Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 31.571
Filtrar
1.
Rev. SPAGESP ; 22(1): 67-82, ene.-jun. 2021.
Artículo en Portugués | LILACS, Index Psicología - Revistas técnico-científicas | ID: biblio-1155515

RESUMEN

Visando analisar as concepções sobre a saúde mental infantojuvenil de enfermeiros da Estratégia Saúde da Família, este estudo, de natureza descritivo qualitativa, foi realizado com 47 enfermeiras, nas Unidades de Saúde da Família de João Pessoa PB, e partiu dos pressupostos das Políticas Públicas de Atenção à Saúde Mental para crianças e adol escentes Para coletar os dados utilizaram se um questionário sociodemográfico e entrevistas semiestruturadas, analisadas por meio da Análise Categorial Temática de Bardin, das quais emergiram uma classe temática, três categorias e sete subcategorias. Os resultados apontaram que as concepções sobre a SMI se pautam no modelo biomédico, sem ênfase na promoção da saúde e com pouca especificidade e familiaridade com questões relativas à saúde mental dessa população.


In order to analyze Family Health Strategy nurses' conceptions of child adolescent mental health, this descriptive qualitative study was conducted with 47 nurses, in the Family Health Units of João Pessoa PB, and started from the assumptions of the Public Policies of Mental Health Care for children and adolescents. Data were collected using a questionnaire, which captured the sociodemographic data, and semi structured interviews were analyzed through Bardin's Thematic Categorical Analysis, which originated a thematic class, three categories and seven subcategories. The results showed that the conceptions a re based on the biomedical model, with no emphasis on health promotion and with little specificity and familiarity with issues related to the mental healt h of this population.


Con el fin de analizar las concepciones sobre la salud mental de niños y adolescentes en las enfermer í as de la Estrategia de Salud Familiar, este estudio descriptivo cualitativo se llevó a cabo con 47 enfermeras, en Unidades de Salud Familiar de Joao Pesso a PB, a partir de los supuestos de las Políticas Públicas de Atención de Salud Mental para niños y adolescentes. Para recopilar los datos, se utilizó un cuestionario, que capturó los datos sociodemográficos, y entrevistas semiestructuradas, analizadas a tr avés del Análisis Categórico Temático de Bardin, de la que surgieron una clase temática, tres categorías y siete subcategorías. Los resultados mostraron que las concepciones sobre SMNA se basan en el modelo biomédico, sin énfasis en la promoción de la salu d y con poca especificidad y familiaridad con los temas relacionados con la salud mental de esta población.


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Salud Mental , Salud de la Familia , Reconocimiento en Psicología , Estrategia de Salud Familiar , Atención a la Salud , Promoción de la Salud , Enfermeras y Enfermeros
2.
Hastings Cent Rep ; 51(2): 16-21, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33840101

RESUMEN

Harrowing stories reported in the media describe Covid-19 ravaging through families. This essay reports professional experiences of this phenomenon, family clustering, as encountered during the pandemic's spread across Southern California. We identify three ethical challenges following from it: Family clustering impedes shared decision-making by reducing available surrogate decision-makers for incapacitated patients, increases the emotional burdens of surrogate decision-makers, and exacerbates health disparities for and the suffering of people of color at increased likelihood of experiencing family clustering. We propose that, in response to these challenges, efforts in advance care planning be expanded, emotional support offered to surrogates and family members be increased, more robust state guidance be issued on ethical decision-making for unrepresented patients, ethics consultation be increased in the setting of conflict following from family clustering dynamics, and health care professionals pay more attention to systemic and personal racial biases and inequities that affect patient care and the surrogate experience.


Asunto(s)
Planificación Anticipada de Atención , Salud de la Familia , Familia/psicología , Salud de las Minorías , Atención al Paciente , Planificación Anticipada de Atención/ética , Planificación Anticipada de Atención/legislación & jurisprudencia , California/epidemiología , Análisis por Conglomerados , Toma de Decisiones Conjunta , Salud de la Familia/ética , Salud de la Familia/etnología , Disparidades en el Estado de Salud , Humanos , Salud de las Minorías/ética , Salud de las Minorías/etnología , Atención al Paciente/ética , Atención al Paciente/psicología , Apoyo Social , Consentimiento por Terceros/ética
3.
CMAJ Open ; 9(2): E324-E330, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33795222

