SYNOPSIS This paper describes the referral pathways taken by 1554 patients newly referred to the mental health services in 11 countries, and documents factors associated with delays in referral. The pathways in centres relatively well provided with psychiatric staff were dominated by general practitioners and to a lesser extent hospital doctors: the relatively less well resourced centres showed a variety of pathways with native healers often playing an important part. Delays were remarkably short in all centres regardless of psychiatric resources, but in some centres we found longer delays on pathways involving native healers. Somatic problems were a common presentation in all centres, and in some centres there was a tendency for patients presenting with somatic problems to have longer delays than those with symptoms of depression or anxiety. The implications of these findings are discussed in the context of an ongoing programme of WHO research activities aimed at improving the quality of mental illness care available in community settings.
Casefile data of 100 male and 93female Hispanics with schizophrenia were analyzed to evaluate the impact on the patient's adherence to medication regimen of biodemographic, social support, and treatment variables, and whether the patient's therapist was also Hispanic and spoke Spanish. Results revealed that older and more motivated patients were more likely to adhere to theirmedication. As predicted, those who had greaterfamily support and who were of higher socioeconomic level were also more likely to adhere. Those whose first therapist was of the same ethnicity as the patient (ie., also Hispanic) were more likely to adhere. No relationship was obtained between adherence and patient's level of acculturation, or the extensiveness of treatment: Adherence was less likely whether the therapist spoke Spanish. Implications of these resultsfor mental health practitioners are discussed
Recibido: 31 de enero 2017Aceptado: 10 de marzo 2017 _____________________________________________________________________
ResumenMedir y monitorear la resiliencia de los sistemas agrosilvopastoriles de pequeños productores es cada vez más urgente para ayudarles a enfrentar de mejor manera los efectos del clima cambiante. Aunque se reconocen otras formas de medir la resiliencia climática, la novedosa herramienta SHARP desarrollada por la FAO permite su identificación, medición y la priorización de acciones para mejorarse de una manera participativa, tomando en cuenta los intereses de los productores. En coordinación con el equipo desarrollador de la aplicación de la FAO en Roma, se tradujeron y utilizaron el cuestionario y la matriz para la evaluación de la resiliencia en 16 fincas agroecológicas situadas en los alrededores del Valle Central de Costa Rica. Una vez colectados e ingresados los datos en SHARP, se llevaron a cabo tres análisis: 1) comparación del perfil de las fincas estudiadas con indicadores a nivel nacional; 2) análisis de brechas para identificar las oportunidades de mejora en términos de resiliencia climática; 3) un análisis para adaptar la herramienta al contexto nacional. A pesar de que las fincas seleccionadas para el estudio son reconocidas como agroecológicas, su nivel medio de resiliencia medido (x̄=15,25; s=1,16) sugiere la necesidad de implementar prácticas de manejo que contribuyan con la construcción de agroecosistemas más resilientes.
Palabras claveAdaptación, agroecología, agroecosistemas, cambio climático, desarrollo rural.
The Graduate Record Examination (GRE) Verbal, Quantitative, and Analytic scores and undergraduate and graduate grade-point averages (U-GPA and G-GPA) for 320 Hispanics and 632 Anglos admitted to graduate school at the University of Texas at El Paso over the past 5 years were evaluated. Multivariate analyses revealed that Anglos scored significantly higher than Hispanics on both U-GPA and G-GPA and all three GRE scores. Multiple regression analyses for the ethnic group, with U-GPA and GRE scores used to predict G-GPA, showed higher correlations for the Anglos compared to Hispanics, although both had relatively poor predictive validity. The regression coefficients for all three GRE scores for the Hispanic group were zero, which reflects no relationship between the GRE and graduate grades; this makes the use of the GRE in selection of Hispanics for graduate school questionable.
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