Avaliação do padrão do ciclo sono-vigília e a cognição em estudantes de medicina com diferentes esquemas de horários de aulas

The sleep patterns of students entering the university, is accompanied by many factors that can lead to changes in sleep habits, such as academic demands, new social opportunities, reduced parental care and irregular teaching schedules. The irregular pattern of sleep-wake cycle is usually accompanied by several daytime consequences, for example, reduced levels of motivation, performance, concentration, alertness and mood as well as increased fatigue and sleepiness.Thus, there are numerous reasons to support the fact that these students may suffer damage in their academic performance. The aim of this study was to evaluate the sleep-wake cycle (SWC) and cognition in medical students with different schemes teaching schedules. One group started classes at 08am, while the other started at 07am. We analyzed the data from 88 volunteers, 39 from each group. However, only those who participated in both stages of the study (n = 78) underwent cognitive testing. For subjective evaluation of the SWC was used questionnaires to check the quality of sleep, chronotype, daytime sleepiness and sleep habits. For objective evaluation was used actigraphy. For cognitive assessment was used the test MoCA (Montreal Cognitive Assessment). The results indicate that the group has class earlier had a greater irregularity of the SWC and a worse performance in cognitive testing. There was a difference between the schedules the week and weekend in the subjective variables, bedtime, wake up and sleep duration in both groups. The objective variables, time in bed showed difference between the schedules the week and weekend to the group started class at 08am and the variables bedtime, get up time, actual sleep time, time in bed and wake bouts in the class at 07am. In the cognitive test, there were differences between the groups in overall score and in the areas of executive function and memory recall. Thus, it is suggested that the class starting time may cause irregularity of the SWC and the irregularity may cause mild cognitive impairment. Moreover, cognitive testing MoCA was sensitive to detect differences among students, although the difference between the schedules is small

Relação entre o ciclo sono e vigília e a função cardiorrespiratória em estudantes de medicina

Students, normally, present an irregular sleep pattern characterized by delays in sleep onset and offset from weekdays to weekends, short sleep duration on weekdays and long sleep duration on weekends. The reduction of the necessary sleep and the irregularity in the sleep patterns provoke relevant short- and long-term impairments on performances, for example, in cardiorespiratory function. The cardiorespiratory performance represents, in addition to fitness, traces associated to health conditions and in several studies to pattern and/or individual s sleep quality. The aim of this study was to evaluate the pattern of the sleep-wake cycle and the cardiorespiratory function of medical students under different class schedules. The study was accomplished with two classes of medical students of UFRN, one had classes at 7 am (n = 47) and the second had classes at 8 am (n = 41) during the week. On the first stage of the study all volunteers filled out an anamnesis, the International Physical Activity questionnaire, the Pittsburgh index of sleep quality, the Portuguese version of the Horne and Östberg cronotype questionnaire, the Health and Sleep questionnaire and the Epworth Scale of Somnolence (ESS). On the second stage, 24 students (12 of each class) had their activity rhythm monitored by actimeters set to record activity at a 2-min interval for 14 days concomitant to the completion of the sleep diary. In this same stage, each volunteer performed the effort test (treadmill) only once in the morning period (between 9:00 and 11:00). The students showed an irregular pattern of the sleep-wake cycle and this irregularity is strongly influenced by the class schedules, in addition to the contribution of the academic demand, social activities and endogenous factors. The students who woke up earlier showed greater irregularity in the sleep-wake pattern. The earlier was the class schedule the worse was the sleep quality and the greater was the frequency of students with excessive diurnal somnolence. The classes schedules and the irregular pattern of the sleep-wake cycle did not show effect on the cardiorespiratory performance of the medical students. The performance on the test seems to be affected by other factors, which can be related to the pattern of the sleep-wake cycle or not. Therefore, it is suggested that the late start of classes provokes less irregularity on the pattern of the sleep-wake cycle. However, it was observed that this irregularity and the class schedule seem not to affect the cardiorespiratory performance directly

