Redução de danos e o saber-fazer de profissionais de um CAPS ad em Natal-RN

The present study had as a main objective to analyze how the professionals at a CAPS ad unit in Natal-RN conceive the knowledge-practice process with regard to the Harm Reduction Policy (HRP) towards alcohol and other drugs. For the accomplishment of this proposal, it was intended: 1) Verifying the possibilities and limits of the HRP implementation at a CAPS ad unit in Natal-RN; 2) Relating the professionals knowledge at a CAPS ad unit in Natal in regard to the Harm Reduction Policy; 3) Enumerating the HRP programmatic actions at the institution. The research had exploratory, descriptive and qualitative approach aspects, guided by the concepts of biopower and self care proposed by Michel Foucault. Data collection occurred in June and July 2011, in which the focal group technique was used. After that, collect field material was analyzed through the content analysis method proposed by Minayo. The results showed some conceptual and practical approach between the harm reduction strategy and the knowledge-practice of the professionals at this CAPS ad unit. The discursive models about drug usage, especially the moral-legal model, still have a significant role in the daily lives of these professionals, being amplified by some demands of their jobs or even through the instituted discourse. The individuals recognize the need for less prohibited practices and more socializing ones, identifying them with the Harm Reduction (HR) logic, when there is a coherent and well-founded understanding about HR among the professionals. Distorted and reductionist views about HR as considering the simple instrumental function of this strategy (distribution of basic supplies) among the professionals, represent one of the main barriers for its implementation. There are few programmatic activities that are related to the RD strategy at this CAPS ad unit which makes a more effective appropriation by the working team difficult to reach. The working processes and the postures adopted by this CAP ad unit professionals have been showing that many of their practices and conceptions were modified to the detriment of new necessities emerged from the demands. Consequently, the self care notion is revealed which brings the need for the valorization of these care agents roles, that is, their collective and individual contribution.

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

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

Identificação de genes em Chromobacterium violaceum relacionados à resposta ao estresse

The sequencing of the genome of Chromobacterium violaceum identified one single circular chromosome of 4.8 Mb, in which approximately 40% of the founded ORFs are classified as hypothetical conserved or hypothetical. Some genic regions of biotechnological and biological interest had been characterized, e. g., environmental detoxification and DNA repair genes, respectively. Given this fact, the aim of this work was to identify genes of C. violaceum related to stress response, as the ones involved with mechanisms of DNA repair and/or genomic integrity maintenance. For this, a genomic library of C. violaceum was built in Escherichia coli strain DH10B (RecA-), in which clones were tested to UVC resistance, resulting in five candidates clones. In the PLH6A clone were identified four ORFs (CV_3721 to 3724). Two ORFs, CV_3722 and CV_3724, were subcloned and a synergic complementation activity was observed. The occurrence of an operon was confirmed using cDNA from C. violaceum in a RT-PCR assay. Further, it was observed the induction of the operon after the treatment with UVC. Thus, this operon was related to the stress response in C. violaceum. The mutagenesis assay with rifampicin after the treatment with UVC light showed high frequency of mutagenicity for the ORF CV_3722 (Pol III δ subunit). In this way, we propose that the C. violaceum δ subunit can act in DH10B in the translesion synthesis using Pol IV in a RecA independent-manner pathway. In growth curve assays other four clones (PLE1G, PLE7B, PLE10B and PLE12H) were able to complement the function at the dose 5 J/m2 and in mutagenicity assays PLE7B, PLE10B and PLE12H showed frequencies of mutation with significant differences upon the control (DH10B), demonstrating that in some way they are involved with the stress response in C. violaceum. These clones appear to be interrelated, probably regulated by a messenger molecule (eg., nucleotide c-di-GMP) and/or global regulatory molecule (eg., σS subunit of RNA polymerase).The results obtained contribute for a better genetic knowledge of this specie and its response mechanisms to environmental stress.

