Health Recovery Research Articles

A ATUAÇÃO DO FISIOTERAPEUTA NA ATENÇÃO PRIMÁRIA À SAÚDE NO CONTEXTO DA ESTRATÉGIA DE SAÚDE DA FAMÍLIA DO BRASIL

The physical therapist has been gradually integrated into the family health strategy (FHS), acting in a relevant role in the national healthcarenetwork. The objective of this studywas to investigate, through an integrative literature review, scientific evidence on the role of physical therapists in primary care within the context of the FHS. The literature search was conducted in the Google Scholar database, Pubmed, Scientific Electronic Library Online (SciElO), Literatura Latino-Americana e do Caribe em Ciências em Saúde (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE) and Periódicos CAPES databases. A total of 45 articles published between 2014 and 2024 were included in the study.. The analysis of the studies demonstrated that the integration of physical therapists into the FHS, alongside the multidisciplinary team, is essential to providing comprehensive care and individualized attention, ensuring efficient assistance.. The study concludes that the role of physical therapists in Primary Health Care is of great importance to public healthgreat importance to public health, as these professionals contribute to the promotion, prevention, and recovery of both individual and collective health, restoring functionality, enhancing quality of life, and helping to reduce waiting times for care in the Unified Health System.. The expansion of the presence of physical therapists in Primary Care, specifically in the Family Health Strategy, is not onlybeneficial for the population but also enhances humanized care and functionality. Therefore, in addition to acknowledging the evidence, there is a need to recognize and support investments from health managers.

Efficacy of positive expressive writing in reducing depression and social anxiety symptoms among schoolchildren during COVID-19: A randomized controlled trial.

The COVID-19 pandemic harmed children's mental health, and limited therapy access exacerbates the issue. We studied positive expressive writing (EW) as a psychological intervention for teachers to reduce depression and social anxiety symptoms among schoolchildren. Altogether, 165 Chinese schoolchildren aged 10-15 were randomly assigned to positive EW, memory EW, or control group. EW groups wrote for 10 minutes weekly for 7 weeks about people and things they felt grateful for (positive EW) or memorable in the past week. The control group continued with regular weekly class meetings. All groups measured depression and social anxiety before and after the intervention. Positive EW significantly reduced depression and social anxiety symptoms compared to the control condition (both Cohen's d = -0.45) and reduced social anxiety symptoms compared to memory EW (Cohen's d = -0.32). Therefore, teachers can implement positive EW to support schoolchildren's mental health recovery during and after disasters.

Vermont association leader wants to drive behavioral integration

The newly appointed executive director of the Vermont Association for Mental Health & Addiction Recovery (VAMHAR) intends to embark on a mission reflecting the organization's name. Daniel Franklin believes that one of Vermont's oldest advocacy organizations can serve as a catalyst for integrating mental health and addiction service systems that remain largely siloed.

"There's no us vs. them, it's just us": a creative approach to centring lived experience within the AVATAR2 trial.

This article describes a Patient and Public Involvement (PPI) led creative workshop space held within a clinical trial of a talking therapy for distressing voices (AVATAR2). PPI adds significant value to clinical research and ensures the work is meaningful to patients and their supporters. However, known issues include tokenism, a common power imbalance between PPI colleagues and researchers and a lack of opportunity for PPI to shape the research. PPI has played a key role at all stages of the AVATAR2 trial, including design, recruitment of staff and participants, data collection, analysis, and dissemination. An active and creative group of people was established, with over 30 members flexibly involved across all four sites. PPI group members were from diverse backgrounds, with lived experience of mental health conditions and recovery, and including carers. During this work, PPI colleagues identified that they would value a creative space which would help to promote the study but extend beyond an exclusive focus on trial deliverables. A regular creative workshop was established to support PPI colleagues in their creative work, including material such as poetry, blogs, art and podcasts. PPI colleagues and trial staff have cowritten a reflective piece to share their experiences on the impact of the creative workshops, organised into four themes. We found the workshops to be a powerful tool for forging relationships among trial staff and PPI colleagues, while also fostering personal development. We reflected on how the workshops built up the confidence of attendees and supported demanding trial activities such as public speaking. Finally, we discussed the impact of the workshops on wider trial culture, by upholding the values of the team and challenging the status quo.

