In recent years psychologists have increased awareness and concern regarding the quality of mental health services provided to people of color. For several reasons clients of color often find traditional mental health services foreign or unhelpful. To help diminish obstacles faced by clients of color, several authors have advocated traditional mental health treatments be modified to better match clients' cultural contexts. Researchers have also begun investigating outcomes associated with culturally modified mental health treatments, often contrasting them with traditional mental health services. Recently numerous studies containing empirical data have been published. To date there has been no attempt to review this rapidly growing body of literature. Due to the sheer number of studies analyzing the efficacy of culturally modified treatment, the literature has become large and unwieldy. The present study used meta-analytic methodology to gather and organize quantitative data obtained from such studies. Across 80 studies that met criteria to be included in this meta-analysis, the resulting random effects weighted average effect size was d = .44, indicating a moderately strong benefit of culturally adapted treatments relative to traditional treatments. To further examine whether the association of treatment outcome and culturally modified treatments varied as a function of various sociodemographic variables, a series of categorical (and where appropriate, continuous) moderator analyses were conducted. Moderation effects were ascertained only for participant age and for Hispanic populations, with studies consisting of participants of higher chronological age and higher percentages of Hispanic participants having effect sizes of greater magnitude than studies with participants of younger ages or with few Hispanic participants. These results may indirectly provide evidence for the importance of client acculturation, given that older populations tend to be less acculturated (and therefore more in need of cultural modifications) than younger populations and that Hispanic populations are more likely to speak Spanish, necessitating adaptation of therapy to be conducted in their native language. Other variables, such as participant gender, did not moderate the results. Overall, the findings provide evidence for the benefit of modifying psychotherapy to match the cultural context of the client. Recommendations for future research on the topic are provided.

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Os serviços de clínica spa cada vez mais tem atraído pessoas em busca de lazer, prevenção e até tratamento para as mais variadas doenças. Esta pesquisa pretendeu caracterizar a clientela de uma clínica/spa localizada no interior do estado de São Paulo que utiliza tratamentos naturais. Para tanto foi realizado um levantamento de dados constantes na ficha de hospedagem dos clientes num período de cinco meses. Observou-se que a clínica é procurada preferencialmente pelo sexo feminino (63,3%); a média de idade geral é de 48 +- 1,1 anos; maioria casada (75,2%); exerciam profissão diversa, com grande parte da área de educação ou religiosa. Os clientes eram provenientes das cinco regiões do Brasil, especialmente do estado de São Paulo, mais especificamente da Grande São Paulo (38,4%). O principal objetivo de procura por esta clínica foi o controle do peso (39,9%), seguida de descanso (33,5%). Em relação às queixas emocionais, a mais citada pelos clientes foi a ansiedade (44,3%), seguida por estresse (24,2%) e depressão (17,5%). Em relação a hábitos de vida, a grande maioria disse que era onívora (69,3%); mais clientes não praticam exercício físico (51,1%) em relação aos que praticam (48,9%); a média de quantidade de copos de água foi de 6,1 copos por dia; mais clientes relataram terem sono bom (67,5%); poucos clientes informaram fumar (4%) e ingerir bebida alcoólica (19,7%); a ingesta de bebidas cafeinizadas foi baixa nesta amostra (55,5%) em relação ao perfil nacional e por fim 55,7% disseram que usavam algum tipo de medicamento. Conclusão: Para manter a qualidade do trabalho, é importante averiguar quais as características da clientela e seus objetivos ao buscar uma clínica Spa. O perfil desta clientela foi semelhante a de outras clínicas Spa ao redor do mundo e esta clínica pode desenvolver estratégias para melhor atender seus clientes ajudando-os a terem saúde e melhor qualidade de vida / Clinic spa services are increasingly attracting people seeking