Implicações das síndromes da tensão pré-menstrual e do transtorno disfórico pré-menstrual na qualidade de vida

Enquadramento: Embora o ciclo menstrual seja um fenômeno normal na vida de mulheres em idade fértil, a ele podem se associar síndromes de intensidade variável. Objectivo: Determinar o impacto da síndrome pré-menstrual e da síndrome disfórica pré-menstrual na qualidade de vida de mulheres em idade fértil, comparadas a mulheres sem essas síndromes. Material e Métodos: Procedeu-se a estudo quantitativo, descritivo, correlacional, transversal, com 60 participantes do sexo feminino (16 com síndrome pré-menstrual, 28 com sintomatologia compatível com SDPM e 16 não apresentavam sintomas compatíveis com diagnóstico), A colheita de dados foi no Ambulatório de Ginecologia do Hospital Militar de nível terciário no período de janeiro a fevereiro de 2015, apresentando idade entre 18 e 56 anos, menarca há mais de um ano; ciclos menstruais em ausência de uso de terapia de reposição hormonal, com queixas associadas ao período menstrual. Três instrumentos de recolha de dados foram empregados: um questionário de identificação da paciente e caracterização de vida reprodutiva; o Questionário de Triagem de Sintomas Pré-menstruais e o Short Form Health-Survey com 36 itens. Para organização e análise dos dados, foi empregado o programa Statistical Package for Social Sciences, na versão 21.0. As variáveis foram dicotomizadas, para análise de contingência com o teste exato de Fisher. Para comparação de médias, foram utilizados o teste de diferença de médias de amostras independentes e o teste Kruskal Wallis, todos em nível de significância de 0,05. Resultados: A prevalência de síndrome menstrual igualou-se a 76,3%, sendo 46,6% compatível com síndrome disfórica e 29,7% com síndrome pré-menstrual. Esses grupos diferiram significantemente nos sintomas de ansiedade/tensão, fadiga/perda de energia, dificuldade de concentração, fome excessiva ou anorexia e sentimento de opressão. A síndrome disfórica pré-menstrual associou-se a maior comprometimento de relações sociais, familiares e domésticas, bem como à perda de saúde geral e de saúde mental, nos domínios de vitalidade, funções sociais, limitações devidas a problemas emocionais e saúde mental. Essas alterações não interferiram na percepção da libido e de orgasmo, mas alguns domínios da qualidade de vida estiveram associados a características reprodutivas. Conclusão: As síndromes pré-menstruais comprometem a qualidade de vida das utentes e requerem assistência voltada à melhoria do conhecimento das mulheres sobre seu problema de saúde. Palavras-chave: Síndrome pré-menstrual, Síndrome disfórica pré-menstrual, Qualidade de vida.

Piercings orais: implicações e consequências

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

A ansiedade dentária em odontopediatria e suas implicações

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Descentralização: Implicações na Gestão Municipal - Uma aplicação na Ilha de Santiago, Cabo Verde

A presente dissertação centrou-se na análise do programa de descentralização em Cabo Verde e as suas implicações na gestão municipal, particularmente nos municípios da Ilha de Santiago. Os objectivos foram avaliar a percepção da participação dos cidadãos na elaboração de políticas, nas decisões locais, na fiscalização e controlo da acção dos dirigentes municipais, estudar o conhecimento dos mecanismos de participação, analisar o nível de dependência financeira em relação ao governo central e discutir a relação entre as capacidades técnicas municipais e a qualidade das decisões. Com base em questionários aplicados aos cidadãos e autarcas de três municípios da Ilha e, nos documentos oficiais e estudos já publicados, constatou-se que a participação dos cidadãos na gestão municipal é limitada e, por conseguinte, um fraco controlo, por parte dos cidadãos, sobre a acção dos governantes. Outrossim, a capacidade dos municípios em gerar receitas próprias é limitada, e sua dependência face à administração central é muito elevada, e uma certa carência em termos de pessoal técnico.

