RESUMO
Introducción: Las picaduras de serpientes constituyen un grave problema de Salud Pública. Objetivo: Describir los casos de mordeduras de serpientes notificados al Programa Nacional de Control de Zoonosis y Centro Antirrábico Nacional, Paraguay durante el año 2015. Método: Estudio observacional, descriptivo, retrospectivo y de corte transversal. Los criterios de inclusión fueron toda persona que haya sido mordida por alguna serpiente y que haya sido notificado al Programa Nacional de Control de Zoonosis y Centro Antirrábico Nacional durante el año 2015. Tipo de muestreo no probabilístico. Resultados: Fueron notificados 169 casos de mordeduras de serpientes. De acuerdo con las características sociodemográficas, la mayoría de los afectados fueron varones, con una edad promedio de 26,39 ±1.36. Los lugares más frecuentes donde ocurrieron los accidentes ofídicos fueron las chacras, y en el Departamento de San Pedro. En la mayoría de las mordeduras no se pudo identificar a la serpiente agresora, y cuando fueron identificadas, fueron las del genero Bothrops, las más frecuentes. En cuanto a la localización de las picaduras, fueron más frecuentes en los miembros inferiores, siendo necesario la hospitalización para el tratamiento. No se reportaron fallecidos. Conclusión: En el año 2015 fueron notificados 169 casos, los departamentos con mayor prevalência fueron San Pedro, Itapúa y Caazapá. El perfil del afectado es un varón con promedio de edad de 26 años, trabajador rural. Las serpientes del género Bothrops causaron el 32,5% de las mordeduras. Palabras clave: Mordeduras de serpiente; Envenenamiento; Epidemiología.
Introduction: Snake bites are a serious public health problem. Objective: To describe the cases of snake bites reported to the National Zoonosis Control Program and National Anti-Rabies Center, Paraguay during 2015. Method: Observational, descriptive, retrospective and cross-sectional study. The inclusion criteria were any person who has been bitten by a snake and it has been notified to the National Zoonosis Control Program and National Anti-Rabies Center during 2015. Type of non-probabilistic sampling. Results: 169 cases of snake bites were reported. According to the sociodemographic characteristics, the majority of those affected were males, with an average age of 26.39 ± 1.36. The most frequent places where theophidic accidents occurred were the farms, and in the Department of San Pedro. In most of the bites the aggressor snake could not be identified, and when they were identified, they were those of the genus Bothrops, the most frequent. As for the location of the bites, they were more frequent in the lower limbs, requiring hospitalization for treatment. No deaths were reported. Conclusion: In the year 2015, 169 cases were notified, the departments with the highest prevalence were San Pedro, Itapua and Caazapá. The profile of the affected is a male with an average age of 26 years, a rural worker. The snakes of the genus Bothrops caused 32.5% of the bites. Keywords: Snake bites; Poisoning; Epidemiology.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Mordeduras de Serpentes/epidemiologia , Programas Nacionais de Saúde , Paraguai/epidemiologia , Prevalência , Estudos Transversais , Estudos RetrospectivosRESUMO
The aims of this study were to examine differences in self-schemas between persons living with HIV/AIDS with and without depressive symptoms, and the degree to which these self-schemas predict depressive symptoms in this population. Self-schemas are beliefs about oneself and include self-esteem, HIV symptom management self-efficacy, and self-compassion. Beck's cognitive theory of depression guided the analysis of data from a sample of 1766 PLHIV from the USA and Puerto Rico. Sixty-five percent of the sample reported depressive symptoms. These symptoms were significantly (p ≤ 0.05), negatively correlated with age (r = -0.154), education (r = -0.106), work status (r = -0.132), income adequacy (r = -0.204, self-esteem (r = -0.617), HIV symptom self-efficacy (r = - 0.408), and self-kindness (r = - 0.284); they were significantly, positively correlated with gender (female/transgender) (r = 0.061), white or Hispanic race/ethnicity (r = 0.047) and self-judgment (r = 0.600). Fifty-one percent of the variance (F = 177.530 (df = 1524); p < 0.001) in depressive symptoms was predicted by the combination of age, education, work status, income adequacy, self-esteem, HIV symptom self-efficacy, and self-judgment. The strongest predictor of depressive symptoms was self-judgment. Results lend support to Beck's theory that those with negative self-schemas are more vulnerable to depression and suggest that clinicians should evaluate PLHIV for negative self-schemas. Tailored interventions for the treatment of depressive symptoms in PLHIV should be tested and future studies should evaluate whether alterations in negative self-schemas are the mechanism of action of these interventions and establish causality in the treatment of depressive symptoms in PLHIV.