leisure, prevention and treatment for a wide range of diseases. This research aims to characterize a clientele of a clinic spa located in the interior of the state of São Paulo that uses therapeutic instruments. For this purpose a data collection was run based in clientes hosting form within a five month period. It was observed that the clinic spa is mainly sought by females (63.3%); the average age is general of 48 + - 1,1 years; married majority (75.2%); Covering a variety of profession, largely on education or religious field. The clients came from the five regions of Brazil, especially from the state of São Paulo, more specifically Sao Paulo capital (38.4%). The main objective in this clinic was weight control (39.9%), followed by rest (33.5%). Regarding emotional complaints, the most cited was anxiety (44.3%), followed by stress (24.2%) and depression (17.5%). Regarding lifestyle habits, the vast majority was omnivorous (69.3%); more are not practicing physical exercise (51.1%) compared to those practiced (48.9%); The measurement of quantity of water was 6.1 cups per day; more clients reported having good sleep (67.5%); some clients reported smoking (4%) and drinking alcohol (19.7%); the intake of caffeinated beverages was low in this sample (55.5%) in relation to the national profile and finally 55.7% said they used some type of medication. Conclusion: In order to maintain the quality of work, it is important to evaluate client characteristics and goals when seeking a Spa clinic. This clientele profile was similar to other World Spa clinics and this clinic may develop strategies to enrich the execution of their spa, helping them to be healthy and improving the quality of life

The purpose of this research study was to explore female service members, reservists, and veterans feelings regarding service related trauma and what they want clinicians to know regarding treatment. This was a qualitative study that used a snowball sample to interview seven women; data collected was transcribed from recordings, analyzed, and categorized into themes. Qualitative themes included vulnerability, connection to clinician, and mental health stigma. Potential changes endorsed included understanding gender roles, clinician’s ability to build better therapeutic relationships, and decreasing mental health stigma. Limitations included not being able to generalize the study as service members, reservists, and veterans were not looked at independently from one another. Recommendations for the social work profession include upholding the dignity and worth of each client, understanding client’s perceptions, and advocating for policy changes. Future research will be fundamental in understanding how to provide better mental health treatment to females in combat military roles.

When adolescents forgo oral health treatment, factors that hinder them from obtaining these services put them at risk of detrimental consequences in their oral and overall health. The purpose of this qualitative phenomenological study was to identify the various barriers that adolescents encounter causing them to defer oral treatment. Through this study, public health officials, school health care providers, the state, and parents could be made aware of these factors and work together to implement programs and supplemental aid to help adolescents become more knowledgeable of the importance of oral care and encourage them to desire and seek treatment. The oral health and behavioral conceptual models provided foundations for the development of the research questions, and they highlighted the selection of risk factors on the deferment process. Twenty adolescents who had oral health treatment/services in the past 12 months participated in the study. Interviews were transcribed verbatim and analyzed thematically. The results of this study show that oral health beliefs, as well as personal, behavioral, and environmental factors, shaped adolescents' decision to forgo oral health treatment. Financial barriers, dental fear, and transportation obstructed their capacity to seek care for themselves. The positive social change implications of this study include increasing the proportion of adolescents receiving oral health treatment yearly through the development of targeted interventions (such as school programs) that are designed to increase the adolescents' access to and use of dental care services. Such efforts would support the strategies implemented to achieve Healthy People 2020 objectives.

