Confidential Support Research Articles

Supporting the Mind in Space: Psychological Tools for Long-Duration Missions.

The psychological well-being of astronauts is becoming just as vital as their physical and technical readiness as space missions extend into deep space. Long-duration missions pose unique challenges, such as isolation, confinement, communication delays, and microgravity, which can significantly affect mental health and cognitive performance. This commentary discusses the need for innovative mental health support systems, including automated psychotherapy, as well as Earth-based training methods like mindfulness and relaxation techniques, to address the psychological demands of space travel. By integrating these approaches into pre-mission preparation and in-flight routines, astronauts can develop self-regulation strategies to manage stress, improve focus, and enhance emotional resilience. Automated psychotherapy available 24-7 provides real-time confidential support when communication with Earth is delayed. As space exploration moves forward, the success of missions will depend not only on technological advancements but also on the development of psychological countermeasures that prioritize mental health alongside physical well-being. This paper emphasizes the importance of continued research and collaboration to refine and test these tools in analog environments, ensuring astronauts are mentally and emotionally prepared for the challenges of space.

Confidential outsourced support vector machine learning based on well-separated structure

Support Vector Machine (SVM) has revolutionized various domains and achieved remarkable successes. This progress relies on subtle algorithms and more on large training samples. However, the massive data collection introduces security concerns. To facilitate secure integration of data efficiently for building an accurate SVM classifier, we present a non-interactive protocol for privacy-preserving SVM, named NPSVMT. Specifically, we define a new well-separated structure for computing gradients that can decouple the fusion matter between user data and model parameters, allowing data providers to outsource the collaborative learning task to the cloud. As a result, NPSVMT is capable of removing the multiple communications and eliminating the straggler’s effect (waiting for the last), thereby going beyond those developed with interactive methods, e.g., federated learning. To further decrease the data traffic, we introduce a high-efficient coding method to compress and parse training data. In addition, unlike outsourced schemes based on homomorphic encryption or secret sharing, NPSVMT exploits functional encryption to maintain the data confidentiality, achieving dropout-tolerant secure aggregation. The implementations verify that NPSVMT is faster by orders of magnitude than the existing privacy-preserving SVM schemes on benchmark datasets.

Addressing the Complex Needs of Customers Who Contact the Veterans Crisis Line.

Since its creation in 2007, the Veterans Crisis Line (VCL) has provided 24/7, confidential crisis support services for Veterans, Service Members, and their families, supporting the VA's highest clinical priority of suicide prevention. As part of this effort, VCL created the Customers with Complex Needs (CWCN) program to manage the individual needs and operational impact of VCL customers who call at a high frequency, are abusive toward hotline staff, exhibit sexually inappropriate behavior, and/or make threats of violence. This paper describes the VCL CWCN program and customer characteristics. Call data from 2012 to 2022, including operational data for 1,096 CWCN customers identified from October 2017 to December 2020, were used for analysis. At the cohort's peak size in 2020, calls from CWCN customers accounted for 0.4% of all distinct phone numbers received by VCL and for 22.1% of total VCL call volume. Implementation of the CWCN program was associated with significant annual reductions in average individual call volume among high frequency callers. However, no change in call volume was observed among nonhigh frequency callers. Formative challenges and future directions for the CWCN program and implications for other crisis lines are discussed.

A stakeholder-driven approach to designing a peer recovery coach role for implementation in community-oriented primary care teams in South Africa.

