A multisensory mindfulness experience: exploring the promotion of sensory awareness as a mindfulness practice.

Objectives: In this preliminary and multidisciplinary exploratory study, we assessed whether a mindfulness practice could be enhanced through a multisensory experience design that mimics the "beginner's mind," relying on sensory awareness and biofeedback processes as participants interact with the experience. Methods: We piloted and designed two conditions, being (a) a guided mindfulness practice based on the senses as an anchor to the present moment, using audio instruction only; and (b) an experience of mindfulness practice with successive sensory stimulation (olfactory, audio, and visual stimulation) followed by an interactive experience with biofeedback that provides a visual representation of the person's heartbeat in real-time. For each of the conditions we assessed anxiety (state and trait), as well as other psychological variables pre- and post-experience. Additionally, we measured the heart rate variability (HRV) at baseline, during each stage of the experience as well as post intervention. Results: We collected valid data for a total of 68 individuals. Both groups were similar regarding mean age, sex, and occupation and had similar prior experience with mindfulness. There were no significant differences regarding prior state or trait anxiety between the groups. Analysis of the physiological variables showed that for both groups there was an increase in the parasympathetic activity after the multisensory experience, with small differences in the conditions of stimulation. We did not observe significant differences between the pre and post measures for state of test anxiety. The observed parasympathetic activity variations after both experiences compared with pre and post-surveys demonstrate the importance of physiological vs psychological inspection beyond the common human rational experience that is not always resonate with the body's response and impacts the needed literacy to self-awareness of emotional well-being. Conclusion: Participants in both conditions could effectively connect with the experience, while achieving a physiological response different from their baseline state. The acceptance of the designed stimuli was very high, although more research is still needed to uncover its full potential. In sum, the design of multisensory experiences using technology to create an interactive connection with the sensory stimulus, is a promising field in mindfulness and especially in practices involving sensory awareness through the monitoring of parasympathetic activity as an inference indicator of the present-moment connection.

Latin America and the Caribbean Code Against Cancer 1st Edition: 17 cancer prevention recommendations to the public and to policy-makers (World Code Against Cancer Framework).

Preventable risk factors are responsible of at least 40% of cases and almost 45% of all cancer deaths worldwide. Cancer is already the leading cause of death in almost half of the Latin American and the Caribbean countries constituting a public health problem. Cost-effective measures to reduce exposures through primary prevention and screening of certain types of cancers are critical in the fight against cancer but need to be tailored to the local needs and scenarios. The Latin America and the Caribbean (LAC) Code Against Cancer, 1st edition, consists of 17 evidence-based recommendations for the general public, based on the most recent solid evidence on lifestyle, environmental, occupational, and infectious risk factors, and medical interventions. Each recommendation is accompanied by recommendations for policymakers to guide governments establishing the infrastructure needed to enable the public adopting the recommendations. The LAC Code Against Cancer has been developed in a collaborative effort by a large number of experts from the region, under the umbrella strategy and authoritative methodology of the World Code Against Cancer Framework. The Code is a structured instrument ideal for cancer prevention and control that aims to raise awareness and educate the public, while building capacity and competencies to policymakers, health professionals, stakeholders, to contribute to reduce the burden of cancer in LAC.

Latin America and the Caribbean Code Against Cancer 1st edition: Building capacity on cancer prevention to primary healthcare professionals.

