Africa. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002588. [PMID: 38709813 PMCID: PMC11073682 DOI: 10.1371/journal.pgph.0002588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/08/2024] [Indexed: 05/08/2024]
Abstract
In South Africa, Mental Health (MH), HIV, and Intimate Partner Violence (IPV) form a syndemic, that disproportionately affects women. These challenges are often co-occurring and create complex adversities for women. Recognising these intersections and the broader socio-cultural dynamics at play is crucial to understanding the layered experiences of these women and developing effective interventions. This research explores the experiences of the women living with at least two of the epidemics (HIV, IPV and or MH) and how they cope. A qualitative study design was used and 20 women (22-60 years) were recruited from Mpumalanga, South Africa. To be eligible for the study the women had to have experienced at least two of the epidemics. Data were collected through home-based interviews, arts-based activities, and analysed thematically using MAXQDA (2022) software. MH challenges were prevalent among all the participants and were linked to both IPV and HIV, resulting in symptoms such as anxiety, depression, and suicidal thoughts. In relation to the HIV-MH link, MH challenges in this combination included feelings of denial, sadness and anxiety related to participant's HIV diagnosis. A bidirectional relationship also existed in the IPV-MH group where pre-existing MH challenges among women increased their vulnerability of having violent partners, whilst IPV also increased MH challenges. In the IPV-MH-HIV group early childhood violence exposure was linked with MH challenges and later victimization and vulnerability to HIV. Participants primarily used religion, acceptance, occasional alcohol, and family support as coping strategies. Particularly in IPV situations, alcohol use/misuse was the most prevalent coping strategies. The study highlights the syndemic relationship between HIV, IPV and MH challenges among South African women living in a peri-urban community, with a central emphasis on MH challenges. Interventions should holistically address these challenges, with particular focus on MH challenges, cultural sensitivity, and promotion of healthy coping strategies.
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Affiliation(s)
- Mpho Silima
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Hannabeth Franchino-Olsen
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
| | - Nataly Woollett
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Visual Arts, University of Johannesburg, Johannesburg, South Africa
| | - Franziska Meinck
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- School of Social and Political Sciences, University of Edinburgh, Edinburgh, United Kingdom
- School of Health Sciences, North-West University, Vanderbijlpark, South Africa
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Pontoppidan M, Nygaard L, Hirani JC, Thorsager M, Friis-Hansen M, Davis D, Nohr EA. Effects on Child Development and Parent-Child Interaction of the FACAM Intervention: A Randomized Controlled Study of an Interdisciplinary Intervention to Support Women in Vulnerable Positions through Pregnancy and Early Motherhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:587. [PMID: 38791801 PMCID: PMC11121224 DOI: 10.3390/ijerph21050587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
Health inequality can have a profound impact on a child's life. Maternal mental health challenges can hinder bonding, leading to impaired functioning and poorer child outcomes. To provide extra support for vulnerable pregnant women, the FACAM intervention offers the services of a health nurse or family therapist from pregnancy until the child starts school. This study examined the effects of FACAM intervention on pregnant women in vulnerable positions and their children until the child turned two years old. We randomly assigned 331 pregnant women to either FACAM intervention or care as usual and assessed them at baseline and when the infant was 3-6, 12-13.5, and 24 months old. The primary outcome was maternal sensitivity measured by Coding Interactive Behavior (CIB). Secondary outcomes included the parent-child relationship, child social-emotional development, child developmental progress, parent-child interaction, and child development. Our findings indicate that care-as-usual children were significantly more involved than FACAM children when the child was 4-6 months old (b = -0.25, [-0.42; -0.08] d = -0.42). However, we suspect this result is due to a biased dropout. We did not find any significant differences in any other outcomes. Therefore, the study suggests that the FACAM intervention is not superior to care as usual regarding child development and parent-child interaction outcomes.
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Affiliation(s)
- Maiken Pontoppidan
- VIVE—The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark; (J.C.H.); (M.T.); (M.F.-H.)
| | - Lene Nygaard
- Research Unit for Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark; (L.N.); (E.A.N.)
- Department of Gynaecology and Obstetrics, Odense University Hospital, 5230 Odense, Denmark
| | - Jonas Cuzulan Hirani
- VIVE—The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark; (J.C.H.); (M.T.); (M.F.-H.)
| | - Mette Thorsager
- VIVE—The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark; (J.C.H.); (M.T.); (M.F.-H.)
| | - Mette Friis-Hansen
- VIVE—The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark; (J.C.H.); (M.T.); (M.F.-H.)
| | - Deborah Davis
- Faculty of Health, University of Canberra and ACT Health, Bruce, ACT 2617, Australia;
| | - Ellen Aagaard Nohr
- Research Unit for Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark; (L.N.); (E.A.N.)
- Department of Gynaecology and Obstetrics, Odense University Hospital, 5230 Odense, Denmark
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Handiso DW, Paul E, Boyle JA, Shawyer F, Meadows G, Enticott JC. Trends and determinants of mental illness in humanitarian migrants resettled in Australia: Analysis of longitudinal data. Int J Ment Health Nurs 2024. [PMID: 38651241 DOI: 10.1111/inm.13327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/13/2024] [Accepted: 03/24/2024] [Indexed: 04/25/2024]
Abstract
Given the frequent exposure of humanitarian migrants to traumatic or stressful circumstances, there exists a potential predisposition to mental illness. Our objective was to pinpoint the trends and determinants of mental illness among humanitarian migrants resettled in Australia. This study considered five waves of longitudinal data involving humanitarian migrants resettled in Australia. Post-traumatic stress disorder (PTSD) and psychological distress were assessed using PTSD-8 and Kessler-6 screening tools. Through a Generalised Linear Mixed model (GLMM), variables displaying a 95% CI that excluded the value of 1.0 for the odds ratio were identified as associated factors for both PTSD and elevated psychological distress. The selection of multivariable covariates was guided by causal loop diagrams and least absolute shrinkage and selection operators methods. At baseline, there were 2399 humanitarian migrants with 1881 retained and at the fifth yearly wave; the response rate was 78.4%. PTSD prevalence decreased from 33.3% (95% CI: 31.4-35.3) at baseline to 28.3% (95% CI: 26.2-30.5) at year 5. Elevated psychological distress persisted across all waves: 17.1% (95% CI: 15.5-18.6) at baseline and 17.1% (95% CI: 15.3-18.9) at year 5. Across the five waves, 34.0% of humanitarian migrants met screening criteria for mental illness, either PTSD or elevated psychological distress. In the multivariate model, factors associated with PTSD were loneliness (AOR 1.5, 95% CI: 1.3-1.8), discrimination (AOR 1.6: 1.2-2.1), temporary housing contract (AOR 3.7: 2.1-6.7), financial hardship (AOR 2.2:1.4-3.6) and chronic health conditions (AOR 1.3: 1.1-1.5), whereas the associated factors for elevated psychological distress were loneliness (AOR 1.8: 1.5-2.2), discrimination (AOR 1.7: 1.3-2.2) and short-term lease housing (AOR 1.6: 1.0-1.7). The prevalence, persistence and consequential burden of mental illness within this demographic underscore the urgent need for targeted social and healthcare policies. These policies should aim to mitigate modifiable risk factors, thereby alleviating the significant impact of mental health challenges on this population.
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Affiliation(s)
- Demelash Woldeyohannes Handiso
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Eldho Paul
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Jacqueline A Boyle
- Health Systems and Equity, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Frances Shawyer
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, Victoria, Australia
| | - Graham Meadows
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, Victoria, Australia
- Mental Health Program, Monash Health, Melbourne, Victoria, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Joanne C Enticott
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, Victoria, Australia
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Maher EJ, Stoner SA, Gerlinger J, Ferraro AC, Lepper-Pappan H. Study protocol for a randomized controlled trial of the Parent-Child Assistance Program: a case management and home visiting program for people using substances during pregnancy. Trials 2024; 25:264. [PMID: 38627843 PMCID: PMC11020811 DOI: 10.1186/s13063-024-08098-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Perinatal substance use can have significant adverse effects on maternal and child health and family stability. Few interventions are specifically designed to address this significant public health problem. The Parent-Child Assistance Program (PCAP) is a 3-year case management and home-visiting intervention that seeks to help birthing persons with at-risk substance use during pregnancy to achieve and maintain substance use disorder recovery and avoid exposing future children to substances prenatally. At-risk refers to a level of substance use that creates problems in the individuals' lives or puts them or their children at risk of harm either prenatally or postnatally. Although the program has consistently shown substantial pre- to post-intervention improvements in its participants, PCAP remains to be tested with a rigorous randomized controlled trial (RCT). This study protocol describes a randomized controlled trial that aims to examine the effectiveness of the intervention compared to services as usual in affecting primary outcomes related to substance use and family planning. Secondary outcomes will concern connection to recovery support services and family preservation. METHODS Using an intent-to-treat design, the study will recruit from two metro areas in Oklahoma and enroll 200 birthing individuals who are pregnant or up to 24 months postpartum with at-risk substance use during their current or most recent pregnancy. Participants will be randomly assigned, stratified by location, to receive either PCAP or services as usual for 3 years. Participants in the PCAP condition will meet with their case manager approximately biweekly over the course of the intervention period, in their local communities or in their own homes whenever possible. Case managers will assist with goal setting and provide practical assistance in support of participants' goals. Primary and secondary outcomes will be assessed at baseline and 12, 24, and 36 months post-baseline using the Addiction Severity Index interview and a self-administered survey. DISCUSSION Results from this trial will help to gauge the effectiveness of PCAP in improving parent and child well-being. Results will be reviewed by federal clearinghouses on home-visiting and foster care prevention to determine the strength of evidence of effectiveness with implications for federal financing of this program model at the state level. TRIAL REGISTRATION ClinicalTrials.gov NCT05534568. Registered on 6/8/2022.
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Affiliation(s)
- Erin J Maher
- Department of Sociology, University of Oklahoma, 780 Van Vleet Oval, Kaufman Hall 311, Norman, OK, 73019, USA.
| | - Susan A Stoner
- Department of Psychiatry & Behavioral Sciences, Addictions, Drug & Alcohol Institute, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356560, Seattle, WA, 98195-6560, USA
| | - Julie Gerlinger
- Department of Sociology, University of Oklahoma, 780 Van Vleet Oval, Kaufman Hall 311, Norman, OK, 73019, USA
| | - A C Ferraro
- Department of Sociology, University of Oklahoma, 780 Van Vleet Oval, Kaufman Hall 311, Norman, OK, 73019, USA
| | - Heather Lepper-Pappan
- Department of Sociology, University of Oklahoma, 780 Van Vleet Oval, Kaufman Hall 311, Norman, OK, 73019, USA
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Alferink MT, Moreno-Sanz B, Cabrera-Lafuente M, Ergenekon E, de Haan TR, van Kempen AAMW, Lakhwani J, Rabe H, Zaharie GC, Pellicer A. RISEinFAMILY project: the integration of families at neonatal intensive care units (NICUs) to empower them as primary caregivers: study protocol for a stepped wedge cluster controlled trial. Trials 2024; 25:248. [PMID: 38594733 PMCID: PMC11005221 DOI: 10.1186/s13063-024-08043-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Family Integrated Care (FICare) has demonstrated positive outcomes for sick neonates and has alleviated the psychological burden faced by families. FICare involves structured training for professionals and caregivers along with the provision of resources to offer physical and psychological support to parents. However, FICare implementation has been primarily limited to developed countries. It remains crucial to assess the scalability of this model in overcoming social-cultural barriers and conduct a cost-effectiveness analysis. The RISEinFAMILY project aims to develop an adapted FICare model that can serve as the international standard for neonatal care, accommodating various cultural, architectural, and socio-economic contexts. METHODS RISEinFAMILY is a pluri-cultural, stepped wedge cluster controlled trial conducted in Spain, Netherlands, the UK, Romania, Turkey, and Zambia. Eligible participants include infant-family dyads admitted to the Neonatal Intensive Care Unit (NICU) requiring specialised neonatal care for a minimum expected duration of 7 days, provided there are no comprehension barriers. Notably, this study will incorporate a value of implementation analysis on FICare, which can inform policy decisions regarding investment in implementation activities, even in situations with diverse data. DISCUSSION This study aims to evaluate the scalability and adaptation of FICare across a broader range of geographical and sociocultural contexts and address its sustainability. Furthermore, it seeks to compare the RISEinFAMILY model with standard care, examining differences in short-term newborn outcomes, family mental health, and professional satisfaction. TRIAL REGISTRATION ClinicalTrials.gov NCT06087666. Registered on 17 October 2023. PROTOCOL VERSION 19 December 2022; version 2.2.
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Affiliation(s)
- M T Alferink
- Division of Pediatrics/Neonatology, OLVG, Location East and West, Amsterdam, The Netherlands
| | - B Moreno-Sanz
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research-IdIPAZ, Madrid, Spain
| | | | - E Ergenekon
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - T R de Haan
- Division of Neonatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - A A M W van Kempen
- Division of Pediatrics/Neonatology, OLVG, Location East and West, Amsterdam, The Netherlands
| | - J Lakhwani
- Department of Neonatology, Women and Newborn Hospital, University Teaching Hospitals, Lusaka, Zambia
| | - H Rabe
- Brighton and Sussex Medical School, and Department of Neonatology, University Hospitals Sussex, Brighton and Hove, UK
| | - G C Zaharie
- Division of Neonatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca-Napoca, Romania
| | - A Pellicer
- Department of Neonatology, La Paz University Hospital, Madrid, Spain.
- Hospital La Paz Institute for Health Research-IdIPAZ, Madrid, Spain.
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Nedergaard HK, Weitling EE, Rahbech M, Frøslev-Friis C, Quitzau LH, Strøm T, Brøchner AC, Jensen HI. Presence of the partner in the operating room during a category 1 cesarean section: a prospective explorative study. Int J Obstet Anesth 2024; 57:103939. [PMID: 37891124 DOI: 10.1016/j.ijoa.2023.103939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/19/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Little information exists regarding attitudes related to the presence of the partner in the operation room (OR) during category 1 emergency cesarean section (cat. 1 CS). We investigated how cat. 1 CS under general anesthesia is experienced, both by partners present in the OR and those not. METHODS An explorative prospective cohort trial, with qualitative elements, involving all cat. 1 CS in 2022 in two hospitals. At site 1 the partner was present in the OR during cat. 1 CS, whereas at site 2 the partner was not. Parents and staff answered questionnaires following each cat. 1 CS and semi-structured interviews with partners were held three months after surgery. Qualitative data were analyzed using content analysis. The primary outcome was the partner's answer to the question: "Would you have preferred not being present/being present in the OR?" respectively. RESULTS Seventeen and eight cat. 1 CS occurred at each site respectively. All parents agreed to participate. No partners in site 1 would have preferred to wait outside, and all evaluated the experience very positively. Partners at site 2 also evaluated not being present positively. Overarching themes from the qualitative analysis were "Being the family witness" and "Experience of being the partner". Mothers and staff from site 1 were very positive about their partners' presence. CONCLUSION Partners present in the OR during cat. 1 CS under general anesthesia evaluated this very positively. Most partners, who had not been present in the OR, also evaluated this positively. No partners had post-traumatic stress.
