Global mental health (Cambridge, England)最新文献

{"title":"Mental distress in ongoing conflict and non-conflict settings during COVID-19: a study on Syrians in different countries.","authors":"Ameer Kakaje, Ammar Fadel, Ayham Ghareeb, Ragheed Al Zohbi","doi":"10.1017/gmh.2021.12","DOIUrl":"https://doi.org/10.1017/gmh.2021.12","url":null,"abstract":"When applying cut-off points, Syrians in Syria comprised of 72 (31 3%) with avoidance symptoms, 106 (46 5%) with arousal symptoms, and 103 (45 4%) with re-experience symptoms, whereas Syrians outside Syria comprised of 96 (41 6%) with avoidance symptoms, 112 (49 6%) with arousal symptoms, and 111 (50 5%) with re-experience symptoms [ ]only avoidance was significantly more frequent in Syria (p = 0 022) K10 scores, days unable to work, social support and PTSD in different countries Characteristic Syria mean (s d ) Outside Syria mean (s d ) p value Nearby country mean (s d ) Canada mean (s d ) Egypt mean (s d ) UAE mean (s d ) Russia mean (s d ) Germany mean (s d ) p valuea Arousal 1 55 (1 427) 1 79 (1 563) 0 089 1 80 (1 560) 1 46 (1 266) 1 69 (1 569) 1 96 (1 641) 2 73 (1 272) 1 56 (1 586) 0 131 Avoidance 1 82 (1 726) 2 17 (1 889) 0 035 2 59 (1 968) 1 69 (1 974) 2 04 (1 605) 2 17 (1 872) 2 00 (2 145) 1 82 (1 820) 0 067 Re-experience 0 93 (1 284) 1 21 (1 600) 0 042 1 38 (1 686) 1 00 (1 206) 0 85 (1 287) 1 27 (1 724) 1 18 (1 471) 1 15 (1 638) 0 307 Total SPTSS 4 30 (3 735) 5 07 (4 422) 0 045 5 71 (4 630) 4 08 (3 796) 4 48 (3 435) 5 27 (4 698) 5 91 (4 571) 4 39 (4 422) 0 158 Friends support 15 620 (7 5494) 15 232 (7 7590) 0 590 15 372 (8 1975) 14 269 (8 9550) 15 115 (6 4750) 16 848 (8 0415) 7 727 (4 5131) 15 481 (7 0557) 0 038 Family support 19 097 (6 9193) 19 613 (6 8274) 0 423 18 633 (6 9157) 19 500 (9 0692) 19 058 (6 5793) 20 924 (6 6533) 20 500 (7 5299) 19 972 (6 2935) 0 632 Significant other support 19 273 (7 6526) 20 226 (7 3404) 0 174 19 880 (6 8556) 19 923 (8 4307) 19 111 (8 1090) 21 340 (7 4324) 18 864 (7 7495) 20 636 (7 3500) 0 653 Total social support 53 85 (18 307) 54 55 (18 263) 0 686 53 68 (17 675) 53 69 (21 092) 52 02 (19 812) 58 31 (19 702) 47 09 (15 152) 55 45 (16 854) 0 567 Total K 10 support 22 5633 (8 74049) 23 4474 (9 63162) 0 305 23 8108 (9 26131) 20 1538 (10 91517) 24 6071 (10 71288) 24 4681 (8 74481) 20 3636 (7 24255) 22 8909 (10 42375) 0 508 Days unable to work in the past 4 weeks 7 81 (11 050) 179 220 15 (2 444 117 919) 0 326 584 802 67 (4 415 106 822) 5 55 (9 048) 5 41 (6 681) 14 82 (58 913) 7 44 (7 502) 7 88 (7 860) 0 493 We used one-way analysis of variance and independent t test in this table a This p value is when comparing Syria with the previous countries [ ]there were no significant differences in the relationship with the partner and housemates, being distressed from war noise, being themselves or family exposed/infected to COVID-19, being hospitalized, self-quarantined with or without symptoms, losing jobs, and worries of work and study being affected [ ]as Syria did not have many active cases and the conflict was relatively less severe at the time of this study, Syrians in Syria were particularly concerned about providing food and a reduced ability to earn","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e12"},"PeriodicalIF":3.9,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2021.12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39123593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health integration in primary health services after the earthquake in Nepal: a mixed-methods program evaluation.","authors":"Ashley Leichner,&nbsp;Aemal Akhtar,&nbsp;Caoimhe Nic A Bhaird,&nbsp;Rebecca Wener,&nbsp;Shiromi M Perera,&nbsp;Inka Weissbecker","doi":"10.1017/gmh.2021.8","DOIUrl":"https://doi.org/10.1017/gmh.2021.8","url":null,"abstract":"<p><strong>Background: </strong>In the aftermath of the devastating 2015 earthquakes in Nepal, three non-governmental organizations collaborated to develop a program responding to the immediate mental health and psychosocial support (MHPSS) needs in three severely affected districts: Dhading, Gorkha, and Sindhuli. The program was implemented between April 2015 and February 2017 and aimed to (i) strengthen health worker capacity to provide integrated MHPSS services; and (ii) increase access to mental health services. This paper describes the program's implementation and the results of a pragmatic evaluation of the program's overall reach, effectiveness, and lessons learned.</p><p><strong>Methods: </strong>The mixed-methods evaluation used routine program data, quantitative data from pre- and post-tests conducted with trainees and service users, and qualitative data from stakeholder interviews and focus group discussions.