INTRODUCTION: Every year 1.5 million new cancer cases are diagnosed in Latin America and the Caribbean (LAC). Of these, about 40 % could be prevented. Health illiteracy has been identified as a main barrier for cancer prevention. Primary healthcare professionals (HCP) are key in cancer prevention as they are the first entry point of the population into the healthcare system. The LAC Code Against Cancer 1st edition aims to improve health literacy and awareness of cancer prevention in the LAC population, through building capacity of primary HCP. METHODS: The definition and development of the learning objectives, curriculum, structure, and evaluation of an online learning program for primary HCP was led by a dedicated group of experts from the LAC Code Against Cancer project. A pedagogical guideline and a template to ensure harmonization across topics were produced to guide the program development. Two rounds of internal revisions and an editorial process were performed. RESULTS: An online competency-based microlearning program for primary HCP was produced, taking the LAC Code Against Cancer as a basis. The competences addressed in the curriculum are core knowledge, communication skills, decision-making and applying knowledge to real-world situations. A comprehensive evaluation to assess acquisition of these competences, based on the Miller's Pyramid, was designed with three data collection points: a) immediately before, to assess baseline knowledge and skills; b) immediately after, to determine acquired competences; and c) at 3-6 months follow-up, to assess performance in daily practice. The e-learning will be freely available in the Virtual Campus for Public Health of the Pan American Health Organization in Spanish, English, and Portuguese. CONCLUSION: Primary HCP, perceived as trustworthy sources of information, are key actors to increase the population's awareness and literacy on cancer prevention. Building capacity of these professionals has the potential to increase dissemination and impact of the LAC Code Against Cancer by prompting communication with the public and offering personalized actionable preventive messages through counselling.

Latin America and the Caribbean Code Against Cancer 1st edition: Formative research on the comprehension and persuasiveness of the recommendations by the general population.

BACKGROUND: Cancer prevention is the most efficient and cost-effective strategy in cancer control. One prevention strategy is giving credible, clear, and evidence-based recommendations to the individual; however, it is key that these messages are accepted and understood properly by the public. This study aimed to pilot the draft recommendations developed as part of the Latin America and the Caribbean (LAC) Code Against Cancer 1st edition, in terms of comprehension and persuasion of each message. METHODS: A mixed method two-wave study, in which two versions of the messages were presented to the general population in five LAC countries. We used an ad-hoc questionnaire and interviews that followed the cognitive-pretesting methodology. RESULTS: Findings suggest that the messages were generally well understood, especially in Spanish speaking countries, and that the messages were generally more understandable than persuasive. We adapted and revised the recommendations based on the findings of the first Wave and held a second iteration in the Spanish speaking countries. We observed a better understanding of most messages in Wave 2. CONCLUSION: The LAC Code Against Cancer is a valuable tool of well understood messages for the public, with concrete actions everyone can take to prevent cancer. Further research should assess particularities of the region for further efficient dissemination of these important health messages, identify key messages for certain population groups and future interventions that strengthen health literacy in rural and less educated populations to increase behavior change.

Sense of coherence, resilience, and habitual optimism in cancer patients

Background/Objective: The aim of this study was to investigate whether the three resource variables sense of coherence, resilience, and dispositional optimism become impaired when people are ill with cancer, whether there are sex and age differences in these variables, and how these variables are associated with quality of life (QoL). Method: A sample of 1108 patients with mixed cancer diagnoses were examined using the Sense of Coherence Scale-3 (SOC-3), the Brief Resilience Scale (BRS), the Life Orientation Test (LOT-R), and the QoL questionnaire EORTC QLQ-C30. Results: The three resource variables showed somewhat lower levels in the patients’ sample in comparison with general population controls, with effect sizes between −0.10 and −0.23. While there were only small sex differences in the resource variables, significant age differences were found in these variables, with stronger detriments in younger patients. The correlations among the resource variables ranged between .53 and .61. Sense of coherence was more strongly correlated with QoL than resilience and optimism. Conclusions: Cancer patients with low levels of personal resources adapt to their disease more poorly than patients with high levels. In addition to limitations in QoL, health care professionals should also consider patients’ resources for coping with the disease. Special attention should be given to young cancer patients. (AU)

"My Body, My Rhythm, My Voice": a community dance pilot intervention engaging breast cancer survivors in physical activity in a middle-income country.

