Adaptation and validation into Portuguese language of the HIV Antibody Testing Attitude Scale

Objective. To culturally adapt and validate a version in European Portuguese language of the HIV Antibody Testing Attitude Scale. Methods. Study conducting a methodological investigation for the adaptation and validation of an attitude measurement instrument. The instrument translation and back-translation were performed. Then, a pre-test was conducted. The study used a sample of 317 subjects from the academic community - students, professors and other professionals - who were contacted in the campus. Ethical principles were observed. Results. Three analyses were conducted using the method of principal component analysis (PCA) with five, four and three factors. A three-factor solution was achieved, which presents 50.82% variance. In the analysis of inter-item correlation, values between -0.018 and 0.749 were observed. Internal consistency shows Cronbach’s alpha coefficients of 0.860 overall and between 0.865 and 0.659 in the three factors. Conclusion. The instrument version shows psychometric properties that allow its use in Portuguese-speaking countries.

Influence of socio-cultural identity of ase foundation adolescent students in their participation and attitude in the english class

Tesis (Licenciado en Lenguas Castellana, Inglés y Francés).--Universidad de La Salle. Facultad de Ciencias de La Educación. Licenciatura en Lengua Castellana, Inglés y Francés, 2014

Regional differences of outpatient physician supply as a theoretical economic and empirical generalized linear model

BACKGROUND: Regional differences in physician supply can be found in many health care systems, regardless of their organizational and financial structure. A theoretical model is developed for the physicians' decision on office allocation, covering demand-side factors and a consumption time function. METHODS: To test the propositions following the theoretical model, generalized linear models were estimated to explain differences in 412 German districts. Various factors found in the literature were included to control for physicians' regional preferences. RESULTS: Evidence in favor of the first three propositions of the theoretical model could be found. Specialists show a stronger association to higher populated districts than GPs. Although indicators for regional preferences are significantly correlated with physician density, their coefficients are not as high as population density. CONCLUSIONS: If regional disparities should be addressed by political actions, the focus should be to counteract those parameters representing physicians' preferences in over- and undersupplied regions.

Identification des grands utilisateurs de soins de santé chez les patients souffrant de la douleur chronique non cancéreuse et suivis en soins de première ligne

Contexte: La douleur chronique non cancéreuse (DCNC) génère des retombées économiques et sociétales importantes. L’identification des patients à risque élevé d’être de grands utilisateurs de soins de santé pourrait être d’une grande utilité; en améliorant leur prise en charge, il serait éventuellement possible de réduire leurs coûts de soins de santé. Objectif: Identifier les facteurs prédictifs bio-psycho-sociaux des grands utilisateurs de soins de santé chez les patients souffrant de DCNC et suivis en soins de première ligne. Méthodologie: Des patients souffrant d’une DCNC modérée à sévère depuis au moins six mois et bénéficiant une ordonnance valide d’un analgésique par un médecin de famille ont été recrutés dans des pharmacies communautaires du territoire du Réseau universitaire intégré de santé (RUIS), de l’Université de Montréal entre Mai 2009 et Janvier 2010. Ce dernier est composé des six régions suivantes : Mauricie et centre du Québec, Laval, Montréal, Laurentides, Lanaudière et Montérégie. Les caractéristiques bio-psycho-sociales des participants ont été documentées à l’aide d’un questionnaire écrit et d’une entrevue téléphonique au moment du recrutement. Les coûts directs de santé ont été estimés à partir des soins et des services de santé reçus au cours de l’année précédant et suivant le recrutement et identifiés à partir de la base de données de la Régie d’Assurance maladie du Québec, RAMQ (assureur publique de la province du Québec). Ces coûts incluaient ceux des hospitalisations reliées à la douleur, des visites à l’urgence, des soins ambulatoires et de la médication prescrite pour le traitement de la douleur et la gestion des effets secondaires des analgésiques. Les grands utilisateurs des soins de santé ont été définis comme étant ceux faisant partie du quartile le plus élevé de coûts directs annuels en soins de santé dans l’année suivant le recrutement. Des modèles de régression logistique multivariés et le critère d’information d’Akaike ont permis d’identifier les facteurs prédictifs des coûts directs élevés en soins de santé. Résultats: Le coût direct annuel médian en soins de santé chez les grands utilisateurs de soins de santé (63 patients) était de 7 627 CAD et de 1 554 CAD pour les utilisateurs réguliers (188 patients). Le modèle prédictif final du risque d’être un grand utilisateur de soins de santé incluait la douleur localisée au niveau des membres inférieurs (OR = 3,03; 95% CI: 1,20 - 7,65), la réduction de la capacité fonctionnelle liée à la douleur (OR = 1,24; 95% CI: 1,03 - 1,48) et les coûts directs en soins de santé dans l’année précédente (OR = 17,67; 95% CI: 7,90 - 39,48). Les variables «sexe», «comorbidité», «dépression» et «attitude envers la guérison médicale» étaient également retenues dans le modèle prédictif final. Conclusion: Les patients souffrant d’une DCNC au niveau des membres inférieurs et présentant une détérioration de la capacité fonctionnelle liée à la douleur comptent parmi ceux les plus susceptibles d’être de grands utilisateurs de soins et de services. Le coût direct en soins de santé dans l’année précédente était également un facteur prédictif important. Améliorer la prise en charge chez cette catégorie de patients pourrait influencer favorablement leur état de santé et par conséquent les coûts assumés par le système de santé.

