Who is not using condoms among HIV-positive patients in treatment in the largest city in Brazil?

Data on risky sexual behaviors in people living with HIV/AIDS (PLWHA) is still scarce in some populations around the world. The purpose of this study was to assess the factors associated with the use of condoms in a representative sample of PLWHA in outpatient treatment in the city of São Paulo. Six hundred and sixty-seven HIV-positive patients (383 men and 284 women) who were being treated at eight centers participated in this study. Data were collected using a sociodemographic survey, the Beck depression and anxiety inventories, a survey of alcohol and other drugs use, the Alcohol Use Disorders Identification Test, a sexual behavior survey, and the Sexual Risk Behavior Assessment Schedule. The majority of study participants were sexually active (almost 62% of the sample had at least one sexual partner in the last three months), and at least one-fourth engaged in unsafe sex (25.3% did not use condoms during at least one instance of anal and/or vaginal intercourse in the past three months). Multivariate logistic regression showed that engaging in unprotected sex was more likely among females (p < .001), persons with an HIV-positive partner (p < .001), and people using cannabis before sex (p = .002). These findings should stimulate health-care workers to create specific groups for women, seroconcordant couples, and cannabis users to discuss condom use, as they seem to be vulnerable groups.     

Nutrition Knowledge and Dietary Intake of Adolescents in Cofimvaba,Eastern Cape,South Africa

The aim of the study was to assess the nutrition knowledge, nutrient intakes, and association between nutrition knowledge and dietary intakes of 98 adolescents attending five schools in rural Cofimvaba, South Africa. Measures included a socioeconomic questionnaire, two 24-hour-recall questionnaires, and food-frequency and nutrition knowledge questionnaires. The overall score for the multiple-choice section on general nutrition and the South African Food-Based Dietary Guidelines was 72.9%; 75.4% for correct identification of food groups; and 41.3% for correct identification of food portions/serving sizes. Median nutrient intakes, measured by 24-hour recall, failed to meet average requirements, with the exception of protein, carbohydrates, chromium, riboflavin, pantothenate, and vitamin K among girls. A similar trend was observed for boys. Lower total carbohydrate and fat and higher protein intakes were associated with a higher quartile score for nutrition knowledge. The study provided a valuable understanding of the association between nutrition knowledge and dietary intakes of adolescents.     

济南市中老年居民骨质疏松预防相关知识调查及影响因素分析

目的了解济南市中老年居民骨质疏松预防相关知识认知水平及其影响因素,为制定切合实际的干预方案提供科学依据。方法采用问卷对本地40岁以上的常住居民(居住时间半年以上)进行问卷调查。结果本地中老年居民骨质疏松相关知识总得分为(9.80±4.24)分,条目平均分的总体水平为(0.45±0.19)分;年龄段、婚姻状态、文化程度、经济状况、工作情况、医疗保险种类和体重指数不同分组的中老年居民预防相关知识认知水平不同,差异均有统计学意义(P0.05);多重线性回归分析显示,文化程度、工作情况和婚姻状态是骨质疏松预防相关知识认知水平的影响因素。结论疾控或健康教育工作者需要以骨质疏松基础知识、危险因素、治疗和随访、钙摄入以及运动等方面的知识或技能为重点,采用专家讲座、发材料和社区展板等方式面向中老年居民持续加强骨质疏松预防相关知识的普及;宣教时要注重文化程度较低、待业或失业和不在婚这几类中老年居民。     

Why are they reluctant to report? A study of the barriers to reporting to child welfare services among public dental healthcare personnel

This study is a national cross‐sectional survey, conducted in November 2014, of 366 dental hygienists and dentists who had suspected maltreatment but did not report it to Norwegian Child Welfare Services (CWS). The aims of the present paper are to identify the reasons why public dental healthcare professionals are reluctant to report suspected child maltreatment to CWS and to determine whether there are differences in the identified barriers according to socio‐demographic variables. The questionnaire was based on earlier studies and was adapted to fit the Norwegian context. The most frequently chosen reason for not reporting was “unsure of own assessment” (90.4%). Thirteen items pertaining to not reporting were factorised into three factors of barriers. These factors were “insufficient knowledge of child maltreatment and reporting”, “fear of the consequences for oneself and the dental clinic”, and “fear of the consequences for the patient and their family”. A t test revealed that public dental healthcare personnel who had not received training on maltreatment and reporting to CWS during their professional education scored significantly higher on the barrier “insufficient knowledge of child maltreatment and reporting” than did dental personnel who had received such training. Furthermore, dental personnel with more years of experience (11+) scored higher on this barrier than did dental personnel with less experience. No other significant differences in barriers were observed. Public dental healthcare personnel have a mandatory obligation to report to CWS if they suspect child maltreatment. Despite this obligation, the present study reveals that several barriers to reporting exist. This study underscores the importance of strengthening knowledge among dental hygienists and dentists about when and how to report, both during education and in clinical practice.     

Patients Are Knowledge Workers in the Clinical Information Space

Background  Limited research exists on patient knowledge/cognition or “getting inside patients'' heads.” Because patients possess unique and privileged knowledge, clinicians need this information to make patient-centered and coordinated treatment planning decisions. To achieve patient-centered care, we characterize patient knowledge and contributions to the clinical information space. Methods and Objectives  In a theoretical overview, we explore the relevance of patient knowledge to care provision, apply historical perspectives of knowledge acquisition to patient knowledge, propose a representation of patient knowledge types across the continuum of care, and include illustrative vignettes about Mr. Jones. We highlight how the field of human factors (a core competency of health informatics) provides a perspective and methods for eliciting and characterizing patient knowledge. Conclusion  Patients play a vital role in the clinical information space by possessing and sharing unique knowledge relevant to the clinical picture. Without a patient''s contributions, the clinical picture of the patient is incomplete. A human factors perspective informs patient-centered care and health information technology solutions to support clinical information sharing.     