BACKGROUND: Interventions to promote physical activity among women breast cancer survivors (BCS) in low- to middle-income countries are limited. We assessed the acceptability and preliminary effectiveness of a theory-driven, group-based dance intervention for BCS delivered in Bogotá, Colombia. METHODS: We conducted a quasi-experimental study employing a mixed-methods approach to assess the 8-week, 3 times/week group dance intervention. The effect of the intervention on participants' physical activity levels (measured by accelerometry), motivation to engage in physical activity, and quality of life were evaluated using generalized estimating equation analysis. The qualitative method included semi-structured interviews thematically analyzed to evaluate program acceptability. RESULTS: Sixty-four BCS were allocated to the intervention (n = 31) or the control groups (n = 33). In the intervention arm, 84% attended ≥ 60% of sessions. We found increases on average minutes of moderate-to-vigorous physical activity per day (intervention: +8.99 vs control: -3.7 min), and in ratings of motivation (intervention change score = 0.45, vs. control change score= -0.05). BCS reported improvements in perceived behavioral capabilities to be active, captured through the interviews. CONCLUSIONS: The high attendance, behavioral changes, and successful delivery indicate the potential effectiveness, feasibility, and scalability of the intervention for BCS in Colombia. TRIAL REGISTRATION: ClinicalTrial.gov NCT05252780, registered on Dec 7th, 2021-retrospectively registered unique protocol ID: P20CA217199-9492018.

Sense of coherence, resilience, and habitual optimism in cancer patients.

Background/Objective: The aim of this study was to investigate whether the three resource variables sense of coherence, resilience, and dispositional optimism become impaired when people are ill with cancer, whether there are sex and age differences in these variables, and how these variables are associated with quality of life (QoL). Method: A sample of 1108 patients with mixed cancer diagnoses were examined using the Sense of Coherence Scale-3 (SOC-3), the Brief Resilience Scale (BRS), the Life Orientation Test (LOT-R), and the QoL questionnaire EORTC QLQ-C30. Results: The three resource variables showed somewhat lower levels in the patients' sample in comparison with general population controls, with effect sizes between -0.10 and -0.23. While there were only small sex differences in the resource variables, significant age differences were found in these variables, with stronger detriments in younger patients. The correlations among the resource variables ranged between .53 and .61. Sense of coherence was more strongly correlated with QoL than resilience and optimism. Conclusions: Cancer patients with low levels of personal resources adapt to their disease more poorly than patients with high levels. In addition to limitations in QoL, health care professionals should also consider patients' resources for coping with the disease. Special attention should be given to young cancer patients.

Cross-sector co-creation of a community-based physical activity program for breast cancer survivors in Colombia.

Benefits of physical activity (PA) in breast cancer survivors (BCS) are well established. However, programs to promote PA among BCS tailored to real-world contexts within low- to middle-income countries are limited. Cross-sector co-creation can be key to effective and scalable programs for BCS in these countries. This study aimed to evaluate the networking process to engage multisector stakeholders in the co-creation of a PA program for Colombian BCS called My Body. We employed a mixed-methods design including semistructured interviews, workshops and a social network analysis of centrality measures to assess stakeholders' engagement, resources and skills enabling the collaborative work, challenges, outcomes and lessons learned. The descriptive analysis and the centrality measures of the network revealed that 19 cross-sector stakeholders engaged in the My Body collaborative network. Through ongoing communication and cooperation, My Body built relationships between the academic lead institutions (local and international), and local and national public, private and academic institutions working in public health, sports and recreation, social sciences and engineering fields. The outcomes included the co-creation of the community-based PA program for BCS, its implementation through cross-sector synergies, increased relationships and communications among stakeholders, and successful dissemination of evidence and project results to the collaboration partners and other relevant stakeholders and community members. The mixed-methods assessment enabled understanding of ways to advance cross-sector co-creation of health promotion programs. The findings can help to enable continued development of sustainable cross-sector co-creation processes aimed at advancing PA promotion.