Apitidão funcional e comportamentos relacionados à saúde em mulheres idosas do município de Jequié-BA

The identification of the factors that interfere in the decline of functional conditions is useful in the planning of actions addressing the improvement in the conditions of the lives of elderly people. The purpose of this investigation was to analyze the relationship between social demographics and health aspects of the functional condition in elderly women of low income of the Brazilian northeast. This crosssectional study involved a representative sample of 222 women with an average age of 70 years (± 7.1), belonging to coexisting groups and that were resident in the urban area of the municipal district of Jequié /Bahia. In order to achieve this objective, a battery of physical tests of functional aptitude was carried out previously tested in pilot study, anthropometric measurements collected with a comparison of the measures referred to the reported weight and height as well as the application of an interview with questions containing subjects related to social demographic variables, clinical conditions and health, physical conditions and behaviors. Descriptive statistics Proceedings (frequency, average, standard deviation and percent distribution) were used for statistic analysis, and the calculation of the respective odds ratio by binary logistics regression, for the analysis of factors hierarchically grouped; p<0.05. The prevalence of 56% (n=122) of women considered with moderated or serious type of functional limitations was found, In which from multi-varied hierarchical analysis, significant association was verified with the age group over 80 years (p=0.02), conditions of widowhood (p=0.04), presence of arterial hypertension (p=0.001), and physical inactivity during leisure time (p=0.03). On the other hand for functional incapacities the prevalence was of 46.8% (n=104) being associated to the increase of the age (p=0.01), hospitalization (p=0.02), absence of physical activities along their lives (p=0.001) and the occurrence of alterations in the cognitive function (p=0.001). The normative table for the parameters of physical fitness generated conducive to health professionals in the diagnosis of health conditions and the prescription of physical exercises. The identified characteristics that are associated with the functional limitations / functional incapacities suggest a complex causal net in the determination of the functional condition in elderly women. However, actions addressed to the incentive of the practice of physical activities in the leisure time and the preservation of the cognitive function can contribute to a life with more quality for these people. This research was multidisciplinary approach to involve elements of psychology, nutrition and Physical Education in the elucidation of the object of study related to the functional condition of elderly women

Fatores genéticos e étnicos relacionados à evolução da infecção por Leishmania infantum

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Estudo clínico das manifestações orais e fatores relacionados em pacientes diabéticos tipo 2

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Aspectos socioeconômicos e demográficos relacionados ao estresse e a síndrome de Burnout em fisioterapeutas no Brasil

Dos problemas de saúde existentes no ambiente de trabalho, 18% afetam o aparelho psíquico, a exemplo do estresse, atingindo cerca de 30% dos trabalhadores em geral. A persistência e intensidade do estresse, associada às sucessivas tentativas de lidar com os mesmos, tornam os indivíduos vulneráveis ao surgimento da Síndrome deBurnout. O objetivo deste trabalho foi identificar a relação dos aspectos socioeconômicos e demográficos com o estresse e a Síndrome de Burnout em fisioterapeutas do Brasil. Para isso, este estudo teve uma abordagem do tipo transversal, com 1040 fisioterapeutas do Brasil, através de uma amostragem do tipo snowbolle não probabilística. Utilizou-se um questionário socioeconômico, demográfico e profissional, a Escala de Estresse no Trabalho (EET) e a adaptação do Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo (CESQT). Na análise dos dados, foram utilizadas a estatística descritiva e inferencial. Dentre os principais resultados obtidos, percebeu-se uma maior representatividade da região Nordeste (48,7%), com idade média de 31anos, sexo feminino (75,7%), carga horária semanal de 35,4 horas, com 3-5 anos de atuação profissional. Observou-se que 37,0% apresentavam estresse relacionado estatisticamente com a idade (p=0,008),atividade física (p=0,039) e satisfação com a saúde (r=-0,322; p<0,001). Não foi observado nenhum caso de Burnout, porém houve uma média elevada nas dimensões, desgaste psíquico, indolência e culpa, totalizando 49,0% comtendência ao desenvolvimento da síndrome. Portanto, as variáveis, idade, prática da atividade física e satisfação com a saúde obtiveramrelação com o estresse. Para o Burnout, destacaram-se a região de moradia (centro-oeste), satisfação com a saúde, local de trabalho (clínicas e hospitais), além do maior número de locais de trabalho. Diante desse contexto, os estudos sobre o estresse e a Síndrome de Burnout se apresentam como elementos derelevância dentro do contexto da prevenção dos riscos laborais e da análise das condições de trabalho

