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PLOS Global Public Health 2024Combination HIV prevention packages have reduced HIV incidence and improved HIV-related outcomes among young people. However, there is limited data on how package...
Combination HIV prevention packages have reduced HIV incidence and improved HIV-related outcomes among young people. However, there is limited data on how package components interact to promote HIV-related prevention behaviours. We described the uptake of HIV prevention interventions supported by Determined, Resilient, Empowered, AIDS-free, Motivated and Safe (DREAMS) Partnership and assessed the association between uptake and HIV-related behaviours among young people in rural KwaZulu-Natal, South Africa. We analysed two cohorts followed from May 2017 to December 2019 to evaluate the impact of DREAMS, covering 13-29 year-old females, and 13-35 year-old males. DREAMS interventions were categorised as healthcare-based or social. We described the uptake of interventions and ran logistic regression models to investigate the association between intervention uptake and subsequent protective HIV-related outcomes including no condomless sex and voluntary medical male circumcision (VMMC). For each outcome, we adjusted for socio-demographics and sexual/pregnancy history and reported adjusted odds ratios (aOR) and 95% confidence intervals (CI). Among 5248 participants, uptake of healthcare interventions increased from 2018 to 2019 by 8.1% and 3.7% for males and females respectively; about half of participants reported receiving both healthcare and social interventions each year. The most utilised combinations of interventions included HIV testing and counselling, school-based HIV education and cash transfers. Participation in social interventions only compared to no intervention was associated with reduced condomless sex (aOR = 1.60, 95%CI: 1.03-2.47), while participation in healthcare interventions only was associated with increased condomless sex. The uptake of interventions did not significantly affect subsequent VMMC overall. Among adolescent boys, exposure to school-based HIV education, cash transfers and HIV testing and counselling was associated with increase in VMMC (aOR = 1.79, 95%CI: 1.04-3.07). Multi-level HIV prevention interventions were associated with an increase in protective HIV-related behaviours emphasizing the importance of accessible programs within both school and community settings for young people.
PubMed: 38820546
DOI: 10.1371/journal.pgph.0003258 -
Journal of Vision May 2024Perceptual reality monitoring refers to the ability to distinguish internally triggered imagination from externally triggered reality. Such monitoring can take place at...
Perceptual reality monitoring refers to the ability to distinguish internally triggered imagination from externally triggered reality. Such monitoring can take place at perceptual or cognitive levels-for example, in lucid dreaming, perceptual experience feels real but is accompanied by a cognitive insight that it is not real. We recently developed a paradigm to reveal perceptual reality monitoring errors during wakefulness in the general population, showing that imagined signals can be erroneously attributed to perception during a perceptual detection task. In the current study, we set out to investigate whether people have insight into perceptual reality monitoring errors by additionally measuring perceptual confidence. We used hierarchical Bayesian modeling of confidence criteria to characterize metacognitive insight into the effects of imagery on detection. Over two experiments, we found that confidence criteria moved in tandem with the decision criterion shift, indicating a failure of reality monitoring not only at a perceptual but also at a metacognitive level. These results further show that such failures have a perceptual rather than a decisional origin. Interestingly, offline queries at the end of the experiment revealed global, task-level insight, which was uncorrelated with local, trial-level insight as measured with confidence ratings. Taken together, our results demonstrate that confidence ratings do not distinguish imagination from reality during perceptual detection. Future research should further explore the different cognitive dimensions of insight into reality judgments and how they are related.
