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Fundamento: dentro de las problemáticas que afrontan los cuidadores familiares de pacientes con padecimientos oncológicos está el hecho, que estos asumen el cuidado de sus familiares sin los conocimientos específicos, ni las habilidades requeridas para el ejercicio del cuidado, lo que genera una sobrecarga en ellos. Objetivo: identificar las principales características psicosociales del cuidador familiar del paciente con padecimientos oncológicos en la zona urbana de Niquero, durante el período de noviembre de 2019 a marzo del 2022. Métodos: se realizó un estudio descriptivo en el período comprendido de noviembre 2019 a marzo 2022 en el municipio Niquero en la provincia Granma. El universo de estudio quedó conformado por 305 cuidadores familiares de pacientes con padecimientos oncológicos, escogiéndose una muestra de 255 de ellos por medio de los criterios establecidos. Las variables analizadas fueron: edad, sexo, nivel de escolaridad, factores psicosociales presentes. Se realizó un muestreo intencional y probabilístico. Resultados: prevaleció el grupo de 50-59 años, el sexo femenino y como nivel de escolaridad, predominó el de secundaria básica, el miedo fue el estado emocional más referido por ellos. En los antecedentes sociales la situación económica desfavorable fue la que prevaleció, así como el nivel de afrontamiento familiar inadecuado ante el rol de cuidador. Conclusión: el miedo, la situación económica desfavorable y el nivel de afrontamiento inadecuado ante el rol de cuidador, fueron las principales características psicosociales que predominaron.

Background: among the problems faced by family caregivers of patients with oncological diseases is the fact that they take care of their relatives without the specific knowledge or skills required for the exercise of care, which generates an overload in them. Objective: to identify the main psychosocial characteristics of the family caregiver of the patient with oncological conditions in the urban area of ​​Niquero, during the period from November 2019 to March 2022. Methods: a descriptive study was carried out in the period from November 2019 to March 2022 in the Niquero municipality in the Granma province. The universe of study was made up of 305 family caregivers of patients with oncological conditions, choosing a sample of 255 of them by means of the established criteria. The variables analyzed were: age, sex, level of education, psychosocial factors present. An intentional and probabilistic sampling was carried out. Results: the age group prevailed in the family caregivers of cancer patients aged 50-59 years, the female sex and as level of education, the basic secondary predominated, fear was the emotional state most referred to by them. In the social background, the unfavorable economic situation was the one that prevailed, as well as the level of inadequate family coping with the role of caregiver. Conclusion: fear, the unfavorable economic situation and the inadequate level of coping with the role of caregiver, were the main psychosocial characteristics that prevailed.

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BACKGROUND: Travelers from international airports who travel to endemic countries know the knowledge, attitudes, and practices (KAP) about malaria; however, it is still unknown to interprovincial travelers who go to the endemic regions of Peru. The objective is to determine the level of KAP about malaria among Peruvian travelers to risk areas. METHODS AND PRINCIPAL FINDINGS: This are an analytical cross-sectional study of 277 passengers from a bus station in a low-risk area of malaria in Peru, whose destination was an intermediate/high-risk area during February-March 2018. Absolute and relative frequencies of personal variables associated with the trip and KAP were estimated. RESULTS: Less than 50% know the main symptoms of malaria and at what time of day there is a greater risk of becoming infected. Five out of ten people knew which practices were preventive against contagion, and four out of ten answered that the treatment can be given in a health establishment, pharmacy, or by some healer. CONCLUSIONS: Travelers to malaria endemic areas have a low level of knowledge and practice (39.7%) as well as an inadequate preventive attitude (35.4%) against malaria.

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RESUMEN La esquizofrenia es probablemente el trastorno más enigmático y trágico que tratan los psiquiatras, y quizás, el más devastador. Se manifiesta en la juventud, por lo que los pacientes esquizofrénicos normalmente viven muchos años después del inicio de la enfermedad y continúan padeciendo sus efectos sin poder llevar una vida completamente normal. Se realizó una revisión bibliográfica para la cual se emplearon los recursos disponibles en Infomed, específicamente en las bases de datos EBSCO, SCIELO y libros de textos de autores cubanos y extranjeros. Se aplicó el método analítico-sintético y se revisaron 18 artículos científicos. Se expusieron los elementos que abordan el desarrollo histórico- cultural de la esquizofrenia desde la perspectiva de la ciencia, la tecnología y la sociedad. Se realizó esta revisión con el objetivo de contribuir al conocimiento sobre el desarrollo histórico cultural de la esquizofrenia, teniendo en cuenta las teorías que ha desarrollado el hombre a través de la ciencia para explicar la aparición de la enfermedad y la importancia de los factores sociales en la aparición, evolución y rehabilitación de este padecimiento.

ABSTRACT Schizophrenia is probably the most enigmatic and tragic disorder that psychiatrists treat, and perhaps the most devastating. It manifests itself in youth, so schizophrenic patients usually live many years after the onset of the disease and continue to suffer from its effects without being able to lead a completely normal life. A bibliographic review was carried out using the resources available in Infomed, specifically in the EBSCO and SCIELO databases and textbooks by Cuban and foreign authors. The analytical-synthetic method was applied and 18 scientific articles were reviewed. The elements that address the historical-cultural development of schizophrenia from the perspective of science, technology and society were exposed. This review was carried out with the aim of contributing to the knowledge about the historical cultural development of schizophrenia, taking into account the theories that man has developed through science to explain the appearance of the disease and the importance of social factors in the appearance, evolution and rehabilitation of this condition.

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Background: Excess dietary salt consumption is a major contributor to hypertension and cardiovascular disease. Public education programs on the dangers of high salt intake, and population level interventions to reduce the salt content in foods are possible strategies to address this problem. In Jamaica, there are limited data on the levels of salt consumption and the population's knowledge and practices with regards to salt consumption. This study therefore aims to obtain baseline data on salt consumption, salt content in foods sold in restaurants, and evaluate knowledge, attitudes, and practices of Jamaicans regarding salt consumption. Methods: The study is divided into four components. Component 1 will be a secondary analysis of data on urinary sodium from spot urine samples collected as part of a national survey, the Jamaica Health and Lifestyle Survey 2016-2017. Component 2 will be a survey of chain and non-chain restaurants in Jamaica, to estimate the sodium content of foods sold in restaurants. Component 3 is another national survey, this time on a sample 1,200 individuals to obtain data on knowledge, attitudes and practices regarding salt consumption and estimation of urinary sodium excretion. Component 4 is a validation study to assess the level of agreement between spot urine sodium estimates and 24-hour urinary sodium from 120 individuals from Component 3. Discussion: This study will provide important baseline data on salt consumption in Jamaica and will fulfil the first components of the World Health Organization SHAKE Technical Package for Salt Reduction. The findings will serve as a guide to Jamaica's Ministry of Health and Wellness in the development of a national salt reduction program. Findings will also inform interventions to promote individual and population level sodium reduction strategies as the country seeks to achieve the national target of a 30% reduction in salt consumption by 2025.

