Health promotion, participation in collective actions and situation of violence among users of Primary Health Care.

Este artigo visa a analisar a rela??o entre a promo??o de sa?de, mensurada por meio da participa??o em a??es coletivas, e a viol?ncia entre usu?rios das unidades de sa?de da aten??o prim?ria, no munic?pio de Ribeir?o das Neves (MG). Trata-se de estudo de abordagem quantitativa, cuja metodologia consiste de entrevistas semiestruturadas com usu?rios da aten??o prim?ria do munic?pio de Ribeir?o das Neves (MG). A an?lise estat?stica foi baseada em tabelas de frequ?ncias absolutas e percentuais para as distribui??es uni e bivariada, destacando-se o perfil sociodemogr?fico. As associa??es e suas signific?ncias estat?sticas foram avaliadas por meio do teste Qui-quadrado e da an?lise de correspond?ncia. Foram entrevistados 628 usu?rios de 58 Unidades B?sicas de Sa?de; as viol?ncias mais frequentes foram: verbal, psicol?gica e tentativa de suic?dio. A participa??o em a??es coletivas est? predominantemente ligada a cultos religiosos. O desenvolvimento de a??es de preven??o ? viol?ncia na aten??o primaria ? baixo. Na an?lise de correspond?ncia, a baixa frequ?ncia de a??es coletivas se associou fortemente ? presen?a de viol?ncia e ? tentativa de suic?dio. A presen?a de a??es ligadas a atividades esportivas/ art?sticas se associa ? aus?ncia de viol?ncia verbal e sexual; a participa??o em associa??es/ sindicatos se associa ? aus?ncia de viol?ncia psicol?gica, f?sica e tentativa de suic?dio; por fim, a??es de trabalho volunt?rio se associam ? aus?ncia de viol?ncia sexual, ter parente assassinado e conhecer algu?m que foi assassinado. Concluiu-se que a participa??o e a n?o participa??o em a??es coletivas se associam, respectivamente, com menor e maior preval?ncia de viol?ncia.This article aims to analyze the relationship between health promotion, measured by means of participation in collective actions, and violence among users of primary health units, in the municipality of Ribeir?o das Neves (MG). This is a quantitative approach study, whose methodology consists of semi-structured interviews with users of primary care of the municipality of Ribeir?o das Neves (MG). The statistical analysis was based on absolute and frequency tables for univariate and bivariate distributions, highlighting the sociodemographic profile. The associations and their statistical significance were evaluated through Chi-square test and correspondence analysis. A total of 628 users from 58 Basic Health Units were interviewed; the most frequent violences were:verbal, psychological and attempted suicide. Participation in collective actions is predominantly linked to religious services. The development of actions to prevent violence in primary care is low. In the correspondence analysis, the low frequency of collective action was strongly associated to the presence of violence and suicide attempt. The presence of actions related to sports/art activities is associated with the absence of verbal and sexual violence; participation in associations/unions is associated with absence of psychological, physical and attempted suicide; finally, voluntary work actions are associated with lack of sexual violence, having a relative murdered and knowing someone who was murdered. It was concluded that participation and non-participation in collective actions are associated, respectively, with lower and higher prevalence of violence

Development and content validity of the perceived barriers with antiretroviral treatment scale.

