219 research outputs found
ImplicaçÔes da covid-19 na saĂșde mental, nos Ăłbitos por suicĂdio e no acesso a serviços da rede psicossocial brasileira
O objetivo desta tese Ă© compreender e avaliar as implicaçÔes da pandemia da COVID-19 em desfechos de saĂșde mental (SM) e no acesso a serviços da rede de atenção psicossocial brasileira. Para isso, foram realizados trĂȘs estudos teĂłricos, desenvolvidos no perĂodo inicial da pandemia, e duas investigaçÔes originais com anĂĄlise de dados secundĂĄrios, concernentes ao primeiro ano da crise. No artigo 1, intitulado ââPandemic fearâ and COVID-19: mental health burden and strategiesâ, foi conduzida uma revisĂŁo teĂłrica e, a partir de informaçÔes sobre surtos, epidemias e pandemias prĂ©vias, buscou-se compreender os potenciais impactos da COVID-19 na SM da população. Estimou-se que estaria ocorrendo uma pandemia de medo paralela Ă pandemia viral e, como consequĂȘncia, o cenĂĄrio da SM da população, que jĂĄ era preocupante, provavelmente seria agravado. Diante disso, ofereceram-se recomendaçÔes iniciais para mitigar o impacto da crise na SM. Com mĂ©todo semelhante, no artigo 2, denominado âThe impact of the COVID-19 pandemic on the mental health of healthcare professionalsâ, foram debatidos os reflexos da crise na SM dos profissionais da saĂșde, que se depararam com as sobrecargas fĂsica e emocional decorrentes do aumento do nĂșmero de casos e de Ăłbitos, e com a ausĂȘncia de fĂĄrmacos reconhecidamente eficazes para prevenir ou tratar a doença. Neste manuscrito, tambĂ©m foram sugeridas possĂveis estratĂ©gias e intervençÔes para amenizar o impacto da pandemia na SM da população estudada. No artigo 3, âThe COVID-19 pandemic and its impact on substance use: Implications for prevention and treatmentâ, foram discutidas as consequĂȘncias da pandemia na SM de pacientes com transtornos por uso de substĂąncias. Este grupo Ă© caracterizado pelo alto Ăndice de problemas clĂnicos e psicossociais e, portanto, particularmente sensĂvel ao estresse pandĂȘmico. Entretanto, o acesso a medidas terapĂȘuticas pode ter sido dificultado em decorrĂȘncia das medidas de contenção da transmissĂŁo do vĂrus. No artigo 4, âThe next pandemic: impact of COVID-19 in mental healthcare assistance in a nationwide epidemiological studyâ, foram analisados os dados oficiais sobre o acesso a serviços de SM ocorridos no Sistema Ănico de SaĂșde brasileiro. Observou-se uma redução drĂĄstica nos atendimentos de SM ambulatoriais e hospitalares, um aumento das consultas de emergĂȘncia e de atendimentos domiciliares e a estabilização dos atendimentos por risco de suicĂdio durante os seis primeiros meses da crise, em comparação ao que seria esperado. No artigo 5, âDifferential impact in suicide mortality during the COVID-19 pandemic in Brazilâ, foram avaliados os Ăłbitos por suicĂdio ocorridos no Brasil, comparando os perĂodos prĂ© e intracrise. Verificou-se que, apesar da estabilidade geral do nĂșmero de mortes autoprovocadas, houve um aumento em mulheres e idosos. AnĂĄlises estratificadas demonstraram que o aumento dos suicĂdios ocorreu de forma heterogĂȘnea entre grupos populacionais de diferentes regiĂ”es do Brasil. Houve aumento de suicĂdios em populaçÔes com histĂłrico de dificuldade de acesso Ă saĂșde, que podem ter sido severamente impactadas pela pandemia. Em conjunto, esses dados indicam que os impactos da crise pandĂȘmica extrapolam a esfera fĂsica e podem agravar o cenĂĄrio da SM. As consequĂȘncias da pandemia sĂŁo mĂșltiplas e podem variar ao longo do tempo. Assim, Ă© fundamental que investigaçÔes futuras sigam monitorando desfechos de SM nos prĂłximos anos.The objective of this thesis is to understand and evaluate the implications of the COVID-19 pandemic on mental health (MH) outcomes and access to services in the Brazilian psychosocial care network. For this, three theoretical studies were carried out, developed in the initial period of the pandemic, and two original investigations with analysis of secondary data, concerning the first year of the crisis. In article 1, entitled â'Pandemic fear' and COVID-19: mental health burden and strategiesâ, a theoretical review was carried out and, based on information on previous outbreaks, epidemics, and pandemics, an attempt was made to understand the potential impacts of COVID-19. -19 in the MS of the population. It was estimated that a fear pandemic would be occurring parallel to the viral pandemic and, therefore, the population's MS scenario, which was already