Investigando possíveis relações entre alcoolismo, sofrimento psíquico e violência intrafamiliar na perpectiva de mulheres atendidas pela Saúde da Família

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Organização da demanda no serviço Odontológico do Sistema Único de Saúde

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estratégias pedagógicas no ensino da clínica ampliada na atenção primária à saude: percepções e vivências dos alunos de graduação médica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Organização da demanda de um Centro de Especialidades Odontológicas

Introduction: Secondary care in oral health in Brazil is still a little researched topic. Objective: The aim of this study was to analyze the resolution of dental services in SUS based on the referral to secondary attention and backreferral to primary attention. Methodology: It’s a descriptive, quantitative study that used secondary data collected from dental records of patients seen at Centre of Dental Specialties (Ceo) in a city of São Paulo State. Result: It was analyzed 1030 dental records. Just 1236 proceedings received referral to Ceo and among then, 86.4% showed the first attendance on Basic Health Unity (UBS) through spontaneous demand and 50.4% (n=623) received referral to endodontic treatment. There was evasion of 2.27% of studied population (n=28) on the first specialized consultation. Among 1208 proceedings that started the treatment in Ceo, 62.6% (n=757) were finalized and received back-referral to primary attention, that finalized 61.1% (n=463) of proceedings. To conclude the treatment, considering the time spent in Ceo and primary attention, there was variation according to specialty: periodontics – 62 days (sd ±68) and endodontics – 71 days (sd ±51.8), requiring 3 consultations in average, regardless specialty. Conclusion: The Centre of Dental Specialties gave referral and attention to the majority of demand, regardless specialty. However, there are many cases of evasion during dental treatment, alerting managers to develop methods to entice these patients, reducing service expenses and raising solvability of dental procedures previously initiated.

Epidemiologia molecular e estudo dos fatores de virulência de Staphylococcus aureus resistentes à oxacilina isolados de feridas em pacientes atendidos em unidades básicas de saúde da cidade de Botucatu

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Abandono do tratamento da tuberculose e integralidade da atenção na estratégia saúde da família

Estudo qualitativo que objetivou analisar os motivos que levam o doente de tuberculose a abandonar o tratamento, em municípios da região metropolitana de João Pessoa-PB. Como referencial teórico utilizou-se a integralidade do cuidado. Os dados foram coletados no período de outubro a novembro de 2008, mediante entrevista semiestruturada. Participaram nove usuários que abandonaram o tratamento da tuberculose. Na identificação das unidades de significação, utilizou-se a técnica de análise de conteúdo. Os resultados mostram inconsistências relacionadas ao cuidado integral do doente, no que tange à diretriz doutrinária do Sistema Único da Saúde, à consideração do contexto sócio-cultural do usuário com tuberculose e às debilidades na continuidade da atenção, mediante inadequado acompanhamento do mesmo na rede de atenção à saúde. Esses aspectos, ao dificultarem a construção de uma rede de cuidado e apoio ao doente de tuberculose e sua família, contribuem para o abandono do tratamento da tuberculose.

Neurological Disease Detection and Monitoring from Voice Production

The dramatic impact of neurological degenerative pathologies in life quality is a growing concern. It is well known that many neurological diseases leave a fingerprint in voice and speech production. Many techniques have been designed for the detection, diagnose and monitoring the neurological disease. Most of them are costly or difficult to extend to primary attention medical services. Through the present paper it will be shown how some neurological diseases can be traced at the level of phonation. The detection procedure would be based on a simple voice test. The availability of advanced tools and methodologies to monitor the organic pathology of voice would facilitate the implantation of these tests. The paper hypothesizes that some of the underlying mechanisms affecting the production of voice produce measurable correlates in vocal fold biomechanics. A general description of the methodological foundations for the voice analysis system which can estimate correlates to the neurological disease is shown. Some study cases will be presented to illustrate the possibilities of the methodology to monitor neurological diseases by voice

Lacunarity of the Spatial Distributions of Soil Types in Europe.

Lacunarity as a means of quantifying textural properties of spatial distributions suggests a classification into three main classes of the most abundant soils that cover 92% of Europe. Soils with a well-defined self-similar structure of the linear class are related to widespread spatial patterns that are nondominant but ubiquitous at continental scale. Fractal techniques have been increasingly and successfully applied to identify and describe spatial patterns in natural sciences. However, objects with the same fractal dimension can show very different optical properties because of their spatial arrangement. This work focuses primary attention on the geometrical structure of the geographical patterns of soils in Europe. We made use of the European Soil Database to estimate lacunarity indexes of the most abundant soils that cover 92% of the surface of Europe and investigated textural properties of their spatial distribution. We observed three main classes corresponding to three different patterns that displayed the graphs of lacunarity functions, that is, linear, convex, and mixed. They correspond respectively to homogeneous or self-similar, heterogeneous or clustered and those in which behavior can change at different ranges of scales. Finally, we discuss the pedological implications of that classification.

Using the Simulation Modeling Methods for the Designing Real-Time Integrated Expert Systems

Certain theoretical and methodological problems of designing real-time dynamical expert systems, which belong to the class of the most complex integrated expert systems, are discussed. Primary attention is given to the problems of designing subsystems for modeling the external environment in the case where the environment is represented by complex engineering systems. A specific approach to designing simulation models for complex engineering systems is proposed and examples of the application of this approach based on the G2 (Gensym Corp.) tool system are described.

A terapia comunitária e a vivência de estudantes de medicina: uma estratégia de ensino aprendizagem do cuidado humanizado na ESF?

