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Garcia MLT, Spolander G, Tomlins R, Xavier Leal F, Santana Borges RE, Sukumar A. Entrepreneurship in the Favela: Negotiating Precarity and Mental Health During Covid-19. SOCIAL WORK IN PUBLIC HEALTH 2024; 39:48-61. [PMID: 38439702 DOI: 10.1080/19371918.2024.2316874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
This paper aims to explore the impact of the COVID-19 pandemic on the health and mental health of necessary entrepreneurs in Brasilian favelas, the social problems they experienced and implications for public health social work. The study used structured in-person interviews within selected Favela's, with a sample size of 721 entrepreneurs, aged between 16-70 years. All participants both worked and were resident in 15 out of the 27 Brasilian federal states. The bespoke questions explored socio-demographic questions, sought information on their entrepreneurship, health and administered the Warwick-Edinburgh Mental Wellbeing Scale for Health. The results highlighted that many entrepreneurs have engaged in this form of enterprise due to economic necessity, with 64% of women and 43.6% of men identifying increased levels of anxiety through the pandemic, with the presence of children in the family being statistically significant (p ≤ 0.05 chi-square test) for anxiety. Of the 9.8% sample respondents have accessed the health care service and for women with children, the impact of the pandemic accentuated existing problems of childcare and patriarchy. We conclude by highlighting the importance of universal and accessible health and mental health support and care, their ongoing accessibility, along with the importance of social work during crisis.
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Affiliation(s)
| | - Gary Spolander
- School of Applied Social Studies, Robert Gordon University, Aberdeen, UK
- Extraordinary Professor of Social Work, Centre for Interdisciplinary Studies of Children, Families and Society, University of Western Cape, Cape Town, South Africa
- Honorary Professor of Global Health and Social Care, University of Keele, Newcastle, UK
| | | | - Fabiola Xavier Leal
- International Centre for Transformational, Coventry University, Coventry, UK
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Cabral S, Rocha T, Caetano S, Mari J, Borschmann R, Asevedo E. Decrease in suicide rates in Brazil during the COVID-19 pandemic. Psychiatry Res 2023; 329:115443. [PMID: 37769372 DOI: 10.1016/j.psychres.2023.115443] [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: 02/08/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/30/2023]
Abstract
Natural disasters such as public health epidemics may potentially affect suicide rates. The global COVID-19 pandemic poses an unprecedented challenge for healthcare systems and general populations worldwide. In this retrospective ecological study, we aimed to examine any changes in the suicide rates during the COVID-19 pandemic and to assess the relationship between COVID-19 death rates and deaths by suicide in Brazil. Data on suicide and COVID-19 case numbers were extracted from the Ministry of Health agencies and grouped weekly. We performed a time series analysis of suicide rates, a comparison of mean suicide rates between the pre-COVID-19 period and the COVID-19 period, and conducted a Poisson regression to examine the relationship between deaths due to COVID-19 and suicide rates. Our results showed decreased suicide rates during the COVID-19 pandemic. We also found that deaths owing to COVID-19 impact those owing to suicide after 10 weeks in the upward direction; however, we did not observe for enough time to see a change in the suicide rate curve. These findings are fundamental to understand suicidal behaviors in epidemic situations. However, the field needs more studies evaluating the impact of significant public health events on suicidality, incorporating extended follow-up periods.
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Affiliation(s)
- S Cabral
- Unidade de Psiquiatria, Hospital de Base, Instituto de Gestão Estratégica de Saúde do Distrito Federal (IGESDF), Distrito Federal, DF, Brazil; Departamento de Psiquiatria e Psicologia Médica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - T Rocha
- Departamento de Psiquiatria e Psicologia Médica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - S Caetano
- Unidade de Psiquiatria, Hospital de Base, Instituto de Gestão Estratégica de Saúde do Distrito Federal (IGESDF), Distrito Federal, DF, Brazil
| | - J Mari
- Unidade de Psiquiatria, Hospital de Base, Instituto de Gestão Estratégica de Saúde do Distrito Federal (IGESDF), Distrito Federal, DF, Brazil
| | - R Borschmann
- Justice Health Unit, Centre for Health Equity, The University of Melbourne, Carlton, Victoria, Australia; Department of Psychiatry, University of Oxford, Warneford Hospital, UK; Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia
| | - E Asevedo
- Departamento de Psiquiatria e Psicologia Médica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
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Bado P, da Costa R, Bernardes C, Tripp G, Mattos P, Furukawa E. Needs assessment for behavioral parent training for ADHD in Brazil. Front Psychiatry 2023; 14:1191289. [PMID: 37575579 PMCID: PMC10415012 DOI: 10.3389/fpsyt.2023.1191289] [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: 03/21/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) is a debilitating condition affecting children and their families worldwide. Behavioral parent training is a recommended form of empirically supported non-pharmacological intervention for young children with mild to moderate ADHD. However, access to such treatment is limited in many countries. Here we identify the treatment needs of Brazilian families with children demonstrating symptoms of ADHD, and the barriers families face in accessing behavioral treatment. Methods A qualitative needs assessment was undertaken with parents (n = 23), educators (n = 15), and healthcare providers (n = 16). Semi-structured telephone interviews were conducted, and common themes were identified through inductive coding of participants' responses. Results Participants reported a lack of accessible behavioral treatment, and delays in accessing treatment when available. The majority of parents had not received behavioral parent training, despite it being a recommended form of treatment. Parents, educators and healthcare providers strongly endorsed a need for practical tools to manage the behavior of children with ADHD. Conclusion Existing services might not meet the needs of children with ADHD and their families in Brazil. Easily accessed behavioral parent training programs are recommended to address the identified treatment gap for Brazilian children with ADHD and their families.
