Modesty, religion, and community: Therapists' perspectives regarding the treatment of child sexual abuse in the ultra-orthodox community.

BACKGROUND: Religion is a significant cultural component that impacts child sexual abuse (CSA) in various ways, including its definition, perception, and treatment. This study focuses on the Jewish ultra-Orthodox community in Israel, a strictly religious, segregated, and close-knit community with unique cultural practices and beliefs that impact children's safety and vulnerability to CSA. OBJECTIVE: This qualitative study aimed to explore therapists' perceptions and ascribed meanings of CSA treatment within the ultra-Orthodox community. PARTICIPANTS AND SETTING: Thirty in-depth interviews were conducted with therapists working with the ultra-Orthodox community in Israel. METHODS: The interviews were analyzed using thematic qualitative analysis. RESULTS: Three central axes pertinent to the treatment of CSA in the ultra-Orthodox community were discovered: 1) religious interventions, 2) modest approach, relating to the community's taboo attitude towards sexuality; and 3) the collectivistic nature of the community. The results include specific effect sizes and their statistical significance. CONCLUSIONS: The discussion explores the findings in light of the literature on CSA among religious minority communities and connects them to the unique underlying perception of sexuality in the ultra-Orthodox community. Specific ramifications and recommendations for practice are then considered, alongside the limitations and directions for future study.

Impulsivity assessed ten years earlier and sociodemographic factors predict adherence to COVID-19 related behavioral restrictions in old individuals with hypertension.

BACKGROUND: The COVID-19 pandemic has had clear and dramatic repercussions on health, the economy, and psychosocial well-being. Behavioral measures, such as wearing facemasks and maintaining distance from others, have proven crucial in fighting the contagion's spread. This study aimed to investigate Type A personality traits and sociodemographic predictors of adherence to governmental measures in a sample of frail individuals. METHODS: A sample of 105 Italians over age 60 (Mean age = 70 years; 60.6% male) affected by hypertension who participated in a previous longitudinal study were assessed through a telephone structured interview. Sociodemographic information and Type A personality traits were retrieved from the original longitudinal study. Adherence behaviors were investigated through several questions regarding the compliance with home confinement, the use of facemasks and the observance of social distancing. Repeated measures Analyses of Variance (RMANOVA), Reliable Change Index, and binomial logistic regression analysis were performed. RESULTS: Only 33.3% of the participants reported adherence to all the governmental COVID-19 measures. Being a woman (OR = 4.84; 95% CI = 1.58, 14.90; p < 0.01), being retired (OR = 4.89; 95% CI = 1.09, 21.86; p < 0.05), and suffering from hypertension for a relatively short time (OR = 4.20; 95% CI = 1.22, 14.44; p < 0.05) positively predicted adherence to the governmental measures. Impulsivity resulted in a stable personality characteristic over the last ten years (p = 0.30). Having high levels of impulsivity (OR = 2.28; 95% CI = 1.13, 4.59; p < 0.05) negatively predicted adherence. CONCLUSIONS: Our results demonstrate that impulsivity is a stable personality facet that can have a robust negative impact on adherence behaviors to health claims. Overall, results show the importance to tailor communication strategies that consider the role of sociodemographic indicators and impulsivity to achieve a high level of adherence.

Campañas educativas y de prevención. Una revisión sobre el consumo de sustancias psicoactivas en jóvenes universitarios de Colombia / Educational and prevention campaigns. A review on the use of psychoactive substances in Colombian university students

Resumen El consumo de sustancias psicoactivas en Colombia ha aumentado especialmente en universitarios. Los objetivos de esta investigación fueron: identificar cuáles son las drogas que están consumiendo los jóvenes y cuáles son los fundamentos de los programas de prevención. Metodológicamente se realizó una revisión narrativa de publicaciones científicas bajo criterios de estándares internacionales. Los resultados muestran énfasis en el consumo de alcohol y tabaco. La marihuana, como sustancia ilegal, es la más consumida y es considerada como el canal de iniciación para el consumo de otras sustancias. En conclusión, se destacan como factores de riesgo: el ciclo vital y la facilidad de acceso; y como factores protectores: la satisfacción con la carrera y la visión positiva de futuro. Asimismo, las prácticas preventivas deben apuntar hacia tres esferas: reconocimiento de las consecuencias negativas que trae el abuso de drogas, comunicación clara, sistemática y eficiente, y fomento de la toma de decisiones acertadas de los jóvenes.

Abstract The consumption of psychoactive substances in Colombia has increased, both legal and illegal, especially in university students, if we review the national studies on consumption developed by the Colombian Drug Observatory (2016), we can conclude that not only does consumption increase, but the age of onset decreases, which also constitutes greater needs for care in specialized services for substance abuse. Research questions arise: what are the substances consumed by young university students in Colombia? What risk and protective factors are prioritized in university contexts for the prevention of substance abuse? The objectives of this research were: to identify which drugs are being consumed by young people and how the foundations of prevention programs are established. Methodologically, to carry out the present narrative review, a search was carried out in PubMed, Lilacs, Scielo, Dialnet databases. A chain search was also performed and other studies were located using bibliographic reference lists of the studies retrieved in the primary search. This is a narrative review was carried out under criteria of international standards. The critical evaluation of the articles consisted of the complete reading of the study, its evaluation and filling of the data collection instrument. Those studies published in duplicate or found in more than one database were considered only once. Once all the sources were integrated, it was decided to organize the evidence found by cities, consumption substances, risk perception, risk and protection factors. The results show an emphasis on the consumption of alcohol and tobacco. Marijuana as an illegal substance is the most consumed and considered the initiation channel for other substances. After these, relatively significant use of inhalants, cocaine and LSD is shown. It is evident that the consumption of psychoactive substances presents a behavior similar to that reported by epidemiological studies, the prevalence of consumption is higher for legal substances, as well as the age of onset is lower for these. In conclusion, the following stand out as risk factors: the life cycle and ease of access; and as a protective factor: satisfaction with the career and a positive vision of the future. With this panorama, the Ministry of National Education of Colombia (MEN) (2008) proposes as a strategy to reduce academic dropout, the creation of psychological support programs for students that are focused on the identification and monitoring of people at risk of consumption of psychoactive substances. It is necessary to build campaigns within the framework of social advertising in two scenarios: one, communications conceptualized by professionals towards public awareness training; and two, prevention campaigns to focus on areas and foci of influence, sectored and atomized to specific problems, specific substances and target adopting public. Likewise, the preventive practices that must be incorporated must aim at three areas: recognition of the negative consequences of drug abuse; clear, systematic and efficient communication; and to the promotion of sound decision-making by young people.The promotion of mental health in national health systems and professional health organizations need prevention campaigns with the participation of communities. Within the limitations of this study, this article is the product of the narrative review carried out for Colombia, as it is described geographically, only characterization of three of the regions is obtained and with a strong emphasis on studies of the capital city (Bogotá ), the other two regions that are not described are areas with an active presence of illicit crops that generate a permanent relationship of the communities with the substances, and even with indigenous groups with consumption associated with their cultural identity, aspects that are not reflected by not have information on these areas.

