Suchergebnisse

Angola has a considerable natural resource base - extensive reserves of petroleum, diamonds and other minerals, a good climate and fertile soils, but has failed to profit from its economic potential. The components of a framework for economic transformation are discussed in Section I. Section 2 summarises the Government's efforts to correct the macro-economic imbalances between 1987 and June 1996 and explains why "partial" adjustment reforms have failed. In Section 3, the sequencing, intensity and duration of a structural and systemic transformation programme (SSTP) are discussed, and implementation is summarised over four periods from immediate (1996) to long (2002 onwards). ; N/A

In developed countries chronic disease is currently the main reason why people betake to health care [1]. Negative effects of non-compliance with medical prescription reduce the clinical benefits of the medication, leading in most cases to the use of unnecessary treatments, hospitalization and death [2]. Factors associated with non-compliance with medical prescription may be related to: the doctor-patient relationship, the treatment, the health system, the health condition and the socioeconomic situation. Objective/Aim: To assess the impact of the doctor-patient relationship on non compliance with pharmacological medical prescription in chronic disease. Methods: A cross-sectional design was developed based on a random sample of 141 patients with pathologies covered by Portuguese Exceptional Legislation. To collect the data, it was applied a questionnaire by interview between July 2017 and April 2018. The questionnaire included a list of non-compliance factors associated to doctor-patient relationship, developed by Cabral & Silva (2010) [3]. The IBM SPSS 24.0 software was used to analyse the data. Besides descriptive statistics, the data analysis involved the estimation of a logistic regression model, at a confidence level of 95%. Results: Chronic patients were aged between 20 and 95 years old, with a mean age of 65.3 years (SD = 19.39). Most were female (51.8%), married or lived in marital cohabitation (62.4%), retired (55.3%), and had up to the 3rd cycle of schooling (61%) and an income up to € 1,000 (62.4%). These patients suffered from Chronic Renal Insufficiency (CRI) (63.1%), Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PA) (20.6%), Multiple Sclerosis (MS) (10.6%), Amyotrophic Lateral Sclerosis (ALS) (2.1%), Hepatitis C Virus (HCV) (2.1%), Hepatic disease (HD) (0.7%) and Gaucher Syndrome (GS) (0.7%). The active substances most dispensed were: ferrous sulphate (76.6%), folic acid (73.8%), calcium polysterenonosulfonate (53.2%), alfacalcidol (48.9%), epoetin β (43.3%), complex B (26.2%) for CRI; adalimumab (8.5%), etarnecept (7.1%) and Ustecinumab (4.3%) for RA and PA; interferon B (8.5%) for MS. Modal treatment time was 24 months. The main reason for non-compliance associated to doctor-patient relationship dimension was "the doctor prescribes too many medicines" (35%). The second most mentioned reason was "the fear to ask questions"(18.4%), followed by "I do not understand what doctors say" (17.5%) and the "lack of confidence in doctors" (6.8%). A patient who does not consider that "the doctor prescribes too many medications" has a lower risk of non-compliance with the therapeutic prescription [OR= 0.262; CI (95%): 0.112-0.617]. Conclusion: The doctor-patient relationship is fundamental for compliance with the prescribed therapy and consequently for the improvement of the clinical benefits of medication and well-being of the patient. References (Vancouver Style): [1]. Dowrick, C., Dixon-Woods, M., Holman, H., & Weinman, J. What is chronic illness? Chronic Illness, 1, 2005, 1-6. [2]. Bugalho A & Carneiro A. (2004). Intervenções para aumentar a adesão terapêutica em patologias crónicas. Lisboa Centro de Estudos de Medicina Baseada na Evidência - Faculdade de Medicina de Lisboa. [3]. Cabral, M., Silva, P. A adesão à terapêutica em Portugal: Atitudes e comportamentos da população portuguesa perante as prescrições médicas. APIFARMA, 2010. ; The authors thank FCT, Portugal and FEDER under the PT2020 program for the financial support to CIMO (UID/AGR/00690/2013). UDI/IPG ; info:eu-repo/semantics/publishedVersion

Medication adherence is a multidimensional phenomenon determined by the interaction of factors of diverse nature. The World Health Organization classified in five groups the reasons for non-adherence to therapy, related to, patient, disease, therapy, health system and socioeconomic factors [1]. Objective/Aim: To identify the most prevalent extrinsic and intrinsic factors for non adherence to therapy and to verify the existing differences taking into account the socioeconomic variables. Methods: A random probabilistic sample of 141 outpatient suffering from pathologies covered by specific legislation with dispensing medicines at the hospital pharmacy, treated at the Local Health Unit of the Northeast in Portugal, was selected. The sample included patients with Chronic Renal Insufficiency (n=89), Rheumatoid Arthritis and Psoriatic Arthritis (n=29), Multiple Sclerosis (n=15), Amyotrophic Lateral Sclerosis (n=3), Hepatitis C Virus (n=3), Hepatic disease (n=1) and Gaucher Syndrome (n=1). To collect the data, was applied a questionnaire, by interview, that included socioeconomic variables and a list of non-adhesion factors adapted from Cabral and Silva [2], between July 2017 and April 2018. The list of factors for non-adherence to the therapy consisted of 35 factors that were later aggregated into three dimensions. The first dimension "extrinsic factors", consisted of 11 reasons that could lead patients not to follow completely the indications recommended by the doctor. The second dimension "intrinsic factors" was constituted by 20 factors related to the characteristics of the medicines and the therapeutics. The SPSS 24.0 software was used to analyse the data. The internal consistency was analysed through Alpha Cronbach. For the comparison of groups, the nonparametric Mann-Whitney test was used at a significance level of 5%. Results: In the "extrinsic factors" dimension, the three most prevalent factors were "patient does not like to have the trips to go to consultations" (39%), "patient does not like to take medications" (37.6%) and "patient does not like to think he is ill "(31.9%). It was the female patients with the lowest level of education and the lowest income who were most likely to leave the treatment. The "intrinsic factors" that stand out were: "the schedule of the shots" (36.9%), "drugs were difficult to take" (29.8%) and "treatment duration was long" (29, 1%). It was women, aged 65 years old or more, without professional occupation, with lower levels of income and schooling who were less compliant with medical indications. Conclusion: The socioeconomic variables are differentiated from the non-compliance by the medical indications. References (Vancouver Style): 1. World Health Organization. Adherence to long-term therapies: Evidence for action. Geneva: World Health Organization; 2003. [Access date may, 2017]. Available from:http://www.who.int/chp/knowledge/publications/adherence_report/en/ 2. Cabral, M., Silva, P. A adesão à terapêutica em Portugal: Atitudes e comportamentos da população portuguesa perante as prescrições médicas. APIFARMA, 2010. ; The authors thank FCT, Portugal and FEDER under the PT2020 program for the financial support to CIMO (UID/AGR/00690/2013). UDI/IPG ; info:eu-repo/semantics/publishedVersion

