Determinants for the retreatment groups of pulmonary tuberculosis patients treated in a DOTS programme in Sikkim, India.

OBJECTIVE: To assess knowledge, attitude and different health-seeking behaviours among 250 cured and 250 category-II tuberculosis patients. METHODS: A case-control study was conducted in different health settings in Sikkim, a part of the Indian continent. A questionnaire was filled for the purpose. RESULTS: Results showed significant differences in overcrowding, smoking and alcohol intake. There was a general unawareness with the disease and its treatment between the two groups. 45% of the respondents reported that tuberculosis is caused by germs. 81.4% stated that tuberculosis presents only as cough. 94.8% of the case group and 90.8% of the control group stated that it is a transmissible disease. Sharing food with tuberculosis patients (64% of case group, 55% of the control group; p < 0.05), inadequate diet (16.4% of case group, 9.6% of the control group; p < 0.03) were mentioned as modes of transmission. Sixty six per cent of the case group and 56.8% of the control group mentioned the use of DOTS for prevention and control (p < 0.05). Sixty three per cent of the control group regarded tuberculosis as a life threatening condition (p < 0.00) [(adjusted OR = 2.04, (95% CI: 1.43, 2.93)]. Tuberculosis was considered as a completely curable disease by 96.4% of the case group (p < 0.05). 40.6% of the respondents agreed to be in contact with a tuberculosis infected person. 64% of the retreatment group discontinued their treatment due to frequent travelling for work. CONCLUSION: The study revealed lack of knowledge, positive attitude and inappropriate health seeking behaviours among of the tuberculosis patients, irrespective of their categorization.

Dizer e fazer: a prática de exercícios físicos em portadores de diabetes mellitus tipo 2 / Saying and doing: the practice of physical exercises in individuals with type 2 diabetes mellitus

Pesquisar sobre correspondência verbal pode auxiliar a identificar as variáveis que interferem na adesão ao tratamento, já que se verifica a relação entre o que o paciente diz e o que ele faz. Este estudo teve como objetivo descrever e analisar a correspondência dizer-fazer, em sua ocorrência natural, de três portadoras de diabetes mellitus tipo 2, sobre a sua prática de exercícios físicos. Foi perguntado aos participantes se eles iriam praticar exercícios físicos e, depois, esta prática foi filmada. Os dados revelaram que uma participante apresentou uma boa correspondência, outra apresentou correspondência parcial e a terceira não apresentou nenhuma correspondência Analisando-se os dados demográficos das participantes, levantou-se a hipótese de que variáveis como: escolaridade, nível sócio-econômico, idade e sedentarismo podem ter relação com o grau de correspondência verbal

Researches on verbal correspondence can help identifying variables that intervene in treatment adherence, since it is verified the relation between what the patient says and what he/she does. This study had the purpose to describe and analyze the correspondence say-do, in its natural occurrence, of three female adults, with type 2 diabetes mellitus, about their practice of physical exercises. It was asked to the participants if they would practice physical exercises. Later, this practice was filmed. The data show that one participant showed good correspondence, another one showed partial correspondence and the third one did not present any correspondence. Analyzing the demographic data of the participants, it was hypothesized that some variables, such as schooling, social-economic level, age and sedentariness may be related to the level of verbal correspondence

A relação terapêutica evidenciada através do método de observação direta / The therapeutic relationship evidenced through direct observation method

O presente estudo teve como objetivo observar a relação entre os comportamentos verbais e não-verbais de uma cliente e estagiária-terapeuta realizada numa clínica escola de psicologia. Para tal, foi utilizado o método de observação direta e medida do comportamento no contexto clínico-comportamental. Os participantes foram uma díade terapêutica composta por uma estagiária-terapeuta e cliente, sendo esta, do sexo feminino, casada, com o diagnóstico psiquiátrico de Transtorno do Pânico. As sessões foram filmadas em fitas VHS e destas foram analisados os 15 minutos iniciais de cada sessão, em intervalos de tempo de 30 segundos, num total de 330 intervalos. Da relação foram analisadas 22 categorias comportamentais, sendo oito categorias descritivas de relatos verbais de sensações corporais tais como Verbaliza Medo de Morrer, Verbaliza Palpitações, Verbaliza Sudorese relatadas pela cliente; seis categorias de comportamentos não-verbais repetitivos tais como Punhos Fechados à Altura do Peito, Apoiar a Cabeça nas Mãos; cinco categorias de respostas não-verbais da cliente tais como Olhar Fixamente para a Terapeuta, Sorrir Enquanto a Terapeuta Fala, Balançar a Cabeça Afirmativamente Enquanto a Terapeuta Fala e três categorias do comportamento verbal da terapeuta tais como Perguntar os Antecedentes, Comentar os Conseqüentes, Reforçar a Cliente. Os resultados indicaram que as categorias comportamentais das sensações corporais tiveram maior freqüência nas primeiras sessões, do mesmo modo, as categorias de comportamentos não-verbais repetitivos. Já as categorias da relação terapeuta-cliente, tanto desta como daquela foram freqüentes durante todas as sessões observadas. Os dados foram discutidos em termos da metodologia aplicada

Adherence to directly observed antiretroviral therapy among human immunodeficiency virus-infected prison inmates.

Directly observed therapy (DOT) for human immunodeficiency virus (HIV) infection is commonly used in correctional settings; however, the efficacy of DOT for treating HIV infection has not been determined. We prospectively assessed adherence to antiretroviral therapy regimens among 31 HIV-infected prison inmates who were receiving >or=1 antiretrovirals via DOT. Adherence was measured by self-report, pill count, electronic monitoring caps, and, for DOT only, medication administration records. Overall, median adherence was 90%, as measured by pill count; 86%, by electronic monitoring caps; and 100%, by self-report. Adherence, as measured by electronic monitoring caps, was >90% in 32% of the subjects. In 91% of cases, adherence, as measured by medication administration records, was greater than that recorded by electronic monitoring caps for the same medications administered by DOT. Objective methods of measurement revealed that adherence to antiretroviral regimens administered wholly or in part by DOT was