worrying, would probably be worsened. In view of this, initial recommendations were offered to mitigate the impact of the crisis on MS. With a similar method, in article 2, called âThe impact of the COVID-19 pandemic on the mental health of healthcare professionalsâ, the reflexes of the crisis on the MH of health professionals, who faced the resulting physical and emotional overloads, were discussed. the increase in the number of cases and deaths, and the absence of drugs known to be effective to prevent or treat the disease. In this manuscript, possible strategies and interventions were also suggested to mitigate the impact of the pandemic on MS in the population studied. In article 3, âThe COVID-19 pandemic and its impact on substance use: Implications for prevention and treatmentâ, the consequences of the pandemic on MS in patients with substance use disorders were discussed. This group is characterized by a high rate of clinical and psychosocial problems and is therefore particularly sensitive to pandemic stress. However, access to therapeutic measures may have been hampered because of measures to contain the transmission of the virus. In article 4, âThe next pandemic: impact of COVID-19 in mental healthcare assistance in a nationwide epidemiological studyâ, official data on access to MH services in the Brazilian Unified Health System were analyzed. There was a drastic reduction in outpatient and hospital MH visits, an increase in emergency consultations and home visits, and a stabilization of visits for suicide risk during the first six months of the crisis, compared to what would be expected. In article 5, âDifferential impact in suicide mortality during the COVID-19 pandemic in Brazilâ, the deaths by suicide that occurred in Brazil were evaluated, comparing the pre-and intra-crisis periods. It was found that, despite the general stability in the number of self-inflicted deaths, there was an increase in women and the elderly. Stratified analyzes showed that the increase in suicides occurred heterogeneously among population groups from different regions of Brazil. There has been an increase in suicides in populations with a history of difficult access to healthcare, which may have been severely impacted by the pandemic. Taken together, these data indicate that the impacts of the pandemic crisis go beyond the physical sphere and can worsen the MH scenario. The consequences of the pandemic are multiple and can vary over time. Thus, it is essential that future investigations continue to monitor MS outcomes in the coming years
Ekonomisk vinning till varje pris? En analys av den illegala vapenhandelns kopplingar till fiskeindustrin i omrÄdet kring Victoriasjön.
I filmen Darwins mardröm skildras fiskeindustrin i Victoriasjön och dess kopplingar till illegal vapenhandel. Denna handel pÄverkas och möjliggörs av ekonomiska och politiska aktörers intressen, vilka har rötter som strÀcker sig över staters grÀnser. Vi har, genom en kvalitativ textanalys, analyserat intervjuer i filmen och funnit att bÄde regeringar, transnationella nÀtverk och företag gör ekonomiska förtjÀnster pÄ vapenhandelns fortgÄende. Tillkortakommanden i de nationella och de internationella lagar och förordningar som reglerar denna handel innefattar korruption och organiserad brottslighet. Enligt Mary Kaldor Àr termen nya krig anvÀndbar för att förklara och förstÄ de förÀndringar som pÄ senare tid skett inom krigsföringen, vilka kan hÀrledas till en ökande transnationell sammanbundenhet. DÀrför har vi anvÀnt oss av dessa teorier för att analysera vÄrt empiriska fall. Parter i de nya krigen Àr finansiellt beroende av transnationella nÀtverk och organiserad brottslighet, sÄsom vapenhandel. Alla inblandade parter mÄste ta ett större ansvar för att svagare stater inte ska utnyttjas
Projekt med kvalitet: en studie om hur anvÀndandet av en strukturerad projektmodell prÀglar arbetet i en offentlig organisation
Syftet med studien har varit att studera Helsingborgs stads arbete med projektmodellen. Metoden som anvÀndes var grundad teori och studien baseras pÄ fem öppna intervjuer varav fyra projektledare och en styrgrupp och referensgruppsmedlem. Genom vÄr interaktiva forskningsprocess har uppsatsens omrÄdesfokus successivt vÀxt fram. Under de kontinuerliga analyserna har vi funnit relevanta kopplingar till Peter M. Senges fem discipliner, en teori vilken vi anvÀnt tillsammans med tidigare forskning för att öka vÄr förstÄelse för fenomenet vi studerat. Resultatet visar att projektmodellen skapar struktur, vilken i sin tur skapar förutsÀttningar för tillvaratagande av organisationens (individernas/projektens) kompetens och pÄ sÄ sÀtt rÄder det ett kontinuerligt lÀrande som kan relateras till hur arbetet med projektmodellen genomförs. Resultatet indikerar dÀrutöver pÄ att Helsingborgs stad kan utmÀrka sig som en lÀrande organisation, men resultatet pekar ocksÄ pÄ utvecklingsfaktorer som kan öka förutsÀttningarna för lÀrande inom organisationen ytterligare
