Журнал исследований и разработок в области медицинского образования

This study, conducted among men who have sex with men (MSM) in sub-Saharan Africa (SSA), sought to replicate the syndemic effects of psychosocial health problems on HIV risk by using data collected from a sample of 300 MSM and bisexuals from Tanzania. We also sought to test the utility of syndemic theory by replicating the effects of the number of syndemic conditions on HIV risk behavior in that population.

Five psychosocial health problems (i.e., the syndemic factors), acronymized as SAVID, were examined: substance use while having condomless sexual intercourse, childhood and adolescent sexual abuse, experience of anti-gay violence, internalized homonegativity (IH), and depression. Nine of the 10 odds ratios (ORs) generated from analysis of the bivariate associations between these syndemic factors were found to be statistically significant and positive; the tenth was marginally significant and positive. These results indicate not only a high degree of coexistence of the syndemic factors but also suggest that possible interactions between these factors may have additive effects on the behavioral health outcomes of the study participants. Such additive effects were confirmed by finding a “dose-responseâ€Â relationship between HIV risk-associated sexual behavior and the number of the five syndemic factors reported by each participant. After controlling for demographic and contextual factors, we found that the SAVID syndemic variable significantly increased the odds of engaging in condomless sexual intercourse (OR, 1.48). This substantiates the central tenet of syndemic theory, which is that those participants who were exposed to a greater number of the psychosocial health problems also engaged in higher-risk sexual behavior.

Multivariate regression analyses revealed not only the effect of two of the syndemic conditions (substance use during sex and IH) on HIV risk-related sexual behavior but also confirmed how one demographic variable (younger age) and one culturally structured factor (being gay but still having a meaningful sexual relationship with women) uniquely contributed to syndemic conditions among Tanzanian MSM.

These results suggest that a multifaceted HIV intervention grounded in syndemic theory should be considered as an effective approach to mitigating the risk environment that potentiates the vulnerability to HIV among Tanzanian MSM.

Family education is a fundamental pillar for individuals' education and an essential part of the personality and human constitution of each of us. This is what has motivated our interest in ascertaining what has been published on this important subject. We do so through attempting to discover what has been published in leading Spanish education journals such as Revista de Educación, Revista Española de Pedagogía, Revista Bordón, Revista de Investigación Educativa and Revista Enseñanza and Teaching.

Background: In the extremely homophobic conditions in Tanzania and other countries in sub-Saharan Africa (SSA), men who have sex with men (MSM) experience disproportionate amounts of both HIV infection and psychosocial health problems, but no research has been conducted to examine the synergistic or additive effects of these adversities on their experiences. While the predominantly deficit-based research approach has identified various HIV risks and vulnerabilities, any naturally occurring protective and resilience factors that these men naturally employ to these health-related adversities remain undetermined.

Purpose: This study examined the syndemic effects of psychosocial health problems on HIV infection and HIV risk and simultaneously sought to identify any resilience or protective factors that may buffer against the syndemic production of HIV infection and risk behavior among high-risk Tanzanian MSM. These syndemic health problems were coined as SAVID (Substance abuse during condomless sex, childhood and adolescent sexual abuse, violence, internalized homonegativity and depression)

Methods: Cross-sectional data on demographic characteristics and HIV prevalence and risks among Tanzanian MSM residing in Dar es Salaam and Tanga were used to examine whether there is a proportional increase in HIV infection and risk as the number of syndemic conditions increases. Logistic regression analysis was used to test for interactions between syndemic conditions and to identify any potential resilience factors as a way of establishing protection against the syndemic production of HIV infection and risk among these men. At the level of interaction between protective resilience factors (moderators)-support, age visibility- and SAVID syndemic; those that reported high social visibility among Acquaintance have lower odds of contracting HIV infection when compared to those that have lower social visibility among acquaintances

Results: The results revealed significant additive associations between increasing numbers of SAVID syndemic components and higher rates of HIV infection and risk. Among a variety of identified potential resilience factors, three-functional socio-support, age at self-awareness of sexual orientation and formal social visibility among acquaintances-were found to directly associated with lower odds of contracting HIV infection. At the level of interaction between protective resilience factors (moderators: functional social support, age at awareness of sexual orientation, and formal social visibility among acquaintances) and SAVID syndemics, only those sampled MSM that reported high social visibility among acquaintances had lower odds of contracting HIV infection when compared to sampled MSM that had lower formal social visibility among acquaintances

Conclusion: Harnessing naturally-occurring resilience factors through strength-based research approach and innovatively disseminate them through existing secrete social network may be a cost effective and a novel health promotion strategy suitable for MSM in extreme homophobic environment.

