Discrepancy between behavioral-indicated and perceived candidacy for HIV pre-exposure prophylaxis among men who have sex with men in Chengdu, China / 北京大学学报(医学版)

OBJECTIVE@#To explore the discrepancy between behavioral-indicated candidacy and perceived candidacy (behavioral-perceived gap) and its associated factors of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM), so as to identify the focus population of PrEP interventions and to design and implement targeted interventions.@*METHODS@#We recruited a sample of 622 HIV-negative MSM who were regular clients of a community-based organization located in Chengdu, China, from November to December 2021. A cross-sectional questionnaire was used to collect the participants' information on social demographics, PrEP-related knowledge and cognitions, and risk behaviors. In this study, behaviorally eligible for PrEP was defined as performing at least one type of high-risk behavior in the past six months, including inconsistent condom use, sex with an HIV-positive partner, confirmed sexual transmitted infections (STI) diagnosis, substance use, and post-exposure prophylaxis (PEP) experience. Logistic regression models were fitted, and multivariate analyses were adjusted for social demographics.@*RESULTS@#Among the 622 eligible participants, 52.6% (327/622) were classified as behaviorally eligible for PrEP. Only 37.9% (124/327) of the participants perceived themselves as appropriate candidates for PrEP and 62.1% (203/207) had discrepancy between behavioral-indicated and perceived candidacy. 85.9% (281/327) had heard of PrEP, and 14.2% (40/281) accessed PrEP information through health care providers. Of the 327 participants eligible for behavior-indicated PrEP use, about half (47.1%) knew how to obtain PrEP medication and 33.0% had a professional PrEP counseling experience. The majority (93.3%) had no or few friends using PrEP. 54.1% scored eight or above in PrEP knowledge level. 66.7% reported having two or more sexual partners in the past six months. After adjusting for age and recruitment channel, we found six factors that were associated with perceived candidacy for PrEP, including PEP use [adjusted odds ratio (ORA)=2.20; 95% confidence interval (CI): 1.33-3.63], PrEP availability (ORA=1.69; 95%CI: 1.06-2.68), a greater number of PrEP-using friends (ORA=4.92; 95%CI: 1.77-13.65), PrEP know-ledge (ORA=2.21; 95%CI: 1.38-3.56), multiple sexual partnership (ORA=1.77; 95%CI: 1.07-2.94), and perceiving a higher risk of HIV infection (ORA=4.02; 95%CI: 1.73-9.32). Substance use during sex and PrEP information channel were not statistically associated with this beha-vioral-perceived gap.@*CONCLUSION@#We observed a high discrepancy between behavioral-indicated and perceived candidacy for PrEP among Chengdu MSM in China. Future PrEP implementation efforts should be made in skills training in assessing HIV infection risk, increasing PrEP knowledge, providing professional PrEP counselling, and fostering PrEP support environment.

Disonancia cognitiva y educación universitaria en tiempo demigración venezolana / Cognitive dissonance and university education in Venezuelanmigration time

La disonancia cognitiva (DC) representa un elemento psicológico bastante común en la sociedad. Las personas, sin importar edades ni condición social y mucho menos niveles de estudios, suelen caer permanentemente en este juego de ideas entre valores y realidades. Esto hace que el desarrollo moral y ético de una sociedad muchas veces se vea empañado por circunstancias que inciden directamente en el bien propio y común. La disonancia cognitiva, con base en las representaciones simbólicas de cada actor social, puede ser estudiada desde el campo universitario, visto éste como un espacio en el que los individuos se reúnen con base a un pensamiento libre y donde la construcción y de construcción delas ideas complejiza la propia realidad del individuo lo que hace incida en su entorno. La disonancia cognitiva, en una realidad venezolana donde la migración ha causado desolación en las universidades, pasa a formar parte de las discusiones dialógicas del estamento docente y ocupa la atención de numerosos investigadores, políticos y economistas del país. En este escrito, el objetivo se orienta a develar las representaciones simbólicas del pensamiento estudiantil y docente en consideración a la disonancia cognitiva y al tema de migración venezolana. Sus ideas, sus opiniones y sus sentires son expuestas como una forma de expresión sobre sus mundos internos como participantes pertenecientes a una sociedad con características propias. El método es la hermenéutica basada en la metodología cualitativa. Se utilizó la entrevista como técnica principal de recolección de información. Conclusión: el ambiente social venezolano se ve envuelto por una crisis de análisis, personalidad y de valores, los cuales hacen presencia gracias a la gran disonancia cognitiva (y auto engaño que la misma conlleva) en casi todos los aspectos dela vida diaria, convirtiéndose así en una nación triste, despectiva y poco comprometida(AU)

