Atenção à saúde mental na Estratégia Saúde da Família no Município de Parnamirim/RN: opinião dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population´s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user´s care and the promotion of family health

Indicadores de transtornos de estresse pós-traumático em bombeiros militares

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Estratégias de cuidados por familiares de portadores de transtornos mentais severos residentes na zona rural do alto sertão paraibano

In the current configuration of the Brazilian Psychiatric Reform, family plays a key role in mental health care: shared responsibility and active participation in the process of rehabilitation of people with severe mental disorders. It´s considered that the family member who cares can help users in their daily tasks and articulating trajectories, networks and ways to potentiate social connections. This research was motivaded by interest in the subject and by the lack of research and studies about this reality in rural areas. This study aimed to identify ways of mental health care by relatives of severe mental disorder patients living in rural zone located at sertão of Paraiba. Methodologically was made a work with qualitative research structured in two moments. In the first one, was held a Documentary Research in CAPS II in order to identify: a) users living in rural that had a history of at least one psychiatric hospitalization, b) users who no longer use the reference service (CAPS II) for at least one year. The second stage consisted by home visits and semi-structured interviews with eleven families in rural areas. Results pointed out a profile composed by 56 users: 56 women and 26 men aged between 50 and 64 years, unmarried, without study, farmers and housewives, living six miles from CAPS II and carriers with severe mental disorders. Strategies and resources used by the families for mental health care were: religion, work, medication and help from relatives, neighbors and community. Factors related to non-use of substitute services were lack of internment in CAPS II and lack of money and transportation. The hospital, the house arrest, the police aid and religion were strategies used by family members as support to psychiatric crises. The data pointed to non-solving of care offered by psychosocial support network and the importance of redirecting practices aligned to the asylum model in favor of psychosocial strategies that aimed at rehabilitation and community participation in mental health care

Estado nutricional de escolares do semi-árido do nordeste brasileiro

SILVA, João B. da et al. Estado Nutricional de Escolares do Semi-Árido do Nordeste Brasileiro. Revista de Salud Pública, v. 11, n. 1, p. 62-71, 2009.

Ajuste estrutural e educação superior no Brasil: princípios negados

SILVA, Hiran Francisco Oliveira Lopes da. A juste estruturale educação superior no Brasil: princípios negados. 206 f., 2007. Tese (Doutorado em Educação) - Universidade Federal da Paraiba, João Pessoa, 2007.

Retinopatia de Purtscher-like e pancreatite aguda

Retinopatia de Purtscher-like é uma baixa súbita da visão associada à imagem de múltiplas áreas branco-amareladas (manchas algodonosas) e hemorragias no pólo posterior de ambos os olhos. O exato mecanismo da injúria ainda não é claro, mas provavelmente seria de natureza embólica. Tem sido descrita em uma variedade de condições, incluindo pancreatite aguda, síndrome de embolia gordurosa, insuficiência renal,nascimento (parto e pós-parto), desordens do tecido conectivo, entre outras. Serão relatados três casos de pancreatite aguda confirmada pelos exames laboratoriais e história clínica, associadas a alterações no exame do fundo de olho, compatíveis com esta retinopatia

Sistemas de gerenciamento de bibliotecas: riscos decorrentes do processo de migração de dados

This work aims to analyze risks related to information technology (IT) in procedures related to data migration. This is done considering ALEPH, Integrated Libray System (ILS) that migrated data to the Library Module present in the software called Sistema Integrado de Gestão de Atividades Acadêmicas (SIGAA) at the Zila Mamede Central Library at the Federal University of Rio Grande do Norte (UFRN) in Natal/Brazil. The methodological procedure used was of a qualitative exploratory research with the realization of case study at the referred library in order to better understand this phenomenon. Data collection was able once there was use of a semi-structured interview that was applied with (11) subjects that are employed at the library as well as in the Technology Superintendence at UFRN. In order to examine data Content analysis as well as thematic review process was performed. After data migration the results of the interview were then linked to both analysis units and their system register with category correspondence. The main risks detected were: data destruction; data loss; data bank communication failure; user response delay; data inconsistency and duplicity. These elements point out implication and generate disorders that affect external and internal system users and lead to stress, work duplicity and hassles. Thus, some measures were taken related to risk management such as adequate planning, central management support, and pilot test simulations. For the advantages it has reduced of: risk, occurrence of problems and possible unforeseen costs, and allows achieving organizational objectives, among other. It is inferred therefore that the risks present in data bank conversion in libraries exist and some are predictable, however, it is seen that librarians do not know or ignore and are not very worried in the identification risks in data bank conversion, their acknowledge would minimize or even extinguish them. Another important aspect to consider is the existence of few empirical research that deal specifically with this subject and thus presenting the new of new approaches in order to promote better understanding of the matter in the corporate environment of the information units

