The quality of life of Hansen’s disease patients in a medium-sized city

Study model: cross-sectional study. Objectives: describe the epidemiological profile of HD patients in Uberaba, Minas Gerais, assess their quality of life and verify the association of quality of life with epidemiological and sociodemographic variables. Methods: In order to evaluate the quality of life, we applied the instrument proposed by the World Health Organization (WHOQOL-bref) and a questionnaire of the epidemiological profile built by the authors. The descriptive statistical analysis and the T-Student and Mann-Whitney tests were used. Participation consisted of 29 HD patients. Results: There was a predominance of married male patients with low education and income. The highest quality of life scores were found in social and psychological relationships; the environmental and physical factors obtained the lowest scores. We observed better quality of life in individuals over the age of 60, in social (p=0.0267) and environmental (p=0.0359) relationships; married, in the physical aspect (p=0.0495); and with low education, in the physical (p=0.03) and psychological (p=0.0084) aspects. Conclusions: The study demonstrated the aspects of vulnerability and support to HD patients, presenting better quality of life in elderly, married individuals with low educationModelo do estudo: estudo do tipo transversal. Objetivos: descrever o perfil epidemiológico dos portadores de hanseníase de Uberaba-MG, avaliar a qualidade de vida e verificar a associação dos domínios da qualidade de vida com variáveis epidemiológicas e sociodemográficas. Métodos: Para a avaliação da qualidade de vida, foram aplicados o instrumento proposto pela Organização Mundial de Saúde (WHOQOL-bref) e um questionário do perfil epidemiológico construído pelos autores. Utilizaram-se a análise estatística descritiva e os testes T-Student e Mann-Whitney. Participaram da pesquisa 29 portadores de hanseníase. Resultados: Houve predomínio do sexo masculino, casados, com baixas escolaridade e renda. Encontraram-se os maiores escores de qualidade de vida nos domínios relações sociais e psicológicas; os fatores ambiental e físico obtiveram os menores escores. Foi observada melhor qualidade de vida em indivíduos com mais de 60 anos, nos domínios relações sociais (p=0,0267) e ambiental (p=0,0359); casados, no domínio físico (p=0,0495); e com baixa escolaridade, nos domínios físico (p=0,03) e psicológico (p=0,0084). Conclusões: O estudo permitiu verificar os aspectos de vulnerabilidade e de suporte dos portadores de hanseníase, apresentando-se melhor qualidade de vida em indivíduos idosos, casados e com baixa escolaridad

Health services performance for TB treatment in Brazil: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Researches to evaluate Primary Health Care performance in TB control in Brazil show that different cities aggregate local specificities in the dynamics of coping with the disease. This study aims to evaluate health services' performance in TB treatment in cities across different Brazilian regions.</p> <p>Methods</p> <p>This cross-sectional study was conducted in five cities that are considered priorities for TB control in Brazil: Itaboraí (ITA), Ribeirão Preto (RP) and São José do Rio Preto (SJRP) in the Southeast; Campina Grande (CG) and Feira de Santana (FS) in the Northeast. Data were collected through interviews with 514 TB patients under treatment in 2007, using the <it>Primary Care Assessment Tool </it>adapted for TB care in Brazil. Indicators were constructed based on the mean response scores (Likert scale) and compared among the study sites.</p> <p>Results</p> <p>"Access to treatment" was evaluated as satisfactory in the Southeast and regular in the Northeast, which displayed poor results on 'home visits' and 'distance between treatment site and patient's house'. "Bond" was assessed as satisfactory in all cities, with a slightly better performance in RP and SJRP. "Range of services" was rated as regular, with better performance of southeastern cities. 'Health education', 'DOT' and 'food vouchers' were less offered in the Northeast. "Coordination" was evaluated as satisfactory in all cities. "Family focus" was evaluated as satisfactory in RP and SJRP, and regular in the others. 'Professional asking patient's family about other health problems' was evaluated as unsatisfactory, except in RP.</p> <p>Conclusions</p> <p>Two types of obstacles are faced for health service performance in TB treatment in the cities under analysis, mainly in the Northeast. The first is structural and derives from difficulties to access health services and actions. The second is organizational and derives from the way health technologies and services are distributed and integrated. Incentives to improve care organization and management practices, aimed at the integration of primary, secondary and tertiary services, can contribute towards a better performance of health services in TB treatment.</p

Tuberculosis control program in the municipal context: performance evaluation

ABSTRACT OBJECTIVE The objective of this study is to evaluate the performance of the Tuberculosis Control Program in municipalities of the State of São Paulo. METHODS This is a program evaluation research, with ecological design, which uses three non-hierarchical groups of the municipalities of the State of São Paulo according to their performance in relation to operational indicators. We have selected 195 municipalities with at least five new cases of tuberculosis notified in the Notification System of the State of São Paulo and with 20,000 inhabitants or more in 2010. The multiple correspondence analysis was used to identify the association between the groups of different performances, the epidemiological and demographic characteristics, and the characteristics of the health systems of the municipalities. RESULTS The group with the worst performance showed the highest rates of abandonment (average [avg] = 10.4, standard deviation [sd] = 9.4) and the lowest rates of supervision of Directly Observed Treatment (avg = 6.1, sd = 12.9), and it was associated with low incidence of tuberculosis, high tuberculosis and HIV, small population, high coverage of the Family Health Strategy/Program of Community Health Agents, and being located on the countryside. The group with the best performance presented the highest cure rate (avg = 83.7, sd = 10.5) and the highest rate of cases in Directly Observed Treatment (avg = 83.0, sd = 12.7); the group of regular performance showed regular results for outcome (avg cure = 79.8, sd = 13.2; abandonment avg = 9.5, sd = 8.3) and supervision of the Directly Observed Treatment (avg = 42.8, sd = 18.8). Large population, low coverage of the Family Health Strategy/Program of Community Health Agents, high incidence of tuberculosis and AIDS, and being located on the coast and in metropolitan areas were associated with these groups. CONCLUSIONS The findings highlight the importance of the Directly Observed Treatment in relation to the outcome for treatment and raise reflections on the structural and managerial capacity of municipalities in the implementation of the Tuberculosis Control Program