Background: In developed countries chronic disease is currently the main reason why people betake to health care [1]. Negative effects of non-compliance with medical prescription reduce the clinical benefits of the medication, leading in most cases to the use of unnecessary treatments, hospitalization and death [2]. Factors associated with non-compliance with medical prescription may be related to: the doctor-patient relationship, the treatment, the health system, the heath condition and the socioeconomic situation. Aim: To assess the impact of the doctor-patient relationship on non-compliance with pharmacological medical prescription in chronic disease. Methods: A cross-sectional design was developed based on a random sample of 141 patients with pathologies covered by Portuguese Exceptional Legislation. To collect the data, it was applied a questionnaire by interview between July 2017 and April 2018. The questionnaire included socioeconomic variables and a list of non-compliance factors developed by Cabral & Silva (2010) [3]. The IBM SPSS 24.0 software was used to analyse the data. Besides descriptive statistics, the data analysis involved the estimation of a logistic regression model, at a confidence level of 95%. Results: Chronic patients were aged between 20 and 95 years old, with a mean age of 65.3 years (SD = 19.39). Most were female (51.8%), married or lived in marital cohabitation (62.4%), retired (55.3%), and had up to the 3rd cycle of schooling (61%) and an income up to € 1,000 (62.4%). These patients suffered from Chronic Renal Insufficiency (CRI) (63.1%), Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PA) (20.6%), Multiple Sclerosis (MS) (10.6%), Amyotrophic Lateral Sclerosis (ALS) (2.1%), Hepatitis C Virus (HCV) (2.1%), Hepatic disease (HD) (0.7%) and Gaucher Syndrome (GS) (0.7%). The active substances most dispensed were: ferrous sulphate (76.6%), folic acid (73.8%), calcium polysterenonosulfonate (53.2%), alfacalcidol (48.9%), epoetin β (43.3%), complex B (26.2%) for CRI; adalimumab (8.5%), etarnecept (7.1%) and Ustecinumab (4.3%) for RA and PA; interferon B (8.5%) for MS. Modal treatment time was 24 months. The main reason for non-compliance with pharmacological prescription was "the doctor prescribes too many medications" (35%). The second most mentioned reason was "the fear to ask questions"(18.4%), followed by "not realize what doctors say" (17.5%) and the "lack of confidence in doctors" (6.8%). A patient who does not consider that "the doctor prescribes too many medications" has a lower risk of non-compliance with the pharmacological prescription [OR= 0,262; CI (95%): 0,112-0,617]. Conclusion: The doctor-patient relationship is fundamental for compliance with the prescribed therapy and consequently for the improvement of the clinical benefits of medication and well-being of the patient. References [1]. Dowrick, C., Dixon-Woods, M., Holman, H., & Weinman, J. What is chronic illness? Chronic Illness, 1, 2005, 1-6. [2]. Bugalho A & Carneiro A. (2004). Intervenções para aumentar a adesão terapêutica em patologias crónicas. Lisboa Centro de Estudos de Medicina Baseada na Evidência - Faculdade de Medicina de Lisboa. [3]. Cabral, M., Silva, P. A adesão à terapêutica em Portugal: Atitudes e comportamentos da população portuguesa perante as prescrições médicas. APIFARMA, 2010. ; info:eu-repo/semantics/publishedVersion

Background Globally, xenophobia towards out-groups is frequently increased in times of economic and political instability, such as in infectious disease outbreaks. This systematic review aims to: (1) assess the xenophobic attitudes and behaviors towards migrants during disease outbreaks; and (2) identify adverse health outcomes linked to xenophobia. Methods We searched nine scientific databases to identify studies measuring xenophobic tendencies towards international migrants during disease outbreaks and evaluated the resulting adverse health effects. Results Eighteen articles were included in the review. The findings were grouped into: (1) xenophobia-related outcomes, including social exclusion, out-group avoidance, support for exclusionary health policies, othering, and germ aversion; and (2) mental health problems, such as anxiety and fear. Depending on the disease outbreak, different migrant populations were negatively affected, particularly Asians, Africans, and Latino people. Factors such as perceived vulnerability to disease, disgust sensitivity, medical mistrust individualism, collectivism, disease salience, social representation of disease and beliefs in different origins of disease were associated with xenophobia. Conclusions Overall, migrants can be a vulnerable population frequently blamed for spreading disease, promoting irrational fear, worry and stigma in various forms, thus leading to health inequities worldwide. It is urgent that societies adopt effective support strategies to combat xenophobia and structural forms of discrimination against migrants.