Objects, objectivity and idealism: Robert Brandom's analytic Hegelianism

Dissertação de mestrado em Ciências do Desporto (Atividade Física em Contexto Escolar) apresentada à Faculdade de Ciências do Desporto e Educação Física da Universidade de CoimbraO presente estudo teve por objetivo analisar se a hidroginástica pode ser assumida como um instrumento de gestão no custo com medicamentos consumidos, na saúde, na aptidão física funcional, na qualidade de vida e nos estados de humor de idosos institucionalizados, com idade igual ou superior a 65 anos. Foi também verificada a influência dos níveis de escolaridade nas variáveis referidas. Participaram 54 idosos da cidade de Cuiabá/MT, de ambos os sexos, distribuídos por um grupo de hidroginástica (GE; N=40), organizado e planejado, existente há mais de um ano e por um grupo de controlo que não pratica exercício físico (GI; N=14). Preencheram questionários caracterizadores da qualidade de vida relacionada com a saúde e de estados de humor; foram efetuadas determinações antropométricas, avaliada a aptidão física funcional, a frequência cardíaca e a pressão arterial; foram feitas colheitas sanguíneas e registados os custos com medicamentos. Constatou-se uma predominância de mulheres idosas, brancas, viúvas, com ensino primário, com sobrepeso e que não fazem uso de tabaco e bebida alcoólica. Os praticantes de hidroginástica apresentaram melhores performances na aptidão física funcional, apesar de consumir mais medicamentos e apresentarem níveis elevados nas variáveis sanguíneas. Manifestaram melhor qualidade de vida relacionada com a saúde, menores limitações na realização das suas atividades do seu dia-a-dia, e estados de humor mais positivos. Valores elevados nestas variáveis associaram-se a maiores custos com o consumo de medicamentos. Conclui-se que o programa de hidroginástica devidamente planejada e bem orientada contribui para a melhoria da qualidade de vida dos idosos, tornando-se imprescindível estabelecer ações norteadoras das políticas públicas para promover e manter o envelhecimento ativo, saudável e com melhor qualidade de vida. ABSTRACT The present study aimed to analyze if the hidrogymnastic can be assumed as a management instrument in the cost of medicines consumed, in health, functional fitness, quality of life and mood states of institutionalized elderly, aged 65 years or more. It was also verified the influence of schoolar levels in the variables referred. Participated 54 older adults from the Cuiabá MT city of both sexes, distributed by a group of hidrogymnastic (GE; N=40), existing for over a year and a control group that does not practice physical exercise (GI; N=14). All participants filled out questionnaires characterizing the quality of life related to health and moods; anthropometric measurements were performed, evaluated the functional fitness, heart rate and blood pressure; blood samples were taken and recorded the cost of medicines. There was a predominance of older white women, widows, with elementary school, obese and that don't make use of tobacco and alcohol. Water aerobics practitioners showed best results in functional fitness, despite consuming more medicines and present high levels in blood variables. Have better quality of life, lower health-related limitations in carrying out the activities of daily life, and more positive moods. High values in these variables associated to increased drug consumption. It was concluded that the hidrogymnastic program properly planned and well oriented contributes to improving the quality of life of the elderly, making it essential to establish guiding actions of public policies to promote and maintain active, healthy ageing and with better quality of life

Racial residential segregation, socioeconomic disparities, and the White-Black survival gap.