COMMUNITY KNOWLEDGE, ATTITUDE AND PRACTICES (KAP) ON FLUOROSIS AND ITS MITIGATION IN ENDEMIC AREAS OF ETHIOPIA

Optimum fluoride intake plays an essential role in the prevention of dental caries while fluoride consumption above recommended level interferes with the normal formation of tooth enamel and bones and may increase risk of dental and skeletal fluorosis. The knowledge and practices of endemic communities on etiology of fluorosis will help in its mitigation and prevention. The objective of this study was to investigate the knowledge, attitude and practices of endemic community on fluoride contamination, fluorosis and prevention practices in order to devise coordinated and targeted prevention mechanisms. Focus group discussions (FGD) and key-informant interview were conducted in three dietary areas to collect knowledge, attitude and practices (KAP) of the endemic community in July 2013.The results indicated that health consequences of fluoride contaminated water are fairly understood. None of the discussants mentioned the word “fluoride”. The knowledge and perception of the community on fluoride ingestion is poor. Health extension workers (HEWs) did not teach about fluoride and related health consequences. Dental fluorosis was reported to start at early ages and not commonly perceived as a major problem. However, adolescents worried and felt that they might be singled out when going to other areas. Older people have a skeletal fluorosis, which interferes with their day to day activities. In severely affected people, the teeth were weak and fragile and thus create difficulty in chewing hard foods like unfermented dry flat bread, sugar cane and toasted grains. People prefer rain water rather than water from borehole because of the inconvenient taste of the latter. The endemic communities have no sufficient knowledge and skills on potential sources of fluoride intake, the debilitating effect of high fluoride ingestion, and preventive and mitigatory measures to reduce fluoride intake. The effect of fluoride contamination and mitigatory methods should get sufficient attention by the community, health workers and concerned governmental bodies. The trend of harvesting and using rain water should be encouraged as it reduces fluoride intake. Future studies should focus on information communication on possible fluoride risks, intervention and evaluation studies on defluoridation, rain water harvesting and mitigatory techniques.

Healthcare providers’ knowledge, attitude and behaviour towards breast cancer diagnosis and treatment in Malaysia – a mini systematic review

Breast cancer is the most common cancer among women in Malaysia. Therefore, it is important for the public to be educated on breast cancer and to know the steps that need to be taken to detect it early. Healthcare providers are in a unique position to provide public health education due to their good knowledge of health issues and their roles in healthcare. A systematic review of studies conducted from 2008 till 2015 was undertaken to analyze the knowledge, attitudes and behavior of Malaysian healthcare providers regarding breast cancer, in an attempt to obtain an overall picture of how wellequipped the healthcare providers are to provide optimal breast cancer education, and to ascertain their perceptions and actual involvement in such education. The systematic review was conducted via a primary search of various databases and journal websites, and a secondary search of references cited in eligible studies. Criteria for eligibility include studies conducted in Malaysia and published from the year 2008 to 2015, and written in English language. A total of fifteen articles were identified and reviewed but only two studies were eligible for this review. The findings suggest that future and current Malaysian healthcare providers have moderate knowledge of breast cancer, showed a positive disposition towards involvement in breast cancer education, but displayed poor involvement.

