A atenção em Saúde Mental em municípios de pequeno e médio portes: ressonâncias da reforma psiquiátrica

A partir da análise da Política Nacional de Saúde Mental formulada nos últimos anos e das experiências desenvolvidas após 1987 no país, procura-se compreender como o Sistema Único de Saúde tem contribuído ao avanço da reforma psiquiátrica nos municípios; verificar como a assistência oferecida nesses municípios está viabilizando os princípios da reforma psiquiátrica e a melhora das condições de vida dos usuários, bem como pesquisar o papel dos trabalhadores e gestores na construção de novas práticas de cuidado em Saúde Mental. A análise das práticas discursivas aponta que os vários segmentos sociais envolvidos na Saúde Mental conhecem os princípios e propostas da reforma psiquiátrica. No entanto, as gestões municipais não assumem integralmente as propostas do Ministério da Saúde para a área, sob a alegação de falta de recursos financeiros para a contrapartida exigida. Os usuários e familiares têm aos poucos assumido as novas propostas de intervenção, mas os mecanismos de participação e organização popular ainda são incipientes. Por fim, deve-se destacar que, para uma efetiva consolidação das propostas atuais da reforma psiquiátrica, é necessário um maior compromisso dos gestores com a atenção em Saúde Mental, maior investimento nas equipes multiprofissionais, o estímulo à organização e à participação dos usuários e familiares e a integralidade dos dispositivos de saúde, de assistência social e de cultura existentes nas cidades.

Pessoas com deficiência no mercado de trabalho: considerações sobre políticas públicas nos Estados Unidos, União Europeia e Brasil

Atualmente, discussões a respeito da construção de uma sociedade inclusiva, ou seja, responsiva às diferenças, têm ocorrido em diversos países. de acordo com os princípios da inclusão social, a participação das pessoas com deficiência na sociedade depende de profundas transformações, cabendo à sociedade prover os suportes necessários para que esses indivíduos tenham acesso a todos os recursos disponíveis no meio social e, além disso, ao convívio de maneira não-segregada. Uma questão importante, nesse sentido, é a elaboração de políticas públicas no âmbito do trabalho voltadas para pessoas com deficiência. Embora o acesso ao trabalho seja considerado um dos principais direitos civis dos indivíduos, as pessoas com deficiência ainda encontram diversas barreiras para ingressar no mercado profissional. Partindo dessas afirmações, este artigo teve como objetivo discutir alguns dos principais aspectos das políticas de emprego adotadas nos Estados Unidos, na União Europeia e no Brasil para favorecer a inserção desses indivíduos no mercado de trabalho. Para tanto, três documentos legais, sendo um Nacional, um procedente dos Estados Unidos e outro, da União Europeia, foram analisados quanto aos itens: a) ano de publicação do documento; b) objetivos; c) definição de deficiência; e d) estratégias de inserção da pessoa com deficiência no mercado de trabalho. A partir das considerações realizadas, pode-se dizer que existem avanços e divergências nas políticas de emprego e que estas estão relacionadas às particularidades de cada um dos contextos; no entanto, existe uma preocupação comum em garantir à pessoa com deficiência o ingresso na atividade profissional.

Prevenção de conflitos médico-legais no exercício da medicina

Os conflitos médico-legais que ocorrem no exercício da Cirurgia e da Medicina são motivos de preocupação não só no meio médico, mas também na sociedade como um todo, pois se de um lado geram um maior desgaste emocional ao médico, por outro, os pacientes estão sendo rejeitados. As causas desses conflitos são muitas, envolvendo fatores não assistenciais, como o sistema de saúde distorcido e desorganizado, a falta de participação da sociedade e do médico na melhoria desse sistema, o aparelho formador que lança no mercado grande número de jovens médicos despreparados para o exercício dessa nobre profissão, além da falta do ensino continuado. A solução para esses conflitos não poderá ser por meio de simples criação de leis, e nem pela negativa da existência do erro médico, que ocorre numa freqüência até maior do que os próprios conflitos. Todavia, pode-se afirmar que é muito importante melhorar a relação médico-paciente. É necessário, ainda, que o médico conheça a fundo seus deveres de conduta e que, principalmente, se abstenha de praticar abusos do poder. A sociedade deve também entender que a saúde não é uma questão exclusiva dos médicos e que deve lutar pela melhoria das condições dos níveis de vida.