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Affiliation(s)
- H K Nedergaard
- Department of Anesthesiology and Intensive Care, University Hospital of Southern Denmark, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - E E Weitling
- Department of Anesthesiology and Intensive Care, University Hospital of Southern Denmark, Kolding, Denmark
| | - M Rahbech
- Department of Anesthesiology and Intensive Care, University Hospital of Southern Denmark, Kolding, Denmark
| | - C Frøslev-Friis
- Department of Anesthesiology and Intensive Care, Aabenraa Hospital, Denmark
| | - L H Quitzau
- Department of Anesthesiology and Intensive Care, Aabenraa Hospital, Denmark
| | - T Strøm
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Anesthesiology and Intensive Care, Aabenraa Hospital, Denmark
| | - A C Brøchner
- Department of Anesthesiology and Intensive Care, University Hospital of Southern Denmark, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - H I Jensen
- Department of Anesthesiology and Intensive Care, University Hospital of Southern Denmark, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Macleod E, Heffernan T, Greenwood LM, Walker I, Lane J, Stanley SK, Evans O, Calear AL, Cruwys T, Christensen BK, Kurz T, Lancsar E, Reynolds J, Rodney Harris R, Sutherland S. Predictors of individual mental health and psychological resilience after Australia's 2019-2020 bushfires. Aust N Z J Psychiatry 2024; 58:58-69. [PMID: 37264605 PMCID: PMC10756019 DOI: 10.1177/00048674231175618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIMS We assessed the mental health effects of Australia's 2019-2020 bushfires 12-18 months later, predicting psychological distress and positive psychological outcomes from bushfire exposure and a range of demographic variables, and seeking insights to enhance disaster preparedness and resilience planning for different profiles of people. METHODS We surveyed 3083 bushfire-affected and non-affected Australian residents about their experiences of bushfire, COVID-19, psychological distress (depression, anxiety, stress, post-traumatic stress disorder) and positive psychological outcomes (resilient coping, wellbeing). RESULTS We found high rates of distress across all participants, exacerbated by severity of bushfire exposure. For people who were bushfire-affected, being older, having less financial stress, and having no or fewer pre-existing mental disorders predicted both lower distress and higher positive outcomes. Being male or having less income loss also predicted positive outcomes. Severity of exposure, higher education and higher COVID-19-related stressors predicted both higher distress and higher positive outcomes. Pre-existing physical health diagnosis and previous bushfire experience did not significantly predict distress or positive outcomes. RECOMMENDATIONS To promote disaster resilience, we recommend investment in mental health, particularly for younger adults and for those in rural and remote areas. We also recommend investment in mechanisms to protect against financial distress and the development of a broader definition of bushfire-related impacts than is currently used to capture brushfires' far-reaching effects.
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Affiliation(s)
- Emily Macleod
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Timothy Heffernan
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- School of Built Environment, University of New South Wales, Sydney, NSW, Australia
| | - Lisa-Marie Greenwood
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Iain Walker
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Melbourne Centre for Behaviour Change, The University of Melbourne, Parkville, VIC, Australia
| | - Jo Lane
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia
| | - Samantha K Stanley
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Olivia Evans
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Tegan Cruwys
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Bruce K Christensen
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Tim Kurz
- School of Psychological Science, The University of Western Australia, Perth, WA, Australia
| | - Emily Lancsar
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Julia Reynolds
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Rachael Rodney Harris
- Centre for Entrepreneurial Agri-Technology, The Australian National University, Canberra, ACT, Australia
| | - Stewart Sutherland
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
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Jensen-Campbell LA, Liegey Dougall A, Heller AC, Iyer-Eimerbrink P, Bland MK, Hull K. Do Social Support and Loneliness Influence Emerging Adults' Mental Health during the First Year of the COVID-19 Pandemic? Brain Sci 2023; 13:1691. [PMID: 38137139 PMCID: PMC10741457 DOI: 10.3390/brainsci13121691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/09/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
Youths' mental health is at a crisis level, with mental health problems doubling in the US since the pandemic began. To compound the mental health crisis, there is a global loneliness epidemic, with emerging adults worldwide experiencing some of the highest rates. One study with two phases examined the influence of social support and loneliness on mental health in US emerging adults during the pandemic, including changes in these relationships over one year. Emerging adults (N = 449) completed online questionnaires via Prolific in May 2020 (Phase 1) and again from January to May 2021 (N = 253; Phase 2). More perceived support was related to reduced loneliness, with family support having the most significant influence. Loneliness mediated the link between perceived support and adverse health outcomes. Higher loneliness predicted more perceived stress and sleep difficulties concurrently and over time. There was a bidirectional relationship between loneliness and depression, such that higher levels of either variable at Time 1 predicted increases in the other over time. Results highlight the detrimental impact of loneliness on emerging adults' mental health.
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Affiliation(s)
- Lauri A. Jensen-Campbell
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA; (A.L.D.); (M.K.B.); (K.H.)
| | - Angela Liegey Dougall
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA; (A.L.D.); (M.K.B.); (K.H.)
| | - Abigail C. Heller
- Department of Psychology, Belmont University, Nashville, TN 37212, USA;
| | - Priya Iyer-Eimerbrink
- Department of Psychology, University of North Texas at Dallas, Dallas, TX 75241, USA;
| | - Michelle K. Bland
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA; (A.L.D.); (M.K.B.); (K.H.)
| | - Kristen Hull
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA; (A.L.D.); (M.K.B.); (K.H.)
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11
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Wells R, Acarturk C, Mozumder MK, Kurt G, Klein L, Lekkeh SA, Beetar A, Jahan S, Almeamari F, Faruk MO, McGrath M, Alam SF, Alokoud M, Dewan R, Vecih AE, El-Dardery H, Hadzi-Pavlovic D, Hammadi H, Hamoud MAS, Hasan MT, Joshi R, Kothaa S, Lamia FKC, Mastrogiovanni C, Najjar H, Nemorin S, Nicholson-Perry K, Prokrity TS, Said Yousef R, Tawakol M, Uygun E, Yasaki W, Wong S, Zarate A, Steel Z, Rosenbaum S. Testing the effectiveness and acceptability of online supportive supervision for mental health practitioners in humanitarian settings: a study protocol for the caring for carers project. BMC Psychiatry 2023; 23:884. [PMID: 38017407 PMCID: PMC10683137 DOI: 10.1186/s12888-023-05246-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/01/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Local humanitarian workers in low and middle-income countries must often contend with potentially morally injurious situations, often with limited resources. This creates barriers to providing sustainable mental health and psychosocial support (MHPSS) to displaced individuals. Clinical supervision is an often neglected part of ensuring high-quality, sustainable care. The Caring for Carers (C4C) project aims to test the effectiveness and acceptability of online group-based supportive supervision on the well-being of MHPSS practitioners, as well as service-user-reported service satisfaction and quality when working with displaced communities in Türkiye, Syria, and Bangladesh. This protocol paper describes the aim, design, and methodology of the C4C project. METHOD A quasi-experimental, mixed-method, community-based participatory research study will be conducted to test the effectiveness of online group-based supportive clinical supervision provided to 50 Syrian and 50 Bangladeshi MHPSS practitioners working with Syrian and Rohingya displaced communities. Monthly data will be collected from the practitioners and their beneficiaries during the active control (six months) and supervision period (16 months over two terms). Outcomes are psychological distress (Kessler-6), burnout (the Copenhagen Burnout Inventory), compassion fatigue, compassion satisfaction, and secondary traumatic stress (Professional Quality of Life Scale), perceived injustice, clinical self-efficacy (Counseling Activity Self-Efficacy Scale), service satisfaction, and quality (Client Satisfaction Questionnaire and an 18-item measure developed in this project). A realist evaluation framework will be used to elucidate the contextual factors, mechanisms, and outcomes of the supervision intervention. DISCUSSION There is a scarcity of evidence on the role of clinical supervision in improving the well-being of MHPSS practitioners and the quality of service they provide to displaced people. By combining qualitative and quantitative data collection, the C4C project will address the long-standing question of the effectiveness and acceptability of clinical supervision in humanitarian settings.
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Affiliation(s)
- Ruth Wells
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia.
| | - Ceren Acarturk
- Department of Psychology, Koc University, Istanbul, Türkiye
| | | | - Gülşah Kurt
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Louis Klein
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | | | | | - Sabiha Jahan
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | | | - Md Omar Faruk
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Michael McGrath
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Syeda Fatema Alam
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | | | - Ranak Dewan
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | | | | | - Dusan Hadzi-Pavlovic
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | | | | | - M Tasdik Hasan
- Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia
| | - Rohina Joshi
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Sowmic Kothaa
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | | | - Chiara Mastrogiovanni
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | | | - Shaun Nemorin
- New South Wales Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
| | - Kathryn Nicholson-Perry
- Discipline of Psychological Science, Australian College of Applied Psychology, Sydney, Australia
| | | | | | - Mamoun Tawakol
- Department of Psychology, Koc University, Istanbul, Türkiye
| | - Ersin Uygun
- Trauma and Disaster Mental Health, Bilgi University, Istanbul, Türkiye
| | - Wael Yasaki
- Hope Revival Organization, Gaziantep, Türkiye
| | - Scarlett Wong
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Ariel Zarate
- Suicide Prevention Subgroup, Cox's Bazar, Bangladesh
| | - Zachary Steel
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Simon Rosenbaum
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
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12
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Mahamid F, Veronese G, Bdier D. Development of a context-specific trauma scale among a Palestinian adult population living amidst military violence. Glob Ment Health (Camb) 2023; 10:e79. [PMID: 38161743 PMCID: PMC10755377 DOI: 10.1017/gmh.2023.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/08/2023] [Accepted: 11/18/2023] [Indexed: 01/03/2024] Open
Abstract
The current study aimed to develop a context-specific trauma scale in the Palestinian context. The sample of our study consisted of 490 Palestinian adults - 230 males and 260 females. Our scale ended up with 32 items to measure traumatic symptoms in the Palestinian context. Results of exploratory factor analysis and confirmatory factor analysis revealed a stable construct of a five-factor structure of the Palestinian specific-context trauma: (1) re-experiencing trauma, (2) avoidance and numbing, (3) hyperarousal, (4) somatic symptoms and (5) psychological symptoms. Reliability of the scale was further established by assessing the test-retest and internal consistency of all subscales. Convergent validity for the context-specific trauma scale was conducted by testing the association between the scale and two existing measures - the WHOQOL-BREF and the Impact of the Event Scale (IES-R). We recommend using our scale in empirical studies incorporating spoken or written disclosure about traumatic experiences. The scale should also be considered when working with clinical and non-clinical groups who have experienced politics-related trauma.
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Affiliation(s)
- Fayez Mahamid
- Psychology and Counseling Department, An-Najah National University, Nablus, Palestine
| | - Guido Veronese
- Department of Human Sciences and Education, University of Milano-Bicocca, Milan, Italy
| | - Dana Bdier
- Psychology and Counseling Department, An-Najah National University, Nablus, Palestine
- Department of Human Sciences and Education, University of Milano-Bicocca, Milan, Italy
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13
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Jewkes R, Milovanovic M, Otwombe K, Hlongwane K, Hill N, Mbowane V, Gray G, Coetzee J. Understanding drivers of female sex workers' experiences of external/enacted and internalised stigma: findings from a cross-sectional community-centric national study in South Africa. CULTURE, HEALTH & SEXUALITY 2023; 25:1433-1448. [PMID: 36592099 DOI: 10.1080/13691058.2022.2160014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/14/2022] [Indexed: 01/03/2023]
Abstract
To deepen our understanding of sex work stigma, and to its drivers and their interrelation, we conducted an analysis using structural equation modelling of the South African National Sex Worker Survey. We enrolled 3005 women in sex work using multi-stage sampling across all South Africa's provinces. Experience of external/enacted and internalised stigma was widespread. Non-partner rape, intimate partner violence and partner controlling behaviour (often expressions of external/enacted stigma) compounded internalised stigma. These experiences of violence, other manifestations of external/enacted stigma and food insecurity, were key drivers of internalised stigma, and often had an impact on mental health. We found that considerable protection against stigma emanated from viewing sex work positively. This resistance to stigma provided opportunities to shift the narrative. Reducing sex workers' exposure to external/enacted stigmatising behaviour, including by enabling more to work indoors, and providing greater protection from partner violence and rape, are critical for better health and well-being. Ending the criminalisation of sex work is foundational for safer working conditions and better health outcomes for sex workers, similarly providing adequately funded mental and physical health and social care through sex work specific programmes.
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Affiliation(s)
- Rachel Jewkes
- Gender & Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Office of the President, South African Medical Research Council, Tygerberg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Minja Milovanovic
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Soweto, South Africa
- African Potential Foundation, Kyalami, South Africa
| | - Kennedy Otwombe
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Soweto, South Africa
| | - Khuthadzo Hlongwane
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Soweto, South Africa
| | - Naomi Hill
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Hillbrow, South Africa
| | - Venice Mbowane
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Soweto, South Africa
| | - Glenda Gray
- Office of the President, South African Medical Research Council, Tygerberg, South Africa
| | - Jenny Coetzee
- Gender & Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Soweto, South Africa
- African Potential Foundation, Kyalami, South Africa
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14
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Paphitis S, Akilu F, Chilambo N, Iruayenama A, Samaroo X, Mustapha A, Goldsmith K, Ismail O, Slovak P, Ikpe E, Smith P, Patel P, Sullivan R, Abas M, Olonisakin F. Toward an integrated approach for mental health and psychosocial support and peacebuilding in North-East Nigeria: programme description and preliminary outcomes from 'Counselling on Wheels'. BJPsych Open 2023; 9:e190. [PMID: 37822220 PMCID: PMC10594183 DOI: 10.1192/bjo.2023.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Despite theoretical support for including mental health and psychosocial support (MHPSS) with peacebuilding, few programmes in conflict-affected regions fully integrate these approaches. AIMS To describe and assess preliminary outcomes of the Counselling on Wheels programme delivered by the NEEM Foundation in the Borno State of North-East Nigeria. METHOD We first describe the components of the Counselling on Wheels programme, including education and advocacy for peace and social cohesion through community peacebuilding partnerships and activities, and an MHPSS intervention open to all adults, delivered in groups of eight to ten people. We then conducted secondary analysis of data from 1550 adults who took part in the MHPSS intervention, who provided data at baseline and 1-2 weeks after the final group session. Vulnerability to violent extremism was assessed with a locally developed 80-item scale. Symptoms of common mental disorders were assessed with the Depression, Anxiety and Stress Scale (DASS-21) and Post-Traumatic Stress Disorder Scale (PTSD-8). Data were analysed through a mixed-effect linear regression model, accounting for clustering by community and adjusted for age and gender. RESULTS After taking part in group MHPSS, scores fell for depression (-5.8, 95% CI -6.7 to -5.0), stress (-5.5, 95% CI -6.3 to -4.6), post-traumatic stress disorder (-2.9, 95% CI -3.4 to -2.4) and vulnerability to violent extremism (-44.6, 95% CI -50.6 to -38.6). CONCLUSIONS The Counselling on Wheels programme shows promise as a model for integrating MHPSS with community peacebuilding activities in this conflict-affected region of Africa.