</p><p><strong>Results: </strong>A total of 1041 health workers received MHPSS training and supervision. Participants demonstrated significant improvements in skills, knowledge, and self-rated perceived competency. Trainees went on to provide MHPSS services to 3422 people. The most commonly identified presenting problems were epilepsy (29%) and depression (26%). A total of 67% of service users reported being 'completely satisfied' with the services received and 83% of those experiencing severe functional impairments on enrollment demonstrated improvement after receiving services.</p><p><strong>Conclusions: </strong>Despite operational challenges, the program successfully engaged both laypeople and health workers to provide MHPSS in the aftermath of the crisis. Lessons learned can inform the planning and implementation of future training and integration programs to provide large-scale MHPSS efforts in humanitarian settings.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e10"},"PeriodicalIF":3.9,"publicationDate":"2021-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2021.8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39011041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of service provider competency for child and adolescent psychological treatments and psychosocial services in global mental health: evaluation of feasibility and reliability of the WeACT tool in Gaza, Palestine.","authors":"M J D Jordans,&nbsp;A Coetzee,&nbsp;H F Steen,&nbsp;G V Koppenol-Gonzalez,&nbsp;H Galayini,&nbsp;S Y Diab,&nbsp;S A Aisha,&nbsp;B A Kohrt","doi":"10.1017/gmh.2021.6","DOIUrl":"https://doi.org/10.1017/gmh.2021.6","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of evaluated tools to assess whether non-specialist providers achieve minimum levels of competency to effectively and safely deliver psychological interventions in low- and middle-income countries. The objective of this study was to evaluate the reliability and utility of the newly developed Working with children - Assessment of Competencies Tool (WeACT) to assess service providers' competencies in Gaza, Palestine.</p><p><strong>Methods: </strong>The study evaluated; (1) psychometric properties of the WeACT based on observed role-plays by trainers/supervisors (<i>N</i> = 8); (2) sensitivity to change among service provider competencies (<i>N</i> = 25) using pre-and-post training WeACT scores on standardized role-plays; (3) in-service competencies among experienced service providers (<i>N</i> = 64) using standardized role-plays.</p><p><strong>Results: </strong>We demonstrated moderate interrater reliability [intraclass correlation coefficient, single measures, ICC = 0.68 (95% CI 0.48-0.86)] after practice, with high internal consistency (<i>α</i> = 0.94). WeACT assessments provided clinically relevant information on achieved levels of competencies (55% of the competencies were scored as adequate pre-training; 71% post-training; 62% in-service). Pre-post training assessment saw significant improvement in competencies (<i>W</i> = -3.64; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>This study demonstrated positive results on the reliability and utility of the WeACT, with sufficient inter-rater agreement, excellent internal consistency, sensitivity to assess change, and providing insight needs for remedial training. The WeACT holds promise as a tool for monitoring quality of care when implementing evidence-based care at scale.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e7"},"PeriodicalIF":3.9,"publicationDate":"2021-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2021.6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39009584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the mental health cultural adaptation and contextualization for implementation (mhCACI) procedure: a systematic framework to prepare evidence-based psychological interventions for scaling.","authors":"Manaswi Sangraula, Brandon A Kohrt, Renasha Ghimire, Pragya Shrestha, Nagendra P Luitel, Edith Van't Hof, Katie Dawson, Mark J D Jordans","doi":"10.1017/gmh.2021.5","DOIUrl":"10.1017/gmh.2021.5","url":null,"abstract":"<p><strong>Background: </strong>Because of the high burden of untreated mental illness in humanitarian settings and low- and middle-income countries, scaling-up effective psychological interventions require a cultural adaptation process that is feasible and acceptable. Our adaptation process incorporates changes into both content and implementation strategies, with a focus on local understandings of distress and treatment mechanisms of action.</p><p><strong>Methods: </strong>Building upon the ecological validity model, we developed a 10-step process, the mental health Cultural Adaptation and Contextualization for Implementation (mhCACI) procedure, and piloted this approach in Nepal for Group Problem Management Plus (PM+), a task-sharing intervention, proven effective for adults with psychological distress in low-resource settings. Detailed documentation tools were used to ensure rigor and transparency during the adaptation process.