Ofensores sexuais avaliados pelo desenho da figura humana / Sex offenders evaluated using the human figure drawing / Delincuentes sexuales evaluados por el dibujo de la figura humana

Este estudo se propôs a avaliar características psicológicas de ofensores sexuais intrafamiliares. Participaram do estudo 10 homens, entre 23 e 59 anos de idade, em situação de reclusão em um Centro de Ressocialização, pelo artigo 213 do Código Penal Brasileiro. Uma entrevista semidirigida e o Desenho da Figura Humana foram utilizadas como instrumentos. A coleta dos dados ocorreu de forma individual, sendo analisados no programa estatístico SPSS versão 22.0, para elaboração de análises descritivas simples. Os resultados dessa amostra apontam indicativos de dificuldade em lidar com impulsos corporais na busca pela satisfação imediata das necessidades, inclusive e, sobretudo, sexuais. Essas características foram recorrentes em alguns elementos dos desenhos, como a perspectiva em relação à localização na página, o tronco omitido e ausência de pupila nos olhos. Os principais resultados corroboram as características de personalidade retratadas comumente na literatura e confirmam a inexistência de um perfil psicológico para o ofensor sexual.(AU)

The aim of this study was to evaluate psychological characteristics of intra-family sexual offenders. The study included 10 men, between 23 and 59 years of age, who are inmates in a Resocialization Center as a function of Article 213 of the Brazilian Penal Code. A semi-structured interview and Human Figure Drawing were used, individually, as data collection instruments. Findings were analyzed by the statistic program SPSS version 22.0 for preparation of simple descriptive analyses. The results from this sample indicated difficulty in dealing with physical impulses in seeking immediate satisfaction of needs, including, and primarily, sexual needs. These characteristics were recurrent in some elements of the drawings, such as the location on the paper, the omission of the midsection and the absence of pupils in the eyes. The main findings corroborate the personality characteristics commonly portrayed in the literature and confirm the inexistence of a psychological profile of a sexual offender.(AU)

Este estudio se propuso evaluar las características psicológicas de delincuentes que han cometido violencia sexual intrafamiliar. Participaron del estudio 10 hombres, entre 23 y 59 años de edad, en estado de reclusión en un centro de reinserción social, por el artículo 213 del Código Penal Brasileño. Se utilizaron como instrumentos una entrevista semi-dirigida y el dibujo de la figura humana. La recolección de los datos se realizó en forma individual y se analizaron los mismos mediante la programación estadística SPSS versión 22.0, para la elaboración de análisis descriptivos simples. Los resultados de esta muestra señalan indicativos de dificultad en lidiar con impulsos corporales, en la búsqueda de satisfacción inmediata de las necesidades, principalmente sexuales. Esas características fueron recurrentes en algunos elementos de los dibujos, como la perspectiva en relación a la ubicación en la página, el tronco omitido y ausencia de pupila en los ojos. Los principales resultados confirman las características de la personalidad comúnmente retratadas en la literatura y también la ausencia de un perfil psicológico para el delincuente sexual.(AU)

Ofensores sexuais avaliados pelo desenho da figura humana / Sex offenders evaluated using the human figure drawing / Delincuentes sexuales evaluados por el dibujo de la figura humana

Este estudo se propôs a avaliar características psicológicas de ofensores sexuais intrafamiliares. Participaram do estudo 10 homens, entre 23 e 59 anos de idade, em situação de reclusão em um Centro de Ressocialização, pelo artigo 213 do Código Penal Brasileiro. Uma entrevista semidirigida e o Desenho da Figura Humana foram utilizadas como instrumentos. A coleta dos dados ocorreu de forma individual, sendo analisados no programa estatístico SPSS versão 22.0, para elaboração de análises descritivas simples. Os resultados dessa amostra apontam indicativos de dificuldade em lidar com impulsos corporais na busca pela satisfação imediata das necessidades, inclusive e, sobretudo, sexuais. Essas características foram recorrentes em alguns elementos dos desenhos, como a perspectiva em relação à localização na página, o tronco omitido e ausência de pupila nos olhos. Os principais resultados corroboram as características de personalidade retratadas comumente na literatura e confirmam a inexistência de um perfil psicológico para o ofensor sexual.

The aim of this study was to evaluate psychological characteristics of intra-family sexual offenders. The study included 10 men, between 23 and 59 years of age, who are inmates in a Resocialization Center as a function of Article 213 of the Brazilian Penal Code. A semi-structured interview and Human Figure Drawing were used, individually, as data collection instruments. Findings were analyzed by the statistic program SPSS version 22.0 for preparation of simple descriptive analyses. The results from this sample indicated difficulty in dealing with physical impulses in seeking immediate satisfaction of needs, including, and primarily, sexual needs. These characteristics were recurrent in some elements of the drawings, such as the location on the paper, the omission of the midsection and the absence of pupils in the eyes. The main findings corroborate the personality characteristics commonly portrayed in the literature and confirm the inexistence of a psychological profile of a sexual offender.

