Act Up demonstration to raise more money for AIDS at City Hall Plaza

General note: Title and date provided by Bettye Lane.

Intradialytic exercise : a feasibility study

Background: Exercise is known to improve mental and physical functioning and to improve quality of life. The obstacles faced by individuals with chronic kidney disease on maintenance haemodialysis include increased levels of fatigue, decreased motivation, and the inability to schedule exercise around daily activities and dialysis schedules. Aim: This pilot study was undertaken to determine the feasibility and potential efficacy of an individually-tailored exercise program for in-centre haemodialysis patients. Method: A 16 week program was designed and evaluated in relation to changes in physical capacity, the extent of exercise undertaken, and quality of life indicators. Results and Conclusion: The resultant recommendations regarding the level of motivational support, the time and physical requirements in implementing an exercise program will provide useful information for others embarking on similar studies.

Prestadores de cuidados familiares a doentes com VIH/SIDA: perfil psico-emocional e social

RESUMO: Com o presente estudo pretendemos identificar a sobrecarga resultante do envolvimento familiar com os doentes portadores de VIH/SIDA. Numa breve introdução teórica, procedemos à revisão dos conceitos sobrecarga familiar e dos sentimentos/emoções vivenciados pelos prestadores de cuidados. Metodologia: Estudo do tipo descritivo e exploratório, com uma amostra de 51 indivíduos, cuja finalidade consiste na caracterização dos prestadores de cuidados familiares a doentes com VIH/SIDA. Objectivos: Identificar quem o doente com VIH/SIDA, considera ser a pessoa significativa nos cuidados informais. Caracterizar, do ponto de vista sócio-demográfico, os doentes e os prestadores de cuidados familiares. Identificar sentimentos e emoções de vivências, que justifiquem o sofrimento emocional e as repercussões na sobrecarga familiar nos prestadores de cuidados informais. Instrumentos: Na avaliação da sobrecarga familiar, utilizámos o Questionário de Problemas Familiares”- FPQ (Family Problemas Questionnaire). Para identificação dos Acontecimentos de Vida, adoptámos a escala de Holmes e Rahe (Life Events); Para identificação do estrato social escolhemos escala de Graffar. Finalmente, para a caracterização sócio-demografica concebemos dois questionários: um dirigido aos doentes e o outro aos prestadores de cuidados informais. Conclusões: A sobrecarga da doença VIH/SIDA, nos prestadores de cuidados familiares, não é uniforme nas diferentes dimensões. A dimensão sobrecarga subjectiva é superior à objectiva. O suporte social revela-se fraco, relacionado com as perdas familiares, devidas a morte, pelas relações familiares disfuncionais, entre os membros da família, pela falta de apoio e informação dos técnicos de saúde. O sexo feminino é predominante nos cuidadores. As mães e esposas são o grau de parentesco dominante. Os solteiros são o grupo mais afectado pelo VIH/SIDA. Os cuidadores apresentam idade superior à dos doentes. O estrato social preponderante é o médio baixo e o baixo. Os familiares, apesar da atitude negativa dos doentes perante os cuidadores, mantêm-se envolvidos. Segundo a avaliação multiaxial proposta pelo DM-IV, constatámos, ao nível do eixo I, sintomatologia clínica do tipo das perturbações depressivas e perturbações da ansiedade. No eixo IV, os cuidadores evidenciam problemas psicossociais e ambientais, nomeadamente nas categorias problemas com o grupo de apoio primário, problemas relacionados como grupo social, problemas educacionais, problemas de alojamento, problemas económicos. Os problemas relacionados com o grupo de apoio primário, são os que mais parecem contribuir para os problemas psicossociais e ambientais.---------------------------------------ABSTRACT: This study wants to describe several problems as a result of the family’s relationship with HIV/AIDS patients, like overload. In a brief theoric introduction, we made a small revision about the concepts of family’s overload, and feelings or emotions that have been lived by the people who provide cares to the patients with this chronic disease. Methodology: This is a describing and exploratory study, with a sample with 51 individuals, with the aim to characterize the people inside the family who give care HIV/AIDS patients. Aim: To identify who are the most important people in informal cares from the patient perspective. To characterize, in a social-demographic point of view, patients and the people who take care of them. To identify feelings and emotions that could explain an emotional suffer, and some causes in the family burden. Means: to evaluate the family’s overload we used the Family Problems Questionnaire (FPQ). To identify life events we adopted the Holmes and Rahe scale. To identify the social stratum we used the Graffer scale. Finally to do a socio-economic characterization we did two kinds of questionnaire, the first one was directed for the patients, and the second one was chosen for the people who give care. Conclusions: The HIV/AIDS disease burden on the people who takes familiar cares isn’t uniform on several areas that we studied. The subjective overload it is superior to the objective. The social support is weak and poor, and related with family losses by dead, dysfunctional family relationships, and the lack of support and information by the medical staff. Mothers and wives are the dominant relative degree. And the singles are the major group with HIV/AIDS disease. The people who take care are usually older than the sick. The major social status is low or medium-low. The relatives keep evolved though the negative attitude of the sick. According with the evaluation multiaxial proposed by the DM-IV, in axle 1 we note clinic sintomatologic belonging to the type depressive perturbations and perturbations of the anxiety. Regarding with axle IV the caretakers show up psycho-social and environmental problems, namely on the categories: problems with the primary support group and problems related as social group, educational problems, accommodation problems and.

