Starting treatment: caring for patients and their families

The standards presented in this section focus on providing physical, social and psychological care for the patient at the point he or she is diagnosed with tuberculosis (TB) and starts treatment. Detailed guidance is included with regard to organising directly observed treatment (DOT) safely and acceptably for both the patient and the management unit. The aim is to give the patient the best possible chance of successfully completing treatment according to a regimen recommended by the World Health Organization. If the health service where the patient is diagnosed cannot offer ongoing treatment and care due to a lack of facilities, overcrowding or inaccessibility, the patient needs to be referred to a designated TB management unit (BMU) elsewhere. The patient may also receive treatment from a facility outside a BMU. However care is organised, it is essential for all patients who are diagnosed with TB to be registered at an appropriate BMU so that their progress can be routinely monitored and programme performance can be assessed. To avoid the risk of losing contact with the patient at any stage of their care, good communication is essential between all parties involved, from the patient him/herself to the person supervising their DOT to the BMU.

As vivências: questões de tradução, sentidos e fontes epistemológicas no legado de Vigotski

O objetivo deste artigo é abordar a questão das vivências na perspectiva de L.S. Vigotski, tratando de suas fontes epistemológicas, de suas raízes na língua russa e de seus sentidos específicos, priorizando "A Tragédia do Hamlet, Príncipe da Dinamarca" (1916) e os textos pedológicos dos anos 1930, com destaque para "A questão do meio na pedologia". Destacam-se as transformações das ideias do autor sobre vivências e sua contribuição metodológica à  análise da relação indivíduo-meio no desenvolvimento humano, articulada aos conceitos de consciência e sistema.

Reconciliando divergências: conhecimento implícito e explícito na aprendizagem

O trabalho busca integrar, com base em propostas recentes de vários autores, perspectivas acerca da aprendizagem concebidas como mutuamente excludentes. Essa reflexão se justifica em vista da importância de não se introduzir descontinuidade filogenética em um processo concebido como adaptativo, mas que é também cultural. Assim, são examinadas propostas acerca da coevolução da mente humana e da cultura que apoiariam tal perspectiva, propondo-se uma visão integrada da aprendizagem como um conjunto de processos organizados em um continuum implícito-explícito.

Construção e validação da Escala de Crenças Parentais e Práticas de Cuidado (E-CPPC) na primeira infância

O presente estudo teve como objetivo construir e validar uma escala de crenças parentais e práticas de cuidado na primeira infância para o contexto brasileiro. Após a construção teórica dos itens, a versão final da escala foi aplicada em dois estudos com populações distintas (estudo preliminar - 250 mães; estudo final - 600 mães), visando avaliar a frequência de comportamento e o grau de importância atribuído às práticas. Para as análises psicométricas, foram realizadas: análise fatorial e o cálculo da consistência interna. Em ambos os estudos a análise fatorial resultou em dois fatores, sendo o primeiro denominado "cuidados primários" e o segundo "estimulação". Os alfas de Cronbach apresentaram-se satisfatórios, variando de 0,68 a 0,83. Os resultados do estudo demonstraram a validade e precisão da escala, a qual poderá ser utilizada em futuras pesquisas, bem como em práticas de intervenção familiar, principalmente durante os primeiros anos de vida das crianças.

Violence against women: a study of the reports to police in the city of Itapevi, Sao Paulo, Brazil

Background: violence against women is a serious problem caused by the social construction of feminineness and masculineness that results in the domination of women by men. Public policies on gender have recently been developed in order to confront the problem. But what exactly are the problems faced by women? Purposes: to survey and analyse cases of violence against women reported to the police, as recorded at the Police Stations for Women`s Defence (PSWDs), and to reconstruct the procedures that women must go through in order to denounce their aggressors. Methodology: this quantitative, exploratory and descriptive study was undertaken during 2006-2007 in the city of Itapevi, Sao Paulo metropolitan region, Brazil. As there is no PSWD data were collected from police reports from PSWDs of neighbouring cities. Findings: malicious physical injury (49%) and threats (42%) were the most commonly reported types of violence. The victims were aged between 20 and 49 years (93%). Almost all of the aggressors (97%) were men and most had an intimate relationship with their victim. The use of alcoholic beverages was linked to approximately 25% of the cases. Conclusion: women who are victims of domestic violence in Itapevi report that going through PSWDs of neighbouring cities is a difficult, isolated, long and expensive process that often, provides no institutional protection. Implications for practice: there is an urgent requirement for judicial-assistance and support close to home in order to provide a quality service and follow-up for these women and their aggressors; to provide training for the professionals called to attend them at police stations; and for a caring attitude from health-care professionals.,0 2010 Elsevier Ltd. All rights reserved.

HIV testing and care of the patient co-infected with tuberculosis and HIV

Human immunodeficiency virus (HIV) infection poses one of the greatest challenges to tuberculosis (TB) control, with TB killing more people with HIV infection than any other condition. The standards in this chapter cover provider-initiated HIV counselling and testing and the care of HIV-infected patients with TB. All TB patients who have not previously been diagnosed with HIV infection should be encouraged to have an HIV test. Failing to do so is to deny people access to the care and treatment they might need, especially in the context of the wider availability of treatments that prevent infections associated with HIV A clearly defined plan of care for those found to be co-infected with TB and HIV should be in place., with procedures to ensure that the patient has access to this care before offering routine testing for HIV in persons with TB. It is acknowledged that people caring for TB patients should ensure that those who are HIV positive are transferred for the appropriate ongoing care once their TB treatment has been completed. In some cases, referral for specialised HIV-related treatment and care may be necessary during treatment for TB. The aim of these standards is to enable patients to remain as healthy as possible, whatever their HIV status.