Search

Background: There is a growing recognition that staff attitudes toward coercion in mental health care may influence its application. This study presents the psychometric properties of the Portuguese version of the Staff Attitudes towards Coercion Scale (SACS) and describes mental health professionals' attitudes towards coercion in Portugal. Methods: Mental health professionals working in five Portuguese mental health services in urban and rural regions of Portugal were invited to complete a questionnaire comprising the SACS and a socio-demographic form. Psychometric analyses including construct validity and internal consistency were carried out using R software. Results: A total of 91 out of 119 questionnaires completed were valid for analysis. Fifty-seven (62.64%) respondents were female, with an age range of 24 to 69 years (M = 39.33; SD = 11.09). More than half of them were nurses (52.75%, n = 48), and a third were psychiatrists (36.26%, n = 33). A three-factor structure was confirmed and showed the best fit compared to previously proposed models with a cumulative explained variance of 59%. The Portuguese SACS exhibited adequate internal consistency for both the full-scale and subscales. The highest mean score was in the pragmatic attitude domain (20.60; SD = 3.37). A negative correlation was observed between the critical attitude domain and both age and years of experience (p < 0.05). Conclusion: A three-factor structure was confirmed and showed the best fit compared to previously proposed models. The Portuguese SACS showed excellent psychometric properties and is acceptable for assessing staff attitudes towards coercion. [ABSTRACT FROM AUTHOR]

Around eight-out-of-ten survivors of domestic violence in Lithuania are women, and of those, eight-out-of-ten suffer violence specifically from their intimate partners (IPV). Women who experience IPV are at higher risk of having mental health conditions. This study aims to explore the perspectives of mental health and social care professionals regarding the provision of mental health support to IPV survivors in Lithuania. Four focus groups were conducted among 29 service providers from across the country. Audio-recordings were transcribed verbatim and analyzed thematically using MAXQDA software. The five main themes derived from the analysis reveal: 1) low levels of IPV awareness among IPV survivors who seek support with their mental health; 2) a lack of specialized training among professionals as a barrier to effective support; 3) a low prioritization on the national level; 4) little inter-sectoral collaboration which undermines the complexity of needed responses; 5) broader systemic problems. The provision of mental health support to IPV survivors lacks the recognition that IPV is gender-based violence and a major public (mental) health problem. The complexity of needed services is absent. Further research needs to explore the utilization of mental health services by IPV survivors and their perceptions concerning it. [ABSTRACT FROM AUTHOR]

Amorphous solid phases can be represented by shallow basins in the potential energy hypersurface. Glasses formed by substances with prolific crystal polymorphism, such as nateglinide, an anti-diabetes drug, are susceptible to greater kinetical instability. Their energy landscape is characterized by deep pits in an accessible range, into which the supramolecular configuration can fall, when the amorphous solid relaxes to some crystalline polymorph. Alternative co-amorphization strategies are explored in this work to overcome the crystallization of nateglinide amorphous phases, namely by comparing two synthetic approaches, cryo-milling and quench-cooling, for a dual-drug system in combination with ranolazine. An alternative co-former, the essential amino-acid tryptophan, was also used for the synthesis of a cryo-milled nateglinide co-amorphous system. Enhanced kinetical stability for up to 8 months is achieved with both multicomponent systems. Their physico-chemical characterization in 3 molar ratios is accompanied by the study of their relaxation processes by broadband dielectric spectroscopy. Despite the higher glass transition temperatures obtained for the cryo-milled co-amorphous system with tryptophan, the co-amorphous salt system with ranolazine was found to have higher kinetical stability upon heating or ageing. [ABSTRACT FROM AUTHOR]

Background Lithuania has one of the highest averages in the European Union when it comes to psychological and/or economic intimate partner violence (PE-IPV). IPV survivors are several times more likely to have mental health conditions than those without IPV experiences. The aim of this article is to study the prevalence, characteristics and attitudes of PE-IPV survivors in Lithuania, and the predictors of them accessing mental health services. Methods A cross-sectional study based on a national survey representative of the adult population. The survey was implemented by a third-party independent market research company employing an online survey panel. Logistic regression models were used in the analysis. Results Almost 50% of women in Lithuania experience PE-IPV. Females are significantly more likely to experience it than males. The vast majority of women find PE-IPV unacceptable; however, only one-third of survivors seek any type of help. Only one-tenth approach mental health services, with divorcees being at higher odds of doing so. Conclusions Further research is needed to explore predictors and contextual factors of why IPV survivors seek mental healthcare, or not. Policy implications include the need to eliminate IPV and mental health stigma; develop accessible mental health services and effective treatment approaches. [ABSTRACT FROM AUTHOR]

