Dispositivos de atenção psicossocial

O conte��do deste e dos demais m��dulos do Curso de Especializa����o em Sa��de Mental abordam temas relativos ao cuidado territorial e �� pr��tica da atenção psicossocial voltada ��s pessoas em sofrimento ps��quico. Inicialmente, abordam a no����o de sofrimento e sua vincula����o ��s dimens��es de vida que comp��em os sujeitos. Discute-se princ��pios, diretrizes e dispositivos da abordagem territorial como v��nculo, a����o territorial, responsabiliza����o, projeto terap��utico singular, matriciamento, constru����o de projetos de vida, redu����o de danos, gest��o do cuidado. Finalmente, abordam os dispositivos da Atenção Psicossocial, como as pr��ticas de conviv��ncia, as pr��ticas culturais, as a����es de reabilita����o psicossocial, o habitar, os projetos de inser����o no trabalho, o protagonismo de usu��rios e familiares, elementos da sa��de mental infanto-juvenil, e discute o conceito de Reforma Psiqui��trica e de Desinstitucionaliza����o.

Preval��ncia de obesidade infanto-juvenil : associa����o com os h��bitos alimentares, actividade f��sica e comportamentos sedent��rios dos adolescentes escolarizados de Portugal Conti

RESUMO Nos pa��ses industrializados observam-se elevadas preval��ncias de pr��- obesidade e obesidade em jovens e adolescentes, com consequ��ncias negativas para a sa��de. A obesidade �� apontada como o dist��rbio nutricional mais frequente em crian��as e adolescentes nos pa��ses desenvolvidos e �� resultado da acumula����o excessiva ou anormal de gordura no tecido adiposo. Segundo a I.O.T.F. considera- se que uma crian��a tem pr��-obesidade quando o seu percentil de I.M.C. est�� entre o p88 e p99 para as raparigas e entre o p90 e o p99 para os rapazes. Considerase que tem obesidade quando o percentil de I.M.C. �� superior ao p99, para ambos os sexos. A preval��ncia de pr��-obesidade e obesidade em crian��as e adolescentes tem vindo a aumentar a n��vel mundial a um ritmo alarmante, sobretudo nos pa��ses desenvolvidos e em alguns segmentos de pa��ses em desenvolvimento. Estudos demonstram que a obesidade em crian��as e adolescentes se encontra fortemente correlacionada com o aumento da morbilidade e mortalidade, reflectindo-se numa variedade de situa����es patol��gicas com risco de persist��ncia no adulto. Dada a sua extrema import��ncia em termos de Sa��de P��blica, as tend��ncias para a pr��- obesidade e obesidade em crian��as e adolescentes devem ser monitorizadas com especial atenção. Os h��bitos alimentares e o gasto energ��tico s��o factores que influenciam a obesidade e o seu controlo. H�� estudos que concluem que existe uma associa����o directa entre estes factos e a presen��a de obesidade e outros apresentam conclus��es contr��rias. Pretendeu-se determinar a preval��ncia de excesso de peso (pr��-obesidade e obesidade) infantojuvenil em Portugal e associ��-la com os h��bitos alimentares, actividade f��sica e comportamentos sedent��rios dos adolescentes. A popula����o em estudo �� todos os adolescentes, de ambos os sexos, que frequentam o ensino b��sico (2�� e 3�� ciclos) e secund��rio oficial de Portugal Continental (n=5708). Todos os elementos em estudos foram avaliados antropometricamente (peso e altura) e responderam a um question��rio de h��bitos alimentares e frequ��ncia alimentar, actividade f��sica e comportamentos sedent��rios. Como resultados do estudo verificou-se que a preval��ncia de pr��- obesidade infanto-juvenil em Portugal �� de 22,6% e a preval��ncia de obesidade de 7,8%. Quer a obesidade quer a pr��-obesidade apresentam indicadores superiores nos rapazes (p=0,01) e nos adolescentes mais jovens (p=0,00). Em rela����o aos h��bitos alimentares estudados �� de referir que a frequ��ncia de consumo de refei����es fora de casa �� muito similar entre o grupo normoponderal e o grupo com excesso de peso sendo a refei����o da ceia consumida por um n��mero muito superior de adolescentes normoponderais comparativamente com os que apresentam excesso de peso (p=0,01). Em rela����o �� ingest��o de determinados alimentos ou grupos aliment��cios, verificou-se que, regra geral, o consumo de alimentos de caracter��sticas nutricionais de baixa qualidade (gordura saturada, sal e a��ucares simples) era superior no grupo normoponderal comparativamente ao grupo com excesso de peso (refrigerantes, snacks, fast-food, cereais a��ucarados, sobremesas doces) (p<0,05). Em rela����o �� actividade f��sica, o n��mero de horas semanais de actividade f��sica diminui do grupo normoponderal para o grupo com excesso de peso. Dentro do grupo com excesso de peso, os obesos apresentam ainda uma m��dia inferior em rela����o aos pr��-obesos. Poderemos afirmar que quanto maior o ��ndice de actividade f��sica menor o percentil de I.M.C., mostrando-se assim a actividade f��sica como um factor protector de um peso saud��vel (p<0,05). Quando solicitado que caracterizassem o estilo de vida e a habilidade desportiva, verificou-se que nos grupos com excesso de peso se caracterizavam em indicadores mais baixos do que os normoponderais (p<0,05). No que diz respeito aos comportamentos sedent��rios, verifica-se que s��o mais prevalentes nos grupos com excesso de peso do que no grupo normoponderal (p<0,05). Em conclus��o, os resultados da preval��ncia de obesidade obtidos assemelham-se aos resultados obtidos noutros estudos, constituindo