Indicadores de transtornos de estresse pós-traumático em bombeiros militares

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Gênero, trabalho e saúde mental entre trabalhadoras rurais assentadas na região do Mato Grande Potiguar

The lack of studies aimed at the mental health of the rural population, the social, economic, familial and emotional impact that mental disorders produce and the vulnerability that women have in this context, lead us to believe in the need to investigate the mental health demands of female rural workers, in order to subsidize the development of more effective and culturally sensitive public health programs and policies that take into account the specificities of this population. The present study aims to investigate the prevalence of common mental disorders (CMD) and the possible factors associated with the emergence of such disorders among women living in a rural settlement in Rio Grande do Norte. This survey has a quantitative and qualitative character with an ethnographic approach. As methodological strategies, we made use of an adapted version of the socio-demographic and environmental questionnaire prepared by The Department of Geology/UFRN s Strategic Analysis Laboratory to evaluate the quality of life of the families from the rural settlement and the mental health screening test Self-Reporting Questionnaire (SRQ-20) to identify the prevalence of CMD in adult women from the community. Complementing the role of methodological tools, we use the participant observation and semi-structured interviews with women who presented positive hypothesis of CMD attempting to comprehend the crossings that build the subjective experience of being a woman in this context. The results point to the high prevalence of CMD (43.6%) and suggest the link between poverty, lack of social support, unequal gender relations and the occurrence of CMD. We also verified that the settled women do not access the health network to address issues relating to mental health and that the only recourse of care offered by primary health care is the prescription of anxiolytic medication. In this context, the religiosity and the work are the most important strategies for mental health support among women

Qualidade de vida de pacientes com deformidade dentofacial

In the last decade, an increasing number of studies focusing on the impact of oral deformities on quality of life have been published. However, the evaluation of patients at different phases of the treatment has not been performed. Therefore, the purpose of this study was to determine the impact that dentofacial deformities have on patients` quality of life, as well as the influence exerted by social, economic, demographic and orthodontic factors, type and severity of malocclusion. A bicentric study - of the cross-sectional type of repeated panels - involving two cities - Natal and Rio de Janeiro - was carried out. A total of 227 patients participated in the study: 71 patients in the initial phase of the treatment (before any orthosurgical procedure), 115 patients in the pre-surgical (with braces) phase and 41 patients in the postoperative phase. The quality of life was measured using the Orthognatic Quality of Life Questionnnaire - OQLQ, translated and validated into Portuguese. The normative and aesthetic need for treatment was assessed with the Index of Orthodontic Treatment Need (IOTN) and the Dental Aesthetic Index (DAI); the social, economic and demographic factors, the type of service and malocclusion were also assessed. The data were analyzed through χ2/ Fisher`s exact test to seek the association between the nominal categorical variables in the three phases of treatment, Mann Whitney and Kruskal-Wallis test for gauging the existence of significant differences between two and three groups regarding each domain of OQLQ, respectively. For all tests, it was adopted a significance level of 5%. There was a statistically significant difference (p <0.001) in the general scores of OQLQ and in the domains of social aspects, facial aesthetics and oral function, when the "postoperative group" was compared to the "initial" and "orthodontic preparation" groups. Women, single, aged between 31 and 59 and living in Natal had the greatest impact on quality of life among patients in the "orthodontic preparation" group. Only the variable "income" (2 to 3 minimum wages), for the "initial" group, and gender (female) for the "postoperative" group, showed significant association with quality of life. The normative variable IOTN (DHC and AC) showed significant association with the OQLQ for the "initial" group, and the IOTN-AC-auto in the group of orthodontic preparation, being less important to women. We conclude that the ortho-surgical therapy has positive effects on quality of life after orthognathic surgery

Eosinófilos sanguíneos e fecais em crianças infectadas por helmintos e protozoários

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Prevalência de incontinência urinária e fatores associados em idosos institucionalizados

