Self-reported health as a predictor of mortality: A cohort study of its relation to other health measurements and observation time.

Self-reported health (SRH) is widely used as an epidemiological instrument given the changes in public health since its introduction in the 1980s. We examined the association between SRH and mortality and how this is affected by time and health measurements in a prospective cohort study using repeated measurements and physical examinations of 11652 men and 12684 women in Tromsø, Norway. We used Cox proportional hazard regression to estimate hazard ratios (HRs) of death for SRH, controlling for pathology, biometrics, smoking, sex and age. SRH predicted mortality independently of other, more objective health measures. Higher SRH was strongly associated with lower mortality risk. Poor SRH had HR 2.51 (CI: 2.19, 2.88). SRH is affected by disease, mental health and other risk factors, but these factors had little impact on HRs (Poor SRH: HR 1.99; CI: 1.72, 2.31). SRH predicted mortality, but with a time-dependent effect. Time strongly affected the hazard ratio for mortality, especially after ten-year follow-up (Poor SRH HR 3.63 at 0-5 years decreased to HR 1.58 at 15-21 years). SRH has both methodological and clinical value. It should not be uncritically utilised as a replacement instrument when measures of physical illness and other objective health measures are lacking

The association of religious factors with mental health-service utilisation and satisfaction in a mixed Sámi and Norwegian adult population: Adopting the SAMINOR 2 Questionnaire Survey

The Indigenous Sámi have poorer mental health than the majority population and fairly equal access to professional mental healthcare. Despite this condition, certain studies indicate that this group is underrepresented among the users of such services. Religion or spirituality (R/S) often influences mental health-service utilisation and satisfaction among other Indigenous peoples and ethnic minorities. Thus, this study examines the situation in Sámi-Norwegian areas. We utilised cross-sectional data from the population-based SAMINOR 2 Questionnaire Survey (2012; subsample n = 2,364; 71% non-Sámi) in mixed Sámi-Norwegian regions of Northern and Central Norway. We analysed the associations between R/S factors and past-year mental health-service utilisation and satisfaction among individuals reporting mental health problems, substance use, or addictive behaviours. Multivariable-adjusted regression models considering sociodemographic factors, including Sámi ethnicity, were applied. Religious attendance was significantly associated with infrequent past-year use of mental health services (OR = 0.77) and fewer mental health problems, indicating that the R/S fellowship may buffer mental distress and represent an alternative psychological support to professional services. R/S was not significantly associated with lifetime mental health-service satisfaction. We found no ethnic differences in service utilisation or satisfaction

Responsabilidad extracontractual del estado por el incumplimiento de funciones de las entidades públicas frente a el acoso escolar en Colombia.

This document presents the result of an investigative study that I seek centrally, to establish whether the State can be legally imputed under the regime of extra-contractual liability for the action and omission in the fulfillment of functions, objectives and responsibilities of the public entities that must give observance and obedience to the legal framework on bullying in Colombia, for this it was proposed to solve the following problem question: Is the State liable extracontractually for the action and omission in the fulfillment of functions, objectives and responsibilities of the public entities that must give observance and obedience to the legal framework on bullying in Colombia? For its development, and to respond to the proposed proposal, a legal methodology was used, since a study of the legal system is made in relation to school v i o l e n c e a n d t h e t h e o r y o f S t a t e responsibility and a documentary technique is used. Therefore, to achieve the objective, it was carried out through a review, study, analysis of the norm, the Constitution, jurisprudence and doctrine. En el presente escrito se presenta el resultado de un estudio investigativo que busco centralmente, Establecer si el Estado puede ser imputado jurídicamente bajo el r é g i m e n d e R e s p o n s a b i l i d a d extracontractual por la acción y omisión en el cumplimiento de funciones, objetivos y responsabilidades de las entidades públicas que deben dar observancia y obediencia al marco jurídico sobre el acoso escolar en Colombia, para ello se propuso resolver la siguiente pregunta problema ¿Es el Estado responsable extracontractualmente por la acción y omisión en el cumplimiento de funciones, objetivos y responsabilidades de las entidades públicas que deben dar observancia y obediencia al marco jurídico sobre el acoso escolar en Colombia? Para su desarrollo, y dar respuesta a la propuesta planteada, se utilizó una metodología de carácter jurídico, pues se hace un estudio del ordenamiento jurídico con relación a la violencia escolar y la teoría de la responsabilidad del Estado y se utiliza una técnica de carácter documental, pues para alcanzar el objetivo se realizó a través de revisión, estudio, análisis de la norma, la Constitución, la jurisprudencia y la doctrina

Abordagem da lombalgia ocupacional na Atenção Primária

A high incidence of low back pain in the population generates high expenses with crises at the secondary and tertiary levels. That said, the research sought to understand what are the currently recommended approaches needed for the condition. A survey was carried out on the PubMed platform, using the keywords "occupational", "low back pain", "primary care" and "approach", where it recorded 22 results related to the last 5 years, 9 of which were discarded for not understanding the relevant issues in search. From this review, we might to show effective approaches in the scope of primary care to optimize person-centered care based on the latest available literature. The selected results point to the need for further studies on the condition, since disagreements were found between approaches indicated by the most recent literature and currently indicated by the Clinical Protocol of Therapeutic Guidelines of the Ministry of Health.A grande incidência de lombalgia na população leva a uma grande demanda de tratamento no nível básico, além de gerar gastos com crises agudas nos níveis secundário e terciário. Essa revisão sistemática busca entender quais abordagens seriam pertinentes à condição para que o médico da atenção primária consiga ter a conduta mais adequada e resolutiva. A pesquisa foi realizada na plataforma PubMed utilizando-se descritores “occupational”, “low back pain”, “primary care” e “approach”, onde obteve-se 24 resultados posteriores a 2014 dos quais descartou-se 16 por não compreenderem o objetivo inicial. A partir da leitura buscou-se trazer abordagens eficientes no âmbito da atenção primária de modo a otimizar a resolutividade com base na literatura mais recente disponível. Os resultados apontaram a adoção de uma conduta multidisciplinar, bem como a associação de fármacos adjuvantes a analgésicos no tratamento farmacológico, como preconizado pelo Ministério da Saúde

Subjective experiences of compulsory treatment from a qualitative study of early implementation of the Mental Health (Care and Treatment)(Scotland) Act 2003

Compulsory psychiatric treatment is highly contested, and little research has focused specifically on direct experiences. The Mental Health (Care & Treatment) (Scotland) Act, 2003 introduced new roles and provisions including community treatment orders, and was designed to increase participation, ensure treatment was beneficial and was the ‘least restrictive’ alternative. This article draws on findings from semistructured interviews with 49 individuals who had experienced compulsion under this new legislation during 2007-08, that were part of a broader cohort study. Interviews with service users were conducted at two stages with 80% agreeing to be interviewed twice. The sample included people on a variety of compulsory orders from four Health Board areas, some of whom had been detained for the first time, while others reported ‘revolving door’ experiences. Peer researchers who were mental health service users carried out the interviews with professional researchers. The findings suggest that legislation had a limited impact on participation in the process of compulsion. Consensus was that although service users felt there was increased opportunity for their voices to be heard, this was not matched by having increased influence over professional decision-making, especially in relation to drug treatments. According to people's direct experiences, the passing of the legislation in itself had done little to change the dominant psychiatric paradigm. While providing a foundation for improving the process of compulsion, the findings suggest that as well as legislative reform, fundamental shifts in practice are needed both in terms of the nature of therapeutic relationships, and in embracing more holistic and recovery perspectives