RESUMEN

BACKGROUND: Virtual care for patients with coronavirus disease 2019 (COVID-19) allows providers to monitor COVID-19-positive patients with variable trajectories while reducing the risk of transmission to others and ensuring health care capacity in acute care facilities. The objective of this descriptive analysis was to assess the initial adoption, feasibility and safety of a family medicine-led remote monitoring program, COVIDCare@Home, to manage the care of patients with COVID-19 in the community. METHODS: COVIDCare@Home is a multifaceted, interprofessional team-based remote monitoring program developed at an ambulatory academic centre, the Women's College Hospital in Toronto. A descriptive analysis of the first cohort of patients admitted from Apr. 8 to May 11, 2020, was conducted. Lessons from the implementation of the program are described, focusing on measure of adoption (number of visits per patient total, with a physician or with a nurse; length of follow-up), feasibility (received an oximeter or thermometer; consultation with general internal medicine, social work or mental health, pharmacy or acute ambulatory care unit) and safety (hospitalizations, mortality and emergency department visits). RESULTS: The COVIDCare@Home program cared for a first cohort of 97 patients (median age 41 yr, 67% female) with 415 recorded virtual visits. Patients had a median time from positive testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to first appointment of 3 (interquartile range [IQR] 2-4) days, with a median virtual follow-up time of 8 (IQR 5-10) days. A total of 4 (4%) had an emergency department visit, with no patients requiring hospitalization and no deaths; 16 (16%) of patients required support with mental and social health needs. INTERPRETATION: A family medicine-led, team-based remote monitoring program can safely manage the care of outpatients diagnosed with COVID-19. Virtual care approaches, particularly those that support patients with more complex health and social needs, may be an important part of ongoing health system efforts to manage subsequent waves of COVID-19 and other diseases.


Asunto(s)
Atención Ambulatoria/tendencias , Medicina Familiar y Comunitaria , Grupo de Atención al Paciente/organización & administración , Telemedicina/métodos , Adulto , /terapia , /métodos , Canadá/epidemiología , Atención Integral de Salud , Transmisión de Enfermedad Infecciosa/prevención & control , Salud de la Familia , Medicina Familiar y Comunitaria/métodos , Medicina Familiar y Comunitaria/organización & administración , Estudios de Factibilidad , Femenino , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Apoyo Social
6.
BMJ Open ; 11(3): e045163, 2021 03 02.
Artículo en Inglés | MEDLINE | ID: mdl-33653760

RESUMEN

INTRODUCTION: There is a need to continue primary healthcare services through digital communication for disadvantaged women living in underdeveloped areas of Pakistan, especially in the age of the coronavirus pandemic, social distancing and lockdown of communities. This project will be the first of its kind in aiming to implement a digital health literacy intervention, using smartphone and internet, to disadvantaged women through female community healthcare workers. Improved health literacy in women of reproductive years is known to promote maternal, child and family health overall. METHODS AND ANALYSIS: The study will include a baseline survey, a pre- and post-test survey and a 3-month lasting intervention on (1) hygiene and prevention and (2) coronavirus awareness and prevention. Women of reproductive years will be sampled from disadvantaged areas across the four provinces of Pakistan (Baluchistan, Khyber Pakhtunkhwa, Punjab and Sindh), and the selection criteria will be poor, semiliterate or illiterate, belonging to underdeveloped neighbourhoods devoid of universal healthcare coverage and dependent on free primary health services. A target of 1000 women will comprise the sample, with 500 women each assigned randomly to the intervention and control groups. Analysis of variance and multivariate analysis will be used for analysing the intervention's effects compared with the control group. ETHICS AND DISSEMINATION: Ethics approval for this study has been received from the Internal Review Board of the Forman Christian College University (reference number: IRB-252/06-2020). Results will be published in academic journals of repute and dissemination to the international scientific community and stakeholders will also be planned through workshops. TRIAL REGISTRATION NUMBER: NCT04603092.