Copyright of Capital Científico is the property of Universidade Estadual do Centro-Oeste, Setor de Ciencias Sociais Aplicadas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The implementation of a safety culture and awareness of emergency issues in buildings has been growing in more developed societies. It is essential that all occupants know how to act in an emergency situation, particularly during an emergency evacuation. In higher education institutions (HEIs), which annually host not only their many employees, but also national and international students, it is essential to know and understand the knowledge, attitudes, and behaviors that the academic community demonstrates in this matter. This study aimed to characterize the perception of occupants regarding safety, specifically in the emergency evacuation phase, within the academic community of an HEI. In this observational cross-sectional study, data on general knowledge and attitudes regarding safety and actions during emergency situations were collected through an anonymous questionnaire targeting students, faculty, and non-teaching staff, which was sent via institutional email. Valid responses were received from 392 participants and then scored and assessed on different domains. The results obtained showed that, despite a reasonable average regarding the general level of knowledge, attitudes, and behaviors of the occupants on the subject, the community falls somewhat short in terms of training. It is noteworthy that approximately 64% of the sample has never received awareness or training related to emergency evacuation, and around 68% are unaware of the location of their institution's meeting/gathering point. Finally, by identifying the most common gaps, namely the training dimension, some simple measures could be improved, such as the dissemination of safety instructions accessible through QR codes placed in strategic locations or even conducting small drills during class sessions, as well as learning with simulation concerning different scenarios of emergency. [ABSTRACT FROM AUTHOR]

As part of a Ministry of Science, Technology, and Innovation initiative, the Brazilian Societies of Botany, Microbiology, Virology, and Zoology conducted a comprehensive evaluation of biological collections in Brazil. This assessment aimed to gather insights into the current state of these collections, with the goal of providing support for future public policies, including financial subsidies and prioritization policies. In this context, we present the findings related to microbiological collections, essential to ex situ biodiversity conservation and crucial in supporting research, development, and innovation. A survey was distributed to public and private institutions across Brazil, yielding responses from 168 microbiological collections representing 79 different entities. Notably, 73 of these collections are affiliated with public research institutions and universities, underscoring the State's pivotal role in preserving and safeguarding Brazilian microbial diversity. The primary taxonomic groups encompass bacteria (found in 70.24% of collections) and fungi (comprising 52.98% of collections), sourced from diverse Brazilian ecosystems and biomes, including those that contain several type strains. Furthermore, the collections preserve microorganisms harboring biotechnological potential applicable to environmental protection, public health, industry, and agribusiness. Despite these promising economic and biotechnological prospects, our meticulous data analysis has revealed significant limitations and vulnerabilities, especially regarding physical infrastructure and human resources, emphasizing the urgent need for interventions to guarantee their sustainability. [ABSTRACT FROM AUTHOR]

There is increasing advocacy to reduce coercive practices in mental healthcare. Little research has been done on the topic in developing countries. To explore what mental health professionals in Nigeria think about coercion, why it is used, and what contextual factors influence its use in mental healthcare services. Semi-structured interviews were carried out with 16 doctors and 14 nurses from two psychiatric hospitals in two regions of Nigeria. The audio-recorded interviews were analyzed thematically with the aid of MAXQDA software. Three broad categories relating to the perception of, reasons for, and barriers/facilitators to the use of coercion were derived. Coercion was viewed as being for the best interests of patients, a means to an end, and effective for achieving desired outcomes. Safety was both a reason to use a coercive measure and a deterrent to using specific coercive measures thought to be unsafe. The socio-cultural context, obsolete mental health legislation, staff shortages, and attitudes were factors influencing the use of coercion in mental healthcare. Coercion was perceived to be ultimately beneficial in mental health practice. There is need for a new mental health legislation and more resources for mental health care in Nigeria to address the problem of coercion. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance is an increasing worldwide public health burden that threatens to make existent antimicrobials obsolete. An important mechanism of antimicrobial resistance is the overexpression of efflux pumps, which reduce the intracellular concentration of antimicrobials. TolC is the outer membrane protein of an efflux pump that has gained attention as a therapeutic target. Little is known about the immune response against TolC. Here we evaluated the immune response against TolC from Escherichia coli. TolC in silico epitope prediction showed several residues that could bind to human antibodies, and we showed that human plasma presented higher titers of anti-TolC IgG and IgA, than IgM. E. coli recombinant TolC protein stimulated macrophages in vitro to produce nitric oxide, as well as IL-6 and TNF-α, assessed by Griess assay and ELISA, respectively. Immunization of mice with TolC intraperitoneally and an in vitro re-stimulation led to increased T cell proliferation and IFNγ production, evaluated by flow cytometry and ELISA, respectively. TolC mouse immunization stimulated anti-TolC IgM and IgG production, with higher levels of IgG1 and IgG2, amongst the IgG subclasses. Anti-TolC murine antibodies could bind to live E. coli and increase bacterial uptake and elimination by macrophages in vitro. Intraperitoneal or intranasal, but not oral, immunizations with inactivated E. coli also led to anti-TolC antibody production. Finally, TolC immunization increased mouse survival rates to antimicrobial-sensitive or resistant E. coli infection. Our results showed that TolC is immunogenic, leading to the production of protective antibodies against E. coli, reinforcing its value as a therapeutic target., (© The Author(s) 2024. Published by Oxford University Press on behalf of Society for Leukocyte Biology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Introduction: Supported accommodations (SAs) are key components of community mental health care, but little is known about residents' care pathways. This study analysed the care pathways of residents of SAs, and factors associated with their age of entry and length of stay., Methods: A random sample of SAs' residents in Portugal was interviewed and a questionnaire was specifically developed to assess their care pathways. Associations between sociodemographic and clinical characteristics, age of entry and length of stay, were analysed using hierarchical regression., Results: Overall, 213 residents of 43 different SAs participated. Their mean age was 55 years. Most were male, single, pensioners and had early-onset psychotic disorders. On average, they integrated the current SA at around 50 years old and had a 4.5 year length of stay. Most participants had been in another SA before (35.0% in more supported, 33.8% in less supported and 6.3% in similarly supported SAs)., Conclusions: Findings suggest that residents spend several years in the residential pathway, with a significant proportion moving to more supported SAs. This calls for increasing the number of SAs with different typologies and developing coordinated community supports.

