Comportamentos de saúde e doença numa comunidade Cabo-Verdiana em Lisboa

O objetivo foi compreender como os indivíduos se comportam em termos de saúde e o que fazem em caso de doença. Análise comparativa realçou semelhanças e divergências de práticas de saúde ou em caso de doença. O estudo foi efetuado numa amostra de 40 cabo-verdianos da primeira geração residentes na região de Lisboa, dividida em subgrupos: grupo social, geração e genero. Baseou-se em metodologia qualitativa com entrevistas semi-estruturadas. As práticas analisadas foram agrupadas em preventivas e de saúde, práticas utilizadas em episódios de doença, recursos para prevenção e tratamento, utilização de remédios caseiros e outros recursos ou terapeutas. Indivíduos experimentaram, ao nível das práticas, três sistemas de saúde que coexistiam em Cabo Verde, oficial, popular e tradicional e o recurso à religião. O discurso acerca das práticas de saúde e de doença demonstrou existirem diferenças, em alguns aspectos, entre grupos sociais e entre generos e gerações. Práticas de saúde destes imigrantes são idênticas às dos portugueses em contextos socioeconomicos semelhantes. Resultados sugerem existência de diferenças entre grupos sociais relativamente às práticas, na esfera da saúde e da doença. Mais que cultura e etnicidade, que se moldam às condições materiais de existência, neste estudo, o nível socioeconomico determinou as maiores diferenças a interferir nas práticas de saúde e doença, de grupo com cultura de base comum. Em geral, os indivíduos sobrevalorizaram sua identidade étnica e cultura de origem. Pertencimento a grupos sociais diferentes dá origem a partilha do sentimento de pertença cultural, mas não a comportamentos e práticas idênticos.

Comportamentos de saúde e doença numa comunidade Cabo-Verdiana em Lisboa

This study aims at analysing, through personal reports, the way individuals behave in terms of health and illness. A comparative analysis of the collected data was performed, with the purpose of highlighting divergences in the health and illness practices. The study was undertaken with a sample of 40 «first generation» Cape Verdeans living in the Metropolitan area of Lisbon, divided into distinct groups: social (popular and elite), generation (younger and older) and gender (men and women). A qualitative methodology was employed, by conducting semi-structured interviews for the collection of information. The health and illness practices were grouped into preventive and health care practices, practices used in episodes of illness, resources used for prevention and treatment, use of home remedies, and other alternative resources. Individuals who are part of our study experimented, at the level of practices, with the three health systems that existed in Cape Verde, namely, the official, popular and traditional, and recourse to religion. The discourse analysis concerning health and disease practices showed there are differences, in some respects, between social groups. There were also slight differences between genders and generations. These immigrants’ health practices are identical to those of the Portuguese who are in similar socioeconomic contexts, with no significant effects of immigration itself on these practices. The analysis of the results confirms the existence of differences between social groups concerning the health and illness practices. They were more determined by the socioeconomic factors than by the cultural and ethnic aspects. Those differences also highlighted the existence of a unifying aspect, resulting from their cultural heritage. Although belonging to different social groups, the existence of a common culture and ethnic identity originates a shared feeling of cultural belonging, but not identical behaviours and practices.