Assuntos
Depressão/psicologia , Infecções por HIV/psicologia , Autocuidado/métodos , Autoimagem , Autoeficácia , Adolescente , Adulto , Idoso , Canadá/epidemiologia , China/epidemiologia , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Escolaridade , Emoções/fisiologia , Etnicidade/psicologia , Etnicidade/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Humanos , Julgamento/fisiologia , Masculino , Pessoa de Meia-Idade , Namíbia/epidemiologia , Porto Rico/epidemiologia , Distribuição por Sexo , Inquéritos e Questionários , Tailândia/epidemiologia , Estados Unidos/epidemiologia , Adulto JovemRESUMO
The purpose of this study was to investigate the effects of stressful life events (SLE) on medication adherence (3 days, 30 days) as mediated by sense of coherence (SOC), self-compassion (SCS), and engagement with the healthcare provider (eHCP) and whether this differed by international site. Data were obtained from a cross-sectional sample of 2082 HIV positive adults between September 2009 and January 2011 from sites in Canada, China, Namibia, Puerto Rico, Thailand, and US. Statistical tests to explore the effects of stressful life events on antiretroviral medication adherence included descriptive statistics, multivariate analysis of variance, analysis of variance with Bonferroni post-hoc analysis, and path analysis. An examination by international site of the relationships between SLE, SCS, SOC, and eHCP with adherence (3 days and 30 days) indicated these combined variables were related to adherence whether 3 days or 30 days to different degrees at the various sites. SLE, SCS, SOC, and eHCP were significant predictors of adherence past 3 days for the United States (p = < 0.001), Canada (p = 0.006), and Namibia (p = 0.019). The combined independent variables were significant predictors of adherence past 30 days only in the United States and Canada. Engagement with the provider was a significant correlate for antiretroviral adherence in most, but not all, of these countries. Thus, the importance of eHCP cannot be overstated. Nonetheless, our findings need to be accompanied by the caveat that research on variables of interest, while enriched by a sample obtained from international sites, may not have the same relationships in each country.
Assuntos
Acontecimentos que Mudam a Vida , Adesão à Medicação/psicologia , Relações Profissional-Paciente , Adulto , Fármacos Anti-HIV/uso terapêutico , Canadá , China , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Análise Multivariada , Namíbia , Porto Rico , Inquéritos e Questionários , Tailândia , Estados UnidosRESUMO
Depressive symptoms are highly prevalent yet undertreated in people living with HIV/AIDS (PLHAs). As part of a larger study of symptom self-management (N=1217), this study examined the prevalence, correlates, and characteristics (intensity, distress, and impact) of depressive symptoms, and the self-care strategies used to manage those symptoms in PLHAs in five countries. The proportion of respondents from each country in the total sample reporting depressive symptoms in the past week varied and included Colombia (44%), Norway (66%), Puerto Rico (57%), Taiwan (35%), and the USA (56%). Fifty-four percent (n=655) of the total sample reported experiencing depressive symptoms in the past week, with a mean of 4.1 (SD 2.1) days of depression. Mean depression intensity 5.4 (SD 2.7), distressfulness 5.5 (SD 2.86), and impact 5.5 (SD 3.0) were rated on a 1-10 scale. The mean Center for Epidemiologic Studies Depression Scale score for those reporting depressive symptoms was 27 (SD 11; range 3-58), and varied significantly by country. Respondents identified 19 self-care behaviors for depressive symptoms, which fell into six categories: complementary therapies, talking to others, distraction techniques, physical activity, medications, and denial/avoidant coping. The most frequently used strategies varied by country. In the US sample, 33% of the variance in depressive symptoms was predicted by the combination of education, HIV symptoms, psychological and social support, and perceived consequences of HIV disease.
