When Should Patients With Less Than 6 Months Sobriety Be Transplanted?

Alcoholic liver disease (ALD) and alcohol-induced deaths have increased dramatically over the last 2 decades. Patients are often referred to liver transplant programs critically ill with a life expectancy of less than 6 months. Historically, less than 6 months sobriety has been an absolute contraindication for transplant listing as ALD is stigmatized as a choice, as patients are responsible for their condition because they did not stop drinking. It has been recommended that 6 months of sobriety should not be considered the determining factor for access to transplantation. However, changing years of clinical practice involves developing new protocols, finding available resources, reworking systems, transforming team, and institutional culture. Steps taken by a large, urban, academic liver transplant program to develop a program for patients with end stage ALD with less than 6 months of sobriety are outlined.

Environmental and psychosocial predictors of cervical cancer screening among women in Gwagwalada Area Council, Abuja, North Central, Nigeria.

Cervical cancer (CC) is the second leading cause of cancer morbidity and mortality among Nigerian women. Although screening is a cost-effective strategy for reducing its burden, uptake remains sub-optimal. A descriptive cross-sectional study was conducted among 514 sexually active women aged ≥25 years in Gwagwalada Area Council, Abuja, Nigeria using a semi-structured interviewer administered questionnaire. Mean age of respondents was 38.4±11.6years. 246(46.9%) had good knowledge of CC screening while 268(51.2%) had poor knowledge. Religion (aOR:1.8 [95% CI: 1.1 - 3.1]), location (aOR:1.2 [95% CI: 1.2 - 3.4) and number of children (aOR:2.3 [95% CI: 1.3 - 3.9]) were predictors for screening. Poor access routes to health facilities (aOR:0.5 [95% CI: 0.2 - 0.9]), high cost of screening (aOR:0.4 [95% CI: 0.2 - 0.9]), unaware of screening centers (aOR:0.4 [95% CI: 0.2 - 0.9]) and long waiting hours (aOR:0.5 [95% CI: 0.2 - 0.9) were identified environmental predictors. Fear of positive diagnosis/stigma (aOR:0.3 [95% CI: 0.1 - 0.9]), unacceptable touch (aOR:0.2 [95% CI: 0.1 - 0.8), deficiency in awareness programs (aOR:0.3 [95% CI: 0.2 - 0.7]), and not aware of appropriate screening age (aOR:0.1 [95% CI: 0.1 - 0.4]) were identified psychosocial predictors. This study highlights the need to intensify enlightenment programs, subsidize screening services, and encourage community screening.

Trampas al recuerdo, olvidos inducidos y memorias sesgadas. Representaciones sociales de hechos históricos

Las representaciones sociales en torno a los hechos históricos del conflicto armado, están marcada por un sesgo cognitivo y mnémico, acompañado de olvidos y silencios y por procesos de atribución de responsabilidad en los que se asume como principal responsable y enemigo absoluto a las guerrillas, especialmente a las FARC-EP. Esto invisibiliza la responsabilidad de los otros actores (Paramilitares, Fuerza Pública y Estado), generando olvidos convenientes e inducidos que son funcionales a los intereses de ciertos sectores sociales que ostentan el poder político, económico y mediático, que promueven impunidad y contribuyen al mantenimiento de la violencia política para detentar su poder. Estos procesos de memoria hegemónica se constituyen en barrera psicosocial para la construcción de la paz, la democracia y la reconciliación en Colombia.

Social representations around the historical facts of the armed conflict are marked by a cognitive and mnemic bias, accompanied by forgetfulness and silences, and by processes of attribution of responsibility in which the guerrillas, especially the FARC-EP, are assumed as the main responsible and absolute enemy. This makes the responsibility of the other stakeholders (paramilitaries, security forces, and the State) invisible, by generating a convenient and induced oblivion, which is functional to the interests of certain social sectors that hold political, economic, and media power, which promote impunity and contribute to the maintenance of political violence in order to maintain their power. These hegemonic memory processes constitute a psychosocial barrier to the construction of peace, democracy, and reconciliation in Colombia.

