Compreendendo o acolhimento em uma unidade de saúde da família na perspectiva dos usuários

The present study aimed at understanding humanized reception at a Family Health Unit in a city in São Paulo state according to users’ perspectives. It is a qualitative investigation with a Case Study as its methodological framework and the Theory of Complexity (TC) as its theoretical basis. Data were collected from March to July, 2011 by means of non-directive interviews and participant observation, and the Flowchart that analyzes the care provision model in health care services was used. The discourses were analyzed according to Bardin’s thematic approach, from which two themes emerged: humanized reception as an act that precedes medical consultation and humanized reception as a solution to demands stemming from medical action. The study provided visibility to the forms how humanized reception is understood, that is, the moment that precedes medical consultation, being configured as a pre-consultation instance when punctual actions are performed, such as measuring vital signs, and when users are sure that they will be seen by a doctor, in addition to the perception that humanized reception is not part of the process to solve their need, since such result is achieved by means of medication dispensation permeated by the polite treatment given by professionals. These results show how the fragmented, reductionist and linear approach to caregiving is still present in the words, thoughts and culture of health service users as well as in those of health care team members. TC seems to shed light on these issues, and it may result in important improvement in the understanding of interactional relationships between team members and users concerning the work process in the Family Health model as the main strategy in Primary Care

Saúde mental do idoso: percepções relacionadas com o envelhecimento em interface com o atendimento de saúde na atenção básica

Worldwide, growth is seen in the elderly population, which has prompted the use oftechnologies of care that include all stages of life and for that use, it is necessary toprepare professionals to meet this growing demand population. This work aims to understand how old people feel by their condition and identify how old people perceive this treatment in the Family Health Unit. The research is characterized asqualitative and Minayo second analysis was used Bardin. After, thematicinterviews, it was possible to appreciate the topics: Good, dissatisfaction through the life and likes / dislikes of the service unit. This work can be seen that the elderlywho were well, allied to good living with this family, with spouses, autonomy, respect they encounter in society. And when compared with those who have a complaint, we find that lack of family and age restrictions and diseases are the main complaints

O fazer teórico-prático do nutricionista na estratégia saúde da família: representações sociais dos profissionais das equipes

OBJETIVO: Conhecer as representações sociais dos profissionais das equipes de saúde da família sobre o fazer teórico-prático do nutricionista. A pesquisa foi realizada em Unidades de Saúde da Família de um município do estado de São Paulo. MÉTODOS: Foi utilizada a metodologia qualitativa, tendo como sujeitos 27 profissionais, eleitos por critério intencional. A coleta de dados foi realizada por meio de entrevistas semiestruturadas. Para a interpretação dos dados, utilizou-se a análise categorial temática, apropriando-se da Teoria das Representações Sociais. RESULTADOS: Como resultados, emergiram quatro temas: Nutricionista na Estratégia de Saúde da Família, Abordagem de questões alimentares pelos profissionais da equipe de saúde da família, Educação nutricional e Problematizando a ausência do nutricionista na equipe de saúde da família. As principais representações obtidas com relação ao nutricionista foram relacionadas à prescrição de dietas, além de revelarem um conhecimento mais amplo sobre as funções e atribuições desse profissional. Não houve dúvidas sobre a importância da educação nutricional na promoção de práticas alimentares saudáveis, apesar de os sujeitos terem demonstrado uma visão superficial e pouco abalizada teoricamente sobre o tema. CONCLUSÃO: A ausência do nutricionista na equipe de saúde da família foi atribuída a fatores como o baixo reconhecimento social, a desvalorização profissional, o pouco tempo de existência da profissão, o desconhecimento do núcleo de competência do nutricionista e a manutenção do modelo médico hegemônico. Concluiu-se pela necessidade de mais estudos que problematizem a inserção do nutricionista em equipes de saúde da família.

Prática supervisionada de exercícios físicos durante o tratamento regular com estatinas de pacientes da atenção básica: caracterização, aderência e delimitação das respostas musculares

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Percepção da doença mental por profissionais de saúde: possibilidades de ampliação do cuidado

This study approached perceptions of mental illness by nineteen professionals who work in a Family Health Unit, by means of graphic representations (drawings). We used qualitative methods. Data was collected by means of a Presentative-Expressive Procedure. Four themes were identified using Thematic Analysis. The professionals associate mental disorders with: health care, medical-centered view, exclusion/inclusion, social environment. These perceptions are related to a biological paradigm, favoring the reproduction of prejudices about mental illness. The analysis also emphasizes the importance of a wide range of cares, while considering how difficult it may be for the professionals. We conclude that it is necessary to invest on professional preparation, in an attempt to transform ideoaffective contents presented by the subjects’ imaginary.