Introdu??o: Pessoas vivendo com HIV (PVHA) devem ser devidamente orientadas para iniciar a terapia antirretroviral (TARV), sendo importante identificar as dificuldades de PVHA com o tratamento, no intuito de realizar interven??es para prevenir uma poss?vel falha terap?utica. Objetivos: Desenvolver uma escala para avaliar a percep??o de dificuldades de PVHA com a TARV e analisar sua validade de conte?do. M?todos: Uma escala contendo 47 itens foi proposta a partir de um estudo qualitativo pr?vio e, entre junho e agosto de 2015, foi aplicada em 27 PVHA em tratamento no Hospital Eduardo de Menezes para avaliar a compreens?o dos itens pela popula??o alvo (an?lise sem?ntica). Os itens foram modificados e avaliados por tr?s ju?zes quanto ? relev?ncia, adequa??o e dimensionalidade, utilizando-se o coeficiente de validade do conte?do e coeficiente kappa. Resultados: Ap?s an?lise sem?ntica os itens foram reduzidos para 40. Nenhum item foi exclu?do ap?s an?lise de ju?zes, uma vez que todos foram considerados relevantes. Apenas 30% dos itens foram modificados ap?s serem considerados inadequados. A maior dificuldade dos ju?zes foi classificar itens sobre a adequa??o do medicamento ? rotina entre as dimens?es. Conclus?es: Os resultados apontaram a adequa??o da escala ao conte?do que ela pretende avaliar. A vers?o piloto da escala est? sendo testada empiricamente e poder? ser usada no servi?o de sa?de, em n?vel individual, identificando os casos nos quais ? necess?rio prover educa??o e aconselhamento ao paciente, bem como instrumento de pesquisa, em n?vel coletivo, para o planejamento de interven??es e de pol?ticas p?blicas.Introduction: People living with HIV (PLHIV) should be properly informed when starting antiretroviral therapy (ART). It is important to identify the difficulties of PLHIV, in order to implement interventions to prevent a possible treatment failure. Objectives: To develop a scale to measure the perceived difficulty of PLHIV with ART and analyze its content validity. Methods: A scale containing 47 items was proposed from previous qualitative study. Between June and August 2015, it was applied to 27 PLHIV under treatment at Eduardo de Menezes Hospital to assess the comprehension of items by the target population (semantic analysis). The items were modified and evaluated by three judges regarding the relevance, appropriateness and dimensionality, using the validity of the content and kappa coefficients. Results: After semantic analysis the items were reduced to 40. No items were excluded after analysis of judges, since all were considered relevant. Only 30% of the items were modified after being considered unsuitable. The main difficulty of judges was to evaluate items on their appropriateness of the medication use between dimensions. Conclusions: Results indicated the suitability of the scale to the content that it intends to evaluate. The scale of the pilot version is being tested empirically and can be used in the health service at the individual level, identifying cases where it is necessary to provide education and counseling to the patient, as well as a research tool, at the collective level, to plan interventions and public policies

Unreported cases and invisibility of violence against women.

A viol?ncia contra mulheres configura situa??o pungente de ordem social no Brasil. A Portaria n? 104 de 25 de janeiro de 2011 tornou compuls?ria a notifica??o de viol?ncia, constituindo estrat?gia para reverter a subnotifica??o e ser instrumento de vigil?ncia em sa?de.Violence against women is a very serious social problem in Brazil. The law of violence notification (2011) created a strategy to reverse unreported cases and increase health surveillance

Rela??o entre comportamentos em sa?de e doen?as autorreferidas por servidores.

Introdu??o: Os h?bitos de vida como a pr?tica de atividade f?sica, o lazer, os h?bitos alimentares, o estresse, o tabagismo e etilismo podem implicar diretamente nas condi??es de sa?de do indiv?duo. Objetivo: Este trabalho teve como objetivo verificar a rela??o entre comportamentos em sa?de e as doen?as autorreferidas por servidores de uma universidade p?blica federal da regi?o sudeste. M?todos: Participaram do estudo 815 servidores, sendo 347 docentes e 468 t?cnico-administrativos, com idade de 20 a 65 anos. Trata-se de um estudo transversal. Os dados deste estudo foram coletados de um banco de dados secund?rio, provenientes do Question?rio de Sa?de (condi??es de sa?de autorreferidas por docentes e t?cnico-administrativos), da Pr?- Reitoria de Assuntos Comunit?rios da Institui??o. Dentre as vari?veis avaliadas, foi verificada a rela??o entre o h?bito alimentar, a pr?tica de atividade f?sica, o tabagismo e o consumo de bebida alco?lica com as doen?as autorreferidas (doen?as cr?nicas n?o transmiss?veis e doen?as infecto-parasit?rias, diagnosticadas pelo m?dico nos ?ltimos 12 meses). Resultados: A m?dia de doen?as entre esses docentes e t?cnico-administrativos da pesquisa foi de 3,1 e 2,9, respectivamente. Destacou-se nesse estudo a associa??o estatisticamente signiicante da alimenta??o n?o saud?vel com o acidente vascular encef?lico; a atividade f?sica irregular/sedentarismo com as doen?as end?crinas/nutricionais/metab?licas e do aparelho digestivo; o excesso de peso com as doen?as cardiovasculares, doen?as end?crinas/nutricionais/metab?licas, diabetes mellitus e hipertens?o arterial sist?mica; e o tabagismo com as doen?as osteomusculares. Conclus?o: Sugere-se a ado??o de medidas de preven??o e controle dos comportamentos de risco entre esses servidores.Introduction: Life habits such as physical activity, leisure, eating habits, stress, smoking, and alcohol consumption can directly affect individuals? health. Objective: This study aimed to investigate the relationship between health behaviors and diseases self-reported by employees of a federal public university in southeastern Brazil. Methods: This cross-sectional study included 815 employees, of whom 347 were teachers and 468 were technical-administrative staff, aged between 20 and 65 years old. Data from this study were collected from a secondary database, from the Health Questionnaire (self-reported health conditions by teachers and technical-administrative employees), and from the institution?s Vice Dean of Community Affairs. Among the variables assessed, the relationship between eating habits, physical activity, smoking, alcohol consumption, and self-reported illnesses (chronic diseases and infectious and parasitic diseases diagnosed by a doctor within the last 12 months) was analyzed. Results: The mean prevalence of these diseases among teachers and technical-administrative staff was 3.1 and 2.9, respectively. This study showed a statistically signi?icant association between unhealthy diet and cerebrovascular accidents; between irregular performance of physical activity/sedentary lifestyle and endocrine/nutritional/metabolic and digestive diseases; between overweight and cardiovascular diseases, endocrine/nutritional/metabolic diseases, diabetes mellitus, and hypertension; and between smoking and musculoskeletal diseases. Conclusion: We suggest the adoption of preventative measures and the control of risk behaviors among these employees