UMA ÁNALISE EXEGÉTICA DA PORÇÃO DE MIQUEIAS 2,1-5: A SITUAÇÃO SOCIOECONÔMICA EM JUDÁ E SUAS IMPLICAÇÕES NA HERANÇA DOS CAMPONESES NA SEFELÁ JUDAÍTA NO SÉCULO VIII A.C.

Esta pesquisa procura examinar, à luz da metodologia exegética, a perícope de Miqueias 2,1-5, a fim de reconstruir o cenário no qual emergiu a dura crítica social do profeta. O texto apresenta, em sua análise literária, características de um dito profético coeso, em estilo poético. Sua estrutura encontra-se dividida em duas unidades (denúncia e castigo), sendo que cada uma das unidades possui outras duas subunidades (genérica e específica). O gênero literário harmoniza-se com um dito profético de julgamento geralmente conhecido como oráculo ai . A análise da dimensão histórica situa o acontecimento fundante em 701 a.C., na Sefelá judaíta. Numa análise investigativa do conteúdo da denúncia norteado pelo modelo teórico do modo de produção tributário, observa-se um conflito entre dois grupos. Nesse conflito, Miqueias faz uma acusação a um grupo de poder em Judá que planeja e executa ações criminosas contra a herança camponesa. O castigo descreve a conspiração e o plano divino contra esse grupo de poder. Javé havia planejado um mal idêntico ao que eles haviam cometido, desonra e privação de suas possessões. Os valores culturais de honra e vergonha subjazem a esse oráculo. Por descumprirem seus deveres junto a Javé e ao povo, os criminosos perderiam todos os seus direitos e, sobretudo, a honra perante a própria comunidade. Com base no modelo teórico do modo de produção tributário, constata-se que, na situação social em Judá no oitavo século, prevalecia um conflito entre campo e cidade. As comunidades aldeãs pagavam tributo à cidade em forma de produtos e serviços. A excessiva arrecadação de tributo e as falhas no sistema de ajuda mútua forçaram os indivíduos e famílias a contrair dívidas, a hipotecar suas terras herdadas dos pais e eventualmente perdê-las. O profeta Miqueias é o porta-voz do protesto da classe campesina que resolve reagir aos desmandos praticados pela elite citadina. Para ele, Javé escuta a queixa dos que estão sendo oprimidos e intervém na história tomando o partido do oprimido.(AU)

ANÁLISE DA EPISTEMOLOGIA-ONTOLÓGICA DE PAUL TILLICH: O Princípio de Identidade e implicações para o método e saber teológico

A pesquisa analisa e epistemologia ontológica de Paul Tillich. Considerando a influência de F. W. J. Schelling pretende-se destacar o lugar de certas premissas ontológicas que fundamentaram o pensamento de Tillich, principalmente o Princípio de Identidade , como um dos princípios epistemológicos chave. Partindo do pressuposto de que sua ontologia depende do Princípio de identidade a fim de que possa relacionar essência e existência, destaca-se a identidade substancial entre teologia e filosofia, permitindo melhor compreensão da relação entre ontologia e teologia, caracterizando de forma geral tanto a noção teológicofilosófica da experiência de finitude - choque ontológico como sua relação com as importantes noções de Deus como o Ser-em-si, e ultimate concern enquanto categoria ontológico-teológica. A seguir, críticas voltadas para sua construtividade ontológica serão destacadas e analisadas em termos de seus pressupostos e em seu poder de alcance. Neste âmbito crítico, considerar-se-á breve comparação entre a tentativa do sistema ontológicoteológico de Tillich e os sistemas de Kant e Hegel, com o objetivo de apresentar paralelos críticos entre a postura de tais sistemas no campo epistemológico e ontológico, e suas influências sobre a teologia. Ao final, pretende-se entender as implicações de sua ontologiateológica tanto para a forma metodológica de correlação entre situação e resposta, como na relação com outros sistemas teológicos, que possibilitaram ou não, mediações entre cultura e teologia. Neste segmento, notar-se-á como uma das implicações da ontologia-teológica de Tillich, o imprescindível retorno do saber teológico entre os demais saberes delineadores da realidade; considerando-se certas possibilidades críticas a partir de seu pensamento com respeito ao uso da razão instrumental, ética e espiritualidade.

