Qualidade de vida de mulheres alcoolistas atendidas em serviço ambulatorial

Pós-graduação em Saúde Coletiva - FMB

Adolescentes em semiliberdade: consumo de álcool e outras drogas e atendimento em uma unidade do interior do estado de São Paulo

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Motor development of infants exposed to maternal human immunodeficiency virus (HIV) but not infected

Background: To assess the motor development of infants exposed to maternal human immunodeficiency virus (HIV). Methods: Thirty infants were assessed in the period from November 2009 to March 2010 at the AIDS Reference and Training Centre, in São Paulo, Brazil. The assessment instrument used in the research was the Alberta Infant Motor Scale (AIMS). All 30 infants used the antiretroviral drug properly for 42 consecutive days, in accordance with the protocol of the World Health Organization. Results: Out of the total number of infants, 27 (90%) had proper motor performance and 3 (10%) presented motor delay, according to the AIMS. Discussion: This study demonstrated that only 10% of the assessed group had developmental delay and no relation with environmental variables was detected, such as maternal level of education, social and economic issues, maternal practices, attendance at the day care center, and drug use during pregnancy. It is important to emphasize the necessity of studies with a larger number of participants.

Usuários de serviço de saúde mental: o que conhecem sobre os direitos de cidadania

This is an exploratory descriptive study with a qualitative approach. It aimed at apprehending what users undergoing treatment at a mental health service know about their rights. A semistructured interview was used as a data collection strategy. Five users were interviewed. Thematic content analysis was used for data analysis, and three categories emerged: process of falling ill, experiences of treatment and users’ rights. The users reported voluntary and involuntary hospitalization experiences and that, after treatment commencement at the psychosocial care center, they perceived significant changes in mental health care. They reported that they did not know the mental health legislation, but they knew about the rights stemming from experiencing mental disorder. For users to be able to recognize and take advantage of their citizens’ rights, awareness must be developed by health care professionals, which also includes their academic education

A intersetorialidade nas publicações acerca do Centro de Atenção Psicossocial Infantojuvenil

Current children and youth mental health policy proposes that actions assumed in this field should be added to many others, so that, in a process of permanent intersectional dialogue integral care is assured, according to the Psychosocial paradigm. This paper reflects upon the intersectional place in the last decade scientific papers published in Brazilian journals, and their Mental Health conceptions. We analyzed fourteen indexed papers which dealt with Brazilian Children and Youth Psychosocial Care Centers (CAPSi). Most of these publications focused on individual clinical watch suggesting that Mental Health is understood as a universal and ontological category dependent on the subject’s intrapsychic mechanisms. Some of these studies make reference to the intersectional matter, although it is not clearly discussed. In sum, we understood that the actions assumed by CAPSi cannot neglect others, and discussions should be seriously considered in the scientific field.

A música associada às necessidades terapêuticas de pacientes com deficiência

The use of music and/or its elements (instruments, sound, rhythm, melody and harmony) in environments with people attended by public health centers, aims at promoting communication, facilitating the expression and the relationship in the first contact, hence favoring organization of standards and other relevant therapeutic objectives to assist physical, mental, social and cognitive needs of people, thus promoting the process of environmental adaptation, behavioral conditioning and social inclusion. The purpose of this project is to use music and its sound elements, as well as recreational activities, developed in stages called: socialization session, art workshop and complementary activities, with patients assisted at CAOE (Disabled People Dental Care Center) and their relatives. The objective is to provide them psychological wellbeing, inclusion to physical space, relaxation, stimulation of rhythmic and sonorous perceptions, memorization, emotions externalization, help and encouragement for the development of motor coordination during their daily activities of daily. Recreational activities, handling and contacting with musical instruments, broadcasting and producing sounds, stimulate cognitive capacity, interactivity and entertainment activities can greatly contribute to improve the behavioral reaction and adaptation of these patients, during their dental treatment.

As representações sociais de crianças em acolhimento institucional: proteção ou revitimização?

Pós-graduação em Serviço Social - FCHS

Adolescentes em conflito com a lei e sua noção de regras no jogo de futebol

Adolescents with a course of life based on the lack of ethical and moral values are more vulnerable to the practice of infractions, and in this case the statute of the child and adolescent assumes their insertion on socio educative measures. The objective of this research is to identify the moral development phase in adolescents who are in confl ict with the law. Thirty male adolescents between fi fteen and eighteen years old, who are inserted on the socio educative care Center, were studied. Data were collected through futsal game observation, without the presence of a referee and structured interview, according to the general lines of the Clinical Method of PIAGET (1994). The arrangement of the collected data confi rmed our hypothesis – these adolescents are still with the characteristics of a heteronomical moral, confi rmed by the differences between conscience and the practice of rules in a game situation. Although they know the rules, these are only respected in order to get some benefi ts, like not charging foul, deceive the opponent or simply win the match. It is presumed that the rules would only be respected in the presence of an authority (referee), because he would impose punishments and privations. However, it is believed that the results of this study may become a parameter to educators in order to create favorable situations which can be preventive and interventive to the socio moral development, minimizing suffering and seizing opportunities to the formation of citizens with higher ethical and moral standards, who are able to choose the way to the solidarity, cooperation and justice.