um dado revelador de uma situa����o bastante preocupante em termos de Sa��de P��blica. Em rela����o aos h��bitos alimentares as diferen��as n��o s��o significativas entre os diferentes grupos (normoponderal, pr��-obesidade e obesidade). A actividade f��sica apresentou-se como um factor protector do aumento de peso com uma associa����o directa com o estado nutricional (I.M.C.). Verificou-se que os adolescentes em Portugal que apresentavam indicadores mais elevados de actividade f��sica eram aqueles que se encontravam com peso normal. Os comportamentos sedent��rios apresentaram-se como um factor prop��cio ao desenvolvimento do excesso de peso estando directamente relacionados com o percentil de I.M.C. Os comportamentos sedent��rios mais frequentes s��o o visionamento televisivo e o computador/internet. Assim, poder-se-�� fundamentar a necessidade de medidas interventivas a este n��vel com o intuito de controlar os indicadores encontrados. ABSTRACT In the industrialized countries high prevalences of pre-obesity and obesity are observed in youngsters and adolescents, with negative health consequences. Obesity is pointed as the most frequent nutritional disturbance in children and adolescents in developed countries and results from the excessive or abnormal accumulation of fat in the adipose tissue. According to the IOTF a child is pre-obese when the BMI percentile is between p88 and p99 for girls and between p90 and p99 for boys. Obesity is considered when the BMI percentile is above p99 for both sexes. The prevalence of pre-obesity and obesity in children and adolescents has been rising alarmingly worldwide, especially in developed countries and some segments of developing countries. Studies indicate that obesity in children and adolescents is strongly associated with increased morbidity and mortality resulting in a variety of pathological situations with risk of persistence in adulthood. Given its major Public Health importance, pre-obesity and obesity trends in children and adolescents should be monitored with special attention. Eating habits and energy expenditure are factors that influence obesity and its control. Some studies conclude that there is a direct association between these factors and the presence of obesity and others present opposite conclusions. It was intended to determine the prevalence of overweight (pre-obesity and obesity) in children and youth in Portugal and to associate it with eating habits, physical activity and sedentary behaviors of adolescents. The population in study is constituted by all adolescents of both sexes that attend basic (2nd and 3rd grade) and secondary official education of continental Portugal (n=5708). All participants in study were anthropometrically evaluated (weight and height) and answered a questionnaire of eating habits and food frequency, physical activity and sedentary behaviors. The study results indicate a prevalence of pre-obesity in children and youth in Portugal of 22.6% and a prevalence of obesity of 7.8%. Both obesity and pre-obesity present higher indicators in boys (p=0.01) and younger adolescents (p=0.00). In relation to the studied eating habits it should be noted that the frequency of consumption of meals away from home is very similar between the normal weight group and the overweight group. Moreover, the supper meal is consumed by a much larger number of normal weight adolescents as compared to the ones with overweight (p=0.01). Regarding the intake of certain foods or food groups, it was found that, in general, the consumption of foods with characteristics of low nutritional quality (saturated fat, salt and simple sugars) was higher in the normoponderal group compared with the overweight group (soft drinks, snacks, fast-food, sugary cereals, desserts) (p<0.05). In respect to physical activity, the number of weekly hours of physical activity decreases from the normoponderal group to the group with overweight. Within the group with overweight, obese subjects also present a lower average than pre-obese subjects. As we can affirm that the higher the physical activity index the lower the BMI percentile, physical activity appears as a protective factor for a healthy weight (p<0.05). When they were asked to characterize their lifestyle and sports ability, it was found that overweight groups characterized themselves with lower indicators than the normoponderal group (p<0.05). Regarding sedentary behaviors, it appears that they were more prevalent in groups with overweight than in the normoponderal group (p<0.05). In conclusion, the results of the obesity prevalence attained are similar to the results obtained in other studies, revealing a very worrying situation in terms of Public Health. In relation to the eating habits there were no significant differences between the groups (normoponderal, pre-obesity and obesity). Physical activity appears as a protective factor from weight gain with a direct association with nutritional status (BMI). It was found that young people in Portugal who had the highest indicators of physical activity were those who presented normal weight. The sedentary behaviors were presented as a factor conducive to the development of overweight being directly related to the BMI percentile. The most frequent sedentary behaviors were television viewing and computer/internet