Cannabidiol and mental health : possibilities, uncertainties, and controversies for addiction treatment
The sum of fears in cancer patients inside the context of the COVID-19
The pandemic resulting from COVID-19 has led to the collapse of the health system in dozens of countries. Parallel to clinical risk, the appearance or intensification of psychiatric symptoms has also been documented. The identification of groups at risk is essential for the establishment of preventive and therapeutic strategies. Cancer patients appear to be especially vulnerable both from a clinical and psychiatric perspective. Problems related to contamination and the cancer treatments themselves are intertwined, causing a sum of patients' fears to arise, which can cause mental effects. This study aims to review and investigate the impact of COVID-19 on the mental health of cancer patients and indicate possible support strategies
Multiple clinical risks for cannabis users during the COVID-19 pandemic
The pandemic caused by Sars-CoV-2 (COVID-19) has been a great concern for public and mental health systems worldwide. The identification of risk groups is essential for the establishment of preventive and therapeutic strategies, as for substance users. During COVID-19 pandemic, there was an increase in the use of psychoactive substances during the lockdown, including cannabis. This commentary reviews relevant findings and discusses scientific evidence on the risks of worse clinical and psychiatric complications due to coronavirus disease COVID-19 in subjects who use cannabis. Although they are not included as a risk group in the health recommendations for that disease, they may have a more vulnerable respiratory system to viral diseases. There are certain similarities between the harmful cardiovascular and respiratory effects of cannabis use and those of smoking. Due to the different modes of smoking, cannabis chemicals are retained in the body for longe and may also contain other toxic substances such as tar, a substance found in tobacco and which has been associated with the development of lung cancer, bronchitis and pulmonary emphysema. Therefore, we discuss if individuals who use cannabis regularly might be more vulnerable to COVID-19 infection. This population deserves more clinical attention worldwide and this manuscript can help clinicians become more aware of cannabis risks during pandemics and develop specific intervention strategies
Childhood trauma subtypes may influence the pattern of substance use and preferential substance in men with alcohol and/or crack-cocaine addiction
Objective: To compare the prevalence and subtypes of childhood maltreatment (CM) between individuals with and without substance use disorder (SUD) and investigate the influence of different traumas on the preferential use of substances and the severity of dependence. Methods: The sample consisted of 1,040 men with SUD (alcohol users [n=315], crack-cocaine users [n=406], multiple-substance users [n=319]) and 201 controls. The Childhood Trauma Questionnaire (CTQ) and the Addiction Severity Index-6 (ASI-6) were used to assess CM and drug-use patterns. Results: Individuals with SUD had a higher prevalence of CM than controls (63.4 vs. 28.1%, respectively). Exposure to physical trauma was associated with alcohol use disorder and severity of alcohol use. In contrast, emotional trauma was associated with use of multiple substances and severity of drug use in crack-cocaine users. Conclusions: This study corroborates the association of CM with SUD susceptibility. Our results suggest that the type of CM may influence preferential substance use and addiction severity. In this sense, physical traumas are more associated with alcohol use, while emotional and sexual traumas favor use of multiple drugs, especially crack cocaine. These findings may help the development of tailored prevention and intervention strategies
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