Comportamentos de saúde e doença numa comunidade Cabo-Verdiana em Lisboa

O objetivo foi compreender como os indivíduos se comportam em termos de saúde e o que fazem em caso de doença. Análise comparativa realçou semelhanças e divergências de práticas de saúde ou em caso de doença. O estudo foi efetuado numa amostra de 40 cabo-verdianos da primeira geração residentes na região de Lisboa, dividida em subgrupos: grupo social, geração e genero. Baseou-se em metodologia qualitativa com entrevistas semi-estruturadas. As práticas analisadas foram agrupadas em preventivas e de saúde, práticas utilizadas em episódios de doença, recursos para prevenção e tratamento, utilização de remédios caseiros e outros recursos ou terapeutas. Indivíduos experimentaram, ao nível das práticas, três sistemas de saúde que coexistiam em Cabo Verde, oficial, popular e tradicional e o recurso à religião. O discurso acerca das práticas de saúde e de doença demonstrou existirem diferenças, em alguns aspectos, entre grupos sociais e entre generos e gerações. Práticas de saúde destes imigrantes são idênticas às dos portugueses em contextos socioeconomicos semelhantes. Resultados sugerem existência de diferenças entre grupos sociais relativamente às práticas, na esfera da saúde e da doença. Mais que cultura e etnicidade, que se moldam às condições materiais de existência, neste estudo, o nível socioeconomico determinou as maiores diferenças a interferir nas práticas de saúde e doença, de grupo com cultura de base comum. Em geral, os indivíduos sobrevalorizaram sua identidade étnica e cultura de origem. Pertencimento a grupos sociais diferentes dá origem a partilha do sentimento de pertença cultural, mas não a comportamentos e práticas idênticos.

Ischemic heart disease and primary care: identifying gender-related differences. An observational study

Background: Gender-related differences are seen in multiple aspects of both health and illness. Ischemic heart disease (IHD) is a pathology in which diagnostic, treatment and prognostic differences are seen between sexes, especially in the acute phase and in the hospital setting. The objective of the present study is to analyze whether there are differences between men and women when examining associated cardiovascular risk factors and secondary pharmacological prevention in the primary care setting. Methods: Retrospective descriptive observational study from January to December of 2006, including 1907 patients diagnosed with ischemic heart disease in the city of Lleida, Spain. The clinical data were obtained from computerized medical records and pharmaceutical records of medications dispensed in pharmacies with official prescriptions. Data was analyzed using bivariate descriptive statistical analysis as well as logistic regression. Results: There were no gender-related differences in screening percentages for arterial hypertension, diabetes, obesity, dyslipemia, and smoking. A greater percentage of women were hypertensive, obese and diabetic compared to men. However, men showed a tendency to achieve control targets more easily than women, with no statistically significant differences. In both sexes cardiovascular risk factors control was inadequate, between 10 and 50%. For secondary pharmaceutical prevention, the percentages of prescriptions were greater in men for anticoagulants, beta-blockers, lipid-lowering agents and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, with age group variations up to 10%. When adjusting by age and specific diagnoses, differences were maintained for anticoagulants and lipid-lowering agents. Conclusion: Screening of cardiovascular risk factors was similar in men and women with IHD. Although a greater percentage of women were hypertensive, diabetic or obese, their management of risk factors tended to be worse than men. Overall, a poor control of cardiovascular risk factors was noted. Taken as a whole, more men were prescribed secondary prevention drugs, with differences varying by age group and IHD diagnosis.

Intervención de enfermería en Salud Mental desde los centros escolares

Con la promoción de la salud mental y la prevención de las enfermedades mentales se hace frente a factores determinantesrelacionados con la salud del individuo, familia, comunidad y la sociedad en general reforzando los factores de protección ydisminuyendo los factores de riesgo. Los centros escolares junto con los centros de trabajo son un escenario de actuacionesfundamentales, debido a la cantidad de tiempo que pasan en ellos las personas. Sabemos que la salud mental estádeterminada en gran parte por los primeros años de vida, de ahí la importancia de la promoción de la salud mental en lainfancia y en la adolescencia. En esta línea en la comunidad autónoma de Cataluña se ha diseñado y implementado unprograma “Salud y Escuela” que pretende: Mejorar la salud de los adolescentes a través de acciones de promoción de lasalud, prevención de las situaciones de riesgo y atención precoz de los problemas de salud relacionados con: • La saludafectivo-sexual • El consumo de drogas, alcohol y tabaco • Los trastornos relacionados con la alimentación • La salud mentalEn este programa el profesional de enfermería es el referente en el centro educativo de secundaria, y por tanto es el queinterviene orientando, informando, enseñando o derivando a los adolescentes a los servicios de salud, en función de lasconsultas que recibe. También asesora a los profesores y a las familias

Predictors and consequences of adherence to the treatment of pediatric patients with attention-deficit/hyperactivity disorder in Central Europe and East Asia.

