"Eu pensei que ia sair daqui falando inglês": um estudo sistêmico-funcional sobre papéis sociais atribuídos por alunos de um curso de Letras/Inglês

Research in the area of teacher training in English as a Foreign Language (CELANI, 2003, 2004, 2010; PAIVA, 2000, 2003, 2005; VIEIRA-ABRAHÃO, 2010) articulates the complexity of beginning teachers classroom contexts aligned with teaching language as a social and professional practice of the teacher in training. To better understand this relationship, the present study is based on a corpus of transcribed interviews and questionnaires applied to 28 undergraduate students majoring in Letters/English emphasis, at a public university located in the interior of the Western Amazon region, soliciting their opinions about the reforms made in the curriculum of this Major. Interviews and questionnaires were used as data collection instruments to trace a profile of the students organized in Group 1, with freshmen and sophomore undergraduates who are following the 2009 curriculum, and Group 2, with junior and senior undergraduates who are following the 2006 curriculum. The objectives are to identify, to characterize and to analyze the types of pronouns, roles and social actors represented in the opinions of these students in relation to their teacher training curriculum. The theoretical support focuses on the challenge of historical and contemporary routes from English teachers initial education programs (MAGALHÃES; LIBERALLI, 2009; PAVAN; SILVA, 2010; ALVAREZ, 2010; VIANA, 2011; PAVAN, 2012). Our theoretical perspective is based on the Systemic Functional Grammar of Halliday (1994), Halliday and Hasan (1989), Halliday and Matthiessen (2004), Eggins (1994; 2004) and Thompson (2004). We focus on the concept of the Interpersonal meaning, specifically regarding the roles articulated in the studies by Delu (1991), Thompson and Thetela (1995), and in the Portuguese language such as Ramos (1997), Silva (2006) and Cabral (2009). Moreover, we ascribe van Leeuwen s (1997; 2003) theory of Representation of Social Actors as a theoretical framework in order to identify the sociological aspect of social actors represented in the students discourse. Within this scenario, the analysis unfolds on three levels: grammatical (pronouns), semantic (roles), and discursive (social actors). For the analysis of interpersonal realizations present in the students opinions, we use the computational program WordSmith Tools (SCOTT, 2010) and its applications Wordlist and Concord to quantify the occurrences of the pronouns I, You and They, which characterize the roles and social actors of the corpus. The results show that the students assigned the following roles to themselves: (i) apprentice to express their initial process of English language learning; (ii) freshman to reveal their choice of Major in Letters/English emphasis; (iii) future teacher to relate their expectations towards a practicing professional. To assign the roles to professors in the major, the students used the metaphor of modality (I think) to indicate the relationship of teacher training, while they are in the role of a student and as a future teacher. From these evidences the representation of the students as social actors emerges in roles such as: (i) active roles; (ii) passive roles and (iii) personalized roles. The social actors represented in the opinions of the students reflect the inclusion of these roles assigned to the actions expressed about their experiences and expectations derived from their teacher training classroom

Apreciações de alunos de inglês sobre sua produção oral: um estudo com base no sistema de avaliatividade