Condições de trabalho e terceiro setor: implicações contemporâneas para o serviço social

In the contemporaneity, due to the implementation of the neoliberal project in which one verifies the withdrawal of the State in regard to the development of social policies, it is observed a new way of responding to the multifaceted expressions of the social issue, which is the emergence and expansion of a supposed "third sector" in society. Thus, the productive restructuring process has led to the deterioration of labor relations, as well as a super exploration of human labor power, also triggering structural unemployment. By being delineated in classist interests, the emergence of the "third sector" brings contradictory aspects to the society, one of these being the very concept of "third sector", more ideological than real. By seeking to answer the expressions of the social issue, demands the intervention of social workers in the institutions that "composes it". This way, arises the interest in researching what are the current conditions and labor relations of the social workers who work in the institutions of the "third sector" in Mossoró-RN. Therefore, this study is constituted by a survey for the conclusion of a Master's degree in Social Service at the Universidade Federal do Rio Grande do Norte. Therefore, it was listed out as general objective to identify and analyze the conditions and labor relations of the social workers entered in the institutions of the "third sector" in Mossoró-RN. And by specific objectives: to map the institutions that are part of the "third sector" in the city of Mossoró, which have social workers on its professional staff, in order to profile the same; and, analyze the main challenges presented to the work of the social worker in these institutions. We used the bibliographic and documental research to enlighten the knowledge of the topic approached and the development of the field research, in which for the analysis of the data obtained, through field research, it was used the quantitative and qualitative approach. The search results confirmed that half of the institutions was identified as philanthropics, and most of them are funded by the federal government and that such organizations develop activities in several areas, particularly health and welfare. Concerning the conditions and labor relations, was highlighted the fact that half of the professionals insert themselves within the institutions by appointment; regarding the salary, 57.1% of employees receive between 3 and 4 minimum wages, which is considered relatively low. Was satisfactory the analysis related to the labor rights, because almost all offer a formal contract, which ensures, in great measure, the effectuation of such rights. Now with regard to the workload, 5 of 6 institutions implemented the Law Nº. 12.317/2010 ensuring 30 hours a week for social workers. However, it were cited many challenges relating the reality of the "third sector" to the conditions and labor relations, among them stands out: the delay of salary and non-salary adjustment; the realization of activities that do not relate to professionals, functions and duties; the development of many activities by a single professional. Two important data are the not incentive to a postgraduate and the charging of the fulfillment of the goals for the professional productivity. Here, it is worth to reflect that, although this study presents elements that provide to identify some aspects of labor relations and conditions of social workers in the "third sector" in Mossoró- RN, as well as some challenges that permeate this space of professional insertion, is meant that there is much to be unveiled, and other studies can later do so in an attempt to a better understanding of the complexity of processes that permeate the "third sector"

Características psicológicas do paciente obeso grave e suas implicações pós-operatórias na cirurgia bariátrica