Asunto(s)
Salud del Niño , Salud de la Familia , Alfabetización en Salud , Salud Materna , Atención Primaria de Salud , Femenino , Humanos , Pakistán , Ensayos Clínicos Controlados Aleatorios como Asunto
7.
Nutrients ; 13(3)2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33652798

RESUMEN

Coparenting quality and food parenting practices have been shown to have a strong influence on child outcomes. However, little is known about whether coparenting quality may influence food parenting practices. This study aimed to investigate how coparenting quality is associated with both mothers' and fathers' food parenting practices. A cross-sectional analysis was conducted of 58 mothers and 40 fathers enrolled in the Guelph Family Health Study. The Coparenting Relationship Scale and the Comprehensive Feeding Practices Questionnaire were used to measure coparenting and food parenting practices, respectively. Linear regressions using generalized estimating equations were used to examine associations between coparenting quality and food parenting practices in mothers and fathers. Among mothers, higher coparenting quality was associated with lower use of food for emotional regulation, restriction of food for health, and child control of food intake and with higher encouragement of a balanced and varied diet, provision of a healthy home environment, and modeling of healthy eating behaviors. Among fathers, higher coparenting quality was associated with lower pressure to eat and with higher encouragement of a balanced and varied diet and provision of a healthy home environment. Coparenting quality is associated with food parenting practices among both mothers and fathers. Interventions aiming to improve food parenting practices should include fathers and should consider targeting parents' coparenting relationship.


Asunto(s)
Conducta Infantil/psicología , Padre/psicología , Conducta Alimentaria/psicología , Madres/psicología , Responsabilidad Parental/psicología , Adulto , Niño , Estudios Transversales , Salud de la Familia , Relaciones Familiares/psicología , Femenino , Estudios de Seguimiento , Humanos , Modelos Lineales , Masculino , Ontario , Ensayos Clínicos Controlados Aleatorios como Asunto
8.
Psychiatr Hung ; 36(1): 40-52, 2021.
Artículo en Húngaro | MEDLINE | ID: mdl-33686014

RESUMEN

The alcohol dependence of a family member redraws familiar relationships and creates a dysfunctional network. Therefore, the relationship between the individual and the family, the interactions and processes that occur must be examined during the therapy in order to understand the behavior of an alcoholic. The observations obtained in stu - dying the role of family members in the development and maintenance of pathological alcohol use disorders provide the scientific basis for this. Living in a family is realized by fulfilling role expectations related to the role based on the family status. In the case of discrepancy between the role expectation associated with the status and the individual's ability to fulfill the role, a dysfunctional situation is seen. In the present work, the relationships in the families of two alcohol de - pendent patients were analyzed. In both families, it was possible to identify the conspirator/looking away family member, who was either the spouse or the mother, sometimes both. The dysfunctional fathers were also recognized and there was a self-sacrificing family member in both families, who was the daughter in both cases. As the relatives themselves con - tribute to the survival of both alcohol dependence and the alcoholic game, efforts should be made to involve the family in therapy. Since the most important relationship of a married man is optimally his wife, the interaction between them is decisive for the survival of addiction. This led to the birth of the "wife of alcoholic" technical term. But this approach probably needs to change, as the male/female ratio for drinking began to decline as early as the 1980s. Thus, presumably the "partner of alcoholic" concept better describes today's reality. The involvement of family members in the therapy is necessary for the recovery of addict patient. However, there is a serious difficulty, the alienation of family members from the addict. In addition, the available services are often insufficient for recovery, as already pointed out by Hungarian authors. And further, statistics indicate a decrease in the patient retention capacity of the care system. Therefore, it would be important to rethink the role and possibilities of the addiction care network, and modify its financing.


Asunto(s)
Alcohólicos , Alcoholismo , Salud de la Familia , Familia , Femenino , Humanos , Masculino , Matrimonio
9.
BMJ Open ; 11(1): e041070, 2021 01 31.
Artículo en Inglés | MEDLINE | ID: mdl-33518518

RESUMEN

OBJECTIVES: Having to access life-sustaining treatment during the emerging COVID-19 outbreak has placed patients with cancer at an especially vulnerable position notwithstanding their immunocompromised condition. The present study aimed to elucidate cancer patients' and their caregivers' experiences during this outbreak. DESIGN: Face-to-face semistructured interviews were conducted. SETTING: A tertiary cancer care facility. PARTICIPANTS: 16 patients with cancer and 14 caregivers. Inclusions criteria were: (A) diagnosed with cancer, (B) receiving active treatment or follow-ups, (C) aged 21 years and above and (D) fluent in English or Mandarin. RESULTS: Thematic analysis was conducted. Five themes were identified: heightened sense of threat, impact on healthcare experience, responsibility falls on oneself, striving for normalcy and sense of safety and trust. Heightened threat of COVID-19 was more pronounced in patients and linked to vulnerability and fear, uncertainty and actions of socially irresponsible others. Dominant in their healthcare experience was prioritising cancer and treatment amidst heightened threat and anticipatory worry about treatment disruptions. Both noted on the importance of taking responsibility for one's health, with caregivers reporting a reinforced sense of duty towards patients. They strived to maintain normalcy by viewing COVID-19 as beyond personal control, downplaying and living life as usual. Their resolve was supported by a sense of safety from the actions of authorities, hospitals and trust towards healthcare providers. CONCLUSIONS: Cancer intensifies threat and the emotional impact of COVID-19 and may trigger specific concerns related to treatment. Psychoeducation interventions led by healthcare providers over digital platforms could help address cancer-specific concerns and support patients and caregivers during the pandemic.


