RESUMO
Individuals with antisocial personality disorder (ASPD) are characterized by impulsive behavior and a lack of empathy, which can eventually lead to criminal behavior. In our narrative review, we are investigating the neurological differences in the function, structure, and connectivity of those with ASPD in comparison to those without, with a major focus on psychopathic cluster B populations of ASPD individuals. We reviewed 86 published articles, and five of these met the inclusion criteria for distinct psychopathic and non-psychopathic groups. After reviewing these sources, we found deficits in function and structure leading to a lack of empathy and adherence to social norms in individuals with ASPD. Currently, there are very few treatment options for those living with ASPD. It is our opinion that with a better understanding of the structural and functional differences in those with ASPD, we might see more efficacious treatment therapies for this population group in the medical community.
RESUMO
BACKGROUND: In April 2022, after a year of COVID-19 vaccination, there were large differences in coverage between urban and rural areas in Guatemala. To address barriers in rural communities, the "Health on Wheels" (HoW) strategy was implemented. The strategy deployed mobile brigades with a dedicated team of health workers and a culturally sensitive health promotion plan in selected communities in 15 districts in Alta Verapaz, a health area with low COVID-19 vaccination uptake and a high-level of COVID-19 vaccine hesitancy. This study evaluates the impact of the HoW strategy. METHODS: We measured the relative increase in COVID-19 doses administered prior and during the HoW implementation period in the 190 intervened communities and compared to 188 communities without the intervention. Communities were grouped by health district and the impact analyses were stratified by number of COVID-19 vaccine dose (1st, 2nd, and 3rd doses) and history of vaccine hesitancy. RESULTS: The increase in 1st, 2nd, and 3rd dose-COVID-19 vaccination coverage between before and during HoW implementation was 2.4, 2.2 and 2.6 times higher in intervened communities (20 %, 21 % and 37 % increase in 1st, 2nd and 3rd dose, respectively) than in non-intervened communities (8 %, 10 % and 14 % increase in 1st, 2nd and 3rd dose respectively). For the 1st dose, increase in dose administration was 2.9 times higher in intervened communities (n = 24) with hesitancy (24 % increase) compared to non-intervened communities (n = 188) without hesitancy (8 % increase). CONCLUSION: The deployment of mobile brigades with a dedicated team of vaccinators and culturally sensitive health promotion through the HoW strategy successfully accelerated the increase in COVID-19 vaccination coverage in rural communities in Guatemala.