Community-based Suicide Prevention Research in Remote On-Reserve First Nations Communities

Suicide is a complex problem linked to genetic, environmental, psychological and community factors. For the Aboriginal population more specifically, loss of culture, history of traumatic events, individual, family and community factors may also play a role in suicidal behaviour. Of particular concern is the high rate of suicide among Canadian Aboriginal youth. While the need to develop interventions to reduce suicidal behaviour for First Nations on-reserve populations is evident, there may be an element of distrust of researchers by Aboriginal communities. Furthermore, research in mental health and specifically suicide is much more sensitive than studying medical illnesses like diabetes. Clearly, this issue requires a unique and insightful approach. While numerous suicide prevention/intervention plans and guidelines have been published specifically for work involving Aboriginal people, the literature lacks a comprehensive discussion of the methodological and logistical issues faced by research teams and Aboriginal communities attempting to develop culturally-grounded and community-specific suicide prevention and intervention strategies. This paper outlines the research process, key challenges and lessons learned in a collaborative University-First Nations suicide prevention project conducted with eight north-western Manitoba First Nations communities (Canada)

Implementación de un plan de mejora en la línea de producción de la JACHI 0240 para incrementar la productividad de la empresa JACHI BIOCONTROL EIRL, 2021

La presente tesis titulada “Implementación de un Plan de mejora en la línea de producción de la JACHI 0240 para incrementar la productividad de la empresa JACHI BIOCONTROL EIRL” tiene como objetivo general “Implementar un plan de mejora en la línea de producción de la Jachi 0240 para el incremento de la productividad de la empresa”. Esta investigación es de tipo aplicada no experimental la cual se llevó acabo en la empresa JACHI, obteniendo como resultado el incremento de la productividad actual de la empresa de un 10 a 50%, implementado la metodología 5 “S” y la redistribución adecuada del layout de la empresa, aumentando la capacidad a nivel de producción de las estaciones de trabajo del proceso productivo y se concluye con el análisis económico realizado la viabilidad del proyecto , obteniendo un Valor Actual Neto del proyecto de S/86 057.82 y Tasa interno de retorno del de 0.76 con una rentabilidad de 0.53 soles por cada sol invertido en la aplicación real de la presente investigación

International Group for Indigenous Health Measurement: Recommendations for best practice for estimation of Indigenous mortality

AIM: To provide a best practice guide on Indigenous mortality reporting based on recommendations from the International Group for Indigenous Health Measurement. METHOD: A workshop of the International Group for Indigenous Health Measurement was held in Montreal in 2013 during which best practices in determining Indigenous mortality were discussed. A subsequent discussion paper and draft recommendations were further refined at a meeting in Vancouver in 2014. A working group finalized this best practice guide in follow-up to the two meetings. OUTCOME: Ten final recommendations are made regarding identification, community engagement and ownership, data linkage, uncertainty in official statistics and a timeline for implementation. In this paper we review and discuss these recommendations drawing on examples of best practice in Australia, Canada, New Zealand and the United States of America and highlighting some shortcomings in the current practices of official statistical agencies

Transfusion related acute lung injury: a case report

Transfusion Related Acute Lung Injury (TRALI) is one of the most serious complications of blood transfusion. All blood components have been implicated and most often those that contain plasma. The diagnosis is based fundamentally on the integration of clinical, radiological and gasometry elements, once the rest of the possible causes of acute lung injury have been ruled out. The differential diagnosis of a patient who develops a sudden pattern of respiratory failure after a transfusion of blood products must include hemodynamic overload, anaphylactic reaction, bacterial contamination of transfused blood products, haemolytic transfusion reaction and TRALI. Author presented the clinical case of a 33-year-old female patient with grade III hypovolemic shock due to a ruptured ectopic pregnancy, reanimated with crystalloid solutions, globular packages and fresh frozen plasma. The patient developed TRALI for what was managed with ventilatory and hemodynamic support in ICU

Transfusion related acute lung injury-TRALI: a review

Acute pulmonary damage caused by transfusion is characterized by the sudden onset of respiratory distress in newly transfused patients within 6 hours after the transfusion, bilateral infiltrative changes in chest X-ray, PaO2/FIO2 <300 mmHg, absence of other risk factors for acute lung injury and absence of signs suggesting cardiogenic origin of pulmonary edema. Being one of the most serious complications of blood transfusion, plasma is the most involved factor, although all blood components can cause it, and is caused by antigen reactions/leukocyte antibody and lipid activity with ability to modify the biological response on primitive leukocytes. The diagnosis is based on the integration of clinical, radiological and gasometric elements, ruling out the rest of the possible causes of acute lung injury. Its differential diagnosis should include hemodynamic overload, anaphylactic reaction, bacterial contamination of transfused blood products and transfusion hemolytic reaction. The treatment is supportive measures based on the needs and does not differ from the treatment of acute lung injury secondary to other etiologies, severe cases require endotracheal intubation and mechanical ventilation while the non-severe can be managed with oxygen therapy

La imagen y la narrativa como herramientas para el abordaje Psicosocial en escenarios de violencia. En el Departamento del Meta.