PURPOSE: To assess baseline predictors and consequences of medication non-adherence in the treatment of pediatric patients with attention-deficit/hyperactivity disorder (ADHD) from Central Europe and East Asia. PATIENTS AND METHODS: Data for this post-hoc analysis were taken from a 1-year prospective, observational study that included a total of 1,068 newly-diagnosed pediatric patients with ADHD symptoms from Central Europe and East Asia. Medication adherence during the week prior to each visit was assessed by treating physicians using a 5-point Likert scale, and then dichotomized into either adherent or non-adherent. Clinical severity was measured by the Clinical Global Impressions-ADHD-Severity (CGI-ADHD) scale and the Child Symptom Inventory-4 (CSI-4) Checklist. Health-Related Quality of Life (HRQoL) was measured using the Child Health and Illness Profile-Child Edition (CHIP-CE). Regression analyses were used to assess baseline predictors of overall adherence during follow-up, and the impact of time-varying adherence on subsequent outcomes: response (defined as a decrease of at least 1 point in CGI), changes in CGI-ADHD, CSI-4, and the five dimensions of CHIP-CE. RESULTS: Of the 860 patients analyzed, 64.5% (71.6% in Central Europe and 55.5% in East Asia) were rated as adherent and 35.5% as non-adherent during follow-up. Being from East Asia was found to be a strong predictor of non-adherence. In East Asia, a family history of ADHD and parental emotional distress were associated with non-adherence, while having no other children living at home was associated with non-adherence in Central Europe as well as in the overall sample. Non-adherence was associated with poorer response and less improvement on CGI-ADHD and CSI-4, but not on CHIP-CE. CONCLUSION: Non-adherence to medication is common in the treatment of ADHD, particularly in East Asia. Non-adherence was associated with poorer response and less improvement in clinical severity. A limitation of this study is that medication adherence was assessed by the treating clinician using a single item question.

Biogeochemistry in acid sulphate soil landscapes and small urban centres in Western Finland

The overall purpose of this thesis was to increase the knowledge on the biogeochemistry of rural acid sulphate (AS) soil environments and urban forest ecosystems near small towns in Western Finland. In addition, the potential causal relationship between the distribution of AS soils and geographical occurence of multiple sclerosis (MS) disease was assessed based on a review of existing literature and data. Acid sulphate soils, which occupy an area of approximately 17–24 million hectare worldwide, are regarded as the nastiest soils in the world. Independent of the geographical locality of these soils, they pose a great threat to their surrounding environment if disturbed. The abundant metal-rich acid drainage from Finnish AS soils, which is a result of sulphide oxidation due to artificial farmland drainage, has significant but spatially and temporally variable ecotoxicological impacts on biodiversity and community structure of fish, benthic invertebrates and macrophytes. This has resulted in mass fish kills and even eradication of sensitive fish species in affected waters. Moreover, previous investigations demonstrated significantly enriched concentrations of Co, Ni, Mn and Al, metals which are abundantly mobilised in AS soils, in agricultural crops (timothy grass and oats) and approximately 50 times higher concentrations of Al in cow milk originating from AS soils in Western Finland. Nevertheless, the results presented here demonstrate, in general, relatively moderate metal concentrations in oats and cabbage grown on AS soils in Western Finland, although some of the studied fields showed anomalous values of metals (e.g. Co and Ni) in both the soil and target plants (especially oats), similar to that of the previous investigations. The results indicated that the concentrations of Co, Ni, Mn and Zn in oats and Co and Zn in cabbage were governed by soil geochemistry as these metals were correlated with corresponding concentrations extracted from the soil by NH4Ac-EDTA and NH4Ac, respectively. The concentrations of Cu and Fe in oats and cabbage were uncorrelated to that of the easily soluble concentrations in the soils, suggesting that biological processes (e.g. plant-root processes) overshadow geochemical variation. The concentrations of K and Mg in cabbage, which showed a low spread and were strongly correlated to the NH4Ac extractable contents in the soil, were governed by both the bioavailable fractions in the topsoil and plant-uptake mechanisms. The plant´s ability to regulate its uptake of Ca and P (e.g. through root exudates) seemed to be more important than the influence of soil geochemistry. The distribution of P, K, Ca, Mg, Mn and S within humus, moss and needles in and around small towns was to a high degree controlled by biological cycling, which was indicated by the low correlation coefficients for P, K, Ca, Mg and S between humus and moss, and the low spread of these nutrients in moss and needles. The concentration variations of elements in till are mainly due to natural processes (e.g. intrusions, weathering, mineralogical variations in the bedrock). There was a strong spatial pattern for B in humus, moss and needles, which was suggested to be associated with anthropogenic emissions from nearby town centres. Geogenic dust affected the spatial distribution of Fe and Cr in moss, while natural processes governed the Fe anomaly found in the needles. The spatial accumulation patterns of Zn, Cd, Cu, Ni and Pb in humus and moss were strong and diverse, and related to current industry, the former steel industry, coal combustion, and natural geochemical processes. An intriguing Cu anomaly was found in moss. Since it was located close to a main railway line and because the railway line´s electric cables are made of Cu, it was suggested that the reason for the Cu anomaly is corrosion of these cables. In Western Finland, where AS soils are particularly abundant and enrich the metal concentrations of stream waters, cow milk and to some extent crops, an environmental risk assessment would be motivated to elucidate if the metal dispersion affect human health. Within this context, a topic of concern is the distribution of multiple sclerosis as high MS prevalence rates are found in the main area of AS soils. Regionally, the AS soil type in the Seinäjoki area has been demonstrated to be very severe in terms of metal leaching, this area also shows one of the highest MS rates reported worldwide. On a local scale, these severe AS soil types coincide well with the corresponding MS clustering along the Kyrönjoki River in Seinäjoki. There are reasons to suspect that these spatial correlations are causal, as multiple sclerosis has been suggested to result from a combination of genetic and environmental factors.