O vasto número de pesquisas sobre produção oral no ensino de Inglês como Língua Estrangeira (ILE) ao redor do mundo (p. ex. LITTLEWOOD, 1981; BROWN; YULE, 1983; BROWN, 1994; UR, 1996; CARTER; MCCARTHY, 1997; BROWN, 1994; 2004; ELLIS, 2008), assim como estudos sobre aspectos cognitivos e de aquisição da produção oral (SWAIN, 1985; 1995; LEVELT, 1989; SWAIN; LAPKIN, 1995; SKEHAN; FOSTER, 1997; 1999; ROBINSON, 2001; BYGATE, 2001; D‟ELY;WEISSHEIMER, 2004; GUARÁ-TAVARES, 2007; WEISSHEIMER, 2007; BERGSLEITHNER, 2009; dentre outros) têm revelado aspectos para um ensino de ILE mais eficaz e motivador. Com a proposta de contribuir para esse avanço, o presente estudo está inserido no paradigma qualiquantitativo de pesquisa no campo da Linguística Aplicada (LA), primordialmente com base nos estudos de Moita Lopes (1996; 2006), para quem a LA está centrada na resolução de problemas de uso da linguagem, cujo foco está na linguagem de natureza processual. O estudo tem como objetivo verificar as percepções de 34 alunos, de quatro turmas distintas de um curso de ILE, em uma escola privada de línguas, acerca de sua produção oral, ao participarem de atividades orais. O corpus da pesquisa foi gerado pelas respostas dos alunos a questionamentos sobre sua produção oral, em duas fases, no início e no meio do curso, além de uma entrevista semiestruturada realizada com dez dos alunos, ao final do curso, com o intuito de verificar suas percepções sobre sua produção oral. As discussões relacionadas à produção oral em sala de aula de ILE têm respaldo teórico nos trabalhos de Littlewood (1981), Brown e Yule (1983), Almeida Filho (1993), Brown (1994), Ur (1996), Carter e McCarthy (1997), Nunan (1999), Brown (2004) e Ellis (2008), que explicam fenômenos que exercem influência na produção oral, tais como afeto, interação, características de atividades orais, dentre outras variáveis em relação a aspectos cognitivos da produção oral analisadas pelos estudos de Swain (1985; 1995), Levelt (1989), Swain e Lapkin (1995), Skehan e Foster (1997; 1999), Robinson (2001) e Bygate (2001). A análise e discussão dos dados tem como base a Gramática Sistêmico-Funcional proposta por Halliday (1985; 1994) e posteriormente desenvolvida por Halliday e Hasan (1989), Halliday e Mathiessen (2004) e Eggins (2004), dentre outros. O foco desta pesquisa são os mecanismos de Apreciação, um dos domínios avaliativos do subsistema de Atitude, que por sua vez, é parte integrante do Sistema de Avaliatividade, desenvolvido por Martin (2000), Martin e Rose (2003) e Martin e White (2005). Para análise das escolhas linguísticas feitas pelos alunos, utilizamos a ferramenta computacional WordSmith Tools 6.0 (SCOTT, 2010), cuja função Wordlist (lista de palavras) foi utilizada na busca pelos tipos de processos, assim como epítetos, entre outras marcas linguísticas mais recorrentes que caracterizassem suas percepções. Os resultados revelam que nas percepções dos alunos acerca de sua produção oral, ao longo das três fases da geração dos dados para a pesquisa, eles gradativamente deixaram de mencionar aspectos afetivos quanto ao desenvolvimento de sua produção oral e passaram a perceber aspectos mais estruturais de composição da língua

Postural control and functional balance in individuals with diabetic peripheral neuropathy

A Neuropatia diabética periférica (NDP) cursa com redução somatossensitiva que pode levar a alterações no controle postural. O objetivo do estudo foi avaliar o controle postural na postura ereta, em diferentes condições, e o equilíbrio funcional em indivíduos com NDP, correlacionar os resultados obtidos na avaliação do controle postural com os valores do teste do equilíbrio funcional e comparar os resultados obtidos no grupo neuropata com o grupo controle, verificando as possíveis diferenças entre as condições de avaliação em ambos os grupos. Participaram do estudo 13 mulheres com NDP (GN) e 17 mulheres não diabéticas (GC). A avaliação do controle postural foi realizada por cinemetria nas condições: olhos abertos (OA), olhos fechados (OF) e semi tandem (ST). Após processamento no MATLAB, foram geradas as variáveis: amplitude média de oscilação (AMO) na direção ântero-posterior (AP) e médio-lateral (ML); e velocidade média de oscilação (VMO) na direção AP e ML. O equilíbrio funcional foi avaliado pelo Timed Up and Go Test. Houve diferença significante entre os grupos (p<0,005) na AMO-AP OA e OF, AMO-ML of e ST e VMO-ML ST. Houve diferença entre as condições OA e ST (p<0,005) e of e ST (p<0,005) para as variáveis AMO-ML e VMO-ML, com maior prejuízo para o GN, que também apresentou um menor equilíbrio funcional (p=0,001). A instabilidade ML foi correlacionada positivamente com o desequilíbrio funcional. Os resultados nos mostram uma alteração no sistema de controle postural na NDP, o que pode levar estes indivíduos a um maior risco a quedas e prejuízos funcionais.