Asunto(s)
Cuidadores/psicología , Neoplasias , Distrés Psicológico , /epidemiología , /psicología , Salud de la Familia , Miedo , Femenino , Personal de Salud , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Neoplasias/psicología , Neoplasias/terapia , Rol Profesional , Psicooncología/métodos , Sistemas de Apoyo Psicosocial , Investigación Cualitativa , Singapur/epidemiología , Poblaciones Vulnerables/psicología
10.
Nursing (Säo Paulo) ; 24(273): 5219-5228, fev.2021.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1148484

RESUMEN

Objetivos: identificar os significados acerca da Estratégia Saúde da Família para uma comunidade. Método: estudo qualitativo, exploratório, descritivo e transversal, amostragem não probabilística e intencional, realizado com 20 participantes, com a utilização de dois instrumentos. Os dados das entrevistas foram avaliados considerando a abordagem do Discurso do Sujeito Coletivo pautados na Teoria das Representações Sociais. Quanto aos dados do questionário foram tratados de forma percentual. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: 75% eram do gênero feminino, faixa etária de 61 a 70 anos, 30% possuem ensino médio completo e 6 meses a 10 anos em que residem próximo a ESF. Emergiram duas ideias centrais "muito bom" e "nenhum". Conclusão: a maioria dos entrevistados atribuiu significados positivos diante da inserção da unidade em sua área de moradia. Porém, apesar da facilidade de acesso, ressaltam a necessidade de melhorias nos serviços.(AU)


Objectives: to identify the meanings about the Family Health Strategy for a community. Method: the study is a qualitative, exploratory, cross-sectional, non probabilistic and intentional sampling, composed with 20 participants using two instruments. The data from the interviews were evaluated considering the collective subject discourse approach based on the Theory of Social Representations. Regarding the data from the questionnaire, they were treated in a percentage way. The study was approved by the Research Ethics Committee. Results: 75% were female, aged 61 to 70 years, 30% had completed high school and 6 months to 10 years in which they live near the ESF. Two central ideas emerged "very good" and "none". Conclusion: the most of the interviewees attributed positive meanings to the insertion of the unit in their housing area. However, despite the ease of access, they still emphasize the need for improvements in services.(AU)


Objetivos: Identificar los significados sobre la Estrategia de Salud Familiar para una comunidad. Método: Estudio de enfoque cualitativo, exploratorio, descriptivo y transversal, muestreo no probabilístico e intencional, con un total de 20 participantes, con el uso de dos instrumentos. Los datos de las entrevistas fueron evaluados considerando el enfoque del discurso de sujeto colectivo basado en la Teoría de las Representaciones Sociales. En cuanto a los datos del cuestionario, fueron tratados de manera porcentual. El estudio fue aprobado por el Comité de ética de la investigación. Resultados: el 75% eran mujeres, de 61 a 70 años, el 30% habían completado la escuela secundaria y 6 meses a 10 años en los que viven cerca del FSE. Dos ideas centrales surgieron "muy buenas" y "ninguna". Conclusión: La mayoría de los entrevistados atribuyeron significados positivos a la inserción de la unidad en su área de vivienda. Sin embargo, a pesar de la facilidad de acceso, siguen insistiendo en la necesidad de mejorar los servicios.(AU)


Asunto(s)
Humanos , Salud de la Familia , Estrategia de Salud Familiar , Enfermería de Atención Primaria , Factores Socioeconómicos , Características de la Residencia/estadística & datos numéricos , Investigación Cualitativa
11.
Artículo en Inglés | MEDLINE | ID: mdl-33557402