Obesity is a chronic disease that has multi-factorial aetiology, characterized by high degree of body fat; the degree of obesity will vary according to the Body Mass Index (BMI=m2 /kg). The severe degree of obesity is characterized by BMI>40 and it is regularly associated to endocrine-metabolic or mechanic clinical alterations, and to psychological disorders. Binge Eating (BE) results were overly high for this population. The Bariatric Surgery has been the treatment chosen by those diagnosed with severe obesity as this intervention provides prompt outcomes for loss of weight and clinical improvement conditions. However, recent research has acquiesced that after two years between 20% and 30% of people subject to this intervention gained weight. The main objective of this research is to assess the psychological and behavioral characteristics of those diagnosed with severe obesity that have been subject to Gastric Bypass Surgery in the past 24 months. Specific aspects were investigated: (1) characteristics of different personalities and diagnose of clinic and personality disorders; (2) BE and its relation with loss of weight; (2) the difference between the groups regarding post-surgery care, e.g. physical activity, psychological and dietician input. Method: 40 adults (women and men) aged 23 and 60 year-old who went through a bariatric surgery in the past 24 months, in the city of Natal-RN (Brazil); they were assembled in two groups n=20, Gain group displaying loss of < 50% of their initial surplus of weight, and the Loss group displaying loss of >50%. The research protocol is made of a socio-demographic questionnaire and 3 psychometric instruments: Rorschach – Comprehensive System; Millon Personality Inventory (MCMI-III); and the Binge Eating Scale (Escala de Compulsão Alimentar Periódica (ECAP). Through Rorschach significant differences between these groups were verified according to the kind of personality (EB) - more EB Extratensivo in Gain group and Intratensivo in Loss group – and the lack of control to express affect, increasing the answer for Color Pure at Group I. Concerning the people standardization, the sample as a whole tends to show psychic pain, denigrated selfperception, high levels of self-criticism, distorted perceptions, vulnerability to develop mood disorders and high scores regarding Suicide. MCMI-III results showed more clinic and personality disorders in Group I: Depressive Disorder and Schizotypal, Anxiety, Dysthymia, Major Depressive Disorder; Thought Disorder, Bipolar- Manic and Posttraumatic Stress Disorder. In relation to ECAP, the results indicated significant differences, showing increased BE results in Gain group. There were found significant differences between BE severity and the presence of clinic and personality disorders. Concerning the post-surgery care, the observed differences are statistically significant regarding physical activities with median-increased differences in Loss group. There is a difference between the initial weight and the time post-surgery, indicating that the higher the initial weight and the time after the surgery the higher the re-gain of weight post-surgery. Finally, the results show that the participants with more than 3 years of surgery will have Clinic and Major Depressive Disorders; Somatoform Disorder; Dysthymia. These results confirm prior studies related to BE post-surgery and re-gain of weight as well as the proneness of clinic disorders in severe obesity people. That means the results reinforce that the surgery process is a facet of the severe obesity treatment. The post-surgery process needs to be the main focus of attention and have a long-term input to sustain the care of the surgery results and the quality of life of the patients.