El presente informe, permite articular procesos de reflexión a través de los distintos relatos de violencia, que ayudan en la elaboración de ejercicios de análisis que abordan la subjetividad que se vive en contextos de nuestras regiones donde ha habido escenarios de violencia. A través de preguntas orientadoras estratégicas, circulares y reflexivas, se crea un acercamiento psicosocial en los escenarios expuestos, que sirven como guía para saber cómo intervenir para ayudar a la comunidad a superar las condiciones de victimización. Para el desarrollo del trabajo se cuenta con elementos muy importantes como son dos videos, que a través de su contenido o mensaje permite que haya una aproximación a las características del enfoque narrativo, como también el artículo de Michel White que es un recurso muy importante porque a través de él se obtiene un acercamiento más específico de lo que es la narrativa, ya que hay ejemplos de personas que han pasados por situaciones de violencia y los aportes de este autor nos muestra o nos ayuda a comprender los recursos que podemos utilizar en situaciones de posconflictos. También los aportes de las unidades son de gran ayuda de investigación, porque permiten conocer conceptos de diferentes autores sobre el apoyo psicosocial en problemas de violencia. La realización del análisis se desarrolla teniendo en cuenta cinco relatos de violencia y el caso de Cacarica, que permiten que a través de la lectura y la respuesta a las preguntas, se pueda conocer los pensamientos, sentimientos, reacciones y el impacto psicosocial que se presenta en el contexto de la historia relatada por cada protagonista Se puede decir que el trabajo es un reporte final, que evalúa el conocimiento obtenido durante el diplomado, donde se comprueba el alcance psicosocial que se obtuvo a través de la investigación, y las herramientas que se identificaron para saber cómo analizar elementos simbólicos y subjetivos en fenómenos de violencia, como también conocer las subjetividades e intersubjetividades que se presentan en contexto donde ha habido violencia y la capacidad que se obtuvo para valorar los eventos traumáticos que han tenido que vivir las comunidades desde una perspectiva psicológica.This report allows us to articulate reflection processes through the different stories of violence, which help in the elaboration of analysis exercises that address the subjectivity experienced in contexts of our regions where there have been scenarios of violence. Through strategic, circular and reflective guiding questions, a psychosocial approach is created in the exposed scenarios, which serve as a guide to know how to intervene to help the community overcome the conditions of victimization. For the development of the work there are very important elements such as two videos, which through their content or message allow an approach to the characteristics of the narrative approach, as well as the article by Michel White that is a very important resource because through it you get a more specific approach to what the narrative is, since there are examples of people who have gone through situations of violence and the contributions of this author shows us or helps us understand the resources that we can use in situations of post conflicts. The contributions of the units are also of great research help, because they allow to know concepts of different authors about psychosocial support in problems of violence. The analysis is carried out taking into account five stories of violence and the case of Cacarica, which allow the thoughts, feelings, reactions and psychosocial impact presented to be read through reading and answering the questions. in the context of the story told by each protagonist. It can be said that the work is a final report, which evaluates the knowledge obtained during the diploma, where the psychosocial scope that was obtained through the research is 6 checked, and the tools that were identified to know how to analyze symbolic and subjective elements in phenomena of violence, as well as knowing the subjectivities and intersubjectivities that occur in context where there has been violence and the capacity that was obtained to assess the traumatic events that communities have had to experience from a psychological perspective. Keywords: Violence, Scenarios, Victims, Post-conflict, Analysis

Treatments used for obsessive-compulsive disorder-An international perspective

© 2019 John Wiley & Sons, Ltd.OBJECTIVE: The objective of this study was to characterise international trends in the use of psychotropic medication, psychological therapies, and novel therapies used to treat obsessive-compulsive disorder (OCD). METHODS: Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their samples. Consistency of summary statistics across countries was evaluated. RESULTS: The study surveyed 19 expert centres from 15 countries (Argentina, Australia, Brazil, China, Germany, Greece, India, Italy, Japan, Mexico, Portugal, South Africa, Spain, the United Kingdom, and the United States) providing a total sample of 7,340 participants. Fluoxetine (n = 972; 13.2%) and fluvoxamine (n = 913; 12.4%) were the most commonly used selective serotonin reuptake inhibitor medications. Risperidone (n = 428; 7.3%) and aripiprazole (n = 415; 7.1%) were the most commonly used antipsychotic agents. Neurostimulation techniques such as transcranial magnetic stimulation, deep brain stimulation, gamma knife surgery, and psychosurgery were used in less than 1% of the sample. There was significant variation in the use and accessibility of exposure and response prevention for OCD. CONCLUSIONS: The variation between countries in treatments used for OCD needs further evaluation. Exposure and response prevention is not used as frequently as guidelines suggest and appears difficult to access in most countries. Updated treatment guidelines are recommended.Peer reviewe