Entre a fé, a obra social e a publicidade: uma análise crítica do discurso da responsabilidade social da Igreja Universal do Reino de Deus

Situated on Applied Linguistics (PENNYCOOK, 1998; MOITA LOPES, 2003, 2006, 2008, 2009), this thesis, which is inscribed in a qualitative-interpretative approach of a critical analysis perspective , lies on the speech of social responsibility and the way like that is employed in seeking for legitimacy and prestige within the neopentecostal brazilian religious field, more specifically of the Universal Church of the Kingdom of God. The general goal of this research is t reflect upon the speech on social responsibility and the rethoric of selfpromotion of the Universal Church through the role of social actors in the making of his her identities, materialized in the newspaper Folha Universal. In order to achieve that, we have conjugated, in this research, social and discursive analysis. On the linguistic-discursive approach, the research is based on the Critical Analysis of Discourse (ACD), specially in Fairclough (2001, 2003, 2006), a proposal that provides theoretical-methodological tools to investigate the language beyond the linguistic structures , that is, the discourse, social practices in which it occurs and more ample structures. Theoretical assumptions were also used of Sistemico-Functional Linguistics(LSF), matching with categories of the Transitivity System of Halliday (1994, 2004), of the forms of representation of social actors in the socioeconomic perspective by Van Leeuwen (1997, 2008) and of the Appraisal system by Martin and White (2005). As we develop the argumentation on thesobre social role of religion in this thesis, we make use of the authors such as Freston (1994), Oro (1997, 2003), Campos (1996, 1999), Mariano (1999), Meneses (2008), among several ones. We have also used a series of concepts and categories coming from the field of communication and marketing on the business social responsability and social marketing . In this area, we take as references the contributions of Bueno (2003), Fossá and Sartoretto (2003) and Zenone (2006). The corpus of the work is framed by news taken at the newspaper Folha Universal, in which are given the social responsibility actions of the church . The timeframe used was on the editions of 2010 thru 2012. Results found at he analysis of the News lead to semantic features of Assessment of Affection, Judgment and Appreciation, many times followed by Gradation, and the Attribution, one of the subsystems of the Attachment, are evidence of positive assessments for the Universal Church and its agents and make up rethorical elements which provide structure for the discourse of the Universal Church at the newspaper Folha Universal consisted of its image (style) of social responsibility . Results show that the most frequente social actors of the discourse are, on one hand, the Universal Church itself and its volunteers, famous (actors, actresses, presenters), politicians and authorities, on the other hand, the population which was helped by the Church social projects . The first group seems to be Always activated, however the second one, most of the time rather passive. These are also represented by assimilation in most of the occurrences, however the other ones by individualization and nomination entitled by honorification, except for the volunteers that are represented either as an individual, or as a group

O Macrogênero drama Norte-Riograndense: uma análise de gênero e de discurso sob a perspectiva da linguística sistêmico-funcional