Zeros of a family of hypergeometric para-orthogonal polynomials on the unit circle

Para-orthogonal polynomials derived from orthogonal polynomials on the unit circle are known to have all their zeros on the unit circle. In this note we study the zeros of a family of hypergeometric para-orthogonal polynomials. As tools to study these polynomials, we obtain new results which can be considered as extensions of certain classical results associated with three term recurrence relations and differential equations satisfied by orthogonal polynomials on the real line. One of these results which might be considered as an extension of the classical Sturm comparison theorem, enables us to obtain monotonicity with respect to the parameters for the zeros of these para-orthogonal polynomials. Finally, a monotonicity of the zeros of Meixner-Pollaczek polynomials is proved. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Epidemiology of healthcare-associated infections among patients from a hemodialysis unit in southeastern Brazil

Patients submitted to hemodialysis are at a high risk for healthcare-associated infections (HAI). Presently there are scarce data to allow benchmarking of HAI rates in developing countries. Also, most studies focus only on bloodstream infections (BSI) or local access infections (LAI). Our study aimed to provide a wide overview of HAT epidemiology in a hemodialysis unit in southeastern Brazil. We present data from prospective surveillance carried out from March 2010 through May 2012. Rates were compared (mid-p exact test) and temporally analyzed in Shewhart control charts for Poisson distributions. The overall incidence of BSI was 1.12 per 1000 access-days. The rate was higher for patients performing dialysis through central venous catheters (CVC), either temporary (RR = 13.35, 95% CI = 6.68-26.95) or permanent (RR = 2.10,95% CI = 1.09-4.13), as compared to those with arteriovenous fistula. Control charts identified a BSI outbreak caused by Pseudomonas aeruginosa in April 2010. LAI incidence was 3.80 per 1000 access-days. Incidence rates for other HAI (per 1000 patients-day) were as follows: upper respiratory infections, 1.72; pneumonia, 1.35; urinary tract infections, 1.25; skin/soft tissues infections, 0.93. The data point out to the usefulness of applying methods commonly used in hospital-based surveillance for hemodialysis units. (C) 2013 Elsevier Editora Ltda. All rights reserved.

Experience of family members as a result of children's hospitalization at the Intensive Care Unit

Objective. To describe the experience of family members as a result of children’s hospitalization at the Intensive Care Unit (ICU). Methodology. Descriptive and cross-sectional study. A structured interview was held with 20 relatives of patients hospitalized at two clinics of the Botucatu Medical School at Universidade Estadual Paulista “Júlio de Mesquita Filho”. Information was collected between July and September 2010. Results. The main characteristics of the participating relatives were: 80% mothers of the children; 70% low education level and 70% married. Sixty percent of the children were hospitalized at the ICU for the first time. Eighty percent of the interviewees believe that the children’s behavior changes inside the unit and 85% consider that visiting hours are sufficient. The predominant negative feelings are fear (50%) and insecurity (20%), while the predominant positive feelings are hope (50%) and the expectation of discharge (25%). The professional who most supported the relatives was the nurse (35%). Conclusion. The family members’ experience as a result of the children’s hospitalization at the ICU involves positive and negative aspects, which also affect the child’s behavior at the unit.

A university extension course in leprosy: telemedicine in the Amazon for primary healthcare

There is a high prevalence of leprosy in the Amazon region of Brazil. We have developed a distance education course in leprosy for training staff of the Family Health Teams (FHTs). The course was made available through a web portal. Tele-educational resources were mediated by professors and coordinators, and included the use of theoretical content available through the web, discussion lists, Internet chat, activity diaries, 3-D video animations (Virtual Human on Leprosy), classes in video streaming and case simulation. Sixty-five FHT staff members were enrolled. All of them completed the course and 47 participants received a certificate at the end of the course. At the end of the course, 48 course-evaluation questionnaires were answered. A total of 47 participants (98%) considered the course as excellent. The results demonstrate the feasibility of an interactive, tele-education model as an educational resource for staff in isolated regions. Improvements in diagnostic skills should increase diagnostic suspicion of leprosy and may contribute to early detection.