Leitura e interpretação do gênero artigo de opinião: uma experiência reflexiva em ambiente socioeducativo : Fundação C.A.S.A

Pós-graduação em Letras - FCLAR

Qualidade das medidas antropométricas produzidas em unidades de atenção básica à saúde da região de Botucatu-SP, Brasil

The aim of this study was to evaluate the quality of weight measurements produced in Primary Health Care Centers in Botucatu and surroundings. 14 Health Care Centers were included, all of them located in four towns in the area of Botucatu (4,555; 5,656; 18,761 and 128,397 inhabitants). General conditions and scale calibration conditions found in those Health Care Centers were evaluated. In order to evaluate the weight accuracy obtained by the local team, 10 adult users of each Center were addressed by the rater during the service routine in order to get a new weight evaluation, immediately after the measurement made by the team. The statistic method applied for checking the weight measurement held in the Heath Care Center and the scales accuracy was the measurement error technique (MET). The results have showed that out of 19 scales, 6 of them overestimated the weight by 50 grams, 1 of them underestimated the weight by 200 grams and the others were accurate. Evaluated as a group, the result of the scale MET was 44.3g. Regarding the conformity of the measures obtained by the MET of the adults weighing in the Health Care Centers compared to the ones obtained by the researcher, the expected result was obtained in only one Center (< 100g). The results have showed data compromise, rather due to lack of health team training than due to the conditions of the equipment used for the measurement.

Therapeutic Project at Extra-Hospital Mental Health Services: a critical reflection on the elaboration and management of services' therapeutic projects

Based on a study conducted in Ribeirao Preto, SP, Brazil in extra-hospital mental health services that addressed the organization of these services, therapeutic projects and the inclusion of psychosocial rehabilitation in health actions available, a theoretical-critical reflection concerning the development process of the therapeutic projects by the services' teams is presented. The qualitative study was conducted in an outpatient clinic and a Psychosocial Care Center. Data were collected through semi-structured interviews and focal groups. Data analysis was based on the hermeneutic dialectic philosophy of Jurgen Habermas according to the techniques of reconstruction and interpretation. Data analysis revealed that professionals have difficulty developing and managing therapeutic projects. Health actions are made available without being concretely supported by a proposal guiding the service's practical activities. The therapeutic projects are referred by professionals as the result of guidelines provided by management levels or technical orientations inherent to each profession but not as an activity that represents a philosophy of work of the health team. When the therapeutic project is focused on as a type of consensus that results from a communicative action directed to a mutual and intersubjective understanding among the members of the mental health extra-hospital team, the difficulties of the services' team dialogically organizing themselves to collectively construct the therapeutic project is evidenced.

A critical and descriptive approach to interictal behavior with the Neurobehavior Inventory (NBI)

Purpose: The purpose of this study was to test the psychometric properties of the Neurobehavior Inventory (NBI) in a group of temporal lobe epilepsy (TLE) patients from a tertiary care center, correlating its scores with the presence of psychiatric symptoms. Methods: Clinical and sociodemographic data from ninety-six TLE outpatients were collected, and a neuropsychiatric evaluation was performed with the following instruments: Mini-Mental State Examination (MMSE), structured psychiatric interview (MINI-PLUS), Neurobehavior Inventory (NBI), and Hamilton Depression Rating Scale (HAM-D). Results: Some traits evaluated by the NBI showed adequate internal consistency (mean inter-item correlation between 0.2 and 0.4) and were frequent, such as religiosity (74%) and repetitiveness (60.4%). Principal component analysis showed three factors, named here as emotions (Factor 1), hyposexuality (Factor 2), and unusual ideas (Factor 3). Depressive symptoms on HAM-D showed a strong association with emotions and hyposexuality factors. When patients with left TLE and right TLE were compared, the former exhibited more sadness (p=0.017), and the latter, a greater tendency toward sense of personal destiny (p=0.028). Conclusion: Depression influences NBI scoring, mainly emotionality and hyposexuality traits. Neurobehavior Inventory subscales can be better interpreted with an appropriate evaluation of comorbid mood and anxiety disorders. Compromise in left temporal mesial structures is associated with increased tendency toward sad affect, whereas right temporal pathology is associated with increased beliefs in personal destiny. (C) 2012 Elsevier Inc. All rights reserved.