Urinary incontinence (UI) is a geriatric syndrome that is especially prevalent in institutionalized individuals, and that causes economic and social impacts derived from treatment costs and overload of caregiver. UI also entails physical consequences to the health of the elderly, such as urinary tract infections or pressure ulcers, among other health problems. However, the existing national research on this condition is still scarce and comprises serious methodological biases. Therefore, the objective of this study is to determine the prevalence of urinary incontinence and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted between October and December, 2013 and carried out in 10 nursing homes in the city of Natal (Northeast Brazil). UI was verified through the program Minimum Data Set version 3.0, which was also used to assess fecal incontinence, urinary devices and UI control programs. Data collection included sociodemographic information, UI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity and Pfeiffer test for cognitive status). Bivariate analysis was performed using the Chi-Square Test (or Fisher‟s Exact Test) and the Linear Chi-Square Test, calculating the prevalence ratio with 95% confidence interval. Variables with p value under 0.20 were included in the multivariate analysis, which was performed using the Stepwise Forward logistic regression. The inclusion of variables in the final model depended on the likelihood ratio test, absence of multicollinearity and on the Hosmer-Lemeshow test. A statistical significance level of 0.05 was considered. Six (1.8%) hospitalized elderly, one individual in palliative care (0.3%) and one (0.3%) individual under the age of 60 were excluded from the study. The final sample consisted of 321 elderly, mostly females, with a mean age of 81.5 years. The prevalence of UI was 59.43% and the final model revealed statistically a significant association between UI and white race, physical inactivity, stroke, mobility constraints and cognitive decline. The most frequent UI type was functional UI due to physical or cognitive disability, and incontinence control measures were applied only to a minority of residents (approximately 8%). It is concluded that UI is a health issue that affects more than half of the institutionalized elderly, and is associated with white race, physical inactivity, stroke and other geriatric syndromes such as immobility and cognitive disability. Most of these associated factors are modifiable and therefore the findings of this study highlight the importance of UI prevention and treatment in nursing homes, which include general measures, such as physical and psychosocial activities, and specific measures, such as prompted voiding

Superando a aridez do semi-árido: encontros entre saúde mental e saúde da família na formação de médicos no alto sertão paraibano

A atenção primária à saúde é um importante cenário para o cuidado em saúde mental por suas características e pelo trabalho no território contribuir para a superação do modelo manicomial de atenção. Esta pesquisa partiu do questionamento sobre como acontece a atenção em saúde mental na atenção básica nas unidades em que se desenvolve a Residência de Medicina de Família e Comunidade em um município do sertão paraibano. Objetivou investigar as demandas de saúde mental e práticas de cuidado no contexto de ESF e da RMFC do município de Cajazeiras a partir do discurso dos profissionais ali inseridos e discutir estratégias de qualificação do cuidado em saúde mental nessa realidade. Utilizou-se abordagem qualitativa em que foram realizados grupos focais envolvendo profissionais de duas equipes da ESF e uma equipe de NASF. Os dados produzidos nos grupos foram analisados a partir do referencial da análise do discurso de inspiração foucaultiana. Como resultados evidenciou-se que os profissionais percebem a demanda em saúde mental na atenção básica principalmente na forma de sofrimento psíquico inespecífico e transtornos mentais graves. A atenção a essas pessoas não consegue superar a medicalização que é identificada por esses profissionais. A prática asilar persiste como alternativa para os casos de transtornos mentais graves, sendo limitada a incorporação do paradigma da desinstitucionalização como referencial para a prática profissional. Além disso, a relação com a rede de saúde encontra vários limites destacando-se a dificuldade de produção de continuidade e integralidade do cuidado. A partir disto, analisa-se a formação médica e sua capacidade de garantir o cuidado integral na atenção às demandas de saúde mental. No campo da pesquisa, dois modelos de formação se encontram. Os residentes participantes ou graduaram-se em Cuba ou em escola médica brasileira orientada pelas Diretrizes Curriculares Nacionais. Percebe-se então que a graduação, ao incorporar questões relativas à integralidade do cuidado, não é suficiente para gerar bons profissionais para o SUS. Considera-se necessário somar às mudanças na graduação a perspectiva da Educação Permanente em Saúde no mundo do trabalho, o envolvimento dos profissionais com a transformação das práticas de atenção à saúde e a construção da perspectiva da integralidade e da atenção psicossocial por dentro da Residência de Medicina de Família e Comunidade como importantes estratégias para a formação de médicos generalistas aptos para a atenção às demandas de saúde mental

O trabalho dos assistentes sociais nos hospitais universitários Onofre Lopes (HUOL) e Hospital Ana Bezerra (HUAB) da UFRN: os desafios da formação permanente

This paper discusses the process of training social workers in the environment of University Hospitals- UH s. These hospitals provide space for professional education aiming to achieve a critical and purposeful professional performance. As environments for training, producing knowledge and providing essential services to the public, these hospitals require all members of the healthcare team to have a continued education. Understanding that training has to be a priority and conceived as constant pursuit for update through the interaction of Teaching, Researching and EPO ( Education and Public Outreach). These dimensions provide approximations and domain of theoretical and methodological, giving special importance to understanding the social reality, a sine qua non condition to the work of the Social Service professional. The main goal of the research was to comprehend how the continuous professional education of the social worker occurs and it s relation with the articulations involving Teaching, Researching and EPO, as significant elements for the job of the social workers in the Hospital Universitário Ana Bezerra and Hospital Universitário Onofre Lopes/UFRN. The research was conducted through a literature review, documentary and field inquiries with semistructured interviews including the group of 09 (nine) social workers from the aforementioned hospitals, taking as a reference the quantitative and qualitative approach to analyze mediations that stand between the subject and the social context. The results indicate that social workers in these university hospitals have their insertion beyond the care provided to patients in performance in the areas of education through preceptorship to undergraduate students and social work residents in and extension projects with low insertion in area of research. We note that there is a recognition of the importance of a continuous education, indicating that the qualification of social worker is essential in transforming their daily professional practice to better monitor, critically explain the peculiarities of public health in its everyday showing of how unequally access is provided to the users of the public health system