Efeitos in vivo e in vitro de agonistas parciais do receptor NOP: implicações para o tratamento da ansiedade, depressão e mania

Introduction: This study aimed to investigate the effects of the two peptide NOP partial agonists (UFP-113 and [F/G]N/OFQ(1-13)NH2) and the non peptide NOP partial agonist (AT-090) in the mouse emotional behavior as well as in the intracellular transduction pathways following the receptor binding. Methods: Male Swiss or CD-1 mice were used in this study together with NOP(+/+) and NOP(-/-) mice. The elevated plus maze (EPM) was used to evaluate the effects of compounds on anxiety-like behaviors. Diazepam and the NOP agonists, N/OFQ and Ro 65-6570, were used as positive controls in the EPM. NOP(+/+) and NOP(-/-) mice were used to evaluate the selectivity of those compounds that induced anxiolytic-like behaviors. The forced swim test (FST) was used to evaluate the effects of compounds on depressive-like behaviors. Nortriptyline and the NOP antagonists, UFP-101 and SB-612111, were used as positive controls in the FST. The effects of N/OFQ, UFP-101, SB-612111, UFP-113, [F/G]N/OFQ(1-13)NH2, and AT-090 were assessed in the methylphenidate-induced hyperlocomotion (MIH) test; in this assay valproate was used as positive control. The G protein and β-arrestin 2 transduction pathways of NOP receptor agonists (N/OFQ and Ro 65-6570), antagonist (UFP-101), and partial agonists (UFP-113, [F/G]N/OFQ(1-13)NH2, and AT-090) were also evaluated using an innovative assay that measures a bioluminescence resonance energy transfer process. For this, cell lines permanently co-expressing the NOP receptor coupled to luciferase (energy donor), and green fluorescent protein (energy acceptor) coupled to one of the effector proteins (G protein or β-arrestin 2) were used. Results: Diazepam (1 mg/kg), N/OFQ (1 nmol), Ro 65-6570 (0.1 mg/kg), and AT-090 (0.01 mg/kg) induced anxiolytic-like effect in mice in the EPM. The effects of Ro 65-6570 and AT-090 were selective to NOP receptor. UFP-113 (0.01-1 nmol) and [F/G]N/OFQ(1-13)NH2 (0.1-3 nmol) were inactive in the EPM. In the FST, nortriptyline (30 mg/kg), UFP-101 (10 nmol), SB-612111 (10 mg/kg), UFP-113 (0.01 and 0.1 nmol), and [F/G]N/OFQ(1-13)NH2 (0.3 and 1 nmol) induced antidepressant-like effects, while AT-090 (0.001-0.1 mg/kg) was inactive in this assay. The effects of UFP-113 and [F/G]N/OFQ(1-13)NH2 were selective to NOP receptor. Valproate (400 mg/kg) counteracted methylphenidate (MPH, 10 mg/kg)-induced hyperlocomotion in mice in the open field. N/OFQ (1 nmol), UFP-113 (0.01-0.1 nmol), and [F/G]N/OFQ(1-13)NH2 (1 nmol) were also able to reduce the MPH-induced hyperlocomotion, without changing the locomotor activity per se. The effect of UFP-113 was selective to NOP receptor. The UFP-101 (10 nmol), SB-612111 (10 mg/kg), and AT-090 (0.001-0.03 mg/kg) did not change the hyperlocomotor effect of methylphenidate. In vitro, N/OFQ and Ro 65-6570 behaved as NOP full agonists for G-protein and β-arrestin 2 pathways. AT-090 behaved as NOP receptor partial agonist for both transduction pathways, while UFP-113 and [F/G]N/OFQ(1-13)NH2 behaved as partial agonists and antagonists of NOP receptor for NOP/G protein and NOP/β-arrestin 2, respectively. UFP-101 behaved as NOP receptor antagonist for both transduction pathways. Conclusion: NOP ligands producing same effects on NOP/G protein interaction (partial agonism), but with opposite effects on β-arrestin 2 recruitment (partial agonism vs antagonism), can promote different in vivo effects on anxiety and mood as it was observed in the behavioral tests. This work corroborates the potential of NOP receptor as an innovative pharmacological target for the treatment of emotional disorders.