Assuntos
Transtorno Depressivo/terapia , Infecções por HIV/psicologia , Autocuidado/métodos , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Antidepressivos/uso terapêutico , Colômbia/epidemiologia , Comunicação , Terapias Complementares/métodos , Transtorno Depressivo/complicações , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Porto Rico/epidemiologia , Índice de Gravidade de Doença , Apoio Social , Taiwan/epidemiologia , Estados Unidos/epidemiologia , Adulto JovemRESUMO
En situaciones de cambios en el peso, la evidencia sobre la relación entre la leptina y la insulina con el contenido de grasa corporal no es concluyente. Se planteó establecer asociaciones entre leptina e insulina (ELISA) y pérdida de peso (antropometría) durante un régimen hipocalórico alto en fibra, en 71 individuos (sobrepeso/ obesos), al inicio (I), a dos (2s) y a seis semanas (6s) del régimen. Se aplicaron pruebas no paramétricas para muestras independientes y relacionadas. Hubo disminución significativa de la leptina entre I, 2s y 6s, similar entre sobrepeso y obesidad, normalizándose a las 6s (sobrepeso fueron normales a las 2s y obesos a las 6s). Aumentó la prevalencia de valores normales (leptina <15 ng/mL) durante el régimen. La leptina fue significativamente mayor en obesos que en los con sobrepeso y en mujeres que en hombres, sin diferencias significativas por género para la insulina. Asociación significativa entre leptina e indicadores de adiposidad (índice de masa corporal, circunferencia abdominal). A las 2s, hubo correlación positiva entre leptina e insulina, no evidente a las 6s. El régimen basado en el consumo de fibra fue eficiente para lograr cambios en los parámetros antropométricos y bioquímicos, en especial, una disminución de la leptina.
Leptin acts as a regulatory signal for food intake, body energy balance, body fat content and body weight stability. In order to establish associations among serum leptin, serum insulin and weight loss, 71 obese or overweight adults were assessed by anthropometry and serum determination of leptin at the beginning (B), two weeks (2w) and six weeks (6w) after consuming a dietary regime based on complex carbohydrates intake. Data was analyzed by non parametrical tests for independent and related samples. There was a significant decrease of leptin among B, 2w and 6w of similar nature between overweight and obese participants, with all of them reaching normal values at 6w (overweight at 2w and obese at 6 w). Prevalence of normal leptin values (<15 ng/mL) increased among B, 2w and 6w. Leptin levels were significantly higher in obese vs. overweight and in women vs. men with no differences in serum glucose or insulin by sex. There was a significant association between leptin and adiposity indicators (body mass index and abdominal circumference). At 2w, but not at 6w, a positive correlation between leptin and insulin was found. A dietary regime based on increased consumption of complex carbohydrate (fiber) was efficient to induce favorable changes in anthropometrical and biochemical indicators, especially serum leptin.
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Carboidratos da Dieta/administração & dosagem , Dieta Redutora , Leptina/sangue , Obesidade/dietoterapia , Obesidade/sangue , Redução de Peso/fisiologia , Índice de Massa Corporal , Ingestão de Energia , Hormônios Peptídicos/sangue , Insulina/sangue , Estudos Longitudinais , Sobrepeso/dietoterapia , Sobrepeso/sangue , VenezuelaRESUMO
The prevalence of peripheral neuropathy is frequent in HIV disease and is often associated with antiretroviral therapy. Unhealthy behaviours, particularly substance-use behaviours, are utilized by many HIV-positive individuals to manage neuropathic symptoms. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of unhealthy behaviours to self-manage peripheral neuropathy in HIV disease. Sociodemographic and disease-related correlates and unhealthy behaviours were examined in a convenience sample of 1,217 respondents who were recruited from data collection sites in several US cities, Puerto Rico, Colombia, and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified a variety of unhealthy self-care behaviours including injection drug use, oral drug use, smoking cigarettes and alcohol ingestion. Specific unhealthy behaviours that participants reported to alleviate peripheral neuropathy included use of marijuana (n=67), smoking cigarettes (n=139), drinking alcohol (n=81) and street drugs (n=30). A subset of those individuals (n=160), who identified high levels of neuropathy (greater than five on a scale of 1-10), indicated significantly higher use of amphetamines and injection drug use in addition to alcohol use and cigarette smoking. For participants from Norway, substance use (using alcohol: 56%) was one of the most frequent self-management strategies. Implications for clinical practice include assessment and education of persons with HIV for self-care management of the complex symptom of peripheral neuropathy.