Introduction: Promoting mental health, preventing and treating mental disorders are critically important in public health, and many randomised controlled trials (RCTs) evaluate intervention strategies for these objectives. However, distinguishing promotion from prevention and from treatment RCTs is challenging. A tool to place studies along the promotion-to-treatment continuum in mental health research does not exist, leaving it to researchers and policymakers to decide on how to classify individual RCTs, which hinders evidence synthesis., Methods and Analysis: We present a protocol for the development of a new tool to assist researchers in distinguishing RCTs along the promotion-to-treatment continuum. We will establish a Tool Development Group, and use the Population, Intervention, Comparison and Outcome framework to define constructs. We will generate, define, categorise and reduce the items in the tool using qualitative methods, including cognitive interviews and a Delphi exercise. Psychometric evaluation-including unidimensionality, local independence, monotonicity and item homogeneity-will include data collection, scoring, internal consistency checks and factor analysis of the tool's indicators for available RCTs. We will use standard Cohen's kappa statistics to assess the reliability of the tool., Ethics and Dissemination: This study involves data collection from the already published literature. However, this protocol has been approved by the ethics committee of the Università della Svizzera Italiana (CE 2024 04). The results of the present project will be disseminated in peer-reviewed journals and at international and national scientific meetings. Training materials for the application of the tool will also be developed and disseminated to the scientific community. The tool and all related implementation materials will be published on a website and will be freely accessible to the public., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Objective: The idea of watertight dural closure (WTDC) seems extremely obvious to avoid complications such as cerebrospinal fluid (CSF) leak and infection, especially in spinal and posterior fossa surgeries. Nonetheless, several studies have shown that leaving the dura open is not associated with an increased risk of complications. The aim of this systematic review and meta-analysis is to compare non-WTDC and WTDC in patients undergoing supratentorial craniotomy regarding the risk of postoperative complications., Methods: We searched PubMed, Web of Science, Embase, and Cochrane for randomized control trials and observational studies comparing non-WTDC with WTDC in patients undergoing supratentorial craniotomy. Outcomes of interest were CSF leak, overall infection, meningitis, and subgaleal fluid collection (SFC). Statistical analysis was performed using RStudio 2023.12.1 + 402. Heterogeneity was assessed using I2 statistics., Results: Of 1541 potential articles, 7 met the inclusion criteria. The review comprised 3 randomized control trials, 1 prospective study, and 3 retrospective cohort studies. Among the 1619 patients, 766 (47.3%) and 853 (52.7%) patients were in the non-WTDC and WTDC groups, respectively. There was no significant difference in CSF leak between the non-WTDC and WTDC groups (risk ratio [RR] 1.61; 95% CI 0.68-3.77; P = .276; I2 = 0%). Furthermore, we did not find significant differences in overall infection (RR 1.62; 95% CI 0.95-2.76; P = .078; I2 = 4%), meningitis (RR 1.87; 95% CI 0.64-5.46; P = .251; I2 = 0%), and SFC (RR 1.53; 95% CI 0.64-3.65; P = .342; I2 = 52%) between the non-WTDC and WTDC groups., Conclusion: These findings suggest that non-WTDC is a safe method and is not associated with an increased risk of CSF leak, overall infection, meningitis, and SFC compared with WTDC., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

The emergence and propagation of bacteria resistant to antimicrobial drugs is a serious public health threat worldwide. The current antibacterial arsenal is becoming obsolete and the pace of drug development is decreasing, highlighting the importance of investment in alternative approaches to treat or prevent infections caused by antimicrobial-resistant bacteria. A significant mechanism of antimicrobial resistance employed by Gram-negative bacteria is the overexpression of efflux pumps that can extrude several compounds from the bacteria, including antimicrobials. The overexpression of efflux pump proteins has been detected in several multidrug resistant (MDR) Gram-negative bacteria, drawing attention to these proteins as potential targets against these pathogens. This review will focus on the role of outer membrane proteins (OMPs) from efflux pumps as potential vaccine candidates against clinically relevant MDR Gram-negative bacteria, discussing advantages and pitfalls. Additionally, we will explore the relevance of efflux pump OMP diversity and the possible impact of vaccination on microbiota., (© The Author(s) 2024. Published by Oxford University Press on behalf of Society for Leukocyte Biology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)