Actitudes hacia el VIH/SIDA, el cáncer y la enfermedad de Alzheimer

Esta revisión de la literatura tuvo como objetivo describir las actitudes hacia el VIH/SIDA, el cáncer y la Enfermedad de Alzheimer desde el modelo tripartito. Se revisaron 109 artículos publicados entre 2005 y 2015 en algunas bases de datos especializadas y herramientas de análisis de impacto. También se incluyeron fuentes secundarias ampliándose la búsqueda a los últimos 20 años (1995-2015). Los resultados mostraron que la mayoría de los estudios realizados sobre las actitudes hacia estas tres enfermedades son de tipo cuantitativo y la información se analizó con base en los componentes del modelo tripartito. Algunos aspectos sociodemográficos como el sexo y la edad están asociados con las actitudes hacia las tres enfermedades y predominan las creencias erróneas sobre ellas respecto a sus causas, curso y tratamiento. También predominan actitudes negativas hacia las tres enfermedades y las conductas e intenciones conductuales son diversas hacia cada una de ellas. No se hallaron antecedentes empíricos del estudio de la estructura de las actitudes propuesta por el modelo tripartito hacia las tres enfermedades. La Salud Pública ha liderado la investigación con base en el modelo de conocimientos, actitudes y prácticas propuesto por la OMS.

La disonancia cognitiva y trampa de la memoria en decisiones de Inversión: caso colombiano

Este documento es el resultado de una investigación bajo el enfoque de Finanzas Corporativas del Comportamiento, disciplina relevante en el mundo financiero desde el 2002 y que hasta el momento poco se ha investigado en Colombia. Esta difiere del supuesto tradicional de la racionalidad de los individuos en la toma de decisiones financieras, ya que pueden ser influenciadas por sesgos cognitivos y emocionales que la teoría ortodoxa no tiene en cuenta en sus supuestos. Esta investigación busca indagar, desde el punto de vista conceptual y mediante el análisis de resultados de estudio de campo con operadores del mercado bursátil colombiano, sobre la posible presencia de elementos comportamentales en las decisiones de inversión. Los sesgos que se evaluaron fueron: disonancia cognitiva, heurístico de disponibilidad y sesgo de confirmación. Para la recolección de fuentes primarias, una encuesta fue enviada a los operadores Colombianos, categorizados en operadores con experiencia y operadores jóvenes. Después del filtro, 142 encuestas fueron seleccionadas para el análisis. Los principales hallazgos fueron que los jóvenes son más propensos a experimentar disonancia cognitiva y heurístico de disponibilidad y en ambas categorías, los sesgos analizados influencian medianamente la toma de decisiones de inversión.

A trilogia do sucesso: a educação inclusiva, a investigação-acção e a intervenção no grupo, atendendo à sua diversidade

