Undertreatment of depressive symptomatology in the elderly living in long stay institutions (LSIs) and in the community in Brazil.

The aim of the present study was to assess the presence of depressive symptomatology among elderly residents in long stay institution (LSI) and in the community of Recife, Brazil. In total, 81 LSI elderly patients (mean age of 75.55 + or - 9.18 years) and 132 elderly (mean age of 73.14 + or - 8.27 years) individuals from the community were evaluated. Depressive symptomatology was assessed by the geriatric depression scale (GDS-15), cognitive status by the mini mental state examination (MMSE) and capacity to perform the activities of daily living (ADL) by the Katz Index. Comorbidities and the use of medication were recorded. The LSI elderly exhibited more depressive symptoms (p < 0.001) and more dependency (p < 0.001). We observed no differences in MMSE (p = 0.058). The elderly in the community displayed more comorbidities and the LSI elderly consumed more medication (p < 0.001 and < 0.001, respectively). According to multivariate analysis (logistic regression), being male, having no spouse and having a low schooling level are risk factors for depressive symptoms. In conclusion, most elderly with depressive symptoms received no medication for depression.

Patterns of drug treatment entry by Latino male injection drug users from different national/geographical backgrounds.

BACKGROUND: This study examined patterns of treatment entry by Puerto Rican, Central American, Dominican, and other Latino male injection drug users (IDUs) in the state of Massachusetts over the time period 1996-2002. Specifically, it explored whether these populations had different patterns relative to three paths: entry into detoxification only, entry into residential treatment, or entry into methadone maintenance. METHODS: Using a state-level MIS dataset on all substance abuse treatment entries to all licensed treatment programs, bi-variate and logistic regression methods were employed to examine patterns of drug treatment utilization among Latino men residing in Massachusetts. RESULTS: Three logistic regression models, which controlled for age, education, homelessness, employment, history of mental health treatment, health insurance, criminal justice involvement, having injected drugs in the past month, and number of treatment entries, indicated that Puerto Rican men were significantly less likely to only use detoxification services and residential treatment services, and significantly more likely to enter methadone maintenance compared to Latino men from Central American, Dominican, or other Latino backgrounds. For example, Central American men were 2.4 times more likely to enter only detoxification programs and 54% less likely to enter methadone maintenance programs than Puerto Rican male IDUs. IMPLICATIONS: For program planning, include the need to (a) develop varied drug treatment services to meet the needs of non-homogenous Latino groups within the population, (b) tailor outreach efforts to effectively reach all Latino groups, and (c) increase awareness among practitioners of differential patterns of treatment utilization.

Methodological challenges in assessing children's mental health services utilization.

This paper describes the reliability and validity of the service assessment for children and adolescents (SACA) for use among Spanish-speaking respondents. The test-retest reliability of the instrument was assessed in a randomly selected clinical sample of 146 Puerto Rican children and adolescents aged 4-17. Both parents and children were administered the SACA twice by independent interviewers over an average 12-day follow-up period. The accuracy of parental and youth self-reports was assessed by comparing these reports to information obtained from medical records. The results showed that parents and children (aged 11-17) were able to report with fair to moderate reliability any last year use of mental health services, any outpatient mental health services, and school services. Residential and hospitalization services were reported by both informants with substantial test-retest reliability. Slight or no test-retest reliability was obtained for parent and child on the use of the specific type of mental health professionals, as well as parental reports of several treatment modalities. Substantial sensitivity of the SACA was obtained when comparing medical records to parental and child reports to lifetime use of any service and outpatient mental health service. Moderate sensitivity was obtained for last year use of mental health services for both parent and child informants.

Tratamiento supervisado domiciliario de la tuberculosis: experiencia neuquina - años 1962/92 / Supervised home treatment of tuberculosis: experience neuquina - years 1962/92

Se presentan 1839 pacientes de Tuberculosis entre 1970 y 1992 del Hospital Bouquet Roldán de la Ciudad de Neuquén, Argentina; todos reciben el mismo esquema terapéutico de los cuales 933 estaban bajo régimen domiciliario supervisado y 906 en autoadministrado. Los abandonos totales fueron solamente del 4 por ciento de los supervisados contra el 14 por ciento del autoadministrado y el alta médica fue del 90 por ciento y 70 por ciento respectivamente. La mejor retención de pacientes se registró en las 726 formas pulmonares en tratamiento supervisado domiciliario con sólo el 2 por ciento de abandono y el 91 por ciento de alta médica. Su eficacia, bajo costo y aceptación por parte de los pacientes demuestran las ventajas de la supervisión del tratamiento de la tuberculosis. (AU)

Tratamiento supervisado domiciliario de la tuberculosis: experiencia neuquina - años 1962/92 / Supervised home treatment of tuberculosis: experience neuquina - years 1962/92

Se presentan 1839 pacientes de Tuberculosis entre 1970 y 1992 del Hospital Bouquet Roldán de la Ciudad de Neuquén, Argentina; todos reciben el mismo esquema terapéutico de los cuales 933 estaban bajo régimen domiciliario supervisado y 906 en autoadministrado. Los abandonos totales fueron solamente del 4 por ciento de los supervisados contra el 14 por ciento del autoadministrado y el alta médica fue del 90 por ciento y 70 por ciento respectivamente. La mejor retención de pacientes se registró en las 726 formas pulmonares en tratamiento supervisado domiciliario con sólo el 2 por ciento de abandono y el 91 por ciento de alta médica. Su eficacia, bajo costo y aceptación por parte de los pacientes demuestran las ventajas de la supervisión del tratamiento de la tuberculosis.