Introduction: The World Health Organization's (WHO) Alcohol Use Disorders Identification Test (AUDIT) is used extensively across the world, with cutoff scores recommended by the WHO. We reviewed the use and validity of AUDIT cutoff scores in low-and middle-income countries as cultural contexts are expected to influence the detection of alcohol use disorders. Materials and Methods: The systematic review was guided by an a priori defined protocol consistent with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. We searched Cochrane library, Medline, EMBASE, PsycINFO, CINAHL, Indmed, LILACS, and AJOL databases using appropriate search terms. We conducted a narrative synthesis of the data. Results: We identified 54 distinct studies that used AUDIT cutoff scores which were not in alignment with those recommended by the WHO. India (n=10), Nigeria (n=9), and Brazil (n=9) produced most of these included studies. Most of the studies (n=42) did not conduct psychometric evaluations of AUDIT cutoff scores. Of the twelve studies which did report psychometric results, a wide range of cutoff scores performed well. In these studies the cutoff
Sexually transmitted infections (STI) in adolescents have increased even with access to information. The promotion of adolescents' health depends on the articulated action of the social sectors, with the educational sector fundamental to achieving a positive result. Brazilian studies have shown that STI are among the main diseases related to public health. Thus, there is a need for actions to promote and prevent these diseases among adolescents. Alternative tools such as playful and technological games have influenced teenagers between 12 and 17 years old. The aim of this study was to report the use of strategies aimed at adolescents performed in learning dynamics at a public school in the Federal District. The conceptual strategy was based on Charles Maguerez's Arc Model, which focuses on active methodologies. At the end of the activities, there was a perception of a positive result in the teaching-learning process. It was also possible to identify different behavior patterns, such as indiscipline, lack of interest and conflict between social relationships. The experience of the extension workers allowed a favorable exchange of experiences among the adolescents, as it demonstrated that the recreational means resulted in a greater interest in the prevention of STI.
Background
Tele-psychiatry is an increasingly acceptable and feasible platform to deliver mental health care with the potential to increase access to care in low-resource settings. We aim to examine the acceptability and preliminary impact of the delivery of assisted tele-psychiatry services in primary healthcare settings in Goa, India.
Methods
Before-after uncontrolled treatment cohort study. In total, 161 adults with either a mental or alcohol use disorder were provided tele-consultation by psychiatrists through a customised video conferencing platform, along with medication or counselling (via trained lay counsellors) or both as needed. Data on socio-demographics, clinical outcomes and process indicators were collected at baseline and 3 months post-baseline. Paired t tests were used to assess clinical outcomes pre- and post-treatment using the General Health Questionnaire-12 (GHQ-12) and World Health Organisation Disability Adjustment Schedule (WHODAS) 2.0, and logistic regression was used to find associations between changes in these scores and various factors.
Results
The most common diagnosis was depression (35%). Post-treatment, there was a significant reduction in both GHQ-12 and WHODAS 2.0 scores. Participants showed high satisfaction with the tele-psychiatry services and technology platform. Improvement in GHQ-12 score was associated with being employed [OR 8.74 (1.92–39.75, p = 0.005)] and being a homemaker [OR 6.42 (CI 1.61–25.57, p = 0.008)].
Conclusion
Treatment of mental disorders through a tele-psychiatry platform appears to be highly acceptable and is associated with improved clinical outcomes. Considering its potential for scalability, a model of assisted tele-psychiatry integrated into primary care can be an important strategy to increase access to mental healthcare in low-resource settings.
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