Treatment Adherence, Quality of Life and Clinical Variables in HIV/AIDS Infection

The purpose of the study was to analyze the relationship between treatment adherence, quality of life and clinical variables in HIV/AIDS Infection. The empirical study was conducted at two Portuguese hospitals (Porto and Lisbon) with a sample of 295 outpatients diagnosed with HIV/AIDS attending the Infectology service and on antiretroviral medication, during a 12-month period (February 2009 to February 2010). Data were collected by voluntary fulfillment of three questionnaires: one for socio-demographic variables, one to Assess Adherence to Antiretroviral Treatment-HIV and the Portuguese version of the WHOQOL-Bref to measure the quality of life (QoL). Clinical records were inspected in order to collect clinical information from the patients. The relationship between these variables was accessed by Student’s t-test and ANOVA using Tukey and LSD as the post Hoc test. Regarding disease stages, the post Hoc analysis has showed that asymptomatic patients have a better level of adherence and quality of life when compared to those in more advanced stages of the disease. Undetectable viral load 500 cells/mm3 were also associated with higher QoL in all overall domains. Patients on NRTI + NNTRI regimens have higher adherence when compared to those on NRTI + PI regimens and higher QoL indexes when compared to twice daily regimens, patients on single dose per day regimens have higher adherence and higher QoL in overall domain. Patients experiencing adverse effects have lower QoL and lower adherence levels when compared to those not experiencing such events. We consider the multiplicity and the interaction of several determinants of influence in the adaptation process during the HIV/AIDS treatment. The results may have implications for the psychological intervention to improve the adherence’s level to the antiretroviral therapy.

Cognitive coping strategies, emotional distress and quality of life in mothers of children with ASD and ADHD—A comparative study in a Romanian population sample

The Quality of Life (QoL) represents a dimension of the overall status and of the wellbeing that might be influenced by various factors. Mothers’ emotional and behavioral reactions, when having a child with diagnosis of mental disorder, are different depending on the emotional distress and cognitive coping strategies used. The aim of this study was to assess the cognitive coping strategies, emotional distress and the relationship between them and the quality of life in mothers of children with Autism Spectrum Disorder (ASD) compared to mothers of children with Attention Deficit Hyperactive Disorder (ADHD). Data were collected from 114 mothers of children with diagnosis of ASD or ADHD. Different psychological measurements have been used in order to assess the quality of life (Family Quality of Life Survey) cognitive coping strategies (Cognitive-Emotional Regulation Questionnaire) and emotional distress (Profile of Affective Distress) of the parents. For QOL and emotional distress, we didn’t find significant differences between the two groups. The coping strategies of the mothers of children with ASD that significantly correlated with the overall assessment of the family quality were: positive refocusing, positive reevaluation and catastrophizing. The results suggest that the use of adaptive coping strategies correlates with a higher family quality of life, while for the maladaptive ones, the relationship is reversed.

Neuropsychological features of progranulin-associated frontotemporal dementia: a nested case-control study

The distinction between sporadic and genetic behavioural-variant frontotemporal dementia(bvFTD)regarding some neuropsychological(NP)features remains challenging.Specifically,progranulin(GRN)-associated bvFTD frequently presents with early episodic memory impairment and some degree of parietal dysfunction which are supporters of Alzheimer’s disease(AD)diagnosis.In this context,we aimed to characterize the NP profile of GRN-bvFTD as compared to sporadic-bvFTD and AD in patients with mild dementia(Mini-Mental State Examination score≥17 and Clinical Dementia Rating Scale score≤1.We identified 21 patients at Centro Hospitalar e Universitário de Coimbra,Portugal with GRN mutations belonging to fifteen different families.As our focus was bvFTD variants,FTD-related aphasic forms(3 patients)were excluded.The remaining 18 GRN-bvFTD were further matched with 18 sporadic-bvFTD and 18 AD patients according to disease staging,age and education.All patients completed the Mini-Mental State Examination,Montreal Cognitive Assessment(MoCA)and a comprehensive NP assessment battery.Results were converted into z-scores.Differences between groups in individual NP measures and NP domains were assessed through non-parametric tests(Kruskal-Wallis test analysis)and eta squared(ŋ2)was calculated as a measure of effect size.Group comparisons show that GRN patients have worse performances on verbal retrieval processes(P=0.039,ŋ2=0.110)and visuoconstructive abilities(P=0.039,ŋ2=0.190)than sporadic bvFTD forms.When compared to AD,GRN patients present a higher impairment in frontal(P=0.001,ŋ2=0.211)and parietal(P=0.041,ŋ2=0.129)measures and a better performance in memory tasks(P=0.020,ŋ2=0.120).Sporadic-bvFTD forms are worse than AD in frontal measures(P=0.032,ŋ2=0.200),being better in both memory(P=0.010,ŋ2=0.131)and visuospatial skills(P=0.023,ŋ2=0.231).Considering these results,we conclude that GRN-bvFTD patients present a NP profile that associates the typical patterns of FTD and AD deficits.This is particularly expressive in visuoconstructive abilities,which was the more discriminative feature between groups,followed by episodic verbal memory.This study was approved by the Institutional Ethics Committee of Centro Hospitalar e Universitário de Coimbra,Portugal(CE-029/2019)on June 24,2019.