In South Africa (SA), community-oriented primary care (COPC) teams work to re-engage out-of-care people with HIV (PWH) in treatment, many of whom have substance use (SU) concerns. SU stigma is high among these teams, limiting care engagement efforts. Integrating peer recovery coaches (PRCs) into COPC teams could shift SU stigma and improve patients' engagement in care. The PRC role does not exist in SA and represents a workforce innovation. To enhance acceptability, feasibility, and appropriateness for the local context, we engaged multiple stakeholder groups to co-design a PRC role for COPC team integration. We used a five-step human-centered design process: (i) semi-structured interviews with healthcare worker (HCW, n = 25) and patient (n = 15) stakeholders to identify priorities for the role; (ii) development of an initial role overview; (iii) six ideation workshops with HCW (n = 12) and patient (n = 12) stakeholders to adapt this overview; (iv) refinement of the role prototype via four co-design workshops with HCW (n = 7) and patient (n = 9) stakeholders; and (v) consultation with HIV and SU service leaders to assess the acceptability and feasibility of integrating this prototype into COPC teams. Although all stakeholders viewed the PRC role as acceptable, patients and HCWs identified different priorities. Patients prioritized the care experience through sharing of lived experience and confidential SU support. HCWs prioritized clarification of the PRC role, working conditions, and processes to limit any impact on the COPC team. A personal history of SU, minimum 1 year in SU recovery, and strong community knowledge were considered role prerequisites by all stakeholders. Through the iterative process, stakeholders clarified their preferences for PRC session structure, location, and content and expanded proposed components of PRC training to include therapeutic and professional work practice competencies. Service leaders endorsed the prototype after the addition of PRC integration training for COPCs and PRC mentoring to address community and COPC dynamics. Stakeholder engagement in an iterative HCD process has been integral to co-designing a PRC role that multiple stakeholder groups consider acceptable and that COPC teams are willing to implement. This offers a methodological framework for other teams designing SU workforce innovations.

Minors’ and guardian access to and use of a national patient portal: A retrospective comparative case study of Sweden and Finland

BackgroundApproaches to implementing online record access (ORA) via patient portals for minors and guardians vary internationally, as more countries continue to develop patient-accessible electronic health records (PAEHR) systems. Evidence of ORA usage and country-specific practices to allow or block minors’ and guardians’ access to minors’ records during adolescence (i.e. access control practices) may provide a broader understanding of possible approaches and their implications for minors' confidentiality and guardian support. AimTo describe and compare minors’ and guardian proxy users’ PAEHR usage in Sweden and Finland. Furthermore, to investigate the use of country-specific access control practices. MethodsA retrospective, observational case study was conducted. Data were collected from PAEHR administration services in Sweden and Finland and proportional use was calculated based on population statistics. Descriptive statistics were used to analyze the results. ResultsIn both Sweden and Finland, the proportion of adolescents accessing their PAEHR increased from younger to older age-groups reaching the proportion of 59.9 % in Sweden and 84.8 % in Finland in the age-group of 17-year-olds. The PAEHR access gap during early adolescence in Sweden may explain the lower proportion of users among those who enter adulthood. Around half of guardians in Finland accessed their minor children’s records in 2022 (46.1 %), while Swedish guardian use was the highest in 2022 for newborn children (41.8 %), and decreased thereafter. Few, mainly guardians, applied for extended access in Sweden. In Finland, where a case-by-case approach to access control relies on healthcare professionals' (HCPs) consideration of a minor’s maturity, 95.8 % of minors chose to disclose prescription information to their guardians. ConclusionWhile age-based access control practices can hamper ORA for minors and guardians, case-by-case approach requires HCP resources and careful guidance to ensure equality between patients. Guardians primarily access minors’ records during early childhood and adolescents show willingness to share their PAEHR with parents.

A Psychoanalyst's Confrontation With Illness, Aging, and Death.

Offering a personal example, the author argues for the protocols of respectful, confidential, and responsible institutional support as a corrective to an individual clinician's lack of optimal judgment when facing difficult clinical challenges or personal crises.

Lessons Learned in Improving the Quality of a Free Reproductive Health Hotline in Benin.