Avaliação da estratégia saúde da família na capital potiguar

This research aimed to evaluate the Family Health Strategy (FHS) in Natal, Rio Grande do Norte, through its managers, professionals and users, having as its support the Theory of Belief and the Cognitive-Behavioral Theory. This is a multimethod research and is divided into three sub-studies. In the first study, nine managers answered to a semi-structured interview, to verify the knowledge and beliefs on SUS; the quantitative data were analyzed with descriptive statistics with the aid of SPSS software and the qualitative data were submitted to lexical analysis with support of ALCESTE software. In the second study, we have a descriptive correlational research in which the antecedent variables are related to working conditions in the family health units (FHUs) and to the professionals‟ profile; the corresponding variables refer to the evaluations of the FHS; a stratified probabilistic sample with 475 professionals, who answered to two scales, both consisting of three factors: Physical infrastructure, Material resources, and Treatment effectiveness, and data were analyzed using descriptive, bivariate and multivariate statistics, with the aid of SPSS. The third study is a descriptive correlational research in which the antecedent variables refer to the treatment in the FHUs and to the users‟ profile, and the corresponding variables refer to the evaluations of the FHS, with a stratified non-probabilistic sample with 390 users, who contributed to the construction of a new scale with a factor, effectiveness in treatment, analyzed through descriptive, bivariate and multivariate statistics, with the aid of SPSS. The results showed problems which start from management, under the shape of admission due to political indication and lack of knowledge on SUS and the FHS; they pass through the low tenure of professionals and insufficient professional; and they end up spreading all over the analyzed items: infrastructure of FHUs, material resources, professionals‟ training, accessibility and referral system. One concludes that, despite following an ideal model, the FHS is in need of changes with regard to the barriers to its operational reality

Saúde mental na estratégia saúde da família: notas cartográficas sobre processos de trabalho em saúde

This study aims to map the working process in the health area starting from the meeting between the family and health teams and mental trouble carriers./MTC. The area of research was the Family Health Unit of Ozeas Sampaio, which is located in the county of Teresina-PI. As regard to the methodology procedure, we used a semi-structured interview timetable, aimed to detail the care practices, admittance and diagnostics that those teams realize with their users. Three teams of eleven workers each were interviewed. There was a doctor, a nurse and two health community agents in each team. The other tools we used were a camp logbook, in which we wrote down some informal dialogs, daily observations and feelings of the unit, and also the accompaniment of the staffs in house calls as well as the weekly meetings in the unit. Those meetings allowed us the construction of two analytic axes: 1) description of the establishment (Family Health Unit) of the organization, (municipal foundation of health and the service network), and the institutions and practice of health. 2) Analysis of the meetings between the worker and the user of Mental Trouble Carriers. In the first axis, we verified the repetition of the working logic focused on jobs in the hospital with the maintenance of the hierarchical relations between worker and the work processes which dissociate management and watchfulness in health care. We identified the lack of physical structure, the lack of self-confidence of the worker in the attention of the mental health care. At the second axis, we assess that the meetings, at the Family Health Unit (FHU) or at the dwelling of the users cause nuisance, discomfort and anxiety to the workers because they deal with issues that go beyond what is named as being the health order such as life stories, family conflicts, unemployment, hunger, sexual and psychological violence. As a matter of fact, they involve difficulties for having new relationships, reception and responsibility for this request

A auto-estima da criança que sofre violência física pela família

This research investigates the self-esteem of children who suffered physical violence by family members. Seven children took part in the research: three boys and four girls, aged between six and twelve years old. The analysis were done from the constructed data obtained from: semi-structured interview, activities about human feelings, activities that included facial expressions, unfinished phrases, Pinocchio s story, a drawing of a family and a drawing of their own family. Data were analyzed from the Content Analysis. The Thematic Units were: violence, intrafamily violence, and self-esteem. The synthesis of the categories studied evidenced that the physical violence and the psychological violence present in the lives of children affect the positive development of their self-concept and, consequently, of their self-esteem. Among the results, we emphasize some negative feelings that are present in children s lives such as fear, a sense of guilt, and sadness, arising out of the situations of violence they have experienced