Este estudio se propuso evaluar las características psicológicas de delincuentes que han cometido violencia sexual intrafamiliar. Participaron del estudio 10 hombres, entre 23 y 59 años de edad, en estado de reclusión en un centro de reinserción social, por el artículo 213 del Código Penal Brasileño. Se utilizaron como instrumentos una entrevista semi-dirigida y el dibujo de la figura humana. La recolección de los datos se realizó en forma individual y se analizaron los mismos mediante la programación estadística SPSS versión 22.0, para la elaboración de análisis descriptivos simples. Los resultados de esta muestra señalan indicativos de dificultad en lidiar con impulsos corporales, en la búsqueda de satisfacción inmediata de las necesidades, principalmente sexuales. Esas características fueron recurrentes en algunos elementos de los dibujos, como la perspectiva en relación a la ubicación en la página, el tronco omitido y ausencia de pupila en los ojos. Los principales resultados confirman las características de la personalidad comúnmente retratadas en la literatura y también la ausencia de un perfil psicológico para el delincuente sexual.

O descarte de medicamentos no bairro Grande Terceiro, Cuiabá-MT / Drug disposal at Grande Terceiro Neighborhood, Cuiabá-MT

O descarte inadequado de medicamentos que não são utilizados ou que perdem a validade pode acarretar graves consequências para a saúde pública, bem como impactos ambientais. O objetivo deste estudo é descrever o processo de descarte de medicamentos vencidos ou inutilizados nas residências de pacientes cadastrados no programa Hiperdia do bairro Grande Terceiro, Cuiabá, MT. O levantamento dos dados foi realizado através de questionário fechado, contendo uma série de questões com respostas pré-definidas sobre como o descarte de medicamento é feito, forma de acesso aos medicamentos, conhecimento sobre o que fazer com os medicamentos vencidos ou que sobram e como são armazenados nas residências. Dentre os entrevistados, 75,3% não conheciam sobre descarte correto de medicamentos, sendo que 42,4% afirmaram descartar em lixo doméstico; 34,8% adquiriram os medicamentos através de Unidades Básicas de Saúde. O local de armazenamento mais frequente foram quarto com 49,4%, e cozinha com 40,5%. O destino dado aos medicamentos pode gerar impactos na saúde e no ambiente, portanto a diminuição do excesso de medicamentos, elaboração de políticas que visam o correto descarte e a conscientização da população podem diminuir estes impactos.

The inappropriate disposal of medications that are unused or expired leads to serious consequences for public health, as well as an environmental impacts. The purpose of this study is to describe the process of disposal of expired or unused medicines in the homes of patients registered in the HiperDia program at the Grande Terceiro neighborhood, Cuiabá, MT. The data collection was performed by closed questionnaries containing questions with predefined answers about how the disposal of medicines is done, the form of access to these drugs, knowledge of what to do with the expired or remaining drugs, and how they are stored in homes. Among the interviewed, 75.3% did not know about proper disposal of medicines, and 42.4% reported disposing in common garbage; 34.8% were acquired through Basic Health Units, and the most frequent site of storage was the bedroom with 49.4%, and 40.5% in the kitchen. The final destination of the drugs can have an impact on health and at the environment, thus the reduction of excess drugs, development of politics aimed at the correct disposal and public awareness can reduce these impacts.

Accessing and evaluating urologic health information: differences by race/ethnicity and gender.

Patients with urologic symptoms seek information from a variety of sources outside the traditional health care arena. There are differences between the genders and racial/ethnic groups related to sources consulted and confidence in those sources.

Complementary and alternative therapies for urinary symptoms: use in a diverse population sample qualitative study.

Study participants reported a range of remedies used to treat urinary symptoms, from popular products, such as saw palmetto, to less commonly known remedies, such as moabi. Participants learned about remedies through social network rather than from their primary care provider.

Talking with others about stigmatized health conditions: implications for managing symptoms.

We investigated the influence of social ties on symptom management and help seeking, using urinary symptoms as a case study. Talking with others about these symptoms was common and both facilitated and hindered symptom management and help seeking. In some cases, talking with others resulted in gaining a sense of identification with others suffering the same symptoms, receiving assistance to ease the burden of symptoms, obtaining suggestions to help manage symptoms, and learning information about available treatments. In other cases, talking with others served to normalize symptoms to such an extent that individuals saw no need to manage their symptoms differently.