Assuntos
Infecções por HIV/psicologia , Doenças do Sistema Nervoso Periférico/terapia , Assunção de Riscos , Autocuidado/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Antirretrovirais/efeitos adversos , Atitude Frente a Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/psicologia , Prevalência , Porto Rico/epidemiologia , Fatores de Risco , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Taiwan/epidemiologia , Estados Unidos/epidemiologiaRESUMO
Peripheral neuropathy is the most common neurological complication in HIV and is often associated with antiretroviral therapy. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of peripheral neuropathy in HIV disease, sociodemographic and disease-related correlates and self-care strategies. A convenience sample of 1,217 respondents was recruited from data collection sites in several US cities, Puerto Rico, Colombia and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified 20 self-care behaviors including complementary therapies, use of medications, exercise and rest and/or elevation of extremities. Ratings of frequency and effectiveness were also included. An activities checklist summarized into five categories of self-care behaviors including activities/thoughts, exercise, medications, complementary therapies and substance was used to determine self-care behaviors. Taking a hot bath was the most frequent strategy used by those with peripheral neuropathy (n=292) and received the highest overall rating of effectiveness of any self-management strategies included in this study at 8.1 (scale 1-10). Other self-care strategies to manage this symptom included: staying off the feet (n=258), rubbing the feet with cream (n=177), elevating the feet (n=236), walking (n=262), prescribed anti-epileptic agent (n=80), prescribed analgesics (n=84), over-the-counter medications (n=123), vitamin B (n=122), calcium supplements (n=72), magnesium (n=48), massage (n=156), acupuncture (n=43), reflexology (n=23) and meditation (n=80). Several behaviors that are often deemed unhealthy were included among the strategies reported to alleviate peripheral neuropathy including use of marijuana (n=67), cigarette smoking (n=139), drinking alcohol (n=81) and street drugs (n=30).
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Doenças do Sistema Nervoso Periférico/terapia , Autocuidado/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/terapia , Atitude Frente a Saúde , Colômbia/epidemiologia , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medicamentos sem Prescrição/uso terapêutico , Doenças do Sistema Nervoso Periférico/epidemiologia , Prevalência , Porto Rico/epidemiologia , Fumar/terapia , Taiwan/epidemiologia , Estados Unidos/epidemiologiaRESUMO
Las infecciones respiratorias agudas(IRA)constituyen una causa importante de morbimortalidad en pediatría donde los virus tienen un papel relevante,pudiendo ser diagnosticados por la inmunofluorescencia directa(IFD)con sensibilidad similar al aislamiento en cultivos.El objetivo del estudio fue evaluar la frecuencia de agentes virales asociados a IRA en niños internados por esta causa en diferentes hospitales del país y conocer el aspecto clínico-epidemiológico.Se realizó un estudio de corte transversal donde se ananlizaron por inmunofluorescencia,aspirados nasofaríngeos,secreciones traqueales,nasales y lavados bronquiales.Entre enero y octubre de 1997,se estudiaron 111 muestras de niños de 15 días 10 años,identificándose un agente viral en 59 de ellos.Los agentes hallados fueron virus sincicial respiratorio (VSR)47 por ciento,parainfluenza 1,2,3(5,4 por ciento)adenovirus(3,6 por ciento)influenza A(5,4 por ciento)influenza B(1,8 por ciento).Los patrones clínicos fueron bronquiolitis(49 por ciento)neumonías(42 por ciento)y croup(8,5 por ciento).Los VSR se identificaron con mayor frecuencia con pico en agosto(63 por ciento)en lactantes menores.El virus de influenza A se presentó con temporalidad similar y se relacionó con casos severos en niños mayores de 5 años en el Chaco.El paraonfluenza se observó en menores de 1 año.El adenovirus fue más esporádico pero uno de ellos se relacionó a un caso fatal.Se observaron asociaciones de agentes virales.Con esta técnica de diagnóstico útil se dispone del primer dato sobre la epidemiología de las afecciones respiratorias agudas de probable etiología viral en la población infantil del país que requirió hospitalización,siendo similar a lo observado en otros países
Assuntos
Recém-Nascido , Lactente , Pré-Escolar , Criança , Técnica Direta de Fluorescência para Anticorpo , Infecções Respiratórias , Vírus , PediatriaRESUMO