Strategies and results of the oral cancer prevention campaign among the elderly in Sao Paulo, Brazil, 2001 to 2009

Objective. To describe the strategies and results obtained by the early diagnosis and prevention of an oral cancer campaign targeting the population aged 60 years or older developed since 2001 in the state of Sao Paulo. Methods. The main strategies used to develop the campaign were described based on the review of documents issued by the Health Ministry, National Cancer Institute, Sao Paulo State Health Department, Oncocentro Foundation of Sao Paulo, Sao Paulo City Health Department, School of Public Health at the University of Sao Paulo (USP), and Santa Marcelina Health Care Center. The impact of the campaign on the incidence of new cases of oral cancer in the target population was evaluated. Results. In 2001, 90 886 elderly were examined vs. 629 613 in 2009. The following strategies were identified: training of professionals, development of printed materials to guide municipal governments in developing the campaign and using standardized codes and criteria, guidelines for data consolidation, establishment of patient referral flows, practical training with a specialist at the basic health care unit after the follow-up examination of individuals presenting changes in soft tissues, and increase in the number of oral diagnosis services. Between 2005 and 2009, there was a significant reduction in the rate of confirmed cases of oral cancer per 100 000 individuals examined, from 20.89 to 11.12 (P = 0.00003). Conclusions. The campaign was beneficial to the oral health of the elderly and could be extended to include other age groups and regions of the country. It may also provide a basis for the development of oral cancer prevention actions in other countries, as long as local characteristics are taken into account.

Cardiometabolic risk reduction through lifestyle intervention programs in the Brazilian public health system

Public health strategies to reduce cardiovascular morbidity and mortality should focus on global cardiometabolic risk reduction. The efficacy of lifestyle changes to prevent type 2 diabetes have been demonstrated, but low-cost interventions to reduce cardiometabolic risk in Latin-America have been rarely reported. Our group developed 2 programs to promote health of high-risk individuals attending a primary care center in Brazil. This study compared the effects of two 9-month lifestyle interventions, one based on medical consultations (traditional) and another with 13 multi-professional group sessions in addition to the medical consultations (intensive) on cardiometabolic parameters. Adults were eligible if they had pre-diabetes (according to the American Diabetes Association) and/or metabolic syndrome (International Diabetes Federation criteria for Latin-America). Data were expressed as means and standard deviations or percentages and compared between groups or testing visits. A p-value < 0.05 was considered significant. Results: 180 individuals agreed to participate (35.0% men, mean age 54.7 ± 12.3 years, 86.1% overweight or obese). 83 were allocated to the traditional and 97 to the intensive program. Both interventions reduced body mass index, waist circumference and tumor necrosis factor-α. Only intensive program reduced 2-hour plasma glucose and blood pressure and increased adiponectin values, but HDL-cholesterol increased only in the traditional. Also, responses to programs were better in intensive compared to traditional program in terms of blood pressure and adiponectin improvements. No new case of diabetes in intensive but 3 cases and one myocardial infarction in traditional program were detected. Both programs induced metabolic improvement in the short-term, but if better results in the intensive are due to higher awareness about risk and self-motivation deserves further investigation. In conclusion, these low-cost interventions are able to minimize cardiometabolic risk factors involved in the progression to type 2 diabetes and/or cardiovascular disease.

Dermatomiosite em adulto: experiência de um centro terciário brasileiro

OBJETIVOS: Relatamos os resultados de um estudo de coorte retrospectivo envolvendo 139 pacientes com dermatomiosite, conduzido de 1991 a 2011. MÉTODOS: Todos os pacientes preenchiam pelo menos quatro dos cinco critérios de Bohan and Peter (1975). RESULTADOS: A média de idade dos pacientes no início da doença foi de 41,7 ± 14,1 anos, e a duração da doença foi de 7,2 ± 5,2 anos. A amostragem constitui-se de 90,2% de indivíduos brancos, 79,9% do gênero feminino. Sintomas constitucionais foram detectados em menos da metade dos casos. Envolvimentos cutâneo e articular ocorreram em 95,7% e 41,7% dos pacientes, respectivamente. Em 48,2% dos pacientes foram apresentadas pneumopatia incipiente, opacidades em "vidro fosco" e/ou fibrose pulmonar. Todos os pacientes receberam prednisona (1 mg/kg/dia) e 51,1% receberam também metilprednisolona intravenosa (1 g/dia por três dias). Vários imunossupressores foram usados como poupadores de corticosteroide de acordo com tolerância, efeitos colaterais e/ou refratariedade. Houve recidiva de doença (clínica e/ou laboratorial) em 53,2% dos casos; 76,3% permaneceram em remissão no momento do estudo. A taxa de infecção grave foi de 35,3%, com o predomínio de herpes zoster. Houve 15 (10,8%) casos de câncer, dos quais 12 foram confirmados em um período de um ano após o diagnóstico da doença. Houve ainda 16 óbitos (11,5%) cujas causas principais foram sepse/choque séptico (27,5%), pneumopatia atribuída à doença (31,3%), neoplasias (31,3%) e eventos cardiovasculares (12,5%). CONCLUSÕES: No presente trabalho, os dados clínico-laboratoriais foram semelhantes aos de outros grupos populacionais descritos na literatura, com diferenças mínimas quanto à frequência e às características das manifestações extramusculares.