RESUMEN

At the end of 2019, a new disease caused by the novel coronavirus SARS-CoV-2 appeared in Wuhan Province in China. Children seemed to be infected less frequently than adults, and family clusters seemed to play an important role in the spread of the pandemic. The aim of this study is to evaluate the serological profile of children and young adults between 4 and 16 years of age in order to assess the transmission patterns of COVID-19 between cohabitants. The subjects lived with at least one cohabitant who tested positive for the disease using a nasopharyngeal swab. To avoid contact with the disease, families were interviewed by telephone. Forty-nine children and adolescents with a mean age of 11 years were then subjected to a rapid lateral flow chromatographic test. Of them, seven (14.3%) were immunoglobulin G (IgG)-positive, and four (8.2%) were immunoglobulin M (IgM)-positive. In total, 16.3% of the tested sample had antibodies against SARS-CoV-2: this may confirm the lower vulnerability of children to COVID-19, despite the small sample size. The time from the negativization of the cohabitant until the test day may have influenced the results, especially when this timeframe is wide.


Asunto(s)
Anticuerpos Antivirales/sangre , /inmunología , Adolescente , Niño , China/epidemiología , Salud de la Familia , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Pandemias , Adulto Joven
13.
Medicine (Baltimore) ; 100(5): e24270, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33592869

RESUMEN

ABSTRACT: The study aimed to explore the association between family functioning and quality of life (QOL) in family caregivers of patients with schizophrenia.Totally 121 family caregivers were surveyed in the cross-sectional study by the self-administration questionnaires about sociodemographic characteristics, family functioning and QOL. Family functioning was evaluated in terms of the family assessment device and the Family Adaptability and Cohesion Evaluation Scale II China Version. QOL was evaluated in terms of TSDHE short-form 12-item health survey, version 2. Multiple regression models were built to explore the association between QOL and family functioning.A regression analysis showed that poorer physical health of family caregivers was significantly associated with the lower educational level of caregivers, the closer kinship with patients and the multiple episodes schizophrenia. The other regression analysis showed that better family adaptability and affective responsiveness were significantly associated with the better mental health of family caregivers.Family functioning is associated with mental health rather than the physical health of family caregivers. Psychoeducational intervention could focus on family caregivers with a lower educational level and closer kinship, and those who look after patients with multiple episodes schizophrenia. Further family intervention could focus on family adaptability and affective expression in family caregivers of patients with schizophrenia.


Asunto(s)
Cuidadores/psicología , Costo de Enfermedad , Salud de la Familia , Salud Mental , Calidad de Vida , Esquizofrenia/epidemiología , Psicología del Esquizofrénico , Adaptación Psicológica , Adulto , China/epidemiología , Estudios Transversales , Demografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Factores Socioeconómicos
14.
BMJ Open ; 11(2): e046128, 2021 02 26.
Artículo en Inglés | MEDLINE | ID: mdl-33637551

RESUMEN

OBJECTIVES: To describe experiences of hospitalised patients with COVID-19 following family cluster transmission of the infection and the meaning of these experiences for them. DESIGN: A descriptive phenomenological design was used to construct themes depicting patients' experiences of living with COVID-19. SETTING: This study was conducted in a major teaching hospital in Wuhan, China, in March 2020. PARTICIPANTS: Fourteen patients involved in family cluster transmission of COVID-19 were recruited into the study. The participants consisted of seven males and seven females. Data were collected through semistructured, in-depth, face-to-face interviews. Interviews were transcribed verbatim and analysed using Colaizzi's approach. RESULTS: Six themes emerged from data analysis during two distinct phases of patients going through COVID-19: the early outbreak phase and the later hospitalisation phase. Early in the outbreak, patients experienced life imbalances between individual well-being and family responsibilities. While facing widespread prejudice and rejection, patients dealt with the heavy toll that the illness had left on their body and mind. After being hospitalised, patients described feelings of living with uncertainty, sadness, fear of death and concerns about family, while simultaneously hoping for a better life after recovery. CONCLUSIONS: Our findings suggest that living with COVID-19 is an emotionally and physically challenging experience for patient participants in the study. Psychological evaluations need to be routinely carried out with patients in a public health crisis. Interprofessional and interorganisational collaborative efforts should be made to examine the physical and psychological sequelae of COVID-19, as well as investigate outcomes of existing intervention programmes.