Modelo institucionalizado de tratamiento de la asociabilidad infanto-juvenil.

Fomentar el trabajo en el equipo de los centros favoreciendo un enfoque multidisciplinar. Conocer y comprender el desarrollo evolutivo de los ni��os y adolescentes llamados inadaptados. Concienciar a profesores, directores de colegio, y en general, a todos los que trabajan en centros docentes que estos ni��os son como todos, pero a la vez distintos, por lo que necesitan un apoyo especial. Ense��ar el verdadero sentido de la Integraci��n Social y Escolar. Mostrar y hacer comprender la necesidad de apoyo escolar que necesitan estos ni��os y j��venes fuera de su horario escolar. Fomentar la motivaci��n hacia el estudio y hacia las tareas escolares de los menores. Cuarenta y ocho menores del Centro de Protecci��n de Menores de la Rioja 'Residencia Iregua', con edades comprendidas entre los 4 y 18 a��os. Hip��tesis: los sujetos inadaptados residentes en una Instituci��n padecen fracaso escolar de forma generalizada, en funci��n de las variables socio-familiares que rodean la vida de estos sujetos. Informe formalizado de cada ni��o en base a su historial escolar y socio-familiar. Test de inteligencia Wechsler, Wais, Wisc y Gipsy. Test autoevaluativo Multifactorial de adaptaci��n Infantil de Pedro Hern��ndez. An��lisis comparativo de Inteligencia-adaptaci��n. Analizada la muestra se ha comprobado la hip��tesis inicial del trabajo: el fracaso escolar es una caracter��stica generalizada en todos ellos, no depende del nivel de inteligencia, sino de variables socio-familiares que rodean la vida de estos sujetos. Se observa en las siete octavas partes de la muestra que presentan una inteligencia por encima de lo normal, a pesar de no triunfar en sus estudios; estos ni��os est��n capacitados para triunfar en sus estudios y tener ��xito a nivel escolar, sin embargo se observa en la mayor��a d��ficits en sus aprendizajes b��sicos. Los menores estudiados no han encontrado en sus primeros a��os escolares apoyos, ya que o bien viv��an en sus casa y nadie se preocupaba por llevarlos al colegio, o bien viv��an en instituciones cerradas, cuyo fin primordial era 'recoger' a ni��os abandonados y apenas ten��an fines educativos o pedag��gicos. Las caracter��sticas socio-familiares de estos menores, con un nivel socio-cultural muy bajo y gran problem��tica familiar, es la presencia de graves carencias socio-econ��micas y afectivas, siendo la principal causa de esta institucionalizaci��n, que ha influido negativamente en su actual forma de vida. Estos alumnos deber��an recibir apoyos extraescolares para conseguir los logros acad��micos de la educaci��n. La conclusi��n que nos permite afirmar la investigaci��n realizada permite llegar a una conclusi��n: la familia ejerce una influencia negativa en el desarrollo del ni��o. Los menores que han abandonado el seno familiar y residen en una instituci��n, en algunos casos siguen manteniendo las relaciones con su familia, aunque de fin de semana. Se sienten marginados frente a otros ni��os y forman parte del grupo social de los inadaptados. Los sujetos inadaptados residentes en una instituci��n padecen fracaso escolar de forma generalizada, en funci��n de las variables socio-familiares que rodean la vida de estos sujetos. El fracaso escolar no es consecuencia del tipo de inteligencia sino de factores socio-familiares. La investigaci��n permite extraer las siguientes conclusiones: 1.- Son ni��os y j��venes que han afianzado mal sus aprendizajes b��sicos. 2.- La escolaridad de estos menores ha sido deficiente y precaria. 3.- En su aprendizaje destaca la falta de inter��s y motivaci��n. 4.- Sus a��os de insititucionalizaci��n han influido negativamente en su rendimiento escolar. 5.- Su problem��tica familiar les ha llevado a padecer inestabilidad emocional y a tener problemas de conducta. 6.- Su desarrollo cognoscitivo, social y emocional no es adecuado a causa de las condiciones familiares en las que ha tenido lugar la socializaci��n. 7.- El tipo de educaci��n recibido de sus padres est�� basado en la restricci��n, no en la personalizaci��n. 8.- El bajo nivel socio-econ��mico y cultural influye negativamente en el desarrollo integral del menor. 9.- La familia, es el pilar fundamental del desarrollo del ni��o. 10.- Los sujetos inadaptados residentes en una instituci��n padecen fracaso escolar de forma generalizada, en funci��n de las variables socio-familiares que rodean la vida de estos sujetos.