Before the scenario full of criticism about a medical model that gives privilege to the diseases and not to the diseased, there are many arguments that defend the need of redeem the humanized relationship between doctor and patient. It became indispensable to mold during the medical graduation a professional capable of perform a special care, less instrumental and more humanized; however, even though the advances of the pedagogical program of the medical graduation, we still face numerous challenges in the process of molding. This study has as general goal to understand if the students medicine experience with the Integrative Community Therapy (TCI) at the Primary Attention – APS/Family Healthy Strategy-ESF, presents potential to configure itself while strategy of teaching-learning to the integral and humanized care. It was held a qualitative research with the students of the medical graduation from the tenth to the twelfth semester that had experience with the TCI, as part of the Boarding of Family and Community Medicine – MFC. We used interviews with script and we resorted to analyze the narratives to Gadamerian Hermeneutics. It was possible to find that before join the boarding of MFC, the students were unaware the TCI and their preconceptions lined up with depreciated character. The experience with the TCI enabled the reframing of the prejudices and the build of new concepts. Internship in ESF and participate of TCI revealed potential to learning of the humanized care by the practical exercise with experiences that privilege the built of ties; the autonomy of the patient; the fulfillment of the longitudinality at the care of the patient; the acknowledgment of the power of resilience of the patients, at the strength of the collective, at the pain sharing, at the strength of a good communication, at the gains of qualified listening exercise. The absence of models of what to do was replaced by experiences of pains and joys at the learning of becoming a doctor. The pains spoke of the structural difficulties (inputs), at the get along with the socials vulnerabilities of the users and the difficult of perform a good communication with the patients. The joys were experienced at the finding of the humanized care exercise. Questions as structural difficulties, low number of people with TCI degree, a shortly experience of with TCI, show up as limitations to its utilization as pedagogical tool. In turn, the reflective potential is capable of cause resignifications about the know-how before the pain of the other being very much present at the narratives, signaling the potential of the learning of TCI. Therefore, this study advocate that the participation of the students at the TCI, beyond the power of offering the students a teaching-learning strategy to the humanized care, represents the possibility of enlarge the horizons of those future doctors at a glance much more conscious of the difficulties and potential of a professional at the ESF, contributing to the graduation of more sensitized professionals and prepared to perform an integral and humanized approach of the person and his/her community, contributing to an APS/ESF more resolute and rewarding to everyone.

Avaliação das capacitações de Hanseníase: enfermeiros opinião de médicos e enfermeiros das equipes de saúde da família

MORENO,Cléa Maria da Costa,ENDERS,Bertha Cruz, SIMPSON, Clélia Albino. Avaliação das capacitações de Hanseníase: enfermeiros opinião de médicos e enfermeiros das equipes de saúde da família. Revista Brasileira de Enfermagem, Brasília, v.61,n.esp.p. 671-5.2008.

Avaliação das capacitações de Hanseníase: enfermeiros opinião de médicos e enfermeiros das equipes de saúde da família

MORENO,Cléa Maria da Costa,ENDERS,Bertha Cruz, SIMPSON, Clélia Albino. Avaliação das capacitações de Hanseníase: enfermeiros opinião de médicos e enfermeiros das equipes de saúde da família. Revista Brasileira de Enfermagem, Brasília, v.61,n.esp.p. 671-5.2008.

Evaluaci??n de las medidas de atenci??n a la diversidad de la educaci??n primaria en Galicia : impacto escolar. 'Evaluation of the measures of attention to the diversity in the primary education in Galicia : school impact'

Resumen tomado de la publicaci??n. Con el apoyo econ??mico del departamento MIDE de la UNED

Management of adult attention deficit hyperactivity disorder in UK primary care: a survey of general practitioners

Background: Compared to existing literature on childhood attention deficit hyperactivity disorder (ADHD), little published adult data are available, particularly outside of the United States. Using General Practitioner (GP) questionnaires from the United Kingdom, this study aimed to examine a number of issues related to ADHD in adults, across three cohorts of patients, adults who received ADHD drug treatment in childhood/adolescence but stopped prior to adulthood; adults who received ADHD drug treatment in childhood/adolescence and continued treatment into adulthood and adults who started ADHD drug treatment in adulthood.Methods: Patients with a diagnosis of ADHD and prescribed methylphenidate, dexamfetamine or atomoxetine were identified using data from The Health Improvement Network (THIN). Dates when these drugs started and stopped were used to classify patients into the three cohorts. From each cohort, 50 patients were randomly selected and questionnaires were sent via THIN to their GPs.GPs returned completed questionnaires to THIN who forwarded anonymised copies to the researchers. Datasets were analysed using descriptive statistics.Results: Overall response rate was 89% (133/150). GPs stated that in 19 cases, the patient did not meet the criteria of that group; the number of valid questionnaires returned was 114 (76%). The following broad trends were observed: 1) GPs were not aware of the reason for treatment cessation in 43% of cases, 2) patient choice was the most common reason for discontinuation (56%), 3) 7% of patients who stopped pharmacological treatment subsequently reported experiencing ADHD symptoms, 4) 58% of patients who started pharmacological treatment for ADHD in adulthood received pharmacological treatment for other mental health conditions prior to the ADHD being diagnosed.Conclusion: This study presents some key findings relating to ADHD; GPs were often not aware of the reason for patients stopping ADHD treatment in childhood or adolescence. Patient choice was identified as the most common reason for treatment cessation. For patients who started pharmacological treatment in adulthood, many patients received pharmacological treatment for comorbidities before a diagnosis of ADHD was made.