Community-Based Early Intervention with Trauma Survivors

2020 ◽  
Author(s):  
Josef I. Ruzek
Keyword(s):  
Mental Health ◽  
Large Scale ◽  
Monitoring And Evaluation ◽  
Population Based ◽  
Trauma Survivors ◽  
Care Hospital ◽  
Community Based ◽  
Community Activities ◽  
Number Of Individuals ◽  
Mobile Interventions

The number of individuals affected by frequently occurring traumatic events such as accidents and assaults, as well as large-scale traumas such as war and disaster, calls for systematic, comprehensive community-based responses to manage mental health consequences of such exposure. This chapter reviews several key components of such a comprehensive response; these components can be initiated immediately after a trauma occurs. Communities should develop capacity to identify and engage those at risk for continuing problems; provide phased support to include immediate assistance, brief counseling after the immediate period, and treatment for trauma-related problems; and provide opportunities for participation in trauma-related community activities. Two domains of posttrauma care, hospital-based acute care of injury and assault survivors and disaster mental health, are reviewed to illustrate ways of developing some of these components. Key challenges include engagement of survivors with early interventions, training of providers and effective implementation of interventions, program monitoring and evaluation, and integration of Internet and mobile interventions into community-based service delivery. In the future, there remains significant opportunity for service innovation and improvement of interventions, a need to develop and implement population-based intervention approaches, and an imperative to increase research into early posttrauma interventions in community settings.

Community-based Early Intervention with Trauma Survivors

2012 ◽  
pp. 346-362
Author(s):  
Josef I. Ruzek
Keyword(s):  
At Risk ◽  
Early Intervention ◽  
Large Scale ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Monitoring And Evaluation ◽  
Well Being ◽  
Early Response ◽  
Trauma Survivors ◽  
Community Based

The numbers of individuals affected by frequently occurring traumatic events such as accidents and assaults, as well as large-scale traumas such as war and disaster, call for systematic, comprehensive community-based responses to manage mental health consequences of such exposure. Comprehensive early response by the community to its trauma-exposed members requires integration of several key response components. Communities should develop immediate response services, educate the affected community, reach out to survivors, engage in efficient early identification of those at risk, implement community-wide early intervention counseling services, monitor those at risk, train and support providers, monitor the well-being and needs of the affected population, and provide additional large-community interventions and programs. These services should encompass both trauma survivors and their family members and should target a range of potential negative outcomes, including posttraumatic stress disorder, depression, substance abuse, and impairments in functioning. Increased attention should be given to training and supporting providers, integration of online interventions into community-based service delivery, and program monitoring and evaluation. Those who serve sexual assault survivors, crime victims, deployed military personnel, physically injured assault and motor vehicle accident survivors, and disaster-affected groups can potentially learn much from one another, and efforts should be under taken to ensure that “cross-fertilization” of perspectives can occur in the service of creating integrated and comprehensive community-based responses to trauma.

scholarly journals Access to community-based mental healthcare and psychosocial support within a disaster context

2015 ◽  
Vol 12 (2) ◽  
pp. 44-47 ◽  
Author(s):  
Katherine P O'Hanlon ◽  
Boris Budosan
Keyword(s):  
Mental Health ◽  
Large Scale ◽  
Psychosocial Support ◽  
Mental Healthcare ◽  
Community Services ◽  
Community Based ◽  
Clear Vision ◽  
Mental Health Interventions ◽  
Mental Health Effects

After a large-scale humanitarian disaster, 30–50% of victims develop moderate or severe psychological distress. Rates of mild and moderate mental disorders increase by 5–10% and severe disorders by 1–2%. Those with such disorders need access to mental healthcare. Primary care clinics are appropriate due to their easy accessibility and the non-stigmatising environment. There is a consensus among experts that the mental health effects of disaster are best addressed by existing services, that is, through capacity building rather than by establishing parallel systems. Mental health interventions in emergencies should begin with a clear vision for the long-term advancement of community services.

scholarly journals AlphaImpute2: Fast and accurate pedigree and population based imputation for hundreds of thousands of individuals in livestock populations

2020 ◽  
Author(s):  
Andrew Whalen ◽  
John M Hickey
Keyword(s):  
Large Scale ◽  
Computational Cost ◽  
Population Based ◽  
High Density ◽  
Low Density ◽  
Missing Genotypes ◽  
The Cost ◽  
Iterative Peeling ◽  
Burrows Wheeler Transform ◽  
Number Of Individuals

