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ere alcohol or substance use disorder, and active suicidal or homicidal ideation.

Ethics approval was obtained in January 2019, and recruitment of participants began in June 2019. Recruitment has been conducted via social media, web-based communities, and physician referrals. To date, 52 participants have been recruited to the e-CBT group, and 48 patients have been recruited to the in-person CBT group. Data collection is expected to be completed by March 2021, and analyses are expected to be completed by June 2021, as linear regression (for continuous outcomes) and binomial regression analysis (for categorical outcomes) are still being conducted.

The results of this study can provide valuable information for the development of more accessible and scalable mental health interventions with increased care capacity for MDD, without sacrificing the quality of care.

ClinicalTrials.gov NCT04478058; http//clinicaltrials.gov/ct2/show/NCT04478058.

DERR1-10.2196/27489.

DERR1-10.2196/27489.

If child and adolescent psychiatric (CAP) services were accessible in lower-middle-income countries (LMIC) such as Nigeria, what individual and socio-cultural factors would influence caregivers' willingness to use these services when they are needed?

To address this question, we conducted structured interviews with a stratified random sampling of 442 adult caregivers of children aged 5 to 19-years who lived within 10km of an established CAP outpatient service in Ibadan, Nigeria.

Based on structural equation modeling, our cross-sectional findings indicated that caregivers were generally willing to use the accessible outpatient CAP service for a narrow range of overtly disruptive and developmentally atypical child behavior. However, their decisions were not influenced by their recognition of child and adolescent mental health (CAMH) conditions, competing life stressors, caregiver wellness, nor stigma as we had initially hypothesized. Rather caregivers pragmatically considered a range of approaches to addrse outpatient psychiatric services for their children. However, their beliefs about the etiology and treatment effectiveness of CAMH conditions shaped how they intended to engage the services. These findings underscored the importance of scaling up a broader spectrum of accessible complementary CAMH intervention and prevention services in Nigeria that extend beyond indigenous or biomedical models. In doing so caregivers will come.As community dwelling populations of older people and those living with chronic and life limiting conditions continue to grow, the role of everyday geographies, particularly of community based settings and activities, in supporting health and wellbeing has become a focus in both research and policy development. The therapeutic landscape scholarship provides a holistic view of how place promotes health and wellbeing, and has in recent years expanded its focus from reputable places of healing to everyday geographies. Based on a scoping review of 45 studies on everyday community based therapeutic landscapes, this paper identifies and critically examines the settings, populations and mechanisms of therapeutic experiences. It presents critical summaries of the scales and boundaries of landscapes; the diverse and dichotomous characteristics of places; the therapeutic benefits of proximal and distal socio-spatial interactions; the role of everyday settings and activities as sources of refuge, anchor and resonance and finally the broader social, cultural, political and economic contexts in which everyday therapeutic landscapes are embedded. In so doing the paper highlights the complex nature of everyday therapeutic landscape experiences and how this research can further inform the development of community based settings and activities that promote health and wellbeing. It also identifies areas for future research on everyday therapeutic landscapes.Evaluating whether social policies reduce health inequalities is complicated by the fact that these upstream determinants may also change the socioeconomic distribution. Failure to account for these compositional changes may severely bias the effect estimation procedure. In this article, we illustrate how a health inequality impact assessment of a policy that (also) changes the socioeconomic distribution may produce biased results. First, we show why analyses that do not account for compositional changes fail to estimate the correct counterfactual outcome. This problem most notably occurs when using repeated cross-sectional data, often the only available option to evaluate the health effect of large-scale policies. Temsirolimus mw Second, we conducted a microsimulation study to estimate the magnitude of the bias under various conditions. The results showed that the actual impact of the policy on health inequalities is often underestimated and may even produce results that are in the opposite direction of the actual causal effect of the policy. Future studies should explore new strategies, such as simulation methods, to assess the impact of policies that (also) cause changes in the socioeconomic composition of the population, to enable researchers to accurately estimate their effect on health inequalities.This study examined the relationship between community risk factors (drug outlets density and crime hot spots) and family factors on the risk behaviours (drugs consumption and delinquent behaviour) of male adolescent Mexican students. Results were obtained based on data bank analysis and direct collection of information regarding family factors and risk behaviours of adolescents attending school. Spatial and statistical analysis was performed. The final sample was composed of 1450 male adolescents, from 11 secondary and high schools located in marginal and violent areas of Mexico. Spatial analysis revealed that when considering only the prevalence of the risk behaviours of the adolescents, the area of highest risk was the northwestern area of the city. However, after performing conjunct analysis of all evaluated variables using density point risk (aside from confirming that the northwestern area is still the one with the greatest risk), results indicated that the southern area has a high-density point risk. All densities of the variables showed a statistically significant positive association (p less then 0.

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