Significados de família para crianças em abrigo

This research explores the meanings of family for institutionalized children. It identifies, more specifically, how the relationship between the child and his/ her family is. The field work was developed at a municipal shelter in Natal/RN, which houses children aged between 7 and 11 years old. The subjects of research consisted of three children: two boys and one girl. Besides age-group criterion, which facilitates the use of oral language and the procedures, we took into consideration another selection criterion: children whose family configurations were similar. In order to achieve the objectives, we used toys, pictures, collages and semi-structured interviews. Data were examined under the Thematic Content Analysis, with three thematic categories previously chosen: Configuration of geographic area, family composition and family s internal dynamics. Among the results, we highlight that, for children, the concept of family is based essentially on existence of affection ties, regardless of kinship. Through this study, we hope to contribute to the discussion on the rights of institutionalized children, concerning their need of experiencing family life and living in community

A psicologia e o programa de saúde da família :novas possibilidades, velhos dogmas?

The model of attention to health has been suffering alterations due to the difficulty faced to put into practice its universal, democratic and institutional layout. Since the movement of Sanitary Reform, which focused in the demands of a new health context and the process of work in the area of health, one seeks uninterruptedly, to find a way which leads to the execution of the principles of SUS. Despite having tried, the model of Sanitary Vigilance centered within the work of a multi-professional team has shown fragmentation and little adequacy to the necessity of health in the population. Whilst inserting himself in the field of health, the psychology professional has taken with him his clinic way of attending to individuals being one more in the team to act in a de-contextualised and little critical way. In virtue of this framework, the Ministry of Health invests in the Family Health Program as a new guide in the health system, restructuring the basic attention at a new logic of action. In this way, the municipality of Natal-RN implants, in the year 2002, the PSF in the Northern Sanitary District, a context in which professional teams are created where there is not an inclusion of a psychologist. Consequently, this professional is excluded of his work space in the previous Basic Unities of Health. This piece of work constitutes in the investigation of the implementation and instrumentalization of the Northern Sanitary District PSF of Natal-RN, having as its objective to analyze the implications of this execution for the structuring of the health network services and more specifically the alterations that this implementation could be making to the practice of the Psychology Professionals, emphasizing its advances, obstacles and limitations. To make this work feasible it was necessary to search for data and information from the implementation and execution of the PSF in the DSN, carrying interviews from a semi-structured guide, with 21 institutional actors (members of the team, coordinators and directors of the unities and psychologists)

Desvelando as teias de Pinóquio :concepções de família em jovens moradores de bairros periféricos

This thesis discusses family as a social and historical construction and concerns to the perceptions developed by the peripheral youth living in suburbs. It investigates the speeches of young boys and girls who take part in Engenho de sonhos a forum composed by a pool of eleven non-governmental organizations and UFRN which aim is the elaboration and execution of projects focusing local development of poor communities in violence and social exclusion context. Throughout interactive diagnosis seminars in five communities in West Side of Natal with six hundred teenagers, it was detected the need to work with family relationships. In order to build the methodological corpus a range variety of procedures were done such as: interviews, focal groups and psychosocial questionnaires with nine local young leaders. The purpose to understand data guided the research through the theory of social imagery and pointed out the following themes: conceptions, relationship, roles, family projects. Live stories of these young population reveals conflicts when it comes to the configuration of family ties, far from the family model stated by society. Family is also, in their perception, an important space to the development of affection, in experiences of all sorts, affecting personality development and determining behaviors in local contexts. The research concludes stating the urge to comprehend this academic work as a way to fight against symbolic and emotional poverty in family context producing discussions and critical reflection in a permanent relation between juvenile social vulnerability (characterized by lacks of all orders) and potential