The focus of this qualiquantitative research is the phenomenon we are denominating Drama-of-Rio-Grande-do-Norte, which contemplates short verse texts from the oral tradition, sung and presented on stage by women in communities on the south coast of the northeastern Brazilian State, Rio Grande do Norte. This tradition harkens to the medieval romance of the Iberian Peninsula (CASCUDO, 2001; GURGEL, 1999; GALVÃO, 1993; MAGALHÃES, 1973; ROMERO,1977). The objective of this research is to: identify what characterizes the genre Drama of Rio Grande do Norte; situate this genre within a systemization of genres from the oral tradition in Rio Grande do Norte; investigate the interpersonal relationships of power and solidarity through the role of the women in the discourse, how they see themselves and others, pointing out which elements of the world they evaluate and to identify representations of the feminine in the discourse. The theory of Genre and Register of Martin and Rose (2008) and Generic Structure Potential of Hasan (1989, 1996), which has as a base the Systemic Functional Linguistics of Halliday and Matthiessen (2004), Eggins (1994) among others, offers a theoretical framework for the characterization of the genre through the identification of stages and phases configuring its typology the individual schematic structure and its topology its relation to other phenomena in the oral tradition. Other groupings were mapped of the ‗Macrogenre , from the model of Martin and Rose (2008) as a continuum on two axis: between the poles of how the genre circulates orally x in writing, and recited/individually x staged/collectively; as well as mapping the samples with relation to power using the same model, but with the poles of individual voice x collective voice on an axis between increased power and diminished power. Eleven texts described as Narratives and one Anecdote were selected for the analysis of Attitudes, and Negotiations of power. Through the quantification of semantic discursive resources in the discourse systems of Appraisal (MARTIN; WHITE, 2005) and of Negotiation (MARTIN; ROSE, 2007), as well as reflections about humor (EGGINS; SLADE, 1997) we identified the Attitudes and the Negotiations of interpersonal roles. The quantification is based on the theories of Corpus Linguistics (BERBER SARDINHA, 2010), using WordSmith Tools 5.0 (SCOTT, 2010). Our results show that the Drama-of-Rio-Grande-do-Norte is characterized as a Macrogenre in the Community of Oral Stories, in the Family of Street Theatre/Games, composed of five genre types: Narratives, Praise, Complaints, Anecdotes, and Exemplum. The Macrogenre is characterized by its being circulated orally, staged collectively and the texts analyzed configure in differing degrees of power between men and woman. In synthesis we observe that through humor, the Drama-of-Rio-Grande-do-Norte functions to offer a space for women to voice, comment, judge and orient about social conditions in their communities, such as alcoholism, domestic violence, inequalities before the law etc., as well as circulating positive appreciations of rural/coastal culture and judgments about the behavior of members of the speech community, the role of women being to establish and reinforce norms. We anticipate possible benefits of the addition of the genre analyzed in literacy projects in the schools of Rio Grande do Norte

Sujeitos e atores sociais nas representações discursivas de docentes da rede estadual de ensino em Sergipe: uma análise crítica em tempos de Ideb

According to the studies in Applied Linguistics, this thesis is based on an interdisciplinary perspective (Critical Discourse Analysis, Sociology towards Social Change, Cultural Studies and Systemic-Functional Linguistics). The overall objective of the research was to analyze the discourses of Elementary School teachers in the state of Sergipe, by means of the discursive representations of the social actors, the processes of subjectivity and their fragmented identities in the context of standardized evaluations before the requirements of globalized pedagogical practices, based on the result-based management. The critical analysis of such discourses was motivated by the rapid pace with which the demands of innovation become part of the classroom, aiming at reaching the target in what concerns the indexes of the rankings which characterize the globalized discourse of the national education management, like Ideb (Basic Education Development Index), which makes teachers change their discourses, become silent or keep resistant. The work was initially endorsed by the theoretical lines of the Critical Discourse Analysis (FAIRCLOUGH, 2001, 2006), and poses a proposal for such purpose: the ASCD Discourse Sociological and Communicative Approach (PEDROSA, 2012, 2013). This is an interpretative-qualitative study of the Critical Discourse Analysis (FAIRCLOUGH, 2001, 2003; RAMALHO ; RESENDE, 2011) and to carry it out, semi-structured interviews were used as instruments of data generation (BAUER; GASKELL, 2011; GILL, 2011). Its corpus is composed of thirteen accounts of teachers from the Elementary school who teach Portuguese and work in the fifteen schools which were chosen to be the universe of the research at the Regional Board of Education (02) in the state of Sergipe. Such narratives are related to their impressions, expectations and actions which favor the management of results to which they have to submit themselves. The analytical overview of sociological and discursive line comes from the pan-semiotic categories (Inclusion and Exclusion) which appear in the theory of Representation of Social Actors (VAN LEEUWEN, 1997, 2008). To present the processes of subjectivity of these teachers, this work is based on the socio-analytical proposal of the classification of the subjects, which stems from the individual s work in the Gestão Relacional de Si , which comes from the Applied Sociology (towards) Social Change (BAJOIT, 2006, 2009). The discursive analyses were guided word for word, in their majority, by having the Systemic Functional Grammar as their theoretical basis, specifically by the processes of the Transitivity System postulated by Halliday, (1985); Halliday and Mathiessen, (2004); Eggins (2004); Cunha and Souza (2011). The work makes the field of Cultural Studies emerge towards the dialogue and the presentation of the fragmented identities of the teachers in the context of late modernity (GIDDENS, 2002; HALL, 2011). The thesis promoted a reflection over the teacher s condition, who is immerse in this context of knowledge construction of the present Brazilian educational system, the standardized evaluations, the indexes of development, the targets and the rankings. The considerations and outcomes of such a research dealt with the teachers emerging social practices and the need of planned initial and continuing teacher education towards the new moment which is foreseeable