Topics: Humans; Imagination; Male; Female; Adult; Bayes Theorem; Young Adult; Metacognition; Photic Stimulation; Visual Perception
PubMed: 38814936
DOI: 10.1167/jov.24.5.13 -
Journal of Sleep Research May 2024The world-wide prevalence of insomnia disorder reaches up to 10% of the adult population. Women are more often afflicted than men, and insomnia disorder is a risk factor... (Review)
Review
The world-wide prevalence of insomnia disorder reaches up to 10% of the adult population. Women are more often afflicted than men, and insomnia disorder is a risk factor for somatic and mental illness, especially depression and anxiety disorders. Persistent hyperarousals at the cognitive, emotional, cortical and/or physiological levels are central to most theories regarding the pathophysiology of insomnia. Of the defining features of insomnia disorder, the discrepancy between minor objective polysomnographic alterations of sleep continuity and substantive subjective impairment in insomnia disorder remains enigmatic. Microstructural alterations, especially in rapid eye movement sleep ("rapid eye movement sleep instability"), might explain this mismatch between subjective and objective findings. As rapid eye movement sleep represents the most highly aroused brain state during sleep, it might be particularly prone to fragmentation in individuals with persistent hyperarousal. In consequence, mentation during rapid eye movement sleep may be toned more as conscious-like wake experience, reflecting pre-sleep concerns. It is suggested that this instability of rapid eye movement sleep is involved in the mismatch between subjective and objective measures of sleep in insomnia disorder. Furthermore, as rapid eye movement sleep has been linked in previous works to emotional processing, rapid eye movement sleep instability could play a central role in the close association between insomnia and depressive and anxiety disorders.
PubMed: 38811745
DOI: 10.1111/jsr.14252 -
Nursing Reports (Pavia, Italy) Apr 2024Music evokes positive emotions and reduces stress and anxiety. Operating room (OR) staff face various challenges which can lead to high levels of stress. The aim of the...
BACKGROUND
Music evokes positive emotions and reduces stress and anxiety. Operating room (OR) staff face various challenges which can lead to high levels of stress. The aim of the study is to assess whether listening to music during intraoperative phases improves the work environment by reducing anxiety and stress in the entire surgical team.
METHODS
A prospective observational study was conducted from February to September 2023, involving medical personnel, nursing staff, and nursing students. They were divided into two groups: Group 1 with music during surgical procedures, and Group 2 without music. Participants were administered two validated instruments: the Zung Anxiety Self-Assessment Scale (SAS) to measure anxiety, and the Positive and Negative Affect Schedule to assess emotions generating stress. Additional items were included for demographics, job satisfaction, and the organization method.
RESULTS
Music did not impact anxiety, but increased positive emotions while reducing negative ones. Music had an ancillary effect, highlighting the need for significant organizational interventions aimed at increasing operator satisfaction, including offering voluntary instead of mandatory assignments to nursing staff.
CONCLUSIONS
Music appears to reduce stress in the intraoperative team when supported by a positive work environment in which assigned operators have chosen to work in the OR.
PubMed: 38804415
DOI: 10.3390/nursrep14020082 -
Frontiers in Rehabilitation Sciences 2024Bilateral microprocessor-controlled prosthetic knee (MPK) users have unique needs in traversing environmental barriers compared to unilateral users. An enhancement to...
An enhancement of the Genium™ microprocessor-controlled knee improves safety and different aspects of the perceived prosthetic experience for unilateral and bilateral users.
INTRODUCTION
Bilateral microprocessor-controlled prosthetic knee (MPK) users have unique needs in traversing environmental barriers compared to unilateral users. An enhancement to the Genium™/Genium X3™ MPK which included an updated ruleset, hydraulics, and new bilateral parameter presets was made to improve safety while stumbling and the smoothness of gait for all users while also improving the experience of bilateral users. The purpose of the study was to evaluate the effectiveness of the enhancements in a sample with unilateral and bilateral amputation.
METHODS
A convenience sample of MPK users was recruited from two sites in the USA in two phases. Assessments included the -Test of Functional Mobility, Activity-specific Balance Confidence Scale, Prosthetic Limb User Survey of Mobility, a study-specific questionnaire, and the Comparative Activities of Daily Living (ADL) Questionnaire. Statistical significance of extracted data was tested with the Wilcoxon Rank-Sum Test for independent data and Wilcoxon Signed-Rank for paired data with an significance level of < 0.05. Unilateral subjects were age-matched to the group of bilateral subjects for between-groups and within-groups analyses.
RESULTS
Twenty-six subjects (= 26) were enrolled. Stumble frequency reduced 85% from 16.0 ± 39.7 to 2.4 ± 2.3 (= 0.008) between baseline and final assessment overall. The bilateral group reported 50% ( = 0.009) and 57% ( = 0.009) greater relative improvement in patient-reported ease and safety, respectively, of completing ADLs compared to the unilateral group. The unilateral group reported residual limb pain and low back pain reduced from 2.3 to 1.4 ( = 0.020) and 3.8 to 1.8 ( = 0.027), respectively, whereas the bilateral group did not.