Alterações de linguagem oral e escreta em crianças pré-escolares e escolares com epilepsia

A epilepsia cursa com diversas comorbidades e, entre elas, estão as alterações de linguagem, que levam a criança a problemas educacionais e sociais desfavoráveis. A etiologia das alterações de linguagem envolve aspectos orgânicos, cognitivos e sociais, ocorrendo, na maioria das vezes, uma interrelação entre todos esses fatores. A idade da primeira crise epiléptica, o tipo de epilepsia, o uso de drogas antiepilépticas e a intervenção medicamentosa em politerapia podem implicar na ocorrência dessas alterações em crianças. O objetivo dessa pesquisa foi verificar a ocorrência de alterações de linguagem em crianças pré-escolares e escolares com diagnóstico de epilepsia atendidas no setor de Neurologia Infantil do Hospital de Pediatria Professor Heriberto Ferreira Bezerra. Caracterizou-se como um estudo prospectivo e transversal realizado com 90 crianças com epilepsia, submetidas à avaliação fonoaudiológica de linguagem oral e de leitura e escrita e como pesquisa interdisciplinar uma vez que envolveu áreas como a Fonoaudiologia, a Neurologia e a Psicologia. Os critérios de inclusão foram: 1) diagnóstico inequívoco de epilepsia, segundo a definição da ILAE (2005), 2) idade de 3 aos 12 anos, 3) padrão neurológico e desenvolvimento neuropsicomotor normais; os de exclusão: 1) diagnóstico de epilepsia duvidoso, 2) padrão neurológico e desenvolvimento neuropsicomotor alterados, 3) crianças com patologias pediátricas associadas. Foram analisadas as seguintes variáveis: sexo, idade da primeira crise epiléptica, tipo de crise epiléptica, regime de tratamento, presença de crise epiléptica, frequência à escola, tipo de escola e repetência. A análise estatística centrou-se na análise descritiva; determinou-se a razão de chances (odds ratio), adotando-se um intervalo de confiança de 95%; e na aplicação do teste exato de Fisher, levando-se em consideração p<0,05. Portanto, no que se refere à presença de alterações de linguagem oral, pôdese observar que o início das crises epilépticas durante o período de aquisição e desenvolvimento da linguagem oral bem como o tratamento medicamentoso neste período podem interferir no desenvolvimento da linguagem devido à imaturidade do sistema nervoso central além dos aspectos socioambientais, uma vez que o estigma e as crenças errôneas interferem negativamente no processo interacional tão importante para a aquisição e desenvolvimento da linguagem, o que também repercute nas habilidades de leitura e escrita. Dessa forma percebe-se a importância da atuação de uma equipe interdisciplinar (Fonoaudiologia, Psicologia e Neurologia Infantil) no processo avaliativo e no acompanhamento dos pacientes com epilepsia, o que trará benefícios psicosocioafetivos no que se refere à reorganização da sua qualidade de vida e, consequentemente, de seus familiares.

Níveis de homocisteína e desempenho cognitivo em uma amostra populacional de idosos da cidade do Natal-RN

The imprecision of the frontier that separates those cognitive deficits inherent to the human physiological aging process from those which represent the early signs of nervous system degenerative pathologies ,very prevalent among the elderly, has brought attention to the need of studies aiming to establish clinical and/or laboratorial criteria to allow this differentiation. Elderly people living in poor and developing countries are frequently exposed to precarious socioeconomic conditions which facilitate the development of an array of pathologies which have metabolic and nutritional dysfunctions as the established or proposed etiological agents. The levels of certain micronutrients, such as the vitamins B12 and B9 (folic acid), and of some intermediary metabolites, such as homocysteine are being thought of as etiological factors and/or as biological markers of a group of alterations which affect the normal functioning of the nervous system with important reflexes upon cognitive performance. This study aims to investigate the influence of homocysteine, B12 vitamin and folic acid levels on the cognitive performance of the low income elderly population. This transversal study took place in Natal, Rio Grande do Norte State, Brazil, and involved 205 dwelling elderly people, users of the Programa de Saúde da Família, a public healthcare program, maintained by the city s health authorities. A multidimensional questionnaire was used to assess the socio-demographic aspects and the overall health and nutrition conditions. The cognitive performance was measured by the use of the Portuguese version of the Mini Mental State Exam (MMSE). The serum levels of homocysteine, B12 vitamin and folic acid were determined by chemiluminescence. The association between the socio-demographic and serum levels of Hcy, B12 vitamin and folic acid was determined by multiple linear regression. Serum levels higher than 13.5 μmol/l, indicative of hyperhomocysteinemia (HHcy), were found on 25.4% of the sample, being more prevalent in men (p<0.05). Deficitary levels of folic acid (<5ng/mol) and of B12 vitamin (<193 pg/ml) were found on 3.9% and 10.2% of the sample respectively. A negative correlation was found between cognitive performance with both age and HHcy and a positive correlation was found between cognitive performance and schooling. The isolated HHcy R2 values were an explanation to only 4% of the variance of the MMSE scores. However, when associated with schooling and age, this model explains about 25% of this association