Collaborative work among stakeholders and researchers from different governmental sectors and disciplinary fields can be key to design and implement effective and scalable programs to promote physical activity (PA) among breast cancer survivors (BCS). This might be particularly critical in low- to middle-income countries where the implementation of evidence-based health-promoting programs tailored to real-world contexts are limited. This study aimed to evaluate the networking process to engage multisector stakeholders in the co-creation of a PA program for Colombian BCS. We employed qualitative methods and social network analyses to assess stakeholders' engagement, resources and skills enabling the collaborative work, challenges, outcomes and lessons learned. The co-creation of the program improved synergies between research, policy and practice. Communication through several channels including e-mail and workshops was the key resource to advance the collaborative work. Stakeholders underscored that cross-sector networking allowed allocating resources and achieving shared goals. Sustainable cross-sector collaborative processes are key for health promotion.

Psychometric evaluations of the Life Orientation Test-Revised (LOT-R), based on nine samples.

OBJECTIVE: The aim of this study was to examine psychometric properties of the Life Orientation Test-Revised (LOT-R). DESIGN AND MAIN OUTCOME MEASURES: The LOT-R was administered in five clinical samples, three samples of the adult general population, and one sample of adolescents. Seven of the studies were performed in Germany and two in Colombia. All of the sample sizes were above 300. RESULTS: Cronbach's alpha coefficients were between .57 and .75 for the eight adult samples, the correlations between the scales optimism and pessimism ranged from -.05 to -.37, and the coefficients of temporal stability (test-retest correlations) of the scales ranged from .43 to .69. There were no systematic age and gender effects observed in the nine studies. While the one-factor model of confirmatory factor analyses showed clearly insufficient fit indices among all of the samples, the two-factor model fit was markedly better. CONCLUSIONS: The LOT-R proved to be a suitable instrument for measuring dispositional optimism in patients and in the general population, though the sum score should be viewed with caution. Studies comparing the LOT-R mean scores of different samples need not take age and gender distributions into account.

Psychometric Properties of the Multidimensional Fatigue Inventory (MFI-20), Derived From Seven Samples.

CONTEXT: Fatigue is a frequent symptom in patients suffering from chronic diseases. The Multidimensional Fatigue Inventory (MFI-20) is often used to measure fatigue. The aim of this article was to test the scale structure of the questionnaire. METHODS: The MFI-20 data were obtained from seven samples, including general population samples and samples of patients with different diseases (N between 122 and 1993). Five confirmatory factor analysis (CFA) models were tested for each sample. RESULTS: The scale structure postulated by the original test authors could not be confirmed by the CFAs. The inclusion of a method factor which considers the positive versus the negative orientation of the items yielded a better model fit. Cronbach's alpha was acceptable for most of the samples and scales: the total score of the MFI-20 reached alpha coefficients above 0.89. A short form of the MFI-20 which is restricted to the 10 positively oriented items (MFI-10) showed relatively good CFA indices. CONCLUSION: The factorial validity of the MFI-20 is insufficient, an issue which is due, at least in part, to the inclusion of positively and negatively oriented items. Nevertheless, we recommend maintaining the scale structure of the MFI-20 and not searching for alternative structures.

Quality of life in breast cancer patients: Associations with optimism and social support.

Background/Objective: The purpose of this study was to examine quality of life (QoL) in breast cancer patients from Colombia and to explore the relationship between QoL, habitual optimism, and social support. Method: A sample of 95 breast cancer patients treated in a hospital in Bogotá were administered the QoL instrument EORTC QLQ-C30 and the Life Orientation Test LOT-R. Additionally, they were asked to indicate from whom (physicians, friends, nurses, etc.) they wished and received social support. Reference data for the EORTC QLQ-C30 and the LOT-R were taken from a representative sample of the general Colombian population. Results: The breast cancer patients showed detriments to their QoL on most functioning scales and symptom scales of the EORTC QLQ-C30, while their general assessments of health and QoL were not worse than those of the controls. Optimism was positively correlated with QoL. Most patients wanted and received social support from their physicians and friends/family. Conclusions: The results suggest that optimism helps patients better cope with disease. A general assessment of global QoL cannot replace the more specific assessments of the functioning domains and symptoms.