Cognitive dissonance (CD) represents a fairly common psychological element in society. People, regardless of age or social status and much less levels of education, often fall permanently in this game of ideas between values andrealities. This means that the moral and ethical development ofa society is often marred by circumstances that directly affect the own and common good. Cognitive dissonance, based on the symbolic representations of each social actor, can be studied from the university field, seen as a space in which individuals meet based on free thinking and where the construction and deconstruction of ideas and that complicates the individual'sown reality which makes an impact on his environment. Cognitive dissonance, in a Venezuelan reality where migration has caused desolation in universities, becomes part of the dialogic discussions of the teaching staff and occupies the attentionof numerous researchers, politicians and economists in the country. In this paper, the objective is to reveal the symbolic representations of student and teacher thinking in consideration of cognitive dissonance and the issue of Venezuelan migration.Their ideas, their opinions and their feelings are exposed as a form of expression about their internal worlds as participants belonging to a society with their own characteristics. the method is hermeneutics based on qualitative methodology. The interview was used as the main information gathering technique. Conclusion: the Venezuelan social environment is surroundedby a crisis of analysis, personality and values, which they presentthanks to the great cognitive dissonance (and self-deception thatit entails) in almost all aspects of daily life, thus becoming in asad nation, contemptuous and little compromised(AU)

Evaluación de un programa nutricional para la prevención de trastornos alimentarios en estudiantes de secundaria / Evaluation of a nutritional program for the prevention of eating disorders in junior high school students

Introducción: Los patrones de belleza establecidos por la sociedad y difundidos por los medios de comunicación han ocasionado que los adolescentes presenten trastornos alimentarios; por lo que se desarrollan estrategias de prevención para contrarrestar dicha problemática. Objetivo: Evaluar el efecto de un programa de prevención universal de trastornos alimentarios en estudiantes de una secundaria del Estado de México. Métodos: Estudio cuantitativo de corte longitudinal, la muestra estuvo conformada por cinco grupos de intervención (n = 183) y un grupo control (n = 38), a los que se les aplicó el test de actitudes alimentarias (EAT-23), el test se aplicó antes y después de la intervención de un programa nutricional. Se utilizó la prueba t de Student para muestras relacionadas entre la preprueba y la posprueba del grupo con intervención. Resultados: Se observaron diferencias estadísticamente significativas en la subescala de patrones y estilos alimentarios (t = 1,94, p = 0,05) y en las preguntas de me gusta comer con otras personas y siento que los alimentos controlan mi vida, se vieron cambios positivos en ambas preguntas. Conclusiones: Los programas interactivos generan mayores resultados que aquellos que se basan en la transmisión de conocimientos, de ahí que se deban desarrollar programas específicos para la alfabetización de los medios de comunicación y así generar una actitud crítica ante la presión que ejercen la publicidad y la moda(AU)

Introduction: Beauty patterns established by society and disseminated by the media have caused that adolescents present eating disorders; therefore, prevention strategies are developed to counteract this problem. Objective: Evaluate the effect of a universal prevention program of eating disorders in students from a junior high school in the State of Mexico. Methods: Quantitative longitudinal study. The sample consisted of five intervention groups (n = 183) and a control group (n = 38), to which the dietary attitudes test (EAT-23) was applied. The test was applied before and after the intervention of a nutritional program. Student's t-test was used for samples related to pre-testing and post-testing of the intervention group. Results: Statistically significant differences were observed in the subscale of eating patterns and styles (t = 1.94, p = 0.05) and in the questions ¨I like to eat with other people¨ and I feel that food controls my life¨, positive changes were seen in both questions. Conclusions: Interactive programs generate greater results than those based on the transmission of knowledge, hence specific programs must be developed for media literacy and thus generate a critical attitude towards the pressure exerted by advertising and fashion(AU)