Influential factor combinations leading to language outcomes following a home visiting intervention: A qualitative comparative analysis (QCA).

BACKGROUND: Children who experience adversity are more vulnerable to language difficulties. Early interventions beginning antenatally, such as home visiting, are provided to help prevent these problems. To improve the precision of early interventions, the impact of combinations of risk and protective factors over time must be explored and understood. There is, however, limited research investigating how such factors interact with intervention to change language outcomes over time. AIM: To explore the different paths that lead to Good and Poor language in a cohort of children experiencing adversity whose mothers received an optimal dose of the Maternal Early Childhood Sustained Home visiting (MECSH) intervention over 2.5 years. METHODS & PROCEDURES: A total of 24 low socioeconomic status (SES) mothers experiencing adversity and their children who received more than half the scheduled dose of the MECSH intervention were followed over time: from before birth to school entry. Data were extracted from surveys and direct measurement over the study course. Child language outcome at school entry and the influence of seven key child, maternal and environmental factors, which have been shown in previous research to result in Good and Poor language outcomes, were explored through qualitative comparative analysis (QCA). QCA is a qualitative analytical technique that provides a deeper understanding of factor combinations influencing language development. OUTCOMES & RESULTS: Multiple paths to Good (six paths) and Poor language (seven paths) were found. Paths with mostly protective factors resulted in Good language, except when maternal antenatal distress was present. Paths with two or more influential risks usually resulted in Poor language outcomes. When children experiencing adversity received the MECSH home visiting intervention, there was no one risk or protective factor necessary for Good or Poor language outcomes; however, there were clear patterns of factor combinations. CONCLUSIONS & IMPLICATIONS: Mothers' antenatal psychological resources were a flag for future language concerns which can be used to improve the precision of the MECSH intervention. They were highly influential to their children's Good and Poor language outcomes by 5 years, when over time they were combined with characteristics such as early childhood education, poor maternal responsivity and/or the number of children in the home. Knowledge of early conditions associated with later Poor language can help clinicians identify and respond in preventative and promoting ways to improve language skills. What this paper adds What is already known on the subject Children experiencing adversity are more vulnerable to language difficulties. Both risk for language difficulties and protection against them in this group are via a complex combination of factors. It is unknown how intervention works with these complex factors to result in Good and Poor language outcomes. What this paper adds to existing knowledge There are multiple paths to both Good and Poor language outcomes for children experiencing adversity. Mothers' psychological resources antenatally in combination with other key factors were particularly influential to Good and Poor language outcomes. What are the clinical implications of this work? In this study, maternal antenatal distress together with poor maternal responsivity were present in children's paths to Poor language outcomes at school entry. An extra focus on responsivity is required in antenatally distressed mothers of children experiencing adversity in early interventions. Children of mothers with good psychological resources antenatally who received home visiting intervention had Good language outcomes at 5 years when combined with 3 years or more of early childhood education and if there were one to two children in the home. Knowledge of these influences on language development can improve the precision of home visiting interventions and help clinicians tailor their visits to individual families' needs.

A violência contra a criança e o adolescente na perspectiva de agentes comunitários da saúde / Violence against children and adolescents in the perspective of community health agents / La violencia contra el niño y el adolescente en la perspectiva de agents comunitarios de la salud

A violência intrafamiliar é aquela praticada por familiares, constituindo-se em grave violação dos direitos da criança e do adolescente. O objetivo desse estudo foi investigar se Agentes Comunitários de Saúde (ACS) reconhecem sinais de violência intrafamiliar, se fazem notificação, se conhecem fatores de risco e proteção e se na sua formação receberam informações sobre essas temáticas. Participaram do estudo 119 ACS que responderam três questionários. Constatou-se que os conhecimentos sobre sinais de violência, em especial, de violência sexual e psicológica, sobre notificação, sobre fatores de risco e proteção e sobre práticas parentais e habilidades sociais infantis deveriam fazer parte de cursos de capacitação dos ACS, bem como de toda a Equipe de Saúde, pelo fato de atuarem cotidianamente com as famílias no território. Conclui-se que os ACS não tiveram acesso aos conhecimentos produzidos pela psicologia do desenvolvimento infantil que poderiam orientar sua ação protetiva e preventiva junto às famílias (AU).

Domestic violence is normally practiced by relatives, constituted in serious violation of the rights of the child and the adolescent. The objective of this study was to investigate whether Community Health Agents (CHA) recognize signs of intra-family violence, if they make the notification, if they know risk and protection factors and if in their training they received information about these issues. A total of 119 ACS respond to three questionnaires. We found that knowledge about signs of violence, especially sexual and psychological violence, about notification, about risk and protection factors, and about parental practices and children's social skills should be part of CHA training courses, as well as the Health Team, because they work with families on a daily basis. It is concluded that the ACS did not have access to the knowledge produced by the child development psychology that could guide their protective and preventive action with the families (AU).

La violencia intrafamiliar es aquella practicada por familiares, constituido en grave violación de los derechos del niño y del adolescente. El objetivo de este estudio fue investigar si los Agentes Comunitarios de Salud (ACS) reconocen señales de violencia intrafamiliar, se hacen notificación, si conocen factores de riesgo y protección y si en su formación recibieron informaciones sobre esas temáticas. En este estudio 119 ACS respondieran a tres cuestionarios. Se constató que los conocimientos sobre señales de violencia, en especial, de violencia sexual y psicológica, notificación, factores de riesgo y protección, prácticas parentales y habilidades sociales infantiles deberían formar parte de cursos de capacitación de los ACS, así como de todo el equipo de salud, por el hecho de actuaren cotidianamente con las familias. Se concluye que los ACS no tuvieron acceso a los conocimientos da psicología del desarrollo que podrían orientar su acción proyectiva y preventiva junto a las familias (AU).