Concept analysis of coping with multiple sclerosis

Objective:The concept of coping with disease appears frequently in the literature;however,there is no precise definition of coping.The aim of this study is to clarify coping concept,and to identify its attributes,antecedents,and consequences in patients with multiple sclerosis.Methods:Rodgers'evolutionary method of concept analysis was used to clarify the concept of coping.A literature review was conducted with key terms‘multiple sclerosis’,‘coping’,‘adjustment’,and‘deal with’.After searching databases,1370 papers were found for the period 1995e2017.Finally,55 articles and texts were selected for analysis.Data analysis was carried out using thematic analysis.An independent researcher checked the process to ensure credibility and reduce personal bias.Results:Coping with multiple sclerosis is a multidimensional concept with three main attributes:maintenance of emotional balance,acceptance of the disease,and self-regulation.Social support,awareness toward the disease,attitude toward the disease,and religious-spiritual beliefs were found as antecedents.Health promotion,adherence to treatment regimen,independence in personal life and social relationships,and improvement of family relationships were found as consequences of these attributes.Conclusion:These findings not only add to the body of knowledge in health science,but also serve as an important motivation for further theory development and research in this context.Nurses and health professions can also benefit from a deeper understanding of coping concept in providing and planning healthcare for these patients.

Evaluation of the effectiveness of sexual skills training on increasing marital satisfaction

Background and Aims: Dissatisfaction with sexual relationships can influence the marital life of people and have negative psychological effects on them. Hence, the current research was conducted to evaluate the effectiveness of sexual skills training on marital satisfaction. Methods: The study design was quasiexperimental with pre-test and post-test type along with a control group. The research samples included 14 couples (28 people) who were randomly divided into experimental and control groups to evaluate the effect of sexual medicine intervention. Interventions were provided to the experimental group during 9 sessions. Control group did not receive any interventions during this time. Enrich Marital Satisfaction Questionnaire (short form) was used to collect the data. Data were analyzed using SPSS, version 19, software. Results and Conclusion: The results revealed that sexual skills training increased marital satisfaction (p<0.01). Thus, based on the results obtained and the importance of sexual skills training in increasing marital satisfaction, psychotherapists and counselors are recommended to use this intervention to reduce marital problems and increase satisfaction in couples.

模糊美学的一种认知结构

美学问题存在大量的模糊性现象。本文分析了建立在处理狭义模糊性的L.A.Zadeh模糊集合论基础上的传统的模糊美学。运用模糊性层次的分析方法探讨了模糊美学问题,提出了模糊美学的一种认知结构,提出了结构性模糊美学的概念,讨论了它的本质、特征、研究对象和范围、研究任务和方法。

Immediate effects of the honda walking assist on spatiotemporal gait characteristics in individuals after stroke

The use of unconstrained lower limb exoskeletons has become a promising approach to assist individuals with gait impairments.The Honda Walking Assist(HWA)is a hip-assistive exoskeleton functioning as a gait trainer and has been shown to improve several gait related outcomes after training.Studies investigating its immediate effects on spatiotemporal gait parameters other than walking speed in stroke survivors are lacking.The aim of this study was to investigate immediate differences in spatiotemporal gait parameters of stroke survivors between normal overground walking,walking with an unpowered,non-assisting HWA and walking with an optimally assisting HWA.Five ischemic stroke survivors(mean time since stroke 115±213.6 days)walked 3 times 5 m in each condition.Differences in 14 spatiotemporal gait parameters between all 3 conditions were registered and reported in a descriptive manner.With optimal assistance,4 patients walked faster(0.057–0.095 m/s)with longer strides of the paretic(0.055–0.069 m)and non-paretic(0.053–0.077 m)leg compared to normal walking.Compared to unpowered walking,all patients walked faster(0.020–0.063 m/s)in the optimal assist condition,with longer strides of the paretic(0.036–0.072 m)and non-paretic leg(0.045–0.082 m).During unpowered walking,gait velocity remained unchanged in 2 patients,increased(0.012_0.051 m/s)in 2 patients and decreased(-0.022 m/s)in 1 patient compared to normal walking.Changes in paretic stride lengths ranged from-0.066 to 0.029 m.The optimal individualized motor assistance provided by the HWA induces small,positive changes in gait parameters.This indicates that this light-weight hip-assistive exoskeleton can be of value in rehabilitation setting,where multiple training sessions with the device are possible.

What can atypical language hemispheric specialization tell us about cognitive functions?

Recent studies have made substantial progress in understanding the interactions between cognitive functions, from language to cognitive control, attention, and memory. However, dissociating these functions has been hampered by the close proximity of regions involved, as in the case in the prefrontal and parietal cortex. In this article, we review a series of studies that investigated the relationship between language and other cognitive functions in an alternative way - by examining their functional （co-）lateralization. We argue that research on the hemispheric lateralization of language and its link with handedness can offer an appropriate starting- point to shed light on the relationships between different functions. Besides functional interactions, anatomical asymmetries in non-human primates and those underlying language in humans can provide unique information about cortical organization. Finally, some open questions and criteria are raised for an ideal theoretical model of the cortex based on hemispheric specialization.