Asunto(s)
/psicología , Salud de la Familia , /transmisión , China/epidemiología , Emociones , Femenino , Hospitalización , Hospitales de Enseñanza , Humanos , Masculino , Investigación Cualitativa , Calidad de Vida
15.
Artículo en Inglés | MEDLINE | ID: mdl-33572977

RESUMEN

We assessed the perceived benefits and harms of COVID-19 on family and their associations with sociodemographic factors in Chinese adults in Hong Kong. We conducted an online population-based survey and collected 4891 responses in 6 days. Prevalence estimates were weighted by sex, age, and education of the general population, and associations were analyzed using logistic regression. Our results showed both perceived benefits: 19.0% for family physical health, 7.2% family mental health, and 13.5% family relationships; and harms: 2.3% for family physical health, 37.9% family mental health, 18.6% family relationships, and 37.8% decreased family income. More female or older respondents reported perceived benefits but fewer of them reported perceived harms. More respondents with higher than lower socioeconomic scores (SES) reported perceived benefits on family physical and mental health and family relationships, but more respondents with lower than higher SES reported perceived harm on family income. As the pandemic continues with uncertainties, further studies on the dynamics of benefits and harms are needed. Urgent and additional assistance to underprivileged families and at-risk individuals are needed to reduce the inequities amidst the COVID-19 pandemic.


Asunto(s)
Salud de la Familia , Salud Mental , Pandemias , Factores Socioeconómicos , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Estado de Salud , Hong Kong/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
16.
Res Dev Disabil ; 111: 103884, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33556700

RESUMEN

BACKGROUND: Autism Spectrum Disorder (ASD) is a life-long condition which affects the individual and their family system. Little research understands the impact of an ASD upon families, how this may change over time and how COVID-19 has impacted these dynamics. AIMS: To explore the impact of an ASD on the lived experiences of parents and neurotypical adult siblings, including during the UK COVID-19 lockdown. METHODS: Eight parent-sibling dyads (16 individuals) completed semi-structured interviews discussing their family before, during and after receiving the ASD diagnosis, and in relation to the first UK lockdown. Interview transcripts were analysed using Interpretative Phenomenological Analysis. RESULTS: Three super-ordinate themes were identified: Dominated by ASD; Family Cohesion; and the Need for Support. CONCLUSIONS: The data suggested a closeness within the families and an adoration towards the individual with ASD (IWA). Dyads were, to an extent, consumed by the diagnosis both presently and in the future, implicating the need for a stretch in services to support parents and neurotypical siblings. In terms of the first UK lockdown, the IWA added an extra layer of difficulty to the dyads work-life balance yet there was an essence of family cohesion. Future research should consider longitudinal methods and explore the impact of ASD co-morbidities upon family dynamics.


Asunto(s)
Trastorno del Espectro Autista , Control de Enfermedades Transmisibles/métodos , Relaciones Familiares/psicología , Padres/psicología , Hermanos/psicología , Adulto , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/psicología , Trastorno del Espectro Autista/rehabilitación , /prevención & control , Niño , Salud de la Familia/tendencias , Femenino , Humanos , Masculino , Evaluación de Necesidades , Relaciones entre Hermanos , Apoyo Social , Reino Unido/epidemiología , Equilibrio entre Vida Personal y Laboral
17.
Lancet Glob Health ; 9(3): e331-e339, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33607031