Fatores de risco e proteção e sintomas de depressão na adolescência / Risk and protective factors and symptoms of depression in adolescence / Factores de riesgo y protección y síntomas de depresión en la adolescência

Avaliou-se a relação entre fatores de proteção e risco e sintomas depressivos na adolescência. Foi realizado um estudo transversal com amostra de 388 adolescentes de Sergipe, estudantes do ensino médio. Utilizaram-se (a) um questionário sociodemográfico/escolar e (b) as escalas da Bateria de Avaliação de Indicadores de Depressão Infantojuvenil (BAID-IJ). Os dados foram analisados por meio do teste de Regressão Logística Multinomial. Observou-se que o sexo feminino (OR = 6,1) e ter idade igual ou superior a 16 anos (OR = 3,3) aumentaram consideravelmente as chances de os adolescentes pontuarem no estrato de elevada pontuação quanto à sintomatologia depressiva. Baixa pontuação em autoconceito (OR = 5,7), elevado desamparo (OR = 12,3), elevada solidão (OR = 7,0) e elevada desesperança (OR = 2,8) exibiram impacto significativo para a presença de sintomas de depressão. Acredita-se que tais achados podem auxiliar na elaboração de intervenções eficazes frente aos sintomas depressivos na adolescência.

In this research we evaluated the relationship between protection factors and risk factors with depressive symptoms in adolescence. For that, a cross-sectional study was conducted with 388 Sergipe high school students. A socio-demographic / school questionnaire was used and the scales of the Assessment of Childhood Depression Indicators (BAID-IJ). Data were analyzed using the Multinomial Logistic Regression test. We observed that the female gender (OR = 6.1) and age 16 years or older (OR = 3.3) significantly increased the odds of the adolescents score in the high stratum of depressive symptomatology. Low self-concept scores (OR = 5.7), high helplessness (OR = 12.3), high loneliness (OR = 7.0) and high hopelessness (OR = 2.8) had a significant impact on the presence of symptoms of depression. It is believed that such findings may aid in the development of effective interventions for depressive symptoms in adolescence.

Se evaluó la relación factores de protección y riesgo y síntomas depresivos en la adolescencia. Fue un estudio transversal con 388 adolescentes en Sergipe (Brasil). Se utilizó un cuestionario sociodemográfico/escolar y las escalas de la Batería de Evaluación de Indicadores de Depresión Infantojuvenil (BAID-IJ). Los datos fueron analizados por intermedio de Regresión Logística Multinomial. El sexo femenino (OR = 6,1) y tener edad igual o superior a 16 años (OR = 3,3) aumentaron considerablemente las posibilidades de puntuar en el estrato de alta puntuación de la sintomatología depresiva. La baja puntuación en autoconcepto (OR = 5,7), elevado desamparo (OR = 12,3), elevada soledad (OR = 7,0), y elevada desesperanza (OR = 2,8) mostraron impacto significativo en la presencia de síntomas de la depresión. Se cree que estos hallazgos pueden ayudar en la elaboración de intervenciones eficaces frente a los síntomas depresivos en la adolescencia.

The wish 'not to be'. Survey of suicide cases arriving at the Prosecutor's Office of the Court in Bari in the years 2014-2016.

The issue of suicide has always been a very sensitive and important problem, that raises many questions in the society where it occurs, that is not always able to oppose an adequate response. Every scientist in the field agrees that this is an act provoked by multifaceted reasons, which include cultural, social and biographical motives. Therefore, this topic also poses ethical and civil problems, as well as epistemologic and research methodology issues, because of its complexity as a subject of study. The authors propose a case-by-case contribution, evaluating the judicial acts on 73 suicides made available by the Bari Public Prosecutor's Office for the years 2014-2016. The authors believe collected and systematized data, and the ensuing considerations, can offer a contribution to the debate in the field of legal and socio-healthcare actors, who are often the first to deal with and confront this complex and tragic phenomenon.

[The Influence of Media Consumption During Early Childhood on Media Use and Psychological Disorders in Adolescence]. / Der Einfluss von frühkindlichem Medienkonsum auf die Mediennutzung und psychische Auffälligkeiten im Jugendalter.

The Influence of Media Consumption During Early Childhood on Media Use and Psychological Disorders in Adolescence There are many studies that suggest that there is a link between high media consumption and psychological, physiological and social disorders. Nevertheless, there are also inconsistent results, methodical limitations and a lack of longitudinal studies. The present study analyses habits of media consumption in children and adolescents, the influence of different early childhood risk factors on the use of the media in adolescence and the links between early childhood media consumption and disorders in adolescence. The source of the data is the longitudinal project Future Family III. 249 families participated in the last data collection in the adolescence. Adolescents use the media more than five hours per day on average, nearly fifty percent of these adolescents can be considered as internet addicted and a majority consumes violent contents. A low socioeconomic status, low socio-emotional competences and low intelligence of the child as well as unfavorable educational style and psychological stress of the mother are risk factors for the media use in adolescence. Adolescents with a migration background have an increased risk of internet and computer game dependency. On the other hand, the overall utilization of media in the early childhood has only a low predictive power. The results indicate that these connections seem to be more complex than assumed. There is a need for more longitudinal studies in order to get a better understanding of the consequences of media consumption.

Young offenders in brazil: mental health and factors of risk and protection / Saúde mental e fatores de risco e proteção: focalizando adolescentes cumprindo medidas socioeducativas

INTRODUCTION: The literature has indicated that young offenders may show varied problems of mental health; however, in Brazil a limited number of studies are focused on that question OBJECTIVE: Identify the health, self-esteem and social support levels of male young offenders complying with not confined socio-educational measures, the parenting styles adopted towards them and identify the relationship between these variables METHODS: It is an exploratory and correlational study in which 33 male young offenders aged between 14 and 18 years who attend the socio-educational programme of a mid-size city in the State of São Paulo, Brazil, took part on the study, they answered specific instruments to appraise different variables of focus RESULTS: The results indicate that 67% of the adolescents presented mental health disorders; 84% perceive that the social support received is below "low" or "medium", and 33% judge the parental style of their caregiver as a risk. The greater the negligence and poor support of the family and caregivers, the lower the self-esteem of young offenders CONCLUSIONS: Most of the adolescents had mental health disorders and evaluated the social support received as low or medium. All participants evaluated negatively the parental style adopted by their parents. The parental style used was considered below average and risky. Furthermore, was observed that the lower the self-esteem of the adolescents and the lower the family support perceived by them, the higher was the degree of parental negligence evaluated. It is understood that these results reinforce the need for intersectoral coordination in actions aimed at this population.(AU)