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Affiliation(s)
- Sharli Paphitis
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Department of Philosophy, Rhodes University, South Africa
| | - Fatima Akilu
- Department of Psychology, Research and Policy, The NEEM Foundation, Abuja, Nigeria; and African Leadership Centre, School of Global Affairs, Faculty of Social Sciences and Public Policy, King's College London, UK
| | - Natasha Chilambo
- African Leadership Centre, School of Global Affairs, Faculty of Social Sciences and Public Policy, King's College London, UK
| | - Abiye Iruayenama
- Department of Psychology, Research and Policy, The NEEM Foundation, Abuja, Nigeria
| | - Xena Samaroo
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Asma'u Mustapha
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Kimberley Goldsmith
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Olawale Ismail
- African Leadership Centre, School of Global Affairs, Faculty of Social Sciences and Public Policy, King's College London, UK
| | - Petr Slovak
- Department of Informatics, King's College London, UK
| | - Eka Ikpe
- African Leadership Centre, School of Global Affairs, Faculty of Social Sciences and Public Policy, King's College London, UK
| | - Patrick Smith
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Preeti Patel
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Centre for Conflict and Health Research, King's College London, UK
| | - Richard Sullivan
- Faculty of Life Sciences and Medicine, King's College London, UK
| | - Melanie Abas
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Funmi Olonisakin
- African Leadership Centre, School of Global Affairs, Faculty of Social Sciences and Public Policy, King's College London, UK
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15
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Fu L, Wang B, Wu K, Yang L, Hong Z, Wang Z, Meng X, Ma P, Qi X, Xu G, Wang F, Zhang W, Huang C, Zhang D, Lin Y, Cao W, Sun P, Wu W, Gao Y, Lv F, Qian J, Lu H, Zou H. Epidemiological characteristics, clinical manifestations, and mental health status of human mpox cases: A multicenter cross-sectional study in China. J Med Virol 2023; 95:e29198. [PMID: 37881113 DOI: 10.1002/jmv.29198] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023]
Abstract
Human mpox is occurring worldwide, however, evidence from the Asian Pacific Region is limited. In this multicenter cross-sectional study, information of confirmed mpox cases diagnosed between June 1 and July 31, 2023 in China. Information included demographic and epidemiological characteristics, and clinical manifestations, laboratory results, and mental health status of mpox cases. A total of 115 confirmed mpox cases were enrolled. All cases were men. A total of 102 (90.3%) identified as homosexual. The median age was 31.0 years (interquartile range 27.0-36.5). A total of 65 (56.5%) were HIV-positive, of whom 92.3% were receiving antiretroviral therapy (ART). A total of 19/39 (40.4%) had a CD4 cell count <500 cells/μL. Systemic features such as fever (73.0%), lymphadenopathies (49.6%), and myalgia (28.7%) were commonly observed. Skin lesions were present in all participants: 49.6% in the genital area and 27.0% in the perianal area. Vesicular rash (78.3%) and papular rash (44.3%) were the most common lesion morphologies. People living with HIV were more likely to have anxiety than those living without HIV. The majority of mpox cases had primary genital lesions and sexual activities before diagnosis, which supports the likelihood of sexual contact transmission. Guidelines on hospitalization and isolation protocols for mpox patients necessitate further confirmation.
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Affiliation(s)
- Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Ke Wu
- Beijing Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Liuqing Yang
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern, University of Science and Technology, Shenzhen, China
| | - Zhongsi Hong
- Department of Infectious Diseases, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Ziyu Wang
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China
| | - Xiaojun Meng
- Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Ping Ma
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China
| | - Xiao Qi
- Beijing Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Guangyong Xu
- Department of Dermatology, Qingdao Sixth People's Hospital, Qingdao, Shandong, China
| | - Fuxiang Wang
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern, University of Science and Technology, Shenzhen, China
| | - Weijie Zhang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Chenming Huang
- Beijing Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Dingyan Zhang
- Beijing Chaoyang District Center for Disease Prevention and Control, Beijing, China
| | - Yuanlong Lin
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern, University of Science and Technology, Shenzhen, China
| | - Wanxian Cao
- Division of Life Sciences and Medicine, The First Affiliated Hospital of the University of Science and Technology of China, Hefei, Anhui, China
| | - Ping Sun
- Department of Infectious Diseases, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Weibo Wu
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern, University of Science and Technology, Shenzhen, China
| | - Yong Gao
- Division of Life Sciences and Medicine, The First Affiliated Hospital of the University of Science and Technology of China, Hefei, Anhui, China
| | - Fan Lv
- National Center for AIDS/Sexually Transmitted Disease Control and Prevention, The Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun Qian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Hongzhou Lu
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern, University of Science and Technology, Shenzhen, China
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Southwest Medical University, Luzhou, China
- Kirby Institute, University of New South Wales, Sydney, Australia
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16
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Ratnamohan L, Silove D, Mares S, Krishna Y, Hadzi-Pavlovic D, Steel Z. Breaching the family walls: Modelling the impact of prolonged visa insecurity on asylum-seeking children. Aust N Z J Psychiatry 2023; 57:1130-1139. [PMID: 36632824 DOI: 10.1177/00048674221148399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Children in asylum-seeking families are increasingly subject to deterrent host nation policies that undermine security in the post-migration context, however, little is known on the mental health consequences of such policy. This study examined the impact of prolonged visa insecurity on child mental health, by comparing two cohorts of refugee children entering Australia between 2010 and 2013, distinguished by visa security. METHODS The insecure visa sample comprised children from Tamil asylum-seeking families, while the secure visa sample was drawn from refugee families participating in the multi-ethnic 'Building a New Life in Australia' cohort study. Children in each sample were assessed for current mental health problems and trauma exposure. Mothers were assessed for trauma exposure, post-migration family stressors and post-traumatic stress disorder (PTSD). The effects of prolonged visa insecurity on child mental health via family-and child-level variables were modelled using multi-level path analysis. RESULTS Data comprised 361 children, aged 10-18, and 242 mothers across three levels of visa insecurity: permanent protection (n = 293), temporary protection (n = 40) and bridging visa (n = 28). Modelling showed that (1) visa insecurity was associated with poorer child mental health, (2) the association was mediated sequentially by post-migration family stressors and maternal PTSD and (3) the association was moderated by maternal PTSD. CONCLUSION Our findings suggest that when government policy persistently undermines post-migration security, the capacity of families to protect children from accrued stressors is lowered, leaving a significantly higher proportion of children developing along trajectories of risk rather than resilience.
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Affiliation(s)
- Lux Ratnamohan
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Rivendell Child, Adolescent and Family Mental Health Service, Thomas Walker Hospital, Concord West, NSW, Australia
| | - Derrick Silove
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Sarah Mares
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Yalini Krishna
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | | | - Zachary Steel
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Rivendell Child, Adolescent and Family Mental Health Service, Thomas Walker Hospital, Concord West, NSW, Australia
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17
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Forrest W, Steel Z. The impact of immigration detention on the mental health of refugees and asylum seekers. J Trauma Stress 2023; 36:642-653. [PMID: 37338992 DOI: 10.1002/jts.22944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/22/2023]
Abstract
Studies consistently report that asylum seekers held in immigration detention have relatively high rates of mental distress, yet evidence of the long-term impact of immigration detention is limited. Using propensity score-based methods, we estimated the impact of immigration detention on the prevalence of nonspecific psychological distress, using the Kessler-6, and probable posttraumatic stress disorder (PTSD), using the PTSD-8, among participants in a national sample of asylum seekers in the 5 years following their resettlement in Australia (N = 334). At Wave 1, the prevalence of nonspecific psychological distress was high among all participants regardless of detainment status, OR = 0.28, 95% CI [0.04, 2.06], and did not change over time for either detainees (n = 222), OR = 1.01, 95% CI [0.46, 2.18], or nondetainees (n = 103), OR = 0.81, 95% CI [0.39, 1.67]. In contrast, the odds of probable PTSD were significantly higher for former detainees, OR = 8.20; 95% CI [2.61, 26.73], than nondetainees at Wave 1; although they declined among former detainees, OR = 0.56, 95% CI [0.38, 0.82]), and increased among nondetainees, OR = 1.57, 95% CI [1.11, 2.23], in the years following resettlement. These results imply the use of immigration detention to manage unauthorized migration increases the prevalence of probable PTSD in the short term among former detainees who have resettled in Australia.
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Affiliation(s)
- Walter Forrest
- School of Law, University of Limerick, Limerick, Ireland
| | - Zachary Steel
- School of Psychiatry, University New South Wales, St. John of God Health Care, Richmond Hospital, North Richmond, Australia
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18
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Olko J, Galbarczyk A, Maryniak J, Krzych-Miłkowska K, Tepec HI, de la Cruz E, Dexter-Sobkowiak E, Jasienska G. The spiral of disadvantage: Ethnolinguistic discrimination, acculturative stress and health in Nahua indigenous communities in Mexico. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023. [PMID: 37060286 DOI: 10.1002/ajpa.24745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 02/21/2023] [Accepted: 03/22/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVES The aim of this study was to test the hypothesis that ethnic and ethnolinguistic discrimination, and Post-Traumatic Stress Disorder (PTSD) related to being Indigenous as well as different aspects of acculturative stress, are associated with poorer health and higher levels of depression among the Nahua Indigenous communities. MATERIALS AND METHODS Our quantitative survey was carried out in four different regions inhabited by the Nahua people in Mexico. Self-rated health and depression, the symptoms of PTSD, two facets of acculturative stress and ethnolinguistic discrimination were assessed by questionnaires. The data were analyzed using binary logistic regression models. RESULTS The symptoms of PTSD and acculturative stress experienced in the workplace were significantly associated with a higher risk of poor self-rated health, adjusted for various socio-demographic characteristics. Acculturative stress, discouragement of language use, language avoidance and ethnolinguistic discrimination were related to a higher risk of depression and PTSD. DISCUSSION Our research implies that ethnic and linguistic discrimination, acculturative stress and the memory of harm linked to being Indigenous reflected in the symptoms of PTSD, are important predictors of poorer health and depression among Nahua groups in Mexico. These adverse effects could be significantly counteracted by effective dealing with stigmatization and discrimination against Indigenous people in Mexico and by replacing strong assimilation pressures with integrational approaches that respect ethnolinguistic diversity and reduce socioeconomic marginalization.
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Affiliation(s)
- Justyna Olko
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
| | - Andrzej Galbarczyk
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Joanna Maryniak
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
| | - Karolina Krzych-Miłkowska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | | | - Eduardo de la Cruz
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
- Instituto de Docencia e Investigación Etnológica de Zacatecas, Zacatecas, Mexico
| | - Elwira Dexter-Sobkowiak
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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19
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Jiang W, Shi G, Li Y, Lu C, Guo L, Zhang W. Dynamic contributions of socioeconomic status to mental health with the resettlement process among refugees. Psychiatry Res 2023; 324:115197. [PMID: 37058795 DOI: 10.1016/j.psychres.2023.115197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/31/2023] [Accepted: 04/09/2023] [Indexed: 04/16/2023]
Abstract
Socioeconomic status (SES) is shown to be associated with refugees' mental health, but few studies have considered that these associations may vary over time. This study aimed to examine the dynamic contributions of SES to refugees' mental health during resettlement. We used five waves of data from a cohort study in Australia; 2399 refugees completed the interview in Wave 1, and the remaining waves had 2009, 1894, 1929, and 1881 participants, respectively. SES, high risk of severe mental illness (HR-SMI), and post-traumatic stress disorder (PTSD) were assessed in each wave. Weighted multilevel regression models were performed, and analyses were stratified by sex. For both sexes, financial hardships were consistently positively associated with HR-SMI and PTSD across all five waves. However, time or sex differences were more pronounced for associations between other SES factors and mental health. For males, there were negative associations of current paid jobs with HR-SMI and PTSD in Waves 3-5. For females, the current paid job was negatively associated with HR-SMI only in Wave 5. Our findings highlight the dynamic associations and sex differences between SES and refugees' mental health. We recommend interventions focusing on increasing employment opportunities, particularly for male refugees in the later resettlement stages.
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Affiliation(s)
- Weiqing Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, China
| | - Guangduoji Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, China
| | - Yanzhi Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, China.
| | - Weihong Zhang
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium
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Seidi PAM, Jaff D, Qudrat Abas N, Chung EO, Wilson MW, Potter H, Palmquist AEL. Mental health status of internally displaced persons in the Garmian region of Kurdistan, Iraq: a cross-sectional survey. Med Confl Surviv 2023:1-15. [PMID: 36992622 DOI: 10.1080/13623699.2023.2188384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
There are an estimated 4 million internally displaced persons (IDPs) in Iraq, mainly settled in the Kurdistan Region of Iraq, and yet few studies have documented the mental health of IDPs in the region. The aims of this study were (1) to assess the prevalence of mental health disorders and trauma experiences amongst IDPs and (2) to explore associations between prior displacement and years living in the camp and mental health disorders. A cross-sectional survey was conducted with adults (N = 100) from March - July 2018. Structured surveys were used to collect sociodemographic information, and adapted measures included the Harvard Trauma Questionnaire (HTQ), Post-traumatic Stress Disorder Inventory (PTSD-8), Hopkins Symptoms Checklist-25 (HSCL-25) and the Post-Migration Living Difficulties Checklist (PMLD). The average number of traumatic events experienced was 4.43 (SD = 2.63). The most commonly reported traumatic events included oppression due to ethnicity, religion or sect (92%) and exposure to combat situations (83%). Nearly half of the participants had experienced ill health without access to medical care, 44% lack of shelter and 43% lack of food or clean water. Thirty-two percent of respondents witnessed someone being murdered. There is a critical need for quality mental health services for IDPs in KR.