ARTERIAL STIFFNESS IN CHILDREN WITH AND WITHOUT DEVELOPMENTAL COORDINATION DISORDER

The purpose of this study was to determine whether children with potential developmental coordination disorder (p-DCD) demonstrate increased arterial stiffness and thickness compared to age and school matched controls (mean age 14.7 yrs). We also assessed whether these measures differed by sex. Compliance, distensibility, and intima-media thickness (IMT) were measured at the common carotid artery for 28 children with p-DCD and 47 controls. ECG-R-wave-toe pulse wave velocity (PWV) was also measured for 29 children with p-DCD and 45 controls. We found that compared to controls males with p-DCD had significantly higher PWV (3.8±0.2 vs. 4.1±0.3, p=0.001) and lower distensibility (0.82± 0.19 vs. 0.70± 0.17, p=0.034) while females showed no significant differences (p=0.523 and p=0.123 respectively). As a result, it is apparent that sex differences exist with respect to arterial health within this population and that children with p-DCD may be more likely to develop cardiovascular disease later in life.

Intervención de enfermería en Salud Mental desde los centros escolares

Con la promoción de la salud mental y la prevención de las enfermedades mentales se hace frente a factores determinantes relacionados con la salud del individuo, familia, comunidad y la sociedad en general reforzando los factores de protección y disminuyendo los factores de riesgo. Los centros escolares junto con los centros de trabajo son un escenario de actuaciones fundamentales, debido a la cantidad de tiempo que pasan en ellos las personas. Sabemos que la salud mental está determinada en gran parte por los primeros años de vida, de ahí la importancia de la promoción de la salud mental en la infancia y en la adolescencia. En esta línea en la comunidad autónoma de Cataluña se ha diseñado y implementado un programa “Salud y Escuela” que pretende: Mejorar la salud de los adolescentes a través de acciones de promoción de la salud, prevención de las situaciones de riesgo y atención precoz de los problemas de salud relacionados con: • La salud afectivo-sexual • El consumo de drogas, alcohol y tabaco • Los trastornos relacionados con la alimentación • La salud mental En este programa el profesional de enfermería es el referente en el centro educativo de secundaria, y por tanto es el que interviene orientando, informando, enseñando o derivando a los adolescentes a los servicios de salud, en función de las consultas que recibe. También asesora a los profesores y a las familias

