Transitioning to community-based mental healthcare: reform experiences of five countries

Following the growing global focus on deinstitutionalisation in the past 50 years, accessible community mental health services was a highlighted commitment in the European Mental Health Action Plan 2013–2020 to improve well-being of patients and families. The progress of transition has been uneven in some Eastern European countries. This paper aims to update and reflect on the examples of five countries across the region.

Heatwave-protective knowledge and behaviour among urban populations: a multi-country study in Tunisia, Georgia and Israel

Background There is an expected increase in heatwaves globally. As such, it is imperative to have sufficient levels of heatwave-protective knowledge and behaviour in areas regularly affected by heatwaves. Our study assessed this among urban populations in Tunisia, Georgia and Israel. Methods We undertook a cross-sectional population survey in the three countries. The questionnaire focused on obtaining information on respondents’ knowledge level regarding 1) symptoms due to overheating, 2) risk groups for heatwaves, 3) actions to take when someone is overheated, and 4) heatwave-protective measures. Furthermore, we asked respondents about protective measures they applied during the last heatwave. We compared the results between the countries. Results Heatwave-protective knowledge was highest in Israel, and lowest in Georgia, for all indicators except for heatwave-protective measures, for which knowledge was highest in Tunisia. Most respondents who named certain protective measures had also applied these during the last heatwave: more than 90% for all measures except for one in Tunisia and Israel, and more than 80% for all measures in Georgia. Conclusion There is a need to further improve heatwave-protective knowledge in Tunisia, Georgia and Israel. One potential solution to achieve this is by implementing a National Heat Health Action Plan. Improving knowledge is a vital step before adaptive behaviour can take place.

THE BONE-BRAIN AXIS? BIOPSYCHOSOCIAL ASPECTS OF ORTHOPEDICS AND A MENTAL WELLBEING ACTION PLAN IN MUSCULOSKELETAL CARE

The aim: To review the biopsychosocial aspects of psychiatric comorbidity in patients with musculoskeletal conditions and recommend a relevant mental health action plan. Materials and methods: Keywords (orthopedics, psychiatry, mental health) were used to list down and analyze the literature in PubMed and Google Scholar. All types of articles, including original research, systematic reviews, and meta-analyses, along with gray literature dating back to 2000. We excluded studies reporting a significant conflict of interest and findings dispersed through popular media instead of peer-reviewed journals. Conclusions: The biopsychosocial aspects of the “bone – brain axis” need to be better addressed by means of a pragmatic approach involving all concerned parties and acknowledging the challenges and limitations along the way.

Si Crans-Montana meurt. Soigner le corps malade d’une station

New Alpine companies, like Crans-Montana on the Haut-Plateau, remain, more often than not, trapped in representative logic opposing the clan of modernists to that of defenders of values anchored in an ideal-typical tradition. The Haut-Plateau territory, so named due to its geographic location and topographic conformation – not for the morphology of the soil – was still a space free of any construction in the mid-nineteenth century. This vast alpine meadow was marked by a few utility buildings for sheltering cattle and hay during the intermediate seasons that precede the full summer. At the turn of the 3rd millennium, the built heritage, essentially consisting of hotel structures and holiday residences, is no longer able to welcome the new socio-economic dynamics linked to the mono-culture of skiing. This crisis calls habits, both old and new, into question, given the youth of the tourist resort. In June 2000, a Federal programme selected Crans-Montana as a case study for testing an Environment and Health Action Plan. This provided an opportunity for a group of architects to formulate an inter-municipal blueprint that activated a series of urban renewal projects. The new architectural formulae that emerge try to go beyond stylistic modernism by reinterpreting the relationship with the built environment and its social context.