ObjectiveTo evaluate the association between racial residential segregation, a prominent manifestation of systemic racism, and the White-Black survival gap in a contemporary cohort of adults, and to assess the extent to which socioeconomic inequality explains this association.DesignThis was a cross sectional study of White and Black men and women aged 35-75 living in 102 large US Core Based Statistical Areas. The main outcome was the White-Black survival gap. We used 2009-2013 CDC mortality data for Black and White men and women to calculate age-, sex- and race adjusted White and Black mortality rates. We measured segregation using the Dissimilarity index, obtained from the Manhattan Institute. We used the 2009-2013 American Community Survey to define indicators of socioeconomic inequality. We estimated the CBSA-level White-Black gap in probability of survival using sequential linear regression models accounting for the CBSA dissimilarity index and race-specific socioeconomic indicators.ResultsBlack men and women had a 14% and 9% lower probability of survival from age 35 to 75 than their white counterparts. Residential segregation was strongly associated with the survival gap, and this relationship was partly, but not fully, explained by socioeconomic inequality. At the lowest observed level of segregation, and with the Black socioeconomic status (SES) assumed to be at the White SES level scenario, the survival gap is essentially eliminated.ConclusionWhite-Black differences in survival remain wide notwithstanding public health efforts to improve life expectancy and initiatives to reduce health disparities. Eliminating racial residential segregation and bringing Black socioeconomic status (SES) to White SES levels would eliminate the White-Black survival gap

Erratum to: Sexual Mixing in Shanghai: Are Heterosexual Contact Patterns Compatible With an HIV/AIDS Epidemic?

In the middle of the paragraph just above Figure 6, there is the following sentence: “The range of the mean of the distribution of the proportion infected generated by the simulations is narrow, between 0.5 % and 0.2 % of all nodes.” This should read “between 0.05 % and 0.2 % of all nodes.

Sexual Mixing in Shanghai: Are Heterosexual Contact Patterns Compatible With an HIV/AIDS Epidemic?

China’s HIV prevalence is low, mainly concentrated among female sex workers (FSWs), their clients, men who have sex with men, and the stable partners of members of these high-risk groups. We evaluate the contribution to the spread of HIV of China’s regime of heterosexual relations, of the structure of heterosexual networks, and of the attributes of key population groups with simulations driven by data from a cross-sectional survey of egocentric sexual networks of the general population of Shanghai and from a concurrent respondent-driven sample of FSWs. We find that the heterosexual network generated by our empirically calibrated simulations has low levels of partner change, strong constraints on partner selection by age and education, and a very small connected core, mainly comprising FSWs and their clients and characterized by a fragile transmission structure. This network has a small HIV epidemic potential but is compatible with the transmission of bacterial sexually transmitted infections (STIs), such as syphilis, which are less susceptible to structural breaks in transmission of infection. Our results suggest that policies that force commercial sex underground could have an adverse effect on the spread of HIV and other STIs

Erratum to: Sexual Mixing in Shanghai: Are Heterosexual Contact Patterns Compatible With an HIV/AIDS Epidemic?

In the middle of the paragraph just above Figure 6, there is the following sentence: “The range of the mean of the distribution of the proportion infected generated by the simulations is narrow, between 0.5 % and 0.2 % of all nodes.” This should read “between 0.05 % and 0.2 % of all nodes.

Antiretroviral therapy for refugees and internally displaced persons: a call for equity.

Available evidence suggests that refugees and internally displaced persons (IDPs) in stable settings can sustain high levels of adherence and viral suppression. Moral, legal, and public health principles and recent evidence strongly suggest that refugees and IDPs should have equitable access to HIV treatment and support. Exclusion of refugees and IDPs from HIV National Strategic Plans suggests that they may not be included in future national funding proposals to major donors. Levels of viral suppression among refugees and nationals documented in a stable refugee camp suggest that some settings require more intensive support for all population groups. Detailed recommendations are provided for refugees and IDPs accessing antiretroviral therapy in stable settings

Design and implementation of a sexual health intervention for migrant construction workers situated in Shanghai, China.