Síndrome metabólica e fatores de risco relacionados em crianças e adolescentes com excesso de peso na cidade do Natal

Nas últimas décadas, houve grande aumento da prevalência de obesidade, inclusive na faixa etária pediátrica. Com isso, aumentou o número de crianças e adolescentes afetados por síndrome metabólica (SM), diabetes tipo 2 (DM2) e doenças cardiovasculares (DCV), doenças anteriormente consideradas quase exclusivas de adultos. Os objetivos do estudo foram identificar e correlacionar marcadores antropométricos (IMC- índice de massa corpórea, CA- circunferência abdominal, RCQ- razão cintura/quadril, RCArazão cintura altura e PSE- prega subescapular), PAS e PAD- pressão arterial sistólica e diastólica, respectivamente, e laboratoriais (CT- colesterol total, HDL, LDL, TGL- triglicérides, I/G- razão insulina glicose, HOMA- homeostatic model assessment for insulin resistance) de risco para o desenvolvimento de SM e observar a sua prevalência em crianças e adolescentes com excesso de peso. Foi conduzido estudo transversal, em amostra aleatória, de conveniência, onde foram avaliadas 60 crianças e adolescentes com excesso de peso, atendidas no ambulatório de endocrinologia pediátrica do Hospital de Pediatria da Universidade Federal do Rio Grande do Norte (UFRN) com idade mínima e máxima de 7 e 15 anos, de maio de 2009 a abril de 2010. Foram admitidos os indivíduos que apresentavam sobrepeso (IMC P > 85 e < 95) ou obesidade (IMC P > 95) (CDC, 2000) e história familiar positiva para DM2 em parentes de primeiro ou segundo grau ou algum dos sinais de resistência insulínica (acantose, hipertensão arterial, dislipidemia, síndrome de ovários policísticos). 2 O componente individual para SM mais prevalente foi o percentil da CA ≥ 90 (58,3%), seguido de HDL ≤ 40 mg/dl (36,6%). Na regressão linear simples, observaram-se as variações para mais nos parâmetros laboratoriais e de PA para cada unidade de aumento de IMC, CA, RCA, RCQ e PSE, sendo significantes as seguintes correlações: CA com TGL, HOMA IR, I/G, PAS e PAD; RCQ com TGL, HOMA, I/G, LDL e glicemia; RCA com TGL; PSE com TGL, HOMA-IR, I/G e PAS; e IMC com HOMA IR, I/G, PAS e PAD. De acordo com os critérios da IDF (Federação Internacional de Diabetes International Diabetes Federation) 2007, o diagnóstico de SM foi encontrado em seis indivíduos (10%). Do total, oito (13,3%), estavam em situação de sobrepeso e 52 (86,6%), obesos. As evidências de correlação CA e RCQ, medidas de obesidade centrípeta, com vários marcadores como TGL e HOMA, já sabidamente relacionados à SM, chamam atenção para a necessidade de utilização dessas medidas de forma mais rotineira na prática pediátrica, por serem de fácil obtenção, baixo custo e método não invasivo. Os valores de CA, RCQ, RCA e PSE, quando elevados devem justificar maior detalhamento na avaliação laboratorial de possível resistência insulínica. É importante a identificação de crianças e adolescentes que preencham os requisitos para o diagnóstico da SM, pois são indivíduos de maior risco metabólico e devem ser adequadamente acompanhados.

