Literature Collection

BACKGROUND: Somatic syndrome is one of the remarkably prevalent issues in primary health care and subspecialty settings. We aimed to elucidate multidimensional associations between somatic symptoms with major mental problems and personality traits in the framework of the quantile regression model with a Bayesian approach. METHODS: A total of 4763 employees at Isfahan University of Medical Sciences and Health Services in Isfahan province, Iran, filled out four validated questionnaires including Hospital Anxiety and Depression Scale (HADS), NEO Questionnaire, General Health Questionnaire (GHQ) and PHQ-15 for somatic symptom severity. In addition, Functional Gastrointestinal Disorders (FGIDs) were determined using Rome IV criteria. Exploratory Factor Analysis (EFA) and Bayesian regularized quantile regression with adaptive LASSO penalization were applied for reduced dimension of somatic symptoms and variable selection and parameter estimation, respectively. RESULTS: The 25 major somatic symptoms were grouped into four factors including general, upper gastrointestinal, lower gastrointestinal and respiratory by EFA. Stress, depression, and anxiety had significant effects on all of the four extracted factors. The effect of anxiety in each four extracted factors was more than stress and depression. Neuroticism and agreeableness had significant effects on all of the four extracted factors, generally (p < 0.05). CONCLUSIONS: Given the high prevalence of somatic symptoms and psychosomatic complaints in correlation with the diverse range of mental co-morbidities, developing more detailed diagnostic tools and methods is crucial; nonetheless, it seems that providing better interdisciplinary approaches in general medical practice is groundwork.

Children from circumpolar regions must travel long distances to southern tertiary care centres for specialised care. While there are initiatives underway to support care closer to home, medical travel remains a necessity for many families. The Aakuluk clinic has been operating since 2019 at a tertiary hospital in Ottawa, Canada, to provide care to children from Nunavut. The clinic team includes nurse case managers, physicians, social workers, interpreters, and several community partners. This project aimed to identify the strengths and the challenges of the clinic from the perspectives of parents and healthcare providers. The study was conducted in collaboration with healthcare professionals and community members and was guided by Inuit research approaches. Fifty-one participants (parents and healthcare providers) in Nunavut and Ottawa were interviewed. The main strengths and challenges of the clinic that were reported are related to the following themes: access to holistic care, supporting the role of Inuit professionals as part of the care team, and resources needed to continue offering programmes such as Aakuluk to Inuit families. From the perspectives of parents and healthcare providers, there are several components of the Aakuluk model that can be considered when developing services for Inuit families in other tertiary care centres.