Adolescência e ato infracional: a família em conflito

Numerous studies discuss the issue of adolescent in conflict with the law from the adolescent that committed infraction or from his perceptions. Taking into account the importance of the family in the life of all subject in development, this study sought the look of the families about the infraction of their adolescents under socio-educative measures. For this purpose, semi-open interviews were conducted with 20 families, ten of the boys and equal number of the girls. The institutions where the measures are applied in Natal / RN gave space for most family members to be interviewed. The data collected were arranged in tables and analyzed qualitatively following the socio-historical perspective. The survey revealed that the meanings attributed to the time of conflict with the law of the adolescents differ between the boys families and the girls . Most of the boys families see the infraction as a consequence of the influence of bad company, as a minor provocative of changes in the family s relations, left justified in a context marked by violence. Now for most part of the girls families, the infraction is seen as their responsibility, as generator of transformations within the family both emotional and economic , and inaugurates a search movement for conflicts resolutions. Through the testimonies of these families, it became evident that there was a family reality structured also by a conflicting social, economic and community context. Thus, before there is an infraction that demarcates the conflict in adolescence, there is a family in conflict.

O fazer do psicólogo no núcleo de apoio à saúde da família

The Brazilian Ministry of Health regulated in 2008 the Family Health Support Nucleus (FHSN) as a device for support and complementarity to the Family Health Strategy. The FHSN, through the matrix support, potentiates the Family Health teams on dealing with a great variety of demands and activities that are under their responsibilities. It is structured in teams of professionals from various health specialties, among which is the mental health. In preliminary studies we noticed that the psychologists have been the main representatives of mental health professionals at the FHSN from Rio Grande do Norte (RN-Brazil). On this scenario, this study intends to problematize the professional practice of the psychologists who work at the FHSN teams in RN, regarding how their work is done, discussing it under the perspective of collective health and the directions for the basic health care on Brazilian s health system. Still as a goal, in more specific ways: identify the forms of professional insertion of the psychologists in this field; characterize the work done by the psychologist at the FHSN (developed activities); and produce an analysis of the characteristics and limits of those actions, from theoretical and methodological references based on Marxian ontology. Were performed semistructured interviews with psychologists working in the oldest FHSN teams form RN. We conducted the analysis of the material following the blocks of information: determinants of the psychologist entry at the services, training for current practice; operation of FHSN; activities performed by FHSN team and the psychologist; joint actions; and limits of psychology practice in the FHSN. An important result, we observed the little articulation of practicing between the psychology and other professionals and teams, further indicating the prevalence of the traditional medical model (individual and outpatient) as guidance of their performance instead of the matrix logic that is the foundation of the proposed action for the FHSN. We also emphasize the potential of psychologists actions at the FHSN on contributing to the achievement of comprehensive care

Significados de família para adolescentes em liberdade assistida

Guided by the social-historical perspective, this research aimed to understand how the adolescents in Assisted Freedom measure have meaning the family institution. The Pastoral Minor, located in the city of Natal, was chosen as space of investigation, whose social-educative program is the source of our concerns about the attendance of adolescents in conflict with law. The corpus was accomplished, mainly, through the individual semi- structured interview with four adolescents and seven of their relatives that participated of the research. We use another instruments to constitute the corpus, like the documental research of the technical reports on the participants of program files, and the registered notes in the field diary. As resource to data treatment, we use the Thematic Content Analysis. The data discussion was focused on the three thematic units that emerged: Family, Social-Educational Measure, Family and Social-Educational Measure. On the adolescents perspective, the family configures as a group based on the existence of affective bonds. Despite of the vulnerability of their familiar reality and their wish for freedom with their peers, the affective bonds revealed it as being important in their lives. This study, glimpse possibilities to contribute for the construction of public politics and attendance programs, that can be closer of the social-familiar reality of the adolescents who are in conflict with the law and, in this case, to promote their access to the statute of subjects of rights