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RESUMO Objetivo avaliar o conhecimento, a atitude e a prática de universitários intercambistas provenientes do continente africano acerca das Infecções Sexualmente Transmissíveis. Método estudo transversal, realizado de dezembro de 2019 a março de 2020, em universidade pública internacional brasileira localizada no Ceará. A amostra foi constituída por 150 estudantes africanos de diferentes cursos de graduação. Utilizou-se do inquérito de Conhecimento, Atitude e Prática. Resultados os universitários apresentaram conhecimento satisfatório acerca da forma de transmissão das Infecções Sexualmente Transmissíveis, porém, com deficiências a respeito das hepatites virais. Identificou-se associação entre sexo e atitude acerca do uso de preservativo em relação sexual com parceria fixa (p=0,042). No que se refere às práticas, houve associação entre sexo e uso do preservativo na primeira relação sexual (p=0,001), ter mais que um parceiro (p=0,001) e mais que dez parceiros em toda a vida (0,007). No que se relaciona às práticas sexuais nos últimos 12 meses, observou-se associação estatística entre ter relações sexuais com mais de um parceiro sexual e sexo do participante (p=0,001). Conclusão e implicações para a prática enfatiza-se a importância de a universidade pesquisada realizar atividades de educação em saúde que abordem Infecções Sexualmente Transmissíveis, bem como de extensão universitária, que envolvam alunos imigrantes africanos.

RESUMEN Objetivo evaluar el conocimiento, la actitud y la práctica de estudiantes de intercambio del continente africano sobre las Infecciones de Transmisión Sexual. Método estudio transversal, realizado de diciembre de 2019 a marzo de 2020, en una universidad pública internacional brasileña ubicada en Ceará. La muestra estuvo compuesta por 150 estudiantes africanos de diferentes cursos de pregrado. Se utilizó la encuesta de Conocimiento, Actitud y Práctica. Resultados los universitarios mostraron conocimientos satisfactorios sobre la transmisión de Infecciones de Transmisión Sexual, sin embargo, con deficiencias sobre las hepatitis virales. Se identificó asociación entre el sexo y la actitud sobre el uso del preservativo en las relaciones sexuales con pareja estable (p=0,042). En cuanto a las prácticas, hubo asociación entre sexo y uso de preservativo en la primera relación sexual (p=0,001), tener más de una pareja (p=0,001) y tener más de diez parejas en la vida (0,007). En cuanto a las prácticas sexuales en los últimos 12 meses, hubo asociación estadística entre tener sexo con más de una pareja sexual y el género del participante (p=0,001). Conclusión e implicaciones para la práctica se destaca la importancia de que la universidad investigada realice actividades de educación en salud que aborden las Infecciones de Transmisión Sexual, así como actividades de extensión universitaria, involucrando estudiantes inmigrantes africanos.

ABSTRACT Objective to evaluate the knowledge, attitude and practice of university exchange students from the African continent about Sexually Transmitted Infections. Method a cross-sectional study, conducted from December 2019 to March 2020, in a public international Brazilian university located in Ceará. The sample consisted of 150 African students from different undergraduate courses. It was used the survey of Knowledge, Attitude and Practice. Results the students showed satisfactory knowledge about the form of transmission of Sexually Transmitted Infections, however, with deficiencies regarding viral hepatitis. An association between sex and attitude about condom use in sexual intercourse with a fixed partner was identified (p=0.042). Regarding the practices, there was an association between sex and condom use in the first sexual relation (p=0.001), having more than one partner (p=0.001) and more than ten partners in the whole life (0.007). Regarding sexual practices in the last 12 months, there was a statistical association between having sex with more than one sexual partner and the participant's sex (p=0.001). Conclusion and implications for practice the importance of the university researched carrying out health education activities that address Sexually Transmitted Infections, as well as university extension activities that involve African immigrant students, is emphasized.

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ETHNOPHARMACOLOGICAL RELEVANCE: In French Guiana, traditional phytotherapies are an important part of self-healthcare, however, a precise understanding of the interactions between local phytotherapies and biomedicine is lacking. Malaria is still endemic in the transition area between French Guiana and Brazil, and practices of self-treatment, although difficult to detect, have possible consequences on the outcome of public health policies. AIM OF THE STUDY: The objectives of this research were 1) to document occurences of co-medication (interactions between biomedicine and local phytotherapies) against malaria around Saint-Georges de l'Oyapock (SGO), 2) to quantify and to qualify plant uses against malaria, 3) and to discuss potential effects of such co-medications, in order to improve synergy between community efforts and public health programs in SGO particularly, and in Amazonia more broadly. MATERIALS AND METHODS: This cross-sectional study was conducted in 2017 in SGO. Inhabitants of any age and nationality were interviewed using a questionnaire (122 questions) about their knowledge and habits regarding malaria, and their use of plants to prevent and treat it. They were invited to show their potential responses on a poster illustrating the most common antimalarial plants used in the area. In order to correlate plant uses and malaria epidemiology, all participants subsequently received a medical examination, and malaria detection was performed by Rapid Diagnostic Test (RDT) and Polymerase Chain Reaction (PCR). RESULTS: A total of 1566 inhabitants were included in the study. Forty-six percent of them declared that they had been infected by malaria at least once, and this rate increased with age. Every person who reported that they had had malaria also indicated that they had taken antimalarial drugs (at least for the last episode), and self-medication against malaria with pharmaceuticals was reported in 142 cases. A total of 550 plant users was recorded (35.1% of the interviewed population). Among them 95.5% associated pharmaceuticals to plants. All plants reported to treat malaria were shared by every cultural group around SGO, but three plants were primarily used by the Palikur: Cymbopogon citratus, Citrus aurantifolia and Siparuna guianensis. Two plants stand out among those used by Creoles: Eryngium foetidum and Quassia amara, although the latter is used by all groups and is by far the most cited plant by every cultural group. Cultivated species accounts for 91.3% of the use reports, while wild taxa account for only 18.4%. CONCLUSIONS: This study showed that residents of SGO in French Guiana are relying on both traditional phytotherapies and pharmaceutical drugs to treat malaria. This medical pluralism is to be understood as a form of pragmatism: people are collecting or cultivating plants for medicinal purposes, which is probably more congruent with their respective cultures and highlights the wish for a certain independence of the care process. A better consideration of these practices is thus necessary to improve public health response to malaria.