INTRODUÇÃO: A literatura tem apontado que adolescentes em conflito com a lei podem apresentar diversos problemas de saúde mental, porém poucos estudos brasileiros abordam essa questão OBJETIVOS: Identificar os níveis de saúde mental, auto-estima e suporte social de adolescentes cumprindo medidas sócio-educativas em meio aberto, os estilos parentais adotados pelos seus responsáveis e identificar relações entre estas variáveis MÉTODO: Trata-se de estudo exploratório e correlacional. Participaram do estudo 33 adolescentes em cumprimento de medidas sócio-educativas em uma cidade do interior do estado de São Paulo/Brasil, com idade entre 14 e 18 anos que responderam a instrumentos específicos para avaliação das variáveis focalizadas RESULTADOS: Os resultados revelaram que a maior parte dos adolescentes apresentaram problemas de saúde mental e avaliaram o suporte social que recebem como sendo baixo ou médio. Além disso, o estilo parental adotado pelos responsáveis é regular abaixo da média ou de risco e todos os adolescentes avaliaram negativamente os estilos parentais adotados por seus responsáveis. Observou-se que quanto menor a auto-estima dos adolescentes, menor é o suporte familiar percebido por eles e mais seus responsáveis adotam a prática parental de negligência CONCLUSÃO: A maior parte dos adolescentes apresentaram problemas de saúde mental. Além disso, quanto menor a auto-estima dos adolescentes, menor foi o suporte familiar percebido por eles e mais seus responsáveis adotam a prática parental de negligência. Compreende-se que estes resultados reforçam a necessidade de articulação intersetorial nas ações que focalizam esta população.(AU)

Saúde mental e fatores de risco e proteção: focalizando adolescentes cumprindo medidas socioeducativas / Young offenders in brazil: mental health and factors of risk and protection

The literature has indicated that young offenders may show varied problems of mental health; however, in Brazil a limited number of studies are focused on that question OBJECTIVE: Identify the health, self-esteem and social support levels of male young offenders complying with not confined socio-educational measures, the parenting styles adopted towards them and identify the relationship between these variables METHODS: It is an exploratory and correlational study in which 33 male young offenders aged between 14 and 18 years who attend the socio-educational programme of a mid-size city in the State of São Paulo, Brazil, took part on the study, they answered specific instruments to appraise different variables of focus RESULTS: The results indicate that 67% of the adolescents presented mental health disorders; 84% perceive that the social support received is below "low" or "medium", and 33% judge the parental style of their caregiver as a risk. The greater the negligence and poor support of the family and caregivers, the lower the self-esteem of young offenders CONCLUSIONS: Most of the adolescents had mental health disorders and evaluated the social support received as low or medium. All participants evaluated negatively the parental style adopted by their parents. The parental style used was considered below average and risky. Furthermore, was observed that the lower the self-esteem of the adolescents and the lower the family support perceived by them, the higher was the degree of parental negligence evaluated. It is understood that these results reinforce the need for intersectoral coordination in actions aimed at this population.

A literatura tem apontado que adolescentes em conflito com a lei podem apresentar diversos problemas de saúde mental, porém poucos estudos brasileiros abordam essa questão OBJETIVOS: Identificar os níveis de saúde mental, auto-estima e suporte social de adolescentes cumprindo medidas sócio-educativas em meio aberto, os estilos parentais adotados pelos seus responsáveis e identificar relações entre estas variáveis MÉTODO: Trata-se de estudo exploratório e correlacional. Participaram do estudo 33 adolescentes em cumprimento de medidas sócio-educativas em uma cidade do interior do estado de São Paulo/Brasil, com idade entre 14 e 18 anos que responderam a instrumentos específicos para avaliação das variáveis focalizadas RESULTADOS: Os resultados revelaram que a maior parte dos adolescentes apresentaram problemas de saúde mental e avaliaram o suporte social que recebem como sendo baixo ou médio. Além disso, o estilo parental adotado pelos responsáveis é regular abaixo da média ou de risco e todos os adolescentes avaliaram negativamente os estilos parentais adotados por seus responsáveis. Observou-se que quanto menor a auto-estima dos adolescentes, menor é o suporte familiar percebido por eles e mais seus responsáveis adotam a prática parental de negligência CONCLUSÃO: A maior parte dos adolescentes apresentaram problemas de saúde mental. Além disso, quanto menor a auto-estima dos adolescentes, menor foi o suporte familiar percebido por eles e mais seus responsáveis adotam a prática parental de negligência. Compreende-se que estes resultados reforçam a necessidade de articulação intersetorial nas ações que focalizam esta população.

A família como um dos fatores de risco e de proteção nas situações de gestação e maternidade na adolescência / The family as a risk factor and protection in situations of pregnancy and teenage motherhood

O presente trabalho buscou compreender como o contexto familiar pode servir como fator de risco e de proteção na situação da gestação e maternidade na adolescência. Realizou-se uma revisão sistemática da literatura nos portais Scielo e Pepsic, com os descritores família, adolescência, gravidez, gestação, maternidade, sexualidade, vulnerabilidade, risco e proteção, no período de 2000 a 2010. Para análise do material, utilizou-se uma análise temática de conteúdo. Os resultados sugerem que, dentre os fatores de risco estão: dificuldades no relacionamento familiar, repetição da história familiar de gestação, a ocorrência de gestações sucessivas durante a adolescência, falta ou inadequação da orientação sexual, quantidade de apoio familiar recebido, situações de violência, crenças e valores sobre parentalidade, abuso de drogas. Já entre os fatores de proteção encontra-se: relacionamento familiar satisfatório, apoio recebido da família e impacto positivo advindo da gravidez adolescente. Esses resultados são discutidos a partir da concepção processual de risco/proteção. (AU)

This study sought to understand the family context, both as risk and protective factor in the situation of teenage pregnancy and motherhood. We conducted a systematic review of the literature on search engines Scielo and Pepsic, with descriptors family, adolescence, pregnancy, pregnancy,maternity, sexuality, vulnerability, risk and protection in the period 2000 to 2010. To analyze the material we used a thematic analysis. The results suggest that among the risk factors are: difficulties in family relationships, family history of repeated pregnancy, the occurrence of subsequent pregnancies during adolescence, lack or inadequacy of sexual orientation, amount of family support received, violent situations, beliefs and values about parenting, drug abuse. Among the protective factors found: good family relationships, support from family and positive impact arising from the pregnancy adolescent. These results are discussed from the procedural conception of risk / protection. (AU)