Sleep patterns of day-working, evening high-schooled adolescents of São Paulo, Brazil

Children who grow up in developing countries of the world must work to help financially support their families, and they must also attend school. We investigated the impact of work on the sleep of working vs. nonworking high school students. Twenty-seven São Paulo, Brazil, public high school students (eight male and eight female working students plus six nonworking female and five nonworking male students) 14-18 yrs of age who attended school Monday-Friday between 19:00 to 22:30h participated. A comprehensive questionnaire about work and living conditions, health status, and diseases and their symptoms was also answered. The activity level and rest pattern (sleep at night and napping during the day) were continuously assessed by wrist actigraphy (Ambulatory Monitoring, USA). The main variables were analyzed by a two-factor ANOVA with application of the Tukey HSD test for multiple comparisons, and the length of sleep during weekdays vs. weekends was compared by Student t-test. Working students went to sleep earlier weekends [F-(1,F-23) = 6.1; p = 0.02] and woke up earlier work days than nonworking students [F-(1,F-23) = 17.3; p = 0.001]. The length of nighttime sleep during weekdays was shorter among all the working [F-(1,F-23) = 16.7; p < 0.001] than all the nonworking students. The sleep duration of boys was shorter than of girls during weekends [F-(1,F-23) = 10.8; P < 0.001]. During weekdays, the duration of napping by working and nonworking male students was shorter than nonworking female students. During weekdays, working girls took the shortest naps [F-(1,F-23) = 5.6; p = 0.03]. The most commonly reported sleep complaint during weekdays was difficulty waking up in the morning [F-(1.23) = 6.5; p = 0.02]. During weekdays, the self-perceived sleep quality of working students was worse than nonworking students [F-(1,F-23) = 6.2; p = 0.02]. The findings of this study show that work has negative effects on the sleep of adolescents, with the possible build-up of a chronic sleep debt with potential consequent impact on quality of life and school learning.

Chronic mild prenatal stress exacerbates the allergen-induced airway inflammation in rats

The effects of chronic mild prenatal stress on leukocyte infiltration into the airways was investigated in rat offspring. The chronic prenatal stress consisted of transitory and variable changes in the rat's living conditions. Offspring at adult age were actively sensitized (day 0) and intratracheally challenged (day 14) with ovalbumin. Bronchoalveolar lavage was performed in the offspring at 48 h after intratracheal challenge with ovalbumin. A significant increase in total leukocyte infiltration was observed in the non-stressed offspring group and this was associated with a marked recruitment of eosinophils without a significant effect on the influx of neutrophils and mononuclear cells. In the prenatal stressed offspring, the counts of both total leukocyte and eosinophils, as well as mononuclear cells, was increased by 50% compared to the non-stressed offspring. We provide here the first experimental evidence that chronic mild unpredictable prenatal stress produces a marked increase in the allergen-induced airway inflammation in the rat offspring.

Igreja católica, assistência social e caridade: Aproximações e divergências

This article is the result of a research study concluded in 2003, which aimed at investigating how the conception of Law is expressed in the actions of the so-called social pastoral commissions of the Catholic Church in Londrina, Brazil. By observing that the conception of charity and that of social rights walk side-bi-side within the Catholic Church, a question emerged: how is the conception of social right expressed in the actions of social pastoral commissions? Charity is preached as a Christian duty, as an action expressed in the experience of solidarity towards others who are in a situation that prevents them from having minimal living conditions. At least at discourse level, the actions developed are not limited to provide basic goods, clothes or medicine. We realized that those who act in social pastoral commissions, driven by values such as love to fellow human beings and solidarity, have not lost sight of the idea of social right - on the contrary, they have been reinforcing it. © 2006 Programa de Pós-Graduação em Sociologia - UFRGS.

Survey on tuberculosis teaching in Brazilian nursing schools, 2004

OBJECTIVE: To characterise tuberculosis (TB) teaching in Brazilian nursing schools by state and region and its theoretical and practical contents. METHODOLOGY: In an educational research survey in 2004, 347 nursing schools were identified. Questionnaires were posted to faculties providing training in TB. Data were compiled in a database with a view to descriptive result analysis. Replies to the questionnaire were received by 32% of the nursing schools contacted. RESULTS: Undergraduate TB teaching is heterogeneous. For training in theory, the principle teaching method is through classes in 102 (91.9%) nursing schools. Practical TB teaching is carried out at the primary care level (89.2%). Teachers update their knowledge through events and internet; little reference is made to manuals. The time devoted to practical TB teaching ranges from 10 to 20 hours, although this is not always included in student training. CONCLUSION: Teaching in TB should go beyond the traditional model that focuses only on biological aspects. It should introduce tools that lead to permanent behavioural change, such as a more human approach and social and psychological aspects, such as living conditions, habits and customs. It should involve new partners, such as families, communities and other health professionals, and identify obstacles within the university. © 2006 The Union.