Creencias sociales y orientaciones emocionales colectivas sobre la protesta social en ciudadanos de medellín (colombia) y su área metropolitana

Este artículo tiene como objetivo comprender las creencias sociales y orientaciones emocionales colectivas sobre la protesta social en el proceso de construcción de paz en Colombia. Se utilizó una metodología cualitativa con enfoque hermenéutico y se realizó un análisis de contenido sobre lo expresado en entrevistas semiestructuradas por 18 participantes, ciudadanos del común, quienes se asumieron "a favor de la protesta social", "en contra de la protesta social" y "ambivalentes". Como resultados, se contrastaron creencias y orientaciones emocionales colectivas favorables, como empatía y comprensión, con prejuicios y estigmas. Emergieron creencias sobre el "otro" opositor, como enemigo, expresiones de distancia social, discriminación, exclusión y odio. Los medios de comunicación como mecanismos de configuración de estas creencias y orientaciones emocionales colectivas, asociadas al rechazo a los movimientos sociales, por parte de algunos participantes, alimentaron un ambiente de polarización y redujeron las posibilidades del reconocimiento del otro como ser humano.

This research tries to comprehend the societal beliefs and the collective emotions about the social protest in the context of peacebuilding. It was used a qualitative methodology with hermeneutical approach, and it was made an analysis of content about what was said in the semi-structured interviews of 18 participants that were classified in three groups according to their position about the social protest: a group in favor, a group against it, and a third one with an ambivalent position. As a result, there were contrasted the positive societal beliefs and the collective as empathy, understanding against prejudices and stigmata. There were emerged beliefs about the "other" as an opponent and enemy, expressions of social distance between groups, discrimination, exclusion, and hate. The mass media were identified as configuration mechanisms of these societal beliefs and collective emotions, associated to rejection of social movements that feeds the political polarization and reduces the possibility to recognize the other as a human being.

A scoping review: the psychosocial barriers that exist for people with vulvodynia.

BACKGROUND: Vulvodynia, including generalized vulvodynia and vestibulodynia, affects at least 8% to 16% of people with a vulva and may have a negative impact on one's quality of life, psychological health, interpersonal relationships, and individual behaviors. AIM: The aim of this scoping review is to synthesize and analyze the emerging literature of vulvodynia research while determining what psychosocial barriers exist for people with vulvodynia. METHODS: A rigorous literature search was completed in 6 databases: PubMed, CINAHL, Embase, Web of Science, APA PsycInfo, and Academic Search Premier. Key terms and subject headings, including Medical Subject Headings, were used to systematically search these databases. Two reviewers were utilized to assess the reference list and reduce bias. OUTCOMES: A total of 671 articles were discovered during the search, which was narrowed down to 73 that included at least 1 psychosocial barrier that patients experience in the United States and Canada. RESULTS: The findings of the literature search revealed the various psychosocial barriers that patients commonly face: pain, anxiety, depression, catastrophization, fear, lack of self-efficacy, low desire and arousal, negative body image, stigma, distress, posttraumatic stress disorder, child maltreatment and abuse, mistrust, invalidation and isolation, low levels of self-compassion, negative partner support, low relationship satisfaction, lack of physical affection, emotional regulation, and avoidance and lack of approach goals. In addition to psychosocial barriers, structural determinants and environmental barriers-such as delayed diagnosis, low health literacy, cost, transportation, and racial disparities-adversely affected individuals with vulvodynia. CLINICAL IMPLICATIONS: This review should serve as a guide for researchers, medical providers, and program developers to understand all the barriers that patients may face. STRENGTHS AND LIMITATIONS: This review comprehensively highlights existing psychological barriers while promoting structural and environmental barriers that people with vulvodynia face. More research and greater emphasis on the underlying physical conditions that contribute to vulvodynia are needed to effectively educate providers and patients on vulvar pain conditions. CONCLUSIONS: This scoping review highlights the numerous barriers faced by patients with vulvodynia and serves to improve education for patients and providers to achieve earlier diagnoses and better patient outcomes.

