Familiares de portadores de transtorno mental: vivenciando o cuidado em um centro de atenção psicossocial

Esta investigação teve por objetivo apreender como os familiares de portadores de transtorno mental têm convivido com um serviço de saúde mental. Foi utilizado o método exploratório/descritivo, de natureza qualitativa. Como instrumento de coleta de dados, utilizou-se uma entrevista semiestruturada, sendo sujeitos dessa pesquisa seis familiares que já conviviam há mais de três anos com o adoecimento psíquico. A análise dos dados permitiu inferir que os familiares que acompanham o usuário têm de lidar com um aprendizado que adquiriram na vivência cotidiana e são sujeitos à rejeição de membros da família e da comunidade; com relação ao centro de atenção psicossocial, os familiares se sentem acolhidos em suas queixas, recebendo um atendimento singular; porém, desconhecem os mecanismos para a sua participação social, o que aponta para uma deficiência do serviço, à medida que este deve estimular formas de inserção na comunidade, e da ampliação dos direitos de cidadania dos usuários.

O papel da solidariedade desempenhado por familiares visitantes e acompanhantes de adultos e idosos hospitalizados

Este estudo objetivou compreender o papel da solidariedade desempenhado por familiares visitantes e acompanhantes de adultos e idosos internados. Utilizou-se como referencial teórico a teoria de enfermagem como cuidado solidário e como referencial metodológico a Grounded Theory. Foram entrevistados nove familiares de adultos e idosos hospitalizados no período de abril a setembro de 2002. Dos resultados identificou-se o fenômeno: assumindo o papel de familiar visitante ou de familiar acompanhante, que congrega os temas: querendo desempenhar um papel solidário e compreendendo o estar junto como uma interdependência emocional. Acredita-se que quando a enfermeira reconhece a singularidade da relação de solidariedade e de interdependência familiar, também exerce seu trabalho pautado na solidariedade, visto que colabora para o restabelecimento do doente, alivia seu sofrimento e de seus familiares e, portanto, promove a saúde do grupo familiar.

Mapa dos programas sociais: transferência de renda e dinâmicas sociais no Rio Grande do Norte (2000-2007)

The question of evaluating the fight against poverty in a given society is very complex task, considering the range of factors that permeate, such as education, culture and economy itself. Come hence the relevance of the theme and its constant presence in discussions on the fruits of public policies, institutional structure and economic development which are the guiding elements of this work, and noted that seeks to highlight the social demographics and most important, the most significant trends and issues pertaining to her. The assessment was initially made in all the municipalities of Rio Grande do Norte doing a verticalilzação to the municipalities Caicó, Pau dos Ferros, Ipueira and Taboleiro Grande. Highlighting the role of a social policy through government programs, such as the Bolsa Familia Program (PBF), which creates the possibility of changes in the socio demographic profile given the importance that the action of this public policy has in shaping the regional economic reality As well as social programs and actions of the government here reported that generate mobility of people and new social demands, such as rural retirements, the benefit of continuing provision (BPC), the Program for the Eradication of Child Labor (PETI) that put on the market of population living on the margins of various forms of consumption. Accordingly, the socio economic profile of the state shows a significant improvement in their social indicators, vital education and redistribution of income, due to the significant improvement in life expectancy in the fall of school drop-out rate and the drop in indicators of Proportion Poor and destitute of the state. Where the fall in the proportion of poor and indigent is strongly associated with an increase in income, from social programs. With this transfer and redistribution of income can be gauged that occurs a strengthening of local economies and an engagement of families with the conditionalities of social programs and PETI Bolsa Familia. Our research concludes that simply raising the rents caused by transfers, presents relevant impacts on the education of young people in beneficiary families. There is no doubt that the programs of transfer income, no facing the social field, representing a mechanism to decrease the most perverse ills of poverty, social and economic inequality that is hungry. For a significant portion of the Brazilian population living below the poverty line, programs for the transfer of income are expressed directly in improving the material conditions of life and indirectly in improving self-esteem of women and all family members receiving encouraging yet the integration family. Experiments have shown that improvements in health and nutrition can be obtained through the implementation of adequate social policies like the programs of transfer income, while social inclusion and economic does not become full

