RESUMEN
Qualitative research with 60 males (16-80 years) from two Caribbean countries was carried out to explore men's perspectives on domestic violence (DV). An inductive latent/thematic approach to data analysis supported by analytic software led to five key domains being identified: (1) meanings of violence; (2) patrinormative culture; (3) normalization of violence; (4) male victimization; and (5) blame attribution and empathy. Patriarchal values, together with childhood exposure to violence, were found to reduce empathic capacity and contribute to the normalization of DV. In addition, the minimization of male victimization and the lack of behavior-change support services for men were identified as contributory factors.
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Hombres , Violencia , Humanos , Masculino , Niño , Investigación Cualitativa , Región del CaribeRESUMEN
INTRODUCTION: This study captures the perspectives of stakeholders at multiple levels of the vaccine supply chain regarding their assessment of challenges with storing vaccines within recommended temperature ranges and their perceptions on the benefits of having vaccines with improved stability, including the potential short-term storage and transport of vaccines in a controlled-temperature chain. METHODS: Semi-structured interviews were undertaken with 158 immunization stakeholders in six countries. Interviewees included national decision-makers and advisors involved in vaccine purchasing decisions, national Expanded Programme on Immunization managers, and health and logistics personnel at national, subnational, and health facility levels. RESULTS: Challenges with both heat and freeze-exposure of vaccines were recognized in all countries, with heat-exposure being a greater concern. Conditions leading to freeze-exposure including ice build-up due to poor refrigerator performance and improper icepack conditioning were reported by 53% and 28% of participants, respectively. Respondents were interested in vaccine products with improved heat/freeze-stability characteristics. The majority of those involved in vaccine purchasing indicated they would be willing to pay a US$0.05 premium per dose for a freeze-stable pentavalent vaccine (68%) or a heat-stable rotavirus vaccine (59%), although most (53%) preferred not to pay the premium for a heat-stable pentavalent vaccine if the increased stability required changing from a liquid to a lyophilized product. Most respondents (73%) were also interested in vaccines labeled for short-term use in a controlled-temperature chain. The majority (115/158) recognized the flexibility this would provide during outreach or should cold-chain breaks occur. Respondents were also aware that possible confusion might arise and additional training would be required if handling conditions were changed for some, but not all vaccines. CONCLUSION: Participating immunization stakeholders recognized the benefits of vaccine products with improved stability characteristics and of labeling vaccines for controlled-temperature chain use as a means to help address cold-chain issues in their immunization programs.
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Estabilidad de Medicamentos , Refrigeración , Vacunas , Brasil , China , Almacenaje de Medicamentos , Congelación , Personal de Salud , Calor , India , Entrevistas como Asunto , Perú , Filipinas , Control de Calidad , Tanzanía , Transportes , Potencia de la Vacuna , Vacunas/economíaRESUMEN
Introducción: La demencia asociada al virus de inmunodeficiencia humana (D-VIH) es un tipo de demencia subcortical debido a infecciones crónicas por VIH; y combina alteraciones cognitivas, motoras y conductuales, afectando del 20 al 30% de los pacientes adultos que sufren esta enfermedad. La Escala de Demencia por VIH (EDV) es una herramienta sensible que se utiliza para tamizaje de pacientes infectados por VIH y con riesgo de desarrollar demencia. Objetivos. Aplicar la EDV en pacientes con infección avanzada por VIH que asistían al Centro de Atención Integral (CAI) del Hospital Mario Catarino Rivas (HMCR) y analizar su relación con el conteo de células TCD4 <200. Metodología. Se trata de un estudio cuantitativo, descriptivo, de corte transversal con un muestreo intencionado. En el estudio se incluyó pacientes mayores de 18 años con VIH confirmado, quienes asisten al CAI, alfabetos, con conteo reciente de linfocitos CD4 menor de 200 células y que consintieron participar en el estudio. Se les aplicó la EDV como tamizaje para evaluar su función mental. Resultados. El 81% de los pacientes entrevistados presentaron riesgo de D-VIH con un rango de edad de mayor prevalencia entre 38 y 57 años, siendo el género femenino el de mayor riesgo. Conclusión de acuerdo a los resultados obtenidos, la EDV es una herramienta costo-efectiva para determinar la función cognitiva en los pacientes...(AU)