Healthtalk Online

Healthtalkonline, an award-winning charity website, lets you share in other people's experiences of health and illness. You can watch or listen to videos of the interviews, read about people's experiences and find reliable information about conditions, treatment choices and support. The information on healthtalkonline is based on qualitative research into patient experiences, led by experts at the University of Oxford. These personal stories of health and illness will enable patients, families and healthcare professionals to benefit from the experiences of others.

Lo ambiental y lo social de la aspersión en Colombia. ¿Política ambiental o estrategia antinarcóticos?

En este artículo se revisan y analizan algunos aspectos del Programa de Erradicación de Cultivos Ilícitos con Glifosato (PECIG) y su Plan de Manejo Ambiental, con el ánimo de demostrar que no consideran de manera adecuada los componentes ambiental y social. Desde la perspectiva de las políticas públicas se demuestra que se ajustan más a una estrategia militar-antinarcóticos que social y medioambiental, contrario al querer transmitido en la definición del instrumento, que habla de la compensación, prevención y mitigación de impactos, la protección de los recursos naturales, del medio ambiente y de la salud de la ciudadanía ubicada en las zonas de influencia directa. Para ello, se hace un recuento de cómo está definido el Programa y los organismos que lo componen; después se explica el Plan de Manejo Ambiental y el análisis de su implementación, posteriormente se muestran los resultados obtenidos de esta verificación para, finalmente, formular las respectivas conclusiones.-----This paper reviews and analyzes issues of the Illicit Crop Eradication Program with Glyphosate (ICEPG) and its Environmental Management Plan, with the aim to demonstrate that the environmental and social components have not been properly considered. From the public policy viewpoint, they are shown to fit more into a military antinarcotics strategy rather than a social and environmental strategy, as opposed to the aims contained in the instrument definition, which talks about impact compensation, prevention, and mitigation; and protection of natural resources, environment, and population’s health within the direct influence areas. For this purpose, an initial review of the Program definition and component organizations is provided; the Environmental Management Plan is explained, its implementation is analyzed; the results from this verification are shown; and, finally, the respective conclusions are formulated.

¿Pluralismo o colonialidad médica? Un estudio alrededor del cáncer en diferentes sistemas médicos colombianos

En esta investigación se realiza un análisis del tipo de relaciones que se establecen entre la medicina alopática y la medicina indígena yagecera en el escenario urbano de Bogotá. Para ello, toma distancia de los estudios ya realizados sobre este tema en el campo de la antropología a partir de dos aspectos: en primer lugar, busca acercarse a esta relación a partir de las trayectorias profesionales de un conjunto de médicos (tanto indígenas como alopáticos); en segundo lugar, se aproxima a estas relaciones a partir de una enfermedad particular: el cáncer.

Autoreporte de la calidad de vida en niños y adolescentes colombianos: Estudio FUPRECOL

RESUMEN Introducción: El EQ-5D-Y proxy es un cuestionario genérico, de fácil comprensión y aplicación, que evalúa distintas dimensiones de la salud percibida. El objetivo del siguiente estudio fue describir por autoreporte la calidad de vida relacionada con la salud (CVRS) en una población escolar de Bogotá, Colombia, pertenecientes al estudio FUPRECOL. Métodos: Estudio descriptivo y transversal, realizado en 3.245 niños y 3.354 adolescentes, entre 9 y 17.9 años de edad, de 24 instituciones educativas oficiales de Bogotá, Colombia. Se aplicó de manera auto-administrada la versión validada al castellano por Olivares et al. (2009) del instrumento de CVRS infantil EQ-5D-Y proxy. Se analizaron los datos por medidas de tendencia central y se realizó una comparación de los observados en Colombia con estudios internacionales. Resultados: De la población evaluada, el 58,3% (n=3.848), fueron mujeres. En general, se observa puntuaciones elevadas en la CVRS en niños y adolescentes de ambos sexos. Al comparar por género, las dimensiones del EQ-5D-Y proxy “sentirse triste/preocupado o infeliz” y “tener dolor/malestar”, presentaron la mayor frecuencia de repuesta en el grupo de las mujeres. Al comparar los resultados de este estudio, por grupos de edad, con trabajos internacionales de niños y adolescentes, se observa que las puntuaciones del EQ-5D-Y proxy fueron superiores a los reportados en Suráfrica, Alemania e Italia. Conclusión: Se presentan valores de la CVRS según edad y sexo que podrán ser usados en la evaluación de la salud percibida en el ámbito escolar. Se hace necesario evaluar las propiedades psicométricas del EQ-5D-Y proxy en población Colombiana.

