Desempeño de las RISS en relación al acceso, coordinación y calidad de la atención en cáncer de mama y diabetes mellitus tipo 2 en Colombia

El objetivo de este capítulo es mostrar los resultados de investigación del desempeño de las redes de servicios de salud frente a diferentes dimensiones relacionadas al acceso, coordinación y calidad de la atención en dos enfermedades crónicas como es el cáncer de mama y la diabetes en Colombia, importantes patologías por su incidencia e impacto así como por la necesidad de la mecanismos efectivos de coordinación para la adecuada atención de los usuarios del sistema de salud. Por tanto, se realiza el análisis del desempeño de dos redes de servicios de salud en la atención de usuarias con diagnostico confirmado de cáncer de mama, vinculadas unas a redes pertenecientes al régimen contributivo y otras al régimen subsidiado. Redes que también fueron consideradas para el análisis del desempeño en la atención de usuarios con diagnostico confirmado de diabetes, en el que de manera adicional participó otra red perteneciente al régimen subsidiado con área de operación en el municipio de Soacha, puesto que las dos anteriores tiene influencia en la ciudad de Bogotá. La fuente primaria de los datos fue la historia clínica y éstos fueron extraídos de acuerdo a ciertos indicadores seleccionados por el equipo investigador a través de un previo proceso de validación y a partir de su importancia para evidenciar el desempeño de las redes de servicios de salud en las dimensiones enunciadas anteriormente. Se muestran los resultados del estudio, a partir de los cuales se propone una breve discusión y conclusiones.

A importância das classes socias na relação médico-paciente: adesão ao pré-natal

This article is focused in the understanding of how can social classes influence in prenatal, throughout the patient medical relationship as well as the many aspects surrounding. In the first chapter, reflected about the adherence to prenatal and considerations in gestational period when dealing with public health treatment offer by SUS. Next chapter, patient medical relationship is addressed as a relationship classes, over questioning how this relationship use to be in front of disadvantaged extracts, focused in prenatal. In the third chapter, the patient medical relationship is analyzed throughout the patient vision, pointing the many factors that can induce the success of a therapeutic. In the last chapter, there are reflections about whereby health professionals upgrading, as well as the improve of basic health care networks are necessary to a larger prenatal adherence.

Redes de atenção à saúde para gestantes usuárias de álcool e/ou outras drogas

Pós-graduação em Saúde Coletiva - FMB

O cuidado em saúde mental e o agir em rede: como se agencia um caso de intensa complexidade?

Pós-graduação em Psicologia - FCLAS

Pathways to care in subjects at high risk for psychotic disorders — A European perspective

Evidence-based decisions on indicated prevention in early psychosis require large-scale studies on the pathways to care in high-risk subjects. EPOS (The European Prediction of Psychosis Study), a prospective multi-center, naturalistic field study in four European countries (Finland, Germany, The Netherlands and England), was designed to acquire accurate knowledge about pathways to care and delay in obtaining specialized high risk care. Our high risk sample (n=233) reported on average 2.9 help-seeking contacts, with an average delay between onset of relevant problems to initial help-seeking contact of 72.6 weeks, and between initial help-seeking contact and reaching specialized high risk care of 110.9 weeks. This resulted in a total estimated duration of an unrecognized risk for psychosis of 3 ½ years. Across EPOS EU regions, about 90% of care pathway contacts were within professional health care sectors. Between EPOS regions, differences in the pathways parameters including early detection and health-care systems were often very pronounced. High-risk participants who later made transition to a full psychotic disorder had significantly longer delays between initial help-seeking and receiving appropriate interventions. Our study underlines the need for regionally adapted implementation of early detection and intervention programs within respective mental health and health care networks, including enhancing public awareness of early psychosis.

Redes para la recepción y asistencia a los exiliados argentinos y uruguayos en las posdictaduras