A família como um dos fatores de risco e de proteção nas situações de gestação e maternidade na adolescência / The family as a risk factor and protection in situations of pregnancy and teenage motherhood

O presente trabalho buscou compreender como o contexto familiar pode servir como fator de risco e de proteção na situação da gestação e maternidade na adolescência. Realizou-se uma revisão sistemática da literatura nos portais Scielo e Pepsic, com os descritores família, adolescência, gravidez, gestação, maternidade, sexualidade, vulnerabilidade, risco e proteção, no período de 2000 a 2010. Para análise do material, utilizou-se uma análise temática de conteúdo. Os resultados sugerem que, dentre os fatores de risco estão: dificuldades no relacionamento familiar, repetição da história familiar de gestação, a ocorrência de gestações sucessivas durante a adolescência, falta ou inadequação da orientação sexual, quantidade de apoio familiar recebido, situações de violência, crenças e valores sobre parentalidade, abuso de drogas. Já entre os fatores de proteção encontra-se: relacionamento familiar satisfatório, apoio recebido da família e impacto positivo advindo da gravidez adolescente. Esses resultados são discutidos a partir da concepção processual de risco/proteção...

This study sought to understand the family context, both as risk and protective factor in the situation of teenage pregnancy and motherhood. We conducted a systematic review of the literature on search engines Scielo and Pepsic, with descriptors family, adolescence, pregnancy, pregnancy,maternity, sexuality, vulnerability, risk and protection in the period 2000 to2010. To analyze the material we used a thematic analysis. The results suggest that among the risk factors are: difficulties in family relationships, family history of repeated pregnancy, the occurrence of subsequent pregnancies during adolescence, lack or inadequacy of sexual orientation, amount of family support received, violent situations, beliefs and valuesabout parenting, drug abuse. Among the protective factors found: good family relationships, support from family and positive impact arising from the pregnancy adolescent. These results are discussed from the procedural conception of risk / protection...

Prevalencia y factores de riesgo de Cryptosporidium spp. y Giardia spp. en terneros de ganado lechero de la zona noroccidental de la Sabana de Bogotá / Cryptosporidium spp. and Giardia spp. prevalence and risk factors in dairy calves of the north-western zone of the Bogota Savanna

Objetivo Estimar la prevalencia de Cryptosporidium spp. y Giardia spp. en terneros de 0 a 2 meses de ganado lechero de la zona noroccidental de la Sabana de Bogotá. Se estimaron los factores de riesgo de la producción lechera que puedan incurrir en la infección de personas y animales. Métodos Estudio de corte transversal, mediante la toma de materia fecal de terneros. Se determinó la prevalencia de punto para Giardia spp. y Cryptosporidium spp. a través los resultados de los coprológicos (Ritchie para Giardia spp. y Ziehl-Neelsen modificada para Cryptosporidium spp.). Se calcularon Odds Ratio para establecer los factores de riesgo asociados entre estos dos géneros de protozoarios y el manejo de las Buenas Prácticas Ganaderas. Resultados Se evaluaron 33 fincas dedicadas a la producción lechera, donde se muestrearon 308 terneros. La prevalencia para Giardia spp. fue de 37,3 %, 115 animales positivos y para Cryptosporidium spp. fue de 4,9 % 15, animales positivos. Conclusión Existe un foco de Giardia spp. y Cryptosporidium spp. en el noroccidente de la Sabana de Bogotá, del cual no se tenía conocimiento previo. La prevalencia de Giardia spp. para la región estudiada, está en el límite alto del rango reportado para Sudamérica. En el caso de Cryptosporidium spp. la situación es distinta, la prevalencia se encuentra en el limite bajo del rango reportado para Sudamérica. Los factores de riesgo asociados a Giardia spp. y Cryptosporidium spp. en las explotaciones lecheras del noroccidente de la Sabana de Bogotá, dependen de Buenas Prácticas Ganaderas.

Objective The present study was aimed to establishing Cryptosporidium spp. and Giardia spp. prevalence in 0 to 2 months old dairy calves of the north-western zone of the Bogota Savanna. In addition, associated factors related to a failure in Good Practices of Livestock could incur in human and animal infection. Methods This was a cross-sectional study; calves' fecal samples were used. Farms' Good Practices of Livestock were observed by means of an observation blank. Giardia spp. and Cryptosporidium spp. prevalence was determinate by means of laboratory results (Ritchie for Giardia spp. and modified Ziehl-Neelsen for Cryptosporidium spp.). Odds Ratios (OR) were calculated in association between this two genera of protozoa and Good Practices of Livestock. Results Thirty three dairy farms were evaluated, where fecal samples of 308 calves were taken. Giardia spp. prevalence was 37.7 %, 115 infected animals; Cryptosporidium spp. prevalence was 4.9 %, 15 infected animals. Conclusion There is an important Giardia spp. and Cryptosporidium foci in the north-western zone of the Bogota Savanna, without a previous knowledge. Giardia spp. prevalence for this zone is in the highest rank reported for South-America and Cryptosporidium spp. prevalence is in en the lowest one. Associated risk factors of Giardia spp. and Cryptosporidium spp. in dairy farms of the north-western zone of the Bogota Savanna depend of a Good Practices of Livestock performance.

Gravidez e maternidade de adolescentes: fatores de risco e de proteção / Pregnancy and maternity of adolescents: risk and protector factors

INTRODUÇÃO: a procriação na adolescência é parte das preocupações relativas à saúde e desenvolvimento de jovens, a despeito de seu significado não necessariamente negativo. OBJETIVO: o estudo teve como objetivo avaliar competência, problemas psicológicos e indicativos de fatores de risco e de proteção ao desenvolvimento num grupo de adolescentes grávidas e mães. MÉTODO: com uso do Youth Self Report (YSR) e da Escala de fatores de proteção/risco na maternidade adolescente (FRIP), foram pesquisadas 46 adolescentes de 13 a 18 anos, usuárias de serviços públicos de saúde da Baixada Santista: 27 gestantes primigestas e 19 mães primíparas com filhos menores de um ano. RESULTADO: níveis de competência foram menores nas adolescentes gestantes e mães mais pobres. A pobreza não ficou associada a indicadores de problemas psicológicos, que foram avaliados na amostra com tendência à faixa de normalidade. As mães apresentaram referências de qualidades pessoais em níveis significativamente maiores do que as gestantes. Esperanças e sonhos para a própria vida além do contato positivo com a família e com o pai da criança foram fatores de proteção apontados, enquanto proximidade de moradia ao tráfico de entorpecentes foi o principal fator de risco identificado. CONCLUSÃO: fatores de proteção nos contextos ambientais das adolescentes pesquisadas podem estar interrelacionados ao desenvolvimento da competência, importante recurso frente à situação da maternidade de adolescentes.(AU)