The Relationship of Culturally Responsive Instruction and the Reading Comprehension and Attitude of Struggling Urban Adolescent Readers

Culturally responsive instruction refers to the identification of relevant cultural aspects of students’ lives and infusion of these into the curriculum. This instructional approach assumes that a culturally appropriate curriculum can potentially motivate, engage, and lead students to higher rates of achievement. This quasi-experimental study (N=44) investigated the relationship of culturally responsive instruction and the reading comprehension and attitude of struggling urban adolescent readers. The study incorporated the use of culturally responsive instruction using culturally relevant literature (CRL), the Bluford Series Novels, as authentic texts of instruction. Participants were seventh grade reading students at a Title I middle school in South Florida. After a baseline period, two different classes were taught for 8 weeks using different methods. One class formed the experimental group (n=22) and the other class formed the comparison group (n=22). The CRI curriculum for the experimental group embraced the socio-cultural perspective through the use of small discussion groups in which students read and constructed meaning with peers through interaction with the Bluford Series Novels; gave written responses to multiple strategies according to SCRAP – Summarize, Connect, Reflect, Ask Questions, Predict; responded to literal and inferential questions, while at the same time validating their responses through evidence from the text. The Read XL (basal reader) curriculum of the comparison group utilized a traditional form of instruction which incorporated the reading of passages followed by responses to comprehension questions, and teacher-led whole group discussion. The main sources of data were collected from the Gates-MacGinitie Reading Tests, the Florida Assessments for Instruction in Reading (FAIR), and the Rhody Secondary Reading Attitude Assessment. Statistical analyses were performed using Repeated Measures ANOVAs. Findings from the study revealed that the experimental participants’ reading attitudes and FAIR comprehension scores increased when compared to the comparison group. Overall, the results from the study revealed that culturally responsive instruction can potentially foster reading comprehension and a more positive attitude towards reading. However, a replication of this study in other settings with a larger, more randomized sample size and a greater ethnic variation is needed in order to make full generalizations.

Iowa Physician Orders for Scope of Treatment (IPOST) Work Plan, April 21, 2014

To promote community care coordination and advanced care planning. Seamless communication and execution of individual patient care choices across the healthcare continuum.

Análisis de las barreras para la unificación de una Historia Clínica Electrónica -HCE- en Colombia

Objetivo: Identificar las barreras para la unificación de una Historia Clínica Electrónica –HCE- en Colombia. Materiales y Métodos: Se realizó un estudio cualitativo. Se realizaron entrevistas semiestructuradas a profesionales y expertos de 22 instituciones del sector salud, de Bogotá y de los departamentos de Cundinamarca, Santander, Antioquia, Caldas, Huila, Valle del Cauca. Resultados: Colombia se encuentra en una estructuración para la implementación de la Historia Clínica Electrónica Unificada -HCEU-. Actualmente, se encuentra en unificación en 42 IPSs públicas en el departamento de Cundinamarca, el desarrollo de la HCEU en el país es privado y de desarrollo propio debido a las necesidades particulares de cada IPS. Conclusiones: Se identificaron barreras humanas, financieras, legales, organizacionales, técnicas y profesionales en los departamentos entrevistados. Se identificó que la unificación de la HCE depende del acuerdo de voluntades entre las IPSs del sector público, privado, EPSs, y el Gobierno Nacional.

Barreiras e facilitadores à prática do acompanhamento farmacoterapêutico nos serviços farmacêuticos hospitalares portugueses

