Solvability of mental health care in the Family Health Strategy: social representation of professionals and users

Objective To aprehend the social representations about the solvability in mental health care with users of the Family Health Strategy and professionals of family health teams and of the Center for Psychosocial Care. Method A qualitative study using semi-structured interviews for data collection, and the Alceste software for analysis. This software uses the Hierarchical Descending Classification based on the examination of lexical roots, considering the words as units and providing context in the corpus. Results The representations emerge in two opposing poles: the users require satisfaction with care and the professionals realize the need for improvement of health actions. Although the matricial support in mental health and the home visits are developed, the barriers related to investment in health, continuing education and organization of care persist. Conclusion The different representations enable improvements in customer service, solvability of care and aggregate knowledge and practices in the expanded perspective of health needs in the family, social and therapeutic context.


Social network of family caregivers of disabled and dependent patients

Cross-sectional study that used the Social Network Index and the genogram to assess the social network of 110 family caregivers of dependent patients attended by a Home Care Service in São Paulo, Brazil. Data were analyzed using the test U of Mann-Whitney, Kruskal-Wallis and Spearman correlation. Results were considered statistically significant when p<0,05. Few caregivers participated in activities outside the home and the average number of people they had a bond was 4,4 relatives and 3,6 friends. Caregivers who reported pain and those who had a partner had higher average number of relatives who to trust. The average number of friends was higher in the group that reported use of medication for depression. Total and per capita incomes correlated with the social network. It was found that family members are the primary caregiver’s social network.





Social determinants of hospitalizations for ambulatory care sensitive conditions in Guarulhos, São Paulo

The study goals present an overview of Hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) in Guarulhos, SP, from 2008 to 2012. This is an ecological study based on secondary data obtained from the Brazilian Hospital Information System, and supported by the Praxical Theory of Intervention of Collective Health Nursing. Applied descriptive statistics for analysis. It was observed that Guarulhos shows an upward trend in hospitalizations by ACSC (20% increase), the most frequent causes of heart failure (11.8%), cerebrovascular disease (10.6%) and angina (9.7%), most frequently in the age group ≥ 65years old, for both sexes. The results are similar to other Brazilian studies, but their analysis should extrapolate the biological limits and the supply of healthcare resources, focusing on the social determinants of the health-disease process.




Social representation of domestic violence against women among Nursing Technicians and Community Agents

OBJECTIVE To analyze the social representations of the Nursing Technicians and Community Health Agents about domestic violence against women. METHOD A qualitative study carried out in the city of Rio Grande, RS, in which evocations and interviews were collected between July and November 2013. For the treatment of data were used the EVOC 2005 software and the context analysis. RESULT It is a structured representation, in which the central nucleus contains conceptual, imaging and attitudinal elements, namely: abuse, aggression, physical aggression, cowardice and lack of respect. Such terms were present in the context of the interviews. The professionals acknowledged that violence is not limited to physical aspects and were judgemental about the acts of the aggressor. CONCLUSION This knowledge may enable the problematization of the studied phenomenon with the team, and facilitate the search for prevention and intervention strategies for victims, offenders and managers of health services.

Determination or determinants? A debate based on the Theory on the Social Production of Health

This article aims to discuss the concepts of Social Determination of Health and Social Determinants of Health, by establishing a comparison between each of their guiding perspectives and investigating their implications on the development of health policies and health actions. We propose a historical and conceptual reflection, highlighting the Theory on the Social Production of Health, followed by a debate on the concepts, with a comparative approach among them.

Social representation of Alzheimer's disease for family caregivers: stressful and rewarding

Abstract OBJECTIVE To understand the content of Social Representation (SR) of family caregivers of Alzheimer's disease patients. METHOD Interviews were conducted with 26 caregivers and analyzed by the ALCESTE software. RESULTS The SR content was structured in two thematic axes called Daily Life and Care and Medical and Emotional Concepts and Outcomes. The first axis creates images related to the routine of interaction with the sick person, and contains a description of care procedures, experiences, and practices applied every day. The second is composed of subjective and conceptual aspects that make up the social representation of Alzheimer's disease, with meanings related to the emotional, medical, and biological contexts. CONCLUSION Due to the importance of topics related to patients' dependence and the personal and emotional consequences of the disease, overload is the main content of the SR of Alzheimer's disease for caregivers, and the understanding of these SR by health professionals should support the planning of interventions addressing this group of individuals.

