Um estudo das crenças maternas sobre cuidados com crianças em dois contextos culturais do estado de Santa Catarina

Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Filosofia e Ciências Humanas. Programa de Pós-Graduação em Psicologia.Este trabalho foi parte de uma pesquisa nacional envolvendo seis estados brasileiros com o objetivo de averiguar aspectos biológicos, ecológicos e culturais do cuidado parental. A questão central foi investigar semelhanças e diferenças de crenças de mães sobre cuidados com crianças na capital e interior do Estado de Santa Catarina. Participaram 100 mães (50 por contexto), com idade entre 21 e 49 anos, com pelo menos um filho entre 0 e 6 anos de idade. Foram utilizados questionários e escalas em aplicação individual, submetidos à análise estatística e os resultados foram discutidos a partir do referencial teórico da Psicologia Evolucionista. A primeira parte da pesquisa consistiu na adaptação das escalas para o contexto brasileiro e a segunda parte consistiu na análise dos resultados das escalas referentes ao problema de pesquisa descrito acima. Os dados indicaram que a capital e o interior são grupos de orientação cultural autônomo-relacional, com predomínio de elementos do modelo independente na capital e do modelo interdependente no interior Independência e interdependência foram considerados pólos opostos de uma dimensão, podendo coexistir elementos de um lado ou outro dependendo da situação. Como era esperado, houve crenças semelhantes e diferentes que foram descritas como aspectos universais e culturais, respectivamente, do cuidado parental. Houve também resultados que indicaram relações entre crenças das mães e comportamento. De modo geral, as mães da capital foram criadas na zona urbana, apresentaram maior escolaridade e maior renda familiar, eram vinculadas à família, valorizaram cuidados de estimulação, estabeleceram mais metas de socialização autônomas e valorizaram práticas autônomas e relacionais; enquanto as mães do interior foram criadas na zona rural, apresentaram alto grau de apoio social, de proximidade familiar, de realização e valorização de cuidados primários, estabeleceram metas de socialização autônomas e relacionais e realizaram práticas autônomas

The Effect of Complete Integration of HIV and TB Services on Time to Initiation of Antiretroviral Therapy: A Before-After Study.

Studies have shown that early ART initiation in TB/HIV co-infected patients lowers mortality. One way to implement earlier ART commencement could be through integration of TB and HIV services, a more efficient model of care than separate, vertical programs. We present a model of full TB/HIV integration and estimate its effect on time to initiation of ART

Avaliação da qualidade sensorial de carne de borrego Terrincho. Efeito do sexo e do peso da carcaça

Este trabalho tem como objectivo avaliar o efeito do sexo e do peso da carcaça na caracterização sensorial da carne de um produto DOP, o Borrego Terrincho

Improving access and quality of care in a TB control programme

Objectives. To use a quality improvement approach to improve access to and quality of tuberculosis (TB) diagnosis and care in Cape Town. Methods. Five HIV/AIDS/sexually transmitted infections/TB (HAST) evaluations were conducted from 2008 to 2010, with interviews with 99 facility managers and a folder review of over 850 client records per evaluation cycle. The data were used in a local quality improvement process: sub-district workshops identified key weaknesses and facility managers drew up action plans. Lessons learnt and successful strategies were shared at quarterly district-wide HIV/TB meetings. Results. Geographical access was good, but there were delays in treatment commencement times. Access for high-risk clients improved significantly with intensified TB case finding made routine in both the HIV counselling and testing and antiretroviral treatment (ART) services (

Clinical mentorship of nurse initiated antiretroviral therapy in Khayelitsha, South Africa: a quality of care assessment.

To combat the AIDS epidemic and increase HIV treatment access, the South African government implemented a nurse-based, doctor-supported model of care that decentralizes administration of antiretroviral treatment (ART) for HIV positive patients through nurse initiated and managed ART. Médecins Sans Frontières (MSF) implemented a mentorship programme to ensure successful task-shifting, subsequently assessing the quality of clinical care provided by nurses

The importance of identified cause-of-death information being available for public health surveillance, actions and research

An amendment to the South African Births and Deaths Registration Act has compromised efforts to strengthen local mortality surveillance to provide statistics for small areas and enable data linkage to provide information for public health actions. Internationally it has been recognised that a careful balance needs to be kept between protecting individual patient confidentiality and enabling effective public health intelligence to guide patient care and service delivery and prevent harmful exposures. This article describes the public health benefits of a local mortality surveillance system in the Western Cape Province, South Africa (SA), as well as its potential for improving the quality of vital statistics data with integration into the national civil registration and vital statistics system. It also identifies other important uses for identifiable cause-of-death data in SA that have been compromised by this legislation