Estudo de polimorfismos em genes relacionados ao metabolismo do ácido fólico e sua associação com o desenvolvimento de fendas orais não-sindrômicas

The congenital facial clefts are characterized by incomplete formation of the structures that separate the oral and nasal cavity. It is known that several environmental and genetic factors are involved in its development, among these, polymorphisms associated with folic acid metabolism have been investigated. In this sense, the objective was to observe the frequency of polymorphisms C677T and A1298C methylenetetrahydrofolate reductase gene (MTHFR), methionine synthase A2756G of (MTR), A66G of methionine synthase reductase (MTRR) A80G and the reduced folate carrier (RFC1) in patients with non-syndromic oral clefts, trying to match them with their development. Methods: We studied 140 patients with non-syndromic oral clefts and their mothers and 175 control subjects with their mothers, who underwent a questionnaire to obtain family information. Were collecting blood for DNA extraction from patients and their mothers to identify the genotypes of both by PCRRFLP, in addition to carrying out the determination of glucose, AST, ALT and serum creatinine, folic acid and vitamin B12 Serum and plasma homocysteine, and the hemogram. Results: Most patients have cleft lip and palate (55.8%), followed by isolated cleft palate (24.2%) and cleft lip (20%). Regarding gender, 62% of patients were male and 48% female and, after subdivision of the type of screwdriver according to sex was found a prevalence of males in the cracks of the type lip and palate (69 %) and lip (69.2%) and in the case of cleft palate was a female predominance (59%). The average concentration of serum folate in the group of mothers of cleft patients was significantly lower (13.8 ± 2.4 ng / mL) compared with the group of mothers of control subjects (18.8 ± 3.4 ng / mL) This was also observed for the group of cleft children as compared to controls, the dosage of folic acid had a significant difference with values of 15.6 ± 0.6 (ng / mL) and 17.9 ± 0.6 (ng / mL), respectively. For the biochemical measurements of glucose, AST, ALT and creatinine were not statistically different, nor was observed for haematological parameters performed. In assessing the frequency of polymorphisms C677T and A1298C MTHFR, A2756G MTR, MTRR A66G and A80G of the RFC1 there was no statistically significant difference in genotype distribution between cases and controls both for mothers and in the cleft. Conclusion: Although not observed association of polymorphisms with the development of cracks, the decrease in serum folate in the group of cleft patients and their mothers may reflect a disturbance in the metabolism of this metabolite, necessitating further studies such as studies methylation and expression to further elucidate the involvement of folate in the development of oral clefts

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

Doenças sem doentes: Ocorrência de Distúrbios Osteomusculares Relacionados ao Trabalho DORT nos operadores de caixa de um banco

The changes incurred in the financial system with the introduction of new technologies and new forms of administration of banks has caused impact on the health of workers. These changes, which passed in the process of work, generate a combined share of the risk factors that result in numerous injuries and illnesses among banks, notably between the operators of banks tellers. The Work-Related Musculoskeletal Disordes - WRMD represent a group of occupational diseases always present among these workers. Because of its high incidence and the amount of financial resour envolved to manage the problem has been the object of constant study. This paper aims to analyze the bank teller activity; search the occurrence of WRMD in the activity, identifying the factors determining the occurrence of WRMD in the activity and determine the real number of touchs on a keyboard made by the operator and propose solutions that influence the reduction of illness in the workplace of the bank teller. Methodological tools of ergonomics are used to provide a broad knowledge of aspects of work that have been studied and influential in the generation of occupational diseases studied. It was found that activity put workers to serious risk of occupational diseases. As the main contributory factors and determinants for this illness: the requirements and control the numbers daily endorsements; evaluation system based on performance targets for productivity; management system at time of service to customers; work with stressful factors (broken box); excess of time worked; furniture of workstations with ergonomic inadequacies and policy for the prevention of occupational diseases inefficient. They have also noted cases of illness for DORT workers without fulfilling the legal requirement of the issuance of the communication of labour accident and without the removal of the employee of the workplace