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AIMS: Barbados implemented a 10% tax on sugar sweetened beverages (SSBs) in 2015. We aimed to determine knowledge, attitudes and practices towards SSB consumption and taxation among people with type 2 diabetes (T2D) attending public sector primary care clinics in Barbados. METHODS: People with T2D attending public sector clinics completed a survey including the Beverage Intake Questionnaire (BEVQ-15). Waist circumference was measured. RESULTS: Of 384 participants (34.6% male, median age 67 years, interquartile range 60-74 years, African descent 97.6%) 45.9% had diabetes diagnosed for >10 years, 30.7% used insulin, 31.8% had not seen a dietician since diabetes diagnosis, and 62.2% had abdominal obesity. Most (91.1%) thought that consuming SSB was unhealthy and 91% felt that reducing intake would be easy. Only 44.7% favoured the current 10% tax and 29.7% favoured a 20% tax. The median daily SSB consumption was 26.6ml (IQR 3.0-53.2). Responses did not differ by age, gender or abdominal obesity status (p>0.5). Weight loss was being attempted by 45.6% and 21.1% with and without abdominal obesity respectively (p<0.0001). CONCLUSIONS: While most felt SSB consumption is harmful and the median reported consumption contributes few calories to the diet, a minority supported the current tax.

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Resumo O artigo discute conhecimentos, atitudes e práticas (CAP) de agricultores familiares brasileiros a respeito dos impactos na saúde e no ambiente gerados pelo uso de agrotóxicos. Trata-se de um estudo transversal misto, realizado em 2014 em São José de Ubá, RJ. A pesquisa é composta por uma etapa qualitativa, baseada em observações em campo e entrevistas com 25 participantes sobre CAP, no que se refere ao uso de agrotóxicos. A etapa quantitativa abrange avaliação sociodemográfica e de exposição aos agrotóxicos de 78 agricultores. Apesar de reconhecerem parcialmente os perigos dos agrotóxicos, os agricultores enfrentam os riscos da exposição e comumente adotam práticas laborais inadequadas. Fatores como a carência de apoio técnico e treinamento laboral, baixa escolaridade, dificuldade de compreensão das orientações de bulas e rótulos dos agrotóxicos, valor elevado e desconforto causado pelo equipamento de proteção individual (EPI), além da crença da dependência do uso de agrotóxicos, explicam parcialmente as atitudes não seguras. É preciso promover práticas agrícolas mais sustentáveis, fortalecer o apoio técnico e treinamento laboral, melhorar a comunicação e o gerenciamento dos riscos e reduzir as desigualdades de gênero entre os agricultores brasileiros, como a forma mais eficaz e imediata de prevenir os agravos relacionados ao trabalho com agrotóxicos.

Abstract This paper discusses the knowledge, attitudes, and practices (KAP) of the Brazilian family farmers regarding the impact of pesticides on health and the environment. This mixed cross-sectional study was conducted in 2014 in São José de Ubá, Rio de Janeiro. It encompasses two stages: a qualitative one, based on field observations and interviews with 25 participants on KAP about the use of pesticides; and a quantitative one, assessing sociodemographic data and exposure to pesticides among 78 farmers. Despite partially recognizing the danger of pesticides, farmers face the risks of exposure and usually adopt inappropriate work practices. Lack of technical support and occupational training, low schooling, difficulty in understanding the instructions on pesticides labels and package inserts, high price and discomfort caused by the use of Personal Protective Equipment (PPE), and the belief in the need for using pesticides, partially explain the unsafe attitudes. Effective and immediate prevention of pesticides-related injuries and diseases requires promoting more sustainable agricultural practices, strengthening technical support and occupational training, improving communication and pesticides risk management, and reducing gender inequalities among the Brazilian farmers.

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Objetivo: comparar conhecimentos e atitudes dos profissionais de enfermagem atuantes em hospital público e privado sobre higiene bucal em pacientes críticos. Método: estudo transversal, realizado em duas Unidades de Terapia Intensiva Adulto, uma pública e outra privada no período entre dezembro de 2018 e janeiro de 2019 por meio de um questionário estruturado e autoaplicável. Resultados: a taxa de conhecimento dos profissionais do hospital público foi de 76,6% e a atitude foi de 62,7%, enquanto no hospital privado essas taxas foram de 81,8% e 67,1%, respectivamente. Houve diferença significativa quanto à existência de protocolo (p< 0,006), participação em treinamento (p< 0,004), uso de escova de dentes com cerdas macias e sucção (p< 0,001) no hospital privado. Conclusão: o nível de conhecimento foi mais elevado e as atitudes sobre higiene bucal foram mais positivas entre os profissionais de enfermagem do hospital privado em comparação com os profissionais do hospital público.

Objective: to compare the knowledge and attitudes of nursing professionals working in public and private hospitals on oral hygiene in critically ill patients. Method: a cross-sectional study carried out in two adult Intensive Care Units, one public and the other one private, between the period of December 2018 and January 2019, using a structured and self-administered questionnaire. Results: the knowledge rate of professionals in the public hospital was 76.6% and the attitude was 62.7%, while in the private hospital, these rates were 81.8% and 67.1%, respectively. There were significant differences regarding the existence of a protocol (p <0.006), participation in training (p <0.004), and the use of a toothbrush with soft bristles and suction (p <0.001) in the private hospital. Conclusion: the knowledge level was higher, and the attitudes toward oral hygiene were more positive among nursing professionals at the private hospital compared to the professionals at the public hospital.

Objetivo: comparar los conocimientos y actitudes de los profesionales de enfermería que laboran en un hospital público y privado sobre higiene bucal en pacientes críticos. Método: estudio transversal, realizado en dos Unidades de Cuidados Intensivos de Adultos, una pública y otra privada, entre diciembre de 2018 y enero de 2019, mediante un cuestionario estructurado y autoadministrado. Resultados: la tasa de conocimiento de los profesionales del hospital público fue del 76,6% y la actitud del 62,7%, mientras que en el hospital privado estas tasas fueron del 81,8% y 67,1%, respectivamente. Hubo diferencia significativa con respecto a la existencia de protocolo (p <0,006), participación en entrenamiento (p <0,004), uso de cepillo de dientes con cerdas blandas y succión (p <0,001) en el hospital privado. Conclusión: el nivel de conocimiento fue mayor y las actitudes sobre higiene bucal más positivas entre los profesionales de enfermería del hospital privado en comparación con los profesionales del hospital público.

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Resumen Objetivo: Describir los conocimientos y las prácticas sobre infección respiratoria aguda por parte de cuidadores de menores de 5 años, de las comunas más pobladas y pobres de Bucaramanga, Colombia, y su asociación con variables sociodemográficas y del contexto. Metodología: Estudio de corte. Se realizó muestreo secuencial de cuidadores de menores de 5 años de edad, usuarios de centros de salud de primer nivel de atención de las comunas más pobres de la capital de Santander. Se realizó entrevista sobre conocimientos y prácticas de prevención y control de infección respiratoria aguda. Se calificaron como adecuados o no, usando lineamientos de la Organización Mundial de la Salud. Se compararon con base en el grupo de mayor prevalencia de conocimientos y prácticas adecuados, y se exploraron asociaciones con las variables sociodemográficas. Resultados: Participaron 403 cuidadores, 92,6 % mujeres, 45,9 % mayores de 24 años. En total, 236 tenían conocimiento adecuado y 286 reportaron prácticas adecuadas de prevención. El análisis multivariado mostró que cuidadores con 25 años o más, y escolaridad de 5 o más años, tienen mayor prevalencia de conocimientos y prácticas adecuados. Conclusión: La edad y el nivel educativo de los cuidadores están asociados a prácticas adecuadas de prevención y control de la infección respiratoria aguda. Estos hallazgos orientan a focalizar la educación en cuidadores jóvenes con baja educación, recomendaciones contempladas en la ruta de promoción de la salud del Modelo de Atención Integral en Salud en Colombia.

