THE COUNSELING PROCESS IN STD, HIV AND AIDS AS WELL AS ITS INTERRELATIONSHIP WITH NURSING KNOWLEDGE PATTERNS – A CONNECTION

Artigo de reflexão que tem como objetivo inter-relacionar a prática do processo de aconselhamento aos quatro padrões de conhecimento da Enfermagem, o empírico, estético, pessoal e ético propostos por CARPER (1978) O processo de aconselhamento em DST, HIV e AIDS compreende uma relação de ajuda e cuidado para com o outro, com a finalidade de resgatar a integralidade da pessoa, descobrir suas potencialidades, fortalecer sua autonomia e responsabilidade no desenvolvimento do autocuidado, bem como a transformação na adoção de hábitos mais seguros com vistas a prevenção das DST, do HIV e da AIDS. O aconselhamento pressupõe a existência de uma postura e atitude profissional que constitui diretrizes para esta prática, quais sejam: o exercício do acolhimento, a escuta ativa, a comunicação competente, a avaliação de riscos e reflexão conjunta sobre alternativas para novos hábitos de prevenção e a orientação sobre aspectos clínicos e do tratamento O processo de aconselhamento exige do enfermeiro a aquisição de conhecimentos, competência e habilidades pertinentes à área para que o cuidado possa ser efetivado de forma a contemplar a multidimensionalidade de aspectos envolvidos na vivência de cada ser.A thought-provoking article which aims to interrelate the practice of the counseling process to the four patterns of nursing knowledge (empirical, esthetic, personal and ethical) proposed by CARPER (1978). The counseling process on STD, HIV and AIDS entails a relationship of help and care with the other objectifying to recover his/her wholeness, to find out his/her potentialities, to strengthen his/her autonomy and responsibility undertaking self-care, and effect the adoption of safer habits in order to prevent STD, HIV and AIDS. Counseling implies the existence of a professional posture and attitude, which take up the guidelines for this practice, such as: welcoming exercise, active listening, competent communication, risk assessment and joint pondering over the alternatives towards new preventive habits besides guidance on clinical and treatment aspects. The counseling process demands nurses to acquire proper knowledge, competence and abilities so that care can be provided in such a way to apprehend the multidimensional aspects in the lived experience of each human being

Social cognition impairment in genetic frontotemporal dementia within the GENFI cohort

A key symptom of frontotemporal dementia (FTD) is difficulty interacting socially with others. Social cognition problems in FTD include impaired emotion processing and theory of mind difficulties, and whilst these have been studied extensively in sporadic FTD, few studies have investigated them in familial FTD. Facial Emotion Recognition (FER) and Faux Pas (FP) recognition tests were used to study social cognition within the Genetic Frontotemporal Dementia Initiative (GENFI), a large familial FTD cohort of C9orf72, GRN, and MAPT mutation carriers. 627 participants undertook at least one of the tasks, and were separated into mutation-negative healthy controls, presymptomatic mutation carriers (split into early and late groups) and symptomatic mutation carriers. Groups were compared using a linear regression model with bootstrapping, adjusting for age, sex, education, and for the FP recognition test, language. Neural correlates of social cognition deficits were explored using a voxel-based morphometry (VBM) study. All three of the symptomatic genetic groups were impaired on both tasks with no significant difference between them. However, prior to onset, only the late presymptomatic C9orf72 mutation carriers on the FER test were impaired compared to the control group, with a subanalysis showing differences particularly in fear and sadness. The VBM analysis revealed that impaired social cognition was mainly associated with a left hemisphere predominant network of regions involving particularly the striatum, orbitofrontal cortex and insula, and to a lesser extent the inferomedial temporal lobe and other areas of the frontal lobe. In conclusion, theory of mind and emotion processing abilities are impaired in familial FTD, with early changes occurring prior to symptom onset in C9orf72 presymptomatic mutation carriers. Future work should investigate how performance changes over time, in order to gain a clearer insight into social cognitive impairment over the course of the disease

Disease-related cortical thinning in presymptomatic granulin mutation carriers

Mutations in the granulin gene (GRN) cause familial frontotemporal dementia. Understanding the structural brain changes in presymptomatic GRN carriers would enforce the use of neuroimaging biomarkers for early diagnosis and monitoring. We studied 100 presymptomatic GRN mutation carriers and 94 noncarriers from the Genetic Frontotemporal dementia initiative (GENFI), with MRI structural images. We analyzed 3T MRI structural images using the FreeSurfer pipeline to calculate the whole brain cortical thickness (CTh) for each subject. We also perform a vertex-wise general linear model to assess differences between groups in the relationship between CTh and diverse covariables as gender, age, the estimated years to onset and education. We also explored differences according to TMEM106B genotype, a possible disease modifier. Whole brain CTh did not differ between carriers and noncarriers. Both groups showed age-related cortical thinning. The group-by-age interaction analysis showed that this age-related cortical thinning was significantly greater in GRN carriers in the left superior frontal cortex. TMEM106B did not significantly influence the age-related cortical thinning. Our results validate and expand previous findings suggesting a

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author