Abstract The purpose of this study was to investigate treatment adherence among adolescents receiving mental health care, with a special focus on psychiatric inpatient treatment. Key goals were to derive a general definition of adherence suitable for this purpose and to assess adolescents’ adherence to medication and non-pharmacological treatments. This study had two phases; phase one involved conducting systematic literature reviews, and phase two was based on empirical research in which data were collected by analyzing notes on hospital patients. The aim of the reviews were to review current research evidence into treatment adherence in adolescents and factors relating adherence among adolescents receiving mental health care (original publication n=15 and original publication n=17). Phase two was part of a clinical follow-up project called STUDY-70 conducted at the Department of Psychiatry at Oulu University Hospital in Finland. This phase yielded two further original publications – papers III and IV. Paper III examined adherence among adolescents receiving psychiatric inpatient care (n=72), focusing on both medication and non-pharmacological treatments. Paper IV examined factors affecting treatment adherence among these 72 inpatient adolescents, including family- and clinic-related variables. The systematic reviews demonstrated that many different definitions of adherence have been used in the literature. A concept synthesis was applied to these definitions to establish a basis for empirical research. The main factors that were found to correlate positively with treatment adherence among adolescents were the patients’ own will to be treated and positive sentiments, but family also played an important role. Factors that correlated negatively with adherence included negative feelings, a lack of cooperation with treatment, and adverse mental symptoms. Adolescent who has received special support at school was found to favor treatment adherence, whereas involuntary treatment, self-mutilative behavior and a close maternal relationship were all linked to non-adherence. Treatment adherence is an ongoing process, and achieving high levels of adherence should be an important goal in all treatment processes. It is important for clinical staff to be aware of factors influencing adherence in order to support the provision of effective and high-quality care for adolescents. / Tiivistelmä Tutkimuksen tarkoituksena oli selvittää mielenterveyspalveluita käyttävien nuorien hoitoon sitoutumista ja erityisesti psykiatrisessa osastohoidossa olevan nuoren sitoutumista hoitoon. Keskeisinä tavoitteina oli kuvata hoitoon sitoutumisen määrittelyä ja arvioida nuoren sitoutumista lääke- ja ei-lääkinnälliseen hoitoon. Tutkimus sisälsi kaksi vaihetta: vaihe yksi systemaattiset kirjallisuuskatsaukset sekä vaihe kaksi empiirisen tutkimuksen, jossa tieto kerättiin analysoimalla potilasasiakirjoja. Systemaattisen kirjallisuuskatsauksen tarkoituksena oli selvittää nuoren hoitoon sitoutumista ja siihen yhteydessä olevia tekijöitä (alkuperäisjulkaisu I n=15, alkuperäisjulkaisu II n=17). Vaihe kaksi oli osa Oulun yliopistollisen sairaalan psykiatrian klinikan projektia, STUDY-70, joka tuotti kaksi osajulkaisua. Alkuperäisjulkaisun III tarkoituksena oli tutkia osastohoidossa olevan nuoren sitoutumista lääke- sekä ei lääkinnälliseen hoitoon (n=72). Alkuperäisjulkaisussa IV selvitettiin näiden nuoren sitoutumista hoitoon ja erityinen mielenkiinto tässä tutkimuksessa oli perhe- ja kliinisillä tekijöillä sitoutuminen (n=72). Systemaattisen kirjallisuuskatsauksen perusteella sitoutumisen määrittelyt vaihtelivat. Tästä huolimatta käsitteen määrittelyjen synteesi oli mahdollinen ja se loi pohjan empiiriselle tutkimukselle. Tämän tutkimuksen perusteella nuoren oma tahto ja positiivinen asenne olivat positiivisesti yhteydessä hoitoon sitoutumiseen. Myös perheen toiminta vaikutti hoitoon sitoutumiseen. Nuoren negatiiviset tunteet, yhteistyökyvyttömyys ja mielenterveysoireet vaikuttivat negatiivisesti sitoutumiseen. Lisäksi nuoren saamat erityispalvelut koulussa tukivat osastohoidossa olevan nuoren hoitoon sitoutumista. Vastentahtoinen hoito, viiltely sekä läheinen ja kestävä äitisuhde olivat yhteydessä sitoutumattomuuteen. Hoitoon sitoutuminen on kokonaisvaltainen prosessi ja yksi hoidon tavoitteista, joka voidaan saavuttaa. Hoitoon sitoutumisen edistämiseksi henkilökunnan tulee tiedostaa ne tekijät, jotka vaikuttavat hoitoon sitoutumiseen. Näin voidaan suunnitella ja toteuttaa laadukasta ja vaikuttavaa hoitoa.