RESUMO: O presente trabalho de projecto teve como principal objectivo compreender de que modo se pode promover o sucesso de todos, através do sucesso de cada um, num grupo heterogéneo de crianças do 2º e 3º ano do 1º Ciclo, com diferentes níveis de aprendizagem e problemáticas diversificadas. Com o principal objectivo de provocar mudanças positivas na dinâmica e intervenientes deste contexto, adoptou-se a metodologia de investigação-acção e recorreu-se a técnicas de pesquisa documental, à entrevista semi-directiva, à observação naturalista e à sociometria. O processo interventivo seguiu um plano de acção, inicialmente delimitado face às problemáticas diagnosticadas. Realizou-se de Fevereiro a Junho de 2010 seguindo uma estrutura cíclica e em espiral, composto por etapas de planificação, acção, avaliação e reflexão, para nova acção, que se tornou progressivamente mais informada. Esta metodologia permitiu alcançar resultados muito positivos e mudanças importantes no contexto intervencionado. Especificamente, numa fase inicial, a turma apresentava baixos desempenhos sociais, relacionais, comportamentais e académicos. Conjugados com estas problemáticas, todos os alunos apresentavam uma baixa autonomia, auto-estima e motivação para o processo de ensino-aprendizagem. Para além destes factores, apesar da heterogeneidade do grupo, de onde se destacavam os alunos 5, 9, 11, 12 e 13, considerados com necessidades educativas especiais, a dinâmica da prática pedagógica desenvolvida assentava num modelo de ensino tradicional, centrado no professor e nos desempenhos do aluno médio, reveladora de uma baixa eficiência de resultados. A heterogeneidade da turma era encarada como um obstáculo à aprendizagem. A intervenção desenvolvida, de forma fundamentada, permitiu um ensino inclusivo na turma, suportado na diferenciação pedagógica inclusiva, alcançada através da aprendizagem cooperativa, da tutoria entre pares e de uma estrutura coesa de parceria pedagógica entre a professora titular da turma e a investigadora. Para além destes, a intervenção realizada permitiu resultados positivos ao nível do perfil do grupo-turma, nomeadamente pelo registo de uma melhoria muito significativa nos desempenhos cognitivos, sócio-afectivos e comportamentais dos alunos. ABSTRACT: The present project work had as main objective to understand the way one can promote the success of all through the success of each one in a heterogeneous group of children of the 2nd and 3rd years of the 1st Cycle with different levels of learning and several problematic. With the main purpose of causing positive changes in the dynamics and actors of this context, the action-research methodology was adopted as well as the techniques of documentary research, and the half-directive interview, the naturalistic observation and the sociometry. The intervention process followed an action plan, initially delimited face to the problematic ones diagnosed. It took place from February to June 2010 following a cyclical and spiral structure made of stages of planning, action, evaluation and reflection, to a new action that became gradually more informed. This methodology allowed to reach very positive results and important changes in the interventional context. Specifically, in an initial phase, the group presented low social, relational, behavioral and academics performances. Together with these problematic issues, all the pupils presented a low autonomy, low self-esteem and low motivation for the teach-learning process. In addition to these factors there was the heterogeneity of the group (a group of pupils 5, 9, 11, 12 and 13 considered with special needs), and the teaching process was based on a traditional model centered in the teacher and the performances of the average pupil, revealing a low efficiency of results. The heterogeneity of the group was faced as an obstacle to the learning process. The developed intervention allowed an inclusive educational model in the group based in the inclusive pedagogical differentiation, reached through the cooperative learning, peer tutoring and a cohesive structure of pedagogical partnership between the titular teacher of the group and the researcher. Beyond these aspects, the research allowed positive results in the class, mainly a significant improvement in the cognitive, socio-emotional and behavioral performances of the pupils.

Mortality of Migratory Birds from Marine Commercial Fisheries and Offshore Oil and Gas Production in Canada

There is an imminent need for conservation and best-practice management efforts in marine ecosystems where global-scale declines in the biodiversity and biomass of large vertebrate predators are increasing and marine communities are being altered. We examine two marine-based industries that incidentally take migratory birds in Canada: (1) commercial fisheries, through bycatch, and (2) offshore oil and gas exploration, development, and production. We summarize information from the scientific literature and technical reports and also present new information from recently analyzed data to assess the magnitude and scope of mortality. Fisheries bycatch was responsible for the highest levels of incidental take of migratory bird species; estimated combined take in the longline, gillnet, and bottom otter trawl fisheries within the Atlantic, including the Gulf of St. Lawrence, and Pacific regions was 2679 to 45,586 birds per year. For the offshore oil and gas sector, mortality estimates ranged from 188 to 4494 deaths per year due to the discharge of produced waters resulting in oil sheens and collisions with platforms and vessels; however these estimates for the oil and gas sector are based on many untested assumptions. In spite of the uncertainties, we feel levels of mortality from these two industries are unlikely to affect the marine bird community in Canada, but some effects on local populations from bycatch are likely. Further research and monitoring will be required to: (1) better estimate fisheries-related mortality for vulnerable species and populations that may be impacted by local fisheries, (2) determine the effects of oil sheens from produced waters, and attraction to platforms and associated mortality from collisions, sheens, and flaring, so that better estimates of mortality from the offshore oil and gas sector can be obtained, and (3) determine impacts associated with accidental spills, which are not included in our current assessment. With a better understanding of the direct mortality of marine birds from industry, appropriate mitigation and management actions can be implemented. Cooperation from industry for data collection, research to fill knowledge gaps, and implementation of mitigation approaches will all be needed to conserve marine birds in Canada.

