Feasibility, acceptability, and perceived usefulness of a community-evidence-based harm reduction intervention for sexualized stimulant use among Mexican gay, bisexual, and other men who have sex with men.

BACKGROUND: The use of stimulants and other substances with the purpose of enhancing, maintaining, and prolonging sexual activity is known as sexualized substance use. Also known as chemsex, this pattern of use has been mainly explored in high-income countries. The aim of this article was to assess the feasibility, acceptability, and usefulness of a community- evidence-based harm reduction intervention among Mexican gay, bisexual, and other men who have sex with men (gbMSM) adults who reported sexualized stimulant use in the past 6 months and who were not enrolled in any psychosocial treatment. METHODS: The in-person intervention was designed in partnership with gbMSM who used substances. It consisted of 39 harm reduction strategies before, during, and after episodes of use. The components of the intervention were health and self-care, safety, and psychopharmacology. The intervention was delivered at a university campus, a public recreational space, and an HIV public clinic. Feasibility to deliver the intervention was assessed based on enrolment and completion rates; acceptability through a 28-item, 5-point Likert scale (140 max.) constructed and validated for the Mexican population with good reliability coefficients; usefulness through a 5-point Likert scale ("not useful"-"very useful") for each of the 39 strategies; and potential behavioral change by subtracting the likelihood of implementing each strategy minus the frequency of use of the technique before the intervention. RESULTS: Participants (n = 19; recruitment rate = 35.2%; completion rate = 84.2%) rated the intervention as acceptable with a mean score of 121.6 (SD = 7.5). The highest potential for behavioral change was regarding the use of information about the half-life of stimulants, polysubstance use, and overdose prevention. CONCLUSIONS: This intervention is feasible when provided within public health services where potential participants are already in contact. Harm reduction strategies need to surpass sexually transmitted infections prevention and HIV care and focus on substance use and mental health strategies.

The emergence of Urban Community Resilience Initiatives During the COVID-19 Pandemic: An International Exploratory Study.

All over the world, urban communities take initiative in order to cope with the COVID-19 pandemic. This study conducts a literature review and an international exploratory study in order to identify pathways within which Community Resilience Initiatives (CRIs) emerge within different governance contexts. The CRIs target vulnerable communities, which are hard to reach. Our study results identify four pathways: (1) informal bottom-up community initiatives; (2) formal community initiatives emerging out of existing community-based initiatives; (3) initiatives of external actors, often NGOs, universities or governments and (4) networks of organisations whom together initiate action in response to COVID-19. The pathways lead to different types, scales and complexities of the initiatives. However, all face similar barriers related to funding, weak networks and limited cooperation. CRIs often perceive the government agencies to be unreliable and unsupportive which in turn also hampers CRI's emergence.

Partout dans le monde, les communautés urbaines prennent des initiatives pour faire face à la pandémie de COVID-19. Cette étude mène une revue de la littérature et une étude exploratoire internationale afin d'identifier les voies par lesquelles les initiatives de résilience communautaire (IRC) émergent dans différents contextes de gouvernance. Les IRC ciblent les communautés vulnérables, qui sont difficiles à atteindre. Les résultats de notre étude identifient quatre voies: (1) les initiatives communautaires informelles ascendantes; (2) les initiatives communautaires formelles issues d'initiatives communautaires pré-existantes; (3) les initiatives d'acteurs externes, souvent des ONG, des universités ou des gouvernements; et (4) les réseaux d'organisations qui, ensemble, entreprennent des actions en réponse à la COVID-19. Ces voies mènent à des initiatives de type, d'échelle et de niveaux de complexité différents. Cependant, elles sont toutes confrontées à des obstacles similaires liés au financement, à la faiblesse des réseaux et à une collaboration limitée. Les IRC perçoivent souvent les agences gouvernementales comme étant peu fiables et peu sources de soutien, ce qui freine également l'émergence du CRI.

[Clozapine in epilepsy and psychosis: effects on seizures and metabolic profile]. / Clozapina en epilepsia y psicosis: efectos en las crisis epilépticas y en el perfil metabólico.

