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Frontiers in Public Health 2023Mental health is defined by the World Health Organization as a state of wellbeing in which people are aware of their own abilities to cope with the normal stresses of...
BACKGROUND
Mental health is defined by the World Health Organization as a state of wellbeing in which people are aware of their own abilities to cope with the normal stresses of life, work productively and fruitfully, and contribute to their community. Among the minority groups that may be vulnerable to experiencing greater risks for their physical and mental health and full development is the migrant population. The mobile population's migration experience, from their place of origin to destination translates into psychosocial problems and clearly stressful conditions which could be resolved using certain coping strategies. Accordingly, numerous epidemiological studies have found differences in the prevalence of mental health problems between migrants and native-born residents of destination countries, as well as between migrants and their non-migrant co-nationals.
PURPOSE
To describe sociodemographic characteristics of the Latino migrant population in the United States who visited the Health Windows (HW) and Mobile Health Units (MHU) in 2021, who may have been at risk for mental, neurological or substance use disorders and agreed to a screening for signs and symptoms of mental health conditions.
METHOD
Users of the HW and MHU were offered preventive health services and completed a mental health screening. These variables were registered in SICRESAL. If their results showed signs and symptoms of mental health conditions, they were screened by credentialed professionals from the Psychology Faculty of the National Autonomous University of Mexico. Screened individuals received a diagnosis and specialized care remotely and/or online with the MHU and HW network partners. To analyze sociodemographic variables corresponding to neurological or substance induced mental illness among the Latino migrant population in the United States who visited the Ventanillas de Salud (VDS)/Health Windows (HW), and Unidades Móviles de Salud (UMS)/Mobile Health Units (MHU), during 2021; contingency tables were created showing percentages and chi square with a significant < 0.05.
FINDINGS
During 2021 HW and MHU completed a total of 794 mental health screenings of which 84% were completed at HW. Further, 59% were women with an average age of 43, ranging from 7 to 86 years of age. Twenty percent 20% of the population who voluntarily agreed to screening yielded a positive result for some type of mental health symptom or problem. This percentage (37%) was greater among those who consulted MHU. With respect to age, results showed that youth were at greatest risk for mental health problems. Among the screened population, the independent variables, type of Health Window attended, gender, age group, and place of origin are related to the existence of some type of mental health symptom or problem yielding a significance level of <0.05 for depression and anxiety symptoms.
DISCUSSION AND PROSPECTS
In this study, as in others, the migrant population that visited the HW and UMS in 2021 reported a greater risk of mental health problems, with symptoms related to depression and anxiety among the socio-demographic variables of gender, age group, and place of origin. Thus, these symptoms relate to being a female aged between 18 and 38 and originating from Mexico. Finally, the possibility of screening the migrant population for signs and symptoms of mental health conditions that attended the Health Windows or Mobile Health Units during 2021, made it possible to refer them to psychology or psychiatry services and improve the quality of life of those who accessed the services and, consequently, that of their families and communities.
LIMITATIONS
The main limitation is associated with the information source since we worked with secondary data and relied on the information provided by those who attended both the HW and the MHU.
Topics: Adolescent; Adult; Female; Humans; Male; Young Adult; Anxiety; Hispanic or Latino; Mobile Health Units; Quality of Life; Substance-Related Disorders; United States; Child; Middle Aged; Aged; Aged, 80 and over
PubMed: 36815159
DOI: 10.3389/fpubh.2023.959535 -
Harm Reduction Journal Feb 2018Needle and syringe program (NSP) service delivery models encompass fixed sites, mobile services, vending machines, pharmacies, peer NSPs, street outreach, and... (Review)
Review
BACKGROUND
Needle and syringe program (NSP) service delivery models encompass fixed sites, mobile services, vending machines, pharmacies, peer NSPs, street outreach, and inter-organizational agreements to add NSP services to other programs. For programs seeking to implement or improve mobile services, access to a synthesis of the evidence related to mobile services is beneficial, but lacking.
METHODS
We used a scoping study method to search MEDLINE, PSYCHInfo, Embase, Scopus, and Sociological for relevant literature. We identified 39 relevant manuscripts published between 1975 and November 2017 after removing duplicates and non-relevant manuscripts from the 1313 identified by the search.