Decepción, fatalismo y esperanza: oposiciones emocionales y polarización en torno a la paz negociada en 9 ciudades de Colombia / Disappointment, Fatalism, and Hope: Emotional Oppositions and Polarization around Negotiated Peace in 9 Colombian Cities

Resumen Las Orientaciones Emocionales Colectivas en relación con el proceso de paz entre el Estado colombiano y las Fuerzas Armadas Revolucionarias de Colombia, Ejército del Pueblo (FARC-EP) evidencian emocionales que configuran oposiciones y polarización, según los participantes estén o no de acuerdo con el proceso de paz. Durante la negociación los participantes 'de acuerdo', manifestaban esperanza, tranquilidad y alivio, mientras aquéllos 'en desacuerdo', desconfianza e indignación. Después del plebiscito los primeros, tristeza, decepción y frustración, mientras los segundos alegría y celebración. Finalmente, durante la implementación, los primeros expresan desconfianza, temor e incertidumbre, mientras los segundos indignación. Estas disposiciones emocionales movilizan creencias, actitudes hacia la polarización, obturando diálogos y debates democráticos; constituyendo un clima emocional de fatalismo y resignación como barrera psicosocial para la construcción de paz y reconciliación.

Abstract Collective Emotional Orientations in relation to the peace process between the Colombian State and the Revolutionary Armed Forces of Colombia, People's Army (FARC-EP) evidence emotional oppositions and polarization, depending on whether participants agree or disagree with the peace process. During the negotiation, the participants "in agreement" expressed hope, tranquility and relief, while those "in disagreement" expressed distrust and indignation. After the plebiscite, the former, sadness, disappointment, and frustration, while the latter, joy and celebration. Finally, during implementation, the former express distrust, fear and uncertainty, while the latter indignation. These emotional dispositions mobilize beliefs and attitudes toward polarization, by obstructing dialogues and democratic debates; by constituting an emotional climate of fatalism and resignation as a psychosocial barrier to the construction of peace and reconciliation.

Representaciones sociales de hechos históricos como barreras psicosociales para la construcción de la paz / Social Representations of Historical Events as Psychosocial Barriers to Peacebuilding

Resumen En el proceso de construcción de las representaciones sociales de hechos histórico (RSHH) construidas por ciudadanos del común del Valle de Aburrá (Colombia) se pudo evidenciar como a partir de valencias de poder, desde élites dominantes que hacen uso de la retórica política, los medios de comunicación y la educación básica, se producen y reproducen versiones estereotipadas de la historia. Se posiciona así una memoria hegemónica que se reproduce y desde la cual se prefabrican actores como única causa de la violencia y se exculpan otros actores que incluyen a las mismas élites, políticos y al Estado, quienes se auto determinan como víctimas y no como actores del conflicto armado en Colombia. Así, estas RSHH terminas configurando y objetivando un enemigo absoluto con el cuál es imposible una negociación política, que se traduce en una barrera para la construcción de la paz y la reconciliación en Colombia.

Abstract In the process of construction of social representations of historical facts (RSHH) built by ordinary citizens of Aburrá Valley, Colombia, it was possible to show how from power valences, from dominant elites that make use of political rhetoric, the media, and basic education, stereotyped versions of history are produced and reproduced. In this way, a hegemonic memory is reproduced and from which actors are prefabricated as the only cause of violence and other actors are exculpated, by including the same elites, politicians, and the State, who determine themselves as victims and not as actors of the armed conflict in Colombia. Thus, these RSHH end up configuring and objectifying an absolute enemy with whom political negotiation is impossible, which translates into a barrier for the construction of peace and reconciliation in Colombia.

Perceived Need, Mental Health Literacy, Neuroticism and Self- Stigma Predict Mental Health Service Use Among Older Adults.