Práticas educativas e integralidade na saúde da família: um estudo etnográfico

Primary Health Care, especially in the family health strategy, it is expected that the joint assistance and actions of health promotion. The Ministry of health (BRAZIL, 2007) defines health education as an eyeshadow strategy of prevention and health promotion, based on reflective practices, which allow the user to their condition of historical, social and political subject, under the vision of an expanded clinic on the part of health professionals. In this sense, there are guidelines for it professionals to develop educational activities and that they can interfere in the health/disease process of the population, with a view to the development of autonomy of the subject. This research had as objective to understand in the light of the integrality of the care, as is the production of health education practices, within the framework of the family health strategy from ethnographic study in a family health unit (USF). The location of the research was the unit of USF Felipe Camarão II in West Health District, in the city of Natal, RN, Brazil, selected from preliminary mapping of educational practices deployed in units of health of the family of this municipality, based on criteria such as time-to-deployment of USF and sustainability of existing actions. Immersion in the field consisted of participant observation with journaling, held during the period of August 2012 to January 2013, in which she accompanied team work processes in clinical-welfare actions on the USF, in households and in educational activities of group character. The results presented in ethnographic description were analyzed based on the axes proposed by Ayres (2009) for identification of integrality in health practices:the axis of the needs; the axis of the purposes; the joint axis; and the axis of the interactionsThe evidence described from observation point the presence of each axle up health education practices developed by the teams, even incipient form, namely: articulation and appreciation of knowledge and practices of popular culture with local initiatives (Pastoril do Peixe Boi Encantado, Auto de Natal e Grupo Terapia e Arte); Clinical integration with health promotion actions and coordination of multidisciplinary knowledge, with professional-user link (course for pregnant women). However, a few challenges were identified to be faced in order to move forward in these practices in integral care: the need to break with the fragmentation of actions; strengthening teamwork; need for greater sustainability policy of collective actions; intersectoral work aimed at a better role of the State in the face of the health-disease process, adding to the action of individuals.The analysis produced from observation of the processes experienced indicates the need for a better recognition of local managers that actions similar to those that occur in the USF Felipe Camarão II enable advances in completeness as allows inclusion of actors involved in the processes of health work, and stimulate participation and shared responsibility in the fight for health-disease situations

Avaliação das ações do Núcleo de Apoio à Saúde da Família (NASF) em Macaíba/RN

This research evaluated the contribution of the Support Center for Family Health (SCFH) in relation to its effect on the Family Health Units through perception of the Family Health Strategy (FHS) and SCFH professionals, in addition to the satisfaction of users in relation to that role. Data were collected in the public health services of the city of Macaíba-RN in 2012, through semi-structured questionnaire and non participant systematic observation and it counted as investigated subjects 272 individuals (60 FHS professionals, 12 SCFH professionals and 200 users representatives of 20 units). For analysis of the responses of the opened questions was used categorization process and, in relation to the observational method, that was based on checking the space organization, the characteristics of the participating subjects and the specific set of activities performed by SCFH teams through an observation guide. The results point to a good acceptance of the SCFH teams role by most FHS professionals who reported active participation in the health units routine, its integration activities to the FHS teams with resolving based health promotion actions. Regarding the SCFH professionals, they also reported positive contribution by participating actively in the units routine with integrated activities to the ESF teams and developing resolute actions. For users, the SCFH brought assurance services with better access to specialized, resolving and welcoming care. Systematic observation ratified data obtained by questionnaire. It was perceived the need to implement actions related to man`s health, to invest in expanding the number of the SCFH teams, the greater supply of medications, improving the regulatory process and planning together as a key strategy to promote a more effective integration between teams SCFH / FHS

Análise de redes do cotidiano a partir do encontro entre usuários e profissionais da estratégia saúde da família