Avaliação do desempenho funcional de crianças com paralisia cerebral de acordo com níveis de comprometimento motor

Contextualization: Several studies have examined the mobility of this group of children, however little is known about the impact of motor function in activities of daily living, considering the seriousness of their neuromotor damage. Objective: Identify the functional differences of children with Cerebral Palsy with different levels of motor dysfunction and correlate these differences with the areas of mobility, self-care and social function in functional ability and caregiver´s assistance of these children. Methods: An l analytical cross-section search was developed, which were part 70 children / families aged from 4 to 7.5 years, in the Rehabilitation Center for Children. As tools were used the Pediatric Evaluation Disability Inventory (PEDI) and the Gross Motor Function Classification System (GMFCS). Data analysis was performed by ANOVA and Pearson's correlation tests. Results: The results show the functional variability of children CP in different severity levels of motor disfunction This variation was observed in the areas of mobility, self-care and social function. The results also showed a strong correlation between the domains mobility and self-care, mobility and social function. Conclusions: The variability shown by the children with CP, suggests the use of PEDI and GMFCS as this association appears to increase the understanding of how the gross motor functions are related to activities of daily living, describing the best commitments and their degree of impact on functional activities. This correlation demonstrates how mobility is crucial to evaluate the performance and guide the therapeutic practice, to develop the children´s potencial, and guide the caregiver in stimulation

Impacto do déficit cognitivo na saúde e capacidade funcional da populção idosa do distrito oeste da cidade do Natal-RN

A incapacidade funcional e o déficit cognitivo são condições relacionadas com o processo de envelhecimento humano. O déficit cognitivo é considerado um importante fator preditor de prejuízos funcionais em populações idosas. Este estudo teve um caráter multidisciplinar na sua elaboração e execução, contando com profissionais de distintas áreas da saúde. Trata-se de um estudo transversal que analisou a associação do desempenho cognitivo na capacidade funcional de uma amostra populacional idosa residente em Natal-RN. Foram avaliados 213 idosos pelo Questionário Multidimensional BOAS e pelo Mini-Exame do Estado Mental (MEEM). Através de análise multivariada, mediante regressão linear, os resultados apontam a idade e o nível de escolaridade como fatores associados ao desempenho cognitivo nos idosos do estudo. O modelo explicativo final elaborado através de regressão logística apresentou o desempenho cognitivo como a única variável associada à incapacidade funcional para as atividades da vida diária, mesmo quando ajustado por variáveis sócio-demográficas. A identificação dos fatores, associados ao declínio do estado funcional dos idosos que vivem na comunidade, poderá reduzir o impacto dessas condições na capacidade funcional através da aplicação de medidas preventivas voltadas para este fim

Distúrbios do sono em pacientes com transtorno depressivo

To evaluate sleep disorder complaints in outpatients with depressive disorder from a general hospital. Methods: An observational, cross-sectional study was carried out with a study sample composed of 70 patients (44 women and 26 men) with diagnosis of depressive disorder, according to the DSM-IV criteria. The patients were interviewed and evaluated by the Identification Questionnaire, the Sleep Habits Questionnaire and the Beck Depression Inventory (BDI). Results: In this study, 50 (71.3%) patients had recurrence of sleep disorder complaints. Mean BDI score was 35.83+8.85, with significant differences between patients with (38.50+8.70) and without (29.60+7.80) recurrence (p<0.05) and among patients with 1, 2, 3 and >3 episodes (p<0.05). In this study, 49 (70%) patients had insomnia and 21 (30%) had subjective excessive sleepiness. Significant differences were observed between the mean duration in months of the sleep disorders (7.16+2.10) and the depressive disorder (6.12+1.90) (p<0.05). Discussion: In the study sample, recurrence of sleep disorder complaints was high and significantly associated with severe depression. Insomnia was prevalent and the mean duration of sleep disorders was higher in relation to depressive disorder

Qualidade de vida do servidor da Universidade Federal do Rio Grande do Norte em condição crônica de saúde