Histórias de professores universitários sobre ensinar inglês para fins específicos

This research has as its theoretical and methodological assumptions (1) the Narrative Inquiry (CLANDININ; CONNELLY, 2011), (2) the Systemic Functional Grammar (HALLIDAY, 1985, 1994; THOMPSON, 2002; EGGINS, 1994; HALLIDAY; MATTHIESSEN, 2004) and (3) the English for Specific Purposes Approach (ESP - HUTCHINSON; WATERS, 1987; CELANI, 2005; RAMOS, 2005), and its overall objective is to survey the meanings construed by the participants who are ESP practitioners and have not received a specific education to teach this approach at their undergraduation. The field texts and therefore the analises were divided into two distinct groups: the first with data generated from a questionnaire applied to nine professors from a federal university in the northeast of Brazil, which contains open and closed questions about their training and their experiences in teaching ESP; the second group, focusing this time on the experiences of three professors from the first group who were still teaching ESP, with data generated from interviews with these participants in addition to the data generated from their autobiographies and from the researcher´s as well. The computational tool WordSmith Tools 6.0 (SCOTT, 2012) was used to select, organize, and quantify data to be analyzed in the first group of texts, identifying the types of Processes and Participants through the Transitivity System (HALLIDAY; MATTHIESSEN, 2004). The Processes which were more used by the professors in the questionnaire were the Material, followed by the Relational and then the Mental ones, indicating that most professors reported their actions related to the teaching of ESP, rated or evaluated the approach, their training to teach it and their experiences, hence, rarely showing their thoughts and emotions about teaching ESP. Most of the nine professors say they carry out needs analysis, but not all do it according to the authors cited by them or the ones that are considered a reference in this area, such as the ones used in this research as reference. Similarly, their definitions and conceptions of ESP, in most cases, differed from these authors. All the professors claim not having had specific education to teach ESP at the undergraduation. When examining the stories of the four teachers, in the second group of the field texts, based on meaning composition according to Ely, Vinz, Downing and Anzul (2001), it was revealed that the kind of knowledge they report using when they teach ESP is related to their Personal Practical Knowledge and their Professional Knowledge (ELBAZ, 1983; CLANDININ, 1988). In their autobiographies, metaphors were also identified and they represent their concepts of teaching and being a teacher. Through this research, we hope to contribute to the understanding of what teaching ESP might mean for professors in the researched context and also to the continuing education of ESP practitioners, as well as to a review of the curricula in the English language undergraduate courses and of the role of ESP in the training of these professionals

Alterações da default mode network provocadas pela ingestão de Ayahuasca investigadas por Ressonância Magnética Funcional