OBJECTIVES: Older adults are the least likely age group to seek mental health services. However, few studies have explored a comprehensive range of sociodemographic, psychological, and social barriers and facilitators to seeking treatment in later life. METHODS: A cross-sectional, national sample of Canadian older adults (55+, N = 2,745) completed an online survey including reliable and valid measures of predisposing, enabling, and need characteristics, based on Andersen's behavioral model of health, as well as self-reported use of mental health services. Univariate and hierarchical logistic regressions predicted past 5-year mental health service use. RESULTS: Mental health service use was most strongly and consistently associated with greater perceived need (OR = 11.48) and mental health literacy (OR = 2.16). Less self-stigma of seeking help (OR = .65) and greater neuroticism (OR = 1.57) also predicted help-seeking in our final model, although their effects were not as strong or consistent across gender, marital status, and age subgroups. CONCLUSIONS: The need category was crucial to seeking help, but predisposing psychological factors were also significant barriers to treatment. CLINICAL IMPLICATIONS: Interventions that target older adults high in neuroticism by improving perceptions of need for treatment, mental health literacy, and self-stigma of seeking help may be particularly effective ways of improving access to mental health services.

Significados y experiencias personales de perdón y reconciliación en mujeres víctimas y mujeres excombatientes de las FARC / Meanings and personal experiences of forgiveness and reconciliation in women who are victims and ex-combatents of the FARC

Este trabajo pretende comprender la experiencia subjetiva de mujeres víctimas y excombatientes de las FARC en torno al perdón y la reconciliación. Para ello, se realizó una investigación de corte cualitativo con enfoque fenomenológico-hermenéutico, basada en postulados de la psicología social crítica latinoamericana. Las técnicas para recolectar información fueron la observación participante, la entrevista en profundidad y los grupos de conversación, en donde participaron 8 víctimas y 4 excombatientes. Se realizó un análisis hermenéutico de contenido, identificando concepciones que las participantes tienen sobre perdón y reconciliación, identificando experiencias vividas. Uno de los principales hallazgos es que en el proceso para perdonar y reconciliarse, las participantes transforman su subjetividad, asumiendo reivindicar sus derechos ante el Estado y redescubriendo su humanidad después de la guerra; finalmente, las excombatientes cam-bian las armas por palabras

This work aims to understand the subjective experience of women victims and women ex-combatants of the FARC, around forgiveness and reconciliation. For this purpose, a qualitative research was conducted with a phenomenological-hermeneutic approach, based on postulates of Latin American critical social psychology. The techniques to collect information were participant observation, in-depth interview and conversation groups, in which 8 victims and 4 ex-combatants participated. a hermeneutical analysis of content was carried out, identifying conceptions that the participants have about forgiveness and reconciliation, identifying lived experiences. One of the main findings is that, in the process of forgiving and reconciling, the participants transform their subjectivity, assuming to restore their rights before the State and rediscovering their humanity after the war. Finally, ex-combatants change weapons for words

Physiotherapy support for self-management of persisting musculoskeletal pain disorders.

BACKGROUND: Musculoskeletal pain (MSKP) is an extremely common pain disorder in almost all populations. Self-management (SM) support is a programme to prepare people to self-manage their health condition effectively, while maintaining quality of life. SM is a cost-effective and context-specific strategy to address the global public health burden. OBJECTIVES: Self-management needs a change in behaviour from seeking unnecessary medical care to safely self-managing symptoms. As changing individuals' behaviour is challenging, the objective of my literature review was to identify the characteristics, in both therapist and patient, to successfully engage in SM. METHOD: A narrative literature review, that could inform evidence-based support programmes for SM of MSKP. RESULTS: Studies on successful implementation of SM of MSKP do not report strong outcomes. However, in more recent years a few positive outcomes were reported, possibly as a result of research evidence for the application of psychosocial skills and contemporary pain neuroscience in the management of persistent MSKP. CONCLUSION: Psychologically-informed physiotherapy, addressing psychosocial barriers to the maintenance of SM programmes, could facilitate more successful outcomes. CLINICAL IMPLICATIONS: Before engaging in a SM support programme, obstacles to behaviour change must be identified and addressed in a SM support programme, to facilitate individuals towards taking safe responsibility for their healthcare. Therapists working with patients with persistent MSKP, should upskill themselves to be in line with the latest pain and psychosocial research literature. Moreover, communication skills training seems to be a priority for effective SM support programmes.