Abstract Objective: Describe the knowledge and practices of acute respiratory infection by caregivers of children under 5 years of age from the most populous and poorest communities of Bucaramanga, Colombia, and their association with sociodemographic and context variables. Methodology: Cross-sectional study Sequential sampling of carers of children under 5 years of age, users of first-level health care centers in the poorest communities of the capital of Santander, was carried out. An interview was conducted on knowledge and practices of preventing and controlling acute respiratory infections. Answers were rated as adequate or inadequate, using the World Health Organization's guidelines. They were compared based on the group with the highest prevalence of adequate knowledge and practices, and associations with sociodemographic variables were explored. Results: 403 caregivers participated; 92.6% were women and 45.9% were older than 24. In total, 236 had adequate knowledge and 286 reported adequate prevention practices. The multivariate analysis showed that caregivers aged 25 years and over with a schooling of five or more years have a higher prevalence of adequate knowledge and practices. Conclusions: The age and educational level of caregivers is associated with knowledge of appropriate practices for preventing and controlling acute respiratory infections. These findings guide the focus of education on young carers with a lower level of education, recommendations considered in the promotion of the Comprehensive Health Care Model in Colombia's health route.

Resumo Objetivo: Descrever o conhecimento e as práticas de infecção respiratória aguda dos cuidadores de crianças com menos de 5 anos de idade, das comunidades mais populosas e pobres de Bucaramanga, na Colômbia, e a sua associação com variáveis sociodemográficas e do contexto. Metodologia: Estudo de corte. Foi realizada uma amostragem sequencial de cuidadores de crianças menores de 5 anos, usuários de centros de saúde de primeiro nível de atenção nas comunidades mais pobres da capital do Departamento de Santander. Realizou-se entrevista sobre conhecimentos e práticas de prevenção e controle da infecção respiratória aguda. Classificaram-se como adequados ou não, usando diretrizes da Organização Mundial da Saúde. Compararam-se com base no grupo com maior prevalência de conhecimentos e práticas adequadas, e foram exploradas associações com variáveis sociodemográficas. Resultados: 403 cuidadores participaram, 92,6 % mulheres, 45,9 % com mais de 24 anos. No total, 236 tinham conhecimento adequado e 286 mencionaram práticas de prevenção adequadas. A análise multivariada mostrou que cuidadores com 25 anos ou mais, e escolaridade de 5 anos ou mais, têm maior prevalência de conhecimentos e práticas adequadas. Conclusão: A idade e o nível educativo dos cuidadores estão associados às práticas adequadas para a prevenção e o controle da infecção respiratória aguda. Estes resultados orientam o foco da educação em cuidadores jovens com baixa escolaridade, recomendações consideradas na rota de promoção da saúde do Modelo de Atenção Integral à Saúde na Colômbia.

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El ictus es una de las patologías neurológicas de mayor prevalencia en el país.Objetivo: determinar la eficacia de la intervención educativa en el cambio de conocimientos, actitudes y prácticas frente a los factores de riesgo del ictus.Método: estudio experimental con muestra al azar de intervención en 68 sujetos, quienes recibieron programa educativo y al mismo tiempo actua-ron como control. Se aplicó un cuestionario sobre conocimientos, actitudes y prácticas validado pre y post intervención. Además, se realizó toma de su presión arterial, determinación del índice de masa corporal, perfil lipídico, hemoglobina glicosilada. La efectividad de la intervención educativa se representa como cambio en porcentaje pre y post intervención en un lapso de tres meses.Resultados: la media de edad fue de 61.07 años, 64.7% fueron mujeres, el porcentaje de conocimientos, actitudes y prácticas adecuadas mejoró de 61.36% a 73.7%; de 64.94% a 83.94%; 87.92% y 76.52% respectivamente. La efectividad total fue un incremento del 22%. Las variables cuantitativas como índice de masa corporal, tensión arterial, niveles de perfil lipídico, así como hemoglobina glicosilada no alcanzaron diferencia significativa.Conclusiones: existe una relación directa y eficacia mayor del 20% cuan-do los pacientes son intervenidos educativamente para modificar positiva-mente los conocimientos, actitudes y prácticas sobre los factores de riesgo de ictus.(AU).

Objective: to determine the effectiveness of the educational intervention in the change of knowledge, attitudes and practices regarding ictus.Method: It is a quasi-experimental study with a random sample of intervention in 68 subjects, who received an educational program and at the same time acted as control. A questionnaire on knowledge, attitudes and practices validated before and after intervention was applied.In addition, blood pressure, determination of body mass index, lipid profile and glycosylated hemoglobin were taken. The effectiveness of the educational intervention is represented as a change in pre and post intervention percentage in a period of three months.Results: the average age was 61.07 years, 64.7% were women, the percentage of knowledge, attitudes and appropriate practices improved from 61.36% to 73.7%; from 64.94% to 83.94%; 87.92% and 76.52% respectively. The total effectiveness was an increase of 22%. The quantitative variables such as body mass index, blood pressure, lipid profile levels, as well as glycosylated hemoglobin did not reach a significant difference.Conclusions: there is a direct and efficacy relationship greater than 20% when patients are educated to positively modify knowledge, attitudes and practices on risk factors regarding ictus. (AU).

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Resumo O objetivo deste artigo é avaliar a adesão às boas práticas de atenção ao parto e nascimento, entre médicos, enfermeiros e residentes dos programas de residência em obstetrícia, dos hospitais públicos do Distrito Federal (DF). Estudo transversal do tipo inquérito aplicado a profissionais em 11 hospitais públicos do DF de janeiro a março de 2015. Instrumento com 20 questões sociodemográficas e 39 itens do tipo escala Likert. Para análise estatística, os profissionais foram separados em 4 grupos (enfermeiros, enfermeiro residentes, médicos e médicos residentes). Foram também avaliados os escores de cada hospital estudado. A dimensão processo de trabalho apresentou os maiores escores em relação as demais dimensões. Na comparação entre os grupos e entre os hospitais não foram observadas diferenças significativas em nenhuma das dimensões. A maioria dos profissionais estimula o parto natural. É necessário reforçar as ações para maior adesão às boas práticas de atenção ao parto, tanto na organização da rede de serviços quanto nas atitudes e valores da formação dos novos profissionais de saúde.