Nossos erros me afetam? Efeito de informações negativas na identificação com endogrupo e na autoestima / Nos erreurs me touchent? Effet des informations négatives sur l'identification avec endogroupe et l'estime de soi / Nuestros errores me afectan? Efecto de la información negativa sobre la identificación con el grupo y en la autoestima / Do our mistakes affect me? Effect of negative information in ingroup identification and self-esteem

Resumo Teorias clássicas sobre consistência cognitiva recentemente têm sido exploradas enquanto processos não apenas intraindividuais, mas influenciados por aspectos grupais. Tendo em vista a tendência humana ao enaltecimento pessoal e grupal e a teoria unificada de cognição social implícita, informações negativas a respeito do endogrupo têm potencial de gerar inconsistência por meio da dissonância cognitiva e de desbalanceamento. Para testar as funções protetivas da consistência cognitiva diante das ameaças à avaliação positiva do endogrupo, 156 participantes passaram por pré e pós-teste de autoestima e por manipulação experimental de ameaça ou neutra. Não houve diferença significativa na autoestima dos participantes, nem no estado afetivo. Nos grupos experimentais, embora apontassem os comportamentos como negativos, muitos alegaram ser esperteza e jeitinho brasileiro. Pesquisas sobre dissonância apontam que, quando o objeto da redação contra-atitudinal é uma norma cultural, os efeitos da dissonância e a possibilidade de mudança de atitude são minimizados. Resultados serão discutidos.

Résumé Les théories classiques de la cohérence cognitive ont été récemment exploré les processus non seulement intra-individuelle, mais influencé par les aspects de groupe. Compte tenu de la tendance humaine à agrandissement personnel et de groupe et théorie unifiée de la cognition sociale implicite, des informations négatives sur l'endogroupe a le potentiel pour générer incohérence en dissonance cognitive et de déséquilibre. Pour tester les fonctions de protection de la cohérence cognitive contre les menaces à l'évaluation positive de l'endogroupe, 156 participants ont subi l'estime de soi pré- et post-test et manipulation expérimentale de la menace ou neutre. Il n'y avait pas de différence significative dans l'estime de soi des participants, ou l'état affectif. Dans les groupes expérimentaux, bien que les comportements pointus comme négatif, beaucoup prétendu être moyen ruse et jeitinho brasileiro. La recherche sur la dissonance souligner que lorsque l'attitude contre l'écriture de l'objet est une norme culturelle, les effets de la dissonance et la possibilité d'un changement d'attitude sont minimisés. On discute les résultats.

Resumen Teorías clásicas sobre consistencia cognitiva recientemente han sido exploradas como procesos no solo intraindividuales, pero también influenciados por aspectos grupales. Reconociendo la tendencia humana al engrandecimiento personal y grupal y la teoría unificada de la cognición social implícita, informaciones negativas sobre el endogrupo tienen el potencial para generar inconsistencia por intermedio de la disonancia cognitiva y del desequilibrio. Para probar las funciones de protección de la consistencia cognitiva contra amenazas a la evaluación positiva del endogrupo, la autoestima de 156 participantes fue medida antes y después de la manipulación experimental de amenaza o neutra. No hubo diferencia significativa en la autoestima de los participantes, o en el estado afectivo. En los grupos experimentales, aunque consideraban los comportamientos como negativos, muchos dijeron que era astucia y el jeitinho brasileiro. Investigaciones sobre disonancia indican que cuando el objetivo de la redacción contra actitudinal es una norma cultural, los efectos de la disonancia y la posibilidad de cambio de actitud son minimizados. Resultados son discutidos.