Effectiveness of a three-component intervention supporting unemployed individuals with mental health issues in their job search and mental health recovery (3for1): study protocol of a non-randomized controlled study.

There is a vicious cycle between unemployment and mental health issues. Unemployed individuals with mental health issues require individualized support at multiple levels in order to promote their mental health, and obtain and retain employment. The 3for1-intervention program aims to provide such support with three components (short-term psychotherapy, job coaching based on the Individual Placement and Support approach, and peer support). This study protocol outlines how the effectiveness of this three-component intervention program in terms of re-employment, mental health, and psychosocial outcomes will be evaluated. The 3for1-intervention program will be evaluated with a non-randomized controlled trial design in a multi-center study. 500 eligible participants aged between 18 and 60 years from six job centers in Southern Germany will be allocated to a control group or an intervention group. Allocation is time-based, with the control group being recruited first, followed by recruitment of the intervention group. The control group will receive treatment as usual, whereas the intervention group will receive treatment as usual as well as access to the three intervention components over a period of 12 months. Assessment will be conducted at baseline (t0), and 12 (t1) and 18 (t3) months later. The primary outcome will be the proportion of participants who are in employment subject to social insurance contributions at t1. Differences between control and intervention group will be tested with logistic regression analysis, controlling for relevant covariates. Analyses of secondary outcomes will relate to group differences regarding re-employment, health and well-being, social integration, help-seeking, and self-stigma at t1 and t2, applying logistic regression analysis or analysis of covariance. Additionally, usage of health services will be measured to evaluate the intervention program's cost effectiveness. The 3for1-intervention aims to improve employability and mental health outcomes of a vulnerable population with high need for assistance. Improvements for this population would benefit the German welfare state as well. This study could provide valuable insights into the feasibility, implementation, and sustainability of this individualized, multi-level support program within German job centers. This trial is registered with the German Clinical Trials Register: DRKS00029002 (registered on 11 May 2022).

The Association Between Change in Symptom Severity and Personal Recovery in Patients With Severe Mental Illness

Abstract This study examined the relationship between change in symptom severity and personal recovery in patients with severe mental illness (SMI). Forty-nine outpatients at Mentrum/Arkin, Amsterdam, the Netherlands, were assessed at baseline and 3 years later, using the Brief Psychiatric Rating Scale and the Mental Health Recovery Measure. Correlation coefficients and linear regression analyses were used. Further, the impact of severity of symptoms at baseline on change in personal recovery was evaluated. Results show that change in symptom severity explained 31.8% of the variance of change in personal recovery. Change in depression/anxiety explained 27.3% of the variance of change in personal recovery. Higher affective symptom severity at baseline significantly predicted positive change in personal recovery. In conclusion, besides change in symptom severity, other potential determinants of personal recovery should be addressed in treatment of patients with SMI, for example, self-esteem and social functioning. Treatment of depression/anxiety symptoms may increase personal recovery.

Hard stop: reestablishing the significance of abstinence in the treatment of late stage ultra-processed food addiction

Addiction is a complex neurobiological disorder characterized by compulsive drug-seeking and use despite harmful consequences. While abstinence-based approaches have long been the cornerstone of addiction treatment, recent years have seen legitimate challenges from harm reduction clinicians, and within the food addiction realm, the eating disorder treatment practitioners. This perspective emphasizes the role of abstinence in food addiction recovery using the Koob model and its concept of hyperkatifeia despite these reservations. However, further research is essential before abstinence can be recommended. We need to 1) identify what qualifies as abstinence in relation to ultra-processed food, 2) clarify suitable situations and disease progression for optimal implementation of this approach, 3) provide clear guidelines when it is harmful, and 4) conduct clinical studies to confirm the effectiveness of this strategy for long-term recovery from late-stage food addiction.