Polarización Política y Relaciones Familiares: prácticas relacionales y mecanismos de configuración de la postura política como barreras psicosociales para la democracia y la paz en Medellíni / Political Polarization and Family Relationships: Relational Practices and Configuration Mechanisms of Political Posture as Psychosocial Barriers to Democracy and Peace in Medellin

Resumen A partir de este análisis se identificaron creencias sociales, orientaciones emocionales colectivas y narrativas del pasado que configuran la dinámica de polarización política al interior de las familias y prácticas relacionales que de esta devienen, además de mecanismos de configuración de la postura política desde los cuales se posicionan frente a la diferencia política con el otro. Constituyéndose dicho fenómeno, además, en obstáculo para la apertura de espacios de debate público sobre los problemas del país, para el ejercicio de la subjetividad política y para la misma construcción de democracia y paz en Colombia.

Abstract From this analysis, social beliefs, collective emotional orientations, and narratives of the past were identified, which shape the dynamics of political polarization within families and relational practices, which derive from it, as well as mechanisms of configuration of the political posture from which they position themselves in the face of political difference with the other. This phenomenon is also an obstacle to the opening of public debate spaces about the country's problems, for the exercise of political subjectivity and for the very construction of democracy and peace in Colombia.

Cost considerations for adoption of diabetes technology are pervasive: A qualitative study of persons living with type 1 diabetes and their families.

BACKGROUND: Cost is a major consideration in the uptake and continued use of diabetes technology. With increasing use of automated insulin delivery systems, it is important to understand the specific cost-related barriers to technology adoption. In this qualitative analysis, we were interested in understanding and examining the decision-making process around cost and diabetes technology use. MATERIALS AND METHODS: Four raters coded transcripts of four stakeholder groups using inductive coding for each stakeholder group to establish relevant themes/nodes. We applied the Social Ecological Model in the interpretation of five thematic levels of cost. RESULTS: We identified five thematic levels of cost: policy, organizational, insurance, interpersonal and individual. Equitable diabetes technology access was an important policy-level theme. The insurance-level theme had multiple subthemes which predominantly carried a negative valence. Participants also emphasized the psychosocial burden of cost specifically identifying diabetes costs to their families, the guilt of diabetes related costs, and frustration in the time and involvement required to ensure insurance coverage. CONCLUSION: We found broad consensus in how cost is experienced by stakeholder groups. Cost considerations for diabetes technology uptake extended beyond finances to include time, cost to society, morality and interpersonal relationships. Cost also reflected an important moral principle tied to the shared desire for equitable access to diabetes technology. Knowledge of these considerations can help clinicians and researchers promote equitable device uptake while anticipating barriers for all persons living with type 1 diabetes and their families.

Measuring health information seeking challenges in chronic disease: A psychometric analysis of a brief scale.

Information seeking is a cornerstone of patient activation in chronic disease self-management. To date, there are few brief and literacy-sensitive tools to measure intrinsic barriers of health information seeking. The Health Information National Trends Survey includes four items from the Information Seeking Experiences scale to measure frustration, effort, concern, and comprehension of information sought during a recent medical/health information search. Limited evidence exists for its construct validity and use in primary data collection in chronic disease. This measurement study examines the psychometric properties of the scale. Qualtrics Panelists with at least one chronic disease (N = 684) participated in an online survey. The average score was M = 12.85 (SD = 3.97), indicating a moderate degree of health information seeking challenges. Confirmatory factor analysis of data collected using this scale supported unidimensionality (RMSEA = .03; CFI/TLI = .99/.99). There was adequate scale (ω = .83) and item (value = .98) reliabilities. Rasch analyses showed optimal measurement error and response predictability with item-fit (values = .80-1.20). Response option "agree" was less likely to be selected than any other response option, although not posing a threat to scale reliability. Results demonstrate that this brief scale has sufficient measurement properties for its use as a measure of intrinsic health information seeking barriers among patients with chronic disease.