DISCUSSION
Substantial reductions in stumbles, residual limb pain, and back pain were shown overall. These reductions were driven by the unilateral group who also showed improvements in comfort, exertion, and concentration while walking. The enhancements to the knee likely reduced some gait asymmetry for unilateral users. Improvements in patient-reported ease and safety of completing ADLs were shown overall and were driven by the bilateral group. This study shows further improvement in patient experience is achievable through innovation in MPK technology even for patients who appear to be functioning well.
PubMed: 38798750
DOI: 10.3389/fresc.2024.1342370 -
Sensors (Basel, Switzerland) May 2024Thin copper plate is widely used in architecture, transportation, heavy equipment, and integrated circuit substrates due to its unique properties. However, it is...
Thin copper plate is widely used in architecture, transportation, heavy equipment, and integrated circuit substrates due to its unique properties. However, it is challenging to identify surface defects in copper strips arising from various manufacturing stages without direct contact. A laser ultrasonic inspection system was developed based on the Lamb wave (LW) produced by a laser pulse. An all-fiber laser heterodyne interferometer is applied for measuring the ultrasonic signal in combination with an automatic scanning system, which makes the system flexible and compact. A 3-D model simulation of an H62 brass specimen was carried out to determine the LW spatial-temporal wavefield by using the COMSOL Multiphysics software. The characteristics of the ultrasonic wavefield were extracted through continuous wavelet transform analysis. This demonstrates that the A mode could be used in defect detection due to its slow speed and vibrational direction. Furthermore, an ultrasonic wave at the center frequency of 370 kHz with maximum energy is suitable for defect detection. In the experiment, the size and location of the defect are determined by the time difference of the transmitted wave and reflected wave, respectively. The relative error of the defect position is 0.14% by averaging six different receiving spots. The width of the defect is linear to the time difference of the transmitted wave. The goodness of fit can reach 0.989, and it is in good agreement with the simulated one. The experimental error is less than 0.395 mm for a 5 mm width of defect. Therefore, this validates that the technique can be potentially utilized in the remote defect detection of thin copper plates.
PubMed: 38793959
DOI: 10.3390/s24103103 -
Brain Sciences May 2024Lucid dreaming involves becoming aware that one's current experience is a dream, which has similarities with the notion of mindfulness-becoming aware of moment-to-moment...
Lucid dreaming involves becoming aware that one's current experience is a dream, which has similarities with the notion of mindfulness-becoming aware of moment-to-moment changes in experience. Additionally, meta-awareness, the ability to explicitly notice the current content of one's own mental state, has also been proposed to play an important role both in lucid dreaming and mindfulness meditation practices. However, research has shown conflicting strengths of associations between mindfulness, meditation, and lucid dreaming frequency, and the link between lucid dreaming and meta-awareness has not yet been empirically studied. This study evaluated the associations between lucid dreaming frequency and different meditation practice styles, mindfulness traits, and individual differences in meta-awareness through an online survey ( = 635). The results suggest that daily frequent meditators experience more lucid dreams than non-frequent meditators. However, weekly frequent meditators did not have a higher lucid dreaming frequency. A positive association was observed between open monitoring styles of meditation and lucid dreaming. The findings also indicate that meta-awareness is higher for meditators and weekly lucid dreamers. Furthermore, frequent lucid dreaming was commonly associated with a non-reactive stance and experiencing transcendence. Overall, the findings suggest a positive relationship between specific meditation practices and lucid dreaming as well as the importance of meta-awareness as a cognitive process linking meditation, mindfulness, and lucid dreaming.
PubMed: 38790474
DOI: 10.3390/brainsci14050496 -
Brain Sciences May 2024Clinical case illustrations of patients with an impairment of personality functioning (IPF) have repeatedly reported that progress during psychotherapy is reflected by...
BACKGROUND
Clinical case illustrations of patients with an impairment of personality functioning (IPF) have repeatedly reported that progress during psychotherapy is reflected by alterations in dream content. However, quantitative studies based on samples of psychotherapy patients are scarce. As a core component of both personality functioning and contemporary psychodynamic dream theory, the construct of affect regulation is of specific significance in this context.