INTRODUCTION: breeding in adolescence is among the concerns related to youth development and health, not necessarily with a negative significance. OBJECTIVE: the present study researched competence data, psychological problems and indicative of risk and protection factors inside a group of pregnant teenagers and teen mothers. METHOD: for that purpose, the Youth Self Report (YSR) and a scale of risk/protection factors during teen maternity (FRIP) were used. We surveyed 46 adolescents between 13 and 18 years, users of health services offered in Santos (SP) region: 27 at first pregnancy and 19 with firstborns under one year of age. RESULTS: the level of competence was lower among poorer adolescents, were they pregnant or mothers. Poverty was not associated with indicators of psychological problems, which were evaluated within a normality range by the YSR. Mothers presented self reference of personal qualities in levels significantly higher than the pregnant girls. Risk / protection factors involving environmental systems were indicated. Claims of hope and dreams about their own lives besides positive contacts with their families and with the fathers of their children were appointed as protection factors, while the proximity of their households to the traffic of drugs was the main risk factor identified. CONCLUSION: p rotection factors derived from the environmental contextures of the adolescents researched might be related to the development of the competence, an important resource regarding the situation of adolescent motherhood.(AU)

Gravidez e maternidade de adolescentes: fatores de risco e de proteção / Pregnancy and maternity of adolescents: risk and protector factors

INTRODUÇÃO: a procriação na adolescência é parte das preocupações relativas à saúde e desenvolvimento de jovens, a despeito de seu significado não necessariamente negativo. OBJETIVO: o estudo teve como objetivo avaliar competência, problemas psicológicos e indicativos de fatores de risco e de proteção ao desenvolvimento num grupo de adolescentes grávidas e mães. MÉTODO: com uso do Youth Self Report (YSR) e da Escala de fatores de proteção/risco na maternidade adolescente (FRIP), foram pesquisadas 46 adolescentes de 13 a 18 anos, usuárias de serviços públicos de saúde da Baixada Santista: 27 gestantes primigestas e 19 mães primíparas com filhos menores de um ano. RESULTADO: níveis de competência foram menores nas adolescentes gestantes e mães mais pobres. A pobreza não ficou associada a indicadores de problemas psicológicos, que foram avaliados na amostra com tendência à faixa de normalidade. As mães apresentaram referências de qualidades pessoais em níveis significativamente maiores do que as gestantes. Esperanças e sonhos para a própria vida além do contato positivo com a família e com o pai da criança foram fatores de proteção apontados, enquanto proximidade de moradia ao tráfico de entorpecentes foi o principal fator de risco identificado. CONCLUSÃO: fatores de proteção nos contextos ambientais das adolescentes pesquisadas podem estar interrelacionados ao desenvolvimento da competência, importante recurso frente à situação da maternidade de adolescentes

Gravidez na adolescência: análise contextual de risco e proteção / Early pregnancy: a contextual analysis about risk and protection / Gravidez en la adolescencia: análisis contextual del riesgo e protección

A gravidez precoce pode ser entendida como fator de risco ou proteção no adolescente. É crescente a necessidade de pesquisas que aprofundem os aspectos envolvidos nessa questão. Este estudo exploratório-descritivo teve como objetivo identificar as diferenças existentes entre um grupo de adolescentes que viveu a experiência de gravidez durante a adolescência. A amostra foi composta por 1015 jovens de nível socioeconômico baixo de Porto Alegre, com 14-24 anos, de ambos os sexos. Utilizou-se um questionário com 109 questões que abordam aspectos da vida juvenil: drogas, sexualidade, religiosidade, escola. Observou-se maior número de participantes do sexo feminino 52.3 por cento contra 47.7 por cento do sexo masculino. 53.5 por cento dos jovens já iniciou a vida sexual, dentre estes, 64.6 por cento eram homens. A idade média para a primeira relação foi significativamente menor para eles (M=13.64 anos; dp=1.7) do que para elas (M=14.79 anos; dp=1.4). Os resultados revelam um percentual esperado para gravidez e aborto em jovens de nível socioeconômico baixo, quando comparado a outros estudos. Sobressai a baixa idade para a primeira relação sexual e o fato de que cerca de » da amostra apresentar uso irregular de métodos contraceptivos. Discute-se sobre uso de métodos anticoncepcionais e aborto, associadas à saúde do adolescente.

Early pregnancy has been widely understood as a risk factor, moreover, in some cases, it has been considering as a protective factor. Thus, more studies among this population should be done, looking for the variables involving such question. This exploratory-descriptive study had as aim to identify the existent differences among a group of adolescents that lived the pregnancy experience. Participants were 1015 low SES young people from Porto Alegre, aged between 14-24, males and females. A questionnaire with 109 questions was used asking about major domains of life: drug use, sexuality, religiosity, school. There were more females 52.3 percent than males 47.7 percent in the sample. Most of the participants already had their first sexual intercourse, 53.5 percent, most of them males (64.6 percent). The average for first sexual intercourse was lower for males (M=13.64; dp=1.7) than females (M=14.79; dp=1.4). Results indicate an expected rate of pregnancy and abortion for low SES young. We stress the low age for first sexual intercourse and the fact that » of our sample has an irregular contraceptive method. We discuss about contraceptive method and abortion linked to the adolescents health.