Since 2006, the Ligne Verte project-a toll-free national hotline that provides counseling and provider linkages to family planning, HIV, and sexually transmitted infection services-has been implemented by the Association Béninoise pour le Marketing Social et la Communication pour la Santé (ABMS) in Benin. Annual evaluations have been conducted to monitor client satisfaction, with feedback mechanisms to learn from callers and staff, aiming to continually improve the program. We document lessons learned from these evaluations, outline the adaptation process to improve the quality of the hotline, present results from Ligne Verte caller and counselor studies, and describe how the studies fed client-driven changes to the project. Annual rounds of semistructured phone interviews with Ligne Verte callers and call center advisors were conducted. The sample of clients interviewed included consenting men and women aged 18 years and older who had used Ligne Verte services in the 3 months preceding the evaluation. All advisors working on the helpline were also eligible for inclusion in qualitative interviews. From 2013 to 2020, most callers were satisfied with the Ligne Verte project. Users reported appreciating the accurate, timely, and confidential support they received from the helpline but noted the need to expand the service to other local languages and improve call quality. Call center advisors requested mental health support. In employing a systematic approach to program improvement, ABMS was able to add extended language services, upgrade their telecommunication hardware, and provide a psychologist for call center advisors. These program adaptations have increased caller satisfaction by 20 percentage points, and in 2020, 95% of callers reported being satisfied with their Ligne Verte experience. Taking a consumer-centered approach, listening to user feedback, and making evidence-based recommendations to improve the Ligne Verte project has led to an overall increase in caller satisfaction.

Predictors of physical activity in older adults 65 years and older: findings in health survey of the Valencian Community.

Physical activity is part of a healthy lifestyle in the older adult and is related to multiple variables that promote this behavior. To identify the relationship and predictive power of sociodemographic variables, multimorbidity, severity index, risk of poor mental health, social support, affective support and confidential support with the time devoted to physical activity in the population over 65 years of age in the Valencian Community. Cross-sectional descriptive analytical study of the data collected in the Health Survey of the Valencian Community on a total of 3,199 people over 65 years of age. The study variables were age, sex, educational level, marital status, social class, multimorbidity, severity index collected with the EQ-5D-5L tool, risk of poor mental health collected with the Goldberg general health questionnaire (GHQ-12), and perceived social, affective and confidential support collected with the Duke-Unc social support scale (Duke-UNC-11). All variables, except affective support, are significantly related to the time of physical activity performed by people older than 65 years. The severity index has a predictive capacity of 13.7% of physical activity performed and age is able to predict 1.2% of this variable. Sex, age, education, social class, marital status, multimorbidity, risk of poor mental health or social support and confidentiality are related to the physical activity time of the Valencian population over 65 years of age. On the other hand, the variables severity index and age have been identified as variables capable of predicting up to 14.8% of the variance of the physical activity time variable in our study population.

Understanding and Addressing Youth Mental Health: Challenges and Strategies

The tumultuous phases of adolescence and early adulthood, marked by a whirlwind of physiological, emotional, and psychological changes, form the foundation of an individual’s identity and resilience. This research paper unfolds an intricate narrative—a deep exploration of the multifaceted realm of youth mental health. The weight of academic expectations, the ebb and flow of peer dynamics, the intricate tapestry of familial relationships, and the ever-present societal benchmarks all contribute to the complex matrix of factors that either nourish or erode youth mental health. The urgency of unraveling this complexity stems from an ethical imperative and a pragmatic realization—the mental well-being of our youth not only shapes individual destinies but also reverberates through the very fabric of our society. We confront not only the challenges but also the barriers that obstruct young individuals from seeking assistance. The stubbornness of stigma erects barriers that hinder vulnerable youth from accessing the support they deserve. Limited awareness of available resources and concerns about confidentiality compound these obstacles, creating a chasm between struggling youth and the avenues of aid. These barriers compel us to devise strategies that erode stigma, propagate awareness, and build bridges towards confidential and accessible mental health support.

Implementing psychological support for health and social care staff affected by the COVID-19 pandemic: a qualitative exploration of staff well-being hubs (‘Resilience Hubs’) using normalisation process theory

ObjectivesEvaluate the implementation of Hubs providing access to psychological support for health and social care keyworkers affected by the COVID-19 pandemic.DesignQualitative interviews informed by normalisation process theory to understand how...