En el marco de los procesos de democratización política del Cono Sur, los exiliados políticos argentinos y uruguayos iniciaron gradualmente los retornos hacia sus países de origen. Como parte de ese proceso, y sobre todo entre 1983 y 1986, en Argentina y en Uruguay comenzaron a germinar distintas organizaciones sociales que se preocuparon por responder a esos regresos y ayudar a los exiliados en su reinserción en el país. Este artículo indaga en las respuestas de ambas sociedades en dos claves vinculadas. En primer lugar, recupera en el proceso de formulación de ciertas medidas y programas para la reinserción de retornados un fuerte intercambio de conocimientos, inquietudes y modos de trabajo entre las organizaciones sociales argentinas y las uruguayas. Así, este trabajo rompe con las comparaciones en sentido estricto para detenerse a explorar la formación de una red de trabajo asistencial entre distintos actores de ambas orillas. En segundo lugar, este trabajo se detiene a reflexionar sobre una tensión que se desprende de la red: a pesar de las mutuas influencias, los programas de asistencia tuvieron diferencias importantes entre ambos casos. En consecuencia, este artículo ofrece algunas interpretaciones posibles sobre estas diferencias que se insertan en el marco de las "transiciones democráticas" de cada país y, especialmente, de los lugares que el tema del retorno tuvo en cada agenda posdictadura

Redes para la recepción y asistencia a los exiliados argentinos y uruguayos en las posdictaduras

En el marco de los procesos de democratización política del Cono Sur, los exiliados políticos argentinos y uruguayos iniciaron gradualmente los retornos hacia sus países de origen. Como parte de ese proceso, y sobre todo entre 1983 y 1986, en Argentina y en Uruguay comenzaron a germinar distintas organizaciones sociales que se preocuparon por responder a esos regresos y ayudar a los exiliados en su reinserción en el país. Este artículo indaga en las respuestas de ambas sociedades en dos claves vinculadas. En primer lugar, recupera en el proceso de formulación de ciertas medidas y programas para la reinserción de retornados un fuerte intercambio de conocimientos, inquietudes y modos de trabajo entre las organizaciones sociales argentinas y las uruguayas. Así, este trabajo rompe con las comparaciones en sentido estricto para detenerse a explorar la formación de una red de trabajo asistencial entre distintos actores de ambas orillas. En segundo lugar, este trabajo se detiene a reflexionar sobre una tensión que se desprende de la red: a pesar de las mutuas influencias, los programas de asistencia tuvieron diferencias importantes entre ambos casos. En consecuencia, este artículo ofrece algunas interpretaciones posibles sobre estas diferencias que se insertan en el marco de las "transiciones democráticas" de cada país y, especialmente, de los lugares que el tema del retorno tuvo en cada agenda posdictadura

Redes para la recepción y asistencia a los exiliados argentinos y uruguayos en las posdictaduras

En el marco de los procesos de democratización política del Cono Sur, los exiliados políticos argentinos y uruguayos iniciaron gradualmente los retornos hacia sus países de origen. Como parte de ese proceso, y sobre todo entre 1983 y 1986, en Argentina y en Uruguay comenzaron a germinar distintas organizaciones sociales que se preocuparon por responder a esos regresos y ayudar a los exiliados en su reinserción en el país. Este artículo indaga en las respuestas de ambas sociedades en dos claves vinculadas. En primer lugar, recupera en el proceso de formulación de ciertas medidas y programas para la reinserción de retornados un fuerte intercambio de conocimientos, inquietudes y modos de trabajo entre las organizaciones sociales argentinas y las uruguayas. Así, este trabajo rompe con las comparaciones en sentido estricto para detenerse a explorar la formación de una red de trabajo asistencial entre distintos actores de ambas orillas. En segundo lugar, este trabajo se detiene a reflexionar sobre una tensión que se desprende de la red: a pesar de las mutuas influencias, los programas de asistencia tuvieron diferencias importantes entre ambos casos. En consecuencia, este artículo ofrece algunas interpretaciones posibles sobre estas diferencias que se insertan en el marco de las "transiciones democráticas" de cada país y, especialmente, de los lugares que el tema del retorno tuvo en cada agenda posdictadura

Redes para la recepción y asistencia a los exiliados argentinos y uruguayos en las posdictaduras

En el marco de los procesos de democratización política del Cono Sur, los exiliados políticos argentinos y uruguayos iniciaron gradualmente los retornos hacia sus países de origen. Como parte de ese proceso, y sobre todo entre 1983 y 1986, en Argentina y en Uruguay comenzaron a germinar distintas organizaciones sociales que se preocuparon por responder a esos regresos y ayudar a los exiliados en su reinserción en el país. Este artículo indaga en las respuestas de ambas sociedades en dos claves vinculadas. En primer lugar, recupera en el proceso de formulación de ciertas medidas y programas para la reinserción de retornados un fuerte intercambio de conocimientos, inquietudes y modos de trabajo entre las organizaciones sociales argentinas y las uruguayas. Así, este trabajo rompe con las comparaciones en sentido estricto para detenerse a explorar la formación de una red de trabajo asistencial entre distintos actores de ambas orillas. En segundo lugar, este trabajo se detiene a reflexionar sobre una tensión que se desprende de la red: a pesar de las mutuas influencias, los programas de asistencia tuvieron diferencias importantes entre ambos casos. En consecuencia, este artículo ofrece algunas interpretaciones posibles sobre estas diferencias que se insertan en el marco de las "transiciones democráticas" de cada país y, especialmente, de los lugares que el tema del retorno tuvo en cada agenda posdictadura