AIMS
To test if improvement in personality functioning in the course of psychotherapy is associated with an increasing ability to regulate affects in dreams.
METHOD
In a longitudinal design, affect regulation was compared in N = 94 unsolicited dream reports from the first vs. last third of long term psychotherapy of ten patients with initial IPF. Dream reports were transcribed from recordings of the sessions. Expert ratings of the level of personality functioning were obtained using the Scales of Psychological Capacities. The capacity for affect regulation was assessed using the Zurich Dream Process Coding System. Group differences were assessed using linear mixed models, controlling for dream length as well as the nested structure of this data set.
RESULTS
Patients demonstrated an increased capacity for affect regulation in dreams that was primarily evident in three core features: the complexity of dream elements (cf., e.g., parameter attributes, = 0.024); the extent of affective involvement in the dream ego (cf., e.g., parameter subject feeling, = 0.014); and the flexibility to regulate the dynamics of safety/involvement processes ( ≤ 0.001). This pattern was especially prominent in a subgroup (n = 7) of patients with more pronounced improvements in personality functioning.
CONCLUSION
These findings support the hypotheses that decreasing IPF during psychotherapy is associated with increases in the capacity for affect regulation in dreams. Thus, researchers and therapists can utilize dream reports to illuminate the important aspects of treatment progress in clinical practice.
PubMed: 38790467
DOI: 10.3390/brainsci14050489 -
Brain Sciences May 2024The COVID-19 pandemic increased symptoms of stress and anxiety and induced changes in sleep quality, dream activity, and parasomnia episodes. It has been shown that...
BACKGROUND
The COVID-19 pandemic increased symptoms of stress and anxiety and induced changes in sleep quality, dream activity, and parasomnia episodes. It has been shown that stressful factors and/or bad sleep habits can affect parasomnia behaviors. However, investigations on how COVID-19 has affected sleep, dreams, and episode frequency in parasomnias are rare. The current study focuses on the impact of the pandemic on a specific parasomnia characterized by speech production (sleep talking, ST).
METHODS
We selected 27 participants with frequent ST episodes (STs) during the pandemic and compared them with 27 participants with frequent STs from a previous study conducted during a pre-pandemic period. All participants performed home monitoring through sleep logs and recorded their nocturnal STs for one week.
RESULTS
We observed a higher frequency of STs in the pandemic group. Moreover, STs were related to the emotional intensity of dreams, independent of the pandemic condition. The pandemic was associated with lower bizarreness of dreams in the pandemic group. There were no differences in sleep variables between the two groups.
CONCLUSION
Overall, these results suggest a stressful effect of COVID-19 on the frequency of STs. Both the pandemic and the frequency of STs affect qualitative characteristics of dreams in this population.
PubMed: 38790464
DOI: 10.3390/brainsci14050486 -
Brain Sciences Apr 2024Lucid dreaming (LD) is a physiological state of consciousness that occurs when dreamers become aware that they are dreaming, and may also control the oneiric content. In... (Review)
Review
Lucid dreaming (LD) is a physiological state of consciousness that occurs when dreamers become aware that they are dreaming, and may also control the oneiric content. In the general population, LD is spontaneously rare; thus, there is great interest in its induction. Here, we aim to review the literature on neuropsychopharmacological induction of LD. First, we describe the circadian and homeostatic processes of sleep regulation and the mechanisms that control REM sleep with a focus on neurotransmission systems. We then discuss the neurophysiology and phenomenology of LD to understand the main cortical oscillations and brain areas involved in the emergence of lucidity during REM sleep. Finally, we review possible exogenous substances-including natural plants and artificial drugs-that increase metacognition, REM sleep, and/or dream recall, thus with the potential to induce LD. We found that the main candidates are substances that increase cholinergic and/or dopaminergic transmission, such as galantamine. However, the main limitation of this technique is the complexity of these neurotransmitter systems, which challenges interpreting results in a simple way. We conclude that, despite these promising substances, more research is necessary to find a reliable way to pharmacologically induce LD.
PubMed: 38790404
DOI: 10.3390/brainsci14050426