Tanzanian men who have sex with men (MSM) experience HIV disparity and are disproportionately vulnerable to psychosocial health problems together called SAVID (Substance abuse, childhood and adolescent sexual Abuse [CSA], anti-gay Violence, Internalized homonegativity [IH], and Depression). We applied syndemic theory to assess additive effects of the SAVID problems on HIV seropositivity among 300 MSM from two Tanzanian cities, who provided demographic, psychosocial health–problem, and HIV-status information. Prevalence rates of the problems were substance abuse during condomless sexual intercourse (37.3%), a history of CSA (35.3%), anti-gay violence (22%), high IH (52.7%), and depression (58%). Bivariate analysis showed a significantly positive “dose-response” relationship between the SAVID-problem count and HIV seropositivity: SAVID problems significantly increased the odds of HIV seropositivity (odds ratio, 1.42). This is the first study in sub-Saharan Africa to use syndemic theory to explore additive effects of coexisting psychosocial health problems on HIV seropositivity among Tanzanian MSM. Our results underscore the need for comprehensive HIV interventions targeting MSM.

Context: The purpose of this study is to review the studies that have used educational intervention in the field of emerging infectious diseases, based on methods, application of models, and theories of health education and health promotion and the effect of interventions on prevention and reducing the incidence of these diseases.

Evidence acquisition: Electronic search of databases was performed using the key words in English and Persian. Databases reviewed were, Scientific Information Database (SID), Iran Medex, PubMed, Ebsco, Scopus, Index Copernicus and Cochrane. The databases search was conducted from October 2016 to July 2017.

Results: Interventions to Emerging diseases were divided into two types based on use of models and theories of health education and without use of models and theories of health education. In the 16 articles reviewed, 7 studies were conducted based on theories and models of health education, and 9 studies did not use theories and models of health education.

Conclusion: Training in the community setting to the analogous groups, time, place, length of intervention and use of modern methods of training, are effective in order to decrease morbidity. Overall, health education, combined with health improvement approaches have a greater impact, in prevention and reducing the incidence of emerging diseases.

In Bangladesh, the nutritional status of adolescents is reprehensible, where a large number of adolescent girls are suffering from malnutrition. Among others, anaemia is currently one of the most common and intractable nutritional problems that may develop at any stage of the life cycle but children, adolescent girls and women of reproductive age are high-risk groups for developing anaemia. Although the situation of anaemia among adolescents has improved over the past few years, the current magnitude of the problem in both urban and rural areas is clearly a significant public health concern for the country. Therefore, a specific health education program on nutritional anaemia will be beneficial to sensitize adolescent girls on related topics and also contribute to self-care and behavior change, therefore, improve their quality and value of life.

The concept of a client having both a Substance Abuse Disorder (SAD) as well as a mental disorder is becoming more prevalent with 25 to 33% of all mental health patients considered dual-diagnosed [1]. While counselors are equipped to address one of the disorders in clients readily, the comorbidity creates difficulty in best meeting the client’s needs. The combination of Bipolar and Substance Abuse Disorder in an individual creates two key focal areas to address in counseling that may actually conflict with the other, or in some cases, one disorder may instigate the other. A need exists for both assessments and treatments that address this comorbidity combination.