Abstract Objective To assess adherence to best practices in labor and childbirth care by doctors, nurses, obstetric nursing residents, and obstetric medical residents working in public hospitals in the Federal District of Brazil. Method A cross-sectional study was conducted with care providers working in 11 public hospitals in the Federal District of Brazil between January and March 2015. A questionnaire containing 20 sociodemographic questions and 50 five-point Likert items was administered. The average scores of each group and each hospital were analyzed. Results Nurses obtained the highest scores for the use of evidence-based practices (57.8 ± 12.9), while doctors achieved the highest scores for the work process dimension (72 ± 8.5). Medical residents obtained the highest scores for organization of labor and childbirth care (56.5 ± 8.5). No statistically significant differences were found between groups. Hospital scores ranged from 55 to 64. No statistically significant differences were found between hospitals. Most professionals encourage natural childbirth. Conclusion It is necessary to strengthen actions to promote greater adherence to best care practices, both in relation to organization of labor and childbirth care and to the attitudes and values of health professionals.

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BACKGROUND: Our understanding of healthcare professionals' competence level in both their sexual history taking practices and their attitudes in addressing sexual health concerns of patients in middle and old age is lacking. This research aimed to assess primary care physicians' (PCPs) knowledge, attitudes, and sexual healthcare practices toward patients who are ≥45 years in Trinidad and Tobago. MATERIALS AND METHODS: A self-reported survey instrument assessing clinical sexual health knowledge, attitudes, and practices was administered nationwide to all registered PCPs (n = 155) in the public healthcare service. Descriptive and inferential statistical analyses were conducted using STATA. RESULTS: PCPs, who were foreign medical graduates, middle-aged, male, and worked in urban centers, had improved odds of discussing sexual health with middle-aged and older patients. PCPs with any training in sexual health communication or sexual history taking were three times more likely to initiate a sexual health discussion or take a sexual history. Over 90% of physicians reported taking a sexual history only if the discussion was patient initiated and over 50% of PCPs indicated they will not ask these older patients about their sexual orientation, sexual partners, sexual abuse, or violence. CONCLUSIONS: Even though PCPs reported having a positive willing attitude toward offering sexual health care to these patients, they had a low level of knowledge of sexual function in later life and inconsistent sexual history taking practices. There is a great need for training physicians' on sexual health communication and history taking and on sexual function in older adults.

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O abuso do álcool e outras drogas é um problema de saúde pública, e as equipes de saúde da família devem estar capacitadas e qualificadas para cuidar dessa população. Desse modo, o presente estudo teve como objetivo geral: Avaliar o conhecimento, as atitudes e as práticas dos profissionais que integram as Equipes de Saúde da Família na atenção à saúde dos usuários com problemas relacionados ao uso de substâncias psicoativas; e teve como objetivos específicos: Descrever o conhecimento, as atitudes e as práticas frente ao uso de substâncias psicoativas dos profissionais de saúde que integram as Equipes de Saúde da Família; Realizar capacitação em serviço sobre as substâncias psicoativas baseadas na Intervenção Breve par aos profissionais da Equipe de Saúde da Família; Analisar o impacto da capacitação em serviço sobre o conhecimento dos profissionais das Equipes de Saúde da Família nas perspectivas da Intervenção Breve. Metodologia: Trata-se de uma pesquisa seccional do tipo inquérito Conhecimento, Atitudes e Práticas, seguido de um estudo quase- experimental. Para o estudo seccional foram entrevistados 318 profissionais que atuavam nas Equipes de Saúde da Família em uma área de planejamento do município do Rio de Janeiro. O instrumento de coleta de dados foi um questionário autoaplicável com questões referentes a perfil sociodemográfico, conhecimento, atitudes e práticas relacionadas à atenção à saúde dos usuários de substâncias psicoativas. Para o desenho quase-experimental foi realizada uma capacitação em serviço com 17 profissionais das Equipes de Saúde da Família, sendo utilizado um questionário autoaplicável antes e após a intervenção. Todos os dados foram analisados pelo programa Statistical Package for the Social Sciences (IBM SPSS, v. 23,0). Resultados: Evidenciou-se que a maior parte dos entrevistados foram do sexo feminino, adultos (mediana= 38), cristãos, agentes comunitários de saúde e que trabalhavam na Estratégia de Saúde da Família de 1 a 5 anos. Houve predomínio de conhecimento, atitudes e práticas não adequadas relacionadas à atenção à saúde dos usuários de substâncias psicoativas, houve diferença estatística significativa entre atitudes não adequadas e práticas não adequadas. Após a capacitação em serviço observou-se melhora no conhecimento adequado. Conclusão: Observou-se que ainda existe fragilidade no conhecimento, nas atitudes e nas práticas ofertadas pelos profissionais da Estratégia de Saúde da Família para as pessoas com uso/abuso de substâncias psicoativas. Desse modo, recomenda-se maior oferta de cursos de capacitação em serviço sobre álcool e outras drogas para que o mesmo possa influenciar em atitudes e práticas adequadas.

The abuse of alcohol and other drugs is a public health problem, which family health teams must be trained and qualified for the care of this population. Thus, the present study had the general objective of: Assessing the knowledge, attitudes and practices of the professionals who are part of the Family Health Teams in the health care of users with problems related to the use of psychoactive substances; and had as specific objectives: To describe the knowledge, attitudes and practices regarding the use of psychoactive substances by health professionals who are part of the Family Health Teams; Conduct in-service training on psychoactive substances based on Brief Intervention for professionals in the Family Health Team; To analyse the impact of in-service training on the knowledge of the professionals of the Family Health Teams in the perspective of Brief Intervention. Methodology: This is a Knowledge, Attitudes and Practices sectional survey followed by a quasi-experimental study. For the sectional study, 318 professionals who worked in Family Health Teams in a planning area in the city of Rio de Janeiro were interviewed. The data collection instrument was a self- administered questionnaire with questions related to the socio-demographic profile, knowledge, attitudes and practices related to the health care of psychoactive substances users. For the quasi-experimental design, in-service training was carried out with 17 professionals from the Family Health Teams, using a self-administered questionnaire before and after the intervention. All data was analysed using the Statistical Package for the Social Sciences program (IBM SPSS, v.23.0). Results: It was evident that most of the interviewees were female, adults (median = 38), Christians, community health workers and who worked on the Family Health Strategy for 1 to 5 years. There was a predominance of inappropriate knowledge, attitudes and practices related to the health care of psychoactive substances users, there was a statistically significant difference between inappropriate attitudes and inappropriate practices. After in-service training, there was an improvement in adequate knowledge. Conclusion: It was observed that there is still a weakness in the knowledge, attitudes and practices offered by professionals of the Family Health Strategy for people with use/abuse psychoactive substances. Thus, a greater offer of in-service training courses on alcohol and other drugs is recommended so that it can influence appropriate attitudes and practices.