基于ICT技术的中医向其他自然科学学科知识迁移的研究

探讨中医现代化研究中中医学科向其他自然科学学科知识迁移的问题。通过对学科知识的成分进行分析,提出建立知识模型之间的迁移路径是知识迁移的有效方法。提出中医学科知识到数学和物理学科的迁移过程应该以现代的ICT技术为基础,由文句解析、文字形式化处理、数值图像建模、状态抽象化、导入物理元素、导入环境因素这六个阶段构成。还提出了中医知识迁移的过程中应该利用异步通讯的方法进行反馈。     

HIV/AIDS and economic growth: Evidence from West Africa

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is one of the leading causes of morbidity and mortality in West Africa. Prevalence among the most productive age group in West and Central Africa stood at 1.5%, 3.4.0%, 2.5%, and 2.1% in 1990, 2000, 2010, and 2015 respectively. This study examined the effect of HIV/AIDS on economic growth in West Africa with focus on 11 countries. The augmented Solow model, rooted in the neoclassical growth theory, was used, which was operationalized using dynamic panel data modeling approach. Incidence, prevalence, number of people living with HIV/AIDS (PLWHA), and AIDS‐related deaths were used to measure HIV/AIDS. Estimations using system GMM returned statistically significant results while those of first difference and difference GMM were not. From the outcome of system GMM analysis, a percentage increase in incidence, prevalence, PLWHA, and AIDS deaths correspondingly reduced growth significantly through their effects on life expectancy by 0.15%, 0.02%, 0.004%, and 0.03%. Acquired immune deficiency syndrome deaths and PLWHA lowered economic growth through enrolment but not significantly. The import of the findings is that HIV/AIDS threatens growth through life expectancy in West Africa. Therefore, its spread in the subregion should be effectively contained while proper treatment should be provided for all infected persons.     

广西高校新生对HIV尿液自助采样包的使用意愿及关注因素调查

目的 了解广西高校新生对HIV尿液自助采样包的使用意愿及关注因素,为进一步在高校开展HIV尿液自我采样传递检测提供依据和参考。 方法 采取整群随机抽样方法,分别选取广西A、B两所高校新生进行匿名问卷调查,其中,A校在健康教育讲座前问卷调查,B校在健康教育讲座后问卷调查。 结果 本次调查中,共发放问卷500份,A、B两所高校新生的问卷回收率分别是88.0%(132/150),96.9%(339/350),差异有统计学意义(P<0.001)。A、B两所高校新生艾滋病基本知识平均知晓率分别为73.7%,87.7%,差异有统计学意义(P<0.001)。受访的大学新生中有2.3%(11/471)曾接受过HIV检测。A、B两所高校新生对HIV尿液自助采样包的使用意愿率分别是63.6%(84/132),88.5%(300/339),差异有统计学意义(P<0.001)。男生对HIV尿液自助采样包的使用意愿率均要稍高于女生,但差异无统计学意义(P>0.05)。在阻碍HIV尿液自助采样包的使用因素调查中,54.0%(47/87)认为操作流程不方便,37.9%(33/87)怀疑结果的准确性,8.1%(7/87)认为容易污染。此外,在大学新生对HIV尿液自助采样包的关注因素调查中,首要关注的是保密性(85.4%,402/471),其次是准确性(72.4%,341/471)。超过一半的新生认为100~150元是HIV尿液自助采样包的可接受价格范围,高达97%的新生认为检测结果的反馈时长应小于7 d。 结论 广西高校新生对HIV尿液自助采样包的态度积极,使用意愿较高,对HIV尿液自我采样传递检测持相对开放态度。HIV尿液自助采样包的保密性和准确性是大学新生最为关注的两个因素。举办健康教育讲座对HIV尿液自助采样包进行适当的介绍和宣传,可有效提高使用意愿。     

The feasibility of the draw-and-write technique in exploring the resilience of children orphaned by AIDS

Worldwide, researchers routinely study children indirectly through adults who act as proxies for such children. The call for researchers to rather study children directly and adopt less intrusive child-friendly methodologies has become louder. The draw-and-write technique is regarded as a less intrusive child-friendly method of collecting data that can be used for this purpose. This paper reports the findings of a qualitative study that sought to establish the feasibility of the draw-and-write technique in exploring the resilience of children orphaned by AIDS. This study involved a convenience sample of 23 IsiXhosa-speaking orphaned children aged from 13 to 17. The participants were in grades 6 to 10 and they resided in two child and youth care centres in the Eastern Cape province of South Africa. As part of the draw-and-write technique the participants were asked to make drawings of what enabled them to cope with their lives and to write short narratives in which they explained their drawings. Inductive content analysis was used to analyse the data and this process yielded two main themes, namely: personal protective resources and socio-ecological protective resources. The findings show that complex combinations of personal and socio-ecological resilience resources enabled the resilience of the orphaned children. The findings challenge researchers not to be oblivious to alternative child-friendly methods of research such as the draw-and-write technique when young people are the unit of analysis. The findings of this study have implications for research as well as practice in the field of education and psychology.