Predictors of adherence to influenza vaccination for healthcare workers from a teaching hospital: a study in the prepandemic era

Introduction: Even before the 2009 pandemics, influenza in healthcare workers (HCW) was a known threat to patient safety, while Influenza vaccine coverage in the same group was generally low. Identification of predictors for HCW adherence to Influenza vaccination has challenged infection control committees. Methods: Our group conducted a cross-sectional survey in December 2007, interviewing 125 HCWs from a teaching hospital to identify adherence predictors for Influenza vaccination. The outcomes of interest were: A - adherence to the 2007 vaccination campaign; B - adherence to at least three yearly campaigns in the past five years. Demographic and professional data were assessed through univariate and multivariate analysis. Results: of the HCWs interviewed, 43.2% were vaccinated against Influenza in 2007. However, only 34.3% of HCWs working in healthcare for more than five years had adhered to at least three of the last five vaccination campaigns. Multivariate analysis showed that working in a pediatric unit (OR = 7.35, 95% I = 1.90-28.44, p = 0.004) and number of years in the job (OR = 1.32, 95%CI = 1.00-1.74, p = 0.049) were significant predictors of adherence to the 2007 campaign. Physicians returned the worst outcome performances in A (OR = 0.40, 95%CI = 0.16-0.97, p = 0.04) and B (OR = 0.17, 95%CI = 0.05-0.60, p = 0.006). Conclusions: Strategies to improve adherence to Influenza vaccination should focus on physicians and newly-recruited HCWs. New studies are required to assess the impact of the recent Influenza A pandemics on HCW-directed immunization policies.

Caring for organ donors: the intensive care unit physicians' view

This study examined the meanings that the intensive care unit (ICU) physicians attribute to their practice when caring for brain-dead organ donors. It is a phenomenological study, a qualitative method that searches for describing and understanding the experiences lived. Data were collected through recorded individual interviews made with 10 ICU physicians who work in a university hospital in the interior of São Paulo, Brazil. Three categories emerged from data: (1) providing care for brain-dead organ donors; (2) relating to donors and their families; and (3) the ethical concerns and self-awareness of the physicians. There is consensus as to-many aspects: demand of technical qualification and excellence in practice; need of investing in technology of organ transplant; and donors seen as human beings and holders of human rights. Participants understand that family participation is decisive in the donation process, although interactions between the family members and the physicians are difficult because of the sensitive nature of the situation. The physicians often felt ill-prepared to openly discuss the topic of brain death and organ donation. Educational programs for physicians and family members may assist with this difficult process.

Crystallization and preliminary X-ray diffraction analysis of XAC1151, a small heat-shock protein from Xanthomonas axonopodis pv. citri belonging to the alpha-crystallin family

The hspA gene (XAC1151) from Xanthomonas axonopodis pv. citri encodes a protein of 158 amino acids that belongs to the small heat-shock protein ( sHSP) family of proteins. These proteins function as molecular chaperones by preventing protein aggregation. The protein was crystallized using the sitting-drop vapour-diffusion method in the presence of ammonium phosphate. X-ray diffraction data were collected to 1.65 angstrom resolution using a synchrotron-radiation source. The crystal belongs to the rhombohedral space group R3, with unit-cell parameters a = b = 128.7, c = 55.3 angstrom. The crystal structure was solved by molecular-replacement methods. Structure refinement is in progress.

Surveillance Programme for Healthcare Associated Infections in the State of São Paulo, Brazil. Implementation and the first three years' results

Governmental programmes should be developed to collect and analyse data on healthcare associated infections (HAIs). This study describes the healthcare setting and both the implementation and preliminary results of the Programme for Surveillance of Healthcare Associated Infections in the State of São Paulo (PSHAISP), Brazil, from 2004 to 2006. Characterisation of the healthcare settings was carried out using a national database. The PSHAISP was implemented using components for acute care hospitals (ACH) or long term care facilities (LTCF). The components for surveillance in ACHs were surgical unit, intensive care unit and high risk nursery. The infections included in the surveillance were surgical site infection in clean surgery, pneumonia, urinary tract infection and device-associated bloodstream infections. Regarding the LTCF component, pneumonia, scabies and gastroenteritis in all inpatients were reported. In the first year of the programme there were 457 participating healthcare settings, representing 51.1% of the hospitals registered in the national database. Data obtained in this study are the initial results and have already been used for education in both surveillance and the prevention of HAI. The results of the PSHAISP show that it is feasible to collect data from a large number of hospitals. This will assist the State of São Paulo in assessing the impact of interventions and in resource allocation. (C) 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

Caring for organ donors: The intensive care unit nurses' view

The nursing care for patients who are pronounced brain-dead but kept alive to serve as organ donors demands technical-scientific skills and the ability to handle situations that are often in conflict with the traditional concepts of nursing care. Based on the phenomenological approach in this article, essential themes of the lived experience of caring for these patients, including the technical and specific nursing care, the relationship with organ donors and their families, and the nurses' perception of themselves in this professional situation are described. The results point to the contradictions and ambiguities of this type of nursing, especially in regards to the affective and philosophical aspects.

A experiência do cuidador familiar e da equipe multiprofissional com processo de cuidar de doentes renais crônicos em hemodiálise

Pós-graduação em Enfermagem (mestrado profissional) - FMB