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Affiliation(s)
| | - Dilshad Jaff
- Research, Innovation, and Global Solutions, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Nazdar Qudrat Abas
- Department of Psychology, College of education, University of Garmian, Kalar, Iraq
| | - Esther O Chung
- Department of Epidemiology, Gillings School of Global Public Health, Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | | | - Hannah Potter
- Department of Maternal and Child Health, Carolina Global Breastfeeding Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Aunchalee E L Palmquist
- Department of Maternal and Child Health, Carolina Global Breastfeeding Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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21
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Cone N, Lee JE. Older adult communication types and emotional well-being outcomes during COVID-19 pandemic. BMC Geriatr 2023; 23:178. [PMID: 36973663 PMCID: PMC10042399 DOI: 10.1186/s12877-023-03856-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/28/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND The rationale for the present study is a result of the COVID-19 pandemic, as there are fewer opportunities available for older adults to engage in face-to-face interaction and social activities, which may result in changes in the communication methods with their social contacts. The purpose of this study was to explore the relationship between methods of social connectedness and emotional well-being outcomes among older adults at the start of the pandemic. METHODS Two thousand five hundred and fifty-eight older adults Medicare beneficiaries (65 + years of age) in the National Health and Aging Trends Study at wave 10 (June 2020 to January 2021) were selected for cross-sectional analysis. Participants were measured on brief questionnaires regarding forms of communication with family and friends before and during the pandemic. Emotional well-being outcomes were measured on single items of sadness/depressed and loneliness; as well as a 6-item Likert scale of anxiety during the pandemic. Paired sample t-tests were utilized to examine the forms of communication between before and during pandemic. Hierarchical regressions were conducted to assess the relationship between forms of communication and emotional well-being outcomes. RESULTS We found that there were overall decreases in communication frequency during pandemic. Findings from regression analyses indicated information communication technology (ICT) are associated with negative emotional well-being outcomes, whereas in-person social contact are associated with lower levels of negative affect. CONCLUSION These findings suggest utilizing higher levels of ICT has negative implications for older adults' emotional well-being, contrasting with the positive implication of in-person contacts. These findings highlight the role of ICT in emotional well-being among older adults during pandemic.
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Affiliation(s)
- Nicholas Cone
- Human Development and Family Studies, Iowa State University, 2222 Osborn Dr, Ames, IA, 50011-1084, United States of America.
| | - Jeong Eun Lee
- Human Development and Family Studies, Iowa State University, 2222 Osborn Dr, Ames, IA, 50011-1084, United States of America
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22
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Norton SE, Hunt C, Lah S. Fear of sleep in people with epilepsy. Epilepsy Res 2023; 192:107124. [PMID: 36940587 DOI: 10.1016/j.eplepsyres.2023.107124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
More than one third of people with epilepsy (PWE) report experiencing insomnia. This is highly concerning given that sleep loss both triggers and exacerbates seizures. It is therefore paramount that we understand the underlying mechanisms of insomnia in PWE. Nevertheless, research in this area remains limited, with little understanding of the emerging or maintaining factors of insomnia in PWE. Therefore, the current study sought to explore fear of sleep as a novel explanation for the increased rate of insomnia in PWE, and whether fear of sleep was related to post-seizure trauma. We recruited 184 PWE and 197 healthy controls via social media and collected data using a series of online questionnaires. We found that fear of sleep did not significantly differ between the epilepsy and control group. In the epilepsy group, fear of sleep seemed to be largely driven by trauma, especially post-seizure trauma but also non-seizure related trauma, along with anxiety and higher seizure frequency. Fear of sleep in the control group was also largely driven by trauma, but also anxiety and depression. Finally, we found more severe and prevalent insomnia in PWE relative to controls, and in both groups, fear of sleep was the most significant contributor to insomnia. Our novel findings carry important clinical implications. First, they point to the central role of trauma in fear of sleep not only in PWE but also in the general population. Our findings also indicate that fear of sleep is an important maintaining factor of insomnia. Ultimately, these results suggest that all individuals with insomnia may benefit from insomnia interventions targeted at trauma, depression, anxiety, and fear of sleep. PWE are likely to benefit from additional treatment components for seizure-related trauma and seizure management. To better understand the reliability and generalisability of our novel findings, future research should further assess fear of sleep and its role in maintaining insomnia in the epilepsy population.
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Affiliation(s)
- Shanae Ella Norton
- Department of Psychology, University of Sydney, Camperdown, Sydney, Australia
| | - Caroline Hunt
- Department of Psychology, University of Sydney, Camperdown, Sydney, Australia
| | - Suncica Lah
- Department of Psychology, University of Sydney, Camperdown, Sydney, Australia.
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23
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Llewellyn A, Buckle L, Grieve S, Birklein F, Brunner F, Goebel A, Harden RN, Bruehl S, Vaughan-Spickers N, Connett R, McCabe C. Delphi study to define core clinical outcomes for inclusion in a complex regional pain syndrome international research registry and data bank. Pain 2023; 164:543-554. [PMID: 36006075 DOI: 10.1097/j.pain.0000000000002729] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT Complex regional pain syndrome (CRPS) clinical trials have historically captured a diverse range of outcomes. A minimum set of CRPS patient-reported outcomes has been agreed for inclusion in a future CRPS international clinical research registry and data bank. This study aimed to identify a complementary set of core clinical outcomes. Clinicians and researchers from the international CRPS community informed the content of a 2-round electronic Delphi study. Participation was invited from members of the International Association for the Study of Pain CRPS Special Interest Group and the International Research Consortium for CRPS. In round 1, participants rated the relevance of 59 clinical outcomes in relation to the question "What is the clinical presentation and course of CRPS, and what factors influence it?" (1 = not relevant and 9 = highly relevant). In round 2, participants rerated each outcome in the light of the round 1 median scores. The criterion for consensus was median score ≥7, agreed by 75% of respondents. The core study team considered the feasibility of data collection of each identified outcome in agreeing final selections. Sixty respondents completed both survey rounds, with responses broadly consistent across professions. Nine outcomes met the consensus criterion. Final outcomes recommended for inclusion in the core clinical set were record of medications, presence of posttraumatic stress disorder, extent of allodynia, and skin temperature difference between limbs. Study findings provide robust recommendations for core clinical outcome data fields in the future CPRS international clinical research registry. Alongside patient-reported outcomes, these data will enable a better understanding of CRPS.
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Affiliation(s)
- Alison Llewellyn
- School of Health and Social Wellbeing, University of the West of England, Bristol, United Kingdom
- Research and Education, Dorothy House Hospice, Winsley, Bradford-on-Avon, United Kingdom
| | - Lisa Buckle
- School of Health and Social Wellbeing, University of the West of England, Bristol, United Kingdom
- Research and Development Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, United Kingdom
| | - Sharon Grieve
- School of Health and Social Wellbeing, University of the West of England, Bristol, United Kingdom
- Research and Development Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, United Kingdom
| | - Frank Birklein
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Florian Brunner
- Department of Physical Medicine and Rheumatology, Balgrist University Hospital, Zurich, Switzerland
| | - Andreas Goebel
- Department of Pain Medicine, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - R Norman Harden
- Departments of PM&R and Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United States
| | | | | | - Candida McCabe
- School of Health and Social Wellbeing, University of the West of England, Bristol, United Kingdom
- Research and Education, Dorothy House Hospice, Winsley, Bradford-on-Avon, United Kingdom
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24
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Meinck F, Woollett N, Franchino-Olsen H, Silima M, Thurston C, Fouché A, Monaisa K, Christofides N. Interrupting the intergenerational cycle of violence: protocol for a three-generational longitudinal mixed-methods study in South Africa (INTERRUPT_VIOLENCE). BMC Public Health 2023; 23:395. [PMID: 36849941 PMCID: PMC9969039 DOI: 10.1186/s12889-023-15168-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 01/31/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Violence is a global social and human rights issue with serious public health implications across the life-course. Interpersonal violence is transmitted across generations and there is an urgent need to understand the mechanisms of this transmission to identify and inform interventions and policies for prevention and response. We lack an evidence-base for understanding the underlying mechanisms of the intra- and intergenerational transmission of violence as well as potential for intervention, particularly in regions with high rates of interpersonal violence such as sub-Saharan Africa. The study has three aims: 1) to identify mechanisms of violence transmission across generations and by gender through quantitative and qualitative methods; 2) to examine the effect of multiple violence experience on health outcomes, victimisation and perpetration; 3) to investigate the effect of structural risk factors on violence transmission; and 4) to examine protective interventions and policies to reduce violence and improve health outcomes. METHODS INTERRUPT_VIOLENCE is a mixed-methods three-generational longitudinal study. It builds on a two-wave existing cohort study of 1665 adolescents in South Africa interviewed in 2010/11 and 2011/12. For wave three and possible future waves, the original participants (now young adults), their oldest child (aged 6+), and their former primary caregiver will be recruited. Quantitative surveys will be carried out followed by qualitative in-depth interviews with a subset of 30 survey families. Adults will provide informed consent, while children will be invited to assent following adult consent for child participation. Stringent distress and referral protocols will be in place for the study. Triangulation will be used to deepen interpretation of findings. Qualitative data will be analysed thematically, quantitative data using advanced longitudinal modelling. Ethical approval was granted by the University of Edinburgh, University of the Witwatersrand, North-West University, and the Provincial Department of Health Mpumalanga. Results will be published in peer-reviewed journals, policy briefs, and at scientific meetings. DISCUSSION The proposed study represents a major scientific advance in understanding the transmission and prevention of violence and associated health outcomes and will impact a critically important societal and public health challenge of our time.
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Affiliation(s)
- Franziska Meinck
- School of Social and Political Sciences, University of Edinburgh, 15a George Square, Edinburgh, EH8 9LD UK
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- OPTENTIA, North-West University, Vanderbijlpark, South Africa
| | - Nataly Woollett
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Visual Arts, University of Johannesburg, Johannesburg, South Africa
| | - Hannabeth Franchino-Olsen
- School of Social and Political Sciences, University of Edinburgh, 15a George Square, Edinburgh, EH8 9LD UK
| | - Mpho Silima
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Christina Thurston
- School of Social and Political Sciences, University of Edinburgh, 15a George Square, Edinburgh, EH8 9LD UK
| | - Ansie Fouché
- Department of Social Wellbeing, United Arab Emirates University, Al Ain, UAE
- Compres, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Kopano Monaisa
- OPTENTIA, North-West University, Vanderbijlpark, South Africa
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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25
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Li LW, Hu RX, Luo MS, McLaughlin SJ. Prepandemic Social Integration: Protection or Risk for Older Adults in the Time of COVID-19? J Gerontol B Psychol Sci Soc Sci 2023; 78:330-340. [PMID: 36371802 PMCID: PMC9938925 DOI: 10.1093/geronb/gbac177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To examine the association between prepandemic social integration and posttraumatic stress disorder (PTSD) symptoms during the coronavirus disease 2019 (COVID-19) pandemic and test whether the association is mediated by social support received and social events missed during the pandemic. We also explored age, race, gender, and socioeconomic differences in the association. METHODS We adopted a prospective design. Path analysis was conducted using data from the COVID-19 supplement (2020) and the 2019 wave of the National Health and Aging Trends Study (NHATS). The sample represents Medicare beneficiaries aged 70 years and older (N = 2,694). Social integration was measured using a six-item index. A standardized scale assessed PTSD symptoms. Both social support received and social events missed were single-item measures. The analysis controlled for sociodemographic characteristics, prepandemic physical and mental health, and coronavirus exposure during the pandemic. RESULTS Prepandemic social integration was positively associated with PTSD symptoms during the pandemic. The association was primarily mediated by social events missed-high levels of prepandemic social integration were associated with missing more social events during the pandemic resulting in more PTSD symptoms. Social support received was also a mediator-social integration was positively associated with social support received during the pandemic, with more received support associated with greater PTSD symptoms. Prepandemic social integration had no significant direct effect on PTSD symptoms. The direct, indirect, and total effects of social integration on PTSD symptoms did not significantly differ by age, race, gender, education, or poverty status. DISCUSSION Social integration may carry mental health risks in times of infectious disease outbreaks.
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Affiliation(s)
- Lydia W Li
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Rita Xiaochen Hu
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Meng Sha Luo
- Department of Sociology, Zhejiang University, Hangzhou, Zheijiang, China
| | - Sara J McLaughlin
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
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26
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Mavragani A, Deady M, Mead O, Foright RM, Brenneman EM, Yeager JR, Bryant RA, Harvey SB. Web-Based Mind-Body Tactical Resilience Training Program for First Responders: Pre-Post Study Assessing Feasibility, Acceptability, and Usability. JMIR Form Res 2023; 7:e40145. [PMID: 36724011 PMCID: PMC9932877 DOI: 10.2196/40145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 12/17/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND First responders report elevated rates of mental disorders, including posttraumatic stress disorder (PTSD), yet many are reluctant to seek care. Preventative resilience training programs attempt to proactively address this issue, and there is evidence showing promise for programs targeting cognitive processes. However, these programs rarely address the physical health conditions associated with PTSD. There is emerging evidence of mind-body exercise training improving PTSD symptoms as well as its associated physical health symptoms. However, the feasibility and acceptability of delivering a web-based mind-body resilience training among first responders are not yet known. OBJECTIVE This study aimed to evaluate the feasibility, usability, and acceptability of a web-based mind-body tactical resilience training program designed for first responders. In addition, we explored the preliminary effectiveness of the training program on mental health outcomes, adaptive cognitive strategies, and work productivity. METHODS A total of 42 first responders based in the United States enrolled in the web-based training program. Participants were administered web-based surveys before enrolling in the 6-week web-based program and at the end of the program. The primary outcomes of feasibility were measured using the number of training hours, program adherence rates, and self-reported data on frequency of practice. Acceptability and usability were measured using self-reported data. Secondary outcomes were symptoms of PTSD, psychological distress, emotion regulation, stress mindset, psychological preparedness, and work performance. RESULTS Overall, the training program was feasible based on the median number of training hours spent on the web-based program (7.57 hours out of an expected total of 6 to 9 hours), and 55% (23/42) of the enrolled participants completed more than half of the program. Although acceptability, usability, and frequency of practice were rated as high, this was based on only 29% (12/42) of the respondents who provided follow-up data. Secondary outcomes showed a significant improvement in the adaptive cognitive strategy of the stress mindset, with a mean difference of -5.42 (SD 4.81; 95% CI -8.475 to -2.358; t11=-3.898; P=.002). All other secondary outcomes were not significant. However, the secondary outcomes were exploratory only, and this study was neither designed nor powered to adequately assess efficacy. CONCLUSIONS These findings suggest that a mind-body tactical resilience training program delivered in a web-based format is feasible and acceptable among first responders; however, further refinements may be required to improve adherence rates. Further research using a larger, more rigorous trial design is warranted to examine the effectiveness of this type of training as a possible prevention or treatment strategy for this population.