The journey from concealment to disclosure of an obsessive-compulsive disorder diagnosis in the high school setting: A qualitative study exploring youth perspectives

Disclosure of an OCD diagnosis in the high school setting could allow for timely provision of individualized school-based supports. As few studies have examined adolescent perspectives on the disclosure process in schools, we adopted a qualitative approach to explore this, and to gather recommendations for making disclosure of OCD at school safer and more helpful. Twelve participants, ranging from 13 to 17 years old, were recruited using maximum variance-based heterogeneous purposive sampling. Semi-structured interviews were conducted and analyzed inductively through Interpretive Description. From participants’ stories, we generated a theoretical model describing the journey from concealment of an OCD diagnosis to disclosure. Four phases of youth disclosure were identified: managing enacted and perceived stigma related to the diagnosis, internal bargaining to determine their individualized disclosure boundaries, trust building with school members, and empowerment by being treated as a person first. Participants’ recommendations for the school setting included meaningful education, safe spaces, deep reciprocal connections, and confidential personalized support. The model we developed can help inform school disclosure strategies and optimize support to promote best outcomes for youth with OCD.

ADHERENCE TO TREATMENT IN HYPERTENSIVE ADULTS: RELATIONSHIP WITH SOCIAL SUPPORT, ANXIETY AND DEPRESSION

Objective: This study examined the relationship between Social Support (SS) Anxiety (A) Depressión (D) with adherence to treatment (AT) in hypertensive adults. Design and method: There were 1582 hypertensive adults, males (n = 404) and females (n = 1178), age mean = 72 years, (SD = 12, 57). The Morisky–Green test evaluated compliant and non-compliant, DUKE test evaluated affective social support (ASS) and confidential social support (CSS), Zung Anxiety scale: Minimum anxiety (MiA), Moderate anxiety MoA) and Severe anxiety (SeA) and Zung Depression scale: Non depression (NoD) Minimum Depression (MiD) and Moderate- Severe Depression (MosD), all applied in one day doctor's visit. Results: The means and standard deviations for Systolic Blood Pressure of hypertensive adults was: 158,91 ± 29,82; for Diastolic Blood Pressure of hypertensive adults was 74,43 ± 12,79. Hypertensive adults compliant 20,3% and hypertensive adults non-compliant 79,7%. Good ASS support was 4.1%; bad ASS was 95.9%. Good CSS was 3.4% and 96.6% for bad CSS. MiA 35.6%; MoA 30% and SeA 34.4%. NoD 29.3%; MiD 63.7% and MosD 7%. The Rho Spearman correlation showed a significant correlation between AT and ASS (Rho Spearman: r = ,120**/ p = ,000); AT and CSS (Rho Spearman: r = ,113**/ p = ,000); AT and A (Rho Spearman: r = ,141**/ p = ,000); AT and D (Rho Spearman: r = ,132**/ p = ,000). Conclusions: The results provide evidence of a relationship between AT and ASS, CSS, A, D in hypertensive adults, indicating that social support and mood are important variables that must be evaluated when measuring adherence to treatment and seeking strategies to improve them.

Access to psychosocial support for church-going young people recovering from drug and substance abuse in Zimbabwe: a qualitative study

BackgroundThe church and other religious-affiliated organizations have promising yet underexplored potential to provide social support services for young people recovering from substance abuse in communities where drug and substance rehabilitation services are limited. This study aimed to establish the barriers and facilitators of accessing psychosocial support, the role of the church, and strategies to promote access to psychosocial support for youths recovering from drug and substance abuse.MethodsThis was a qualitative cross-sectional study, and semi-structured interviews of 18 church-going youths and three youth pastors were conducted in eastern Zimbabwe. Data were collected using recorded telephone interviews. Data were transcribed and analyzed using the thematic network analysis technique of producing basic themes, which build into organizing themes. Organizing themes produces one overarching global theme. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for reporting on qualitative research were used in reporting the study findings.ResultsThe interviews produced the following basic themes under organizing theme barriers: stigma and discrimination, parental/guardian denial, radical religious beliefs, and negative role models. Under the organizing theme facilitators, the basic themes were acceptance, confidentiality, peer and parental support, and an organized support program. The church acted as the bridge between the barriers to access to services and support seeking through innovative, inclusive projects and activities, as well as a pillar of social support.ConclusionsAcceptance of one’s addiction problem is critical to initiate seeking psychosocial support. Confidentiality, support from trustworthy relationships, and the availability of a well-coordinated recovery program enable young people to seek support. We recommend formal training church-based counselors in the ethical aspects of psychotherapy to reduce the preconceived social stigma associated with drug and substance abuse.

