202 research outputs found

    Percepção de autoeficácia, assertividade sexual e uso do preservativo em jovens colombianos

    Get PDF
    El uso correcto y consistente del condón en las relaciones sexuales es un procedimiento altamente eficaz para la prevención del VIH/SIDA, así como para otras infecciones de transmisión sexual (ITS). Algunos estudios reportan que las habilidades psicosociales y de interrelación favorecen el desarrollo de prácticas sexuales protegidas, como con el uso de preservativos. El objetivo del presente estudio fue determinar en qué medida la percepción de autoeficacia y la asertividad sexual predicen el uso del condón en las relaciones sexuales en un grupo de jóvenes. Se realizó un estudio descriptivo correlacional y predictivo con una muestra de 631 jóvenes con edades entre 19 y 26 años que reportaron haber tenido relaciones o ser activos sexualmente. Los resultados muestran que la percepción de autoeficacia y la asertividad sexual fueron fuertes predictores del uso del condón en las relaciones sexuales de las mujeres, mientras que para el caso de los hombres, solo la asertividad sexual predijo su uso.O uso correto e consistente do preservativo nas relações sexuais é um procedimento altamente eficaz para a prevenção do HIV/ Aids, bem como para outras infecções de transmissão sexual (ITS). Alguns estudos mostram que as habilidades psicossociais e de inter-relação favorecem o desenvolvimento de práticas sexuais protegidas, como com o uso do preservativo. O objetivo do presente estudo foi determinar em que medida a percepção de autoeficácia e a assertividade sexual predizem o uso do preservativo nas relações sexuais em um grupo de jovens. Realizou-se um estudo descritivo correlacional e preditivo com uma amostra de 631 jovens com idades entre 19 e 26 anos que relataram ter tido relações ou ser ativos sexualmente. Os resultados mostram que a percepção de autoeficácia e a assertividade sexual foram fortes indicadores do uso do preservativo nas relações sexuais das mulheres, enquanto para o caso dos homens, só a assertividade sexual predisse seu uso.The correct and consistent use of condoms during sexual intercourse is a highly effective procedure for the prevention of HIV / AIDS as well as other sexually transmitted infections (STIs). Some studies report that psychosocial skills and interaction promote the development of safe sexual relations by using condoms. The objective of this study was to determine to what extent the perception of self-efficacy and sexual assertiveness predicts condom use in sexual activity in a group of young people. The study was descriptive correlational and predictive.The sample consisted of 645 young people aged between 19 and 26 years who reported having had sex or being sexually active. Results showed that, unlike men, the perception of selfefficacy coupled with sexual assertiveness are strong predictors of condom use in women's sexual relations, whereas for men only sexual assertiveness predicts condom use in sexual relations

    Integrating modes of policy analysis and strategic management practice : requisite elements and dilemmas

    Get PDF
    There is a need to bring methods to bear on public problems that are inclusive, analytic, and quick. This paper describes the efforts of three pairs of academics working from three different though complementary theoretical foundations and intervention backgrounds (i.e., ways of working) who set out together to meet this challenge. Each of the three pairs had conducted dozens of interventions that had been regarded as successful or very successful by the client groups in dealing with complex policy and strategic problems. One approach focused on leadership issues and stakeholders, another on negotiating competitive strategic intent with attention to stakeholder responses, and the third on analysis of feedback ramifications in developing policies. This paper describes the 10 year longitudinal research project designed to address the above challenge. The important outcomes are reported: the requisite elements of a general integrated approach and the enduring puzzles and tensions that arose from seeking to design a wide-ranging multi-method approach

    EuroQol (EQ-5D) measure of quality of life predicts mortality, emergency department utilization, and hospital discharge rates in HIV-infected adults under care