AbstractIn this paper we present a new imputation algorithm, AlphaImpute2, which performs fast and accurate pedigree and population based imputation for livestock populations of hundreds of thousands of individuals. Genetic imputation is a tool used in genetics to decrease the cost of genotyping a population, by genotyping a small number of individuals at high-density and the remaining individuals at low-density. Shared haplotype segments between the high-density and low-density individuals can then be used to fill in the missing genotypes of the low-density individuals. As the size of genetics datasets have grown, the computational cost of performing imputation has increased, particularly in agricultural breeding programs where there might be hundreds of thousands of genotyped individuals. To address this issue, we present a new imputation algorithm, AlphaImpute2, which performs population imputation by using a particle based approximation to the Li and Stephens which exploits the Positional Burrows Wheeler Transform, and performs pedigree imputation using an approximate version of multi-locus iterative peeling. We tested AlphaImpute2 on four simulated datasets designed to mimic the pedigrees found in a real pig breeding program. We compared AlphaImpute2 to AlphaImpute, AlphaPeel, findhap version 4, and Beagle 5.1. We found that AlphaImpute2 had the highest accuracy, with an accuracy of 0.993 for low-density individuals on the pedigree with 107,000 individuals, compared to an accuracy of 0.942 for Beagle 5.1, 0.940 for AlphaImpute, and 0.801 for findhap. AlphaImpute2 was also the fastest software tested, with a runtime of 105 minutes a pedigree of 107,000 individuals and 5,000 markers was 105 minutes, compared to 190 minutes for Beagle 5.1, 395 minutes for findhap, and 7,859 minutes AlphaImpute. We believe that AlphaImpute2 will enable fast and accurate large scale imputation for agricultural populations as they scale to hundreds of thousands or millions of genotyped individuals.

scholarly journals Prevalence of mental health problems in schools: poverty and other risk factors among 28 000 adolescents in England

2019 ◽  
Vol 215 (3) ◽  
pp. 565-567 ◽  
Author(s):  
Jessica Deighton ◽  
Suzet Tanya Lereya ◽  
Polly Casey ◽  
Praveetha Patalay ◽  
Neil Humphrey ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Young People ◽  
Conduct Problems ◽  
Large Scale ◽  
Mental Health Problems ◽  
Health Problems ◽  
Community Based ◽  
School Based ◽  
Mental Health Difficulties

SummaryCurrent mental health provision for children is based on estimates of one in ten children experiencing mental health problems. This study analyses a large-scale community-based dataset of 28 160 adolescents to explore school-based prevalence of mental health problems and characteristics that predict increased odds of experiencing them. Findings indicate the scale of mental health problems in England is much higher than previous estimates, with two in five young people scoring above thresholds for emotional problems, conduct problems or hyperactivity. Gender, deprivation, child in need status, ethnicity and age were all associated with increased odds of experiencing mental health difficulties.Declarations of interestNone.

scholarly journals Temporal Trends in Mental Health Service Utilization across Outpatient and Acute Care Sectors: A Population-Based Study from 2006 to 2014

2018 ◽  
Vol 63 (2) ◽  
pp. 94-102 ◽  
Author(s):  
Maria Chiu ◽  
Evgenia Gatov ◽  
Simone N. Vigod ◽  
Abigail Amartey ◽  
Natasha R. Saunders ◽  
...  
Keyword(s):  
Mental Health ◽  
Acute Care ◽  
Service Use ◽  
Care Service ◽  
Temporal Trends ◽  
Population Based ◽  
Physician Visits ◽  
Outpatient Physician ◽  
Health Related ◽  
Number Of Individuals

Objective: Although evidence suggests that treatment seeking for mental illness has increased over time, little is known about how the health system is meeting the increasing demand for services. We examined trends in physician-based mental health service use across multiple sectors. Method: In this population-based study, we used linked health-administrative databases to measure annual rates of mental health–related outpatient physician visits to family physicians and psychiatrists, emergency department visits, and hospitalizations in adults aged 16+ from 2006 to 2014. We examined absolute and relative changes in visit rates, number of patients, and frequency of visits per patient, and assessed temporal trends using linear regressions. Results: Among approximately 11 million Ontario adults, age- and sex-standardized rates of mental health–related outpatient physician visits declined from 604.8 to 565.5 per 1000 population over the study period ( Ptrend = 0.04). Over time, the rate of visits to family physicians/general practitioners remained stable ( Ptrend = 0.12); the number of individuals served decreased, but the number of visits per patient increased. The rate of visits to psychiatrists declined ( Ptrend < 0.001); the number of individuals served increased, but the number of visits per patient decreased. Concurrently, visit rates to emergency departments and hospitals increased (16.1 to 19.7, Ptrend < 0.001 and 5.6 to 6.0, Ptrend = 0.01, per 1000 population, respectively). Increases in acute care service use were greatest for anxiety and addictions. Conclusions: The increasing acute care service use coupled with the reduction in outpatient visits suggest, overall, an increase in demand for mental health care that is not being met in ambulatory care settings.

scholarly journals Prevalent, Incident, and Persistent Insomnia in a Population-Based Cohort Tested Before (2018) and During the First-Wave of COVID-19 Pandemic (2020)