El papel de los medios de comunicación en la fabricación de recuerdos, emociones y creencias sobre el enemigo que facilitan la polarización política y legitiman la violencia / The role of mass media in the fabrication of memories, emotions, and beliefs about the enemy, which make political polarization easy and legitimize violence

Resumen El presente artículo profundiza en la forma como los medios de comunicación tienen agencia en la construcción de creencias sociales, narrativas del pasado y orientaciones emocionales colectivas sobre el enemigo que agudizan la polarización política y legitiman las salidas armadas al conflicto social y político que existe en Colombia desde hace más de cinco décadas. En los resultados se evidencia un discurso lineal, hegemónico y homogéneo que está claramente inducido desde los medios de comunicación, según la voz de los participantes, que constituye un enemigo absoluto en las guerrillas, particularmente en las FARC, estigma que se extiende a manifestaciones políticas de izquierda o favorables a una solución política negociada del conflicto armado. De otro lado, un actor referido como poco conocido, confundido con las guerrillas o considerado un mal menor o legitimado, son los paramilitares y una narrativa del héroe que se sacrifica, nos cuida y nos protege, en las Fuerzas Militares, de quienes se minimizan sus acciones violatorias de los derechos humanos. Se concluye sobre la necesidad de poner en discusión el papel de los medios de comunicación masiva y las redes sociales, contrastando críticamente la información que ofrecen.

Abstract This article delves into how mass media have agency in building social beliefs, narratives of the past, and collective emotional orientations about the enemy, which sharpen political polarization and legitimize the armed exits to the social and political conflict, which has existed in Colombia for more than five decades. The results show a linear, hegemonic, and homogeneous discourse, which is induced clearly from the media, according to participants' voice, which constitutes an absolute enemy in guerrillas, particularly in the FARC, a stigma that extends to left-wing political demonstrations or to a pro-political settlement of the armed conflict. On the other hand, an actor referred to as little known, confused with guerrillas or considered a minor or legitimized evil, are the paramilitaries and a narrative of the hero who sacrifices, cares for us, and protects us, in the Military Forces, from those who minimize their violated human rights actions. It concludes on the need to discuss the role of mass media and social media, critically by contrasting the information they offer.

Emociones sociales y políticas en la construcción y la obstrucción de la paz en ciudadanos de estrato social medio-alto de la ciudad de Bogotá / Social and Political Emotions in the Construction and the Obstruction of Peace in Citizens of Middle-High Social Stratum in the City of Bogota

Resumen Respecto de la configuración de orientaciones emocionales colectivas (OEC) de carácter político, como barreras psicosociales para la construcción de paz y la reconciliación en personas de la ciudad de Bogotá, desde una perspectiva de género, se lograron identificar distintas emociones como: tristeza y dolor; rabia, indignación y odio; miedo, angustia, desconfianza e incertidumbre; resentimiento y asco; inconformidad, preocupación y decepción; indiferencia, impotencia, frustración y desesperanza; esperanza, felicidad, optimismo y empatía; patriotismo, seguridad, gratitud y admiración, frente al conflicto armado, sus actores, el acuerdo de paz y el futuro del país. A partir de éstas, es posible concluir que algunas OEC se constituyen como barreras psicosociales de acuerdo con la manera en que se vivencian en las y los participantes.

Abstract Regarding the configuration of Collective Emotional Orientations (CEO) of a political nature, such as psychosocial barriers to the construction of peace and reconciliation in the people in the city of Bogotá, from a gender perspective, it was possible to identify different emotions: sadness and pain; rage, anger and hatred; fear, anxiety, mistrust and uncertainty; resentment and disgust; non-conformity, concern and disappointment; indifference, impotence, frustration and hopelessness; hope, happiness, optimism and empathy; patriotism, security, gratitude and admiration, facing armed conflict, its actors, the peace agreement, and the future of the country. From these, it is possible to conclude that some CEO are psychosocial barriers according to the way in which they are experienced by the participants.