Estudio de la inadaptaci��n infanto-juvenil : estudio descriptivo de la inadaptaci��n social infanto juvenil en la Regi��n de Murcia : factores de riesgo y factores pron��sticos.

Estudio descriptivo que intenta llegar a definir y categorizar los factores de riesgo y los factores pron��sticos que caracterizan a la infancia y juventud inadaptadas en la regi��n de Murcia. 189 sujetos entre los 11 y los 18 a��os (110 varones y 79 mujeres) procedentes de instituciones dependientes de la Consejer��a de Bienestar Social de la Comunidad Aut��noma, con expedientes de protecci��n y-o tutela en el momento de comenzar el estudio (total de individuos), adem��s de procedentes de otros centros, colegios, hogares funcionales, etc., dependientes de otras administraciones. El estudio se estructur�� en dos partes. La primera consta de una exploraci��n psicol��gica mediante entrevista, la segunda de un cuestionario psicobiogr��fico de elaboraci��n propia que consta de 307 ��tems en el que se recogen los datos de escolarizaci��n, conflictividad familiar, empleo del ocio, consumo de drogas (institucionalizadas y no), historia cl��nica, sexualidad, antecedentes de conductas asociales, antecedentes sociobiogr��ficos y familiares. Los resultados del estudio reflejan los datos globales ordenados seg��n el sexo de los sujetos entrevistados y, algunos de ellos, seg��n el centro del que proced��a el entrevistado. Adem��s del cuestionario psicobiogr��fico, los rasgos de personalidad se analizaron con los siguientes instrumentos: EPI (Eysenck Personality Questionnaire, EPQ. Seisdedos, 1982), STAI (State Trait Anxiety Inventory-SelfEvaluation Questionnaire-, Spielberg y cols. Berm��dez, 1978). Test de factor g (Culture Fair Intelligence Test, Cattell y Cattell. Ey y cols., 1975). Manual Diagn��stico y Estad��stico de los Transtornos Mentales (DSMIII), de la American Psychiatric Association APA, 1987. Subtest de figuras incompletas de l��a Wechsler Intelligence Scale for Children (WISC) y el Matching Familiar Figures Test (MFFT, Kupietz y Richardson, 1978. Raport y cols., 1980). Prueba de atenci��n-percepci��n de Toulouse-Pi��ron. Test del Laberinto en Espiral de Gibson (test psicomotor que mide la velocidad y precisi��n de la expresi��n muscular en respuesta a un est��mulo controlado). Todos estos instrumentos miden los siguientes rasgos de personalidad: extroversi��n/introversi��n; neuroticismo/estabilidad; temperamento (Galeno, Kant,Wundt);ansiedad; inteligencia; hiperactividad; atenci��n; impulsividad/reflexividad. El an��lisis de los datos obtenidos se realiza con el paquete estad��stico BMDP y el proceso estad��stico se compone de: an��lisis univariante, bivariante , multivariante y discriminante. Los sujetos estudiados muestran elevados niveles de neuroticismo, baja atenci��n, altos niveles de impulsividad, bajas puntuaciones en la variable CI. Prevalencia alta de ansiedad, seg��n el an��lisis global del total de la muestra. Son numerosos los trabajos que relacionan la inadapataci��n juvenil con un d��ficit de inteligencia, esto puede deberse a que las dificultades de desarrollo y maduraci��n determinan unos niveles de inteligencia inferiores a los que se hubiesen alcanzado siendo el medio m��s favorable. Existen muchas referencias que reflejan c��mo la ansiedad es un fen��meno relativamente constante en la institucionalizaci��n de los delincuentes juveniles.