Economic Strain and Recovery Trajectories in Mental Health: The Role of Financial Stability in Mental Health Outcomes

This study explores the intricate relationship between financial stability and recovery from mental health, and clarifies how economic security constitutes an essential feature that enhances mental health results. The study has used SPSS in quantitative analysis for regression analysis, ANOVA, cluster analysis, and structural equation modeling to explore the determinants of influential predictors and patterns in linking financial stability with mental health recovery. The regression outcome showed that financial stability substantially predicts recovery (? = 0.52, p < 0.01), and ANOVA indicated large differences in the scores of recoveries among the financial groups (F = 8.15, p < 0.05). Cluster analysis also indicated a difference such that the average score of recovery for high-stability participants was 8.5, while for low-stability participants it was 4.1. Thus, SEM shows both direct and indirect effects as it manifests that financial stability indeed reduces stress and encourages treatment adherence. The study concludes that economic security indeed plays a multifaceted role ranging from the access of mental healthcare through income support programs to resilience and overall well-being through the promotion of living a financial stability life. Recommendations should include income support programs, financial literacy programs, and integrated financial and mental health support services to form sustainable recovery. Further longitudinal researches, with larger and more diverse samples, should be conducted to study the long-run impact of financial stability on mental health trajectories and tailor policy interventions accordingly.

CONTRIBUIÇÕES DA FISIOTERAPIA AQUÁTICA: REABILITAÇÃO EM PACIENTES COM LESÃO MEDULAR ESPINHAL TRAUMÁTICA

Aquatic Physical Therapy (APT) has been reported as applicable in various specialties within the physiotherapy field, culminating in rehabilitation procedures, especially after Spinal Cord Injury (SCI), with beneficial results for individuals with this condition. It tends to be more effective in restoring some or all movement, initially with plegia, presenting a decrease and even absence of strength and balance post-trauma in the vertebral column region, leading to spinal cord injury. The aquatic environment provides the patient with a bombardment of sensory-motor stimuli, further activating neuroplasticity in rehabilitation, as well as reducing pain, providing relaxation of all muscles, and increasing blood supply to the muscles. In addition to being a therapy in a safe environment, an important factor is the reduction of joint impact and improvement in venous return, making it possible to recover movements. Objective: To understand the contributions of aquatic physiotherapy in functional rehabilitation in (SCI). Methodology: Based on bibliographic research, using the electronic databases Bireme, PubMed, and Scielo, with articles published from 2000 onwards. Conclusion: Aquatic physiotherapy and its benefits in health recovery, achieved through the physical properties of water, have been studied since the time of Hippocrates, which, combined with physiotherapy treatment protocols, promote better functional rehabilitation for patients with (SCI).

Incorporating Lifestyle Medicine into Occupational Medicine Practice - ACOEM Guidance Statement.

Lifestyle Medicine (LM) utilizes evidence-based therapeutic lifestyle changes to address lifestyle factors that impact health, performance, and injury risk and recovery. By integrating LM principles into clinical care, workplace policies, and programs, along with other evidence-based methods, occupational and environmental medicine clinicians and medical directors can enhance worker health and performance, manage chronic disease, and facilitate faster recovery from injury and illness. This guidance addresses approaches that can be used in the clinic and workplace to address tobacco, substance misuse, nutrition, physical activity, overweight/ obesity, sleep, mental well-being, and social connectedness.

Co-creation and recovery in mental health services: a lived experience perspective.

This article explores the shift in mental health recovery from mere symptom management to a holistic approach via the CHIME framework. It delves into the author's experience, beginning with the loss of his father, a war veteran with mental health struggles, at 16, thrusting him into the role of primary caregiver for his mother, who also battled mental health issues and eventually took her own life. These events spotlight the shortcomings of traditional mental health care and the urgent need for empathetic, multifaceted services. Advocating for co-creation in mental health services, the article outlines a transition towards a system that integrates recovery principles through stages from co-ideation to co-evaluation, emphasising holistic, person-centred care. It calls for a reimagined mental healthcare system that respects individual journeys and is rooted in co-creation, signalling a critical move towards systemic change.