Orientaciones emocionales colectivas sobre el conflicto armado y sus actores como barreras para la construcción de la paz y la reconciliación en ciudadanos de Medellín / Collective Emotional Guidelines on the Armed Conflict and its Actors as Barriers for the Construction of Peace and Reconciliation in Colombia

Resumen El presente artículo de investigación analiza orientaciones emocionales colectivas de carácter político como barreras psicosociales para la construcción de la paz y la reconciliación en Colombia. Se realizaron 55 entrevistas semiestructuradas y en profundidad a ciudadanos del común en la ciudad de Medellín, de las que emergieron discursos relacionados con estas orientaciones emocionales, dirigidas al proceso de negociación política del conflicto armado entre el gobierno colombiano y la guerrilla de las Fuerzas Armadas Revolucionarias de Colombia - Ejército del Pueblo (FARC-EP). Se identificaron diversas orientaciones emocionales como ira, indignación y odio, dirigidas hacia las FARC, especialmente por los participantes que se mostraron en desacuerdo. Mientras que, quienes estaban de acuerdo, en menor medida expresaron este tipo de emociones hacia paramilitares. Sin embargo, hacia la fuerza pública, los tres grupos categorizados expresaron orientaciones emocionales de admiración, orgullo y sentimiento de patriotismo. De otro lado, la esperanza y la empatía como posibilitadoras de escenarios de transformación del conflicto armado primaron en quienes se encontraban de acuerdo. Finalmente, la tristeza y el dolor emergieron en la mayoría de los participantes, pero en quienes estaban de acuerdo se asoció con solidaridad hacia las víctimas y deseo de transformar la guerra en Colombia por la vía de la negociación política.

Abstract This current research paper analyzes the collective emotional guidelines of a political nature as psychosocial barriers for the construction of peace and reconciliation in Colombia. 55 deep and semi-structured interviews were carried out to ordinary people in the city of Medellín, from which speech related with these emotional guidelines emerged, which are addressed to the process of political negotiation of the armed conflict between the Colombian government and the guerrilla of Revolutionary Armed Forces of Colombia - Peoples' Army (FARC-EP). Diverse emotional guidelines, such as wrath, outrage, and hatred; targeted to FARC were identified, especially by the participants, who showed their disagreement. While, those who agreed, in a lesser measure, expressed this type of emotions toward paramilitary groups. Nevertheless, toward the law enforcement, the three categorized groups expressed emotional guidelines of admiration, pride, and feeling of patriotism. Otherwise, hope and empathy as enablers of transformation scenarios of the armed conflict prevailed in those who agreed. Finally, sadness and pain emerged in most of the participants, but in those who agreed, it was associated with solidarity toward the victims and the desire of transforming war in Colombia by means of the political negotiation.

Psychological threat avoidance as a barrier to HIV testing in gay/bisexual men.

The present study examined how three psychosocial barriers-anticipated HIV stigma, HIV infectiousness-reduction beliefs, and optimism about available HIV treatments-related to HIV testing history and acceptance of an at-home HIV test among men who have sex with men. We also examined the mediating role of a variable that affects medical screening for other health conditions but has not yet been investigated in HIV contexts: the tendency to avoid psychologically threatening information. Volunteers completed a paper and pencil survey and were offered a free at-home HIV test during the 2015 Atlanta Pride Festival in Atlanta, GA. Anticipated HIV stigma, infectiousness beliefs, and treatment optimism were inconsistently related to HIV testing history and acceptance of an at-home HIV test, but all had direct effects on the desire to avoid HIV information. In a mediation model, each of these psychosocial barriers had indirect effects on both HIV testing outcomes via information avoidance. These findings suggest that information avoidance is an important proximal HIV testing barrier, thus providing a novel target for interventions and information campaigns.

Role of Social Factors in Glycemic Control Among African American Children and Adolescents with Type 1 Diabetes.