Las infecciones respiratorias agudas(IRA)constituyen una causa importante de morbimortalidad en pediatría donde los virus tienen un papel relevante,pudiendo ser diagnosticados por la inmunofluorescencia directa(IFD)con sensibilidad similar al aislamiento en cultivos.El objetivo del estudio fue evaluar la frecuencia de agentes virales asociados a IRA en niños internados por esta causa en diferentes hospitales del país y conocer el aspecto clínico-epidemiológico.Se realizó un estudio de corte transversal donde se ananlizaron por inmunofluorescencia,aspirados nasofaríngeos,secreciones traqueales,nasales y lavados bronquiales.Entre enero y octubre de 1997,se estudiaron 111 muestras de niños de 15 días 10 años,identificándose un agente viral en 59 de ellos.Los agentes hallados fueron virus sincicial respiratorio (VSR)47 por ciento,parainfluenza 1,2,3(5,4 por ciento)adenovirus(3,6 por ciento)influenza A(5,4 por ciento)influenza B(1,8 por ciento).Los patrones clínicos fueron bronquiolitis(49 por ciento)neumonías(42 por ciento)y croup(8,5 por ciento).Los VSR se identificaron con mayor frecuencia con pico en agosto(63 por ciento)en lactantes menores.El virus de influenza A se presentó con temporalidad similar y se relacionó con casos severos en niños mayores de 5 años en el Chaco.El paraonfluenza se observó en menores de 1 año.El adenovirus fue más esporádico pero uno de ellos se relacionó a un caso fatal.Se observaron asociaciones de agentes virales.Con esta técnica de diagnóstico útil se dispone del primer dato sobre la epidemiología de las afecciones respiratorias agudas de probable etiología viral en la población infantil del país que requirió hospitalización,siendo similar a lo observado en otros países
Assuntos
Recém-Nascido , Lactente , Pré-Escolar , Criança , Técnica Direta de Fluorescência para Anticorpo , Infecções Respiratórias , Vírus , PediatriaRESUMO
Las infecciones respiratorias agudas (IRA) constituyen una causa importante de morbimortalidad en pediatría donde los virus tienen un papel relevante, los cuales pueden ser diagnosticados por la inmunofluorescencia directa IFD con sensibilidad similar al aislamiento en cultivos. El objetivo del estudio fue evaluar la frecuencia de agentes virales asociados a IRA en niños internados por esta causa en diferentes hospitales del país y conocer el aspecto clínico-epidemiológico. Se realizó un estudio de corte transversal donde se analizaron por inmunofluorescencia, aspirados nasofaríngeos, secreciones traqueales, nasales, lavados bronquiales. Se estudiaron 111 muestras de enero a octubre de 1997 de niños de 15 días a 10 años identificándose un agente viral en 59 de los casos. Los agentes hallados fueron Virus Sincicial Respiratorio (VSR) 47 por ciento, el Parainfluenza 1, 2, 3 (5,4 por ciento), el Adenovirus(3,6 por ciento), el Influenza A (5,4 por ciento), Influenza B (1,8 por ciento). Los patrones clínicos fueron Bronquiolitis (49 por ciento), Neumonías (42 por ciento) y Croup (8,5 por ciento). Los VSR se identificaron con mayor frecuencia con pico en agosto; (63 por ciento) en lactantes menores. El virus de influenza A se presentó con temporalidad similar y se relacionó con casos severos en niños mayores de 5 años, en el Chaco. El Parainfluenza se observó en menores de 1 año. El Adenovirus fue más esporádico pero uno de ellos se relacionó a un caso fatal. Se observaron asociaciones de agentes virales. Con esta técnica diagnóstico útil se dispone del primer dato sobre la epidemiología de las afecciones respiratorias agudas de probable etiología viral en la población infantil del país que requirió hospitalización, siendo similar a lo observado en otros países
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Bronquiolite/virologia , Técnica Direta de Fluorescência para Anticorpo , Pneumonia/virologia , Adenovírus Humanos/isolamento & purificação , Estudos Transversais , Hospitalização , Vírus da Influenza A/isolamento & purificação , Vírus da Influenza B/isolamento & purificação , Nasofaringe/virologia , Paraguai , Vírus Sinciciais Respiratórios/isolamento & purificação , Infecções Respiratórias/virologia , Respirovirus/isolamento & purificaçãoRESUMO
Trata de las afecciones respiratorias agudas, que constituye una causa importante de morbimortalidad en pediatría, especialmente en los países en vías de desarrollo, en donde los virus tienen un papel relevante, incluye los materiales y métodos utilizados, muestras, y resultados
Assuntos
Doenças Respiratórias/diagnóstico , Doenças Respiratórias/epidemiologia , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Broncopatias/diagnóstico , ParaguaiRESUMO
LAS HIPÓTESIS PLANTEADAS FUERON: Existe una mayor frecuencia de accidentes de trabajo en los trabajadores con alto grado de alcoholismo, comparado contra trabajadores con bajo riesgo de alcoholismo. Existe una variedad más alta en las consecuencias negativas de los accidentes de trabajo en los trabajadores con alto riesgo de alcoholismo en relación. De acuerdo a los resultados del estudio se recomienda a las empresas de la construcción implementar una política clara sobre el consumo de bebidas alcohólicas en el ámbito laboral y diseñar y ejecutar un programa de prevención del alcoholismo.