Barriers and Motivators to Seeking Mental Health Support: An Assessment of a Southeastern Sheriff's Office

Limited research has examined what factors serve as potential barriers and motivators for law enforcement personnel in seeking mental health support. The current study presents findings from a survey of 158 sworn and civilian personnel from a large Southeastern Sheriff's office to shed light on these potential barriers/motivators. We drew on previous literature to create measures related to mental health stigma, confidentiality, burnout, various stressors, and organizational support, among others. The main effects OLS regression models suggest that increased perceptions of stigma and personal stressors significantly lowered employees’ willingness to seek mental health support. However, increased burnout and job satisfaction were associated with employees seeking mental health support. Multiplicative models show that as job satisfaction increased within nonwhite respondents, those respondents were significantly more likely to seek mental health assistance. However, as personal stressors increased among nonwhite respondents, those respondents were significantly less likely to seek help. Finally, as overall health increased among white respondents, those respondents were significantly more likely to seek help. Findings indicate that mental health issues experienced by employees vary based on group membership. We discuss several future research directions and policy implications derived from these findings.

Evaluating the efficacy of hydrogen peroxide vapor against a retroviral vector in a gene therapy manufacturing facility.

An evaluation of the efficacy of 35% hydrogen peroxide vapor (HPV) against a novel Simian Immunodeficiency retrovirus (SIV) was conducted in a 624m3 GMP grade C manufacturing facility. SIV biological indicators, with an average titre of 7.11×108 TU/mL [equivalent to 1.3×108 Reverse transcriptase (RT) nanounits when analysed by F-PERT], were produced on-site using virus presented within an anticipated worst-case support matrix based on the manufacturers commercially confidential virus support media. SIV biological indicators were distributed around the manufacturing facility, including locations identified as key contamination control points by the manufacturer, and exposed to a HPV cycle. Commercially available biological indicators of 6 log10Geobacillus stearothermophilus were co-located with the SIV Biological Indicator (BIs). HPV was found to be efficacious in eliminating the SIV and commercial G. stearothermophilus BIs and offers a simple and robust method for biodecontamination of gene therapy facilities.

Vetlife is here to help

Everyone in the veterinary community - including veterinary nurses, veterinary students and non-clinical staff - is welcome to contact the Vetlife Helpline for free, independent and confidential support, says Eve Ritchie.

Social support and mental health in maternity: Effects of the COVID-19 pandemic

BackgroundMotherhood involves a process of adaptation and the perception of social support influences mental health, breastfeeding or newborn care among others. The COVID-19 pandemic has generated a distancing from family, friends and health professionals. MethodsQuantitative, descriptive, cross-sectional study. The present study aims to describe and analyze the social support and mental health of mothers during this period. MethodsThe sample were 179 women with children older than 6 months. The questionnaires used were the DUKE-UNC-11 and GHQ-12. Data analysis was carried out with Spearman's Rho and Mann Whitney U test. Results75.8% of the sample perceived normal social support during the pandemic. Within the dimensions of social support, women reported perceiving satisfactory confidential support, while affective support was perceived as low. Correlational analysis reported a significant relationship between mental health, confidential support and affective support. Group comparison noted greater confidential support in primiparous. ConclusionsThe sample is sensitive to changes originated by COVID-19 constraints influencing perceived social support and mental health. Affective and confidential support as well as the involvement of health professionals and the environment are fundamental for mental health during the first year of maternity. Relevance to clinical practiceMothers' mental health is sensitive and vulnerable to social changes, in this case, those that occurred as a consequence of the COVID-19 outbreak.