Antecedentes/Objetivo: El objetivo del estudio fue examinar la calidad de vida (QoL, por sus siglas en inglés) en pacientes con cáncer de mama colombianas, y explorar la asociación entre calidad de vida, optimismo disposicional y apoyo social. Método: Se entrevistó una muestra de 95 pacientes con cáncer de mama tratadas en un hospital de Bogotá y les fue aplicado el instrumento de medición de calidad de vida EORTC QLQ-C30 y el test de orientación ante la vida (LOT-R). Adicionalmente, se preguntó acerca de su apoyo social usando varias preguntas. Resultados: En la mayoría de las escalas de funcionamiento del EORTC QLQ-C30 y de las escalas de síntomas, las pacientes con cáncer mostraron detrimentos en su QoL, mientras en la evaluación general de calidad de vida y salud las medias de las pacientes no fueron más bajas que las de los controles. El optimismo estuvo positivamente correlacionado con la calidad de vida. La mayoría de las pacientes desearon y recibieron apoyo social de su médico y de sus amigos/familiares. Conclusiones: Los resultados sugieren que el optimismo ayuda a las pacientes a afrontar mejor la enfermedad. Una evaluación general de la QoL no parece poder sustituir la evaluación más específica de los síntomas y dominios de funcionamiento.

Quality of life in breast cancer patients: Associations with optimism and social support / Calidad de vida en pacientes con cáncer de mama: asociación con optimismo y apoyo social

Background/Objective: The purpose of this study was to examine quality of life (QoL) in breast cancer patients from Colombia and to explore the relationship between QoL, habitual optimism, and social support. Method: A sample of 95 breast cancer patients treated in a hospital in Bogotá were administered the QoL instrument EORTC QLQ-C30 and the Life Orientation Test LOT-R. Additionally, they were asked to indicate from whom (physicians, friends, nurses, etc.) they wished and received social support. Reference data for the EORTC QLQ-C30 and the LOT-R were taken from a representative sample of the general Colombian population. Results: The breast cancer patients showed detriments to their QoL on most functioning scales and symptom scales of the EORTC QLQ-C30, while their general assessments of health and QoL were not worse than those of the controls. Optimism was positively correlated with QoL. Most patients wanted and received social support from their physicians and friends/family. Conclusions: The results suggest that optimism helps patients better cope with disease. A general assessment of global QoL cannot replace the more specific assessments of the functioning domains and symptoms (AU)

Antecedentes/Objetivo: El objetivo del estudio fue examinar la calidad de vida (QoL, por sus siglas en inglés) en pacientes con cáncer de mama colombianas, y explorar la asociación entre calidad de vida, optimismo disposicional y apoyo social. Método: Se entrevistó una muestra de 95 pacientes con cáncer de mama tratadas en un hospital de Bogotá y les fue aplicado el instrumento de medición de calidad de vida EORTC QLQ-C30 y el test de orientación ante la vida (LOT-R). Adicionalmente, se preguntó acerca de su apoyo social usando varias preguntas. Resultados: En la mayoría de las escalas de funcionamiento del EORTC QLQ-C30 y de las escalas de síntomas, las pacientes con cáncer mostraron detrimentos en su QoL, mientras en la evaluación general de calidad de vida y salud las medias de las pacientes no fueron más bajas que las de los controles. El optimismo estuvo positivamente correlacionado con la calidad de vida. La mayoría de las pacientes desearon y recibieron apoyo social de su médico y de sus amigos/familiares. Conclusiones: Los resultados sugieren que el optimismo ayuda a las pacientes a afrontar mejor la enfermedad. Una evaluación general de la QoL no parece poder sustituir la evaluación más específica de los síntomas y dominios de funcionamiento (AU)

Cross-cultural measurement invariance of the General Health Questionnaire-12 in a German and a Colombian population sample.