Cuidado psicossocial em saúde mental: estudo em assentamentos rurais do Rio Grande do Norte

Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people’s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

Cuidado psicossocial em saúde mental: estudo em assentamentos rurais do Rio Grande do Norte

Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people’s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

Matriciamento em saúde mental: atuação de núcleos de apoio à saúde da família

In the context of break with psychiatric hospitals, the Brazilian Psychiatric Reform is a historical process of reformulation of knowledge and mental health practices. In this way, the Centers of Support for Family Health (NASF) have been acting in the supply of matrix support in mental health. So, the present research aims to analyze the actions which the NASF is taking for the matrix support in mental health in the city of Natal/RN. This is a kind of research descriptive, exploratory and qualitative. The data collection, was made by a direct observation of the professional pratices and semi-structured interviews with health professionals NASF's. The Data were analyzed according to thematic analysis technique, with the support of the content analysis method, which is a way to investigate clusters of meanings which make up the communication of the investigated object. Three analytical categories were organized by this method, whose titles were inspired in two theories in the health field called “Health to Paidéia” and “Expanded Clinic”. The name of the categories are: 1. “Mental illness in brackets: working dimensions of the Centers of Support for Family Health interfaces with the concrete subject”, which is about the work process of NASF; 2. “Freedom and engagement in the arrangement of matrix support in mental health���, which explore the matrix support limitations in mental health in Natal/RN from the professionals interviewed at the NASF’s; 3. “Between the desire and interest: influence of expert orientation in mental health in Psychosocial Care Network” (RAPS), which is related to matrix support in mental health, as an organizational arrangement responsible to ensure intersectoral and comprehensive care, strategies inside of context of the constitution of RAPS. We can extract and say that the actions of NASF teams in the brazilian city called Natal/RN, still not part of a structured link with health care networks, as happens with the absence of discussions and lack of professionals in the matrix support. In addition, there is a difficulty to do an specialized orientation in mental health because of the lack of human resources in this area and of the insufficient number of the replacement services for psychiatric hospital pratices, bringing up the discussion about the consolidation and expansion of RAPS in fact investigated.

Adolescent support networks in a health care context: the interface between health, family and education

AbstractOBJECTIVEAnalyze adolescents' perceptions about support networks and their health needs.METHODAnalytical and interpretive study using focus groups conducted in municipal state schools in Fortaleza, in the State of Ceará during the first semester of 2012. The sample comprised 36 male and female adolescents aged between 13 and 16 years attending the ninth grade of the second phase of elementary school.RESULTSThematic analysis revealed that the health care support network and interaction between health professionals, education professionals and family members was insufficient, constituting a lack of an integrated network to enable and provide support for health promotion.CONCLUSIONCoordination between education, health and family services has the potential to act as a support network to help meet adolescents' healthcare needs and demands.

Impedance-based structural health monitoring with artificial neural networks

This paper presents a non-model based technique to detect, locate, and characterize structural damage by combining the impedance-based structural health monitoring technique with an artificial neural network. The impedance-based structural health monitoring technique, which utilizes the electromechanical coupling property of piezoelectric materials, has shown engineering feasibility in a variety of practical field applications. Relying on high frequency structural excitations (typically >30 kHz), this technique is very sensitive to minor structural changes in the near field of the piezoelectric sensors. In order to quantitatively assess the state of structures, multiple sets of artificial neural networks, which utilize measured electrical impedance signals for input patterns, were developed. By employing high frequency ranges and by incorporating neural network features, this technique is able to detect the damage in its early stage and to estimate the nature of damage without prior knowledge of the model of structures. The paper concludes with experimental examples, investigations on a massive quarter scale model of a steel bridge section and a space truss structure, in order to verify the performance of this proposed methodology.

Design and implementation of wireless sensor networks for impedance-based structural health monitoring using ZigBee and Global System for Mobile Communications

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)