</p><p><strong>Findings: </strong>The mhCACI is a 10-step process: (1) identify mechanisms of action, (2) conduct a literature desk review for the culture and context, (3) conduct a training-of-trainers, (4) translate intervention materials, (5) conduct an expert read-through of the materials, (6) qualitative assessment of intervention population and site, (7) conduct practice rounds, (8) conduct an adaptation workshop with experts and implementers, (9) pilot test the training, supervision, and implementation, and (10) review through process evaluation. For Group PM+, key adaptations were harmonizing the mechanisms of action with cultural models of 'tension'; modification of recruitment procedures to assure fit; and development of a skills checklist.</p><p><strong>Conclusion: </strong>A 10-step mhCACI process could feasibly be implemented in a humanitarian setting to rapidly prepare a psychological intervention for widespread implementation.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e6"},"PeriodicalIF":0.0,"publicationDate":"2021-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38988410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral impairment and cognition in Thai adolescents affected by HIV.","authors":"Payal B Patel,&nbsp;Andrew Belden,&nbsp;Ryan Handoko,&nbsp;Thanyawee Puthanakit,&nbsp;Stephen Kerr,&nbsp;Pope Kosalaraksa,&nbsp;Pradthana Ounchanum,&nbsp;Suparat Kanjanavanit,&nbsp;Linda Aurpibul,&nbsp;Chaiwat Ngampiyasakul,&nbsp;Wicharn Luesomboon,&nbsp;Claude A Mellins,&nbsp;Kathleen Malee,&nbsp;Jintanat Ananworanich,&nbsp;Robert Paul","doi":"10.1017/gmh.2021.1","DOIUrl":"https://doi.org/10.1017/gmh.2021.1","url":null,"abstract":"<p><strong>Background: </strong>Cognitive and behavioral impairment are common in children living with perinatally acquired HIV (pHIV) and children exposed to HIV in utero but uninfected (HEU).</p><p><strong>Methods: </strong>We sought to determine the prevalence of adverse behavioral symptomatology using a Thai-translated and validated version of the SNAP-IV questionnaire and assess cognitive function utilizing the Children's Color Trails Test, Delis-Kaplan Executive Function System, and the Wechsler Intelligence Scales, in our cohort of Thai adolescents (10-20 years old) with well-controlled pHIV compared to HEU and HIV-unexposed, uninfected youth. We then evaluated the interaction between HIV status, behavioral impairment, and executive function outcomes independent of demographic variables.</p><p><strong>Results: </strong>After controlling for demographic factors of age and household income, adolescents with pHIV had higher inattentive symptomatology and poorer neuropsychological test scores compared to uninfected controls. Significant interactions were found between inattention and executive function across multiple neurocognitive tests.</p><p><strong>Conclusions: </strong>Behavioral impairment and poor executive functioning are present in adolescents with well-controlled pHIV compared to HIV-uninfected matched peers. The SNAP-IV questionnaire may be a useful tool to identify those with attentional impairment who may benefit from further cognitive testing in resource-limited settings.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e3"},"PeriodicalIF":3.9,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2021.1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39009579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of catastrophic healthcare expenditure and its main determinants in Mexican households caring for a person with a mental disorder.","authors":"Lina Diaz-Castro,&nbsp;Héctor Cabello-Rangel,&nbsp;Carlos Pineda-Antúnez,&nbsp;Alejandra Pérez de León","doi":"10.1017/gmh.2020.29","DOIUrl":"https://doi.org/10.1017/gmh.2020.29","url":null,"abstract":"<p><strong>Background: </strong>There are few studies on the impact of out-of-pocket mental health care expenditures and sociodemographic factors on the probability of Mexican households to incur catastrophic healthcare expenditures (CHE).</p><p><strong>Objective: </strong>The goal of the present study was to estimate the incidence of CHE and its main determinants among the households of persons with mental disorders (MD) in Mexico.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted, including 387 households of persons with MD. The estimation of the CHE was obtained by the health expenditure distribution method. A Logistic Regression (LR) was used to identify the determinants of probability variation of CHE occurrence. Since we expected a proportion of CHE between 20% and 80%, we assume linearity in the probability function, therefore we additionally used an Ordinary Least Squares (OLS) model.</p><p><strong>Results: </strong>In our sample, the incidence of CHE was 34.8%. The two mental illnesses most frequently associated with CHE were schizophrenia and hyperactive disorder (35.5% and 32.6% of CHE cases, respectively). The regression coefficients showed that for each unit (US$53.77) increase in income, the probability of CHE was reduced by 8.6%, while for each unit increase in hospitalization or medication expenditures, the probability of CHE increased by 12.9% or 19%, respectively. For each additional household member, the probability of CHE increased by 3%, and households with a male patient had a 7% greater probability of CHE.