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Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2017-08-15T12:31:41Z No. of bitstreams: 2 Dissertação - Luciana Vaz dos Reis - 2017.pdf: 2209496 bytes, checksum: 138edde69346dd3e576edd82095ac2c3 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-08-15T12:31:57Z (GMT) No. of bitstreams: 2 Dissertação - Luciana Vaz dos Reis - 2017.pdf: 2209496 bytes, checksum: 138edde69346dd3e576edd82095ac2c3 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-08-15T12:31:57Z (GMT). No. of bitstreams: 2 Dissertação - Luciana Vaz dos Reis - 2017.pdf: 2209496 bytes, checksum: 138edde69346dd3e576edd82095ac2c3 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-03-15 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The pedagogical work in the hospital class happens in an environment which is different from the conventional class and it requires specific knowledge due to the peculiarities that its labor demands. In this sense, the following problem arose: How is the performance of the teacher of the hospital class? Based on this question, the following research objectives were established: characterize the teaching work in the hospital class; verify the role of this teacher; and identify the actions that constitute their work. Therefore, the present research focuses on the knowledge inherent to the teaching work and the constitution of the teacher's identity in the hospital class. Moreover, it reflects on the complex reality of teacher performance in the healthcare environment. This study was developed in three hospitals in the city of Goiânia, linked to the Nucleus of Educational Hospital Attendance (NAEH), which offer educational services to hospitalized students. The participants were three teachers from the state education network who perform their craft in a hospital. Data were collected through participatory observation and semi-structured interviews, interpreted from the Content Analysis, according to Bardin (2011). The considerations were grouped in five categories, each one presenting subcategories, which are: routines and environments of educational attendance in hospitals: routines and spaces; school planning and curriculum: school planning and curriculum flexibilization; knowing the student: pedagogical listening, physical and emotional conditions of the student; specificities of care: individualized care and multi-series room, hospital environment; and proof of attendance: daily recording, evaluation. The results showed that the professional identity is constituted in the practice of the teaching activity, given the specificities of the craft, which is part of a socio-historical and cultural process. In addition, it became evident that knowledge is developed throughout the life of the human being, through personal and professional experiences, and, primarily, from initial and continued formation, as well as through the action and reflection of pedagogical practice. As it is, in the hospital, the teacher creates his identity and becomes aware of his role. In this way, in addition to enabling the beginning or continuation of studies, it collaborates with the well-being of the student, who, through overcoming their weaknesses, discovers new knowledge. / O trabalho do docente da classe hospitalar acontece em um ambiente diferente do convencional, que ocorre na escola, e requer conhecimentos específicos devido às peculiaridades exigidas por seu ofício. Nesse sentido, levantou-se a seguinte problemática: Como é a atuação do professor da classe hospitalar? Partindo dessa questão, foram estabelecidos os seguintes objetivos de pesquisa: caracterizar o trabalho docente na classe hospitalar; verificar o papel desse professor; e identificar as ações que constituem seu trabalho. Portanto, a presente pesquisa tem como foco de discussão os saberes inerentes ao trabalho docente e a constituição da identidade do professor na classe hospitalar. Além disso, reflete sobre a realidade complexa da atuação do docente em ambiente da saúde. Este estudo foi desenvolvido em três hospitais da cidade de Goiânia, vinculados ao Núcleo de Atendimento Educacional Hospitalar (NAEH), que oferecem atendimento educacional aos estudantes hospitalizados. Os participantes foram três professoras da rede estadual de educação que exercem seu ofício em um hospital. Os dados foram coletados por meio de observação participativa e entrevista semiestruturada, interpretados a partir da Análise de Conteúdo, de acordo com Bardin (2011). As considerações foram agrupadas em cinco categorias, cada qual apresentando subcategorias, quais sejam: rotinas e ambientes de atendimento educacional nos hospitais: rotinas e espaços; planejamento escolar e currículo: planejamento escolar e flexibilização do currículo; conhecendo o aluno: escuta pedagógica, condições físicas e emocionais do aluno; especificidades do atendimento: atendimento individualizado e sala multisseriada, ambiente hospitalar; e comprovação do atendimento: registro diário e avaliação. Os resultados mostraram que a identidade profissional se constitui na prática da atividade docente, diante das especificidades do ofício, que faz parte de um processo sócio-histórico e cultural. Além disso, ficou evidente que os saberes são desenvolvidos ao longo da vida do ser humano, por meio de experiências pessoais e profissionais, e, primordialmente, a partir de formação inicial e continuada, como também por meio da ação e reflexão da prática pedagógica. Por assim ser, no hospital, o docente cria a sua identidade e toma consciência do seu papel. Desse modo, além de viabilizar o início ou a continuidade dos estudos, colabora com o bem-estar do educando, o qual, por meio da superação de suas fragilidades, descobre novos conhecimentos.