Recurrent urinary tract infections: Evaluation of the prophylactic efficacy of urinary antiseptics methenamine and methylthioninium chloride

Introduction: Urinary tract infection (UTI) is a very common condition in clinical practice, affecting an estimated 50% of all adult women during a lifetime. The most common causative agent is E. coli; UTI may also be caused by S. saprophyticus, Enterobacteria (Klebsiella sp and Serratia sp.), Enterococcus sp., and P aeruginosa. Recurrent UTIs occur at least twice per semester or three times a year. Prophylactic measures to prevent recurrent UTIs include changes in contraception methods, cranberry products, increased fluid intake, urination after intercourse, vaginal estrogen therapy for post-menopausal women, antibiotics, and urinary tract antiseptic agents. Objectives: To evaluate the use of a combination of methenamine and methyl-thioninium chloride in the prophylaxis of recurrent uncomplicated lower UTIs, with respect to: • Signs and symptoms of UTI • Etiologic agent(s) • Recurrence rates • Need for antibiotic therapy in case of recurrence • Incidence of adverse events associated with the treatment, including any reported alterations of laboratory tests Materials & methods: A descriptive, analytic, restrospective study was performed at Hospital Universitário Constantino Otaviano - UNIFESO. Medical charts from patients presenting recurrent uncomplicated lower UTI attended from 2001-present were analyzed, including the following information: Demographic data (age, gender, weight, ethnicity, living conditions): medical history/signs and symptoms of UTI; identification of treatment and dosing regimens; treatment duration; recurrence rates and need for antibiotic therapy in case of recurrence; other medications prescribed; and records of adverse events. Results: E. coli was identified as etiologic agent in 80% of the patients. Following antibiotic therapy, all patients received prophylactic treatment with the combination of methenamine and methylthioninium chloride. Treatment duration ranged from three to six months. Adverse events were observed in 13/60 patients (21.7%). At the end of the respective treatment periods, a statistically significant (p<0.0001) number of patients showed no UTI recurrence. Conclusion: Based on the results from the collected data, we conclude that an orally administered combination of methenamine and methylthioninium chloride is safe and effective in the prophylactic treatment of recurrent uncomplicated lower urinary tract infection. © Copyright Morelra Jr. Editora.

Resilience as protagonism: interpersonal relationships, cultural practices, and personal agency among working adolescents in Brazil

A visual methods study was conducted with 16 at-risk youth living in a mid-sized Brazilian city. In this study, we focus on data obtained from four of those youth who were working adolescents, aged 13-15, and identify contextually specific protective processes associated with resilience. Through a reciprocal process of collaborative research that included observation, photo elicitation, video recording of a 'day in the life' of each youth, and semi-structured interviews, youth and researchers co-constructed an understanding of adaptive coping in a particularly challenging social environment. By employing techniques from grounded theory to analyze the data, we identified a pattern of protagonism among these youth that enabled them to maintain well-being despite exploitation as working children. This conceptualization of protagonism as a protective process has implications for human service workers who intervene to improve the living conditions of working children. © 2013 Taylor & Francis.

Avaliação antropométrica e alimentar de gestantes atendidas pelo Programa de Saúde da Família (PSF) no município de Araraquara-SP

Pós-graduação em Alimentos e Nutrição - FCFAR

O imaginário social sobre o processo saúde-doença e as ações de promoção da saúde entre moradores e equipe de saúde em uma unidade de saúde da família do interior do estado de São Paulo

Pós-graduação em Ciências Sociais - FFC

Indicadores de desenvolvimento humano no campo e na cidade - Ribeirão Preto, SP

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Língua e sociedade nas páginas da Imprensa Negra paulista: um olhar sobre as formas de tratamento

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Bolsa família: uma análise dos resultados sob a óptica educacional

Pós-graduação em Educação - FFC

Segregação socioespacial em cidades pequenas

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)