Caring for organ donors: the intensive care unit physicians' view

This study examined the meanings that the intensive care unit (ICU) physicians attribute to their practice when caring for brain-dead organ donors. It is a phenomenological study, a qualitative method that searches for describing and understanding the experiences lived. Data were collected through recorded individual interviews made with 10 ICU physicians who work in a university hospital in the interior of São Paulo, Brazil. Three categories emerged from data: (1) providing care for brain-dead organ donors; (2) relating to donors and their families; and (3) the ethical concerns and self-awareness of the physicians. There is consensus as to-many aspects: demand of technical qualification and excellence in practice; need of investing in technology of organ transplant; and donors seen as human beings and holders of human rights. Participants understand that family participation is decisive in the donation process, although interactions between the family members and the physicians are difficult because of the sensitive nature of the situation. The physicians often felt ill-prepared to openly discuss the topic of brain death and organ donation. Educational programs for physicians and family members may assist with this difficult process.

Qualidade de vida no transtorno obsessivo-compulsivo: uma revisão

CONTEXTO: O transtorno obsessivo-compulsivo (TOC) foi considerado pela Organização Mundial da Saúde como a 10ª causa de anos vividos com incapacidade, mas pesquisas sobre qualidade de vida (QV) nesse transtorno ainda são relativamente raras. OBJETIVOS: O objetivo deste trabalho foi fazer uma revisão convencional da literatura a respeito de estudos sobre qualidade de vida no TOC, publicados em português e inglês. MÉTODOS: A busca de artigos foi feita pelos sistemas MEDLINE, PsicoInfo e LILACS, cobrindo o período de 1980 a 2007, utilizando-se como palavras-chave: qualidade de vida, transtorno obsessivo-compulsivo, prejuízo funcional e incapacidade. RESULTADOS: Estudos populacionais apresentam indicadores indiretos de comprometimento na QV em pessoas com TOC, como mais desemprego, menor renda e menor índice de união conjugal estável, além de taxas relativamente altas de ideação e tentativas de suicídio. Estudos clínicos encontraram mais comprometimento na QV no TOC em comparação com algumas doenças clínicas crônicas, outros transtornos de ansiedade, quadros depressivos e mesmo esquizofrenia, em alguns aspectos. CONCLUSÃO: O impacto negativo do TOC sobre a QV de seus portadores pode ser grande, afetando vários domínios da vida e repercutindo também nos familiares. A reabilitação psicossocial deve ser vista como parte integrante essencial do tratamento e é preciso aumentar a conscientização da população sobre o problema, assim como o acesso a tratamentos adequados, para minimizar tal impacto, por vezes devastador.

Perfil epidemiológico da violência física intrafamiliar: agressões denunciadas em um município do Estado de São Paulo, Brasil, entre 2001 e 2005

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Oral health education in schools: promoting health agents

Purpose: The aim of this study was to verify the influence of preschool children participating in an oral health education programme on daily health practices of their families, through parent's perception. Methods: A sample of 119 parents of 5- to 6-year-old preschool children were selected. Data were collected using a structured open-closed questionnaire, self-administered. The questions focused on parents' knowledge about activities of oral health education conducted in school, the importance given by them to these activities, learning from their offspring and the presence of habit change at home. Results: In total, 63 (52.9%) parents agreed to participate. Ninety-eight per cent knew about educative and preventive activities developed at school and all of them affirmed that these activities were important, mainly because of knowledge, motivation and improvement in children's health. Ninety and half per cent of parents reported that they learned something about oral health from their children and, among these, almost half (47.8%) cited toothbrushing as the indicator for better learning. Besides this, 87.3% of participants revealed the change in oral health habits of their family members. Conclusion: Preschool children were able to transmit knowledge acquired at school to their parents that included change in oral health routine of their family members.