</p><p><strong>Conclusion: </strong>Household income, household size, hospitalization and medication expenses, and sex of the patient were significant predictors of CHE for households caring for a person with MD.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e2"},"PeriodicalIF":3.9,"publicationDate":"2021-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2020.29","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38899802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of funding patterns in development assistance for mental health: who, when, what, and where.","authors":"Rebecca S F Gribble,&nbsp;Bernhard H Liese,&nbsp;Marisha N Wickremsinhe","doi":"10.1017/gmh.2020.30","DOIUrl":"https://doi.org/10.1017/gmh.2020.30","url":null,"abstract":"<p><strong>Background: </strong>Mental health has recently gained increasing attention on global health and development agendas, including calls for an increase in international funding. Few studies have previously characterized official development assistance for mental health (DAMH) in a nuanced and differentiated manner in order to support future funding efforts.</p><p><strong>Methods: </strong>Data from the Organisation for Economic Cooperation and Development Creditor Reporting System were obtained through keyword searches. Projects were manually reviewed and categorized into projects dedicated entirely to mental health and projects that mention mental health (as one of many aims). Analysis of donor, recipient, and sector characteristics within and between categories was undertaken cumulatively and yearly.</p><p><strong>Findings: </strong>Between the two categories of official DAMH defined, characteristics differed in terms of largest donors, largest recipient countries and territories, and sector classification. However, across both categories there were clear and consistent findings: the top donors accounted for over 80% of all funding identified; the top recipients were predominantly conflict-affected countries and territories, or were receiving nations for conflict-affect refugees; and sector classification demonstrated shifting international development priorities and political drivers.</p><p><strong>Conclusion: </strong>Across DAMH, significant amounts of funding are directed toward conflict settings and relevant emergency response by a small majority of donors. Our analysis demonstrated that, within minimal international assistance for mental health overall, patterns of donor, recipient, and sector characteristics favor emergency conflict-affected settings. Calls for increased funding should be grounded in understanding of funding drivers and directed toward both emergency and general health settings.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e1"},"PeriodicalIF":3.9,"publicationDate":"2021-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2020.30","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38899801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pandemic on mental health in lower- and middle-income countries (LMICs).","authors":"Manasi Kumar,&nbsp;Pushpam Kumar","doi":"10.1017/gmh.2020.28","DOIUrl":"https://doi.org/10.1017/gmh.2020.28","url":null,"abstract":"Poverty and mental health Extreme poverty, measured as earning less than USD 1 90 a day by the World Bank, is accompanied by hunger, overcrowded living conditions, low accessibility and affordability of health services, limited educational and livelihood opportunities, and adverse life events associated with socioeconomic vulnerabilities Over time an awareness in the field of mental health recognizes that this vicious cycle of poverty and mental ill health needs to be viewed from human rights perspective Rise in mental health needs during COVID-19 pandemic COVID-19 is merely one symptom of the dysfunctional relationship between humans and nature, which is manifested through climate change, loss of biodiversity, habitat fragmentation, and domestication of wild animals (UNEP, 2020) The results of a Chinese study reviewing the effect of COVID-19 mitigation plans on mental health led Wuhan's Government officials to develop a multi-layered response that involved forming psychological intervention teams for key populations that are likely to be impacted by exposure to COVID-19 and its adverse risk factors (Kang et al , 2020)","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e35"},"PeriodicalIF":3.9,"publicationDate":"2020-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2020.28","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39123592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability and feasibility of using actigraphy to assess habitual physical activity and sleep parameters in men and women living in rural communities in conflict-affected Eastern Democratic Republic of Congo.","authors":"Lisa J