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Affiliation(s)
- Patricia Bado
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raquel da Costa
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Camila Bernardes
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Gail Tripp
- Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
| | - Paulo Mattos
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Emi Furukawa
- Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
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Watila MM, Duncan C, Mackay G. Evaluation of telemedicine for new outpatient neurological consultations. BMJ Neurol Open 2022; 4:e000260. [PMID: 35571587 PMCID: PMC9082731 DOI: 10.1136/bmjno-2021-000260] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 03/27/2022] [Indexed: 11/11/2022] Open
Abstract
Objective The COVID-19 pandemic has broadened the use of teleneurology, how this compares with face-to-face (F2F) clinics is unclear. This study compared virtual with F2F new neurological consultations. Methods We retrospectively evaluated new outpatient consultations in neurology clinics in Aberdeen Royal Infirmary. We compared sociodemographic data, time to consultation, time to diagnosis, the need for reassessment and re-investigation between traditional F2F and virtual clinics using the web-based Attend Anywhere platform or telephone into patients’ own homes (or chosen location) without a trained assistant. We calculated the relative risk (RR) of the need for reassessment and re-investigation over 6-month periods by the suspected neurological diagnosis. Results 73% of consultations were virtual (Attend Anywhere or telephone) between June and October 2020, this was almost non-existent (<0.1%) in June–October 2019. We analysed 352 F2F (June–July 2019) and 225 virtual consultations (June–July 2020). Compared with F2F clinics, virtual clinics had a longer time to diagnosis (p=0.019), were more likely to be reassessed (RR: 2.2, 95% CI: 1.5 to 3.2; p<0.0001) and re-investigated (RR: 1.50, 95% CI: 0.88 to 2.54; p=0.133), this was likelier in those aged ≥60 years. Patients with headaches and suspected seizures were less likely to need reassessment or re-investigation following virtual clinics than multiple sclerosis and neuroinflammatory disorders, spinal cord disorders and functional neurological disorders. Conclusion This study demonstrates that virtual clinics have higher rates of reassessment and re-investigation than F2F clinics. As virtual clinics become a potential consultation alternative, this study should instruct the selection of patients for either consultation type.
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Affiliation(s)
- Musa Mamman Watila
- Department of Neurology, Aberdeen Royal Infirmary, Aberdeen, UK
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Callum Duncan
- Department of Neurology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Graham Mackay
- Department of Neurology, Aberdeen Royal Infirmary, Aberdeen, UK
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Baumann A, Vázquez A, Macchione A, Lima A, Coelho A, Juras M, Ribeiro M, Kohlsdorf M, Carothers B. Translation and validation of the evidence-based practice attitude scale (EBPAS-15) to Brazilian Portuguese: Examining providers' perspective about evidence-based parent intervention. CHILDREN AND YOUTH SERVICES REVIEW 2022; 136:106421. [PMID: 35431379 PMCID: PMC9012479 DOI: 10.1016/j.childyouth.2022.106421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Few existing evidence-based parent interventions (EBPIs) for prevention and treatment of child and youth mental health disorders are implemented in low-middle-income countries. This study aimed to translate and confirm the factor structure of the Evidence-Based Practice Attitude Scale (EBPAS-15) survey in Brazilian Portuguese with the goal of examining providers' perspective about EBPIs. METHODS We translated and back translated the EBPAS-15 from English to Brazilian Portuguese. Participants were recruited via snowball sampling and data were collected using an online survey from July of 2018 through January of 2020. A confirmatory factor analysis was conducted to determine if the scale retained its original structure. Open-ended questions about providers' perspectives of their own clinical practice were coded using the Theoretical Domains Framework (TDF). Analyses included data from 362 clinicians (318 women, 41 men) from 20 of the 27 states of Brazil. Participants on average were 26.7 years old, held specialist degrees in the field of psychology, actively worked as therapists, and practiced in private clinics. RESULTS The translation of the EBPAS to Brazilian Portuguese retained the same four-factor structure as the English version except for dropping one item from the Divergence domain. When asked about the challenges in their practices, providers generally referred to parents as clients with little skills to discipline their children and lacking knowledge about child development. DISCUSSION The Brazilian version of the EBPAS-15 is promising, but future research should consider using quantitative data alongside qualitative information to better understand providers' attitudes about evidence-based interventions to inform implementation efforts. TRIAL REGISTRATION N/A.