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Affiliation(s)
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Olivia Mead
- YogaShield Yoga For First Responders, Castle Rock, CO, United States
| | - Rebecca M Foright
- YogaShield Yoga For First Responders, Castle Rock, CO, United States.,Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Eric M Brenneman
- YogaShield Yoga For First Responders, Castle Rock, CO, United States
| | - Jamie R Yeager
- YogaShield Yoga For First Responders, Castle Rock, CO, United States
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, Australia
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Hong M, Yi EHG, Kim H. Ethnoracial Disparities in Posttraumatic Stress Disorder Symptoms during the COVID-19 Pandemic: A Brief Report. J Appl Gerontol 2023; 42:336-340. [PMID: 36255221 PMCID: PMC9579819 DOI: 10.1177/07334648221134370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Despite the well-identified vulnerability of older adults during the COVID-19 pandemic, it is unclear about their experiences with COVID-related posttraumatic stress disorder symptomology (COVID-PTSD). This study examined ethnoracial disparities in the level of, and factors associated with, COVID-PTSD using a national data set, including 1926 Whites and 488 ethnoracial minorities. Results showed that ethnoracial minorities reported a greater COVID-PTSD than Whites. COVID-related distress was the common risk factor of COVID-PTSD for the both groups. Being a female and greater social support were associated with COVID-PTSD only for Whites, whereas higher education, greater IADL and fewer ADL limitations were associated with COVID-PTSD for ethnoracial minorities. The findings provided preliminary, but generalizable understanding of ethnoracial disparities in COVID-PTSD, among the Medicare beneficiaries aged ≥65.
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Affiliation(s)
- Michin Hong
- School of Social Work, Indiana University, Indianapolis, IN, USA,Michin Hong, Indiana University, 902 W. New York St., Indianapolis, IN 46202, USA.
| | - Eun-Hye Grace Yi
- Department of Social Work, Indiana State University, Terre Haute, IN, USA
| | - HaeJung Kim
- School of Public Policy and Civic Engagement, Kyung Hee University, Seoul, Republic of Korea
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28
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Williams Roberson S, Nwosu S, Collar EM, Kiehl A, Harrison FE, Bastarache J, Wilson JE, Mart MF, Sevransky JE, Ely EW, Lindsell CJ, Jackson JC. Association of Vitamin C, Thiamine, and Hydrocortisone Infusion With Long-term Cognitive, Psychological, and Functional Outcomes in Sepsis Survivors: A Secondary Analysis of the Vitamin C, Thiamine, and Steroids in Sepsis Randomized Clinical Trial. JAMA Netw Open 2023; 6:e230380. [PMID: 36853612 PMCID: PMC9975932 DOI: 10.1001/jamanetworkopen.2023.0380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/02/2023] [Indexed: 03/01/2023] Open
Abstract
Importance Sepsis is associated with long-term cognitive impairment and worse psychological and functional outcomes. Potential mechanisms include intracerebral oxidative stress and inflammation, yet little is known about the effects of early antioxidant and anti-inflammatory therapy on cognitive, psychological, and functional outcomes in sepsis survivors. Objective To describe observed differences in long-term cognitive, psychological, and functional outcomes of vitamin C, thiamine, and hydrocortisone between the intervention and control groups in the Vitamin C, Thiamine, and Steroids in Sepsis (VICTAS) randomized clinical trial. Design, Setting, and Participants This prespecified secondary analysis reports the 6-month outcomes of the multicenter, double-blind, placebo-controlled VICTAS randomized clinical trial, which was conducted between August 2018 and July 2019. Adult patients with sepsis-induced respiratory and/or cardiovascular dysfunction who survived to discharge or day 30 were recruited from 43 intensive care units in the US. Participants were randomized 1:1 to either the intervention or control group. Cognitive, psychological, and functional outcomes at 6 months after randomization were assessed via telephone through January 2020. Data analyses were conducted between February 2021 and December 2022. Interventions The intervention group received intravenous vitamin C (1.5 g), thiamine hydrochloride (100 mg), and hydrocortisone sodium succinate (50 mg) every 6 hours for 96 hours or until death or intensive care unit discharge. The control group received matching placebo. Main Outcomes and Measures Cognitive performance, risk of posttraumatic stress disorder and depression, and functional status were assessed using a battery of standardized instruments that were administered during a 1-hour telephone call 6 months after randomization. Results After exclusions, withdrawals, and deaths, the final sample included 213 participants (median [IQR] age, 57 [47-67] years; 112 males [52.6%]) who underwent long-term outcomes assessment and had been randomized to either the intervention group (n = 108) or control group (n = 105). The intervention group had lower immediate memory scores (adjusted OR [aOR], 0.49; 95% CI, 0.26-0.89), higher odds of posttraumatic stress disorder (aOR, 3.51; 95% CI, 1.18-10.40), and lower odds of receiving mental health care (aOR, 0.38; 95% CI, 0.16-0.89). No other statistically significant differences in cognitive, psychological, and functional outcomes were found between the 2 groups. Conclusions and Relevance In survivors of sepsis, treatment with vitamin C, thiamine, and hydrocortisone did not improve or had worse cognitive, psychological, and functional outcomes at 6 months compared with patients who received placebo. These findings challenge the hypothesis that antioxidant and anti-inflammatory therapy during critical illness mitigates the development of long-term cognitive, psychological, and functional impairment in sepsis survivors. Trial Registration ClinicalTrials.gov Identifier: NCT03509350.
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Affiliation(s)
- Shawniqua Williams Roberson
- Critical Illness, Brain Dysfunction and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Samuel Nwosu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Erin M. Collar
- Critical Illness, Brain Dysfunction and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Amy Kiehl
- Critical Illness, Brain Dysfunction and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Fiona E. Harrison
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee
| | - Julie Bastarache
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee
| | - Jo Ellen Wilson
- Critical Illness, Brain Dysfunction and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
- Veteran’s Affairs Tennessee Valley Geriatric Research Education Clinical Center, Nashville, Tennessee
| | - Matthew F. Mart
- Critical Illness, Brain Dysfunction and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Veteran’s Affairs Tennessee Valley Geriatric Research Education Clinical Center, Nashville, Tennessee
| | - Jonathan E. Sevransky
- Division of Pulmonary, Allergy Critical Care and Sleep, Emory University School of Medicine, Atlanta, Georgia
- Emory Critical Care Center, Emory Healthcare, Atlanta, Georgia
| | - E. Wesley Ely
- Critical Illness, Brain Dysfunction and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Veteran’s Affairs Tennessee Valley Geriatric Research Education Clinical Center, Nashville, Tennessee
| | | | - James C. Jackson
- Critical Illness, Brain Dysfunction and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Veteran’s Affairs Tennessee Valley Geriatric Research Education Clinical Center, Nashville, Tennessee
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Dietrich H, Estramiana JLÁ, Luque AG, Reissner V. Effects of Posttraumatic Stress Disorder and Mental Disorders on the Labor Market Integration of Young Syrian Refugees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2468. [PMID: 36767834 PMCID: PMC9916024 DOI: 10.3390/ijerph20032468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Civil war experience in the Syrian home country, insecurity and critical life events during migration, or adverse events in the receiving country might affect refugees' mental health. This paper addresses the effects of psychological distress and mental disorders on refugees' labor market integration in Germany between 2016 and 2021. We employ survey data from about 2700 young Syrians, delivering information on individuals' experience of migration and arrival in Germany in 2016. The survey data were successfully merged with register data, delivering detailed information regarding individuals' process of labor market integration and employment status from 2016 to 2021. Overall, the labor market integration of young refugees improved remarkably over time. In 2021, about 69% of the study population was integrated in a wider sense, and 30% was employed in fulltime contracts in 2021. However, the results indicate long-lasting effects of PTSD and mental disorders on individuals' labor market integration, whilst individuals' characteristics related to migration and arrival lose relevance over time and hardly affect labor market integration around five years after arrival. High PTSD scores in 2016 indicate a significantly reduced full-time employment probability in 2021. Anxiety and depression show significant negative effects on individuals' labor market integration, but with a less severe impact compared to a PTSD diagnosis.
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Affiliation(s)
- Hans Dietrich
- Institute for Employment Research (IAB), Regensburger Str. 104, 90478 Nürnberg, Germany
| | - José Luis Álvaro Estramiana
- Departamento de Antropología Social y Psicología Social, Universidad Complutense de Madrid, 28223 Madrid, Spain
| | - Alicia Garrido Luque
- Departamento de Antropología Social y Psicología Social, Universidad Complutense de Madrid, 28223 Madrid, Spain
| | - Volker Reissner
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Wickenburgstr. 21, 45147 Essen, Germany
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Mahmoodi Z, Bahrami G, Ghavidel N, Seddighi H. The effect of social determinants of health on quality of life among Afghan refugees in Iran during the COVID-19 pandemic: a path analysis. BMC Psychiatry 2023; 23:11. [PMID: 36600233 PMCID: PMC9812534 DOI: 10.1186/s12888-022-04502-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has created significant challenges in 2020 in the world and Iran. To help vulnerable groups such as refugees during the response and recovery phases of the COVID-19 pandemic, identifying the quality of life (QOL) and its associated factors is helpful. Considering that research in this field is limited, this study evaluated the effect of social determinants of health on the quality of life among Afghan refugees in Iran during the COVID-19 pandemic. METHODS We conducted a cross-sectional study on 300 Afghan refugees and migrants in Alborz province, Iran, from February to May 2022 using Convenience sampling. Data were completed using the socioeconomic status scale (SES), World Health Organization's quality of life -BREF (WHOQOL), Depression, Anxiety and Stress Scale-21 Items (DASS-21), and COVID-19 Post-Traumatic Stress Disorder Checklist (COVID-PTSD). In addition, path analysis was applied to evaluate the relationships among the research variables with quality of life. RESULTS 64.3% of the study participants were male, with a mean of 29.29 ± 9.64 years. The path analysis showed that SES had the most positive relationship (B = .266), and the number of COVID-19 cases had the most negative relationship (B = -.169) with the quality of life from both paths. The self-rated health had the most positive relationship (B = .25), and the DASS score had the most negative relationship (B = -.2) with the quality of life through only one path. Access to medical services was the only variable that indirectly had a positive causal relationship with QOL (B = .044). CONCLUSION We provided an empirical model that illustrates the relationships between quality of life and social determinants of health among Afghan refugees and migrants during the Covid19 pandemic. The negative emotional states of Depression, Anxiety, and Stress (DAS) as a mediator play an essential role in the quality of life and other variables.
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Affiliation(s)
- Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Giti Bahrami
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Nooshin Ghavidel
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| | - Hamed Seddighi
- Department of Psychology, University of Groningen, Groningen, The Netherlands
- Unit of Child and Family Welfare, Department of Pedagogical and Educational Sciences, University of Groningen, Groningen, The Netherlands
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Drazich BF, Li Q, Perrin NA, Szanton SL, Lee JW, Huang CM, Carlson MC, Samuel LJ, Regier NG, Rebok GW, Taylor JL. The relationship between older adults' technology use, in-person engagement, and pandemic-related mental health. Aging Ment Health 2023; 27:156-165. [PMID: 35243945 PMCID: PMC9440957 DOI: 10.1080/13607863.2022.2046695] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 02/18/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objectives of this study are to 1) describe changes in in-person communication/activity and changes in older adult technology use during the COVID-19 pandemic and 2) examine whether less in-person communication/activity mediates the relationship between pandemic-related mental health and technology use. METHOD Linear regressions (stratified by age and financial strain) and structural equation modeling were employed using a nationally representative, cross-sectional survey of 3,188 older adults from the 2020 National Health and Aging Trends Study's COVID-19 Questionairre. RESULTS Older adults engaged in more technology-based activity (b = 0.24; p<.001), more technology-based health care communication (b = 0.22; p<.001), and more technology-based food acquisition (b = 0.21; p<.001) during the COVID-19 pandemic, as compared to before the pandemic. Results indicate that adults <80 years old demonstrated greater increases in technology-based activity, technology-based health communication, and technology-based food acquisition, compared to adults ≥80 years old. Change in in-person communication significantly mediated the relationship between pandemic-related mental health and technology-based communication (standardized coefficient= -0.012; p=.005), and change in in-person activity significantly mediated the relationship between pandemic-related mental health and technology-based activity (standardized coefficient= -0.017; p=.020). CONCLUSIONS This study suggests that older adults are utilizing technology more, and therefore should be considered in technology design and dissemination. Technology use could be an important positive response to help those with pandemic related worries stay safely engaged with friends and family. Technologies should be produced that are modifiable for older adults with disabilities and affordable for older adults with fixed incomes.
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Affiliation(s)
| | - Qiwei Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Nancy A Perrin
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Department of Health Policy, Johns Hopkins University, Baltimore, MD, USA
- School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
| | - Ji Won Lee
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Chien-Ming Huang
- School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | | | - Laura J Samuel
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
| | - Natalie G Regier
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
| | - George W Rebok
- School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Janiece L Taylor
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
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Carrera-Arce M, Baumler R, Hollander J. A Systematic Review of Assessment Methods for Seafarers' Mental Health and Well-Being During the COVID-19 Pandemic. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231212218. [PMID: 37970799 PMCID: PMC10655656 DOI: 10.1177/00469580231212218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/19/2023] [Accepted: 10/10/2023] [Indexed: 11/19/2023]
Abstract
Seafarers spend more time at sea than on land, which makes them a hard-to-reach community. Since their mental health and well-being is usually addressed from a land-based perspective, dedicated and validated methods incorporating maritime specificities are lacking. During the COVID-19 pandemic, research into seafarers' mental health and well-being flourished. However, a systematic review of the literature to assess the type and appropriateness of assessment methods pertaining to the mental health and well-being of seafarers has yet to be undertaken. This study reviews 5 databases (ERIC, Scopus, PubMed, Google Scholar and EBSCO) to assess the methods used to examine seafarers' mental health and well-being during the pandemic. Peer-reviewed literature alongside grey literature that applied quantitative or qualitative instruments to measure seafarers' mental health and/or well-being, published in English between March 2020 and February 2023, was eligible for the review. Studies from all geographic regions and regardless of nationality, rank and ship type of the subjects were explored. Database searches produced 272 records. Five additional records were identified via other methods. We identified 27 studies suitable for review, including 24 published in peer-reviewed scientific journals and 3 reports and surveys produced by the industry or welfare organizations. Assessment methods used to measure seafarers' mental health and well-being vary significantly in the literature. The frequent use of ad hoc questionnaires limits the possibility to replicate and compare the studies due to various inconsistencies. Furthermore, several validation and reliability measures needed more solidity when applied to the seafaring population. Such inadequate measuring and a mix of assessment methods impacted the comparison of results and might inflate the risks of underreporting or overstating mental complaints.