RESULTS
Charting of the data showed that these publications reported findings related to the service delivery model characteristics, client characteristics, service utilization, specialized interventions offered on mobile NSPs, linking clients to other services, and impact on injection risk behaviors. Mobile NSPs are implemented in high-, medium-, and low-income countries; provide equipment distribution and many other harm reduction services; face limitations to service complement, confidentiality, and duration of interactions imposed by physical space; adapt to changes in locations and types of drug use; attract people who engage in high-risk/intensity injection behavior and who are often not reached by other service models; and may lead to reduced injection-related risks.
DISCUSSION
It is not clear from the literature reviewed, what are, or if there are, a "core and essential" complement of services that mobile NSPs should offer. Decisions about service complement for mobile NSPs need to be made in relation to the context and also other available services. Reports of client visits to mobile NSP provide a picture of the volume and frequency of utilization but are difficult to compare given varied measures and reference periods.
CONCLUSION
Mobile NSPs have an important role to play in improving HIV and HCV prevention efforts across the world. However, more work is needed to create clearer assessment metrics and to improve access to NSP services across the world.
Topics: Harm Reduction; Health Services Accessibility; Humans; Mobile Health Units; Needle-Exchange Programs; Program Evaluation; Referral and Consultation
PubMed: 29422042
DOI: 10.1186/s12954-018-0212-3 -
British Medical Journal Sep 1972This paper describes the organization, evaluation, and costing of an independently financed and operated accident flying squad. 132 accidents involving 302 casualties...
This paper describes the organization, evaluation, and costing of an independently financed and operated accident flying squad. 132 accidents involving 302 casualties were attended, six deaths were prevented, medical treatment contributed to the survival of a further four, and the condition or comfort of many other casualties was improved. The calls in which survival was influenced were evenly distributed throughout the three-and-a-half-year survey and seven of the 10 so aided were over 16 and under 30 years of age, all 10 being in the working age group.The time taken to provide the service was not excessive and the expense when compared with the overall saving was very small. The scheme was seen to be equally suitable for basing on hospital or general practice or both, and working as an integrated team with the ambulance service. The use of specialized transport was found to be unnecessary. Other benefits of the scheme included use of the experience of attending accidents to ensure relevant and realistic training for emergency service personnel, and an appreciation of the effect of ambulance design on the patient.
Topics: Accidents, Traffic; Adolescent; Adult; Ambulances; Costs and Cost Analysis; Emergency Medical Services; Emergency Service, Hospital; England; Family Practice; First Aid; Humans; Male; Middle Aged; Mobile Health Units; Radio; Time Factors
PubMed: 5069642
DOI: 10.1136/bmj.3.5826.569 -
Psychiatrike = Psychiatriki Dec 2022The present paper aims to highlight the importance of Mobile Mental Health Units (MMHUs) in the delivery of mental health services in remote areas in rural Greece. Since...
The present paper aims to highlight the importance of Mobile Mental Health Units (MMHUs) in the delivery of mental health services in remote areas in rural Greece. Since the foundation of the first MMHUs in the eighties till nowadays, those services have expanded in many rural areas and there is some evidence that they are effective in the management of patients with severe mental disorders. The care of those patients seems to contribute to a significant reduction in voluntary and involuntary acute admissions and in length of hospital stay. Cost/effectiveness analysis studies have also shown favorable results. Besides their regular clinical work, MMHUs conduct research, such as epidemiologic surveys. Other research explores the care of elderly patients in rural areas and the care of immigrants that permanently reside in Greece. Other research involves the study of psychotic disorders in the rural context, such as the long-term outcome, the patients' functioning, and the long-term treatment with benzodiazepines. Current challenges for MMHUs involve staffing, particularly for those run by public hospitals, and the retainment of highly trained personnel. Other important challenges are related to the aging of the rural population and the refugee/migrant influx. The MMHUs of the islands that initially accept the refugee flow, have already faced an increased number of new referrals. Given the disparities in mental healthcare between rural and urban areas, further enhancement of the MMHUs' operation is required, as well as continuing training of their workforce. Research at the national level is needed and could be the basis for the design and staffing of new services. The establishment of valid and broadly accepted clinical indices to measure treatment outcomes would facilitate research and ensure the recording and evaluation of the MMHUs' work and their effectiveness as well; and would highlight their utility within the contemporary health system.