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Affiliation(s)
- A.A. Baumann
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, MO, USA
| | | | - A.C. Macchione
- Centro Paradigma de Ciências do Comportamento, São Paulo, Brazil
| | - A. Lima
- Sam Houston State University, TX, USA
| | - A.F. Coelho
- Universidade de Brasilia, Brasília-DF, Brazil
| | - M. Juras
- Florida Gulf Coast University, USA
| | - M. Ribeiro
- Aiutare Instituto de Psicologia, Brasília-DF, Brazil
| | - M. Kohlsdorf
- Centro Universitario UniCEUB, Brasília-DF, Brazil
| | - B.J. Carothers
- Brown School, Washington University in St. Louis, Missouri, United States
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SILVA NHLPD, OTTOLIA RF, MARQUES LG, ANTÚNEZ AEA. Use of digital technologies in mental health during COVID-19. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2022. [DOI: 10.1590/1982-0275202239e200225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Most countries did not have a consolidated digital health structure before the pandemic. Both social distancing and mental health problems resulting from the situation justify the urgency of discussions on web-mediated interventions. The objective of this work is to present the panorama of technological mediation in mental health services and their specificities in the context of the pandemic. This paper is grounded on a critical look at the migration from face-to-face care to the Internet environment, highlighting: the international experiences using digital technologies in the pandemic context; the challenges in online consultations, emphasizing the importance of the ethical, technical/technological, and clinical domains, which are recurring issues in the international literature; the challenges and perspectives in the use of technologies. It is essential to develop strategies aligned with government incentives, aiming at the quality of the offered services and the guarantee of an adequate hybrid qualification.
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Mucic D, Shore JH, Hilty DM, Krysta K, Krzystanek M. Lessons Learned or Forgotten? Impacts of COVID-19 on the Future Direction of Global (e-)Mental Health Care. Curr Psychiatry Rep 2021; 23:86. [PMID: 34842979 PMCID: PMC8628486 DOI: 10.1007/s11920-021-01300-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic has impacted lives globally, posing unique challenges to mental health services exposing vulnerability and limitations within these systems. During the course of the pandemic, telecommunications technologies (e-mental health care) have served a critical role in psychiatric care. It is important to understand current lessons learned in e-mental health care and implications for global mental health systems for both emerging from the pandemic and after the pandemic has ended. RECENT FINDINGS There are significant regulatory, policy, and evaluation challenges for global e-mental health impacting patients, clinicians, health systems, and decision-makers. These include complex regulatory issues, difficulties of providing care across boundaries, and keeping pace with the implementation of new technologies in behavioral health. The collaborative development of global standards along with policies, appropriate regulations, and developing new models of research and development opens the possibility of improved access to care across national boundaries.
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Affiliation(s)
- D Mucic
- Little Prince Treatment Centre, Havneholmen 82, 5th, 1561, Copenhagen V, Denmark.
| | - J H Shore
- Office of Telehealth and Technology Implementation for Behavioral Health Practice and Science (TIPS), Department of Psychiatry, Aurora, USA
- Department of Psychiatry and Family Medicine, School of Medicine And Centers for American Indian and Alaska Native Health, School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - D M Hilty
- VA Northern California Health Care, System & UC Davis School of Medicine, 2230 Stockton Boulevard, Sacramento, CA, 95817, USA
| | - K Krysta
- Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences in Katowice, Clinic of Psychiatric Rehabilitation, Medical University of Silesia, Ziołowa 45/47, 40-635, Katowice, Poland
| | - M Krzystanek
- Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences in Katowice, Clinic of Psychiatric Rehabilitation, Medical University of Silesia, Ziołowa 45/47, 40-635, Katowice, Poland
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Associations of Sociodemographic Factors and Health Behaviors with the Emotional Well-Being of Adolescents during the COVID-19 Pandemic in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116160. [PMID: 34200307 PMCID: PMC8201123 DOI: 10.3390/ijerph18116160] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/28/2021] [Accepted: 06/03/2021] [Indexed: 02/07/2023]
Abstract
This cross-sectional study utilizes data from a nationwide web-based survey aimed to identify the factors affecting the emotional well-being of Brazilian adolescents aged 12–17 during the period of school closures and confinement. Data collection took place from 27 June to 17 September 2020. We used the “virtual snowball” sampling method, and students from private and public schools were included. A total of 9470 adolescents were analyzed. A hierarchical logistic regression model was used to find the factors associated with reporting at least two of three self-reported problems—sadness, irritability, and sleep problems. The main proximal factor was loneliness (AdjOR = 8.12 p < 0.001). Problems related to school closures also played an important role. Regular intake of fruits and vegetables, as well as physical activity, demonstrated a positive influence on emotional well-being, while excessive screen time (AdjOR = 2.05, p < 0.001) and alcohol consumption negatively affected outcomes (AdjOR = 1.73, p < 0.001). As for distal variables, less affluent adolescents were the most affected, and males reported fewer emotional problems than females. Uncertainty regarding the disease in a context of socioeconomic vulnerability, together with rises in unhealthy behaviors and isolation from their immediate social circles, have negatively affected adolescents’ emotional status throughout the COVID-19 pandemic.
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