El abuso de alcohol y otras drogas es un problema de salud pública en el que los equipos de salud familiar deben estar capacitados y calificados para atender a esta población. Por lo tanto, el presente estudio tuvo el objetivo general de: evaluar los conocimientos, las actitudes y las prácticas de los profesionales que forman parte de los Equipos de Salud Familiar en la atención de la salud de los usuarios con problemas relacionados con el uso de sustancias psicoactivas; y tenía como objetivos específicos: describir el conocimiento, las actitudes y las prácticas con respecto al uso de sustancias psicoactivas por parte de los profesionales de la salud que forman parte de los Equipos de Salud Familiar; Realizar capacitación en el servicio sobre sustancias psicoactivas basada en la Intervención Breve para profesionales del Equipo de Salud Familiar; Analizar el impacto de la capacitación en el servicio sobre el conocimiento de los profesionales de los Equipo de Salud Familiar en la perspectiva de la intervención breve. Metodología: Esta es una encuesta seccional Conocimiento, Actitudes y Prácticas seguida de un estudio cuasi-experimental. Para el estudio seccional, se entrevistó a 318 profesionales que trabajaron en Equipos de Salud Familiar en un área de planificación en la ciudad de Río de Janeiro. El instrumento de recopilación de datos fue un cuestionario autoadministrado con preguntas sobre el perfil sociodemográfico, el conocimiento, las actitudes y las prácticas relacionadas con la atención de la salud de los usuarios de sustancias psicoactivas. Para el diseño cuasiexperimental, se llevó a cabo capacitación en el servicio con 17 profesionales de los equipos de salud familiar, utilizando un cuestionario autoadministrado antes y después de la intervención. Todos los datos se analizaron utilizando el Paquete Estadístico para el programa de Ciencias Sociales (IBM SPSS, v.23.0). Resultados: fue evidente que la mayoría de los entrevistados eran mujeres, adultos (mediana = 38), cristianos, trabajadores de salud comunitarios y que trabajaron en la Estrategia de Salud Familiar hace de 1 a 5 años. Predominaran el conocimiento, las actitudes y las prácticas inapropiadas relacionadas con la atención de la salud de los usuarios de sustancias psicoactivas, hubo una diferencia estadísticamente significativa entre las actitudes inapropiadas y las prácticas inapropiadas. Después de la capacitación en servicio, hubo una mejora en el conocimiento adecuado. Conclusión: se observó que todavía existe debilidad en el conocimiento, las actitudes y las prácticas ofrecidas por los profesionales de la Estrategia de Salud Familiar para las personas con uso/abuso de substancias psicoactivas. Por lo tanto, se recomienda mayor oferta de cursos de capacitación en servicio sobre alcohol y otras drogas para que pueda influir en las actitudes y prácticas apropiadas.

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RESUMO OBJETIVO Este estudo procurou avaliar a técnica do role-playing na abordagem da objeção de consciência no currículo médico, estimulando o raciocínio ético e a habilidade de comunicação, competências necessárias a um maior conforto na alegação de recusa por parte do profissional. MÉTODOS Estudo de intervenção que envolveu 120 acadêmicos de Medicina no momento em que encerravam o internato em Perinatologia. Os estudantes responderam a um questionário autoaplicável, antes e depois da intervenção, contendo variáveis demográficas e questões sobre a anuência de conduzir ou não situações em saúde reprodutiva, como abortamento legal, orientação contraceptiva a jovens adolescentes e prescrição da pílula do dia seguinte. O grau de conforto dos estudantes ao conduzirem estes casos e os conhecimentos éticos sobre o tema também foram questionados. Recolhidos os questionários, os alunos assistiram a três filmes de curta-metragem, um tratando da recusa de um médico a realizar um abortamento previsto em lei; outro sobre orientação contraceptiva a uma jovem de 13 anos e sem o consentimento dos pais; e um terceiro, acerca da prescrição da pílula do dia seguinte a uma jovem que teve uma relação desprotegida no 14º dia do ciclo. Encerrada esta etapa, se estimulou uma discussão sobre os seguintes tópicos: aspectos legais sobre o tema, direito à objeção de consciência do médico, violação da autonomia da paciente e prejuízo à saúde do solicitante decorrente da recusa por parte do médico. Encerrada esta fase preparatória, formaram-se subgrupos de três alunos que simularam os três casos clínicos, havendo um revezamento entre os papéis de médico, paciente e observador. Após a dramatização, os estudantes foram estimulados a discutir as inter-relações nos papéis de médico e paciente, a objeção de consciência do médico, o efeito da recusa ao tratamento no paciente e a capacidade de comunicação do médico. Ao final, foi reaplicado o mesmo questionário, com as mesmas questões sobre a anuência ou não da condução dos casos clínicos, o conforto ou não ao conduzi-los, como também as perguntas referentes aos conhecimentos éticos sobre objeção de consciência. Os dados foram analisados pelo teste do X2, teste t e teste de McNemar, com nível de significância de 5%. RESULTADOS A alteração do conforto do estudante na condução do abortamento previsto em lei, após a intervenção, foi significativa (p < 0,001). O mesmo foi observado na orientação contraceptiva a jovens adolescentes (p < 0,001) e na prescrição da contracepção de emergência (p = 0,002). A mudança de opinião quanto à objeção ao abortamento legal foi significativa (p = 0,003) e também quanto à orientação contraceptiva a jovens adolescentes (p = 0,012). Não se observaram diferenças na prescrição da pílula do dia seguinte (p = 0,500). CONCLUSÕES A aplicação dessa metodologia no grupo participante tornou mais confortável a condução dos casos discutidos e forneceu um conteúdo técnico, legal e ético para melhor embasamento de suas opiniões.

ABSTRACT OBJECTIVES To evaluate the effectiveness of role-playing in addressing the issue of conscientious objection in the medical curriculum. METHODS This is an intervention study involving 120 medical students on completion of their internship in Perinatology.The project consisted of eight modules with 15 students in each. Initially a questionnaire was applied to obtain the students' demographic information, religion, ethical knowledge of conscientious objection in medical practice, whether or not the students agreed with it, and the level of comfort in addressing situations such as legal abortion, the prescription of emergency contraceptives, and giving advice on contraception to young adolescents. Subsequently, three short films, created exclusively for the project, were shown. The first addressed a doctor's refusal to perform an abortion on a 15-year-old girl who had been the victim of sexual violence. The second simulatedes a doctor's objection to providing advice on contraception to a 13-year-old adolescent without parental consent, and the third portrayed the doctor's refusal to prescribe emergency contraception to a young woman after having unprotected intercourse on the 14th day of her cycle. A discussion was then instigated on the following topics: the existing legislation on the subject, the doctor's right to conscientious objection, violation of the patient's autonomy, and the potential for discrimination and harm to the patient's health due to the doctor's refusal. Subgroups of three students were then formed, to simulate clinical cases, with the students taking turns to play the roles of the physician, patient and observer. At the end, the questionnaire was reapplied. The data were analyzed by the χ2 test, t-test and McNemar's test, with a level of significance of 5%. RESULTS Abortion was rejected by 35.8% of the students, contraception for adolescents by 17.5%, and emergency contraception by 5.8%. The predictors identified with legal abortion were stronger religious belief (p < 0.001) and more frequent attendance of religious services (p = 0.034). The refusal to provide contraception to adolescents was significantly higher among women (p = 0.037).Of the sample, 25% did not explain the reason for their refusal, 15% did not describe all procedures, and 25% said they would not forward patients. The change in comfort in conducting legal abortion after the intervention was significant (p < 0.001). The same was observed in the attitude to providing contraceptives to young adolescents (p < 0.001) and in the prescription of emergency contraception (p = 0.002). The change of opinion regarding objection to legal abortion was significant (p = 0.003), as was the attitude to providing and also regarding the contraceptives to young adolescents (p = 0.012). No differences were observed in the prescription of emergency contraception (p = 0.500). CONCLUSIONS The application of this methodology in the participant group made the students more comfortable about conducting cases like those discussed, and provided technical, legal and ethical content for a better grounding of their opinions.