A qualitative inquiry of patient-reported outcomes: the case of lower urinary tract symptoms.

BACKGROUND: Patient-reported outcomes are a valuable tool for assessing healthcare, particularly for symptom-based conditions that lack definitive physiological measures of treatment efficacy. OBJECTIVE: To explore the value of qualitative methods for understanding and developing patient-reported outcomes of medical care for symptom-based conditions by examining the case of lower urinary tract symptoms. METHODS: Semistructured interviews were conducted with a diverse community sample of 90 respondents who had spoken with a provider about their urinary symptoms. Content and thematic analyses were conducted for the areas of symptom relief, patient adherence, and satisfaction with care according to gender, race or ethnicity, and socioeconomic status. RESULTS: Across social groups, most patients experienced either no symptom relief or partial relief, reported that they adhered to recommendations, and were satisfied with the care received. The primary reason for no symptom relief was not receiving a treatment recommendation. For patients, even partial relief made symptoms more manageable both physically and emotionally. Satisfaction with care was mediated by the quality of the patient-provider relationship as well as expectations other than symptom relief, particularly for patients of low socioeconomic status. DISCUSSION: Patients' assessments of the outcomes of seeking medical care for this symptom-based condition broadened the criteria for quality of care beyond providing a cure. For healthcare providers, this can widen the path for meeting patient needs, even without complete symptom relief. For providers and researchers, as the evidence base expands to include patient reports, the context provided by a qualitative approach can enhance understanding of patients' perspectives and the ability to construct meaningful quantitative measures.

Race and ethnic differences in health beliefs about lower urinary tract symptoms.

BACKGROUND: Health beliefs are an important mediator between the experience of symptoms and health behaviors, and these beliefs can vary by race or ethnicity. OBJECTIVES: The aim of this study was to better understand the gap between experiencing symptoms and not seeking medical care by examining health beliefs about lower urinary tract symptoms across race and ethnic groups. METHOD: Qualitative, semistructured interviews were conducted with 35 Black, Hispanic, and White people who reported at least one urinary symptom but had not spoken with a healthcare provider about the symptom(s). Drawing on Shaw's framework of health behavior and outcomes, a range of beliefs was examined: cause, consequence, continuation, and treatability. Interviews were transcribed, coded, and analyzed for themes according to race or ethnic background. RESULTS: The belief that lower urinary tract symptoms are a typical part of aging and not amenable to medical treatment was most common among White respondents. Black respondents more commonly attributed their symptoms to personal behaviors over which they had control and therefore did not require medical care. Hispanic respondents appeared more often to live with uncertainty about the cause of their symptoms and an accompanying concern about a future health consequence. DISCUSSION: The combination of a range of health beliefs to form a cognitive representation made sense of the behavior of not seeking medical care. The finding that sociocultural differences shaped these cognitive representations underscores the need for cultural competency in patient assessment and education. Results have implications for theories of health behavior and indicate further research with larger samples, additional psychosocial influences, and other symptoms.

Moderating perceptions of bother reports by individuals experiencing lower urinary tract symptoms.

We compared reports of symptom bother for the same urinary symptoms to understand why symptom severity and bother do not correspond in a straightforward manner. We used a grounded theory approach to analyze qualitative data from 123 individual interviews and developed a conceptual framework, identifying three symptom perceptions that might moderate symptom bother: causal, relative, and uncertainty. Symptom bother was lower for respondents who viewed symptoms causally (symptoms seemed explainable or "normal") or relatively (urinary symptoms were compared to other symptoms or conditions). Bother tended to be higher for respondents who viewed symptoms with uncertainty (when symptom etiology and course were unknown). A greater portion of respondents in the causal perception group had not sought health care for their symptoms. This conceptual framework is useful for understanding the relationship between reactions to and health care seeking for other symptoms.

Murine typhus as a cause of Fever in travelers from Tunisia and mediterranean areas.

BACKGROUND: Travelers are exposed to a variety of health risks in unfamiliar environments and fever is a common problem in patients returning from travel abroad. Rickettsial diseases are increasingly frequently being reported among international travelers. Here we present cases of Rickettsia typhi infection, the agent of murine typhus, that were identified in our laboratory the last year, in travelers from Tunisia. METHODS: For each patient we tested an acute-phase serum sample and for one patient we tested a convalescent-phase serum sample. IgG and IgM antibody titers were estimated with use of the microimmunofluorescence (MIF) assay. Western blot (WB) assay was performed for all the patients. RESULTS: We identified three cases of murine typhus after a travel in Tunisia. All cases were observed during late summer and early autumn and patients were suffering by persistent fever. None of them presented rash or inoculation eschar. MIF was positive for Rickettsia sp. in the acute-phase serum samples of two patients. In one patient, two acute-phase serum samples were Rickettsia sp. negative whereas a third convalescent-phase serum sample that was obtained 2 weeks after was Rickettsia sp. positive. By WB assay we identified infection by R typhi. A treatment was immediately started and patients became apyretic. CONCLUSIONS: In the countries of North Europe, although autochthones cases of murine typhus have not been described, sporadic cases of R typhi infection are identified in travelers who visited murine typhus endemic areas. Murine typhus should be considered in the diagnosis of febrile illness without rash in travelers returning from disease endemic areas, like the south Mediterranean area.