Topics: Humans; Aged; Mental Health; Mobile Health Units; Psychotic Disorders; Mental Health Services; Delivery of Health Care
PubMed: 35621257
DOI: 10.22365/jpsych.2022.084 -
BMJ Open Mar 2023COVID-19 has strained healthcare systems, requiring the redesign of their structure, human resource management and clinical approach. Countries have adopted... (Review)
Review
OBJECTIVES
COVID-19 has strained healthcare systems, requiring the redesign of their structure, human resource management and clinical approach. Countries have adopted implementation strategies and maximise field hospital functionality to address the issue of overflow of patients with COVID-19. This scoping review was based on the main research question, 'What are the implementation strategies, challenges and opportunities in managing the field hospital during the COVID-19 pandemic?', and aimed to consolidate all recent evidence on COVID-19 field hospital implementation approaches, challenges and potentialities.
DESIGN
Scoping review, following the Arksey and O'Malley's framework, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.
DATA SOURCES
PubMed, Web of Science and Scopus were searched from 1 January 2020 through 31 December 2021.
ELIGIBILITY CRITERIA
Original articles, reviews, case studies and reports written in English were included. Works without full article and articles that did not answer the research questions were excluded.
DATA EXTRACTION AND SYNTHESIS
Data were extracted using a standardised data extraction form in Microsoft Excel. The findings of all included articles were synthesised narratively.
RESULTS
Eighty-five records were reviewed and 25 studies were included. For the field hospital implementation strategies, 'surge capacity', namely space, human resource, supply and system, was discussed in addition to the preparation and workflow of other services such as pharmacy, rehabilitation, food and nutrition. The management of COVID-19 field hospitals is challenging with respect to staff and resource shortages, inability to anticipate patient load and poor communication. The opportunities and recommendations for improvement of management were also highlighted.
CONCLUSIONS
The compilation of lessons learnt may help improve the future management of field hospitals, administratively and clinically.
Topics: Humans; COVID-19; Mobile Health Units; Pandemics; Delivery of Health Care
PubMed: 36918252
DOI: 10.1136/bmjopen-2022-067227 -
BMJ (Clinical Research Ed.)
Topics: Aircraft; Developing Countries; Education, Medical, Graduate; Eye Diseases; General Surgery; Humans; Medical Missions; Mobile Health Units
PubMed: 2279170
DOI: 10.1136/bmj.301.6766.1444 -
Updates in Surgery Sep 2020
Topics: COVID-19; Coronavirus Infections; Disease Outbreaks; General Surgery; Influenza Pandemic, 1918-1919; Italy; Mobile Health Units; Pandemics; Periodicals as Topic; Pneumonia, Viral; World War I
PubMed: 32880869
DOI: 10.1007/s13304-020-00875-7 -
The American Journal of Tropical... Jan 2021Poor food hygiene practices, child feces not being disposed of in a latrine, child mouthing of contaminated fomites, and poor hand hygiene of caregivers have been...
Poor food hygiene practices, child feces not being disposed of in a latrine, child mouthing of contaminated fomites, and poor hand hygiene of caregivers have been associated with diarrheal diseases, environmental enteropathy, and impaired growth in young children. Mobile health (mHealth) programs present a low-cost approach to delivering water, sanitation, and hygiene (WASH) programs. We conducted a theory-driven and evidence-based approach to formative research and intervention development to design and pilot test a Baby WASH mHealth program targeting food hygiene, child mouthing, and child feces disposal behaviors in urban Dhaka, Bangladesh. Formative research activities included 31 semi-structured interviews, five group discussions, six mHealth workshops, and a three-phase iterative pilot study among 102 households. Findings from semi-structured interviews and group discussions indicate that caregivers of young children have relatively high awareness of the need for safer food hygiene, child mouthing, and child feces disposal practices, but are limited by existing household responsibilities and restricted access to enabling technology that would facilitate practicing recommended behaviors. The piloted Baby WASH mHealth program was well-received by households. This study presents a theory-driven and evidence-based approach for intervention development that can be implemented for the development of future WASH mHealth programs in low-resource settings.