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Household air pollution is the sixth leading risk factor for premature mortality in Guatemala. Households in Guatemala are gradually adopting liquefied petroleum gas (LPG) stoves, but a strong tradition of woodstove use persists. We conducted a mixed-methods study of LPG stove use in peri-urban Guatemala. We used knowledge, attitudes and practices surveys with 187 LPG stove owners who also used woodstoves to identify perceptions of stove and cooking practices. Barriers to sustained use of LPG stoves were evaluated through focus groups, participant observations with stove users, and key informant interviews with community leaders. Seven themes emerged that explain household decisions to use LPG stoves: (1) The "new technology" should be framed in terms of what the "old technology" lacks, (2) income is not a predictor of gas stove acquisition but may predict sustained use, (3) men are key decision-makers but messages about LPG do not target them, (4) when stoves are viewed as "prize possessions" they may not be used, (5) collective fear about gas stoves is not based on personal experience, but on "stories we hear," (6) sustained LPG use is hampered by two major factors, seasonally available wood and LPG retailers who are perceived as dishonest, and (7) wood fuel collection is a time to enjoy the company of friends and family and is not "drudgery." National policies should promote the use of clean cookstove technologies in peri-urban and rapidly urbanizing areas in Guatemala where LPG stoves are in use, but used intermittently, instead of the current plan to install 100,000 "improved" woodstoves by 2032. This could be done by improving dependable cylinder distribution services, targeting gas safety and promoting positive health messages that appeal to men, as well as women.

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Introducción: La atención en las unidades de cuidado intensivo neonatal (UCIN) ha sido centrada en diversos equipos tecnológicos que han dejado a un lado la parte humana y el acercamiento de los padres en esta etapa vulnerable, es por ello que las iniciativas de cuidados humanos en neonatología se consideran como un método que permite humanizar el cuidado de estos bebés constituyéndose como la herramienta más apropiada los avances tecnológicos, en armonía con el contacto del entorno familiar.Materiales y métodos: Estudio descriptivo que con la aplicación de instrumento tipo CAP y una guía de observación determinó los conocimientos, actitudes y prácticas de los enfermeros sobre las iniciativas de cuidados humanos en neonatología en las UCIN en Valledupar. Resultados: La mayor parte de la población se ubica en edades entre 18- 30 años, femeninas en su totalidad, con experiencia laboral entre 1- 5 años y formación avanzada a nivel de diplomado en el área. El 100% de las enfermeras conocen las iniciativas de practicarlas. Solo el 16% interviene en el protocolo de mínima manipulación neonatal, y fomenta el neurodesarrollo del recién nacido. Discusión y conclusionesiniciativas de cuidados humanos en neonatología, tienen una actitud abierta a practicarlas, solo implementan el protocolo de mínima manipulación y fomentan el cuidado hacia el neurodesarrollo de los prematuros

Introduction: Care in Neonatal Intensive Care Unit (NICU) has been focused on various technological equipment that has left aside the human touch, and the closeness of parents with children in this vulnerable stage. This is why the initiatives for Human Care Neonatology are considered as a method to humanize the care for these babies, of technological progress, in harmony with the touch of a family environment. Materials and methods: Descriptive study with the application of CAP instrument type. An observation guide determined the knowledge, attitudes and practices of nurses related to human care initiatives in neonatology in NICUs in Valledupar. Results: Participants ́ ages range between 18- 30 years, all women, with work experience between 1- 5 years, and post graduate training in the area (diplomado). 100% of nurses them. Only 16% is involved in neonatal minimal protocol handling, and encourages neurodevelopmental newborn. Discussion and conclusionsneonatology, have an open attitude to practice them, they only implement the protocol of minimal handling and foster care for premature neurodevelopment

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RESUMO Objetivo: identificar a estrutura das representações sociais sobre a aids entre pessoas com Vírus da Imunodeficiência Humana. Método: pesquisa descritiva, fundamentada pela Teoria do Núcleo Central das representações sociais. Aplicou-se um teste de associação livre de palavras com, entre 231 adultos em terapia antirretroviral. As evocações foram processadas com o software Ensemble de programmes permettantl'analyse dês evocations - EVOC2000®, que gerou um quadro correspondente à provável estrutura da representação. Resultados: o núcleo central foi integrado pelos elementos doença, tristeza, medo, morte e transmissão. O sistema periférico constituiu-se em maior frequência por: preconceito, remédio e tratamento, na primeira periferia; difícil, preservativo e cura, na segunda periferia; ruim, prevenção e normal, na zona de contraste. Conclusão: as percepções centrais revelaram elementos compartilhados desde o surgimento da infecção. O sistema periférico apontou a necessidade de esforço contínuo para o enfrentamento da sociedade e sentimentos negativos, até que alcancem a cura.

RESUMEN Objetivo: identificar la estructura de las representaciones sociales sobre el SIDA entre personas con Virus de la imunodeficiencia humana. Método: investigación descriptiva, fundamentada en la Teoría del Núcleo Central de las representaciones sociales. Se aplicó un test de asociación libre de palabras entre 231 adultos en terapia antiretroviral. Las evocaciones fueron procesadas en el software Ensemble de programmes permettantl'analyse dês evocations - EVOC2000® que generó un cuadro correspondiente a la probable estructura de la representación. Resultados: el núcleo central fue integrado por los elementos enfermedad, tristeza, miedo, muerte y transmisión. El sistema periférico se constituyó en mayor frecuencia por prejuicio, remedio y tratamiento, en la primera periferia: difícil, preservativo y cura, en la segunda periferia: malo, prevención y normal, en la zona de contraste. Conclusión: las percepciones centrales revelaron elementos compartido desde el surgimiento de la infección. El sistema periférico apuntó la necesidad de esfuerzo continuo para el enfrentamiento de la sociedad y sentimientos negativos, hasta que alcancen la cura.

ABSTRACT Objective: was to identify the social representations structure about AIDS among people with Human Immunodeficiency virus. Method: this is a descriptive research, based on the Central Core Theory of social representations. A free association test of words among 231 adults in antiretroviral therapy was applied. Software Ensemble de programmes permettantl'analyse dês evocations - EVOC2000® processed the evocations, generating a chart corresponding to the probable representation structure. Results: the elements disease, sadness, fear, death and transmission integrated the central nucleus. The peripheral system constituted itself more frequently by: prejudice, medicine and treatment, in the first periphery; difficult, preservative and healing, in the second periphery; bad, prevention and normal in the contrast zone. The central perceptions revealed shared elements since the onset of the infection. Conclusion: the peripheral system pointed to the need for continuous effort to coping with society and negative feelings, until they reach a cure.