RESUMEN

BACKGROUND: Many governments have introduced pay-for-performance programmes to incentivise health providers to improve quality of care. Evidence on whether these programmes reduce or exacerbate disparities in health care is scarce. In this study, we aimed to assess socioeconomic inequalities in the performance of family health teams under Brazil's National Programme for Improving Primary Care Access and Quality (PMAQ). METHODS: For this longitudinal study, we analysed data on the quality of care delivered by family health teams participating in PMAQ over three rounds of implementation: round 1 (November, 2011, to March, 2013), round 2 (April, 2013, to September, 2015), and round 3 (October, 2015, to December, 2019). The primary outcome was the percentage of the maximum performance score obtainable by family health teams (the PMAQ score), based on several hundred (ranging from 598 to 914) indicators of health-care delivery. Using census data on household income of local areas, we examined the PMAQ score by income ventile. We used ordinary least squares regressions to examine the association between PMAQ scores and the income of each local area across implementation rounds, and we did an analysis of variance to assess geographical variation in PMAQ score. FINDINGS: Of the 40 361 family health teams that were registered as ever participating in PMAQ, we included 13 934 teams that participated in the three rounds of PMAQ in our analysis. These teams were located in 11 472 census areas and served approximately 48 million people. The mean PMAQ score was 61·0% (median 61·8, IQR 55·3-67·9) in round 1, 55·3% (median 56·0, IQR 47·6-63·4) in round 2, and 61·6% (median 62·7, IQR 54·4-69·9) in round 3. In round 1, we observed a positive socioeconomic gradient, with the mean PMAQ score ranging from 56·6% in the poorest group to 64·1% in the richest group. Between rounds 1 and 3, mean PMAQ performance increased by 7·1 percentage points for the poorest group and decreased by 0·8 percentage points for the richest group (p<0·0001), with the gap between richest and poorest narrowing from 7·5 percentage points (95% CI 6·5 to 8·5) to -0·4 percentage points over the same period (-1·6 to 0·8). INTERPRETATION: Existing income inequalities in the delivery of primary health care were eliminated during the three rounds of PMAQ, plausibly due to a design feature of PMAQ that adjusted financial payments for socioeconomic inequalities. However, there remains an important policy agenda in Brazil to address the large inequities in health. FUNDING: UK Medical Research Council, Newton Fund, and CONFAP (Conselho Nacional das Fundações Estaduais de Amparo à Pesquisa).


Asunto(s)
Salud de la Familia/normas , Atención Primaria de Salud/organización & administración , Calidad de la Atención de Salud/organización & administración , Reembolso de Incentivo/estadística & datos numéricos , Brasil , Disparidades en Atención de Salud/economía , Disparidades en Atención de Salud/normas , Humanos , Estudios Longitudinales , Grupo de Atención al Paciente/organización & administración , Atención Primaria de Salud/economía , Atención Primaria de Salud/normas , Indicadores de Calidad de la Atención de Salud , Calidad de la Atención de Salud/economía , Calidad de la Atención de Salud/normas , Factores Socioeconómicos
18.
Medicine (Baltimore) ; 100(5): e23991, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33592854

RESUMEN

ABSTRACT: Since the first infected case of Coronavirus Disease 2019 (COVID-19) was reported in Wuhan, China in December 2019, the virus has spread swiftly, inflicting upon millions of people around the globe. The objective of the study is to investigate and analyze the clinical characteristics and outcomes of patients infected with COVID-19 in Wuxi, China.Cross-sectional study.The Fifth People's Hospital of Wuxi, China.A total of 48 COVID-19 patients were enrolled in the study from 23 January 2020 to 8 March 2020, and the clinical data of these subjects were collected.Epidemiological, clinical, laboratory, and radiologic characteristics, as well as treatment and outcome data, were collected and analyzed.Of these 48 patients with confirmed COVID-19, 3 were mild cases (6.3%), 44 were moderate cases (91.7%), 1 was severe case (2.1%). The median age of the subjects was 45 years (interquartile range [IQR], 24-59; range, 5-75 years). Twenty-five of the patients (52.1%) were male and 23 (47.9%) were female. Twenty-eight cases (58.3%) returned to Wuxi, Jiangsu Province. Thirty-four (70.8%) cases were infected due to clustering epidemic and 29 cases (85.3%) were attributable to family-clustering epidemic. No obvious clinical symptoms were observed in the cohort of patients, except for 3 mild cases. The most common symptoms include fever (41 [85.4%]), cough (28 [58.3%]), asthenia (13 [27.1%]), expectoration (11 [22.9%]), diarrhea (10 [20.8%]), and dyspnea (5 [10.4%]). Seventeen (35.4%) patients had lower lymphocyte values than baseline, 31 patients (64.6%) had higher d-dimers to exceed the normal range. The distribution of high-resolution computed tomography (HRCT)-positive lesions were as follows: left lung in 5 cases (10.4%), right lung in 9 cases (18.8%), and bilateral lungs in 31 cases (64.6%). In terms of density of lesions: 28 cases (58.3%) showed ground glass shadows in the lung, 7 cases (14.6%) showed solid density shadows, and 10 cases (20.8%) showed mixed density shadows. Extrapulmonary manifestations found that mediastinal lymph nodes were enlarged in 2 cases (4.2%) and that pleural effusion was present in 1 case (2.1%). All patients underwent treatment in quarantine. Forty-five (93.8%) patients received antiviral treatments, 22 (45.8%) patients received antibacterial treatments, 6 (12.5%) patients received glucocorticoid treatments, 2 (4.2%) patients received high flow oxygen inhalation treatments, and 6 (12.5%) patients received noninvasive ventilation treatments. As of 8 March 2020, all 48 patients included in this study were cured. The average time of hospitalization of the 48 patients was 18 ±â€Š6 (mean ±â€ŠSD) days, the average time of the lesion resorption was 11 ±â€Š4 days, and the average time taken to achieve negativity in the result of nucleic acid examination was (10 ±â€Š4) days.The epidemiological characteristics of 48 COVID-19 patients in Wuxi were mainly imported cases and clustered cases. The clinical manifestations of these patients were mainly fever and cough. Laboratory results showed that the lymphocytopenia and increased d-dimer are positively correlated with disease severity. Pulmonary imaging showed unilateral or bilateral ground glass infiltration. Most of the patients entered clinical recovery stage within 15 days after hospitalization.