OBJECTIVE: With the rising incidence of Type 1 diabetes (T1DM), it is important to recognize deficiencies in care and areas of improvement to provide better access to resources and education for T1DM patients. The objective of this study was to recognize social factors and compliance barriers affecting glycated hemoglobin (A1c) level in T1D patients among the minority population. METHODS: A total of 84 T1DM patients, ages 3 to 21 years, 49% males, 87% African American participated in the study. Study questionnaires assessing patient knowledge and other variables were distributed and patient charts were reviewed retrospectively to obtain relevant clinical data. T-tests, one-way ANOVA and spearman correlation were used for analysis. RESULTS: Mean A1c in our study was 10.5% and mean knowledge score was 10.1 out of 14. There was no significant correlation (r = 0.12, p = 0.26) between A1c and patients' knowledge scores. Patients with more frequent blood sugar (BS) monitoring (3-4 times/day) had 2 points lower A1c (9.6 vs 11.6 %, 95% CI 0.2-3.7, p = 0.03) than those with 2 or less times/day. No significant difference in A1c between 3-4 checks/day vs >4 checks/day BS checks. Most patients reported 'forgetfulness' (19%) followed by 'too time consuming' (17.9%) as barriers to daily BS monitoring. There was no significant difference in A1c between pen or pump users (10.5 vs 10.2 %, p = 0.55). Surprisingly, those with home supervision had higher A1c than those without (10.7 vs 9.6 %, p = 0.04) while there was no significant difference between those with or without nurse supervision at school (10.6 vs 9.8 %, p = 0.33). Those reporting happy mood interestingly had higher A1c than those with sad/depressed mood (10.7 vs 9.4 %, p = 0.04). On multiple linear regression analysis, frequency of BS checks, home supervision and mood were the most significant predictors of A1c and altogether explained 20% of the variability in A1c. CONCLUSION: Frequent BS monitoring is associated with lower A1c. Supervision at home and school did not improve A1c, but it was self-reported information. Mood did not affect A1c contrary to that reported in other studies.

Barreras psicosociales para la paz y la reconciliación / Psychosocial Barriers for Peace and Reconciliation

Resumen En medio de situaciones de conflicto armado degradado y de violencia política prolongada como la vivida en Colombia durante más de 70 años, ciertos sectores sociales despliegan procesos de ideologización mediante una serie de mecanismos discursivos y retóricos, comunicativos, mediáticos y educativos, que dan lugar a la configuración de barreras psicosociales para la construcción de la paz y la reconciliación. Dichas barreras refieren un entramado de narrativas del pasado como memorias colectivas victimistas, creencias sociales rígidas y emociones políticas de odio, ira, miedo, asco y humillación; que deshumanizan al adversario, polarizan la sociedad y legitiman la violencia. De esta manera, los procesos de ideologización atraviesan la subjetividad y configuran una cultura bélica, que constituye la base cultural y psicosocial de la violencia; cuya trasformación resulta imperativa de cara a construir paz, reconciliación y democracia.

Abstract Amidst the situations of degraded armed conflict and prolonged political violence, such as that experienced in Colombia for more than 70 years, certain social sectors unfold processes of ideological standpoint through a series of discursive and rhetorical, communicative, media, and educational mechanisms, which give rise to the configuration of psychosocial barriers to the construction of peace and reconciliation. These barriers refer to a network of narratives of the past as victimized collective memories, rigid social beliefs, and political emotions of hatred, anger, fear, disgust, and humiliation, which dehumanize the adversary, polarize so ciety, and legitimize violence. In this way, ideological standpoint proces ses traverse subjectivity and shape a warlike culture, which constitutes the cultural and psychosocial foundation of violence, whose transforma tion is imperative in order to build peace, reconciliation, and democracy.

Pre-surgical, surgical and post-surgical experiences of weight loss surgery patients: a closer look at social determinants of health.

Using a novel qualitative approach, Photovoice, researchers assessed social, psychological, physical and economic barriers encountered by patients of weight loss surgery. Applying the Photovoice approach and Williams' theory of narrative reconstruction for qualitative interviewing, the research team set out to investigate the bariatric patient experience from pre-surgery to hospitalization to post-surgery. Fifteen participants were given digital cameras and asked to take photographs that represented their weight loss journeys. Photographs and qualitative interviews were used to theorize the role played by comorbidities, social determinants of health, provider communication experiences and understanding of insurance coverage in patient outcomes. Several themes emerged from the interviews and photographs including themes centred around: (i) racial/ethnic standards of beauty; (ii) gender expectations; (iii) comorbidities, depression/disordered eating and obesity discrimination and (iv) financial hardship impacting adherence. Photographs also illuminated the impact of hospital and state-wide policies on patient lives. Results suggest that Photovoice may be a useful adjunct to standard-of-care to help patients identify barriers, and to identify shortcomings in health services. Additional screening tools for gender- and income-related barriers (and concomitant referrals to support services) provide an opportunity to improve patient care and reduce post-operative readmissions.