Australian healthcare workers experiences of peer support during COVID-19: Hand-n-Hand peer support.

IntroductionFounded at the beginning of the COVID-19 pandemic, Hand-n-Hand Peer Support (HnH) offers free, confidential peer support to healthcare workers (HCWs) across Australia and New Zealand. This survey aimed to evaluate HCWs experiences of peer support and collect demographic data about what groups of HCWs were seeking support.MethodsAn online survey was conducted in November 2021 of HCWs who were either active or past HnH participants (n = 158). Questions included 5-point Likert scales, multiple choice and free text responses.ResultsWe received 66 responses (42% response rate). The median age range of respondents was 41–45 years and most were female (87.9%). Most respondents (57.4%) reported experiencing no barriers to accessing peer support. The vast majority (81.4%) of HCWs reported a ‘good’ or ‘very good’ peer support experience. Respondents felt peer support helped in multiple ways, particularly in feeling less alone and having a safe space to discuss issues.ConclusionAustralian HCWs accessing peer support tended to be female and more senior clinicians. Most HCWs engaged in HnH reported overall very positive experiences. Our survey helped to identify several areas for improvement in HnH, including clearer marketing about peer support and more targeted triage assessments.

Systematic assessment of the quality and integrity of popular mental health smartphone apps using the American Psychiatric Association's app evaluation model.

Mobile phones are playing an increasingly important role in supporting mental health, by providing confidential, accessible and scalable support for individuals who may not seek or have means of accessing professional help. There are concerns, however, that many apps claiming to support mental health do not meet professional, ethical or evidence-based standards. App store search algorithms favour popularity (reviews and downloads) and commercial factors (in-app purchases), with what appears to be low prioritisation of safety or effectiveness features. In this paper, the most visible 100 apps for “depression”, “anxiety” and/or “mood” on the Google Play and Apple App stores were selected for assessment using the American Psychiatric Association App Evaluation model. This model systematically assesses apps across five broad steps: accessibility, integrity, clinical and research evidence base, user engagement and interoperability. Assessment is hierarchical, with the most fundamental requirements of apps assessed first, with apps excluded at each step if they do not meet the criteria. The relationship between app quality and app store visibility was first analysed. App quality was also compared across four different app function types: mental health promotion or psychoeducation; monitoring or tracking; assessment or prevention; and intervention or treatment. Of the 92 apps assessed (after eight failed to meet inclusion criteria), half failed to meet the first criterion step of accessibility, and a further 20% of the remaining apps failed to meet the second criterion step of security and privacy. Only three of the 10 apps most visible on app stores met the criteria for research/clinical base and engagement/ease of use, and only one app fulfilled all five criterion steps of the evaluation model. Quality did not differ significantly across app function type. There was no significant correlation between app quality and app store visibility, which presents a potential risk to vulnerable consumers. The findings of this review highlight the need for greater accountability of app developers to meet, and report, at least minimum quality and integrity standards for their apps. Recommendations are also provided to assist users and clinicians to make informed choices in their selection of reputable and effective mental health apps.

Anuvaad

Machine Translation is best alternative to traditional manual translation. The corpus of Sanskrit literature includes a rich tradition of philosophical and religious texts as well as poetry, music, drama, scientific, technical and other texts. Due to the modernization of tradition and languages, Sanskrit is not on everyone's lips. Translation makes it convenient for users to understand the unknown text. This paper presents a language Machine Translation System from Hindi to Sanskrit and Sanskrit to Hindi using a rule-based technique. We developed a machine translation tool 'anuvaad' which translates Sanskrit prose text into Hindi & vice versa. We also developed bi-lingual corpora to deal with Sanskrit and Hindi grammar rules and text applied rule based method to perform the translation. The experimental results on different 110 examples show that the proposed anuvaad tool achieves overall 93% accuracy for both types of translations. The objective of our work is to ensure confidentiality and multilingual support, which can be tedious and time consuming in case of manual translation.