Efeitos in vivo e in vitro de agonistas parciais do receptor NOP: implicações para o tratamento da ansiedade, depressão e mania

Introduction: This study aimed to investigate the effects of the two peptide NOP partial agonists (UFP-113 and [F/G]N/OFQ(1-13)NH2) and the non peptide NOP partial agonist (AT-090) in the mouse emotional behavior as well as in the intracellular transduction pathways following the receptor binding. Methods: Male Swiss or CD-1 mice were used in this study together with NOP(+/+) and NOP(-/-) mice. The elevated plus maze (EPM) was used to evaluate the effects of compounds on anxiety-like behaviors. Diazepam and the NOP agonists, N/OFQ and Ro 65-6570, were used as positive controls in the EPM. NOP(+/+) and NOP(-/-) mice were used to evaluate the selectivity of those compounds that induced anxiolytic-like behaviors. The forced swim test (FST) was used to evaluate the effects of compounds on depressive-like behaviors. Nortriptyline and the NOP antagonists, UFP-101 and SB-612111, were used as positive controls in the FST. The effects of N/OFQ, UFP-101, SB-612111, UFP-113, [F/G]N/OFQ(1-13)NH2, and AT-090 were assessed in the methylphenidate-induced hyperlocomotion (MIH) test; in this assay valproate was used as positive control. The G protein and β-arrestin 2 transduction pathways of NOP receptor agonists (N/OFQ and Ro 65-6570), antagonist (UFP-101), and partial agonists (UFP-113, [F/G]N/OFQ(1-13)NH2, and AT-090) were also evaluated using an innovative assay that measures a bioluminescence resonance energy transfer process. For this, cell lines permanently co-expressing the NOP receptor coupled to luciferase (energy donor), and green fluorescent protein (energy acceptor) coupled to one of the effector proteins (G protein or β-arrestin 2) were used. Results: Diazepam (1 mg/kg), N/OFQ (1 nmol), Ro 65-6570 (0.1 mg/kg), and AT-090 (0.01 mg/kg) induced anxiolytic-like effect in mice in the EPM. The effects of Ro 65-6570 and AT-090 were selective to NOP receptor. UFP-113 (0.01-1 nmol) and [F/G]N/OFQ(1-13)NH2 (0.1-3 nmol) were inactive in the EPM. In the FST, nortriptyline (30 mg/kg), UFP-101 (10 nmol), SB-612111 (10 mg/kg), UFP-113 (0.01 and 0.1 nmol), and [F/G]N/OFQ(1-13)NH2 (0.3 and 1 nmol) induced antidepressant-like effects, while AT-090 (0.001-0.1 mg/kg) was inactive in this assay. The effects of UFP-113 and [F/G]N/OFQ(1-13)NH2 were selective to NOP receptor. Valproate (400 mg/kg) counteracted methylphenidate (MPH, 10 mg/kg)-induced hyperlocomotion in mice in the open field. N/OFQ (1 nmol), UFP-113 (0.01-0.1 nmol), and [F/G]N/OFQ(1-13)NH2 (1 nmol) were also able to reduce the MPH-induced hyperlocomotion, without changing the locomotor activity per se. The effect of UFP-113 was selective to NOP receptor. The UFP-101 (10 nmol), SB-612111 (10 mg/kg), and AT-090 (0.001-0.03 mg/kg) did not change the hyperlocomotor effect of methylphenidate. In vitro, N/OFQ and Ro 65-6570 behaved as NOP full agonists for G-protein and β-arrestin 2 pathways. AT-090 behaved as NOP receptor partial agonist for both transduction pathways, while UFP-113 and [F/G]N/OFQ(1-13)NH2 behaved as partial agonists and antagonists of NOP receptor for NOP/G protein and NOP/β-arrestin 2, respectively. UFP-101 behaved as NOP receptor antagonist for both transduction pathways. Conclusion: NOP ligands producing same effects on NOP/G protein interaction (partial agonism), but with opposite effects on β-arrestin 2 recruitment (partial agonism vs antagonism), can promote different in vivo effects on anxiety and mood as it was observed in the behavioral tests. This work corroborates the potential of NOP receptor as an innovative pharmacological target for the treatment of emotional disorders.

O problema mente-corpo na psicologia fenomenológica de Edith Stein : implicações para uma fundamentação da ciência psicológica

Psychology is a relatively new scientific branch and still lacks consistent methodological foundation to support its investigations. Given its immaturity, this science finds difficulties to delimit its ontological status, which spawnes several epistemological and methodological misconceptions. Given this, Psychology failed to demarcate precisely its object of study, leading, thus, the emergence of numerous conceptions about the psychic, which resulted in the fragmentation of this science. In its constitution, psychological science inherited a complex philosophical problem: the mind-body issue. Therefore, to define their status, Psychology must still face this problem, seeking to elucidate what is the mind, the body and how they relate. In light of the importance of this issue to a strict demarcation of psychological object, it was sought in this research, to investigate the mind-body problem in the Phenomenological Psychology of Edith Stein (1891-1942), phenomenologist philosopher who undertook efforts for a foundation of Psychology. For that, the discussion was subsidized from the contributions of the Philosophy of Mind and the support of the phenomenological method to the mind-body problem. From there, by a qualitative bibliographical methodology, it sought to examine the problem of research through the analysis of some philosophical-psychological philosopher's works, named: "Psychic Causality” (Kausalität Psychische, 1922) and “Introduction to Philosophy" (Einführung in die Philosophie, 1920). For this investigation, it was made, without prejudice to the discussion, a terminological equivalence between the terms mind and psyche, as the philosopher used the latter to refer to the object of Psychology. It sought to examine, therefore, how Stein conceived the psyche, the body and the relationship between them. Although it wasn't the focus of the investigation, it also took into account the spiritual dimension, as the philosopher conceived the human person as consisting of three dimensions: body, psyche and spirit. Given this, Stein highlighted the causal mechanism of the psyche, which is based on the variations of the vital force that emerges from the vital sphere. In relation to the corporeal dimension, the philosopher, following the analysis of Edmund Husserl (1859-1938), highlighted the dual aspect of the body, because it is at the same time something material (Körper) and also a linving body (Leib). On the face of it, it is understood that the psyche and the body are closely connected, so that it constitutes a dual-unit which is manifested in the Leib. This understanding of the problem psyche-mind/body provides a rich analysis of this issue, enabling the overcoming of some inconsistencies of the monistic and dualistic positions. Given this, it allows a strict elucidation of the Psychology object, contributing to the foundation of this science.