O Ofício das Rezadeiras: um estudo antropológico sobre as práticas terapêuticas e a comunhão de crenças em Cruzeta/RN

The present Master´s dissertation aims to study the practices of the rezadeiras, Brazilian women healers, through an anthropological perspective. Special attention will be given to the understanding of these practices as a dynamic process in relation to those women who heal in Cruzeta (Seridó, Rio Grande do Norte), where is located our ethnographic research. For this research, twenty four rezadeiras were contacted and colaborated with our work plan. Among them, two were pentecostal rezadeiras and another one was member of the Jurema cult, an afro-brazilian religious cult. Similarities among these women healers were perceived in the research process, mostly in terms of their learning process and the use of certain objects and ritual techniques. However, apparent differences among them gave us the chance for understanding and reflecting on the actual heterogeneity of this world of specialists. Furthermore, i tried to capture the relations between the rezadeiras and the therapeutic practices from health professionals or the religious practices of religious leaders (Catholic, pentecostal, etc). It is possible to ascertain about the complementarity between therapeutic practices from different cultural logics. This complementarity is also perceived through the religious interchanges and transits among different healers, including those who have different religious beliefs. In this work, rituals are also described and they are a crucial factor to the understanding of this particular religious and therapeutic practice conducted by women. Following these ideas, our basic aim is to understand how the rezadeiras make interpretations about health and illness, specially those ones which are particular associated with their practices, the so called "doenças de rezadeiras"

Ambiente pesqueiro e saúde: representações sociais sobre saúde e doença de pescadores e marisqueiras nos distritos de Diogo Lopes, Barreiras e Sertãozinho Macau RN

According to Brazil s Ministry of Fisheries and Aquaculture, artisanal fishermen are responsible for a significant fish production at national level, highlighting the importance of this activity. In Rio Grande do Norte State, Brazil, fishing has become an important part of economic and social processes. In this context, there are many inland fishing communities such as Barreiras, Diogo Lopes and Sertãozinho, which are part of Ponta do Tubarão State Reserve of Sustainable Development (RDSEPT), located in Macau and Guamaré, Rio Grande do Norte coastline cities. Fishermen and women, the last ones known as marisqueiras who work alongside the menfolk at sea, especially in the shellfish harvest, have been developing narrow relationships with nature, mainly with the sea, from where they extract their families subsistence. However, those communities have been facing several issues related to living conditions, health and diseases. Social representations have been analyzed in the speeches of fishermen/women who were registered active members in a fishermen association named Associação Colônia de Pescadores Z-41, regarding the period from 2008 to 2011. The analysis involved socio-economic profiles verification, identification and analysis of the group s main representative diseases and representations related to health and illness. This study searched for elements in order to provide the comprehension of the relationships among people s social representations and the fishing environment in which they live.. This qualiquantitative study was performed using recordings and transcriptions of structured and open-question interviews. The Collective Subject Speech tecnique proposed by Lefevre & Lefevre (2002) was applied to perform the interviews analysis using QualiQuantiSoft® software. The results showed that health and illness phenomena as well as social representations related to them in the fishing environment are not only abstract states but also physical ones, which interfere in all life extensions, establishing a set of relevant information that indicates that those people realize their own socio-cultural, economic, environmental and political context