A content analyses of guided imagery scripts: a strategy for the development of cultural adaptations.

This paper proposes a first step in deciding whether it is necessary to develop a cultural adaptation by comparing the cultural characteristics of an intervention with the same characteristics of a specific group. Larger cultural differences suggest a greater need to conduct a cultural adaptation. This recommendation stems from the cultural match theory (CMT) which, explains that therapeutic outcomes increase as interventions are more similar to the cultural characteristics of specific treatment groups. However, the CMT has rarely been tested, partly because strategies to effectively measure the cultural characteristics of an intervention are still lacking. This article addresses this gap by assessing two dimensions of the self-orientation relevant to cultural adaptations, namely, idiocentrism--the tendency to define oneself in isolation from others--and allocentrism--the tendency to define oneself in relationship to others--through a content analysis of guided imagery scripts. Two independent evaluators analyzed 123 guided imagery scripts (published during 1989-2008) using 6 theoretically derived categories to analyze idiocentrism versus allocentrism. Results indicated that idiocentric elements were 1.5 to 52.3 times more frequently used than were allocentric ones. The implications of these findings for the development of culturally adapted interventions are discussed.

The Brazilian experience of implementing the active pharmacovigilance of dolutegravir.

In 2017, the Ministry of Health Brazilian started using dolutegravir (DTG) 50 mg to all people living with HIV who began antiretroviral therapy (ART) or rescue regimens. Although DTG is thought to have better tolerability levels and a lower possibility of causing adverse reactions, it is necessary to continuously evaluate the safety profile of the drug in the population. Therefore, an active pharmacovigilance project for DTG was implemented. The objective of this study was to describe the Brazilian experience of implementing pharmacovigilance and the results obtained during the period between April and December 2017.Active pharmacovigilance was implemented through patient interviews and an online questionnaire developed in the Medication Logistics Control System (SICLOM).Of the total number of people on DTG in Brazil (79,742) 90.33% participated in the project, and 2.24% of those who participated reported adverse reactions to the drug; of those who reported adverse reactions, 73.86% were on first-line ART regimens, and 26.13% were on third-line regimens. The mean age of the patients who had adverse reactions to DTG was 39 years; 68.79% were male, and 31.21% were female. Of the adverse reactions reported, 50.39% were considered persistent. The 3 most frequent reactions were nausea (13.34%), diarrhea (9.83%), and headaches (9.23%).The Brazilian experience with this project has been deemed successful by federal and local managers, and the online tool to collect data has proved to be an important strategy for the pharmacovigilance of DTG as well as that of other drugs.

[Factors associated with the overburden of male and female caregivers of psychiatric patients]. / Fatores associados à sobrecarga subjetiva de homens e mulheres cuidadores de pacientes psiquiátricos.

Various studies have investigated the factors associated with the overburden of family caregivers of psychiatric patients. This research sought to identify the factors associated with overburden in groups of male and female caregivers, analyzed separately. Fifty people of each sex participated in the study of family caregivers of psychiatric patients who filled out the Family Overburden Interview Schedule and a standardized sociodemographic data questionnaire. The results showed that different factors were associated with overburden in male and female groups. In the female group, the predictors of a greater degree of overburden were: no children at home, greater number of people living with the family, the patient not performing activities outside the home, the presence of comorbidity and greater incidence of patient problematic behavior. For men, the associated variables were: the family caregiver member not living with the patient, having income, reporting illness resulting from the caregiver role, number of children of the family caregiver, the patient not having a single room at home, patient's age, physical illness and quantity of drugs taken by the patient. These results point to the need for differentiated strategies in the family interventions developed by the mental health services.

A culturally competent relaxation intervention for Latino/as: assessing a culturally specific match model.

In this study, we explored 2 questions: (a) Consistent with the cultural match theory (CMT), did treatment adherence and outcome improve as discrepancies between the cultural features of an anxiety treatment and patient characteristics decreased, and (b) In agreement with the specific therapy ingredient model (STIM), did the psychotherapeutic outcomes of a Culturally Competent Relaxation Intervention (CCRI) designed to reduce anxiety more effectively reduce anxiety rather than depression symptoms? The CCRI includes allocentric (the tendency to define oneself in relationship to others) relaxation interventions, while traditional relaxation strategies employ idiocentric (the tendency to define oneself in isolation from others) relaxation interventions. The CCRI was assessed with 44 Latino/a adults of low socioeconomic backgrounds. The results supported 2 hypotheses: (a) Based on the CMT, a relationship was found between participants' levels of allocentrism and their consequent levels of treatment adherence, and (b) Consistent with the STIM, treatment adherence on the CCRI was correlated with reductions in anxiety, but not with depressive symptoms. These findings are discussed with a focus on future efforts to create culturally competent interventions.

Fatores associados à sobrecarga subjetiva de homens e mulheres cuidadores de pacientes psiquiátricos / Factors associated with the overburden of male and female caregivers of psychiatric patients

ResumoEstudos têm avaliado os fatores associados à sobrecarga dos familiares cuidadores de pacientes psiquiátricos. A pesquisa visou identificar os fatores associados à sobrecarga subjetiva de grupos de homens e mulheres, analisados separadamente. Participaram da pesquisa 50 homens e 50 mulheres cuidadores de pacientes psiquiátricos que responderam às questões da Escala de Avaliação da Sobrecarga dos Familiares de Pacientes Psiquiátricos e a um questionário sociodemográfico. Os resultados mostraram que diferentes fatores estiveram associados à sobrecarga subjetiva em cada grupo. No grupo de mulheres, os fatores preditores de maior sobrecarga foram: ausência de crianças em casa, maior número de pessoas morando com o familiar, o paciente não desempenhar atividades fora de casa, presença de comorbidade e maior número de comportamentos problemáticos dos pacientes. No grupo de homens, os fatores associados foram: o familiar não morar com o paciente, possuir renda, relatar doença resultante do papel de cuidador, maior número de filhos do familiar, o paciente não possuir quarto individual na casa, ter doença física, idade do paciente e quantidade de medicamentos ingeridos pelo paciente. É necessário adotar abordagens diferenciadas para cada grupo nas ações desenvolvidas pelos serviços de saúde mental.

