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Participatory research denotes the engagement and meaningful involvement of the community of interest across multiple stages of investigation, from design to data collection, analysis, and publication. Traditionally, people with first-hand experience of psychiatric diagnoses, service users, and those living with a psychosocial disability have been seen objects rather than agents of research and knowledge production, despite the ethical and practical benefits of their involvement. The state of the art of knowledge about participatory research in mental health Brazil is poorly understood outside of its local context. The purpose of this article was to conduct a scoping review of participatory and user-led research in mental health in Brazil. We identified 20 articles that met eligibility criteria. Participation in research was not treated as separate from participation in shaping mental health policy, driving care, or the broader right to fully participate in societal life and enjoy social and civil rights. Studies identified several obstacles to full participation, including the biomedical model, primacy of academic and scientific knowledge, and systemic barriers. Our extraction, charting, and synthesis yielded four themes: power, knowledge, autonomy, and empowerment. Participation in this context must address the intersecting vulnerabilities experienced by those who are both Brazilian and labeled as having a mental illness. Participatory research and Global South leadership must foreground local epistemologies that can contribute to the global debate about participation and mental health research.
Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China.
Two mental health surveys, using the International Classification of Disease (ICD-10), were conducted in the same six townships of Xinjin county, Chengdu, China in 1994 and 2015. A total of 308 persons with SMI identified in 1994 were followed up in 2015. The profiles of poverty transitions were identified and regression modelling methods were applied to determine the predictive factors of poverty transitions.
The poverty rate of persons with SMI increased from 39.9% to 49.4% in 1994 and 2015. A larger proportion of them had fallen into poverty (27.3%) rather than moved out of it (17.8%). Those persons with SMI who had lost work ability, had physical illness and more severe mental disabilities in 1994, as well as those who had experienced negative changes on these factors were more likely to live in persistent poverty or fall into poverty. Higher education level and medical treatment were major protective factors of falling into poverty.
This study shows long-term evidence on the social drift of persons with SMI during the period of rapid social development in China. Further targeted poverty alleviation interventions should be crucial for improving treatment and mental recovery and alleviating poverty related to SMI.
OBJECTIVES/SPECIFIC AIMS: This poster will present preliminary results from a study examining whether person-centered care planning—a new innovation in community mental health care—responds to the culture of, and helps reduce health disparities among, Latinx and Asian populations. METHODS/STUDY POPULATION: The study was funded by an NIMH/NIH Administrative Supplement for Minority Health and Mental Health Disparities Research and approved by the Institutional Review Board of the authors’ university. Participants included 26 mental health clients and 12 mental health providers of diverse backgrounds. The study employed empirical qualitative methods to explore client understandings of mental health, client experiences of culture and discrimination, and the process of care engagement and care planning from both client and provider perspectives. The analysis team itself included people of Latinx and Asian background, as well as a person with lived experience of mental health recovery. RESULTS/ANTICIPATED RESULTS: We anticipate that the results will show ways in which person-centered care successfully incorporates clients’ goals, but that there will also be evidence of ways in which the clinical encounter struggles to incorporate more social, collective, and cultural values and approaches. DISCUSSION/SIGNIFICANCE OF IMPACT: The poster will present up-to-date findings on this project, which speaks to pressing issues of health equity and community engagement for 2 of the fastest growing populations in the country.
Uninterrupted provision of vital energy services (see Chapter 1, Section 1.2.2) – energy security – is a high priority of every nation. Energy security concerns are a key driving force of energy policy. These concerns relate to the robustness (sufficiency of resources, reliability of infrastructure, and stable and affordable prices); sovereignty (protection from potential threats from external agents); and resilience (the ability to withstand diverse disruptions) of energy systems. Our analysis of energy security issues in over 130 countries shows that the absolute majority of them are vulnerable from at least one of these three perspectives. For most industrial countries, energy insecurity means import dependency and aging infrastructure, while many emerging economies have additional vulnerabilities such as insufficient capacity, high energy intensity, and rapid demand growth. In many low-income countries, multiple vulnerabilities overlap, making them especially insecure.