Social wasps of two Cerrado localities in the northeast of Maranhão state, Brazil (Hymenoptera, Vespidae, Polistinae)

Social wasps of two Cerrado localities in the northeast of Maranhão state, Brazil (Hymenoptera, Vespidae, Polistinae). Results are presented of a survey of social wasps from two savanna localities 30 km apart from each other in the northeastern part of the Brazilian state of Maranhão, Brazil: village of Bom Jesus (municipality of Urbano Santos) and village of Tabocas (municipality of Barreirinhas). Two hundred and twenty-seven nests of 31 species of 13 genera were found and mapped. Polybia rejecta was the species with the largest average density of colonies/ha in both areas. The similarity (Jaccard's index) between the Tabocas and Bom Jesus faunas was 41.9%. Twenty-seven species of plants were utilized as nesting substrate. In Tabocas, Qualea parviflora Mart. (Vochysiaceae) trees were used as substrate by 30.3% of the wasp colonies. In Bom Jesus, the vast majority of colonies (27.9%) were found in a secondary vegetation type, the so-called carrasco, indicator of vegetation change. The number of social wasp species recorded in this study is similar to others obtained in several areas of Cerrado vegetation in Brazil. Nine species are new to Maranhão, and Mischocyttarus cerberus had its distribution confirmed, increasing to 58 the number of species known to occur in that state.

Notes on social wasps of the group of Mischocyttarus(Omega) punctatus (Ducke), with description of six new species (Hymenoptera, Vespidae, Polistinae)

ABSTRACTA revision of the taxonomic status and an identification key for wasp species of the genus Mischocyttarus related to M. punctatus (Ducke, 1904) are presented here. Six new species are proposed (M. tayrona Silveira sp. nov.; M. anchicaya Silveira sp. nov.; M. caxiuana Silveira sp. nov.; M. verissimoi Silveira sp. nov.; M. rodriguesi Silveira sp. nov.; M. ryani Silveira sp. nov.), raising to nine the number of species in the M. punctatus group. The highest diversity of the group concentrates in northern South America, in Andean areas and Amazonia. New information concerning the very peculiar nests of these wasps is also given.

Social disability of Brazilian mood disorder patients

Mood disorders cause many social problems, often involving family relationships. Few studies are available in the literature comparing patients with bipolar, unipolar, dysthymic, and double depressive disorders concerning these aspects. In the present study, demographic and disease data were collected using a specifically prepared questionnaire. Social adjustment was assessed using the Disability Adjustment Scale and family relationships were evaluated using the Global Assessment of Relational Functioning Scale. One hundred patients under treatment for at least 6 months were evaluated at the Psychiatric Outpatient Clinic of the Botucatu School of Medicine, UNESP. Most patients were women (82%) more than 50 (49%) years old with at least two years of follow-up, with little schooling (62% had less than 4 years), and of low socioeconomic level. Logistic regression analysis showed that a diagnosis of unipolar disorder (P = 0.003, OR = 0.075, CI = 0.014-0.403) and dysthymia (P = 0.001, OR = 0.040, CI = 0.006-0.275) as well as family relationships (P = 0.002, OR = 0.953, CI = 0914-0.992) played a significant role in social adjustment. Unipolar and dysthymic patients presented better social adjustment than bipolar and double depressive patients (P < 0.001), results that were not due to social class. These patients, treated at a teaching hospital, may represent the severest mood disorder cases. Evaluations were made knowing the diagnosis of the patients, which might also have influenced some of the results. Social disabilities among mood disorder patients are very frequent and intensive.

Nutritional composition of Annona crassiflora pulp and acceptability of bakery products prepared with its flour

Annona crassiflora offers an edible fruit native to the Savanna. This study aimed to develop a flour meal from Annona crassiflora pulp; analyze the chemical composition of the fresh pulp and its flour; develop and verify the acceptance of formulations with different concentrations of the flour of Annona crassiflora pulp. Fruit used were selected and processed. The pulp was dried in an oven at 60-65 ºC/48h. We analyzed the chemical composition, and two formulations of breads were prepared with 10 and 20% Annona crassiflora pulp. The results showed that the drying of Annona crassiflora pulp enriched its nutritional value. The Annona crassiflora pulp showed important chemical components, as insoluble fibers (pulp and flour), minerals (potassium, calcium, manganese and others) and antioxidant compounds. The formulations were well-accepted in a sensory point of view and proved to be a good alternative to the exploitation of the fruit.