O suicídio: uma reflexão sobre medidas preventivas

No presente artigo serão trazidos à baila algumas questões relacionadas ao suicídio, sobretudo com relação aos métodos preventivos. Nesse contexto, será abordado o disposto pela OMS, que reconheceu o suicídio como sendo uma prioridade de saúde pública. Em decorrência, publicou em 2014 o primeiro Relatório Mundial de Suicídio da OMS “Prevenção do suicídio: um imperativo global”, cujo objetivo seria aumentar a conscientização sobre a importância da saúde pública para as tentativas de suicídio e suicídio, fazendo da prevenção ao suicídio uma alta prioridade na agenda global em termos de saúde pública. No mais, além do disposto pela OMS, será discorrido a respeito da prevenção ao suicídio sob a perspectiva da importância da família, salientando-se para o uso e influência das tecnologias, a busca pelo sentido da vida e a valorização da autoestima em crianças e adolescentes. Para tanto, será realizada pesquisa bibliográfica em livros, revistas, textos e artigos científicos.Descritores: Suicídio; Prevenção Controle; Saúde Pública.RferênciasGuia Intersetorial de Prevenção do Comportamento Suicida em Crianças E Adolescentes; 2019.Kovacs MJ. Morte e desenvolvimento humano. São Paulo: Casa do Psicólogo; 1992.Rocha GMA. Condutas autolesivas: uma leitura pela Teoria do Apego. Rev Bras Psicologia. 2015;2(01):62-70.OMS. Organização Mundial de Saúde. Prevenção do suicídio um recurso para conselheiros. Departamento de Saúde Mental e de Abuso de Substâncias. Gestão de Perturbações Mentais e de Doenças do Sistema Nervoso. Genebra; 2006.p.9-11.Durkheim E. O Suicídio. estudo de Sociologia. São Paulo: Martins Fontes; 2000.Franco M. Após experiências familiares, psicóloga vira 'suicidologista' para prevenir casos. Folha de S. Paulo, São Paulo, 29 out. 2018. Disponível em: https://www1.folha.uol.com.br/equilibrioesaude/2018/10/apos-experiencias-familiares-psicologa-vira-suicidologista-para-prevenir-casos.shtml. Acesso em: 02 fev. 2020.WHO. World Health Organization. Suicide. Geneva; 2019. Disponível em: https://www.who.int/news-room/fact-sheets/detail/suicide. Acesso em: 13 jan. 2020.WHO. World Health Organization. Comprehensive mental health action plan 2013–2020. Geneva; 2013. Disponível em: https://www.who.int/mental_health/action_plan_2013/en/. Acesso em: 13 jan. 2020.Botega NJ. Comportamento suicida: epidemiologia. Psicologia USP. 2014;25(3):231-36.Brasil. Ministério da Mulher, da Família e dos Direitos Humanos. O suicídio e a automutilação tratados sob a perspectiva da família e do sentido da vida. 2019. p. 1-42.Moraes, FT. Depressão em adolescentes cresce impulsionada por uso de redes sociais. Folha de S. Paulo, São Paulo, 5 nov. 2018. Disponível em: https://www1.folha.uol.com.br/equilibrioesaude/2018/11/depressao-em- adolescentes-cresce-impulsionada-por-uso-de-redes-sociais.shtml. Acesso em: 01 fev. 2020.University of Michigan Health System. Pediatricians update digital media recommendations for kids. ScienceDaily. 2016. Disponível em: https://www.sciencedaily.com/releases/2016/10/161021093834.htm. Acesso em: 20 jan. 2020.

Assessing the use and understanding of the Portuguese heat–health warning system (ÍCARO)

ABSTRACT Background Heatwaves can lead to increased mortality. In the Portuguese heat–health warning system (HHWS), ÍCARO, a daily report with heat-related mortality prediction is sent to heat–health action plan (HHAP) practitioners. HHAP practitioners assess risk and implement measures to prevent heatwave-related impact, but ÍCARO’s use and understanding are unknown. We assessed ÍCARO’s use and understanding by key HHAP practitioners. Methods We conducted semi-structured interviews with national/regional HHAP practitioners. Interviews were recorded, transcribed and analysed using thematic content analysis. To maximize credibility a validation process was implemented through researcher triangulation; a sample of 30 segments was recorded by independent researchers. Results We conducted six interviews with nine professionals (mean time 52 min) from five regions. We identified four categories: report’s content and presentation, report’s reception and communication, ÍCARO and risk assessment and other issues. Practitioners use ÍCARO and perceived it as relevant; they raised issues on its interpretation and felt these were not fully addressed, given researchers’ use of statistical/epidemiological terms. We identified the need for improved communication and report’s clarity. Conclusions Our study stresses the need for collaboration between experts within HHWS/HHAP. Despite ÍCARO’s understanding being challenging, practitioners consider it a relevant tool. Researchers should use less statistical language and clarify ÍCARO’s interpretation. Practitioners’ needs should be considered when developing/revising tools.