Abstract Classical theories on cognitive consistency have recently been explored not only as intraindividual processes, but influenced by group aspects. Given the human tendency to personal and group enhancement and the unified theory of implicit social cognition, negative information about the ingroup has the potential of generating inconsistency through cognitive dissonance and imbalance. To test the protective functions of cognitive consistency considering the threats to the positive evaluation of the ingroup, 156 participants underwent pre- and post-test of self-esteem and by neutral or threat experimental manipulation. There was no significant difference in participants' self-esteem nor in their affective state. In experimental groups, although behaviors were pointed as negative, many claimed to be cunning and the jeitinho brasileiro (the Brazilian way of doing things). Research on dissonance point that, when the object of counterattidudinal writing is a cultural norm, the effects of dissonance and the possibility of change in attitude are minimized. Results will be discussed.

Self-perceived factors associated with smoking cessation among primary health care nurses: a qualitative study / Tabagismo em enfermeiras de cuidados primários à saúde: um estudo qualitativo / Tabaquismo en enfermeras de Atención Primaria: un estudio cualitativo

The aim of this work was to characterize the views of nurses about factors modulating smoking cessation. Results of this study will allow us to design helping interventions with the maximum specificity for nurses. A qualitative study through a semi-structured interview of 15 Primary Health Care nurses who were smokers was performed. In contrast with other studies in which nurses were not aware of any particular social pressure to give up smoking, 18 months after the application of the Anti-Smoking Spanish Law, this feeling was expressed. Therefore, the main reasons for giving up smoking include that smoking in public is every day worse seen, together with a sense of shame and guilt in front of their social and family environment, especially for being a professional group dedicated to health.

O objetivo deste estudo foi identificar os fatores percebidos por enfermeiras fumantes como facilitadores ao abandono do tabagismo, com o propósito de, posteriormente, elaborar intervenções de ajuda com maior especificidade para esse grupo. Foi realizado estudo qualitativo, por meio de entrevistas semiestruturadas, com 15 enfermeiras de cuidados primários à saúde, que eram fumantes. Ao contrário de outros estudos, os quais as enfermeiras não percebiam pressão social para deixar o hábito tabágico, 18 meses após a vigência da Lei de Prevenção ao Tabagismo, as enfermeiras entrevistadas expressaram sentir pressão social. Portanto, entre os principais motivos para abandonar o hábito tabágico é que, a cada dia, fumar em público é malvisto, e está aliado a sentimentos de vergonha e culpa no seu entorno social e familiar, principalmente por se tratar de um grupo profissional dedicado aos cuidados da saúde.

El objetivo de este trabajo fue identificar los factores percibidos por las enfermeras fumadoras como moduladores del cese tabáquico, con el fin de diseñar posteriormente intervenciones de ayuda con la máxima especificidad para este colectivo. Se realizó un estudio cualitativo mediante entrevista semiestructurada a 15 enfermeras fumadoras de Atención Primaria de Salud. Contrariamente a otros estudios en los que las enfermeras no percibían una especial presión social para dejar el hábito tabáquico, 18 meses después de vigencia de la Ley de Prevención del Tabaquismo sí que la expresan. Por ello, entre los principales motivos de cese figura el que cada día esté peor considerado fumar en público, unido a un sentimiento de vergüenza y de culpa ante su entorno social y familiar, especialmente por tratarse de un colectivo profesional dedicado a los cuidados de salud.

Hipoglicemia recurrente como causa reversible de síndrome demencial en adultos mayores diabéticos, a propósito de un caso / Cognitive impairment probably related to repeated episodes of hypoglycemia. Report of one case

We report a 78 year-old diabetic woman, treated with gliburide and metformin, consulting in the emergency room for a non fuctuating impairment in consciousness. She had a history of similar episodes in the last two months. A brain CAT scan showed an old putamen lacunar infarction. Noteworthy was the presence of a low glycosilated hemoglobin level of 5.2 percent. Hypoglycemic medications were discontinued and the patient was discharged in good conditions. After six months of follow up, the patient did not have further episodes of impairment of consciousness.