Barriers to Initiation of Antiretrovirals during Antituberculosis Therapy in Africa

In the developing world, the principal cause of death among HIV-infected patients is tuberculosis (TB). The initiation of antiretroviral therapy (ART) during TB therapy significantly improves survival, however it is not known which barriers prevent eligible TB patients from initiating life-saving ART.Setting. A South African township clinic with integrated tuberculosis and HIV services. Design. Logistic regression analyses of a prospective cohort of HIV-1 infected adults (≥18 years) who commenced TB therapy, were eligible for ART, and were followed for 6 months.Of 100 HIV-1 infected adults eligible for ART during TB therapy, 90 TB patients presented to an ART clinic for assessment, 66 TB patients initiated ART, and 15 TB patients died. 34% of eligible TB patients (95%CI: 25-43%) did not initiate ART. Male gender and younger age (<36 years) were associated with failure to initiate ART (adjusted odds ratios of 3.7 [95%CI: 1.25-10.95] and 3.3 [95%CI: 1.12-9.69], respectively). Death during TB therapy was associated with a CD4+ count <100 cells/µL.In a clinic with integrated services for tuberculosis and HIV, one-third of eligible TB patients--particularly young men--did not initiate ART. Strategies are needed to promote ART initiation during TB therapy, especially among young men

Outcomes from the implementation of a counselling model supporting rapid antiretroviral treatment initiation in a primary healthcare clinic in Khayelitsha, South Africa

Background: Lengthy antiretroviral treatment (ART) preparation contributes to high losses to care between communicating ART eligibility and initiating ART. To address this shortfall, Médecins Sans Frontières implemented a revised approach to ART initiation counselling preparation (integrated for TB co-infected patients), shifting the emphasis from pre-initiation sessions to addressing common barriers to adherence and strengthening post-initiation support in a primary healthcare facility in Khayelitsha, South Africa. Methods: An observational cohort study was conducted using routinely collected data for all ART-eligible patients attending their first counselling session between 23 July 2012 and 30 April 2013 to assess losses to care prior to and post ART initiation. Viral load completion and suppression rates of those retained on ART were also calculated. Results: Overall, 449 patients enrolled in the study, of whom 3.6% did not return to the facility to initiate ART. Of those who were initiated, 96.7% were retained at their first ART refill visit and 85.9% were retained 6 months post ART initiation. Of those retained, 80.2% had a viral load taken within 6 months of initiating ART, with 95.4% achieving viral load suppression. Conclusions: Adapting counselling to enable rapid ART initiation is feasible and has the potential to reduce losses to care prior to ART initiation without increasing short-term losses thereafter or compromising patient adherence

Contribuições das representações sociais ao estudo da aids

O presente artigo tem o objetivo apresentar um breve histórico da aids relacionando os aspectos médicos da doença aos fenômenos sociais, destacando as implicações e conseqüências para o indivíduo de ser portador de uma doença estigmatizante. O assunto foi tratado a partir do referencial teórico da psicologia social, em especial da teoria das representações sociais. Alguns conceitos teóricos necessários para a compreensão do tema também foram abordados: epidemia, prevenção e atitudes. Foram ainda identificadas as pesquisas atuais na área, bem como o enfoque das campanhas de prevenção e a contribuição da teoria das representações sociais para o estudo da doença. Assim, para que seja possível refletir sobre a disseminação da aids devem-se considerar as transformações desta epidemia na sua história, principalmente em relação às formas de transmissão, às tendências de instabilidade e vulnerabilidade da doença, e também aos significados construídos para enfrentar essa realidade. Palavras-chave: representações sociais; AIDS; prevenção.The present article aims to present a brief history of AIDS, relating the medical aspects of the disease to social phenomena, highlighting the individual implications and consequences of being a bearer of a stigmatizing disease. The issue was considered from the theoretical framework of social psychology, specially the social representations theory. Some theoretical concepts that are necessary for the understanding of the theme were also commented: epidemy, prevention and attitudes. Current studies in the area were also identified, as well as the focus in prevention campaigns and the contribution of social representations theory to the study of the disease. Therefore, transformations of AIDS epidemy through history, specially the ones related to transmission forms, tendencies of unstability and vulnerability of the disease and the meanings that are constructed to cope with this reality must be considered in order to stimulate a reflection about the disease's dissemination.   Keywords:  scientific social representations; AIDS; prevention