Ayahuasca is psychotropic beverage that has been used for ages by indigenous populations in South America, notably in the Amazon region, for religious and medicinal purposes. The tea is obtained by the decoction of leaves from the Psychotria viridis with the bark and stalk of a shrub, the Banisteriopsis caapi. The first is rich in N-N-dimethyltryptamine (DMT), which has an important and well-known hallucinogenic effect due to its agonistic action in serotonin receptors, specifically 5-HT2A. On the other hand, β-carbolines present in B. caapi, particularly harmine and harmaline, are potent monoamine oxidase inhibitors (MAOi). In addition, the tetrahydroharmine (THH), also present in B. caapi, acts as mild selective serotonin reuptake inhibitor and a weak MAOi. This unique composition induces a number of affective, sensitive, perceptual and cognitive changes in individuals under the effect of Ayahuasca. On the other hand, there is growing interest in the Default Mode Network (DMN), which has been consistently observed in functional neuroimaging studies. The key components of this network include structures in the brain midline, as the anterior medial frontal cortex, ventral medial frontal cortex, posterior cingulate cortex, precuneus, and some regions within the inferior parietal lobe and middle temporal gyrus. It has been argued that DMN participate in tasks involving self-judgments, autobiographical memory retrieval, mental simulations, thinking in perspective, meditative states, and others. In general, these tasks require an internal focus of attention, hence the conclusion that the DMN is associated with introspective mental activity. Therefore, this study aimed to evaluate by functional magnetic resonance imaging (fMRI) changes in DMN caused via the ingestion of Ayahuasca by 10 healthy subjects while submitted to two fMRI protocols: a verbal fluency task and a resting state acquisition. In general, it was observed that Ayahuasca causes a reduction in the fMRI signal in central nodes of DMN, such as the anterior cingulate cortex, the medial prefrontal cortex, the posterior cingulate cortex, precuneus and inferior parietal lobe. Furthermore, changes in connectivity patterns of the DMN were observed, especially a decrease in the functional connectivity of the precuneus. Together, these findings indicate an association between the altered state of consciousness experienced by individuals under the effect of Ayahuasca, and changes in the stream of spontaneous thoughts leading to an increased introspective mental activity

Multiplane ultrasound approach to quantify pleural effusion at the bedside

To assess the accuracy of a multiplane ultrasound approach to measure pleural effusion volume (PEV), considering pleural effusion (PE) extension along the cephalocaudal axis and PE area.Prospective study performed on 58 critically ill patients with 102 PEs. Thoracic drainage was performed in 46 patients (59 PEs) and lung computed tomography (CT) in 24 patients (43 PEs). PE was assessed using bedside lung ultrasound. Adjacent paravertebral intercostal spaces were examined, and ultrasound PEV was calculated by multiplying the paravertebral PE length by its area, measured at half the distance between the apical and caudal limits of the PE.Ultrasound PEV was compared to either the volume of the drained PE (59 PE) or PEV assessed on lung CT (43 PE). In patients with lung CT, the accuracy of this new method was compared to the accuracy of previous methods proposed for PEV measurement. Ultrasound PEV was tightly correlated with drained PEV (r = 0.84, p < 0.001) and with CT PEV (r = 0.90, p < 0.001). The mean biases between ultrasound and actual volumes of PE were -33 ml when compared to drainage (limits of agreement -292 to +227 ml) and -53 ml when compared to CT (limits of agreement -303 to +198 ml). This new method was more accurate than previous methods to measure PEV.Using a multiplane approach increases the accuracy of lung ultrasound to measure the volume of large to small pleural effusions in critically ill patients.