Caracterização estrutural do fator de crescimento de fibroblasto-10 (FGF-10) e seu papel na fisiologia folicular ovariana

Background: Interest in folliculogenesis has grown extensively in recent years. Nevertheless, several aspects of follicular activity are still poorly understood. Thus, in vitro culture of ovarian follicles using new substances has been established as a very viable model, enhancing the prospects for a better understanding of follicular activity. Among the family members of the fibroblast growth factor (FGFs), FGF-10 has received recent attention for its ability to regulate the development of ovarian follicles and oocyte maturation. Given the relevance of FGF-10 in the folliculogenesis process, this review aimed to describe the structural features, expression and the main biological effects of FGF-10 on the development of ovarian follicles in mammals.Review: Along this work, it was shown aspects related to structural characterization of FGF-10 and its receptors, as well as FGF-10 expression in different cell types, emphasizing its importance to follicular development. FGF-10 is a paracrine member of the family of FGFs, and is characterized by promoting biological responses via cell surface receptors (FGFRs) of tyrosine kinase-type. of these receptors, FGFR-1, FGFR-2 and FGFR-3 may undergo alternative transcriptional arrangements, enabling the formation of two isoforms (b and c) that have varying degrees of affinity for the various FGFs. Thus, seven FGFR proteins (FGFRs 1b, 1c, 2b, 2c, 3b, 3c and 4) with different binding specificities are generated from the four FGFR genes. The FGFRs transmit intracellular signals after binding with the ligand through the phosphorylation of tyrosine, which activates various transduction patterns in the cytoplasm. The signal transduction of FGF-10 may occur through three main pathways: protein of rat sarcoma (Ras)/MAPK, PLC gamma/Ca(2+) and phosphatidylinositol-3 kinase (PI3K)/protein kinase B (Akt), which are involved in the transmission of biological signals, leading to cellular proliferation and differentiation. FGF-10 mRNA expression was detected in the ovarian stroma, oocyte and theca cells of preantral and antral follicles. on the other hand, the expression of mRNA for FGF-10 receptors was found in, granulosa cells, theca cells, cumulus cells and oocytes. Although FGFs are widely distributed in different tissues and cell types, the importance and function of FGFs in the ovary are still poorly documented. FGF-10 has been shown to be an important mediator of mesenchymal and epithelial cell interactions during follicle development, promoting follicular survival, activation and growth. Besides the action on folliculogenesis, FGF-10 was recently identified as a growth factor able to improve oocyte competence. However, in antral follicles, the presence of FGF-10 is associated with increased follicular atresia, which matches its anti-estrogenic action.Discussion: From this review, we can conclude that FGF-10 is an important regulator of female reproduction. This growth factor acts in follicle survival, oocyte maturation, expansion of cumulus cells and proliferation of granulosa/theca cellsthrough direct and/or indirect actions in the control of folliculogenesis. Furthermore, FGF-10 seemed to have different effects throughout the follicular development. However, it is necessary to perform additional studies that may provide a better understanding about the importance of FGF-10 during folicullogenesis.

Diagnóstico de hemoglobinopatias em recém-nascidos do Hospital de Base de São José do Rio Preto-SP

The neonatal period is considered the most effective for the screening of hemoglobinopathies. This allows prophylaxis and prevention, improving the patient's survival and guidance of parents and heterozygote carriers. The present work aims at the early detection of abnormal hemoglobins, the establishment of standard analysis and to examine the viability of the prevention program. Blood samples were collected by heel stick and from blood cord of children born in the Hospital de Base São José do Rio Preto, from April 1998 to November 1999. Electrophoresis and cytological, biochemical, cromatographic analyses were made for abnormal hemoglobin characterization. A total of 1,478 neonatal blood samples were analyzed in which 14.62% presented with hemoglobins alterations: 3.32% had Hb S; 0.61% had Hb C; 7.44% were suggestive of alpha thalassemia; 1.55% were suggestive of beta thalassemia, and 1.70% had alpha/beta thalassemia interactions. The samples collected from the blood cord showed better results in all analyses while the blood samples collected by heel stick on filter paper, were applicable to only specific methodologies. The routine laboratory methods allowed identification of the thalassemic and variant forms, and isoelectric focusing presented sensitivity only for variant identification in this age range. The suspected cases were reassessed after six months, which permitted genetic counseling of their family members and clinic attendance. A multidisciplinary approach in programs of this kind is fundamental for its success.