Asunto(s)
Tos , Fiebre , Hospitalización/estadística & datos numéricos , Atención al Paciente , Evaluación de Síntomas/estadística & datos numéricos , /sangre , /fisiopatología , China/epidemiología , Análisis por Conglomerados , Tos/diagnóstico , Tos/etiología , Salud de la Familia/estadística & datos numéricos , Femenino , Fiebre/diagnóstico , Fiebre/etiología , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Linfopenia/diagnóstico , Linfopenia/etiología , Masculino , Persona de Mediana Edad , Atención al Paciente/métodos , Atención al Paciente/estadística & datos numéricos , Radiografía Torácica/estadística & datos numéricos , Tomografía Computarizada por Rayos X/métodos
19.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(2): 108-111, 2021 Feb 10.
Artículo en Chino | MEDLINE | ID: mdl-33565059

RESUMEN

OBJECTIVE: To explore the genetic basis for three children with Menkes disease. METHODS: The patients were subjected to next-generation sequencing (NGS) to detect potential variants of the ATP7A gene. Suspected variants were verified by Sanger sequencing of their family members and 200 healthy individuals. Multiplex ligation-dependent probe amplification (MLPA) was also carried out to detect potential deletions in their family members and 20 healthy individuals. RESULTS: Variants of the ATP7A gene were detected in all of the three families, including a novel c.1465A>T nonsense variant in family 1, a novel c.3039_3043del frame-shifting variant in family 2, and deletion of exons 3 to 23 in family 3, which was reported previously. Based on the standards and guidelines of American College of Medical Genetics and Genomics, the c.1465A>T and c.3039_3043del variants of ATP7A gene were predicted to be likely pathogenic (PVS1+PM2). CONCLUSION: Variants of the ATP7A gene may underlay the Menkes disease in the three children. Above findings have facilitated clinical diagnosis and enriched the spectrum of genetic variants of Menkes disease.


Asunto(s)
ATPasas Transportadoras de Cobre/genética , Síndrome del Pelo Ensortijado , Estudios de Casos y Controles , Niño , Exones , Salud de la Familia , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Síndrome del Pelo Ensortijado/genética , Mutación , Linaje
20.
Child Psychiatry Hum Dev ; 52(2): 200-204, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33619672

RESUMEN

The COVID-19 pandemic exposed mothers to stress and social isolation during the pre- and post-natal periods. The deleterious effects of stress on both pregnant women and their infants are well documented, with research suggesting that effects are exacerbated by reduced social support. In this brief report, we summarize evidence linking stress and social isolation to negative outcomes for mothers and infants and present a conceptual model featuring inflammation as a driving mechanism. There is strong evidence that the coronavirus pandemic will affect mothers and infants through immune pathways that, in previous research, have been shown to link stress and social isolation during the pre- and post-natal periods with deficits in maternal mental health and infant well-being and development across developmental stages. We close with recommendations for novel research, policy changes, and integrated clinical care that can address these biological threats to infants and mothers while leveraging the anti-inflammatory effects of social support.


Asunto(s)
Desarrollo Infantil , Madres/psicología , Atención Perinatal , Aislamiento Social/psicología , Estrés Psicológico , /epidemiología , /psicología , Salud de la Familia/tendencias , Femenino , Predicción , Humanos , Recién Nacido , Salud Mental/tendencias , Atención Perinatal/métodos , Atención Perinatal/normas , Embarazo , Sistemas de Apoyo Psicosocial , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Estrés Psicológico/psicología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...