Prevención de la transmisión sexual del VIH en adolescentes

En una muestra de 119 estudiantes de cuarto de Educación Secundaria Obligatoria (ESO) y primero de Bachillerato (52,6% mujeres) se analizan los conocimientos sobre la prevención de la transmisión sexual del virus del sida, las expectativas de resultados y de autoeficacia respecto a los métodos preventivos y el tipo de prevención utilizada durante la última relación sexual. Para evitar las respuestas inducidas respecto a los comportamientos preventivos se emplea un formato de pregunta abierta. Los resultados muestran que sólo el 23,5% de los estudiantes han dado dos respuestas totalmente correctas sobre estrategias consideradas eficaces en la prevención sexual del VIH: uso del preservativo y abstinencia (por este orden). El 70,5% valoran totalmente o muy eficaz el preservativo para evitar la transmisión sexual del VIH y el 95% de los que dan la segunda respuesta juzgan totalmente eficaz la práctica de la abstinencia con la misma finalidad. En el caso del preservativo se sienten totalmente o muy capaces de usarlo el 64,3%, mientras que cuando se trata de la abstinencia sólo se perciben con esa competencia el 20%. Por lo que se refiere al uso autoinformado de métodos preventivos en la última relación, por parte de los 29 estudiantes que tuvieron actividad sexual durante el mes anterior, se observa que 21 de ellos emplearon el preservativo, dos la píldora anticonceptiva, otros dos no precisan el tipo de precaución y el resto no tomó ninguna. Tanto el reducido nivel de conocimientos sobre prevención, como la baja percepción de autoeficacia para mantenerse abstinentes, nos alertan sobre la necesidad de hacer un mayor esfuerzo de información para eliminar creencias equivocadas, como por ejemplo: sobre la pretendida eficacia protectora de tener relaciones sexuales con una pareja estable o conocida. Así mismo, conviene insistir en el uso del preservativo como anticonceptivo de elección entre los adolescentes

Prevención de los comportamientos sexuales de riesgo en los adolescentes: SIDA, otras enfermedades de transmisión sexual y embarazos no deseados

En la actualidad, los adolescentes son uno de los grupos que por sus características conductuales, cognitivas y sociales, se encuentran en mayor riesgo frente al posible contagio con el VIH. Esta amenaza para la salud y el bienestar de los adolescentes, se ha venido a sumar a otros problemas ya existentes en este colectivo: los embarazos no deseados y las enfermedades de transmisión sexual (ETS), que también se derivan de la no utilización de precauciones en las relaciones sexuales. En este trabajo se exponen diversos factores biológicos, psicológicos (conductuales y cognitivos) y sociales que pueden facilitar, dificultar o impedir los comportamientos sexuales de prevención de los adolescentes, y se revisan y valoran algunas de las intervenciones preventivas realizadas. A partir de esta revisión se argumenta sobre la conveniencia de unificar los programas para la prevención simultánea de los tres trastornos, maximizando de esta forma los recursos disponibles

Ventajas e inconvenientes del uso del preservativo con una pareja afectiva heterosexual

Se analiza la validez de constructo y la consistencia interna de un cuestionario sobre ventajas e inconvenientes del uso del preservativo con una pareja afectiva heterosexual, así como su capacidad para predecir el uso del preservativo en el pasado y la intención de uso en los próximos tres meses. Participan en el estudio 1711 estudiantes universitarios (46.3% varones y 60% menores de 21 años) elegidos mediante muestreo de conveniencia. Se emplea un diseño transversal y los datos se recogen mediante autoinforme voluntario y anónimo. Los resultados muestran que la consistencia interna del cuestionario es equiparable a la de otros instrumentos semejantes (alfas de Cronbach en escala de ventajas: .605 y en escala de inconvenientes: .725). Tanto las ventajas como los inconvenientes del uso del preservativo predicen significativamente su uso sistemático en el pasado, con un mayor peso de las ventajas. Entre los jóvenes que no lo han utilizado siempre, y únicamente en los varones, las ventajas predicen la intención de uso en los próximos tres meses. Los resultados apoyan la realización de programas preventivos que destaquen los beneficios derivados del uso de preservativo y, así mismo, reduzcan las percepciones negativas asociadas a su empleo, con una atención preferente a los primeros