Rastreamento familiar do fator V de Leiden: a importância da detecção de portadores heterozigotos

O fator de Leiden é uma mutação genética que predispõe seus portadores ao tromboembolismo venoso. O objetivo do estudo foi investigar a distribuição dos alelos em 21 membros da família de três pacientes portadores de trombose com a presença da mutação do fator V de Leiden. A detecção da mutação no gene do fator V foi realizada entre portadores da mutação no estado heterozigoto. Este estudo foi realizado no Centro de Hematologia e Hemoterapia do Ceará - Hemoce. Observou-se a presença da mutação no estado heterozigoto na família 1 (83,3%), na família 2 (40%) e na família 3 (50%). No total de 24 membros (pacientes e familiares) analisados, 50% (12/24) apresentaram a mutação, todos no estado heterozigoto, 66,7% (8/12) não apresentaram trombose. A detecção do fator V de Leiden em pacientes portadores de eventos trombóticos é recomendado para esclarecimento das causas e para efetuar o rastreamento em membros de sua família, ainda sem o aparecimento de eventos trombóticos, de forma a avaliar os riscos associados e assim determinar um acompanhamento médico preventivo.

GNN is a self-glucosylating protein involved in the initiation step of glycogen biosynthesis in Neurospora crassa

The initiation of glycogen synthesis requires the protein glycogenin, which incorporates glucose residues through a self-glucosylation reaction, and then acts as substrate for chain elongation by glycogen synthase and branching enzyme. Numerous sequences of glycogenin-like proteins are available in the databases but the enzymes from mammalian skeletal muscle and from Saccharomyces cerevisiae are the best characterized. We report the isolation of a cDNA from the fungus Neurospora crassa, which encodes a protein, GNN, which has properties characteristic of glycogenin. The protein is one of the largest glycogenins but shares several conserved domains common to other family members. Recombinant GNN produced in Escherichia coli was able to incorporate glucose in a self-glucosylation reaction, to trans-glucosylate exogenous substrates, and to act as substrate for chain elongation by glycogen synthase. Recombinant protein was sensitive to C-terminal proteolysis, leading to stable species of around 31 kDa, which maintained all functional properties. The role of GNN as an initiator of glycogen metabolism was confirmed by its ability to complement the glycogen deficiency of a S. cerevisiae strain (glg1 glg2) lacking glycogenin and unable to accumulate glycogen. Disruption of the gnn gene of N. crassa by repeat induced point mutation (RIP) resulted in a strain that was unable to synthesize glycogen, even though the glycogen synthase activity was unchanged. Northern blot analysis showed that the gnn gene was induced during vegetative growth and was repressed upon carbon starvation. (C) 2004 Elsevier B.V. All rights reserved.

Penfigo foliaceo no Hospital das Clinicas da Faculdade de Medicina de Botucatu, SP

BACKGROUND - Pemphigus foliaceus is an autoimmune bullous disease that is endemic in Brazil and in other South American countries such as Paraguay, Bolivia, Peru and Colombia. OBJECTIVES - To compare the observed clinical and epidemiological data with those referred in the literature. METHOD - Retrospective study in patients with pemphigus foliaceus admitted to and treated at University Hospital of the School of Medicine of Botucatu, SP, Brazil, from 1976 to 1993, analyzing the following variables: age, sex, race, origin and onset of disease. RESULTS - From 1976 to 1993, 63 patients were treated, with an average of 3.7 cases/year. Patients within the age range of 20 to 60 years old were the most affected. Most of the patients were white, females being slightly more affected than males. The majority of male patients were rural workers. Some towns presented higher incidence of cases. Most of the patients from rural areas became sick mainly in summer and in autumn. Occurrence of similar cases was observed in blood-related family members and neighbors. CONCLUSIONS - Clinical and epidemiological data were similar to those referred in the literature.