O presente estudo discute a formação de Redes Sociais no cotidiano da Estratégia Saúde da Família, a partir de aportes da teoria sociológica sobre redes, interações, dádiva e reconhecimento. O objetivo geral é analisar as redes sociais locais em saúde a partir da interação de usuários e profissionais da Estratégia Saúde da Família na Unidade de Saúde de Ligéia, em Natal, RN. Seus objetivos específicos são: Mapear as redes sociais locais em saúde existentes no território adscrito; Identificar os tipos de interações cotidianas entre os sujeitos; Compreender a percepção dos sujeitos sobre o processo de formação de redes sociais a partir das interações. Caracteriza-se enquanto pesquisa qualitativa exploratória cujos sujeitos foram profissionais e usuários vinculados à referida unidade de saúde. Para a coleta de dados foram utilizadas entrevistas individuais semiestruturadas e debates em grupos focais, estimulados pela Metodologia de Análise de Redes do Cotidiano (MARES), pertinente para abordar a complexidade das relações sociais e mapear os diferentes conteúdos expressos e as formas de mobilização coletiva. A análise dos dados foi realizada através da Técnica de Análise Temática de Conteúdo, proposta por Minayo. Os resultados foram interpretados à luz das Teorias da Dádiva (Mauss) e do Reconhecimento (Honneth). Os sujeitos visualizaram: Rede Virtual (28,20%); Rede de Atenção à Saúde (25,64%); Redes de Usuários (17,95%); Rede Pessoal (10,26%); Conselho Comunitário (10,26%); Escolas (7,69%). Os participantes não perceberam os arranjos familiares enquanto Redes Sociais. Os tipos de interações sociais identificadas foram: Confrontação/Negociação (41.02%); Harmônicas (25,70%); Correlativas (17,90%); Definidas pela Organização (15,38%). A formação de redes sociais ocorre a partir de interações cotidianas entre pessoas, pela articulação inseparável de conteúdos e formas, catalisadas pelo contexto, experiência e cognição, valorizando a liberdade, a expressividade e a diversidade dos parceiros de significação. Foram encontradas duas categorias, na percepção dos sujeitos, sobre a formação de redes sociais do cotidiano: Diálogo e Encontro. Validamos e recomendamos o uso da metodologia MARES: Na formação, para despertar uma visão mais tolerante e humana de si e do outro; Na avaliação qualitativa dos serviços, por facilitar a reflexão sobre a prática e (re)organização do processo de trabalho; Na comunidade, para estimular movimentos sociais existentes ou emergentes. A aposta no circuito da dádiva e do reconhecimento recíproco, durante o trânsito nas redes sociais em saúde, pode ser capaz de tecer uma práxis transformadora, pela busca e alcance de confiança, respeito e estima, nos espaços de encontro entre usuários e profissionais da Estratégia Saúde da Família

PET-saúde na percepção de estudantes: contribuições para a formação na área de saúde

This dissertation aimed to analyze the perception of students about (EPW Health) Education Program at Work for Health Training in the area of Health. It discusses the proposed theme from the perception of students graduating from the EPW- Health courses participants (dentistry, medicine, physiotherapy, nursing, nutrition, physical education) who have developed their school activities in family health units in the city of João Pessoa between 2009/2011.The program aims policies curricular changes as a potential route of contributions to training in healthcare. Attention is drawn to the new possibilities of working health training contextualized, ethically grounded, socially endorsed. It is pointed out in this process the need to adapt to the demands of professional profiles of SUS (Sistema Único de Saúde). This is an exploratory, descriptive study within a qualitative approach, conducted in the city of João Pessoa in the context of health care courses at the Federal University of Paraiba. The empirical material of this study was treated by the use of technical analysis "Categorical Content Theme" by Bardin. The results indicate prospects for promoting new practices and curricular changes, which highlights the EPW- Health, which has been presenting important experiences in teaching -community -service- with the inclusion of students in the municipal health network. We conclude that the path from collection to data analysis, corroborated with the literature to reaffirm the importance and urgency of change in educational processes with a view to greater proximity to the health needs and the SUS. The EPW- Health project is incipient and requires further investigation in terms of effective interdisciplinary and multidisciplinary character of its proposal