The game of contacts: Estimating the social visibility of groups

Estimating the sizes of hard-to-count populations is a challenging and important problem that occurs frequently in social science, public health, and public policy. This problem is particularly pressing in HIV/AIDS research because estimates of the sizes of the most at-risk populations-illicit drug users, men who have sex with men, and sex workers-are needed for designing, evaluating, and funding programs to curb the spread of the disease. A promising new approach in this area is the network scale-up method, which uses information about the personal networks of respondents to make population size estimates. However, if the target population has low social visibility, as is likely to be the case in HIV/AIDS research, scale-up estimates will be too low. In this paper we develop a game-like activity that we call the game of contacts in order to estimate the social visibility of groups, and report results from a study of heavy drug users in Curitiba, Brazil (n = 294). The game produced estimates of social visibility that were consistent with qualitative expectations but of surprising magnitude. Further, a number of checks suggest that the data are high-quality. While motivated by the specific problem of population size estimation, our method could be used by researchers more broadly and adds to long-standing efforts to combine the richness of social network analysis with the power and scale of sample surveys. (C) 2010 Elsevier B.V. All rights reserved.

A pessoa idosa com doença crônica não transmissível atendida em serviços de média complexidade na cidade de Natal/RN

The demographic and epidemiological transition process caused by a declining in birth rates and in mortality, also changes occurred in morbidity and mortality is represented by the increasing of the aging population and the raising of chronic diseases. These diseases are characterized by multiple etiologies, risk factors, long latency period, a prolonged evolution, non-infectious origin and it has association with functional impairment and disability. Thus, elderly with chronic non-communicable disease has priority because they belong to a vulnerable group to get affection of comorbidities in aging, with increased demand and spending on health services. This study is aimed to analyse the understanding of elderly people with chronic non comunicable disease in the medium complexity service as a contribution to the improvement of health care in the city of Natal / RN. This is a descriptive and exploratory study with a quantitative approach, carried out at the Specialized Center for Elderly Health Care and at the Pescadores Hospital. The population was composed of 4,180 persons with a sample of 124 elderly aged above 60 years, attended in these medium complexity services. The instrument, a structured form, adapted from a questionnaire for monitoring risk and protective factors for chronic disease of the Ministry of Health. To collect data was was used the interview form containing demographic data, habits, health status and health care services. The results were processed using the Statistical Package for Social Science, version 18.0, analyzed by simple statistics. It was found that most seniors were female, predominantly between 70 and 74 years old, married, with a brown skin tone and Catholic religion, more than half had incomplete basic education, family income between one to two minimum wages and living with their families. Regarding the interviewers lifestyle, 94.4%, of them ate chicken and 97.6%, fruits, it was observed a reduction in smoking, alcoholism habits and physical activity according to the increasing age, 58.1 and 18.5% had insomnia18,5 % used sleeping pills. The elderly (51.6%) reported using services in times of sickness, seeking primary care at first (30.6%), 52% did not receive referral and was looking for free demand (38.7%). The most reported morbidity was hypertension, followed by musculoskeletal disorders. Regarding the difficulties in seeking health services, the delay in treatment and the waiting line were the most cited by the elderly. Almost all of them reported no activities to promote health in these services and those who received individual counseling on chronic diseases. Almost always, the health professionals who care of them, were mostly doctors followed by nurses. Based on the results presented, it is considered that the health services of medium complexity must undergone a more continuous dialogue with other attention level and focus on actions of health promotion and prevention. It is also recommended the necessity for qualified professionals to delivery health care to elderly and the implementation of protocols by a multidisciplinary health team, intending to provide better and continous care for the elderly with chronic diseases. The healthcare professionals who served them, were mostly physicians, followed by nurses. Through the results presented, it is considered that the medium complexity healthcare services need to perform a more continuous dialogue with the other levels of attention focusing attention to the health promotion and prevention actions. It is also recommended the necessity for qualified professionals to delivery healthcare for the elderly, in addition, a protocol implementation for the multidisciplinary health care team, to provide better care, and also the care continuity to elderly with chronic diseases