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Ridehalgh C, Fundaun J, Bremner S, Cercignani M, Young R, Trivedy C, Novak A, Greening J, Schmid A, Dilley A. Does peripheral neuroinflammation predict chronicity following whiplash injury? Protocol for a prospective cohort study. BMJ Open 2022; 12:e066021. [PMID: 36521884 PMCID: PMC9756191 DOI: 10.1136/bmjopen-2022-066021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Whiplash-associated disorder grade 2 (WAD2) is characterised by musculoskeletal pain/tenderness but no apparent nerve injury. However, studies have found clinical features indicative of neuropathy and neuropathic pain. These studies may indicate peripheral nerve inflammation, since preclinical neuritis models found mechanical sensitivity in inflamed, intact nociceptors. The primary aim of this study is to establish the contribution of peripheral neuroinflammation to WAD2 and its role in prognosis. Participants will be invited to participate in a sub-study investigating the contribution of cutaneous small fibre pathology to WAD2. METHODS AND ANALYSIS 115 participants within 1 month following whiplash injury and 34 healthy control participants will be recruited and complete validated questionnaires for pain, function and psychological factors. Data collection will take place at the Universities of Sussex and Oxford, UK. Clinical examination, quantitative sensory testing and blood samples will be undertaken. MRI scans using T2-weighted and diffusion tensor images of the brachial plexus and wrist will determine nerve inflammation and nerve structural changes. Skin biopsies from a substudy will determine structural integrity of dermal and intraepidermal nerve fibres. At 6 months, we will evaluate recovery using Neck Disability Index and a self-rated global recovery question and repeat the outcome measures. Regression analysis will identify differences in MRI parameters, clinical tests and skin biopsies between participants with WAD2 and age/gender-matched controls. Linear and logistic regression analyses will assess if nerve inflammation (MRI parameters) predicts poor outcome. Mixed effects modelling will compare MRI and clinical measures between recovered and non-recovered participants over time. ETHICS AND DISSEMINATION Ethical approval was received from London-Brighton and Sussex Research Ethics Committee (20/PR/0625) and South Central-Oxford C Ethics Committee (18/SC/0263). Written informed consent will be obtained from participants prior to participation in the study. Results will be disseminated through publications in peer-reviewed journals, presentations at national/international conferences and social media. TRIAL REGISTRATION NUMBER NCT04940923.
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Affiliation(s)
- Colette Ridehalgh
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, UK
- School of Sport and Health Sciences, University of Brighton, Eastbourne, UK
| | - Joel Fundaun
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Stephen Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Mara Cercignani
- Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK
| | - Rupert Young
- School of engineering and informatics, University of Sussex, Brighton, UK
| | - Chetan Trivedy
- Emergency Departments, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
- Queen Mary University of London, London, UK
| | - Alex Novak
- Emergency Medicine Research Oxford, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jane Greening
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, UK
| | - Annina Schmid
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Andrew Dilley
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, UK
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Baygi F, Smith A, Mohammadian Khonsari N, Mohammadi-Nasrabadi F, Mahmoodi Z, Mahdavi-Gorabi A, Qorbani M. Seafarers' mental health status and life satisfaction: Structural equation model. Front Public Health 2022; 10:969231. [PMID: 36530699 PMCID: PMC9748074 DOI: 10.3389/fpubh.2022.969231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/09/2022] [Indexed: 12/02/2022] Open
Abstract
Background A variety of factors influence seafarers' health. Such factors might affect their satisfaction with life. Aims To examine the relationships between seafarers' mental health status and satisfaction with life by using a structural equation method. Methods In this survey, 470 seafarers were selected via convenience sampling method from two shipping companies. Validated questionnaires including Satisfaction with Life Scale (SWLS), generalized anxiety disorder-7 (GAD-7), Post-traumatic Stress Disorder-8 (PTSD-8), Patient Health Questionnaire-9 (PHQ-9), General Health Questionnaire-12 (GHQ-12), Perceived Health status and Depression-Anxiety-Stress scale-21 (DASS-21) were used to assess different aspects of well-being and life satisfaction. The stratified path analysis method was applied to analyze the data. Results 439 seafarers (200 officers and 237 non-officers) with a mean age of 34.5 (SD: 8.05) participated in the current study. The GHQ score directly affected satisfaction with life in both officers (β = 0.35) and non-officers (β = 0.40). Also, perceived health status directly and indirectly affected satisfaction with life among officers (β = 0.19) and non-officers (β = 0.06). While officers working days per month indirectly impacted satisfaction with life through the general anxiety disorder, perceived health status, depression, anxiety, stress and current mental health. In non-officers, generalized anxiety disorder had the most potent indirect effects on satisfaction with life through perceived health status and current mental health. Conclusion Perceived health status, directly and indirectly, affected seafarers' satisfaction with life. Measures should be taken in order to improve seafarers' perceived health status and its effects on satisfaction with life.
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Affiliation(s)
- Fereshteh Baygi
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Andrew Smith
- Centre for Occupational and Health Psychology, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | | | - Fatemeh Mohammadi-Nasrabadi
- Food and Nutrition Policy and Planning Research Department, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Armita Mahdavi-Gorabi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Longitudinal consistency of self-reports of adverse childhood experiences among adolescents in a low-income setting. SSM Popul Health 2022; 19:101205. [PMID: 36091299 PMCID: PMC9449854 DOI: 10.1016/j.ssmph.2022.101205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/25/2022] Open
Abstract
A sizeable literature documents the associations between adverse childhood experiences (ACEs) and poor health in later life. By and large, ACEs are measured using retrospective self-reports. Little is known about the longitudinal consistency of these self-reports in panel data with multiple measurements. This is especially true in adolescence, as most studies using ACEs self-reports have been conducted among adults. Furthermore, very few studies have explored the consistency of ACEs self-reports in low- and middle-income countries, where the reported prevalence of ACEs tends to be higher than in high-income countries. Addressing these gaps, the current study examines the consistency of ACEs self-reports among a cohort of adolescents (N = 1,878, age 10 to 16 at survey baseline) in rural Malawi. We use data from two waves of the ACE project of the Malawi Longitudinal Study of Families and Health carried out in 2017-18 and 2021. In addition to the high prevalence of self-reported ACEs among adolescents in our sample, we document very low consistency of self-reports over time (average Kappa coefficient of 0.11). This low consistency is attributable not only to adolescents reporting more ACEs over time, which could be due to new exposures, but also to adolescents reporting fewer ACEs over time. Analyses of survey vignettes indicate that individual and sociocultural perceptions of abuse do not explain this low consistency. We find that external events (such as changes in socioeconomic status and negative economic shocks) and internal psychological states (such as depression and post-traumatic stress disorder) both predict inconsistencies in ACEs self-reports. Compared with results from prior studies, our findings indicate that the longitudinal consistency of ACEs self-reports may be lower in adolescence than in adulthood. Taken together, these findings suggest that ACEs self-reports provided by adults may be biased by key processes unfolding in adolescence. Very low consistency of ACEs self-reports in a cohort of adolescents. Individual and sociocultural perceptions of abuse do not explain low consistency. Psychological states such as depression and PTSD predict inconsistent self-reports. Consistency of ACEs self-reports may be lower in adolescence than in adulthood.
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Adjorlolo S, Adjorlolo P, Andoh-Arthur J, Ahiable EK, Kretchy IA, Osafo J. Post-Traumatic Growth and Resilience among Hospitalized COVID-19 Survivors: A Gendered Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610014. [PMID: 36011649 PMCID: PMC9408188 DOI: 10.3390/ijerph191610014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 05/16/2023]
Abstract
The literature on behavioral outcomes associated with the COVID-19 pandemic is inundated with mental health burdens such as depression and stress disorders. The current study investigated gender invariance on resilience and post-traumatic growth (PTG) as positive psychological changes associated with the COVID-19 pandemic. A total of 381 survivors of the COVID-19 infection completed measurements of resilience, PTG, violence and stigma experience, and mental health problems like post-traumatic stress disorder (PTSD). The data were analyzed using descriptive statistics, correlation, multivariate regression, and a latent profile analysis. The results revealed that more than half of the participants had high scores on resilience (53.6%) and PTG (60.9%). The positive psychological changes, although independent of each other, were moderated by gender, and influenced by the negative experiences of participants such as stigma, violence, and PTSD. Latent profile analyses revealed three classes of participants, two of which were characterized by high scores on mental health problems and PTG. The clusters were invariant across gender. Surviving COVID-19 contributed to resilience and PTG. These can be targeted for intervention programs to mitigate the mental health burden occasioned by the pandemic.
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Affiliation(s)
- Samuel Adjorlolo
- Department of Mental Health, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Legon, Accra P.O. Box LG 43, Ghana
- Research and Grant Institute of Ghana, Legon, Accra P.O. Box LG 1004, Ghana
- Correspondence:
| | - Paul Adjorlolo
- Department of Statistics and Actuarial Science, College of Basic and Applied Sciences, University of Ghana, Legon, Accra P.O. Box LG 43, Ghana
| | - Johnny Andoh-Arthur
- Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, Legon, Accra P.O. Box LG 84, Ghana
| | | | - Irene Akwo Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Accra P.O. Box LG 43, Ghana
| | - Joseph Osafo
- Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, Legon, Accra P.O. Box LG 84, Ghana
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Allinson CH, Berle D. Association between unmet post-arrival expectations and psychological symptoms in recently arrived refugees. Transcult Psychiatry 2022; 60:39-51. [PMID: 35876417 DOI: 10.1177/13634615221111022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Thwarted expectations regarding one's post-settlement life may challenge the mental health of refugees. The present study aimed to investigate the relationship between pre-arrival expectations and the course of psychological symptoms across time. A secondary analysis of 1,496 principal visa applicants across five waves of the Building a New Life in Australia (BNLA) study was conducted. The cross-sectional associations between expectations on the one hand, and post-traumatic stress (PTSD-8) symptoms and psychological distress (Kessler-6; K6) on the other, were assessed using multiple regression. Latent class growth analysis (LCGA) was used to identify discrete symptom trajectories of psychological symptoms across five years following settlement, and multinomial regressions were used to determine if violated expectations predicted membership of identified PTSD-8 and K6 class trajectories. LCGA supported a four-class solution for the PTSD-8 "Resilient Post Traumatic Stress (PTS)" (54.1%), "Improving PTS" (15.0%), "Deteriorating PTS" (17.3%), and "Persistently High PTS" (13.6%). For the K6, three classes were identified: "Persistently Mild K6" (60.4%), "Resilient K6" (9.4%), and "Persistently High K6" (30.2%). Thwarted expectations were found to significantly predict membership of less favourable symptom trajectories classes in the context of other established predictors. Post-settlement expectations may thus have weak but unique predictive value for the course of psychological symptoms alongside other factors such as older age and financial stress. Implications of these findings for service provision and policy are discussed.
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Affiliation(s)
- Claire H Allinson
- Discipline of Clinical Psychology, Graduate School of Health, 1994University of Technology, Sydney, Ultimo, NSW, Australia
| | - David Berle
- Discipline of Clinical Psychology, Graduate School of Health, 1994University of Technology, Sydney, Ultimo, NSW, Australia.,Discipline of Psychiatry and Mental Health, 7800University of New South Wales, Sydney, NSW, Australia
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Pontoppidan M, Thorsager M, Friis-Hansen M, Slade A, Sadler LS. Minding the Baby versus usual care: study protocol for a quasi-cluster-randomized controlled study in Denmark of an early interdisciplinary home-visiting intervention for families at increased risk for adversity. Trials 2022; 23:529. [PMID: 35751089 PMCID: PMC9229526 DOI: 10.1186/s13063-022-06434-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inequality in health can have profound effects on a child's opportunities later in life. To prevent these downstream effects in families at increased risk of adversity, programs are needed to provide support and improve well-being across several domains. The present trial is aimed at assessing the effectiveness of the Minding the Baby® (MTB) home visiting intervention in improving the mother-child relationship, parental reflective functioning, well-being, and mental health, as well as child development and well-being in families at known risk of adverse health, relational, and developmental outcomes. METHODS The study is a pragmatic, prospective, quasi-cluster-randomized controlled trial in which seven Danish municipalities were randomized to MTB training in either 2018 or 2019. A total of 250 pregnant women at increased risk of adversity will be recruited (75 care as usual families and 175 intervention families). Care as usual families will be recruited before and after the MTB training. The MTB intervention is an attachment-based, interdisciplinary home visiting intervention offered from the third trimester of pregnancy until the child is 2 years old. The participants are assessed at baseline, and when the infant is 3, 12, and 24 months old. The primary outcome is maternal sensitivity measured by the Coding Interactive Behavior scale applied to video recordings of mother-infant interactions. Secondary outcomes include parent-child interaction, parental reflective functioning, parental mental health, maternal satisfaction, parental stress, and child development and well-being. The treatment effect is estimated as a fixed effect using a binary indicator of MTB treatment, and cluster-robust standard errors based on wild bootstrap are used for inference. DISCUSSION This is the first trial of MTB in a Scandinavian context and will include the largest sample yet in a trial of MTB. The trial is expected to contribute to knowledge about the effect of early support for pregnant women, their infants, and their families at increased risk of adversity. TRIAL REGISTRATION ClinicalTrials.gov NCT03495895 . The study was registered on April 12, 2018.
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Affiliation(s)
- Maiken Pontoppidan
- VIVE - The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen, Denmark.
| | - Mette Thorsager
- VIVE - The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen, Denmark
| | - Mette Friis-Hansen
- VIVE - The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen, Denmark
| | - Arietta Slade
- Yale Child Study Center, 230 S Frontage Rd, New Haven, CT, USA
| | - Lois S Sadler
- Yale Child Study Center, 230 S Frontage Rd, New Haven, CT, USA
- Yale University School of Nursing, 400 West Campus Drive, Orange, CT, USA
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Mazumdar S, Chong S, Eagar S, Fletcher-Lartey S, Jalaludin B, Smith M. Exploring the Use of Hospital and Community Mental Health Services Among Newly Resettled Refugees. JAMA Netw Open 2022; 5:e2212449. [PMID: 35653157 PMCID: PMC9163998 DOI: 10.1001/jamanetworkopen.2022.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Resettled refugees in high-income countries represent a vulnerable population. It is known that refugees have high rates of trauma-related mental health issues; however, ad hoc research has generally revealed low rates of health services use among refugees. Such research usually samples a population at a single point in time and is based on targeted surveys. Because refugee populations change over time, such research becomes expensive and time-consuming for agencies interested in routinely publishing statistics of mental health services use among refugees. The linking of large administrative data sets to establish rates of use of mental health services among resettled refugees is a flexible and relatively inexpensive approach. OBJECTIVE To use data linkage to establish rates of mental health services use among resettled refugees relative to the general population. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study implemented data linkage from the Refugee Health Nurse Program for 10 050 refugees who resettled in Sydney, Australia, from October 23, 2012, to June 8, 2017, with data concerning use of community mental health services and mental health hospitalization from New South Wales Health databases. Data were analyzed between June 1, 2019, and December 31, 2021. MAIN OUTCOMES AND MEASURES Rates of service contacts with community mental health services among the resettled refugees were compared with those of the general population by age, sex, and the most common International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, diagnosis codes. Length of community mental health service sessions and rates of mental health hospitalizations were also compared. RESULTS Among the 255 resettled refugees who had contacts with community mental health care services and were not missing data (median age, 35 [range, 4-80] years; 117 [64%] male and 138 [54%] female), 153 (60%) were born in Iraq and 156 (61%) were Arabic speaking. This population was less likely to use mental health services than the general population and had shorter community mental health consultations. The rate of contacts with community mental health services for depressive disorders among the resettled refugee population was 40% (95% CI, 33%-46%) lower than that among the general population. Rates of same-day hospitalization per 10 000 person-years were not significantly different between the refugee population (4 [95% CI, 2-8]) and the general Australian population (7 [95% CI, 7-7]). However, the refugee population was 17% (95% CI, 6%-29%) more likely than the general Australian population to interact with the community mental health system for severe stress- and adjustment disorder-related diagnoses. CONCLUSIONS AND RELEVANCE These findings suggest that refugees who have resettled in Australia tend to use fewer mental health services than the general population except for services devoted to stress- and adjustment disorder-related diagnoses. These findings also suggest that it is possible to successfully leverage data linkage to study patterns of mental health services use among resettled refugees.