Relationship between blood glucose excursion and cognitive performance in diabetic patients over 60 years old / 中华全科医师杂志

Objective To explore relationship between excursion of blood glucose levels and cognitive performance in diabetic patients over aged 60 years.Methods A total of 108 diabetic patients over aged 60 years were recruited in this study and they wore under continuous blood glucose monitoring system (CGMS) for three days to evaluate excursion of their mean blood glucose (MBG) level and its standard deviation (SD).All the participants accepted cognitive function tests during continuous blood glucose monitoring, including mini mental status examination (MMSE), Montreal cognitive assessment (MOCA) and clock drawing test (CDT).Relationship of the SD of blood glucose level and cognitive performance in the three cognitive tests was assessed.Data were analyzed with CGMS software version 3.0.Results The SD reversely correlated with scores of MMSE (r = - 0.324, P ＜ 0.01 ) and CDT ( r =-0.325, P = 0.001 ), but they did not significantly correlate with MOCA scores (r = -0.212, P =0.081 ).Statistically significant difference was observed between the SD and scores of all three cognitive tests adjusted for glycosylated hemoglobin Alc (HbAlc) level (r = -0.387, -0.046 and -0.292, P =0.029, ＜0.001 and ＜ 0.001, respectively).The SD reversely correlated with scores of MMSE, MOCA and CDT adjusted for MBG (r= -0.314, -0.466 and -0.345, P ＜0.01, respectively).Results of multivariate linear regression analysis showed that the SD reversely correlated to scores of MMSE, MOCA and CDT (β = - 0.378, - 0.224 and - 0.346, all P ＜ 0.05).Conclusions Excursion of blood glucose levels can influence their cognitive performance in diabetic patients over aged 60 years, leading to decrease in their overall cognitive function and activities as its excursion large enough.

Brain-derived neurotrophic factor gene val66met polymorphism and executive functioning in patients with bipolar disorder / Polimorfismo do gene do fator neurotrófico derivado do cérebro val66met e função executiva em pacientes com transtorno bipolar

OBJECTIVE: In the present study, we investigate the association between the val66met polymorphism of the brain-derived neurotrophic factor (BNDF) and the performance on the Wisconsin Card Sorting Test in a sample of Caucasian Brazilian patients with bipolar disorder. METHOD: Sixty-four patients with bipolar disorder were assessed and their performance on the Wisconsin Card Sorting Test was compared with the allele frequency and genotype of the val66met polymorphism of the brain-derived neurotrophic factor. RESULTS: The percentage of non-perseverative errors was significantly higher among patients with the val/val genotype. There was no association between (BNDF) genotype frequency and other Wisconsin Card Sorting Test domains. CONCLUSION: Our results did not replicate previous descriptions of an association between a worse cognitive performance and the presence of the met allele of the val66met brain-derived neurotrophic factor gene polymorphism.

OBJETIVO: O presente estudo tem por objetivo investigar a associação entre o polimorfismo val66met do gene do fator neurotrófico derivado do cérebro (BDNF) e o desempenho cognitivo no Teste Wisconsin de Classificação de Cartas em uma amostra de pacientes bipolares brasileiros caucasianos. MÉTODO: Sessenta e quatro pacientes com transtorno bipolar foram avaliados em relação a sua cognição por meio do Teste Wisconsin de Classificação de Cartas que foi comparada com a freqüência alélica e genotípica do polimorfismo val66met do gene do fator neurotrófico derivado do cérebro. RESULTADOS: O percentual de erros não-perseverativos foi significativamente maior nos indivíduos com genótipo val/val. Não foi encontrada diferença significativa entre a freqüência genotípica do polimorfismo do BDNF e os outros domínios do Teste Wisconsin de Classificação de Cartas. CONCLUSÃO: O estudo do polimorfismo val66met em relação ao desempenho executivo em pacientes bipolares caucasianos de uma amostra brasileira não reproduziu achados anteriores que sugeriam um pior desempenho em indivíduos portadores do alelo met.