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El objetivo de este estudio fue identificar el conocimiento, las actitudes, prácticas y percepción sobre la tuberculosis de Pacientes Afectadas por Tuberculosis (PATB) en la ciudad de Sucre. Se trata de un estudio de carácter cuali-cuantitativo no experimental, descriptivo, sincrónico o transversal, realizada con 28 PATB que realizan su tratamiento en centros de primer nivel de la ciudad de Sucre. Para la recolección de los datos se aplicó la encuesta con uso de cuestionarios previamente elaborados y validados. Entre los resultados se obtuvo que la mayoría de las personas afectas por TB eran del sexo masculino (53.6%), 35.1% casados, y la edad abarca de 18 a 86 años, siendo el promedio de edad de 42.8 años. El 33.8% concluyó la primaria, el 40.5% refirió trabajar. En lo que refiere al conocimiento la mayoría (65.5%) refiere conocer sobre la enfermedad, el 71.2% reconoce los síntomas de la enfermedad así como el 93.3% manifiesta la forma correcta de contagio. En cuanto al tratamiento, el 100% de las pacientes lo realizan en servicio público, de los cuales el 52% manifiestan hablar sobre su enfermedad con el personal de salud. El 44.8% de los pacientes percibe como muy buena la calidad de los servicios de apoyo, finalmente la mayoría (78.5%) de los pacientes se sienten bien informados a la hora de la encuesta.

The objective of this study was to identify the knowledge, attitudes, practices and perception regarding tuberculosis of Patients Affected by Tuberculosis (PATB) in the city of Sucre. This is a non-experimental qualitative, quantitative, descriptive, synchronous or cross-sectional study, conducted with 28 PATBs that perform their treatment in first level centers in the city of Sucre. To collect the data, the survey was applied using previously developed and validated questionnaires. Among the results it was obtained that the majority of people affected by TB were male (53.6%), 35.1% married, and the age ranges from 18 to 86 years, being the average age of 42.8 years. 33.8% finished primary school, 40.5% referred to work. With regard to knowledge, the majority (65.5%) report knowing about the disease, 71.2% recognize the symptoms of the disease as well as 93.3% state the correct form of infection. Regarding treatment, 100% of patients perform it in public service, of which 52% say they discuss their illness with health personnel. 44.8% of patients perceive the quality of support services as very good, finally most (78.5%) of patients feel well informed at the time of the survey.

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A oferta de profissionais médicos para o cuidado de populações em áreas remotas e desfavorecidas é um dos maiores entraves ao acesso universal à saúde e à adequada atuação das equipes de Saúde da Família. O Programa Mais Médicos (PMM), iniciado em 2013, incluiu 18 mil médicos na Atenção Básica do Sistema Único de Saúde (SUS) até 2015, dentre os quais mais de 11 mil cubanos. A polêmica corporativa sobre a participação de médicos estrangeiros no PMM, especialmente os cubanos, envolveu aspectos do mercado de trabalho e da abrangência das práticas profissionais. Considerando que a integralidade é uma diretriz do SUS e um atributo essencial da Atenção Primária à Saúde, esta pesquisa teve como objetivo analisar a integralidade das práticas no PMM, na Atenção Básica no município do Rio de Janeiro. Foi realizado estudo qualitativo na Área Programática 3.1 do município do Rio de Janeiro, no período de 2013 a 2016. A análise da integralidade das práticas foi operacionalizada através de uma matriz composta por duas dimensões: abordagem biopsicossocial do cuidado, com orientação comunitária e elenco ampliado e integrado de ações de promoção, prevenção e assistência. Para cada dimensão foram definidos componentes, categorias e indicadores. As fontes de informação foram: entrevistas semiestruturadas com médicos (24), grupo focal com supervisoras PMM (4) e relatórios da Organização Social de Saúde Viva Rio e de supervisão prática do webportfólio do PMM. Os resultados identificam a presença, em diferentes graus, de todos os atributos da integralidade das práticas operacionalizados na matriz, tanto na dimensão da abordagem biopsicossocial do cuidado, com orientação comunitária quanto do elenco ampliado e integrado de ações de promoção, prevenção e assistência à saúde. Os médicos cubanos, com maciça participação no PMM, apresentam perfil compatível para a atuação na Atenção Básica, pois executam um leque amplo de ações e serviços e são atentos às demandas sociais e epidemiológicas do território. Os profissionais possuem marcada capacidade de inserção comunitária, enfoque preventivo, planejamento de ações e bom relacionamento interpessoal, identificando-se posturas e técnicas de acolhimento, vínculo, responsabilização e qualidade da atenção. A pesquisa contribui para a compreensão sobre as práticas no Programa Mais Médicos, percebendo-se um impacto positivo sobre a integralidade. Apontam-se fortes indícios de que o PMM, além do acesso às consultas médicas, tem possibilitado a oferta de cuidados integrais em saúde e o fortalecimento do Sistema Único de Saúde.(AU)

The supply of medical professionals in remote and disadvantaged areas is one of the major barriers to universal access to healthcare and to the proper development of Family Health teams. The More Doctors Programme (PMM), created in 2013, added 18.000 doctors to the Primary Care of the Unified Health System (SUS), among whom more than 11.000 Cubans. The controversies over the participation of foreign doctors in PMM, especially Cubans, involved aspects of the labor market and the scope of practices. Taking into consideration that comprehensiveness is a principle of SUS and an essential attribute of the Primary Health Care, this research aims to analyze the comprehensiveness of the professional practice in PMM, in the municipality of Rio de Janeiro. A qualitative study was carried out in the 3.1 Programme Area of the municipality of Rio de Janeiro, between 2013 and 2016. The comprehensiveness of the professional practice analysis was conducted through a matrix composed of two dimensions: 1) bio-psychosocial and community orientation approach; 2) wide and integrated range of health promotion, disease's prevention and care actions. For each dimension, components, categories and indicators were defined. The information sources were: interviews with participant doctors (24), focus group with supervisors (4), Social Health Organization provider reports and national web-portfolio of PMM. The results identified the presence, in varying degrees, of all the attributes of comprehensiveness of practices in both dimensions. Cuban physicians present a compatible profile for the perfomance in Primary Care, since they executed a wide range of actions and services and are attentive to the social and epidemiological demands of the territory. The professionals present strong ability for community orientation, preventive focus, planning of actions and good interpersonal relationship, identifying "user embracement", bonding, accountability and quality of care. The research has contributed towards a better understanding of the More Doctors Programme practices, noting a positive impact of the effects of comprehensiveness. There are evidences that the Programme has gone beyond guarantying access to medical appointments, enabling the supply of comprehensive health care and the strengthening of the Unified Health System (SUS).(AU)

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