ABSTRACT
Abstract Introduction The Cognitive Distortions Questionnaire (CD-Quest) is an instrument that identifies logical errors or cognitive distortions and is used in trial-based cognitive therapy (TBCT). However, it had previously only been available for adults. Objectives To develop and validate a version of the CD-Quest for teens (CD-Quest-T) aged 11 to 17 years and test its psychometric properties. Method A total of 299 schoolchildren participated in the investigation. After content validity was assessed, the language was adapted for the target age group, and the length of the instrument was reduced to eight items (from the initial 15). Five cognitive therapists analyzed the content and structure of the items. Finally, to investigate the construct validity of the CD-Quest-T, the instrument was divided into a full scale and two subscales, which measure the frequency of the distortions and the intensity attributed to them, respectively. Results The overall internal consistency of the scale was α = 0.77, whereas subscale indices were α = 0.75 for the frequency scale and α = 0.73 for the intensity scale. Results from exploratory factor analysis and concurrent validity analysis indicated that the CD-Quest-T items have good psychometric properties and generate scores reliably. Conclusion The psychometric properties of the CD-Quest-T demonstrate its adequacy for measurement of cognitive distortions in adolescents.
ABSTRACT
Tuberculosis is the leading cause of death amongst adults with human immunodeficiency virus (HIV) infection. The lifetime risk of tuberculosis disease for a person with latent infection is estimated at 5-10% with most cases occurring within five years of initial infection. The World Health Organization recommends isoniazid preventive therapy (IPT) for latent tuberculosis treatment, amongst other strategies. The aim was to assess tuberculosis incidence, survival (free of tuberculosis) and associated factors in HIV-positive patients. IPT was offered to participants with a positive (≥5mm) tuberculin skin test. Participants were followed from February 2003-December 2016. Kaplan-Meier was used for survival analysis. Variables with p-value ≤ 0.2 in the univariate analysis entered into the multivariate Cox-Model, keeping those with p-value ≤ 0.05. The 95% confidence interval of incidence of tuberculosis was estimated using Poisson distribution. One hundred nineteen patients completed the IPT and were followed for a median duration of 110.7 months (IQR 93.1-121.0). The probability of developing tuberculosis (10 years post-IPT) was 5.4%. Tuberculosis incidence was 0.58/100 patient/years (CI 95% 0.213-1.264). IPT over 6 months provided long-term protection against tuberculosis. AIDS-defining illness was the only statistically significant variable (HR=5.67) in the multivariate model.
Subject(s)
Humans , Survival Analysis , HIV , Latent Tuberculosis , IsoniazidABSTRACT
Pesquisa qualitativa descritiva, com objetivo de conhecer a percepção dos gestores sobre a organização daatenção básica à saúde da criança na Estratégia Saúde da Família. Os dados foram coletados mediante entrevista comcinco gestores atuantes na Secretaria de Saúde de um município da Região Metropolitana de Curitiba e analisados pelatécnica de análise temática. Emergiram as seguintes categorias: identificação dos modelos de atenção; atenção à saúde dacriança: limites e possibilidades no alcance da equidade; infraestrutura e força de trabalho; e planejamento, organização eterritorialização. Observa-se que existe esforço por parte dos gestores locais em organizar a atenção à saúde de forma aatender às necessidades de saúde das crianças, porém, ainda há dificuldades na articulação entre os diferentes serviçosde saúde.
It is a qualitative and descriptive reserch, which aims to find out the managers? perception about theorganization of primary health care of children on the Family Health Strategy. The research subjects were five managersworking in the a Secretary of Health of Curitiba Metropolitan Region. Data were collected through a semi-structuredinterview, and then analyzed by the thematic analysis technique. The following categories emerged: identification ofmodels of attention; child health attention; limits and possibilities by the equity scope; infrastructure and the workforce;planning, organization and territorialization. It appears that despite the efforts of local administrators to create forms oforganization of care that meet the needs of the children?s health, there is still a failure in the articulation among the placesof primary care and health service.
Investigación cualitativa descriptiva, con objetivo de conocer la percepción de los gestores sobre laorganización de la atención básica de la salud del niño en la Estrategia de la Salud de la Familia. Los datos fueronrecolectados por medio de entrevista con cinco gestores que trabajaban en un Departamento de Salud de un municipio enla región metropolitana de Curitiba e analizados mediante la técnica de análisis temática. Surgieron las siguientes categorías:identificación de los modelos de atención; atención a la salud del niño; límites y posibilidades en el alcance de la equidad;infraestructura y la mano de obra; planeamiento, organización y territorialización. Se observa que existe esfuerzo por partede los gestores locales en organizar la atención a la salud de forma a atender a las necesidades de salud de los niños, sinembargo, todavía existen dificultades en la articulación entre los diferentes servicios de salud.