Perceived controllability modulates the neural response to pain

The response to painful stimulation depends not only on peripheral nociceptive input but also on the cognitive and affective context in which pain occurs. One contextual variable that affects the neural and behavioral response to nociceptive stimulation is the degree to which pain is perceived to be controllable. Previous studies indicate that perceived controllability affects pain tolerance, learning and motivation, and the ability to cope with intractable pain, suggesting that it has profound effects on neural pain processing. To date, however, no neuroimaging studies have assessed these effects. We manipulated the subjects' belief that they had control over a nociceptive stimulus, while the stimulus itself was held constant. Using functional magnetic resonance imaging, we found that pain that was perceived to be controllable resulted in attenuated activation in the three neural areas most consistently linked with pain processing: the anterior cingulate, insular, and secondary somatosensory cortices. This suggests that activation at these sites is modulated by cognitive variables, such as perceived controllability, and that pain imaging studies may therefore overestimate the degree to which these responses are stimulus driven and generalizable across cognitive contexts. [References: 28]

The effect of postnatal depression on mother-infant interaction, infant response to the still-face perturbation, and performance on an instrumental learning task

A representative community sample of primiparous depressed women and a nondepressed control group were assessed while in interaction with their infants at 2 months postpartum. At 3 months, infants were assessed on the Still-face perturbation of face to face interaction, and a subsample completed an Instrumental Learning paradigm. Compared to nondepressed women, depressed mothers' interactions were both less contingent and less affectively attuned to infant behavior. Postnatal depression did not adversely affect the infant's performance in either the Still-face perturbation or the Instrumental Learning assessment. Maternal responsiveness in interactions at 2 months predicted the infant's performance in the Instrumental Learning assessment but not in the Still-face perturbation. The implications of these findings for theories of infant cognitive and emotional development are discussed.

Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression 2. Impact on the mother-child relationship and child outcome

Background: Postnatal depression is associated with adverse child cognitive and socio-emotional outcome. It is not known whether psychological treatment affects the quality of the mother-child relationship and child outcome. Aims: To evaluate the effect of three psychological treatments on the mother-child relationship and child outcome. Method: Women with post-partum depression (n=193) were assigned randomly to routine primary care, non-directive counselling, cognitive-behavioural therapy or psychodynamic therapy The women and their children, were assessed at 43, [8 and 60 months post-partum. Results: Indications of a positive benefit were limited. All three treatments had a significant benefit on maternal reports of early difficulties in relationships with the infants, counselling gave better infant emotional and behaviour ratings at 18 months and more sensitive early mother-infant interactions. The treatments had no significant impact on maternal management of early infant behaviour problems, security of infant-mother attachment. Infant cognitive development or any child outcome at 5 years. Conclusions: Early intervention was of short-term benefit to the mother-child relationship and infant behaviour problems. More-prolonged intervention may be needed. Health visitors could deliver this.

The psychological, neurochemical and functional neuroanatomical mediators of the effects of positive and negative mood on executive functions

In this review we evaluate the cognitive and neural effects of positive and negative mood on executive function. Mild manipulations of negative mood appear to have little effect on cognitive control processes, whereas positive mood impairs aspects of updating, planning and switching. These cognitive effects may be linked to neurochemistry: with positive mood effects mediated by dopamine while negative mood effects may be mediated by serotonin levels. Current evidence on the effects of mood on regional brain activity during executive functions, indicates that the prefrontal cortex is a recurrent site of integration between mood and cognition. We conclude that there is a disparity between the importance of this topic and awareness of how mood affects, executive functions in the brain. Most behavioural and neuroimaging studies of executive function in normal samples do not explore the potential role of variations in mood, yet the evidence we outline indicates that even mild fluctuations in mood can have a significant influence on neural activation and cognition. (c) 2006 Elsevier Ltd. All rights reserved.