Assuntos
Prevenção de Acidentes , Alcoolismo , Categorias de TrabalhadoresRESUMO
Se realizó el presente estudio en el cual se incluyeron 85 lactantes menores con una edad comprendida entre 12 días a 15 meses, el periodo abarcado es desde marzo 1992 a agosto de 1996. En cada caso se tomaron muestras de aspirados nasofaríngeos y fueron analizadas las fichas de ingreso con los datos clínicos, evolución y tratamiento de los pacientes. Resultaron positivos 22 casos(25 por ciento) de los cuales 18 pacientes(82 por ciento) fueron memores de 3 meses y 4 pacientes (28 por ciento) mayores de 3 meses, resultando 15 pacientes del primer grupo menores de 8 semanas. Todos los casos positivos de neumonías por Chlamydia trachomatis fueron tratados con Eritromicina por 14 días con buena evolución y no se observo ningún caso fatal
Assuntos
Infecções Respiratórias , Chlamydophila psittaci , Pneumonia , ParaguaiRESUMO
Present regulations on the issuance of dental licenses are very different between the United States of America and the European Community. Two different mechanisms attempt to arrive at the fairest possible solution: licenses controlled by either national and/or local examinations in the United States, and licensing by credentials in the European Community. Both are compared and discussed.
Assuntos
União Europeia , Licenciamento em Odontologia/legislação & jurisprudência , Credenciamento/legislação & jurisprudência , Europa (Continente) , Estados UnidosRESUMO
There has been a long-standing interest in the relationship between cardiovascular disease (CVD) and psychiatric morbidity, specifically depressive symptoms. The aims of this study were to determine the following: 1. The relationship between the presence of angina and depressive symptoms; 2. The influences of sociodemographic covariates on this relationship; and 3. The effects of functional impairment or inactivity level in mediating the relationship between angina and depressive symptoms. The data utilized for this study was from the Hispanic Health and Nutrition Examination Survey (HHANES) on 1,558 Mexican American women. The survey was cross sectional, conducted in 1982-84. The dependent variable was depression as measured by the Center for Epidemiologic Depression Scale (CES-D). The independent variable was the presence of angina as measured by the Rose Questionnaire. Covariates included functional impairment, physical activity, age, education, acculturation, poverty level, marital status, and work status. The findings suggest that functional impairment has a stronger association with depressive symptoms than angina or physical inactivity. Significant sociodemographic variables include single marital status and poverty. Comorbidity has been a neglected area of research for Mexican American women, but this study suggests that functional impairment is a more important factor associated with depressive symptomatology than angina.
Assuntos
Atividades Cotidianas , Angina Pectoris/complicações , Depressão/complicações , Exercício Físico , Americanos Mexicanos , Saúde da Mulher , Adulto , Idoso , Angina Pectoris/etnologia , Comorbidade , Estudos Transversais , Depressão/etnologia , Feminino , Humanos , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos/epidemiologiaRESUMO
One hundred widows participating in experimental research entitled Efficacy of Support Groups for Mexican American Widows were studied to learn how they express the loss of their husbands. Mourning practices, acknowledged symptoms of dysphoria, and somatic reactions were studied to learn if the syndrome of nervios subsumes their reaction to bereavement. In addition, their responses to instruments designed to measure depression, the Spanish version of the Beck Depression Inventory and the Center for Epidemiologic Studies Depression Scale, were examined for correlation with nervios and relationships to Mexican American acculturation. Nervios seems to be a manifestation of dysphoria rather than a specific syndrome for these women.