The concept of a client having both a substance abuse disorder as well as a mental disorder becoming more prevalent with 25 to 33% of all mental health patients considered dual-diagnosed [1]. The psychiatric textbooks based their findings on little data and clinical lore [2]. Soon after, epidemiological studies were done on both substance abuse clients as well as those with mental disorders. The studies determined that not only was dual-diagnosis more prevalent, but also that a large number of those that have a mental disorder also have issues with substance use [2]. There are many disorders that can be combined with those that suffer from a substance use disorder (SUD) including eating disorders, gambling, compulsive shopping, and sexual disorders, as well has other physical and psychological disorders. In this paper, the disorders of bipolar and substance abuse will be identified, but also, attention will be given to the comorbid client that suffers from both disorders and potential treatment for this individual.

Nursing education has direct relationship with quality based clinical practice and standardized care; however, private versus public education makes a difference among the graduates. Unfortunately, in Pakistan, nursing education has been facing numerous challenges with respect of lack of unified policies, absence of strategic planning, and constraint resources. This paper describes comparison between private and public (government) nursing academic institution in Karachi, Pakistan. This paper comprises similarities, differences, strengths, limitations, and challenges of both institutions including their bases and recommendation for possible solution particularly with reference of regulatory body Pakistan Nursing Council (PNC) and World Health Organization (WHO) guidelines.

Objectives: This study aims to investigate likely impact of pre-service IMCI- training on nursing students’ case assessment and management skills. Methods: The study was carried out at Blinded Nursing Institute, Oman in May 2016. We developed a validated four constructs for developing a hypothetical model. The four constructs namely General Skills (GS), Knowledge, Attitudes and Skills (KAS), Confidence Level (CL) and Holistic Treatment Skills (HTS) that were used as latent variables to highlight their likely impact on the formative variable Assessment and Management Skills (AMS). Data were collected through qualitative structured questionnaires designed to measure participants’ opinions about the studied constructs. For data collection purpose, we developed a qualitative questionnaire and invited nursing students to voluntarily take part in the study. The purpose of the study and research details was explained to the potential participants in written. Participants were invited through printed posters in the institute. In response, 114 participants completed the questionnaires. Four respondents did not complete the entire questionnaire consequently they were excluded from the sample. The final sample size of the completed responses was 110 (n=110). Results: We first examined the factor loadings and calculated variances to ensure convergent validity. By exceeding 0.50, all the items in the model loaded well. We then measured the internal consistency reliability among the items through Cronbach’s Alpha that was observed to be 0.694. For all the constructs, the values exceeded the desired value of 0.50. The composite reliability of all the constructs in the model evidently surpassed the recommended value of 0.700. In the cross-loadings, the value of R2 was noted as 0.675 (R2=67.5%). Conclusion: The findings from the structural model support the hypothetical structural model. All the four studied constructs appear to significantly influence case assessment and management skills of pre-service IMCI-trained nursing students.

As an illness, cancer is strongly established in the social imagination. Individuals build ideas from medical, social, and media discourses, which makes it sometimes difficult for them to comprehend the subject. Educational interventions have focused on disseminating information concerning the disease but have remained indifferent to its social connotations. The present study aimed to identify the presence and temporal change of the social representations about cancer among 980 adolescents from Brazilian public and private schools. To this end, a voluntary and anonymous questionnaire was applied so that a quantitative and statistical evaluation could be performed. In general, the results indicate that negative social representations concerning the disease predominate in younger age groups. This tendency is gradually reduced as students grow older. Social representations are not static but change structurally, depending on the surroundings and social contexts. Family, the media, and teachers are the main sources of information. In this context, a pessimistic view regarding the disease is prevalent among men. Generally, the disease is seen from three perspectives. “Destruction” centers on statements concerning death, especially when a family member or friend has the disease. The “incurability” perspective associated with death is equally divided among the opinions on the binomials of life/death and heal/get sick. Finally, “resolution” or cure depends on early diagnosis and treatment. Although there is a consensus at this aspect, most perceptions describe the disease as negative, responsible for the loss of hair and weigh, being more severe in females and occasionally associated with a divine punishment. The obscure logic of contagion appears in the discourse of lay people as a possible means of transmission. These findings reflect the unique structure of the representations in a population of adolescents, which in some cases, may hinder an understanding of the benefits of preventive behaviour.