Depression, confidence, and decision: evidence against depressive realism

This research examined how retrospective self-assessments of performance are affected by major depression. To test the validity of the depressive realism versus the selective processing hypotheses, aggregate posttest performance estimates (PTPEs) were obtained from clinically depressed patients and an age-matched comparison group across 4 decision tasks (object recognition, general knowledge, social judgment, and line-length judgment). As expected on the basis of previous findings, both groups were underconfident in their PTPEs, consistently underestimating the percentage of questions they had answered correctly. Contrary to depressive realism, and in partial support of the selective processing account, this underconfidence effect was not reduced but modestly exacerbated in the depressed patients. Further, whereas the PTPEs of the comparison group exceeded that expected on the basis of chance alone those of the depressed individuals did not. The results provide no support for the depressive realism account and suggest that negative biases contribute to metacognitive information processing in major depression.

Effective elements of cognitive behaviour therapy for psychosis: results of a novel type of subgroup analysis based on principal stratification

Background. Meta-analyses show that cognitive behaviour therapy for psychosis (CBT-P) improves distressing positive symptoms. However, it is a complex intervention involving a range of techniques. No previous study has assessed the delivery of the different elements of treatment and their effect on outcome. Our aim was to assess the differential effect of type of treatment delivered on the effectiveness of CBT-P, using novel statistical methodology. Method. The Psychological Prevention of Relapse in Psychosis (PRP) trial was a multi-centre randomized controlled trial (RCT) that compared CBT-P with treatment as usual (TAU). Therapy was manualized, and detailed evaluations of therapy delivery and client engagement were made. Follow-up assessments were made at 12 and 24 months. In a planned analysis, we applied principal stratification (involving structural equation modelling with finite mixtures) to estimate intention-to-treat (ITT) effects for subgroups of participants, defined by qualitative and quantitative differences in receipt of therapy, while maintaining the constraints of randomization. Results. Consistent delivery of full therapy, including specific cognitive and behavioural techniques, was associated with clinically and statistically significant increases in months in remission, and decreases in psychotic and affective symptoms. Delivery of partial therapy involving engagement and assessment was not effective. Conclusions. Our analyses suggest that CBT-P is of significant benefit on multiple outcomes to patients able to engage in the full range of therapy procedures. The novel statistical methods illustrated in this report have general application to the evaluation of heterogeneity in the effects of treatment.

The role of negative maternal affective states and infant temperament in early interactions between infants with cleft lip and their mothers

OBJECTIVES: The study examined the early interaction between mothers and their infants with cleft lip, assessing the role of maternal affective state and expressiveness and differences in infant temperament. METHODS: Mother-infant interactions were assessed in 25 2-month-old infants with cleft lip and 25 age-matched healthy infants. Self-report and behavioral observations were used to assess maternal depressive symptoms and expressions. Mothers rated infant temperament. RESULTS: Infants with cleft lip were less engaged and their mothers showed more difficulty in interaction than control group dyads. Mothers of infants with cleft lip displayed more negative affectivity, but did not report more self-rated depressive symptoms than control group mothers. No group differences were found in infant temperament. CONCLUSIONS: In order to support the mother's experience and facilitate her ongoing parental role, findings highlight the importance of identifying maternal negative affectivity during early interactions, even when they seem have little awareness of their depressive symptoms.

Impact of Huntington's across the entire disease spectrum: the phases and stages of disease from the patient perspective

Although Huntington's disease (HD) is a neurodegenerative disease characterized by motor, cognitive and behavioural disturbances, there has been little empirical data examining what patients are most concerned about throughout the different stages of disease, which can span many years. Semi-structured face-to-face interviews were individually conducted with 31 people living with different stages of Huntington's, from pre-clinical gene carriers to advanced stage. We examined how often participants raised issues and concerns regarding the impact of Huntington's on everyday life. The Physical/functional theme hardly featured pre-clinically, but was strongly present from Stage 1, rose steadily and peaked at Stage 5. There were no significant changes between stages for the Emotional, Social, and Self themes that all featured across all stages, indicating that these issues were not raised more frequently over the course of the disease. Likewise, the more rarely mentioned Financial and Legal themes also remained similar across stages. However, the Cognitive theme only featured between Stages 1 and 4, and hardly at all pre-clinically and at Stage 5. These findings provide insight into patients' important and unique perspective and have implications for the management and development of interventions across the spectrum of HD stages.