Objectivos: Identificar e compreender as barreiras e os facilitadores à prática do Acompanhamento Farmacoterapêutico (AFT) nos serviços farmacêuticos hospitalares portugueses. Método: Estudo qualitativo mediante realização de entrevistas semi-estruturadas a farmacêuticos hospitalares com e sem experiência no AFT e análise de conteúdo, retroactiva e temática. Resultados: Estrutura dos serviços farmacêuticos: barreiras (1) falta de tempo, organização das actividades orientadas para a logística, instabilidade dos recursos humanos, barreiras físicas à comunicação, relações em divergência; facilitadores (2) reestruturação, trabalho em equipa. Farmacêutico: (1) resistência à mudança, qualificação inadequada; (2) atitude positiva, legitimação, formação. Meio externo: (1) falta de apoio institucional, relacionamento com o doente, o médico e farmacêutico comunitário, ensino inadequado; (2) apoio institucional, procura do doente, cooperação com o médico e o farmacêutico comunitário, ensino adequado. Tecnologia: (1) acesso aos dados clínicos e a informação, método inadequado; (2) acesso à informação, método adequado, documentação, informatização, marketing, boas práticas. Conclusão: As entrevistas semi-estruturadas fornecerem uma visão ampla, detalhada e pragmática dos potenciais determinantes de uma prática generalizada do AFT nos serviços farmacêuticos hospitalares portugueses. /ABSTRACT: Objectives: To identify and understand the barriers and facilitators for the practice of Medication Therapy Management (MTM) in portuguese’s hospital pharmacy. Method: Qualitative study trough semi-structured interviews with MTM experienced and inexperienced hospital pharmacists followed by retroactive content and thematic analysis. Results: Structure of hospital pharmacy: barriers (1) lack of time, activities focused on logistics, instability of human resources, physical barriers to communication, divergent relationships; facilitators (2) restructuring, teamwork. Pharmacist: (1) resistance to change, inadequate skills, (2) positive attitude, legitimating, formation. Environment: (1) lack of institutional support, relationship with patient, physician and community pharmacist, inadequate teaching, (2) institutional support, patient's demand, cooperation with physician and community pharmacist, appropriate teaching. Technology: (1) lack of access to clinical data and information, inadequate method, (2) access to information, appropriate method, documentation, computerization, marketing, good pharmacy practices. Conclusion: The semi-structured interviews provide a broad, comprehensive and pragmatic view of potential determinants for wide practice of MTM in Portuguese’s hospital pharmacy.

Adaptation and validation of HIV Antibody Testing Attitude Scale in Portuguese

Introduction; The awareness of HIV positiveness is important for health of the individual and of the comunity. The identicatio of HIV antibodies is possible both using conventional lab tests and quick result tests. In the bibliography it was made clear that there are no instruments in Portuguese to assert the reactions to the HIV quick tests and it was therefore considered it would be useful to adapt and validate a scale in Portuguese, since the language is the official language of 7 different countries and spoken by more than 250 milion people, Objectives: the purpose is to validate a version in European Portuguese of the HIV Antibody Testing Attitude Scale. Methods: the study refers to methodological research for the adaptation and validation of an instrument of attitude measurement. A translation and back-translation was prepared and a trial test was then carried out. A total of 317 students, lectures and co-workers of a Portuguese University was interviewes. Ethical principles were taken into consideration. the pool was obtained in the seven components of the University campus. Results: 3 trials of factorial testing of the main components of 5, 4 and 3 factors. It ended up a solution of 3 factors that explains 50.82% of the variability. In the analysis of the inter-items correlation values of between 0.018 and 0.749 were observed. The internal consistency reveals an alpha Cronbach coefficient of 0.860 as a whole, and in between 0,865 and 0.659 in the 3 factors. Conclusions: this version of the instrument shows that the psychometric properties allow its use in the Portuguese speaking countries.

BELIEF AND THE LINGUISTIC ATTITUDE OF CAPANEMENSE

Despite not using the Spanish language, Brazil borders with several countries that speak this language. The State of Paraná, for instance, has nineteen districts bordering with Paraguay and Argentina. In this geographical context is inserted Capanema city, whose multi-ethnic environment not only promotes the exchange of goods but also culture, beliefs, customs, and especially the language. This work takes as its investigation object the speech of Capanemenses with the aim of verifying the positive and negative views of these subjects regarding the multiple languages ​​and varieties with which they live on today. Following the mentalist methodology (LÓPEZ MORALEZ, 1993), the collected data analysis through interviews in locus showed that, compared to Argentines, most Capanemenses presents a positive attitude, both in relation to the Argentine people properly said, as their mother tongue, seen in a prestigious way by the interviewees. As for Paraguayan, a significant amount of informants showed not see them in a positive way, presenting a justification for this refusal the difference in culture, indigenous origin, low technology and education, as well as the language issue - Guarani, Jopará. On the other hand, the German people’s seen as introverted by their lack of emotion, but responsible in everything they do. The German language has not been evaluated positively by the Capanemenses, as it’s considered difficult and awkward. Finally, we note that, believing that Italian culture and language are close to the one existing in Brazil, due to Latin ascendancy, respondents react favorably on the Italians, people judged by Capanemenses as joyful and spontaneous. Keywords: beliefs and linguistic attitudes, language prejudice, languages in contact, Capanema.