Healing the Self: Mental Health and Existential Recovery in the Select Works of Don DeLillo

This paper explores the coping mechanisms of existential beings during moments of crisis, focusing on the works of Don DeLillo, Zero K, The Body Artist, and Falling Man. Grounded in existential philosophy, psychology, and psychiatry, the study analyzes how DeLillo’s characters navigate crises of meaning, death, and isolation, revealing core existential traits both during and after their experiences. Drawing on theories from Sartre, Heidegger, Nietzsche, Frankl, and Yalom, the research demonstrates that these characters confront alienation, death, and absurdity by embracing authenticity, rebellion, and self-transformation. Through close reading and thematic analysis, the paper argues that DeLillo’s characters use suffering and trauma as catalysts for existential growth, reflecting the human capacity to find meaning and transformation in moments of profound disorientation. The study bridges literature and the humanities, illustrating how the existential crises depicted in DeLillo’s works resonate with universal themes of coping, identity, and survival in the face of the absurd. It will also propose the C.A.R.E model as a healing way to overcome crisis.

Reducing the harms of cannabis use in youth post-legalization: insights from Ontario youth, parents, and service providers

BackgroundCanada has one of the highest prevalence of cannabis use globally, particularly among young adults aged 20–24 (50%) and youth aged 16–19 (37%). In 2018, Canada legalized recreational cannabis with the aim of protecting youth by restricting their access and raising public awareness of health risks. However, there has been limited qualitative research on the perceptions of harms associated with youth cannabis use since legalization, which is crucial for developing effective harm reduction strategies. This qualitative study examined perceptions of cannabis use among youth from the perspectives of youth, parents, and service providers. We explored how participants described the perceived risks or harms associated with youth cannabis use, as well as how they described their own and others’ approaches to reducing cannabis-related risks and harms.MethodsThis qualitative study used a community-based participatory research approach in partnership with Families for Addiction Recovery (FAR), a national charity founded by parents of youth and young adults with addiction issues. Virtual semi-structured interviews were conducted, and the data were analyzed using thematic analysis.ResultsThe study included 88 participants from three key groups (n = 31 youth, n = 26 parents, n = 31 service providers). Two main themes emerged regarding perceived risks or harms associated with cannabis use: (1) concerns about cannabis-related risks and harms, including addiction, brain development, impact on family, and various adverse effects on areas such as motivation, concentration, finances, employment, education, physical and mental health; and (2) minimization of risks and harms, featuring conflicting messages, normalization, and perceptions of cannabis being less harmful than other substances. Additionally, two themes related to harm reduction approaches were identified: (1) implementation of harm reduction, and (2) challenges in implementing a harm reduction approach. Specific challenges for each participant group were noted, along with structural barriers such as unavailable and inaccessible services, easy access to cannabis, inadequate public education, and insufficient information on lower-risk cannabis use guidelines.ConclusionsYouth cannabis use is a significant public health concern that requires a multi-pronged approach. Developing youth-centered harm reduction strategies that recognize the developmental needs and vulnerabilities of youth, as well as the important role of families, is imperative.

Sequenced co-design with stakeholder communities to support the development of spaces for mental health recovery and healing

This research reports on a sequenced co-design process to engage lived experience consumers, carers, healthcare professionals, sector advocates and government representatives in co-designing spatial and experiential inputs to a residential eating disorders facility. The stakeholder community was enabled to co-design a model of care and, building on this, shape the functional brief for the design of health spaces. The stakeholder community input provided architects and designers with a more expansive understanding of user needs regarding specific architectural qualities including psychological safety, flexibility, social connection, and sensory experiences. Our approach yields insights across three interlinked areas: capacity building in the stakeholder community to develop the design language to contribute to design discussions; co-design processes to question pre-existing design assumptions; and subsequently, the development of a more nuanced brief for health spaces. The research supports designers, architects, health organizations and health planners to meaningfully engage with future users of complex healthcare environments.

Exploring Indonesian coastal communities’ responses to the 2019 Ambon earthquake and their preparedness for future disasters