Provision of health care actions and services for the management of HIV/AIDS from the users’ perspective

Objective To analyse the provision of health care actions and services for people living with AIDS and receiving specialised care in Ribeirão Preto, SP. Method A descriptive, exploratory, survey-type study that consisted of interviews with structured questionnaires and data analysis using descriptive statistics. Results The provision of health care actions and services is perceived as fair. For the 301 subjects, routine care provided by the reference team, laboratory tests and the availability of antiretroviral drugs, vaccines and condoms obtained satisfactory evaluations. The provision of tests for the prevention and diagnosis of comorbidities was assessed as fair, whereas the provisions of specialised care by other professionals, psychosocial support groups and medicines for the prevention of antiretroviral side effects were assessed as unsatisfactory. Conclusion Shortcomings were observed in follow-up and care management along with a predominantly biological, doctor-centred focus in which clinical control and access to antiretroviral therapy comprise the essential focus of the care provided

Anatomia do escapo floral de esp\ue9cies brasileiras de Paepalanthus subg\ueanero Platycaulon (Eriocaulaceae)

Foi estudada a anatomia dos escapos de 17 espécies de Paepalanthus subgênero Platycaulon, sendo 10 da sect. Divisi e sete da sect. Conferti. O trabalho foi realizado para caracterizar anatomicamente os escapos. como contribuição para o entendimento do grupo, uma vez que. morfologicamente, esse é o caráter laxonômico mais importante. Procurou-se, também, confirmar ou não o reconhecimento das duas seções dentro do subgênero. Para os estudos anatômicos utilizou-se material proveniente do Brasil, obtido de exsicatas de diferentes herbários e/ou coletado na Serra do Cipó, MG. Neste trabalho observou-se que Paepalanthus subg. Platycaulon é caracterizado morfologicamente por apresentar escapos pluricapitulados no ápice. Anatomicamente, as espécies estudadas da sect. Divisi apresentam escapos com vários cilindros vasculares, na região mediana e, ainda apresentam, em Paepalanthus vellozioides e P. spixianus, feixes vasculares corticais, características únicas na família. Diferentemente, as espécies avaliadas da sect. Conferti apresentam escapos com cilindro vascular único na região mediana, padrão análogo ao das demais Eriocaulaccae, e ainda apresentam, em Paepalanthus itatiaiensis, P. planifolius e P. paulensis, feixes vasculares medulares, que até então não haviam sido referidos para a família.The scape anatomy of 17 taxa of Paepalanthus subgenus Platycaylon were studied, being 10 taxa of sect. Divisi and seven of sect. Conferti. The study was carried out to see whether scape morphology and anatomy provide valid taxonomic characters at the subgeneric level in Paepalanthus and to lest a proposal to recognize two sections within Paepalanthus subgenus Platycaylon: sect. Divisi and sect. Conferti. The material for anatomical study was collected in Brazil, partly from herbarium specimens and partly from fresh material collected in the field, from the Serra do Cipó. Minas Gerais State. In this work, we observe that Paepalanthus subg. Platycaulon is characterized morphologically by its pluricapitulate scapes. Anatomycally, the studied species of the Divisi sect, are characterized by having separate vascular cylinders, and present cortical vascular bundles in Paepalanthus vellozioides and P. spixianus, being these characteristics unique to the family, while the scapes of the studied members of sect. Conferti display a continuous vascular cylinder, which is analogous with other groups within the Eriocaulaceac, and present pith vascular bundles in Paepalanthus itatiaiensis, P planifolius and P. paulensis, characteristics unique to the family

Italian Catholic Intellectuals and Indigenous Latin Americans: Transnational Networks and Violence at the End of the Cold War

The Latin American indigenous question has represented over the centuries, between modern and contemporary age, a laboratory that is apparently marginal but in its own way singularly powerful for the Italian Catholic cultural world. The question has in fact contributed to the elaboration of political symbols and instruments, cultural, religious, moral and solidarity projects. The construction of an original perspective, mirror of a distant world, has in fact allowed Italian Catholicism to carry out a sort of self-analysis, in the face of modernization processes, the relationship between power and law, between local and global perspectives, between past and present. With this in mind, 1992 represented a real crossroads. While the global Cold War was closing, the disputed celebrations of the 500th anniversary of the “discovery” and European conquest of the Americas, together with the awarding of the Nobel Peace Prize to the Maya Quiché Rigoberta Menchú Tum and the Genoese celebrations for the “Colombiadi”, opened an intense debate in Italy. In particular, a group of Catholic intellectuals, laity and religious, tried to reflect on the legacies and contradictions of that Euro-American encounter-clash produced and on the transformation of the global history that ensued. A reflection that connected to the ongoing debate on the violations of human rights in Latin American dictatorships was calling into question the responsibilities of Europe as a community in the making.1partially_openopenDe Giuseppe, MassimoDe Giuseppe, Massim