Background: Clozapine (CZP) is an antipsychotic used in resistant psychosis, but has adverse metabolic effects and is associated with new onset or worsening of epileptic seizures (ES). There is not enough information available regarding its effect on metabolic variables and on ES in patients with epilepsy. Objective: To describe the effect of CZP on the metabolic and hematologic profiles, and on ES in patients with epilepsy and with psychosis and/or aggressive behavior. Methods: A case series of patients with epilepsy and psychosis and/or aggressive behavior that received CZP with an 18-week follow-up. Clinical records were assessed from 2008-2018. 30 patients with epilepsy that received CZP were included. A paired analysis (Student's t-test or Wilcoxon signed rank test) was performed with metabolic variables (glucose, cholesterol, and triglycerides), hematologic variables, weight, body mass index (BMI), and monthly ES before and after CZP administration. Results: The median age to CZP initiation was 31.9 ± 16.07 years. Median CZP dosage was 193 mg/day. There were changes on BMI (p = 0.001; 3.2 kg/m2 increase, median = 3.08), triglycerides (p = 0.002) and glucose (p = 0.030). Weight increase was 7 kg (p = 0.292; median = 4 kg). Monthly ES mean was decreased from 4.9 (median = 2) to 2.04 (median = 1; p = 0.001). Conclusions: This study provide information regarding the security profile of CZP in patients with epilepsy with psychosis and/or aggressive behavior. A decrease on monthly ES was observed, as well as moderate increases in triglycerides, glucose and BMI, which coincide with that described by other authors.

Introducción: La clozapina (CZP) es un antipsicótico efectivo en la psicosis que no responde a otros antipsicóticos, pero tiene efectos metabólicos adversos y se relaciona con la generación de crisis epilépticas (CE). Existe poca información sobre su efecto en variables metabólicas y sobre las CE en pacientes con epilepsia. Objetivo: Describir el efecto de la CZP en el perfil metabólico, el perfil hematológico y la frecuencia de CE en pacientes con epilepsia y con psicosis o agresividad. Método: Serie de casos de pacientes con epilepsia y psicosis o agresividad que recibieron CZP con un seguimiento de 18 semanas. Se revisaron los expedientes clínicos de 2008-2018. Se incluyeron 30 pacientes con epilepsia que recibieron CZP. Se hizo una comparación pareada (prueba t de Student o de signo y rango de Wilcoxon), antes y después del inicio de la CZP, de las variables metabólicas (glucosa, colesterol y triglicéridos) y hematológicas, el peso, el índice de masa corporal (IMC) y las CE mensuales. Resultados: La edad media al iniciar la CZP fue de 31.9 ± 16.07 años. La dosis media fue 193 mg/día. Hubo incremento en el IMC (p = 0.001; aumento de 3.2 kg/m2; mediana = 3.08), los triglicéridos (p = 0.002) y la glucosa (p = 0.030). La ganancia de peso fue de 7 ± 10.4 kg (p = 0.292; mediana = 4 kg). El promedio de CE mensuales se redujo de 4.9 (mediana = 2) a 2.04 (p = 0.001; mediana = 1). Conclusiones: Este estudio aporta información del perfil de seguridad del uso de CZP en pacientes con epilepsia y psicosis o agresividad. Se observó una disminución en la frecuencia mensual de CE, así como aumentos moderados de los triglicéridos, la glucosa y el IMC, que coinciden con lo descrito por otros autores.

Análisis bibliométrico de los problemas de comportamiento externalizado en niños y adolescentes de la ciudad de Bogotá (2003-2013) / Bibliometric analysis of externalizing behavior problems in childrenand adolescents of Bogota city (2003-2013)

El objetivo del presente estudio fue realizar un análisis bibliométrico de los trabajos de investigación de pregrado y posgrado que sobre los problemas de comportamiento externalizado en niños y adolescentes se llevaron a cabo en universidades y fundaciones universitarias de Bogotá (Colombia) entre los años 2003 y 2013. Para ello se diseñó y validó por parte de cinco jueces expertos una ficha de análisis, que incluyó las siguientes variables: título, año, autores, directores, universidad, nivel de formación, palabras clave, tipo de problemática, diseño de investigación, edad y población. En total se analizaron veintiún trabajos de grado correspondientes a ocho instituciones de educación superior de la ciudad de Bogotá, entre las cuales se pudo identificar que con relación al nivel de formación se evidenció que pregrado y maestría fueron las que más abordaron este tema. Entre los años 2010-2013 se realizó un mayor número de investigaciones sobre esta problemática y finalmente se encontró que la población que más se caracterizó en los trabajos de grado fueron los adolescentes

The objective of this research was to conduct a bibliometric analysis of the undergraduate and graduate research projects about problems of externalizing behavior in children and adolescents. This information was gathered in universities and colleges from Bogota (Colombia) from 2003 to 2013. Five expert judges validated an analysis index card that we designed which included the following variables: title, year, authors, directors, university, level of training, keywords, type of problem, type of research, age, and population. Altogether, twenty-one papers were analyzed corresponding to eight institutions in Bogota, where it was evidenced that in regard the level of training; undergraduate and master levels were those who mostly discussed this topic. Along 2010 and 2013, a large number of investigations on this issue were made and finally it was found that the population that was mentioned the most in the research projects was the adolescents