Avaliação de Percepção de periodontistas, protesistas, ortodontistas e leigos sobre parâmetros periodontais relacionados à estética do sorriso

The concept of facial esthetics has been increasingly diffused, being of interest to both the general public and the surgeon-dentists. However the difficult standardization and high variability in parameters aesthetic existing in the literature result in a huge difference of opinions between professionals and layperson. In this way, objective of this research was to evaluate the perception of periodontistas, protesistas, orthodontists and layperson about aesthetics smile. The sample included 30 periodontistas, 30 protesistas, 31 orthodontists and 37 layperson. The data collection was performed through an interview indirect, by the site, which had fifteen photos to be assessed by the participants. Each photograph was intentionally modified, with four increments 1mm for each amendment, in the program Adobe Photoshop CS2 version 9.0, adding-four aesthetic alterations: exposure gingival, recession gingival, absence of papilla and contour gingival. The smile for periodontistas, 3mm for orthodontists and laity and 4mm for protesistas. And changes in recession gingival, have undertaken the aesthetics of smiling from 2mm in accordance with the periodontistas and protesistas and 4mm for orthodontists and lay people. The end of the research was possible to conclude that the perception of periodontistas, protesistas, orthodontists and layperson are different in relation to aesthetics smile, and that among the changes in the research evaluated the papilla and recession have undertaken the aesthetics of smile

Estudo da organização funcional do sistema circadiano por meio de ferramentas computacionais e matemáticas

Circadian rhythms are variations in physiological processes that help living beings to adapt to environmental cycles. These rhythms are generated and are synchronized to the dark light cycle through the suprachiasmatic nucleus. The integrity of circadian rhythmicity has great implication on human health. Currently it is known that disturbances in circadian rhythms are related to some problems of today such as obesity, propensity for certain types of cancer and mental disorders for example. The circadian rhythmicity can be studied through experiments with animal models and in humans directly. In this work we use computational models to gather experimental results from the literature and explain the results of our laboratory. Another focus of this study was to analyze data rhythms of activity and rest obtained experimentally. Here we made a review on the use of variables used to analyze these data and finally propose an update on how to calculate these variables. Our models were able to reproduce the main experimental results in the literature and provided explanations for the results of experiments performed in our laboratory. The new variables used to analyze the rhythm of activity and rest in humans were more efficient to describe the fragmentation and synchronization of this rhythm. Therefore, the work contributed improving existing tools for the study of circadian rhythms in mammals

Antidepressivos modificam a extinção de uma memória aversiva em ratas

Treatment of major depression, posttraumatic stress disorder and other psychopathologies with antidepressants can be associated with improvement of the cognitive deficits related to these disorders. Although the mechanisms of these effects are not completely elucidated, alterations in extinction of aversive memories are believed to be present in these psychopathologies. Moreover, researches with laboratory animals usually focus on male subjects, and we have recently verified that extinction of an aversive task is reduced in female rats when compared to males. In the present study, female rats were long-term treated with clinically used antidepressants (fluoxetine, nortriptyline or mirtazapine) and tested in the plus-maze discriminative avoidance and forced swimming tests in order to evaluate learning, memory, extinction, anxiety and depression-related behaviors. All groups learned the task, but learning was somewhat faster in nortriptyline and mirtazapine-treated animals . Task retrieval was also showed by all experimental groups. Chronic treatment with fluoxetine, but not with the other antidepressants, increased extinction of the discriminative task. In the forced swimming test, animals treated with fluoxetine and mirtazapine showed decreased immobility duration. In conclusion, antidepressants interfere with learning and female rats treated with fluoxetine presented increased extinction of the aversive memory task. On the other hand, both fluoxetine and mirtazapine were effective in the forced swimming test, suggesting dissociation between the antidepressant effects and the extinction of aversive memories