Topics: Bangladesh; Child Rearing; Cholera; Cooking; Family Characteristics; Health Education; Humans; Hygiene; Infant, Newborn; Mobile Health Units; Pilot Projects; Sanitation; Water Microbiology; Water Supply
PubMed: 33025876
DOI: 10.4269/ajtmh.20-0456 -
Asian Pacific Journal of Cancer... Feb 2021We are reporting the evaluation of an opportunistic point of care cervical cancer screening initiative in Pune, India using a mobile screening unit (MSU).
OBJECTIVES
We are reporting the evaluation of an opportunistic point of care cervical cancer screening initiative in Pune, India using a mobile screening unit (MSU).
METHODS
We conducted 290 cervical cancer screening outreach clinics in the MSU. Screening was performed by trained nurses/ health care providers using visual inspection with 5% acetic acid (VIA). Screen positive women when eligible were treated by thermal ablation during the same sitting. Women with large lesions not eligible for treatment with thermal ablation were referred for colposcopy and treatment.
RESULTS
A total of 10, 925 women were screened between Nov 2016 and June 2019 in 290 outreach clinics in the MSU. The overall screen positivity was 6.6% (95% CI 6.1, 7.0) with a declining trend over time. A total of 304/717 (42.4%, 95% CI 38.7, 46.1) women received treatment with thermal ablation. About 3.6% (11/304) reported minor side effects and 1.6% (5/304) reported lower abdominal pain and all of them subsided after treatment. Among the 413 women who were advised colposcopy, only 84 (20.33%) women underwent the procedure. Of these 84 women, 64 (76.19%) had normal colposcopy/ histopathology, 7 (8.33%) had CIN1, 2 (2.38%) had CIN 2, 9 (10.71%) had CIN 3 disease and 2 (2.38%) women were diagnosed with invasive cancer.
CONCLUSION
MSUs are useful for providing cervical cancer screening services, using the 'screen and treat' strategy. Thermal ablation is safe in the field clinics. Additional efforts are needed to improve the compliance for referral of those with large lesions requiring additional visits.
Topics: Adult; Colposcopy; Early Detection of Cancer; Endometrial Ablation Techniques; Female; Humans; India; Middle Aged; Mobile Health Units; Socioeconomic Factors; Uterine Cervical Neoplasms; Young Adult
PubMed: 33639655
DOI: 10.31557/APJCP.2021.22.2.413 -
Globalization and Health Mar 2018This short letter from the field is offered as a rapid communiqué of the emergency medical situation in Mosul and surrounding areas on the eve of the final onslaught to...
This short letter from the field is offered as a rapid communiqué of the emergency medical situation in Mosul and surrounding areas on the eve of the final onslaught to liberate the city. This letter is based on emergency medical work at two World Health Organization (WHO) and Ministry of Health (MoH) Iraq lead Role II+ Field Hospital facilities south of Mosul City from April to June 2017; these facilities are currently and temporarily managed and administered by private medical industry until full handover to MoH Iraq, with WHO support and expert facilitation. The prominence of non-state actors in the conflict, using hybrid warfare tactics that maximize casualties, makes health security a particular challenge for the global community. This challenge requires health leaders and other actors in the region to set clear strategic goals that support public health of the many millions displaced, maimed and affected by the war. Whether in clinical medicine, development, peace and stability operations, or global health diplomacy, the shared values and conviction to best serve vulnerable communities and mitigate morbidity must embrace the lessons of evidenced based practice derived from military medical experience. WHO is leading the charge in disaster response for the conflict in Iraq, and many challenges remain. This might also include developing a new process in emergency medical response that utilizes private contracting to improve efficiency in delivery and overall sustainability.
Topics: Emergency Medical Services; Humans; Iraq; Mobile Health Units; Warfare; World Health Organization
PubMed: 29510752
DOI: 10.1186/s12992-018-0346-9