Morfologia, performance e fatores contextuais do nadador salvador infanto-juvenil madeirense

O objetivo central do presente estudo foi triplo: (1) reunir a bibliografia existente sobre o nadador infanto-juvenil; (2) avaliar a estrutura, a composi����o corporal e a aptid��o f��sica geral e espec��fica do nadador infanto-juvenil madeirense e (3) investigar as rela����es entre o crescimento f��sico humano, a aptid��o f��sica e as vari��veis contextuais. A amostra incluiu 97 nadadores, 46 do sexo masculino e 51 do sexo feminino, 11-16 anos, que integravam 4 clubes de Nata����o Pura Desportiva da Regi��o Aut��noma da Madeira. A altura, o peso corporal, a envergadura, os di��metros ��sseos, os comprimentos e larguras, os per��metros musculares e as pregas de adiposidade subcut��nea foram medidos. A aptid��o f��sica geral e espec��fica, a atividade f��sica, o estatuto socioecon��mico (ESE) e a pr��tica desportiva foram quantificados. O teste t, o teste de Mann-Whitney U, o teste para a diferen��a entre duas propor����es independentes e a an��lise de regress��o m��ltipla foram utilizados na an��lise estat��stica dos dados. Os nadadores apresentaram valores m��dios mais elevados do que as nadadoras na altura, peso corporal, envergadura, comprimento e/ou largura dos segmentos e na quase totalidade dos di��metros ��sseos e per��metros musculares. As nadadoras apresentaram valores m��dios mais elevados do que os nadadores nas pregas de adiposidade subcut��nea. Os nadadores apresentaram mais massa isenta de gordura do que as nadadoras. O tipo f��sico do nadador foi mesomorfo equilibrado (3,2-4,6-3,1) e o da nadadora endo-mesomorfo (4,3-3,5-2,9). Os nadadores apresentaram desempenhos mais elevados na quase totalidade dos testes motores. As nadadoras foram mais proficientes no ���sit and reach���. As nadadoras, 14-16 anos, apresentaram valores m��dios mais elevados no peso corporal, envergadura, di��metro biacromial, percentagem de gordura, batimento em placas, ���sit ups���, anos de pr��tica formal e total de horas de treino semanal, comparativamente aos 11-13 anos. As nadadoras foram, tamb��m, mais altas e pesadas, aos 11-13 anos, do que as n��o-atletas. A idade, o r��cio envergadura/altura, a percentagem de gordura corporal, o ���sit and reach���, o salto em comprimento sem corrida preparat��ria, os ���sit ups���, o ���shuttle run���, a corrida de 12 minutos, o ��ndice dos tempos livres e o total de competi����es nacionais por ��poca desportiva explicaram 75,9% da vari��ncia no teste de nado de 12 minutos. Os resultados demonstraram um diferencial morfofuncional em fun����o do sexo, idade e popula����o de estudo. Os preditores do teste de nado de 12 minutos foram os indicadores de crescimento f��sico humano, a aptid��o f��sica e as vari��veis contextuais.

A palavra cantada nos espa��os intersubjetivos de um centro de atenção psisossocial do munic��pio do Natal/RN