While the General Health Questionnaire, 12-item version (GHQ-12) has been widely used in cross-cultural comparisons, rigorous tests of the measurement equivalence of different language versions are still lacking. Thus, our study aims at investigating configural, metric and scalar invariance across the German and the Spanish version of the GHQ-12 in two population samples. The GHQ-12 was applied in two large-scale population-based samples in Germany (N = 1,977) and Colombia (N = 1,500). To investigate measurement equivalence, confirmatory factor analyses were conducted in both samples. In the German sample mean GHQ-12 total scores were higher than in the Colombian sample. A one-factor model including response bias on the negatively worded items showed superior fit in the German and the Colombian sample; thus both versions of the GHQ-12 showed configural invariance. Factor loadings and intercepts were not equal across both samples; thus GHQ-12 showed no metric and scalar invariance. As both versions of the GHQ-12 did not show measurement equivalence, it is not recommendable to compare both measures and to conclude that mental distress is higher in the German sample, although we do not know if the differences are attributable to measurement problems or represent a real difference in mental distress. The study underlines the importance of measurement equivalence in cross-cultural comparisons.

Standardization of the Beck Hopelessness Scale in the general population.

BACKGROUND: The Beck Hopelessness Scale (BHS) is a self-report instrument for the quantification of hopelessness in nonpsychiatric, as well as psychiatric patients. Hopelessness is a key psychological variable in suicide prediction. Until now the psychometric properties of the instrument have not been studied in a representative sample of the general population. AIMS: The objectives of the study were to generate normative data and to further investigate the construct validity and factorial structure of the BHS. METHODS: A nationally representative face-to-face household survey was conducted in Colombia in 2012 (N = 1500). RESULTS: Cronbach's alpha coefficient for the BHS was 0.81. Confirmatory factor analysis supported a three-factor model, achieving good fit indices (total sample: RMSEA = 0.043, CFI = 0.936, TLI = 0.921). Normative data for the BHS were generated for both genders and different age levels. Intercorrelations with hopelessness were highest for depression (r = 0.57), followed by anxiety (r = 0.52). CONCLUSIONS: The normative data provide a framework for the interpretation and comparisons of the BHS with other populations. Evidence supports reliability and validity of the three-factor BHS as a measure of hopelessness in the general population.

Is the General Self-Efficacy Scale a Reliable Measure to be used in Cross-Cultural Studies? Results from Brazil, Germany and Colombia.

This study evaluated cross-cultural measurement invariance for the General Self-efficacy Scale (GSES) in a large Brazilian (N = 2.394) and representative German (N = 2.046) and Colombian (N = 1.500) samples. Initially, multiple-indicators multiple-causes (MIMIC) analyses showed that sex and age were biasing items responses on the total sample (2 and 10 items, respectively). After controlling for these two covariates, a multigroup confirmatory factor analysis (MGCFA) was employed. Configural invariance was attested. However, metric invariance was not supported for five items, in a total of 10, and scalar invariance was not supported for all items. We also evaluated the differences between the latent scores estimated by two models: MIMIC and MGCFA unconstraining the non-equivalent parameters across countries. The average difference was equal to |.07| on the estimation of the latent scores, and 22.8% of the scores were biased in at least .10 standardized points. Bias effects were above the mean for the German group, which the average difference was equal to |.09|, and 33.7% of the scores were biased in at least .10. In synthesis, the GSES did not provide evidence of measurement invariance to be employed in this cross-cultural study. More than that, our results showed that even when controlling for sex and age effects, the absence of control on items parameters in the MGCFA analyses across countries would implicate in bias of the latent scores estimation, with a higher effect for the German population.

Is the general self-efficacy scale a reliable measure to be used in cross-cultural studies? Results from Brazil, Germany and Colombia

This study evaluated cross-cultural measurement invariance for the General Self-efficacy Scale (GSES) in a large Brazilian (N = 2.394) and representative German (N = 2.046) and Colombian (N = 1.500) samples. Initially, multipleindicators multiple-causes (MIMIC) analyses showed that sex and age were biasing items responses on the total sample (2 and 10 items, respectively). After controlling for these two covariates, a multigroup confirmatory factor analysis (MGCFA) was employed. Configural invariance was attested. However, metric invariance was not supported for five items, in a total of 10, and scalar invariance was not supported for all items. We also evaluated the differences between the latent scores estimated by two models: MIMIC and MGCFA unconstraining the non-equivalent parameters across countries. The average difference was equal to (.07) on the estimation of the latent scores, and 22.8% of the scores were biased in at least .10 standardized points. Bias effects were above the mean for the German group, which the average difference was equal to (.09), and 33.7% of the scores were biased in at least .10. In synthesis, the GSES did not provide evidence of measurement invariance to be employed in this cross-cultural study. More than that, our results showed that even when controlling for sex and age effects, the absence of control on items parameters in the MGCFA analyses across countries would implicate in bias of the latent scores estimation, with a higher effect for the German population (AU)