A família do portador de sofrimento psíquico e os serviços de saúde mental: Estudo de caso

This qualitative research, case study type, aimed at presenting the understanding of psychic sufferers in search for mental health services during emergency situation, partial hospitalization or in ambulatory services. 12 family members were interviewed. They reported difficulties in the attendance in the emergency room when the patient is in crisis, as well as doctors considering merely the present symptomatology and undervaluing their own knowledge of the sickening process. The day-care hospital is conceived as a place to provide care, occupation and should teach as a school. The ambulatory service represents for the family the possibility of the patient being responsible for their attendance to the consultations and for the correct use of the medication.

Care arrangements for people with dementia in developing countries

Background: Rapid demographic ageing will soon lead to large increases in the numbers of persons with dementia in developing countries. This study is the first comprehensive assessment of care arrangements for people with dementia in those regions. Methods: A descriptive and comparative study of dementia care; caregiver characteristics, the nature of care provided, and the practical, psychological (Zarit Burden Interview, General Health Questionnaire) and economic impact upon the caregiver in 24 centres in India, China and South East Asia, Latin America and the Caribbean and Africa. Results: We interviewed 706 persons with dementia, and their caregivers. Most caregivers were women, living with the person with dementia in extended family households. One-quarter to one-half of households included a child. Larger households were associated with lower caregiver strain, where the caregiver was co-resident. However, despite the traditional apparatus of family care, levels of caregiver strain were at least as high as in the developed world. Many had cutback on work to care and faced the additional expense of paid carers and health services. Families from the poorest countries were particularly likely to have used expensive private medical services, and to be spending more than 10% of the per capita GNP on health care. Conclusions: Older people in developing countries are indivisible from their younger family members. The high levels of family strain identified in this study feed into the cycle of disadvantage and should thus be a concern for policymakers in the developing world. Copyright © 2004 John Wiley & Sons, Ltd.

The plant energy-dissipating mitochondrial systems: Depicting the genomic structure and the expression profiles of the gene families of uncoupling protein and alternative oxidase in monocots and dicots

The simultaneous existence of alternative oxidases and uncoupling proteins in plants has raised the question as to why plants need two energy-dissipating systems with apparently similar physiological functions. A probably complete plant uncoupling protein gene family is described and the expression profiles of this family compared with the multigene family of alternative oxidases in Arabidopsis thaliana and sugarcane (Saccharum sp.) employed as dicot and monocot models, respectively. In total, six uncoupling protein genes, AtPUMP1-6, were recognized within the Arabidopsis genome and five (SsPUMP1-5) in a sugarcane EST database. The recombinant AtPUMP5 protein displayed similar biochemical properties as AtPUMP1. Sugarcane possessed four Arabidopsis AOx1-type orthologues (SsAOx1a-1d); no sugarcane orthologue corresponding to Arabidopsis AOx2-type genes was identified. Phylogenetic and expression analyses suggested that AtAOx1d does not belong to the AOx1-type family but forms a new (AOx3-type) family. Tissue-enriched expression profiling revealed that uncoupling protein genes were expressed more ubiquitously than the alternative oxidase genes. Distinct expression patterns among gene family members were observed between monocots and dicots and during chilling stress. These findings suggest that the members of each energy-dissipating system are subject to different cell or tissue/organ transcriptional regulation. As a result, plants may respond more flexibly to adverse biotic and abiotic conditions, in which oxidative stress is involved. © The Author [2006]. Published by Oxford University Press [on behalf of the Society for Experimental Biology]. All rights reserved.