El embarazo precoz puede ser entendida como un factor de riesgo o protección para el adolescente. La necesidad de investigaciones que profundicen los aspectos involucrados en esta cuestión es creciente. Hecho en Porto Alegre, capital de la provincia de Rio Grande do Sul, ubicada al sur de Brasil, este es un estudio exploratorio descriptivo, con una muestra de 1015 jóvenes de ambos sexos con edad entre 14 y 24 años y de bajo nivel socio económico. La investigación se valió de una encuesta con 109 cuestiones que abordan aspectos de la vida juvenil: drogas, sexualidad, religiosidad, escuela. El porcentaje de los encuestados correspondiente al sexo femenino fue de 52.3 por ciento y 47.7 por ciento del sexo masculino. De estos jóvenes 53.5 por ciento ya empezó la vida sexual, entre los cuales, 64.6 por ciento eran hombres. De hecho, de la observación de los datos se desprende una clara tendencia a una mayor precocidad para los hombres (M=13.64 anos; dp=1.7) aunque la media de edad de las mujeres para iniciarse en las relaciones sexuales no esté muy por debajo (M=14.79 anos; dp=1.4). El análisis de los datos revela un porcentual esperado para embarazo y aborto en jóvenes de bajo nivel socio económico, lo que corrobora los resultados de otros estudios ya publicados. Sobresale en la encuesta la edad precoz para el primer encuentro sexual y el hecho de que al rededor de » de la muestra hace uso irregular de los métodos contraceptivos. Plantease sobre el uso de los métodos anticonceptivos y sobre el aborto, asociados a la salud del adolescente.

Gravidez na adolescência: análise contextual de risco e proteção / Early pregnancy: a contextual analysis about risk and protection / Gravidez en la adolescencia: análisis contextual del riesgo e protección

A gravidez precoce pode ser entendida como fator de risco ou proteção no adolescente. É crescente a necessidade de pesquisas que aprofundem os aspectos envolvidos nessa questão. Este estudo exploratório-descritivo teve como objetivo identificar as diferenças existentes entre um grupo de adolescentes que viveu a experiência de gravidez durante a adolescência. A amostra foi composta por 1015 jovens de nível socioeconômico baixo de Porto Alegre, com 14-24 anos, de ambos os sexos. Utilizou-se um questionário com 109 questões que abordam aspectos da vida juvenil: drogas, sexualidade, religiosidade, escola. Observou-se maior número de participantes do sexo feminino 52.3 por cento contra 47.7 por cento do sexo masculino. 53.5 por cento dos jovens já iniciou a vida sexual, dentre estes, 64.6 por cento eram homens. A idade média para a primeira relação foi significativamente menor para eles (M=13.64 anos; dp=1.7) do que para elas (M=14.79 anos; dp=1.4). Os resultados revelam um percentual esperado para gravidez e aborto em jovens de nível socioeconômico baixo, quando comparado a outros estudos. Sobressai a baixa idade para a primeira relação sexual e o fato de que cerca de ¼ da amostra apresentar uso irregular de métodos contraceptivos. Discute-se sobre uso de métodos anticoncepcionais e aborto, associadas à saúde do adolescente.(AU)

Early pregnancy has been widely understood as a risk factor, moreover, in some cases, it has been considering as a protective factor. Thus, more studies among this population should be done, looking for the variables involving such question. This exploratory-descriptive study had as aim to identify the existent differences among a group of adolescents that lived the pregnancy experience. Participants were 1015 low SES young people from Porto Alegre, aged between 14-24, males and females. A questionnaire with 109 questions was used asking about major domains of life: drug use, sexuality, religiosity, school. There were more females 52.3 percent than males 47.7 percent in the sample. Most of the participants already had their first sexual intercourse, 53.5 percent, most of them males (64.6 percent). The average for first sexual intercourse was lower for males (M=13.64; dp=1.7) than females (M=14.79; dp=1.4). Results indicate an expected rate of pregnancy and abortion for low SES young. We stress the low age for first sexual intercourse and the fact that ¼ of our sample has an irregular contraceptive method. We discuss about contraceptive method and abortion linked to the adolescents health.(AU)

El embarazo precoz puede ser entendida como un factor de riesgo o protección para el adolescente. La necesidad de investigaciones que profundicen los aspectos involucrados en esta cuestión es creciente. Hecho en Porto Alegre, capital de la provincia de Rio Grande do Sul, ubicada al sur de Brasil, este es un estudio exploratorio descriptivo, con una muestra de 1015 jóvenes de ambos sexos con edad entre 14 y 24 años y de bajo nivel socio económico. La investigación se valió de una encuesta con 109 cuestiones que abordan aspectos de la vida juvenil: drogas, sexualidad, religiosidad, escuela. El porcentaje de los encuestados correspondiente al sexo femenino fue de 52.3 por ciento y 47.7 por ciento del sexo masculino. De estos jóvenes 53.5 por ciento ya empezó la vida sexual, entre los cuales, 64.6 por ciento eran hombres. De hecho, de la observación de los datos se desprende una clara tendencia a una mayor precocidad para los hombres (M=13.64 anos; dp=1.7) aunque la media de edad de las mujeres para iniciarse en las relaciones sexuales no esté muy por debajo (M=14.79 anos; dp=1.4). El análisis de los datos revela un porcentual esperado para embarazo y aborto en jóvenes de bajo nivel socio económico, lo que corrobora los resultados de otros estudios ya publicados. Sobresale en la encuesta la edad precoz para el primer encuentro sexual y el hecho de que al rededor de ¼ de la muestra hace uso irregular de los métodos contraceptivos. Plantease sobre el uso de los métodos anticonceptivos y sobre el aborto, asociados a la salud del adolescente.(AU)

Adolescentes en riesgo psicosocial y resiliencia / Adolescents in psychosocial risk and resilience

El objetivo de la investigación fue detectar las variables individuales y sociales que contribuyen al fortalecimiento del proceso de resiliencia en 210 adolescentes escolarizados de ambos sexos de un nivel socioeconómico bajo, residentes en la ciudad de Córdoba (Argentina). La investigación permitió detectar dos grupos (resilientes- no resilientes), los cuales fueron comparados en relación a las características sociodemográficas y con las variables en estudio. Se observaron diferencias significativas en relación con auto-concepto, soporte social, inteligencia y sucesos estresantes de vida por problemas personales. El análisis realizado a través de la regresión múltiple logística indica que el autoconcepto es la variable mejor predictora de la resiliencia, seguida de soporte social y autorregulación de habilidades (cognitivas- emocionales).

The goal of this investigation was to detect individual and social variables that contribute to the strengthening of the resilience process in 210 school adolescents (male and female) of a low social-economic level residing in the City of Córdoba (Argentina). The research carried out detected two groups (resilient and non-resilient) which were compared in relation to social demographic characteristics and with variables now being study. The research found significant differences concerning self-concept, social support, intelligence and stressful situations in life due to personal problems. The analysis done through the logistic multiple regressions indicates that self-concept is the best predictable variable of resilience, followed by social support and self-regulation skills (cognitive and emotional).