No disponible

Standardization of the Colombian version of the PHQ-4 in the general population.

BACKGROUND: The PHQ-4 is a widely used open access screening instrument for depression and anxiety in different health care and community settings; however, empirical evidence of its psychometric quality in Colombia is lacking. The objectives of the current study were to generate normative data and to further investigate the construct validity and factorial structure of the PHQ-4 in the general population. METHODS: A nationally representative face-to-face household survey was conducted in Colombia in 2012 (n = 1,500). The item characteristics of the PHQ-4 items, including the inter-item correlations and inter-subscale correlations, were investigated. To measure the scale's reliability, the internal consistency (Cronbach's α) was assessed. For factorial validity, the factor structure of the PHQ-4 was examined with confirmatory factor analysis (CFA). RESULTS: The Cronbach's alpha coefficient for the PHQ-4 was 0.84. The confirmatory factor analysis supported a two-factor model, which was structurally invariant between different age and gender groups. Normative data for the PHQ-4 were generated for both genders and different age levels. Women had significantly higher mean scores compared with men [1.4 (SD: 2.1) vs. 1.1 (SD: 1.9), respectively]. The results supported the discriminant validity of the PHQ-4. CONCLUSIONS: The normative data provide a framework for the interpretation and comparisons of the PHQ-4 with other populations in Colombia. The evidence supports the reliability and validity of the two-factor PHQ-4 as a measure of anxiety and depression in the general Colombian population.

Anxiety and depression in the general population in Colombia: reference values of the Hospital Anxiety and Depression Scale (HADS).

PURPOSE: The objective of this study was to generate normative values and to test psychometric properties of the Hospital Anxiety and Depression Scale (HADS) for the general population of Colombia. While there are several normative studies in Europe, Latin American normative values are missing. The identification of people with mental distress requires norms obtained for the specific country. METHODS: A representative face-to-face household study (n = 1,500) was conducted in 2012. The survey questionnaire contained the HADS, several other questionnaires, and sociodemographic variables. RESULTS: HADS mean values (anxiety: M = 4.61 ± 3.64, depression: M = 4.30 ± 3.91) were similar to those reported from European studies. Females were more anxious and depressed than males. The depression scale showed a nearly linear age dependency with increasing scores for old people. Mean scores and percentiles (75 and 90%) are presented for each age decade for both genders. Both anxiety and depression correlated significantly with the total score of the multidimensional fatigue inventory and with the mental component summary score of the quality of life questionnaire SF-8. Internal consistency coefficients of both scales were satisfying, but confirmatory factorial analysis results only partially supported the two-dimensional structure of the questionnaire. CONCLUSION: This study supports the reliability of the HADS in one Latin American country. The normative scores can be used to compare a patient's score with those derived from a reference group. However, the generalizability to other Latin American regions requires further research.

Cuando el cáncer de seno no significa insatisfacción sexual. Un estudio comparativo / No disponible