BACKGROUND: China's growing population of internal migrants has exceeded 236 million. Driven by rapid development and urbanization, this extreme population mobility creates opportunities for transmission of HIV and sexually-transmitted infections (STI). Large numbers of rural migrants flock to megacities such as Shanghai in search of employment. Although migrants constitute a key population at heightened risk of acquiring HIV or an STI, there is a lack of easily accessible sexual health services available for them. In response, we designed a short, inexpensive sexual health intervention that sought to improve HIV and STI knowledge, while reducing stigma, risky sexual behaviour, and sexual transmission of HIV and STI among migrant construction workers (MCW) situated in Shanghai, China. RESULTS: We implemented a three-armed, community-randomized trial spread across three administrative districts of Shanghai. The low-intensity intervention included educational pamphlets. The medium-intensity intervention included pamphlets, posters, and videos. The high-intensity intervention added group and individual counselling sessions. Across 18 construction sites, 1871 MCW were allocated at baseline to receive one intervention condition. Among baseline participants, 1304 workers were retained at 3-months, and 1013 workers were retained at 6-months, representing a total of 579 person-years of follow-up. All workers, regardless of participation, had access to informational materials even if they did not participate in the evaluation. Overall outputs included: 2284 pamphlets distributed, 720 posters displayed, 672 h of video shown, 376 participants accessed group counselling, and 61 participants attended individual counselling sessions. A multivariable analysis of participation found that men (aOR = 2.2; 95 % CI 1.1, 4.1; p = 0.036), workers situated in Huangpu district (aOR = 5.0; 95 % CI 2.6, 9.5; p < 0.001), and those with a middle school education (aOR = 1.9; 95 % CI 1.2, 3.0; p = 0.01) were more likely to have participated in intervention activities. CONCLUSION: A brief educational intervention that prioritized ease of delivery to a highly mobile workforce was feasible and easily accessed by participants. Routine implementation of sexual health interventions in workplaces that employ migrant labour have the potential to make important contributions toward improving HIV and STI outcomes among migrant workers in China's largest cities

Health-care professionals' assessment of a person-centred intervention to empower self-management and health across chronic illness: Qualitative findings from a process evaluation study.

BACKGROUND: Person-centred care (PCC) empowers patients to manage their chronic illness and promote their health in accordance with their own beliefs, values and preferences. Drawing on health-care professional's (HCP's) experiences implementing an empowerment-focused, person-centred intervention called the Bodyknowledging Program (BKP), we undertook a process evaluation that aimed to assess the impact on patient health and well-being. METHODS: We used individual in-depth interviews and semi-structured focus groups comprising n = 8 interprofessional HCP who facilitated intervention sessions with n = 58 patients situated in Norwegian specialist care sites. Content analysis was used to analyse the data and summarize major themes. RESULTS: Health-care professional interviews revealed four main ways in which the intervention operated in support of health-related patient outcomes: (i) addressing the whole person; (ii) hope and affirmation; (iii) expanding recovery; and (iv) social support and revitalized relationships. The intervention provided new tools for patients to understand the social, emotional and physical impact of their illness. Health-care professional reported new insights to facilitate patient engagement and to promote patients' health. CONCLUSIONS: The Bodyknowledging Program facilitated patient engagement through the promotion of patient-centred care while developing the patients' ability to exploit their own resources for effectively managing their health within illness. The process evaluation supported the underlying theoretical basis of the intervention and was suggestive of its potential transferability elsewhere

Health Care Professionals' Experiences of Facilitating Patient Activation and Empowerment in Chronic Illness using a Person-Centered and Strengths-Based Self-Management Program.

OBJECTIVE: Patients with chronic illness who are empowered and activated are more likely to engage in self-management in order to stabilise their condition and enhance their quality of life. This study aimed to explore Health Care Professional's (HCP) assessment of a person-centered intervention called 'The Bodyknowledging Program' (BKP) for the facilitation of empowerment and patient activation in the context of chronic illness. METHODS: This study employed a qualitative process evaluation after programme completion. Data was collected through focus-groups and individual interviews with HCPs and content analysis was used in the analysis. RESULTS: Four themes were identified: 1) Shifts towards the patient-perspective, 2) The value of a patient-centered conceptual framework, 3) Patient activation through dialogue based support and 4) Challenging competencies. Discussion: This study introduces 'The Bodyknowledging Program' as a useful tool to uncover patients' needs and to activate and empower them to take more responsibility for their health through self-care management. The usability of the new intervention depends on HCP's ability to develop their counselling skills and changing their approach towards utilising patients' individual resources in the promotion of their health