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Affiliation(s)
- Soumya Mazumdar
- Population Health Intelligence, South Western Sydney Local Health District, Liverpool, Australia
- South Western Sydney Clinical School, University of New South Wales Medicine, Liverpool, Australia
| | - Shanley Chong
- Population Health Intelligence, South Western Sydney Local Health District, Liverpool, Australia
- South Western Sydney Clinical School, University of New South Wales Medicine, Liverpool, Australia
| | - Sandy Eagar
- New South Wales Refugee Health Service, Liverpool, Australia
| | | | - Bin Jalaludin
- School of Population Health, University of New South Wales Medicine, Kensington, Australia
| | - Mitchell Smith
- New South Wales Refugee Health Service, Liverpool, Australia
- School of Population Health, University of New South Wales Medicine, Kensington, Australia
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Reciprocal relationships between employment status and psychological symptoms: findings from the Building a New Life in Australia study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1085-1095. [PMID: 34817636 DOI: 10.1007/s00127-021-02204-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Finding work is an important priority for many refugees in the initial years following settlement in a host country. Difficulties in finding work could conceivably both contribute to and be a consequence of symptoms of posttraumatic stress disorder (PTSD) and psychological distress commonly reported by refugees. PURPOSE We sought to determine the direction of these relationships and the possibility of a reciprocal association between employment status on one hand, and symptoms of PTSD and psychological distress on the other, in a large refugee sample. METHODS A secondary analysis of three face-to-face interview assessments conducted across 5 years with 894 adult refugee participants (M = 39.9 years, SD = 12.8) from the Building a New Life in Australia study was conducted. Symptoms of psychological distress, posttraumatic stress, and employment status were assessed on each occasion. Preliminary analysis identified the cross-sectional relationships between psychological distress, PTSD symptoms, and employment status, while cross-lagged models were used to identify the longitudinal relationships between these respective symptoms. RESULTS Symptoms of psychological distress and not being in paid work were significantly correlated with each other at each time point (ranging 0.09-0.25) and they reciprocally influenced each other over time. Likewise, PTSD symptoms and not being in paid work were correlated with each other after 3 years and 5 years (r = 0.21 and 0.23 respectively), and a reciprocal relationship between these was found over time. CONCLUSION The current findings indicate that interventions which target either mental health or work opportunities could have multiple downstream benefits for refugees.
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Sumner RC, Kinsella EL. Solidarity appraisal, meaning, and markers of welfare in frontline workers in the UK and Ireland during the Covid-19 pandemic. SSM - MENTAL HEALTH 2022; 2:100099. [PMID: 35463800 PMCID: PMC9017115 DOI: 10.1016/j.ssmmh.2022.100099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/09/2022] [Accepted: 04/09/2022] [Indexed: 12/26/2022] Open
Abstract
Throughout the Covid-19 pandemic, frontline workers have carried out essential roles to keep society going, while the public have been called to minimise the infection rate to limit the burden on frontline workers. In this sense, navigating Covid-19 has necessitated interdependence between frontline workers and key stakeholder groups (such as their colleagues, organisations, their government, and the public). Reports suggest that frontline workers have perceived varying degrees of solidarity with others throughout the pandemic, yet the influence of perceived solidarity on psychological welfare has received limited empirical or theoretical attention. The aim of the present study was to test the importance of perceived solidarity (or solidarity appraisal) by assessing the relationship between perceptions of solidarity and psychological welfare in frontline workers — across all sectors — during Covid-19, and explore the role of a potential mechanism (i.e., meaning in life) for explaining this relationship. To assess this proposed model, we used cross-sectional and longitudinal data from a project tracking a cohort of frontline workers in the UK and Ireland since March 2020. Participants were surveyed at baseline (T1), at six months (T2), and 12 months (T3). At T3, participants (N = 414) reported their perceived solidarity (with colleagues, organisations, government, and public) along with a range of psychological welfare measures. Overall, frontline workers’ levels of meaning in life dropped significantly over time. Lower levels of perceived solidarity were predictive of poorer wellbeing, and higher anxiety, burnout, post-traumatic stress symptoms, and somatic stress symptoms, and these relationships were mediated by the presence of meaning in life. These findings suggest that perceived solidarity with interdependent social groups may imbue life with meaning, which can in turn have a positive influence on psychological welfare in chronic and cumulatively stressful occupational settings.
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Affiliation(s)
- Rachel C Sumner
- Health & Human Performance Global Academy, Cardiff Metropolitan University, Cyncoed Road, Cardiff, CF23 6XD, UK
| | - Elaine L Kinsella
- Department of Psychology, RISE Lab, University of Limerick, Castletroy, Limerick, Ireland
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Andersen TE, Ravn SL, Meildal A, Roessler KK. Values-based Cognitive Behavioral Therapy for the Prevention of Chronic Whiplash Associated Disorders: A Randomized Controlled Trial. Eur J Pain 2022; 26:1256-1268. [PMID: 35364620 PMCID: PMC9322531 DOI: 10.1002/ejp.1945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/28/2022] [Indexed: 11/16/2022]
Abstract
Background Whiplash is a common traffic‐related injury with up to 50% of those affected continuing to experience symptoms one‐year post‐injury. Unfortunately, treatments have not proven highly effective in preventing and treating chronic symptomatology. The overall aim of this study was to test the effectiveness of an early values‐based cognitive‐behavioural therapeutic intervention (V‐CBT) delivered within 6 months post‐injury in preventing chronic symptomatology compared to wait list controls. Methods The study was a two‐armed randomized controlled trial. Participants (n = 91) experienced pain, disability and at least one psychological risk factor (e.g. enhanced pain‐catastrophizing) after a whiplash trauma no later than 6 months prior. Participants were randomized to 10 sessions of V‐CBT starting 1 week (group A) or 3 months (group B) post‐randomization. The primary outcome was pain‐related disability, while secondary outcomes were pain intensity, neck‐pain related disability, depression, anxiety, PTSD symptoms, pain‐catastrophizing and kinesiophobia. These were evaluated at baseline and at 3, 6, 9 and 12 months post‐randomization. Results At 3 months, group A demonstrated clinically important effects on all outcomes that were significantly better than group B (waitlist). When group B received the intervention at 6 months, they also demonstrated clinically important effects on all outcomes. However, there was a significant difference at 12 months for the primary outcome, in which group B increased their disability levels, while group A remained stable. Conclusions While this indicates that an intervention window for early prevention of disability after whiplash injury may exist, this needs to be tested in a truly early intervention. Significance An early Values‐based Cognitive Behavioural Therapeutic intervention delivered within 6 months post‐injury (mean days 117) was effective in reducing pain‐related disability and psychological distress compared to the control group that received the intervention later after a three months wait‐list period. The effects were sustained at 12 months follow‐up. The early intervention was significantly more effective in reducing pain‐related disability compared to the control group, indicating that an intervention window for early prevention of disability after whiplash injury may exist.
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Affiliation(s)
- T E Andersen
- University of Southern Denmark: Syddansk Universitet, Odense, Denmark
| | - S L Ravn
- University of Southern Denmark: Syddansk Universitet, Odense, Denmark
| | - A Meildal
- University of Southern Denmark: Syddansk Universitet, Odense, Denmark
| | - K K Roessler
- University of Southern Denmark: Syddansk Universitet, Odense, Denmark
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Professional Mental Health Help-Seeking Amongst Afghan and Iraqi Refugees in Australia: Understanding Predictors Five Years Post Resettlement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031896. [PMID: 35162916 PMCID: PMC8835451 DOI: 10.3390/ijerph19031896] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023]
Abstract
The current longitudinal study sought to identify predictors of professional help seeking for mental health problems amongst Afghan and Iraqi refugees five years post-settlement utilising the Building a New Life in Australia dataset (BNLA). Data were collected via face-to-face or phone interviews across five waves from October 2013 to March 2018. Afghan and Iraqi born refugees numbering 1180 and over 18 years of age with a permanent humanitarian visa were included in this study. The results suggest differences in help-seeking behaviors amongst the two ethnic groups. Amongst the Afghan sample, older adults with high psychological distress were more likely to seek help, while living in regional Australia, not requiring interpreters, and knowing how to find out information about government services were related to lower likelihood of help-seeking. Within the Iraqi sample, poor overall health and knowing how to find out about services were related to a greater likelihood of help-seeking, while fewer financial hardships decreased the likelihood of help-seeking. Amongst those with probable PTSD, disability was associated with an increased likelihood of help-seeking while experiencing fewer financial hardships and living in regional Australia resulted in a lower likelihood of help-seeking in this group. These results have implications for promotional material and mental health interventions, suggesting that more integrated services tailored to specific characteristics of ethnic groups are needed.
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Baygi F, Blome C, Smith A, Khonsari NM, Agoushi A, Maghoul A, Esmaeili-Abdar M, Gorabi AM, Qorbani M. Post-traumatic stress disorder and mental health assessment of seafarers working on ocean-going vessels during the COVID-19 pandemic. BMC Public Health 2022; 22:242. [PMID: 35123421 PMCID: PMC8817943 DOI: 10.1186/s12889-022-12673-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 01/31/2022] [Indexed: 11/30/2022] Open
Abstract
Background There are increasing concerns about mental health consequences of the COVID-19 pandemic among seafarers. This study aims to assess the effects of the current global health pandemic on life satisfaction and adverse psychological outcomes among seafarers. Methods In this cross-sectional study, 470 multinational seafarers working on board ships of two international shipping companies were assessed. Mental health outcomes were assessed by the general anxiety disorder (GAD-7) questionnaire, post-traumatic stress disorder (PTSD-8) questionnaire, and patient health questionnaire (PHQ-9) depressive severity score. Multivariate logistic regression was used to determine the association of demographic and work-related variables with mental health outcomes. Results Overall, 439 out of 470 invited seafarers with a mean age of 34.5 (SD: 8.05) years participated in this study (participation rate: 93.4%). The prevalence of anxiety, depressive, and post-traumatic stress symptoms was 12.4, 14.1, and 37.3%, respectively. In the multivariate model, the current vessel’s signing duration was directly associated with the odds of depressive and intrusion symptoms. Moreover, the duration of work per week was inversely associated with hyper-vigilance and avoidance. Also, non-officers, compared to officers, experienced significantly lower anxiety and depressive symptoms, hyper-vigilance, and avoidance. Conclusion The present study revealed a high prevalence of mental health problems among seafarers during the COVID-19 pandemic. We recommend that more evidence is generated regarding psychosocial health issues for this vulnerable occupation.
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Kankaanpää R, Aalto S, Vänskä M, Lepistö R, Punamäki RL, Soye E, Watters C, Andersen A, Hilden PK, Derluyn I, Verelst A, Peltonen K. Effectiveness of psychosocial school interventions in Finnish schools for refugee and immigrant children, "Refugees Well School" in Finland (RWS-FI): a protocol for a cluster randomized controlled trial. Trials 2022; 23:79. [PMID: 35086535 PMCID: PMC8793091 DOI: 10.1186/s13063-021-05715-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schools are natural environments in which to enhance young people's social and emotional skills, mental health, and contact between diverse groups, including students from refugee and immigrant backgrounds. A layered or tiered provision of services is recommended as it can be effective to meet the needs of war-affected adolescents who variably show mental health problems (such as posttraumatic stress disorder (PTSD)). The current protocol describes the study design for a multi-layered intervention model. The study will test the effectiveness of two interventions: a teacher-training intervention In-Service Teacher Training (INSETT) combined with targeted cognitive-behavioral treatment-based Teaching Recovery Techniques (TRT) and a classroom-focused preventive intervention Peer Integration and Enhancement Resources (PIER). We analyze, first, whether the interventions are effective in decreasing psychological distress and increasing positive resources, i.e., prosocial behavior and resilience among refugee and immigrant students. Second, we analyze which student-, school-, and parent-related factors mediate the possible beneficial changes. Third, we look at which groups the interventions are most beneficial to. METHODS A three-arm cluster RCT with parallel assignment, with a 1:1:1 allocation ratio, is applied in 16 schools that agreed to participate in the Refugees Well School interventions and effectiveness study. Schools were randomized to three conditions of two active interventions and a waiting list control condition. Students, their parents, and teachers in intervention and control schools participated in the study at baseline before the interventions, after the interventions, and at 6 to 12 months after the interventions. The primary effectiveness criterion variables are psychological distress (SDQ) symptoms, resilience (CYRM-12), and prosocial behavior (SDQ). DISCUSSION The current study presents a recommended universal approach of layered interventions aiming to reduce psychological distress and increase resilience among refugee and immigrant students. A combination of promotive, preventive, and targeted interventions may offer a holistic, ecological intervention package for schools to better address the needs of the whole group. TRIAL REGISTRATION ISRCTN ISRCTN64245549 . Retrospectively registered on 10 June 2020.