The study aimed to analyze the influence of chronic health conditions (CHC) on quality of life (QOL) of UFRN servers assaulted by CHC. It is a descriptive and cross-sectional study with prospective data and quantitative approach, accomplished in the ambulatory clinic of the Department of Server Assistance (DSA) of the Pro-Rectory of Human Resources, during three months. The sample was composed by accessibility, totaling 215 people, being 153 active and 62 inactive servers, in chronic health condition. The data were collected through the application of the sociodemographic characterization, health, environmental and laboral form, the Medical Outcome Study 36-Item Short Form (SF-36). The study was evaluated by the HUOL Ethics Committee (CAAE no. 0046.0.294.000.10), obtaining assent. The results were analyzed in the SPSS 15.0 program through the descriptive and inferential statistics. It was identified servants predominantly male (59,1%), under 60 years old, married or in stable union, Catholics, brown color, living in the capital and residents in own home. Regarding labor issues, there was a predominance of active servers technical-administrative with intermediate and medium level positions and small proportion of docents. Among the CHC, the non-communicable diseases - NCDs (95.8%) had a higher frequency, followed by persistent mental disorders - PMDs (18.6%) and, finally, the continuous and structural physical deficiency - CSPD (16.9 %). The QOL of servers was considered good, with a mean score of 72.5 points in the total score, with the most affected domains: physical (59.1), general health (66.2), bodily pain (66.3) and functional aspects (72.0). The mental health dimension (76.5) had a better average than the physical dimension (68.0 points). It was found that the decrease in QOL scores is significant statistically related to higher number of CHC (ρ <0.001), with no statistical significance regarding the functional situation (p = 0.259). The administrative technicians of elementary, primary, secondary levels and docents had the worst QOL scores. After the correlation analysis of CHC with the domains and dimensions of the SF-36, there was statistically significant, negative and weak correlation of the domains: functional aspect (ρ = 0.002, r = -0.207), physical aspects (ρ = 0.007; r = -0.183), vitality (ρ = 0.002, r = -0.213), social function (ρ = 0.000, r = -0.313), emotional aspects (ρ = 0.000, r = -0.293), mental health (ρ = 0.000 , r = -0.238), physical health dimension (ρ = 0.002, r = -0.210) and mental health dimension (ρ = 0.000, r = -0.298). The presence of PMD isolated or together, contributed to a lower SF-36 scores, being the domains variation of mean significant, except for bodily pain, general health and physical aspects. By correlating the categories of CHC and QOL, there was a weak correlation (r ≤ -0.376) and significant (ρ ≤ 0.011), mainly related to the NCD, PMDs and NCD + PMD, affecting the mental health, social function, emotional aspects, vitality and functional aspect domains. Front of the results, it was concludes that the servers quality of life is influenced by the CHC. Thus, it was inferred that the presence of CHC causes a negative effect on quality of life, leading the active and inactive servers to exposure their overall life activities and work over the years, due to the morbidity affected, mainly related to NCDs and PMDs. Descriptors: Quality of life. Chronic disease. Occupational Health. Nursing

Avaliação dos parâmetros hematológicos e imunofenotípicos de pacientes com doenças linfoproliferativas crônicas no Rio Grande do Norte

Chronic lymphoproliferative disorders (DLPC) are lymphoid system diseases characterized by the abnormal proliferation of mature lymphocytes that affect B cells, T lymphocytes and NK cells. The aim of the study was to demonstrate the relevance of immunophenotyping by flow cytometry in patients with prolonged lymphocytosis and / or cytomorphological changes compatible with lymphoproliferative diseases. In this study 460 patients (244 men and 216 women) with DLPC were evaluated. Were analyzed by flow cytometry with a panel of monoclonal antibodies consisting of CD3, CD4, CD5, CD8, CD10, CD19, CD22, CD23, CD25, CD38, CD45, CD16/CD56, and HLADR heavy and light chains of immunoglobulins. It also examines information regarding age, gender of patients and laboratory data as leucocytes, cytomorphological analysis, platelet count and hemoglobin determination. The results showed 398 cases of chronic lymphoproliferative disorders and 62 of DLPC B cell lymphoproliferative diseases T. B showed the following distribution : 253 cases of chronic lymphocytic leukemia (CLL), 42 cases of multiple myeloma ( MM ), 37 cases of lymphoma non - Hodgkin lymphoma in leukemic phase (NHL) , 17 cases of pro- B lymphocytic leukemia ( B -PLL), 15 cases of mantle cell lymphoma (MCL ), 12 cases of plasma cell leukemia ( PCL), 9 cases of lymphoma Burkitt (Linf B), 8 cases of leukemia villous cells ( LCV), 3 cases of splenic lymphoma with villous cells (LECV), a case of follicular lymphoma (LF) and a Waldenströn macroglobulinemia ( MW). The diseases source NK / T were 23 cases of peripheral T cell lymphoma (LCTP), 14 cases of T prolymphocytic leukemia (T -PLL), 10 cases of leukemia T of large granular lymphocytes (LGL -T) 9 cases of leukemia cells of adult T (LCTA), 5 cases of Sezary syndrome (SS) and a case of large granular NK leukemia (LGL -NK) lymphocytes. In conclusion, the combined use of the monoclonal antibody panel careful cytomorphological analysis was shown to be essential in immune diagnosis and classification of chronic lymphoproliferative disorders. This study was approved by the IRB - HUOL under number 356 / 09