The psychiatric care and mental health are undergoing constant change over the History. The Brazilian Psychiatric Reform, which brings up the deinstitutionalization as a structuring in the restorative care process. The Reform has as one of the mainly substitutive services the Centers for Psychosocial Care (CAPS), which work from the Singular Therapeutic Project (PTS) in order to restore the autonomy and restore the dignity of users. The therapeutic workshop is some of the resources used and work several kinds of activities as: writing, handcraft, music, poetry, and so forth. This study set up to apprehend the social representations of helping of the music workshop carried out in the CAPS II east of Natal/RN, from the reports given by the participants of the workshop, using the focal group as technique. This is a descriptive exploratory study with a qualitative approach. A total of 16 users participated in four musical therapeutic workshops from April to May 2010. The study was approved by the Ethics and Research Committee of UFRN. The discursive material from the workshop was submitted to the informational resource of Analyse Lexicale par Contexte d um Ensemble de Segments de Texte, ALCESTE, and analyzed based on the Theory of Representations and the Central Core Theory. The majority of subjects were men (62.5%), single (62.5%), aged 40-49 years (37.6%) and elementary school level (56.2 %). The reports were transcribed and submitted to the classification system of ALCESTE, which elected the following categories: Category 1 - Experience in the Word Family Sung, Category 2 - Musical Experiences and Approaches, and Category 3 - Feelings and emotions evoked by music. The representation of these individuals is anchored in the experience they have with the CAPS, lived and socialized by common sense, through this particular social group workshop objectified in music therapy as a therapeutic modality enjoyable. The central core revealed the intrinsic relationship between users and the music, establishing a relationship of openness to use the same while its therapeutic use in workshops of substitute services for mental health. Peripherals elements issues are related to listen, share and experience music in the family. Intermediary Elements relate to the feelings and emotions evoked by music, given her close relationship with it. It was found in the study that music can be construed as an artifact of good therapeutic responsiveness to users, configuring it as an invigorating and enjoyable therapy, confirming the need for continuity of this activity, as well as its expansion into the service

Sa��de mental infanto-juvenil: uma reflex��o sobre pol��ticas p��blicas a partir do dispositivo intercessor como meio de produ����o de conhecimento na pr��xis

Coordena����o de Aperfei��oamento de Pessoal de N��vel Superior (CAPES)

Trabalho infanto-juvenil: as representa����es da pedagogia do trabalho

P��s-gradua����o em Psicologia - FCLAS

Territ��rios e sentidos: espa��o, cultura, subjetividade e cuidado na atenção psicossocial

In the light of the collective health and of the mental health, the concept of territory is present in multiple dimensions and meanings. It appears in documents that express principles and guidelines of the health policies and in the planning of local actions, and it is a central element to organize the care network in psychosocial attentiveness. This present essay aims to discuss the concept of territory and its uses in the practices of psychosocial care, developing a dialogue with the geographer Milton Santos and the philosophers Gilles Deleuze and F��lix Guattari who, from different fields and perspectives, work with this concept. This dialogue made it possible to think the territory in its complexity, as space, process and composition, in order to optimize the relationship between service, culture, production of care and production of subjectivity.

Constru����o e evid��ncias de valida����o de instrumentos de pesquisa para avalia����o da assist��ncia nos centros de atenção psicossocial

Coordena����o de Aperfei��oamento de Pessoal de N��vel Superior - CAPES

Avalia����o da estrutura e processo de trabalho dos centros de atenção psicossocial

Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program ���Validate Epi Info 3.5.4��� , used along with the ���SPSS 17.0��� for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; ���Fisher's��� exact test to check the CAPS impact on hospital admissions and the ���Bonferroni��� adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.

Atua����o dos profissionais no atendimento ��s fam��lias nos centros de atenção psicossocial

This study aimed to evaluate the work of professionals to care for families in Psychosocial Care Centers ( C APS) of Rio Grande do Norte ( RN), from the roles and functions performed by these professional services. For this, it was pointed out the following objectives: To describe the profile and the activities conducted by mental health teams in the RN CAPS ; Know the opinion of professionals in the mental health teams of the poli ti c , practices and training in mental health; Check the suitability of the roles and functions of professionals working in the RN CAPS in relation to care for families . This is an analytic al cross - sectional study of quantitative and qualitative approach . Data were c ollected through a questionnaire in 33 CAPS RN, between March and October 2014 , after being approved by the Research Ethics Committee / UFRN , opinion n��217.808 , CAAE : 10650612.8. 1001.5537 , on March 1 2013. T he sample was adopted , defined by inclusion and exclusion criteria , and is composed of 183 professionals. The database preparation followed two steps: 1. Preparation and processing of data of closed questions of the questionnai re concerning the characterization and practices in mental health research subjects through informational resource Statistical Package for Social Scienses (SPSS) Statistics version 20.0 ; 2. To check the significance level was chosen by applying the chi - squ are test. Preparation and treatment of the corpus formed by the answers to open questions relating to the policies, practices and training in psychiatry through Analyse lexicale pair Contexte software d' un Ensemble of Segments of Texte ( ALCESTE) together a nd categorized by content analysis technique , Bardin (2004) . The data analysis is supported in the literature . It m ade explicit the results through three articles waxing the following results. In the first, participants profile was characterized by a predo minance of females (76.5 %), aged 40 - 58 years ( 61.7 %). They work between 30 and 40 hours per week (63.5 %), working in mental health for over 10 years ( 98.4%). The sample directs the care of family groups ( 65.7%), predominantly the care team of social worke rs, nurses, psychologists and occupational therapists . The doctor performs emergency care without interaction with the staff (48.6%) . On the difficulties encountered in services are ranked in : materials and supplies ( 75.1%), financial ( 78.5%) and structura l ( 66.9%). The second article contains qualitative data organized into five categories : Promoting the rehabilitation of users of CAPS ; Needs training ; Conflicts and satisfactions of teamwork ; Practices developed in CAPS ; Effective difficulties of Mental He alth Policy . The third article highlights the inadequacy of care for families ( 93.4%) and comparing the care families and groups in CAPS both types show to be inadequate : family ( 92.63%), groups ( 92, 60%). The main data obtained reveal the urgent need for transformation in psychosocial care . It shows also the importance of investments in inputs, physical structure and training of human resources for the CAPS.