The analysis of the neural metabolites in patients with global brain atrophy and different cognitive function in hippocampus and frontal cortex / 中华老年医学杂志

Objective Global brain atrophy was reported as an important structural change in Alzheimer's disease (AD), while it has been detected in the older person with normal cognitive function. Therefore, this study was aimed at investigating the difference of the neural metabolites in the left hippocampus (HIP) and left frontal cortex (FC) among patients who showed global brain atrophy but with different cognitive function. Methods The 33 patients with global brain atrophy confirmed by MRI scan, underwent a comprehensively clinical and neuropsychological assessment including mini-mental state examination (MMSE), activities of daily living scale (ADL) and clock drawing test(CDT). According to the diagnostic and statistical manual of mental disorders, fourth edition(DSM-Ⅳ) and Mayo clinic rochester(MCR), 14 patients were diagnosed as AD, 9 patients as amnestic mild cognitive impairment(aMCI), and 10 patients as normal cognition. Every person was taken a cerebral proton magnetic resonance spectroscopy(1H-MRS) scan to measure the levels of n-acetylaspartate(NAA), choline(Cho), myo-inositol(MI) and Creatine(Cr) in the left HIP and the left FC. Results While compared with the group with normal cognition, the ratio of NAA/Cr in the AD group reduced 10.2% in the left HIP and 5.3% in the left FC, and the ratio of Cho/Cr increased 17.5% in the left HIP and 16.7% in the left FC, and the ratio of MI/Cr increased 39.5% in the left HIP and 19.2% in the left FC. The ratio of NAA/Cr of the left HIP in the AD group was lower than that in the aMCI group at the decrease rate of 6.4%, while the ratio of NAA/Cr of the left FC was not significantly different between the two groups. The AD group had higher ratios of Cho/Cr at the increase rate of 9.3% in the HIP and 12.3% in the FC, and higher MI/Cr ratios at the increase rate of 30% in the HIP and 17% in the FC than in the aMCI group. The aMCI group showed significantly lower ratio of NAA/Cr at the decrease rate of 4.1% and higher ratio of Cho/Cr at the increase rate of 7.5% in the left HIP than in the normal cognition group. Conclusions Among patients with global brain atrophy, the decrement of ratio of NAA/Cr in the left HIP and the increment of the ratio of Cho/Cr and MI/Cr are predictive of the progress from aMCI to AD. Moreover, the decrement of ratio of NAA/Cr in the left HIP and the increment of the ratio of Cho/Cr are helpful to distinguish the aMCI and the persons with normal cognition.

Leisure Activities, Cognitive Function and Depression in Female Elderly / 성인간호학회지

PURPOSE: The purpose of this study was to investigate cognitive function, leisure activities and depression in female elderly, to examine the relationships among those variables and to investigate leisure activities and depression according to cognitive function. METHODS: The subjects were 105 female elderly visiting two senior citizen centers in Seoul, Korea. Data were collected from November to December 2006. The participants were assured of anonymity and confidentiality. All information was collected through face-to-face interviews using questionnaires. RESULTS: 26.0% of the participants were cognitive impaired but not demented and 17.3% were demented. The level of depression was severe and 77.9% of the subjects were depressed. The subjects were not actively engaging in leisure activities. There were significant correlations between cognitive function, leisure activities and depression in female elderly. Demented or CIND subjects were more actively engaging in extra family fulfillment type leisure activities than normal subjects, CONCLUSION: These findings showed the need for a program for female elderly regarding leisure activities. When counseling the elderly, nurses must consider their cognitive function, leisure activities and depression.

On Attitud Education of Students. Education in Affectivity in Medical Education / 医学教育

Only technical knowledge is taught at medical school. How medical professionals should behave and emphasize with patients is not taught. It is strange that the purely scientific has dominated medical education for so long. Without the incentive to care for and protect patients, it is difficult to acquire the ability to apply medical knowledge and skills. In other words, emotion and knowledge cannot be separated in medical education. Being full of consideration for the patient constitutes the affective basis of medicine. This attitude should be taught repeatedly in clinical practice. The best model for aspiring doctors is the good conduct and attitudes of other doctors senior to them.