Since the seventeenth century, megathrust earthquakes and tsunamis have occurred and have been recorded in Maluku Province, Indonesia. The Maluku community lives on land of most alluvial soil, areas where tsunamis have occurred, besides the active path of seismic and volcanoes, which has negatively impacted humans during disasters. Therefore, learning from past communities’ responses and experiences is vital to decrease the risk associated with potential future disasters. However, studies about the Indonesian coastal communities’ seismic responses and preparedness at the grassroots level, particularly in Maluku Province, have yet to be done. Thirty survivors of the Mw 6.5 Ambon earthquake in 2019 with over a thousand aftershocks, living in the three coastal villages on Ambon Island, were selected as respondents in the semi-structured interviews. The research results showed that the survivors had various responses to the earthquake and its aftershocks. Religious belief was a critical factor for their capability to encounter calamities, besides social support that has helped them survive. The 2019 earthquake has also enhanced their creativity, engagement, and participation. Some disaster preparedness gaps still exist, although their experiences have taught them to be more aware and prepared for future disasters. The gaps are the early warning system availability, public education and information, risk transfer capability, protection development, humanitarian aid protocols and procedures, and health recovery. With its crucial recommendations, this study strengthens disaster governance in archipelagic countries like Indonesia and adds to the literature on how coastal communities handle multiple seismic disasters.

Resilience to major life events: Advancing trajectory modeling and resilience factor identification by controlling for background stressor exposure.

Resilience has been defined as the maintenance or quick recovery of mental health during and after stressor exposure. One popular operationalization of this concept is to model prototypical trajectories of mental health in response to an adverse event, where trajectories of undisturbed low or rapidly recovering symptoms both comply with the resilience definition. However, mental health responses are likely also influenced by other stressors occurring before or during the observation time window. These "background" stressors may affect a person's assignment to a trajectory class. When using these classes as dependent variables to identify resilience-predictive factors, this may lead to false estimates. A new method to build exposure-controlled trajectories based on time courses of stressor reactivity (SR), rather than pure mental health scores, is demonstrated on a data set of 707 initially healthy participants living in Germany (67.33% female; Mage = 29.20, SD = 8.27). SR scores express individual deviations from the sample's normative mental health reaction to observed real-life stressors during the observation time window, thus accounting for individual differences in exposure to background stressors. The resulting trajectory models are plausible. In analyses additionally controlling for background stressors occurring before the observation time window (past life events), low SR trajectories are predicted by the well-documented resilience factor sense of coherence, suggesting construct validity. Further, they are associated with lower odds of developing categorical mental health conditions, suggesting predictive validity. Our study provides the first proof of principle for a refined method to identify predictors of resilience to major stressor events. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Public school teachers' perceptions of internet gaming problems among students: current status and challenges

Objectives This study aimed to identify and understand the challenges faced by public school teachers regarding issues related to Internet gaming.Methods An electronic questionnaire was administered to 400 public school teachers in the Saitama Prefecture from September to November 2021. A total of 352 valid responses were obtained. The survey content included teachers' knowledge of gaming disorders, whether their students experienced gaming-related problems, difficulties perceived by teachers, how they discovered the problems, how they dealt with them, the challenges they faced in dealing with the problems, and desired support. Data were analyzed based on the teachers' roles, responsibilities, type of school, and knowledge of gaming difficulties. Fisher's exact probability tests were used to determine significance, and adjusted standardized residuals were used to assess the differences between groups.Results Nearly 63.1% of the teachers already had knowledge of gaming disorders, and 49.4% acknowledged the existence of students with gaming problems. The most common reasons for discovering problems were disrupted daily rhythm (51.7%) and increased tardiness and early dismissal (34.7%). The main actions taken to address gaming problems were "consultation and information sharing with families" (48.6%) and "individual guidance by teachers" (34.1%). Approximately half of the teachers indicated that they regularly experienced difficulties in activities related to prevention, early detection, student support, and interaction with parents. Specific challenges included limited guidance and involvement with families (61.4%) and the inability to intervene and provide effective support (62.5%). Teachers' support included programs for addiction recovery (56.8%), awareness programs for parents (56.0%), and staff training to increase the understanding of gaming disorders (50.5%). The responses varied according to teacher role and school type, indicating that implementation rates and difficulties were higher in middle schools.Conclusion We found that teachers tended to view internet gaming problems as family problems and provide complementary support for home education. Teachers also found it difficult to deal with students with gaming problems. Depending on the teacher's role in the school and the type of school, requests for support varied. Elementary and special-needs schools needed teaching materials that could be used for classroom and school-wide instruction and guidance for concerned students and their parents; junior high schools needed a consultation system with school counselors and other professionals and cooperation with healthcare; and high schools needed measures and support, including social support.