Wood,&nbsp;Mervyn Christian,&nbsp;Nancy Perrin,&nbsp;Alfred Backikenge Mirindi,&nbsp;Jean Heri Banywesize,&nbsp;Clovis Murhula Mitima,&nbsp;Arsene Kajabika Binkurhorwa,&nbsp;Eric Mitima Ntqali,&nbsp;Gisele Ntakwinja Mushengezi,&nbsp;Mitima Mpanano Remy,&nbsp;Nancy Glass","doi":"10.1017/gmh.2020.25","DOIUrl":"https://doi.org/10.1017/gmh.2020.25","url":null,"abstract":"<p><strong>Background: </strong>The goals of this study were to (1) determine the feasibility and acceptability of using actigraphy to objectively measure sleep quality and habitual physical activity in rural Democratic Republic of Congo (DRC) and (2) examine the relationship between sleep parameters, self-report symptoms, daytime physical activity, and physical function, including the ability to work.</p><p><strong>Method: </strong>Thirty individuals were asked to wear a wrist-worn accelerometer for 5 nights and 4 days. Nighttime sleep parameters derived were average and intra-individual variability (IIV) in total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), and wake after sleep onset (WASO). Daytime habitual physical data derived were average and peak activity and daytime napping.</p><p><strong>Results: </strong>Ninety-three percent (<i>n</i> = 28) of participants completed the study. All participants who wore the device marked sleep and wake cycles and periods of non-wear using the marker. Trauma-related symptoms were not associated with mean or IIV in TST, SE, SOL, or WASO (<i>p</i> > 0.01). Those with higher levels of bodily pain slept longer (<i>β</i> = 0.633, <i>p</i> = 0.003, adjusted <i>R</i> ² = 0.279), were more likely to report that their physical health limited their physical activities (<i>β</i> = 0.71, <i>p</i> < 0.001, adjusted <i>R</i> ² = 0.679) and had greater difficulty doing daily work (<i>β</i> = 0.84, <i>p</i> = 0.001, adjusted <i>R</i> ² = 0.665).</p><p><strong>Conclusion: </strong>The use of actigraphy to collect objective measures of activity and sleep quality in rural post-conflict settings is feasible and acceptable. Our preliminary findings suggest that bodily pain and not trauma-related symptoms have a significant impact on sleep and functional outcomes in men and women survivors of prolonged conflict in the DRC.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e33"},"PeriodicalIF":3.9,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2020.25","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38775455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing medical students and psychiatry residents in Ghana to consider psychiatry as a career option - a qualitative study.","authors":"Vincent I O Agyapong,&nbsp;Amanda Ritchie,&nbsp;Kacy Doucet,&nbsp;Gerald Agyapong-Opoku,&nbsp;Reham Shalaby,&nbsp;Marianne Hrabok,&nbsp;Thaddeus Ulzen,&nbsp;Akwasi Osei","doi":"10.1017/gmh.2020.24","DOIUrl":"https://doi.org/10.1017/gmh.2020.24","url":null,"abstract":"<p><strong>Background: </strong>Currently, Ghana has 14 actively practicing psychiatrists and about 26 psychiatric residents for a population of over 28 million people. Previous research suggests a lack of interest by Ghanaian medical students and medical graduates in considering psychiatry as a career option.</p><p><strong>Objectives: </strong>To examine the perception of medical students and psychiatry residents in Ghana about the barriers which hinder Ghanaian medical graduates from choosing careers in psychiatry and how these barriers could be overcome.</p><p><strong>Methods: </strong>This was a cross-sectional qualitative study with data gathered using focus group discussion. Twenty clinical year medical students were selected through block randomization from the four public medical schools in Ghana and invited to participate in one of two focus group discussions. Also, four psychiatric residents were invited to participate in the focus group discussions.</p><p><strong>Results: </strong>The main barriers identified by participants could be grouped under four main themes, namely: (a) myths and stigma surrounding mental health and patients, (b) negative perceptions of psychiatrists, (c) infrastructure and funding issues, (d) lack of exposure and education. To address the barriers presented, participants discussed potential solutions that could be categorized into five main themes, namely: (a) stigma reduction, (b) educating professionals, (c) addressing deficient infrastructure, (d) risk management, and (e) incentivizing the pursuit of psychiatry among students.</p><p><strong>Conclusion: </strong>Health policy planners and medical training institutions could consider implementing proposed solutions to identify barriers as part of efforts to improve the psychiatrist to patient ratio in Ghana.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e31"},"PeriodicalIF":3.9,"publicationDate":"2020-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2020.24","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38775454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}