AbstractVarious studies have investigated the factors associated with the overburden of family caregivers of psychiatric patients. This research sought to identify the factors associated with overburden in groups of male and female caregivers, analyzed separately. Fifty people of each sex participated in the study of family caregivers of psychiatric patients who filled out the Family Overburden Interview Schedule and a standardized sociodemographic data questionnaire. The results showed that different factors were associated with overburden in male and female groups. In the female group, the predictors of a greater degree of overburden were: no children at home, greater number of people living with the family, the patient not performing activities outside the home, the presence of comorbidity and greater incidence of patient problematic behavior. For men, the associated variables were: the family caregiver member not living with the patient, having income, reporting illness resulting from the caregiver role, number of children of the family caregiver, the patient not having a single room at home, patient's age, physical illness and quantity of drugs taken by the patient. These results point to the need for differentiated strategies in the family interventions developed by the mental health services.

Sobrecarga de familiares de pacientes psiquiátricos: influência do gênero do cuidador / Burden in families of psychiatric patients: influence of caregivers' gender

Estudos têm avaliado a sobrecarga dos familiares cuidadores de pacientes psiquiátricos, mas poucos investigaram a influência do gênero do cuidador nas dimensões específicas da sobrecarga, tendo apresentado resultados divergentes. Esta pesquisa visou comparar os graus das sobrecargas objetiva e subjetiva sentidas por homens e mulheres cuidadores e as dimensões mais afetadas de suas vidas, em cada grupo. Participaram desta pesquisa 50 homens e 50 mulheres cuidadores de pacientes psiquiátricos. Os sujeitos foram entrevistados para aplicação da Escala de Avaliação da Sobrecarga dos Familiares de Pacientes Psiquiátricos (FBIS-BR) e de um questionário sociodemográfico. Os resultados mostraram que o grau de sobrecarga objetiva foi maior no grupo das mulheres cuidadoras, especialmente em relação à assistência cotidiana prestada ao paciente, ao impacto na sua vida social e profissional e a alguns itens da supervisão de comportamentos problemáticos. Os homens, por sua vez, relataram sentir maior peso financeiro do que as mulheres cuidadoras. A sobrecarga subjetiva foi semelhante para os dois grupos. As diferenças encontradas nesta pesquisa apontam para a necessidade dos serviços de saúde mental planejarem intervenções específicas para cada grupo de cuidadores.

Studies have evaluated the burden presented by family caregivers of psychiatric patients, but few of them have investigated the influence of gender in the degree and dimensions of burden, with divergent results. This research aimed to compare the degree of subjective and objective burden felt by men and women family caregivers and the dimensions of their lives most affected in each group. Participated in this study 50 men and 50 women caregivers of psychiatric patients. Subjects were interviewed with the application of the Family Burden Interview Schedule (FBIS-BR) and a standardized sociodemographic data questionnaire. The results showed that the degree of objective burden was higher in the group of women caregivers, especially regarding the daily care provided to the patients, the impact on their social and professional life and some items of the supervision of problematic behaviors. Men, in turn, reported feeling greater financial burden than women caregivers. The subjective burden was similar for both groups. The differences found in this study point to the need for mental health services to plan specific interventions for each group of caregivers.

Morbilidad y mortalidad en 142 casos de ano imperforado / Morbility and mortality in 142 cases of imperforate anus

Antecedentes. La mortalidad de esta anomalía congénita se reporta que está disminuyendo. Materiales y Métodos. Revisamos los expedientes de 142 casos de ano imperforado que fuerón asistidos en el Servicio de Cirugía del Hospital Dr. Robert Reid Cabral, en Santo Domingo, República Dominicana, durante el periodo enero 1990-diciembre 1995. Resultados. La edad de las madres 43 (32.8//) eran menores de 20 años, 37 estaban entre 20 y 24 años (28.2//), para un 61.0// de los casos. De los pacientes 89 (62.7//) pertenecían al sexo masculino y 53 (37.3//) al femenino. Los signos mas frecuentes de presentación fueron ausencia del orificio anal 38 casos (26.8//) y distensión abdominal 36 casos (25.4//) para un 52.2//. en 110 casos (77.5//) existía otra anomalía congénita asociada, la mas frecuente de ellas fístula rectales, 64 casos (45//). encontramos una mortalidad de 29//. De los fallecidos 33 (82.5//), eran masculinos (p>0.01), en 32 casos (71.1//) el ano imperforado era variedad alta (p< 0.01), el peso en 27 casos (67.5//) era menor de 3 kilos (p< 0.01). En 18 de los fallecidos (45//) el post-operatorio se complicó con septicemia. el factor de mejor pronóstico la presencia de las fístulas rectales, pues de los 40 casos que las presentaban solo fallecio uno para una mortalidad de 2.4// (p< 0.01). Comentario. Una mortalidad de 29// para esta anomalía congénita es muy alta y se deben tomar las medidas necesarias para reducirlas rapidamente. La presencia de fístulas rectales es de gran importancia para mejor pronóstico