SLEEP ◽  
2021 ◽  
Author(s):  
Charles M Morin ◽  
Lydi-Anne Vézina-Im ◽  
Hans Ivers ◽  
Jean-Arthur Micoulaud-Franchi ◽  
Pierre Philip ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Sleep Quality ◽  
Large Scale ◽  
Mental Health Problems ◽  
Psychological Symptoms ◽  
Population Based ◽  
Lifestyle Changes ◽  
Anxiety And Depression ◽  
Lower Social Support

Abstract Study Objectives High rates of sleep and mental health problems have been reported during the COVID-19 pandemic, but most of the evidence is retrospective without pre-pandemic data. This study documented rates of prevalent, incident, and persistent insomnia and psychological symptoms during the COVID-19 pandemic (2020) compared to pre-pandemic data (2018). Methods Data were derived from a longitudinal, population-based study of insomnia in Canada. When the first lockdown started in the province of Quebec, a subsample of participants who had completed the latest 2018 follow-up were surveyed (April-May 2020) about their sleep, insomnia, and psychological symptoms since the beginning of the pandemic. Prevalence, incidence, and persistence rates of insomnia, and severity of stress, anxiety, and depressive symptoms were estimated, as well as their associations with confinement, loneliness, social support, use of electronics, and other lifestyle changes occurring during the pandemic. A sleep/health survey and validated questionnaires of insomnia, sleep quality, stress, fatigue, anxiety, and depression were administered at both assessments. Results The sample consisted of 594 adults (mean age: 48.3 ± 13.1 years; 64.0% women). Prevalence of insomnia increased from 25.4% to 32.2% (symptoms) and from 16.8% to 19% (syndrome) from 2018 to 2020, for an overall 26.7% increase in insomnia rates. Of those classified as good sleepers in 2018 (n = 343), 32.6% (n = 112) had developed new insomnia during the COVID-19 pandemic. Among participants who had insomnia in 2018, the persistence rate was 76.5% two years later. There was a significant worsening of sleep quality, fatigue, anxiety and depression (all ps &lt; 0.005) during the COVID-19 pandemic compared to 2018. Significant associations were found between sleep and psychological symptoms and with living alone and being in confinement, lower social support, increased time using electronic devices, reduced physical exercise, and higher financial stress. Conclusions The COVID-19 pandemic is associated with significant increases in insomnia and psychological symptoms compared to the pre-pandemic period. Large scale public sleep and mental health intervention programs should be prioritized during and after a pandemic such as the the COVID-19.

scholarly journals Process Evaluation of a Large-Scale Community-Based Nutrition Program in Malawi

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Julie C Ruel-Bergeron ◽  
Kristen M Hurley ◽  
Audrey Buckland ◽  
Trust Mlambo ◽  
Yunhee Kang ◽  
...  
Keyword(s):  
Process Evaluation ◽  
Program Implementation ◽  
Large Scale ◽  
Monitoring And Evaluation ◽  
High Fidelity ◽  
Food Groups ◽  
Community Based ◽  
Nutrition Program ◽  
Direct Observations ◽  
Quality Aspects

ABSTRACT Background Global attention to the study of nutrition program implementation has been inadequate yet is critical for effective delivery and impact at scale. Objectives The objective of this mixed-methods process evaluation study was to measure the recruitment, fidelity, and reach of a large-scale, community-based nutrition program in Malawi. Methods The nutrition program delivered a small-quantity lipid-based nutrient supplement (SQ-LNS) and social and behavior change communication (SBCC) to improve infant and young child feeding (IYCF) and water, sanitation, and hygiene (WASH) practices in households with children aged 6–23 mo. Program monitoring and evaluation data were used to measure program recruitment, reach, and fidelity. Structured direct observations and knowledge questionnaires with program volunteers measured quality aspects of program fidelity. The number of times activities were done correctly was used to tabulate proportions used to represent program functioning. Results Half (49.5%) of eligible children redeemed program benefits by 8 mo of age during the first 4 y of program implementation. Implementation of training activities for SBCC cadres exceeded program targets (100.6%), but the completion of certain modules (breastfeeding and complementary feeding) was lower (22.9% and 18.6%, respectively). Knowledge of IYCF, WASH, and SQ-LNS messages by volunteers was &gt;85% for most messages, except ability to list the 6 food groups (35.7%). Structured direct observations of SQ-LNS distributions indicated high fidelity to program design, whereas those of household-level counseling sessions revealed lack of age-appropriate messaging. Program reach showed participation in monthly distribution sessions of 81.0%, group counseling of 93.3%, and individual-level counseling of 36.9%. Conclusions This community-based nutrition program was implemented with high fidelity and quality, with specific interventions requiring further attention. The documentation of implementation contributes to our understanding about how program impacts were achieved.

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