A atenção �� crise e o apoio matricial: analisadores da estrat��gia atenção psicossocial

The National Policy on Mental Health is characterized as a territorial - political community , and it has the Psychoso cial Care Strategy (Eaps) as guideline for the proposal and the development of their actions. In its design, CAPS is idealized to be a strategic equipment within the Psychoso cial Care Network/RAPS. Matricial support and at tention to the crisis constitute strategic areas of action of CAPS in its replacement mission , and as it is g uided by the scope of deinstitutionalization, those are essential to the success of these services. We argue that sustain crises in existential territories of life is a condition for the effectiveness of psychosocial care and, ultimately, to the sustainability of its Reform. In this direction, the matricial support tool reveals a territorial supporter, intercessory and powerful in building a psychosocial care to the crisis. Recognized as one of the major challenges by the Brazilian Ministry of Health, forward these fronts materializes for workers in their mi cropolitical crafts. Our research arises as an investment toward empower them , and aimed to understand the operationalization of attention to the crisis and matricial support in a CAPS II, in the view of its workers . Besides, it aims to examine such practi ces forward the principles and purposes of Psychosocial Care Strategy. Inspired by the research - intervention and by the political and social ideas of Institutiona l Analysis, we offer a space for reflection and exchange, by implicational interviews , enablin g workers to launch them in analysis of practices in the EAPs view. We have done a documentary consulting CAPS Technical Project, and a return stage to the institution, by organizing workshop and conversation groups with CAPS workers. The results have show n that there are institutional logics in competition on that service. When operating the logic risk, some difficulties in sustaining most intense crisis situations were identified, the psychiatric hospital internment is used as a facility, particularly in view of some cases, in which the aggressiveness of the person in crises becomes aggressive, and when the brackets SAMU, the CAPS III and Comprehensive Care Beds do not respond satisfactorily to their users requests. Order weaknesses were indicated in this thesis as macropolitical and micropolitical interfering in network support. The matricial actions were identified as a powerful intercessor resource in crisis care appeared weakened, and indicates little porosity in the relationship between the Service and the territory where it takes place. Noticed by the logic of home care, without operate primarily as a knowledge exchange device, we saw capture points in the logic of assistance with ambulatoriza tion production of CAPS, welfare practices and "ext empore " . T he E APs , although it emerge s as a guiding, it is not seen to workers as effective practice. On the one hand, the results signaled that the attention to the crisis and the matricial actions are developed without tenacious connection with the purposes of EA Ps, on the other hand, successful cases were indicated with the main leads to conducting wire of intersectoral actions to the powerful bonds and to the participation of user in their care process es , indicating insurgent forces tha t intend by traditional lo gic .

Situa����es de Viol��ncia: Viol��ncia infanto-juvenil [hist��ria em quadrinhos e not��cia de jornal fict��cias]

Introdu����o �� Situa����es de Viol��ncia infanto-juvenil, atrav��s do estudo do hist��rico, conceitos, atributos e modelos nacionais e internacionais.

Viol��ncia Infanto-Juvenil

Aula em Power point narrada na qual s��o elucidadas as situa����es de viol��ncia infanto-juvenis