Effect of Amaranth addition on the nutritional composition and consumer acceptability of extruded provitamin A-biofortified maize snacks

The objective of this study was to determine the effect of adding Amaranth leaf powder on the nutrient content and consumer acceptability of extruded provitamin A-biofortified (PVA) maize snacks. Flours of four varieties of PVA maize were composited with Amaranth leaf powder at 0, 1 and 3% (w/w) substitution of, respectively, and extruded into snacks. The ash content of the snacks increased from 0.53 g/100 g-0.58 g/100 g to 0.650 g/100g-89 g/100 g and protein content increased from 9.12 g/100 g-10.94 g/100 g when Amaranth was increased from 0% to 3%. Similarly, lysine content increased from 0.10 g/100 g to 0.17 g/100 g, whilst methionine increased from 0.14 g/100 g to 0.19 g/100 g. The provitamin A content of the snacks ranged from 1.29 µg/g to 1.40 µg/g at 0% Amaranth and 1.54 µg/g to 1.78 µg/g at 3% Amaranth. The acceptability of the snacks decreased with increasing Amaranth concentration, only a very small proportion (2-8%) of the panel liked the snacks extremely. PVA maize with added Amaranth leaf powder has a potential for use in nutritious and healthy extruded snacks, but the consumer acceptability of the snacks should be improved.

Physicochemical characteristics and sensory acceptability of ready-to-eat sliced frozen roast beef with partial reduction of sodium chloride

Abstract Sodium chloride in meat products provides microbiological stability and desirable technological and sensory effects. Therefore, the reduction of this ingredient is a challenge for the meat industry. The objective of this study was to evaluate the physicochemical and sensory characteristics of ready-to-eat sliced frozen roast beef with partial replacement of sodium chloride by a commercial additive mostly composed of potassium chloride. The analyses performed were chemical composition, cooking yield and post defrosting loss, microbiological evaluation and sensory analysis. There was higher moisture content (p < 0.05) in the control treatment (without the presence of the replacement additive) and all treatments were not different (p ≥ 0.05) in the cooking yield and in post-defrosting loss. The results of microbiological analysis are according to Brazilian Legislation. The sensory evaluation showed no difference between the control treatment and the T1 treatment (with the reduction of 35% of NaCl), while the T2 treatment (with reduction of 70% of NaCl) had the lowest average values in all attributes. The study showed that the reduction of 35% NaCl for commercial additive, mostly composed of potassium chloride, in roast beef is feasible since no changes were observed in sensory and technological characteristics evaluated.

Social control of public expenditures in a multilevel principal-agent approach

ABSTRACTThis study enhances the principal-agent model by incorporating a multilevel perspective and differences among agency situations. A theoretical discussion is developed using a proposed intersection of methodological focuses and a descriptive-exemplificative hypothetical analysis. The analysis is applied to public expenditure social control in representative democracies, and as a result, a principal-agent model unfolds that incorporates a decision-making perspective and focuses on formulation, negotiation, articulation, and implementation competencies. Thus, it is possible to incorporate elements into the principal-agent model to make it more permeable to individual, group, and societal idiosyncrasies with respect to public expenditure social control.

Family expectation, social adjustment and gender differences in a sample of schizophrenic patients

A case series to study factors related to family expectation regarding schizophrenic patients was conducted in an out-patient setting in the city of S. Paulo, Brazil. Patients diagnosed as presenting schizophrenia by the ICD 9th Edition and having had the disease for more than four years were included in the study. Family Expectation was measured by the difference between the Katz Adjustment Scale (R2 and R3) scores based on the relative's expectation and the socially expected activities of the patient (Discrepancy Score), and social adjustment was given by the DSM-III-R Global Assessment Scale (GAS) . Outcome assessments were made independently, and 44 patients comprised the sample (25 males and 19 females). The Discrepancy mean score was twice as high for males as for females (p < 0.02), and there was an inverse relationship between the discrepancy score and social adjustment (r =-0.46, p < 0.001). Moreover, sex and social adjustment exerted independent effects on the discrepancy score when age, age at onset and number of psychiatric admissions were controlled by means of a multiple regression technique. There was an interaction between sex and social adjustment, the inverse relationship between social adjustment and discrepancy score being more pronounced for males. These findings are discussed in the light of the potential association between the family environment, gender and social adjustment of schizophrenic patients, and the need for further research, i.e. ethnographic accounts of interactions between patient and relatives sharing households particularly in less developed countries.

The network social support experience of people involved in home care

Objective: To build a theoretical model to configure the network social support experience of people involved in home care. Method: A quantitative approach research, utilizing the Grounded Theory method. The simultaneous data collection and analysis allowed the interpretation of the phenomenon meaning The network social support of people involved in home care. Results: The population passive posture in building their well-being was highlighted. The need of a shared responsibility between the involved parts, population and State is recognized. Conclusion: It is suggested for nurses to be stimulated to amplify home care to attend the demands of caregivers; and to elaborate new studies with different populations, to validate or complement the proposed theoretical model.