Transplante cardíaco (TC): a experiência do portador da doença de Chagas

O sucesso do transplante cardíaco com portadores da doença de Chagas está condicionado a cuidados especiais durante todas as fases do transplante, com necessidade de acompanhamento específico e rigoroso pela equipe de saúde. Os receptores devem estar conscientes da permanência do Trypanossoma no organismo, e das possibilidades de reativação da infecção após o transplante. Portanto, seu conhecimento dessa condição, e a sua participação ativa no próprio tratamento, têm importância fundamental. O objetivo do estudo foi investigar a experiência do transplante cardíaco vivenciada por pacientes portadores da doença de Chagas, para buscar compreender os significados que eles atribuem a esta experiência. Os procedimentos metodológicos abrangeram: a seleção dos pacientes; as entrevistas; a análise dos dados, indicando as unidades de significado e a análise individual; a busca de convergências dos discursos; e análise hermenêutica das convergências. da análise dos dados emergiram os seguintes temas: o tempo vivido pelo receptor, portador da Doença de Chagas; a concepção do TC apresentado pelo portador de Chagas; o cuidado na trajetória do TC.

Avaliacao das condicoes de saude bucal dos idosos em um municipio brasileiro

This study assessed the oral health of individuals 60 years or older in the city of Araraquara, Sao Paulo, Brazil, in 1998. Of the 194 people who participated in the study, 91 of them were institutionalized and had an average age of 73.6 years, and 103 were not institutionalized and had an average age of 69.3 years. The study participants were examined by a previously trained oral surgeon who determined the prevalence of the most common oral health problems. The results revealed a large number of edentulous individuals (72% of those institutionalized and 60% of the noninstitutionalized participants) and many persons with extracted teeth (93% and 90%, respectively), as well as a high frequency of periodontal pockets (57% and 75%, respectively) and of inadequate dentures (80% and 61%, respectively). Our results show reduced quality of life for a large proportion of these older individuals, and also indicate that public health services should pay greater attention to this population group.

Percepções de portadores de diabetes sobre a doença: contribuições da Enfermagem

Este estudo objetivou descrever a percepção dos usuários sobre a diabetes. A pesquisa foi descritiva e exploratória, com abordagem qualitativa; o cenário foi um hospital na cidade de Belém-PA, com participação de 32 sujeitos. Empregando-se a técnica de análise de conteúdo temática, emergiram quatro categorias: Controle do diabetes: a enfermagem na automonitorização da glicemia; O diabético e a enfermagem: uma interação para o autocuidado; Consulta de enfermagem ao diabético: a intervenção no processo saúde-doença; Diabetes e suas complicações: o medo repercutido na perda de funções. Observou-se que o paciente começa a se cuidar impulsionado pelo medo de perder sua saúde, obrigando-o ao autocuidado. O enfermeiro está diretamente ligado com o controle da diabetes, a partir do momento que realiza os cuidados e orientações da automonitorização da doença.

Avaliação do perfil de mutações e resistência aos inibidores de transcriptase reversa e protease em pacientes pediátricos infectados pleo HIV-1

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Rastreamento e detecção precose de doença aterosclerítica em pacientes com HIV positivo

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the Duke Anticoagulation Satisfaction Scale

Aim. The aim of this study was to evaluate the internal reliability and validity of the BrazilianPortuguese version of Duke Anticoagulation Satisfaction Scale (DASS) among cardiovascular patients. Background. Oral anticoagulation is widely used to prevent and treat thromboembolic events in several conditions, especially in cardiovascular diseases; however, this therapy can induce dissatisfaction and reduce the quality of life. Design. Methodological and cross-sectional research design. Methods. The cultural adaptation of the DASS included the translation and back-translation, discussions with healthcare professionals and patients to ensure conceptual equivalence, semantic evaluation and instrument pretest. The BrazilianPortuguese version of the DASS was tested among subjects followed in a university hospital anticoagulation outpatient clinic. The psychometric properties were assessed by construct validity (convergent, known groups and dimensionality) and internal consistency/reliability (Cronbachs alpha). Results. A total of 180 subjects under oral anticoagulation formed the baseline validation population. DASS total score and SF-36 domain correlations were moderate for General health (r = -0.47, p < 0.01), Vitality (r = -0.44, p < 0.01) and Mental health (r = -0.42, p < 0.01) (convergent). Age and length on oral anticoagulation therapy (in years) were weakly correlated with total DASS score and most of the subscales, except Limitation (r = -0.375, p < 0.01) (Known groups). The Cronbachs alpha coefficient was 0.79 for the total scale, and it ranged from 0.76 (hassles and burdens)0.46 (psychological impact) among the domains, confirming the internal consistency reliability. Conclusions. The BrazilianPortuguese version of the DASS has shown levels of reliability and validity comparable with the original English version. Relevance to clinical practice. Healthcare practitioners and researchers need internationally validated measurement tools to compare outcomes of interventions in clinical management and research tools in oral anticoagulation therapy.