Beyond incontinence: the stigma of other urinary symptoms.

AIM: This paper is a report of a study conducted to characterize the stigma of urinary frequency and urgency and differentiate it from the stigma of incontinence and to describe race/ethnic and gender differences in the experience of stigma among a diverse sample of individuals. BACKGROUND: Lower urinary tract symptoms, including frequency, urgency and incontinence, are susceptible to stigma, but previous stigma research has focused almost exclusively on incontinence. METHOD: The Boston Area Community Health Survey is a population-based, random sample epidemiological survey of urologic symptoms (N = 5503). Qualitative data for this study came from in-depth interviews conducted between 2007 and 2008 with a random subsample of 151 black, white and Hispanic men and women with urinary symptoms. FINDINGS: Respondents reported stigma associated with frequency and urgency - not just incontinence. The stigma of frequency/urgency is rooted in social interruption, loss of control of the body, and speculation as to the nature of a non-specific 'problem'. Overall, the stigma of urinary symptoms hinged upon whether or not the problem was 'perceptible'. Men felt stigmatized for making frequent trips to the bathroom and feared being seen as impotent. Women feared having an unclean body or compromised social identity. Hispanic people in particular voiced a desire to keep their urinary symptoms a secret. CONCLUSION: The stigma of urinary symptoms goes beyond incontinence to include behaviours associated with frequency and urgency. Healthcare practitioners should assess for stigma sequelae (e.g. anxiety, depression) in individuals with frequency and urgency, and stress treatment options to circumvent stigmatization.

Likely correlation between sources of information and acceptability of A/H1N1 swine-origin influenza virus vaccine in Marseille, France.

BACKGROUND: In France, there was a reluctance to accept vaccination against the A/H1N1 pandemic influenza virus despite government recommendation and investment in the vaccine programme. METHODS AND FINDINGS: We examined the willingness of different populations to accept A/H1N1 vaccination (i) in a French hospital among 3315 employees immunized either by in-house medical personnel or mobile teams of MDs and (ii) in a shelter housing 250 homeless persons. Google was used to assess the volume of enquiries concerning incidence of influenza. We analyzed the information on vaccination provided by Google, the website of the major French newspapers, and PubMed. Two trust Surveys were used to assess public opinion on the trustworthiness of people in different professions. Paramedics were significantly more reluctant to accept immunisation than qualified medical staff. Acceptance was significantly increased when recommended directly by MDs. Anecdotal cases of directly observed severe infections were followed by enhanced acceptance of paramedical staff. Scientific literature was significantly more in favour of vaccination than Google and French newspaper websites. In the case of the newspaper websites, information correlated with their recognised political reputations, although they would presumably claim independence from political bias. The Trust Surveys showed that politicians were highly dis-trusted in contrast with doctors and pharmacists who were considered much more trustworthy. CONCLUSIONS: The low uptake of the vaccine could reflect failure to convey high quality medical information and advice relating to the benefits of being vaccinated. We believe that the media and internet contributed to this problem by raising concerns within the general population and that failure to involve GPs in the control programme may have been a mistake. GPs are highly regarded by the public and can provide face-to-face professional advice and information. The top-down strategy of vaccine programme management and information delivered by the Ministry of Health could have aggravated the problem, because the general population does not always trust politicians.

Adopting best practices: lessons learned in the Collaborative Initiative to Help End Chronic Homelessness (CICH).

The Collaborative Initiative to Help End Chronic Homelessness (CICH) was established to provide housing and supportive services for individuals experiencing chronic homelessness. As part of this initiative, 11 projects across the country received funding to apply models of best practices to support their clients in housing. This paper reports on the experiences of the CICH projects in their use of Assertive Community Treatment (ACT) and Motivational Interviewing (MI), clinical practice models commonly used by CICH projects. A qualitative analysis identified five areas of challenge for the projects: (1) Incomplete and underdeveloped staff teams; (2) Incomplete understanding of the practice models; (3) Using the elements of the practice models; (4) Interagency teaming; and (5) Competing expectations of multiple federal agencies. The paper describes the specific challenges in each of the five areas as well as training approaches and gaps in training and the perceived benefits of the practice models as reported by project staff.