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Affiliation(s)
- Reeta Kankaanpää
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Sanni Aalto
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Mervi Vänskä
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Riina Lepistö
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | | | - Emma Soye
- School of Education and Social Work, University of Sussex, FIN-33014 Tampere, Finland
| | - Charles Watters
- School of Education and Social Work, University of Sussex, FIN-33014 Tampere, Finland
| | - Arnfinn Andersen
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Per Kristian Hilden
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Ilse Derluyn
- Department of Social Pedagogy, Ghent University, Ghent, Belgium
| | - An Verelst
- Department of Social Pedagogy, Ghent University, Ghent, Belgium
| | - Kirsi Peltonen
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
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Pontoppidan M, Nygaard L, Thorsager M, Friis-Hansen M, Davis D, Nohr EA. The FACAM study: protocol for a randomized controlled study of an early interdisciplinary intervention to support women in vulnerable positions through pregnancy and the first 5 years of motherhood. Trials 2022; 23:73. [PMID: 35073975 PMCID: PMC8785506 DOI: 10.1186/s13063-022-06022-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/12/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Inequality in health can have profound short- and long-term effects on a child's life. Infants develop in a responsive environment, and the relationship between mother and infant begins to develop during pregnancy. The mother's ability to bond with the fetus and newborn child may be challenged by mental health issues which can cause impaired functioning and poorer health outcomes. Families with complex problems need interdisciplinary interventions starting in early pregnancy to be prepared for motherhood and to ensure healthy child development. This study aims to examine the effects of an early and coordinated intervention (the Family Clinic and Municipality (FACAM) intervention) offered to vulnerable pregnant women during pregnancy and the child's first year of life on the mother-child relationship, maternal social functioning, mental health, reflective functioning, well-being, parental stress, and the development and well-being of the child. METHODS The study is a prospective randomized controlled trial where we will randomize 320 pregnant women enrolled to receive antenatal care at the family clinic at Odense University Hospital, to either FACAM intervention or usual care. The FACAM intervention consists of extra support by a health nurse or family therapist during pregnancy and until the child starts school. The intervention is most intensive in the first 12 months and also includes attachment-based support provided either individually or in groups. The participants are assessed at baseline, and when the infant is 3 and 12 months old. The primary outcome is maternal sensitivity measured by the Coding Interactive Behavior (CIB) instrument. Secondary outcomes include prenatal parental reflective functioning, mental well-being, depressive symptoms, breastfeeding duration, maternal satisfaction, child development, parent competence, parental stress, and activities with the child. DISCUSSION The trial is expected to contribute knowledge about the effect of early coordinated support in antenatal and postnatal care for vulnerable pregnant women and their families. TRIAL REGISTRATION ClinicalTrials.gov NCT03659721 . Registered on September 6, 2018.
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Affiliation(s)
- Maiken Pontoppidan
- VIVE - The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen, Denmark.
| | - Lene Nygaard
- University of Canberra and ACT Health, Bruce, Australia
- Research Unit for Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mette Thorsager
- VIVE - The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen, Denmark
| | - Mette Friis-Hansen
- VIVE - The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen, Denmark
| | - Deborah Davis
- University of Canberra and ACT Health, Bruce, Australia
| | - Ellen Aagaard Nohr
- Research Unit for Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
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Yeo EJ, Hlongwane K, Otwombe K, Hopkins KL, Variava E, Martinson N, Strathdee SA, Coetzee J, Milovanovic M. Key risk factors for substance use among female sex workers in Soweto and Klerksdorp, South Africa: A cross-sectional study. PLoS One 2022; 17:e0261855. [PMID: 35061728 PMCID: PMC8782394 DOI: 10.1371/journal.pone.0261855] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Sex workers in South Africa experience high levels of trauma and mental health issues, but little is known about their drug and alcohol use. This study assessed the prevalence of substance use and its key risk factors amongst female sex workers (FSWs) at two sites in South Africa. METHODS Two cross-sectional studies were conducted, in Soweto and Klerksdorp, South Africa. Using respondent-driven sampling (RDS) 508 FSWs in Soweto and 156 in Klerksdorp were enrolled. A study-specific survey was used to collect social and demographic information, substance use, mental ill-health, and HIV status. Raw and RDS-adjusted data were analyzed using Chi-squared tests of association. Weighted and unweighted Poisson regression models were used to assess key risk factors for alcohol and drug use at both univariate and multivariate levels. RESULTS Of the 664 FSWs, 56.2% were binge drinkers and 29.4% reported using drugs within the last year. Living in a home with regular food (RR: 1.2597, 95% CI: 1.1009-1.4413) and being HIV positive (RR: 1.1678, 95% CI: 1.0227-1.3334) were associated with a higher risk of binge drinking. Having symptoms suggestive of post-traumatic stress disorder (RR: 1.1803, 95% CI: 1.0025-1.3895) and past year physical/sexual abuse from either intimate (RR: 1.3648, 95% CI: 1.1522-1.6167) or non-intimate partners (RR: 1.3910, 95% CI: 1.1793-1.6407) were associated with a higher risk of drug use. DISCUSSION In conclusion, our findings demonstrate a high prevalence of alcohol and drug use among FSWs in Soweto and Klerksdorp with site-specific contextual dynamics driving substance use. Site differences highlight the importance of tailoring site-specific substance use harm mitigation for this key population.
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Affiliation(s)
- Ellis Jaewon Yeo
- Harvard Global Health Institute, Harvard University, Cambridge, Massachusetts, United States of America
| | - Khuthadzo Hlongwane
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of The Witwatersrand, Soweto, South Africa
| | - Kennedy Otwombe
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of The Witwatersrand, Soweto, South Africa
- School of Public Health, Faculty of Health Sciences, University of The Witwatersrand, Johannesburg, South Africa
| | | | - Ebrahim Variava
- School of Public Health, Faculty of Health Sciences, University of The Witwatersrand, Johannesburg, South Africa
| | - Neil Martinson
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of The Witwatersrand, Soweto, South Africa
- Department of Internal Medicine, Klerksdorp Tshepong Hospital Complex, University of The Witwatersrand, Matlosana, South Africa
- Johns Hopkins University Center for TB Research, Baltimore, Maryland, United States of America
| | - Steffanie A. Strathdee
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Jenny Coetzee
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of The Witwatersrand, Soweto, South Africa
- South African Medical Research Council, Cape Town, South Africa
- African Potential Management Consultancy, Kyalami, South Africa
| | - Minja Milovanovic
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of The Witwatersrand, Soweto, South Africa
- African Potential Management Consultancy, Kyalami, South Africa
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Baygi F, Mohammadian Khonsari N, Seif E, Asayesh H, Qorbani M. The mental health status of offshore oil platform workers during the COVID-19 pandemic. Front Psychiatry 2022; 13:1009602. [PMID: 36304563 PMCID: PMC9593038 DOI: 10.3389/fpsyt.2022.1009602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Previous studies indicated that offshore workers have a high level of work-related stress on an everyday basis. This study aims to assess the prevalence and determinants of mental health conditions in offshore oil platform workers during the COVID-19 pandemic. METHODS Workers of three oil and gas platforms were assessed in this cross-sectional study. Their mental status was evaluated by the Posttraumatic Stress Disorder (PTSD-8) questionnaire, and Depression Anxiety, Stress Scales (DASS) questionnaires. Furthermore, we assessed satisfaction with life (SWL) with a single question. Finally, multivariate logistic regression was used to determine the association of demographic and work-related variables with mental health outcomes. RESULTS Overall, 278 (Males:197, Females: 81) out of 315 invited workers with a mean age of 35.6 (SD: 7.2) years were included in this study using a random sampling method (participation rate: 88.2%). PTSD symptoms and Insomnia were observed in 9 (3.2%) and 138 (49.6%) of the participants, respectively. The prevalence of stress, anxiety, and depressive symptoms were 72 (25.9%), 70 (24.6%), and 85 (30.5%), respectively. Based on multivariable (adjusted) logistic regression analysis, women had significantly higher odds of stress and anxiety than men; those with an academic education were significantly more dissatisfied with their lives than those without an academic education. CONCLUSION Our findings revealed a high prevalence of anxiety, depressive symptoms, and stress among offshore oil platformers during the COVID-19 pandemic, especially in women. Indicating that women and those with a higher education level in the oil platform work settings are more susceptible to stressors.
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Affiliation(s)
- Fereshteh Baygi
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Ehsan Seif
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Sexual IPV and non-partner rape of female sex workers: Findings of a cross-sectional community-centric national study in South Africa. SSM - MENTAL HEALTH 2021; 1:None. [PMID: 34957423 PMCID: PMC8654680 DOI: 10.1016/j.ssmmh.2021.100012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/05/2021] [Accepted: 08/03/2021] [Indexed: 11/21/2022] Open
Abstract
Background Globally female sex workers (FSWs) are vulnerable to violence from intimate partners, police and clients due to stigma and criminalisation. In this paper we describe South African FSWs' exposure to violence and factors associated with having been raped in the past year. Methods We conducted a multi-stage, community-centric, cross-sectional survey of 3005 FSWs linked to sex worker programmes in 12 sites across all nine provinces that had a SW programme. Adult women who sold sex in the preceding six months were recruited for interviews via sex worker networks. Survey tools were developed in consultation with peer educators and FSWs. Results In the past year, 70.4% of FSWs experienced physical violence and 57.9% were raped: by policemen (14.0%), clients (48.3%), other men (30.2%) and/or and intimate partner (31.9%). Sexual IPV was associated with food insecurity, entering sex work as a child, childhood trauma exposure, post-traumatic stress disorder (PTSD), drinking alcohol to cope with sex work, working more days, partner controlling behaviour, having an ex-client partner, and having no current partner to protect from ex-partners. Rape by a client, other men or policemen was associated with food insecurity, childhood trauma, PTSD, depression, using alcohol and drugs, being homeless or staying in a sex work venue, selling sex on the streets, working more days and having entered sex work as a child and been in sex work for longer. Conclusion South African FSWs are very vulnerable to rape. Within the social climate of gender inequality, sex work stigma, criminalisation, and repeated victimisation, the key drivers are structural factors, childhood and other trauma exposure, mental ill-health, circumstances of sex work and, for SIPV, partner characteristics. Mostly these are amenable to intervention, with legislative change being foundational for ending abuse by policemen, enhancing safety of indoor venues and providing greater economic options for women.
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Doody CB, Robertson L, Cox KM, Bogue J, Egan J, Sarma KM. Pre-deployment programmes for building resilience in military and frontline emergency service personnel. Cochrane Database Syst Rev 2021; 12:CD013242. [PMID: 34870330 PMCID: PMC8647095 DOI: 10.1002/14651858.cd013242.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Military personnel and frontline emergency workers may be exposed to events that have the potential to precipitate negative mental health outcomes such as depression, symptoms of post-traumatic stress and even post-traumatic stress disorder (PTSD). Programmes have been designed to build psychological resilience before staff are deployed into the field. This review presents a synthesis of the literature on these "pre-deployment resilience-building programmes". OBJECTIVES The objective of this review was to assess the effectiveness of programmes that seek to build resilience to potentially traumatic events among military and frontline emergency service personnel prior to their deployment. These resilience programmes were compared to other interventions, treatment as usual or no intervention. SEARCH METHODS Studies were identified through searches of electronic databases including Ovid MEDLINE, Embase, PsycINFO, Web of Science and Google Scholar. The initial search took place in January 2019, with an updated search completed at the end of September 2020. SELECTION CRITERIA Only studies that used a randomised controlled trial (RCT)/cluster-RCT methodology were included. The programmes being evaluated must have sought to build resilience prior to exposure to trauma. Study participants must have been 18 years or older and be military personnel or frontline emergency workers. DATA COLLECTION AND ANALYSIS Studies that met the inclusion criteria were assembled. Data extracted included methods, participants' details, intervention details, comparator details, and information on outcomes. The primary outcomes of interest were resilience, symptoms of post-traumatic stress and PTSD. Secondary outcomes of interest included acute stress disorder, depression, social support, coping skills, emotional flexibility, self-efficacy, social functioning, subjective levels of aggression, quality of sleep, quality of life and stress. Assessment of risk of bias was also completed. A total of 28 studies were included in a narrative synthesis of results. MAIN RESULTS All 28 included studies compared an experimental resilience building intervention versus a control or no intervention. There was a wide range of therapeutic modalities used, including cognitive behavioural therapy (CBT) informed programmes, biofeedback based programmes, stress-management programmes, mindfulness and relaxation programmes, neuropsychological-based programmes, and psychoeducational-informed programmes. The main outcomes are specified here, secondary outcomes such as depression, social support, coping skills, self-efficacy, subjective levels of aggression and stress are reported in text. No studies reported on the following pre-specified outcomes; acute stress disorder, emotional flexibility, social functioning, quality of sleep and quality of life. Resilience Eight studies reported resilience as an outcome. We narratively synthesised the data from these studies and our findings show that five of these interventions had success in building resilience in their respective samples. Two of the studies that reported significant results utilised a CBT approach to build resilience, while the other three successful programmes were mindfulness-based interventions. Symptoms of post-traumatic stress Our narrative synthesis of results included eight studies. Two of the eight studies produced significant reductions in symptoms of post traumatic stress compared to controls. These interventions used neuropsychological and biofeedback intervention models respectively. PTSD caseness Four studies reported PTSD caseness as an outcome. Our narrative synthesis of results suggests that evidence is mixed as to the effectiveness of these interventions in reducing clinical diagnosis of PTSD. One study of a neuropsychology-orientated Attention Bias Modification Training (AMBT) programme had success in reducing both symptoms of post-traumatic stress and numbers of participants receiving a diagnosis of PTSD. A stress-management programme reported that, when baseline differences in rates of pre-deployment mental health issues were controlled for, participants in the control condition were at 6.9 times the risk of a diagnosis of PTSD when compared to the intervention group. Given the diversity of intervention designs and theoretical orientations used (which included stress-management, neuropsychological and psychoeducational programmes), a definitive statement on the efficacy of pre-deployment programmes at reducing symptoms of post-traumatic stress and PTSD cannot be confidently offered. AUTHORS' CONCLUSIONS While a number of evaluations of relevant programmes have been published, the quality of these evaluations limits our ability to determine if resilience-building programmes 'work' in terms of preventing negative outcomes such as depression, symptoms of post-traumatic stress and diagnoses of PTSD. Based on our findings we recommend that future research should: a) report pre-/post-means and standard deviation scores for scales used within respective studies, b) take the form of large, RCTs with protocols published in advance, and c) seek to measure defined psychological facets such as resilience, PTSD and stress, and measure these concepts using established psychometric tools. This will provide more certainty in future assessments of the evidence base. From a clinical implications point of view, overall there is mixed evidence that the interventions included in this review are effective at safe guarding military personnel or frontline emergency workers from experiencing negative mental health outcomes, including PTSD, following exposure to potentially traumatic events. Based on this, practitioners seeking to build resilience in their personnel need to be aware of the limitations of the evidence base. Practitioners should have modest expectations in relation to the efficacy of resilience-building programmes as a prophylactic approach to employment-related critical incident traumas.
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Affiliation(s)
- Colm B Doody
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Lindsay Robertson
- Cochrane Common Mental Disorders, University of York, York, UK
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Katie M Cox
- National University of Ireland Galway, Galway, Ireland
| | - John Bogue
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Jonathan Egan
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Kiran M Sarma
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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