El cáncer de seno es considerado un problema de salud pública, en la medida en que actualmente se presenta como uno de los factores más comunes de morbimortalidad en mujeres de países de todo el mundo, y de Colombia. Aunque se haya verificado un aumento importante en el número de sobrevivientes de cáncer de seno, la vivencia de esta enfermedad puede comprometer aspectos relacionados con la sexualidad, lo que implica atribuir mayor relevancia a los procesos de adaptación psicosocial, y a su impacto en la calidad de vida de estas mujeres. Este estudio busca evaluar los niveles de satisfacción sexual de pacientes con cáncer de seno. Para esto, se recolectaron datos de 100 mujeres sanas y de 84 pacientes con diagnóstico de cáncer de seno, en un hospital universitario en la ciudad de Bogotá. Se aplicó el Index of Sexual Satisfaction (ISS) y el Suplementary Questionnaire Breast Cancer Module (EORTC, QLQ BR-23). Los resultados mostraron que existen diferencias significativas en el nivel de insatisfacción sexual en los dos grupos (t(156)=9,33, p<0,001), pero contrario a lo que se esperaba, las pacientes se encuentran menos insatisfechas con su sexualidad (M=24,6, SD=17,5), en comparación con el grupo de mujeres sanas (M=46,9, SD=12,4). Los tratamientos que más se asocian con la insatisfacción sexual son la radioterapia (M=26,2, SD=16,6) y la terapia hormonal (M=26,3, SD=16,8) pero los resultados no fueron estadísticamente significativos. El disfrute (r=-0,542, p=0,01), el interés en el sexo (r=-0,285, p=0,015) y la vida sexual activa (r=-0,240, p=0,04) parecen ser aspectos protectores en cuanto al nivel de satisfacción sexual en las mujeres. El proceso de ajuste a la enfermedad puede variar de acuerdo a las características de la paciente, de la enfermedad, y del trascurso de la misma, lo que lleva a concluir que un diagnóstico de esta naturaleza es de carácter multidimensional. Asimismo, la reinterpretación de los acercamientos entre la pareja, el ofrecimiento de apoyo y la valoración de la relación como satisfactoria, pueden mediar la interpretación de la vida sexual. Más allá de los aspectos físicos presentes en el nivel de satisfacción sexual, existen otros aspectos de orden emocional que pueden llegar a predecir la satisfacción reportada por la persona (AU)

Breast cancer is currently considered a public health problem, since it is one of the most common factors of morbidity and mortality in women in countries around the world, and also in Colombia. Although there has been an increase in the number of breast cancer survivors, the experience of the disease may compromise sexuality aspects, which highlights the importance of the process of psychological adaptation, and its impact on the quality of life of these women. This study aims to assess the levels of sexual dissatisfaction in patients with breast cancer. For this purpose, 100 healthy women were interviewed and their answers were compared to those of 84 patients diagnosed with breast cancer, contacted through a university hospital in Bogotá. The Index of Sexual Satisfaction (ISS) and the Supplementary Questionnaire Breast Cancer Module (EORTC QLQ BR-23) were applied. The results showed significant differences in the level of sexual dissatisfaction in both groups (t(156)= 9.33, p<0.001), where the group of patients was less dissatisfied with their sexuality (M=24.6, SD=17.5), compared with the group of healthy women (M=46.9, SD=12.4). The treatments that are mostly associated with sexual dissatisfaction are (AU)

Ambivalent attitudes towards pre-implantation genetic diagnosis in Germany.

BACKGROUND: Pre-implantation genetic diagnosis (PGD) is a modern technique in reproductive medicine which can be used to diagnose genetic disorders of an embryo. PGD is currently not legal in Germany, still there are debates being held regarding the issue of legalization. Both the internationally "accepted" indications and new or alternative approaches can lead to complex ethical dilemmas. The attitudes towards PGD have rarely been assessed in the general population. METHODS: In our study, 2110 persons aged 18-50 years were interviewed about their attitudes towards PGD and related topics. We assumed that religion, world views and the evaluation of PGD would influence the attitude a person has towards this procedure. RESULTS AND CONCLUSIONS: In our survey, the majority of respondents would agree to a restricted legalization of PGD in Germany. Our results also confirmed some of our assumptions but religion did not have the expected influence. The evaluation of costs and benefits of PGD and the feelings associated with this technique explained more of the final attitude whether PGD should remain prohibited in Germany or not. The agreement to a restricted legalization may be connected to an overall rejection of prohibitions made by the state concerning the individual reproductive autonomy.