Factores de riesgo de retraso en el crecimiento linear en niños de 12 a 120 meses de edad en Arandas, Jalisco-México / Risk factors associated to growth retardation in children 12 to 120 months of age in Arandas, Jalisco-México

El propósito fue identificar los factores asociados a retraso en el crecimiento en niños de una región semi-rural en Arandas, Jalisco, México. En estudio transversal analítico se incluyeron 432 niños de 12 a 120 meses. Se analizaron variables sociales, demográficas, económicas, dietéticas y patológicas. Se utilizó la puntuación Z del índice talla/edad (< -1 DE y < - 2 DE) para evaluar el déficit de crecimiento. Con la prueba de chi cuadrada y la razón de momios (IC 95 por ciento) se estimaron los factores de riesgo y protección. Los factores de riesgo fueron: > tres niños en la familia [RM 1.71 (1.01, 2.87)], consumo de sodas azucaradas > 4 veces por semana [RM 2.36 (1.19-4.73), ingreso familiar mensual < 200 USA dólares [RM 3.5 (1.28, 9.76)] y gasto per cápita en alimentación < 10 por ciento de un salario mínimo (100 USA dólares al mes) [RM 1.81 (1.06, 3.09)]; edad < 24 meses [RM 2.02 (1.09, 3.75)], adición de azúcar al biberón [RM 8.56 (1.84, 54.9)], modificación de la dieta durante la diarrea [RM 2.40 (1.02, 5.77)] ingestión de leche < 4 veces a la semana [RM 2.71 (1.55, 4.73)] y casi significativo: consumo de frijoles [RM 1.75 (0.98, 3.13)]. Factores de protección: familia nuclear [RM 0.28 (0.09, 0.85)] y dilución adecuada de la fórmula de alimentación [RM 0.71 (0.60, 0.85)]. En el modelo de regresión los factores de riesgo fueron: consumo de sodas, frijoles y adición de azúcar u otros edulcorantes al biberón.

The purpose was to identify risk factors associated to deficit on linear growth in children from a semi-rural population in Arandas, Jalisco, Mexico. In a cross sectional study 432 children, 12 to 120 months old were included. Social, demographic, economical, dietetic and pathological characteristics and deficit in the height /age index (< - 1 and - 2 z score) were considered. A chi square test and Odds Ratio (CI 95 percent) to identify the risk and protection factors were also obtained. Risk factors for height/age deficit were: > 3 children in the family [OR 1.71 (1.01, 2.87)], soft drinks consumption > 4 times a week [OR 2.36 (1.19-4.73)], family’s monthly income < 200 USA dollars [OR 3.5 (1.28, 9.76)] and per capita food expenses < 10 percent of a minimum salary (100 USA dollars a month) [OR 1.81 (1.06, 3.09)]; age < 24 months [OR 2.02 (1.09, 3.75)], adding sweeteners to the bottle [OR 8.56 (1.84, 54.9)], diet modification during diarrhea [OR 2.40 (1.02, 5.77)], milk intake < 4 times a week [OR 2.71 (1.55, 4.73)] and nearly significant, bean consumption [1.75 (0.98, 3.13). Protection factors: nuclear family [OR 0.28 (0.09, 0.85)] and an adequate infant formula dilution [OR 0.71 (0.60, 0.85)]. In multivariate models associated factors to deficit of height were higher consumption of soft drinks, beans and the addition of sweeteners to the bottle. In addition to socioeconomic variables, lower consumption of high quality food and proteins and higher intake of legumes were important risk factors for mild and moderate deficit height/age.

Factores convencionales y no convencionales asociados con fracaso al tratamiento antituberculoso: Medellín, 2003-2004 / Conventional and non-conventional factors associated to failure of anti-tuberculosis treatment: Medellín, 2003-2004

Objetivo: Determinar los factores asociados con fracaso al tratamiento de la tuberculosis en Medellín-Colombia, durante enero 2003 a diciembre 2004, para generar información útil que reoriente los programas de control. Metodología: Estudio de casos-controles, los casos fueron pacientes nuevos que iniciaron tratamiento antituberculoso en el Programa de Control de Tuberculosis de Medellín y que egresaron como fracaso con baciloscopia positiva al sexto mes de tratamiento. Los controles fueron pacientes nuevos que iniciaron tratamiento en el Programa y culminaron con esputo negativo al sexto mes. La muestra se conformó por todos los pacientes reportados como “Fracaso” y un número mayor de pacientes reportados como “Curados”, con una razón de 1:5. Resultados: Pertenecer al género masculino (OR=5,23 IC:1,24–25,35; p=0.009); pertenecer al grupo de familia no nucleada (OR=8,19 IC:8-39,83; p=0.03); recibir atención en una institución de salud privada (OR=6,67, IC:1,84–25,08; p=0.0005) se comportaron como un factor de riesgo para el fracaso en el tratamiento antituberculoso. Recibir atención en una institución pública es un factor de protección para el fracaso al tratamiento (OR=0,13 IC: 0,05–0,34; p=0.0005). Conclusiones: El fracaso de la Terapia debe ser intervenido para evitar la resistencia a medicamentos y la transmisión de enfermedad en la comunidad, dando prioridad a grupos de: hombres, sin familia constituida y del régimen privado de salud...

Objective: To determine the factors associated to the failure in the treatment of tuberculosis in Medellín, Colombia from January 2003 to December 2004, in order to gather useful information to redefine the control programs. Methodology: An analytical study of Cases and Controls was carried out. The chosen Cases were all patients that started anti-tuberculosis treatment in the Tuberculosis Control Program of Medellín and left the programas failing cases before the sixth months of treatment. The Control group was made up of patients who started the treatment in the program and were released as cured. The sample population was made up of all patients reported as “failure cases” and a five times bigger number of patients reported as “cured”. Results: It was found that being a male (OR= 5, 23.CI: 1,24-25,35; p= 0.009) and not belonging to a nuclear family group (OR= 8,19. CI: 8-39,83; p=0.003) were factors associated to TB treatment failure. In regards to non-conventional risk factors, it was found that being affiliated to Private health service institutions(OR=6,67. CI: 1,84-25,08; p=0.0005), becomes a risk factor with a strong association to TB treatment failure. On the other hand, receiving attention in Public institutions decreases the risk of TB treatment failure (OR=0,13. CI: 0,05-0,34; p= 0.0005). Conclusions: The failure of the therapy must be intervened to avoid resistance to medication and transmission of the disease in the community, giving priority to the group conformed by males, affiliated to the private health service system and whose don’t belong to a nuclear family.