Oil and its products lack easily available substitutes in the transport sector, where they provide at least 90% of energy in almost all countries. Furthermore, the global demand for transport fuels is steadily rising, especially rapidly in Asian emerging economies. Disruptions of oil supplies may thus result in catastrophic effects on such vital functions of modern states as food production, medical care, and internal security. At the same time, the global production capacity of conventional oil is widely perceived as limited. These factors result in rising and volatile prices of oil affecting all economies, especially low-income countries, almost all of which import over 80% of their oil supplies.
Hope has long been considered a relevant variable in medical disciplines, but little attention has been paid to the concept, and its clinical and research implications, in psychiatry. This article illuminates the topic of hope from four different perspectives relevant to psychiatric research and practice. The four authors discuss hope from the viewpoint of their specific area of expertise, providing an overview of philosophical, conceptual, research and recovery-related reflections concerning hope in psychiatry.
The aim of this contribution is to explore how different treatments are experienced from the perspective of individu-als with mental illnesses. We used data drawn from qualitative, narrative interviews. When asked to discuss their lives, people rarely discuss their psychiatric treatment. When asked about treatment, they describe hospitalization and medication but not out-patient care. What is described as most helpful are relationships with others, especially in 24-hour centers, clubhouses, and user-run organizations; places where they report feeling that they are accepted, understood, and cared about. Also important are experiences of “giving back” to others and employment as ways of increasing participants’ sense of self-worth and value. Participants also indicated the importance of med-ication, but described protracted processes of having to find the right prescriber, the right medication, at the right dosage, and taking the medication long enough to derive its benefits. For others, symptoms were described as being an integral part of who they were and not something they wanted to eliminate. Traditional treatments (e.g., medication), if given by a practitioner who understands the person and is willing to try to find the right medication and dosage, may serve as a foundation for instrumental experiences of being accepted, understood, valued, and being able to give back to others.
Highly ionized plasmas are being considered as a medium for
charge neutralizing heavy ion beams in order to focus beyond
the space-charge limit. Calculations suggest that plasma at
a density of 1–100 times the ion beam density and at a
length ∼0.1–2 m would be suitable for achieving a
high level of charge neutralization. An Electron Cyclotron
Resonance (ECR) source has been built at the Princeton Plasma
Physics Laboratory (PPPL) to support a joint Neutralized Transport
Experiment (NTX) at the Lawrence Berkeley National Laboratory
(LBNL) to study ion beam neutralization with plasma. The ECR
source operates at 13.6 MHz and with solenoid magnetic fields
of 1–10 gauss. The goal is to operate the source at pressures
∼10−6 Torr at full ionization. The initial
operation of the source has been at pressures of
10−4–10−1 Torr. Electron
densities in the range of 108 to 1011
cm−3 have been achieved. Low-pressure operation
is important to reduce ion beam ionization. A cusp magnetic
field has been installed to improve radial confinement and reduce
the field strength on the beam axis. In addition, axial confinement
is believed to be important to achieve lower-pressure operation.
To further improve breakdown at low pressure, a weak electron
source will be placed near the end of the ECR source. This article
also describes the wave damping mechanisms. At moderate pressures
(> 1 mTorr), the wave damping is collisional, and at low
pressures (< 1 mTorr) there is a distinct electron cyclotron
Most pharmacotherapy trials in post-traumatic stress disorder (PTSD) have been conducted upon male combat veterans. Outcome studies relating to civilians are therefore needed.
To demonstrate that fluoxetine is more effective than placebo in treating PTSD.
Civilians with PTSD (n=53) were treated for 12 weeks with fluoxetine (up to 60 mg/day) or placebo. Assessments of PTSD severity, disability, stress vulnerability, and high end-state function were obtained.
Fluoxetine was more effective than placebo on most measures at week 12, including global improvement (much or very much improved: fluoxetine 85%, placebo 62%, difference 0.24, 95% CI 0.01–0.47; very much improved: fluoxetine 59%, placebo 19%, difference 0.40, 95% CI 0.16–0.64), and high end-state function (fluoxetine 41%, placebo 4%, difference 0.37, 95% CI 0.17–0.57)
Fluoxetine was superior for measures of PTSD severity, disability, stress vulnerability, and high end-state function. The placebo-group response was low when viewed as a broad outcome based on a portfolio of ratings, but was higher with a traditional global rating criterion.
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