Support for Mothers, Fathers, or Guardians of Transgender Children and Adolescents: A Systematic Review on the Dynamics of Secondary Social Networks.

Mothers', fathers', or guardians' support for disclosures of diverse gender identity has significant relationships with decreased suicidality for transgender children and adolescents. They play an essential role in facing transphobia, protecting trans children, and strengthening the expression of their identity. These guardians need structural, emotional, and informative support; they need to be prepared to recognize and manage of their own feelings, as well as deal with the challenges that come with new social contexts of transphobia in schools, health institutions, and other community spaces. This study aimed to analyze the scientific evidence on the dynamics of secondary social networks to support mothers, fathers, or guardians of transgender children and adolescents. This is a systematic review of qualitative studies, guided by PRISMA guidelines. Controlled and free vocabularies were used to survey the primary studies in the following databases: EMBASE; Scopus; MEDLINE; Cumulative Index to Nursing and Allied Health Literature (CINAHL); PsycInfo; Latin American and Caribbean Literature in Health Sciences (LILACS); and Web of Science. A total of 28 articles made up the final sample of this review. Secondary social networks were described as fragile, characterized by conflicting and broken ties with healthcare services and professionals, isolation and unpreparedness from schools, and emotional and informational support from peer groups and some qualified healthcare professionals. The literature shows the potential of the dynamics of secondary social support networks; however, it presented the unpreparedness of professionals and institutional policies for welcoming transgender children and adolescents and their families, with the peer group being the main emotional and informative support network.

Health services performance for TB treatment in Brazil: a cross-sectional study.

ABSTRACT: BACKGROUND: Researches to evaluate Primary Health Care performance in TB control in Brazil show that different cities aggregate local specificities in the dynamics of coping with the disease. This study aims to evaluate health services' performance in TB treatment in cities across different Brazilian regions. METHODS: This cross-sectional study was conducted in five cities that are considered priorities for TB control in Brazil: Itaboraí (ITA), Ribeirão Preto (RP) and São José do Rio Preto (SJRP) in the Southeast; Campina Grande (CG) and Feira de Santana (FS) in the Northeast. Data were collected through interviews with 514 TB patients under treatment in 2007, using the Primary Care Assessment Tool adapted for TB care in Brazil. Indicators were constructed based on the mean response scores (Likert scale) and compared among the study sites. RESULTS: "Access to treatment" was evaluated as satisfactory in the Southeast and regular in the Northeast, which displayed poor results on 'home visits' and 'distance between treatment site and patient's house'. "Bond" was assessed as satisfactory in all cities, with a slightly better performance in RP and SJRP. "Range of services" was rated as regular, with better performance of southeastern cities. 'Health education', 'DOT' and 'food vouchers' were less offered in the Northeast. "Coordination" was evaluated as satisfactory in all cities. "Family focus" was evaluated as satisfactory in RP and SJRP, and regular in the others. 'Professional asking patient's family about other health problems' was evaluated as unsatisfactory, except in RP. CONCLUSIONS: Two types of obstacles are faced for health service performance in TB treatment in the cities under analysis, mainly in the Northeast. The first is structural and derives from difficulties to access health services and actions. The second is organizational and derives from the way health technologies and services are distributed and integrated. Incentives to improve care organization and management practices, aimed at the integration of primary, secondary and tertiary services, can contribute towards a better performance of health services in TB treatment.

Perfil de hipertensos em um núcleo de saúde da família / Hypertensives profile in a family health center

O estudo caracteriza o perfil de hipertensos em um Núcleo de Saúde da Família do interior paulista. As variáveis sexo, idade, escolaridade, doenças associadas e tratamento foram obtidas da ficha A do SIAB(Sistema de Informação da Atenção Básica); do prontuário médico e analisadas pelo programa Epi-Info. A população foi de 343 hipertensos. Destes, 188 são usuários do serviço, sendo 70% mulheres e 30% homens;74,80% idosas, 66,66% idosos; 7,44% analfabetos, 65,42% com 1º grau de escolaridade, 15,95% com 2º graue 5,31% com ensino superior. As doenças mais referidas foram as cardiovasculares que se destacam com os percentuais mais elevados atingindo 25,53%, o diabetes aparece em 22,34%; seguido da dislipidemia (20,74%), obesidade (17,02%), tabagismo (5,31%), doença cérebro vascular (4,78%) e doença renal (1,59%). Os fármacos mais utilizados foram os Inibidores da Enzima Conversora de Angiotensina, Diréticos Tiazídicos, Anti-agregantes plaquetários e os Hipoglicemiantes orais. Tais resultados poderão subsidiar o desenvolvimentode estratégias para prevenção de complicações e retardo de agravos.

This study characterizes the hypertensives´ profile in a Family Health Care Center from the interior of SãoPaulo. The variables such as the age, sex, years of study and treatment were taken from the registered cardA from the BHIS (Basic Health Information System), and the medical record; these were analyzed by the EpiInfo program. A total of 343 hypertensives comprised the population. Out of these, 188 were users of this service: 70% women and 30% men, 74.8% elderly women, 66.6% elderly men, 7.44% were illiterate, 65.42% had primary school, 15.95% had high school and 5.31% had university level. Cardiovascular disease was theleading reported disease, the highest percentual (25.53%), diabetes (22.34%), following dislipidemy (20.74%),obesity (17.02%), tobacco (5.31%), brain disease (4.78%) and kidney disease (1.59%). The drugs most used were Angiotensina converting enzyme inhibition, Diuretics, Aspirin, and Hipoglicemiants. These results canprovide the development of strategies for prevention of short and long-term complications.