Levels of toxic and essential metals in maternal and umbilical cord blood from selected areas of South Africa-results of a pilot study

This pilot study uses concentrations of metals in maternal and cord blood at delivery, in seven selected geographical areas of South Africa, to determine prenatal environmental exposure to toxic metals. Samples of maternal and cord whole blood were analysed for levels of cadmium, mercury, lead, manganese, cobalt, copper, zinc, arsenic and selenium. Levels of some measured metals differed by site, indicating different environmental pollution levels in the regions selected for the study. Mercury levels were elevated in two coastal populations studied (Atlantic and Indian Ocean sites) with mothers from the Atlantic site having the highest median concentration of 1.78 mu g/L ranging from 0.44 to 8.82 mu g/L, which was found to be highly significant (p < 0.001) when compared to other sites, except the Indian Ocean site. The highest concentration of cadmium was measured in maternal blood from the Atlantic site with a median value of 0.25 mu g/L (range 0.05-0.89 mu g/L), and statistical significance of p < 0.032, when compared to all other sites studied, and p < 0.001 and p < 0.004 when compared to rural and industrial sites respectively, confounding factor for elevated cadmium levels was found to be cigarette smoking. Levels of lead were highest in the urban site, with a median value of 32.9 mu g/L (range 16-81.5 mu g/L), and statistically significant when compared with other sites (p < 0.003). Levels of selenium were highest in the Atlantic site reaching statistical significance (p < 0.001). All analysed metals were detected in umbilical cord blood samples and differed between sites, with mercury being highest in the Atlantic site (p < 0.001), lead being highest in the urban site (p < 0.004) and selenium in the Atlantic site (p < 0.001). To the best of our knowledge this pilot investigation is the first study performed in South Africa that measured multiple metals in delivering mothers and umbilical cord blood samples. These results will inform the selection of the geographical sites requiring further investigation in the main study.

Toxic and essential elements in blood from delivering women in selected areas of São Paulo State, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Levels of selected persistent organic pollutants in blood from delivering women in seven selected areas of São Paulo State, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The placenta as a barrier for toxic and essential elements in paired maternal and cord blood samples of South African delivering women

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Métodos para abandono do tabagismo e tratamento da dependência da nicotina

O tabagismo está relacionado a 30% das mortes por câncer. É fator de risco para desenvolver carcinomas do aparelho respiratório, esôfago, estômago, pâncreas, cérvix uterina, rim e bexiga. A nicotina induz tolerância e dependência pela ação nas vias dopaminérgicas centrais, levando às sensações de prazer e recompensa mediadas pelo sistema límbico. É estimulante do sistema nervoso central (SNC), aumenta o estado de alerta e reduz o apetite. A diminuição de 50% no consumo da nicotina pode desencadear sintomas de abstinência nos indivíduos dependentes: ansiedade, irritabilidade, distúrbios do sono, aumento do apetite, alterações cognitivas e fissura pelo cigarro. O aconselhamento médico é fundamental para o sucesso no abandono do fumo. A farmacoterapia da dependência de nicotina divide-se em: primeira linha (bupropiona e terapia de reposição da nicotina), e segunda linha (clonidina e nortriptilina). A bupropiona é um antidepressivo não-tricíclico que age inibindo a recaptação de dopamina, cujas contra-indicações são: epilepsia, distúrbios alimentares, hipertensão arterial não-controlada, abstinência recente do álcool e uso de inibidores da monoaminoxidase (MAO). A terapia de reposição de nicotina pode ser feita com adesivos e gomas de mascar. Os efeitos da acupuntura no abandono do fumo ainda não estão completamente esclarecidos. As estratégias de interrupção abrupta ou redução gradual do fumo têm a mesma probabilidade de sucesso.

The lived experience of long-term psychiatric hospitalization of four women in Brazil

PROBLEM: What is the experience from long-term psychiatric hospitalization? How can psychiatric nursing contribute to reduce the emotional suffering and the feeling of social exclusion related to this process?METHODS: This study was conducted on four women committed to long periods of psychiatric hospitalization in Brazil. Data were collected through open interviews and drawings made by the patients, and interpreted according to the theory of social representations.FINDINGS: Reports on the patients refer to a process of social exclusion, emotional suffering, and inadequate treatment in the hospital, leading to no other option but recurrent hospitalization.CONCLUSION: Negative experiences related to long-term hospitalization could possibly be minimized through adequate assistance provided by psychiatric nursing in open services, as proposed in the recent Brazilian psychiatric reform.