Experiences of caregivers of patients with traumatic brain injury during hospitalization in western China: A qualitative study

ABSTRACT Family members frequently provide both physical and emotional support to patients. Previous studies have focused primarily on the experiences of patients with traumatic brain injury (TBI) and their caregivers during home care and the transition from hospital care to the community, with less emphasis on their experiences during acute hospital care immediately after TBI. This study aimed to explore the experiences of caregivers of patients with TBI during acute hospitalizations. A qualitative descriptive study using individual semistructured interviews was conducted at the trauma center of a tertiary hospital in western China. A purposive sample of 21 caregivers of patients with TBI were recruited. The interviews were conducted face to face in the inpatient ward from July to September 2023. Conventional content analysis was used to conduct the framework analysis. The experiences of caregivers were identified within three key themes: TBI consequences in patients (physical impairments, psychological distress, and cognitive dysfunctions), challenges of caregivers (physiological/emotional/economic burdens, conflicts, and concerns regarding recovery), and needs of caregivers (health information, medical services, and recovery expectations). This study highlights the experiences of caregivers of patients with TBI during hospital stays in western China. The challenges faced by caregivers and the needs of caregivers are multidimensional. Appropriate support should be provided to alleviate the burden of caregiving.

Archetypes and change in wildfire risk perceptions, behaviours and intentions among adults in Tasmania, Australia

Background Anthropogenic climate change globally increases wildfire risk. Understanding how wildfire threats impact community-wide risk perceptions and response options will critically inform resilience education strategies. Aim To gain an increased understanding of wildfire risk perceptions and self-evacuation intentions among residents in the wildfire-prone state of Tasmania, Australia. Methods We co-designed survey questions with stakeholders from emergency management, health and community recovery, using a computer-aided telephone interview to survey residents over 18 years of age. Numerical classification analysis, linear regression and descriptive statistics were used to analyse survey data. Results We identified four archetypes – the ‘immediate leaver’, ‘prepared stayer’, ‘unprepared leaver’ and ‘informed leaver’, each with distinct sociodemographic characteristics. Key variables were gender, age, location and income, with women most likely to leave and lower-income householders from rural areas most likely to stay. Previous wildfire experience and owning a home were significantly associated with increased preparedness actions. Compared to 2016, we found a significant increase in the proportion of residents intending to leave their property, with rural men least likely and urban women most likely to leave. Implications Recent education campaigns have likely driven increases in wildfire threat-related self-evacuation, yet the existence of distinct archetypes argues for more tailored messaging and education programs.

Public health resilience and recovery in Ukraine: Academic partnerships to improve population health

Abstract Background Strengthening the public health workforce is among top priorities for the transformation of Ukraine’s public health system. As part of the USAID Public Health System Recovery and Resilience Activity, an Academic Partnership Collaborative brought together three Ukrainian universities (National University Kyiv-Mohyla Academy, I. Horbachevsky Ternopil National Medical University, Sumy State University), two American universities (Temple University and Drexel University), and the All-Ukrainian Association of Public Health Specialists (UPHA) to enhance the competencies of public health graduates in Ukraine. Objectives The collaborative focuses on strengthening the Ukrainian universities’ public health curricula and the teaching and research competencies of the Ukrainian faculty, making the curricular changes in Ukraine better aligned with US and European academic standards. The university partners are collaborating with the newly established UPHA in building partnerships with peer organizations in the US (American Public Health Association) and Europe (EuPHA) and sharing advancements in public health education with the broader community of public health practitioners in Ukraine to enhance their competencies to improve population health and align with European systems of public health. Results We have established linkages among all partners via an initial meeting in Uzhhorod, Ukraine in April 2024. We anticipate results by November 2024 to include curriculum review recommendations, coaching on prioritized topics for the Ukrainian partners, faculty development plans, and the establishment of continuing professional development programs in collaboration with UPHA. Conclusions Through this partnership, selected Ukrainian universities will have an enhanced and sustainable capacity to train the public health workforce and will become leading examples for other public health programs to simulate and collaborate with beyond the project. Key messages • Ukraine’s resilience and recovery relies upon the strength of the current and future public health workforce; mechanisms for building public health training are essential to a healthy population. • A collaborative process of strategic activities among American and Ukrainian universities and professional associations can be effective in building a resilient public health system in Ukraine.