Self-reported adverse reactions among patients initiating antiretroviral therapy in Brazil

A cross-sectional analysis was carried out to describe adverse reactions to antiretroviral therapy (ART) reported by HIV-infected patients initiating treatment at two public health AIDS referral centers in Belo Horizonte, Brazil, 2001-2003 and to verify their association with selected variables. Adverse reactions were obtained through interview at the first follow-up visit (first month) after the antiretroviral prescription. Socio-demographic and behavioral variables related to ART were obtained from baseline and follow-up interviews and clinical variables from medical charts. Patients with four or more reactions were compared to those with less than four. Odds ratio with 95% confidence interval were estimated using logistic regression model for both univariate and multivariate analyses. At least one adverse reaction was reported by 92.2% of the participants while 56.2% reported four or more different reactions. Antiretroviral regimens including indinavir/ritonavir, irregular use of antiretrovirals and switch in regimens were independently associated with four or more adverse reactions (OR=7.92, 5.73 and 2.03, respectively). The initial period of ARV treatment is crucial and patients´ perception of adverse reactions should be carefully taken into account. Strategies for monitoring and management of adverse reactions including the choice of regimens and the prevention of irregular ART should be developed in AIDS/HIV referral centers in Brazil to promote better adherence to antiretroviral therapy

Intera??es sociais e a ades?o ? terapia antirretroviral de pessoas vivendo com HIV/AIDS.

Despite increasing accessibility to antiretroviral treatment regimens, adherence remains a challenge for the health systems in Brazil. Difficulties related with low adherence among patients living with HIV/AIDS include adapting to treatment and poorer social interactions, usually due to the stigma of the disease. These and other psychosocial aspects of subjects are expressed in their social interactions. This is a qualitative study. The participants were patients of reference services for HIV treatment. It was reached on 30 interviews; we defined greater empirical categories using Content Analysis. We observed that patients distanced from their partners, family, friends and neighbors, as opposed to sharing their experience with the disease experienced decreased support from their social network. These data pointed out the need to improve patient education and encourage more effective interventions, favoring multidisciplinary work to promote greater treatment adherence, as well as a more integrated approach to healthcare.Apesar do aumento de acessibilidade aos regimes de tratamento antirretrovirais, a ades?o continua a ser um desafio para os sistemas de sa?de no Brasil. Dificuldades relacionadas ? baixa ades?o entre os pacientes que vivem com HIV/ Aids incluem a adapta??o ao tratamento e intera??es sociais mais pobres, devido, geralmente, ao estigma da doen?a. Esses e outros aspectos psicossociais dos indiv?duos s?o expressos em suas intera??es sociais, objeto deste estudo qualitativo. Os participantes foram pacientes de servi?os de refer?ncia para o tratamento do HIV. Realizaram-se 30 entrevistas, sendo definidas categorias emp?ricas a partir da an?lise de conte?do realizada. Observou-se que os pacientes que se distanciaram de seus parceiros, fam?lia, amigos e vizinhos, em oposi??o a partilhar a sua experi?ncia com a doen?a, experimentaram diminui??o de apoio de sua rede social. Esses dados salientaram a necessidade de melhorar a educa??o do paciente e incentivar interven??es mais eficientes, favorecendo o trabalho multidisciplinar e uma abordagem integrada dos cuidados de sa?de, para promover maior ades?o ao tratament