    Get PDF
    BACKGROUND: Health-related quality of life (HR-QOL) is a relevant and quantifiable outcome of care. We implemented HR-QOL assessment at all primary care visits at UCSD Owen Clinic using EQ-5D. The study aim was to estimate the prognostic value of EQ-5D for survival, hospitalization, and emergency department (ED) utilization after controlling for CD4 and HIV plasma viral load (pVL). METHODS: We conducted a retrospective analysis of HIV clinic based cohort (1996–2000). The EQ-5D includes single item measures of: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each item is coded using 3-levels (1 = no problems; 2 = some problems; 3 = severe problems). The instrument includes a global rating of current health using a visual analog scale (VAS) ranging from 0 (worst imaginable) to 100 (best imaginable). An additional single item measure of health change (better, much the same, worse) was included. A predicted VAS (pVAS) was estimated by regressing the 5 EQ-5D health states on VAS using reference cell coding of health states and random effects linear models. Survival models were fit using Cox modelling. Hospitalization and ED rate models were estimated using population-averaged Poisson models. RESULTS: 965 patients met eligibility criteria. 12% were female; 42% were non-white. Median time-at-risk was 1.2 years. Median CD4 was 233. Median log(10)(pVL) was 4.6. 47 deaths occurred. In two Cox models controlling for CD4 and pVL, the adjusted hazard ratios (aHR) for VAS and pVAS as time-varying covariates were 0.73 (95% CI: 0.63–0.83) and 0.66 (95% CI: 0.56–0.77) respectively, for every 10 point increase in (p)VAS rating. In Poisson regression models predicting ED visit rates and hospital discharge rates controlling for current CD4 and pVL, each of the EQ-5D health dimensions, VAS, and health change items were significantly (p < 0.05) associated with the outcomes. For ED visit rates, the adjusted incidence rate ratios (aIRR) were 0.86 (0.83–0.89) and 0.79 (0.75–0.82) for VAS and pVAS, respectively. For hospital discharge rates, the aIRR's were 0.85 (0.82–0.88) and 0.79 (0.75–0.82) for VAS and pVAS, respectively. CONCLUSION: EQ-5D is a brief and prognostically useful predictor of mortality, hospitalization, and ED utilization among adults under care for HIV infection, even after adjusting for CD4 and HIV plasma viral load

    Reciprocity as a foundation of financial economics

    Get PDF
    This paper argues that the subsistence of the fundamental theorem of contemporary financial mathematics is the ethical concept ‘reciprocity’. The argument is based on identifying an equivalence between the contemporary, and ostensibly ‘value neutral’, Fundamental Theory of Asset Pricing with theories of mathematical probability that emerged in the seventeenth century in the context of the ethical assessment of commercial contracts in a framework of Aristotelian ethics. This observation, the main claim of the paper, is justified on the basis of results from the Ultimatum Game and is analysed within a framework of Pragmatic philosophy. The analysis leads to the explanatory hypothesis that markets are centres of communicative action with reciprocity as a rule of discourse. The purpose of the paper is to reorientate financial economics to emphasise the objectives of cooperation and social cohesion and to this end, we offer specific policy advice

    Allocating HIV Prevention Funds in the United States: Recommendations from an Optimization Model

    Get PDF
    The Centers for Disease Control and Prevention (CDC) had an annual budget of approximately $327 million to fund health departments and community-based organizations for core HIV testing and prevention programs domestically between 2001 and 2006. Annual HIV incidence has been relatively stable since the year 2000 [1] and was estimated at 48,600 cases in 2006 and 48,100 in 2009 [2]. Using estimates on HIV incidence, prevalence, prevention program costs and benefits, and current spending, we created an HIV resource allocation model that can generate a mathematically optimal allocation of the Division of HIV/AIDS Prevention’s extramural budget for HIV testing, and counseling and education programs. The model’s data inputs and methods were reviewed by subject matter experts internal and external to the CDC via an extensive validation process. The model projects the HIV epidemic for the United States under different allocation strategies under a fixed budget. Our objective is to support national HIV prevention planning efforts and inform the decision-making process for HIV resource allocation. Model results can be summarized into three main recommendations. First, more funds should be allocated to testing and these should further target men who have sex with men and injecting drug users. Second, counseling and education interventions ought to provide a greater focus on HIV positive persons who are aware of their status. And lastly, interventions should target those at high risk for transmitting or acquiring HIV, rather than lower-risk members of the general population. The main conclusions of the HIV resource allocation model have played a role in the introduction of new programs and provide valuable guidance to target resources and improve the impact of HIV prevention efforts in the United States
    corecore