“É acompanhante ou usuária?” Implicações sobre a posição da família no atendimento a crianças e adolescentes em um Centro de Atenção Psicossocial da Infância e Adolescência - CAPSi

This study emerged and founded itself with the aim to analyze the position taken by the family – and the implications in this subjective area – in attending children and adolescents in a Childhood Psychosocial Care Center (CAPSi). A secondary goal has come up as the comprehension surrounding the institutional representation made about the family and the service offered to children, adolescents and relatives. For such, the historical perspective on the relation between the State (laws and institutions) and the family was resumed, and the understanding of how it was reconciled by the medical knowledge and attended the ideological and political means. The social and ideological transformations of the 20th century culminated in the need of change required by the Psychiatric Reform and the achievement of patients on the right to return home and to their families. This new situation, permeated by the attempt of building an assistance model in Mental Health, presented a peculiarity–the close relationship between family and Mental Health services. The observations and conversations at CAPSi that were the investigation objects in this research, intended to learn on the quotidian of families and the possible treatment alternatives that would take into account the family circumstances. Conceiving the status of the families in Mental Health services is a germinal matter yet to be adjusted among the active knowledge in the post-Reform devices. The discussion about the family bonds, anchored in the theoretical perspective of Binding Psychoanalysis brought up elementary concepts such as psychic heritage, denial pact, unconscious alliances, the familiar psychic set, among other. The concept of family organizer helped to think of the family trajectories and stablishes a sort of identity for the family, as well as interferes in the establishment of its boundaries. The family path within the institution, as well as the status they establish facing the institutional approach, reflect the ghosts and the organizers shared by the group-family. It follows that the family is an important protagonist to be considered in the current therapeutic and political processes and, thus, is key to welcome the family bonds for the alliances act over the affective destinations, as well as try to remain sealed from the proposed changes.

O BOCA A BOCA ON-LINE: AS IMPLICAÇÕES DA VOZ DO CONSUMIDOR NA COMUNICAÇÃO DE MERCADO

O consumidor contemporâneo, inserido em um novo ambiente de comunicação, potencializa suas expressões, capaz de avaliar uma marca ou produto e transmitir sua opinião pelas redes sociais, ou seja, o consumidor expressa suas opiniões e desejos dialogando com seus pares de forma espontânea nas redes sociais on-line. É neste ambiente de participação e interação (ciberespaço) que está nosso objeto de estudo, o boca a boca on-line – a voz do consumidor contemporâneo, também conhecido como uma manifestação informativa pessoal ou uma conversa, a opinion sharing. Proporcionado pelos consumidores nas redes sociais on-line, o boca a boca se fortalece em função das possibilidades de interação, característica da sociedade em rede. Nesse cenário, oobjetivo desta pesquisa é caracterizar o boca a boca on-line como um novo fluxo comunicacional entre consumidores, hoje potencializado pelas novas tecnologias da comunicação, capazes de alterar a percepção da marca e demonstrar o uso, pelas marcas, das redes sociais on-line ainda como um ambiente de comunicação unidirecional. Mediante três casos selecionados por conveniência (dois casos nacionais e um internacional), o corpus de análise de nossa pesquisa se limitou aos 5.084 comentários disponibilizados após publicação de matérias jornalísticas no Portal G1 e nas fanpages (Facebook), ambos relativos aos casos selecionados. Com a Análise de Conteúdo dos posts, identificamos e categorizamos a fala do consumidor contemporâneo, sendo assim possível comprovar que as organizações/marcas se valem da cultura do massivo, não dialogando com seus consumidores, pois utilizam as redes sociais on-line ainda de forma unidirecional, além de não darem a devida atenção ao atual fluxo onde se evidencia a opinião compartilhada dos consumidores da sociedade em rede.