Turismo e meio ambiente: uma análise do ecoturismo e sua contribuição sócio-ambiental no distrito matutuine: caso da reserva especial de Maputo Moçambique

Mozambique holds a potential for tourism development, especially for nature tourism, due to the existence of conservation areas around the country. The Maputo Special Reserve (MES) is considered as one of the most important conservation area and has benefited from investment in order to incruse the development of tourism in the region. Currently the number of visitors to MES has grown substantially with the intention to develop recreational activities related to ecotourism. Now the challenge lies in the way of optimizing opportunities for tourism development in order to achieve economic benefitis reduction the lead to poverty, without degrading the environment. Ecotourism face the demands and environmental discussions has been assumed as an alternative to the tourist market focused on protected areas, as it is believed that this segment is able to reconcile tourism development and simultaneously improve the conservation of the natural environment and still ensure the recovery of local communities and promoting their welfare. This study aims to analyze, from the perception of the local community, social and environmental contribution of ecotourism in Maputo Special Reserve, Mozambique. The research sought to investigate the relationship between ecotourism development in the region and generate benefits for the socio-environmental communities for residents. To achieve the objective, was chosen a critical analysis about the generation of socio-environmental benefits versus ecotourism in which we opted for a qualitative and quantitative approach seeking to establish the degree of agreement and disagreement about the benefits generated by ecotourism through interviews with community members

Alterações ambientais em Parelhas, Rio Grande do Norte: metais pesados em sedimentos de drenagens e percepção de comunidades rurais em relação a mudanças na paisagem

The conservation of natural resources is essential and constitutes the main subject of many researches, which characterize important aspects concerning the environmental alterations in the ground, water, landscape and socioeconomic information. This study aimed to investigate the anthropogenic input of heavy metals in the environment, in the area of the Parelhas dump site and in part of the Seridó River and to determine the concentration of heavy metals in the sediments. This can result in risk to the environment and human health. In addition, we sought to establish the socioeconomic profile of rural communities adjacent to Seridó River and to comprehend the perception of these dwellers about the changes in the places they live. The area of this study is located in the city of Parelhas/RN, in the centralsouthern part of the State, in the micro-region of the Oriental Seridó. This area comprehends the place where the dump site is located, next to RN 086, the Caldeirão dam, the Quintos river called by local citizens Caldeirão creek and part of Seridó river, perpetuated by the Boqueirão dam, which crosses the city and it includes the rural communities of Almas, Domingas, Sussuarana II and Colonos. Regarding the study with bottom sediments, the samples were collected and taken to the laboratory of geochemistry, where they were dried, sieved, weighted and submitted to weak acid attack. The analysis of heavy metals was held by Atomic Absorption Spectrophotometer - Flame AAS. We applied 23 closed questionnaires constituted by 38 questions to collect informations in the rural communities, oriented to establish the socioeconomic profile and the environmental perception of the participants. The participants were distributed in the communities of Almas (1), Domingas (2), Sussuarana II (10) and Colonos (10). Most of them presented similar socioeconomic profiles. They are from 45 to 60 years old and live in these localities for 20 to 30 years or more. The families are composed by 3 or 4 people; the agriculture is the main activity, livestock is the secondary and 48% of them earn the minimal wage. Regarding the environmental perception, the participants can realize some changes in vegetation, soil, water and landscape. People living longer in the community, and with more years of experience on the local reality can perceive the depletion of the soil, pastures and changes in the landscape. These changes portray how the place was previously and what it represents today. The perception of these changes, besides the environmental ones, includes others concerning the increasing number of dwellers in the last years, as well as the number of houses. The changes happened through activities developed by the dwellers over the years, including agricultural practices, livestock, grass planting and even the cultivation of cotton. The study provided the acquisition of new data about the environmental reality of this region. It can subsidize the definition of public policies that can be implemented from the perspective of conservation of water resources and of the coexistence and survival of man in the semi-arid

Percepção de riscos ambientais de populações vulneráveis a inundações e deslizamentos de dunas em Natal-RN

In urban, flooding and landslides are among the troubles that most bring human and material loss. Therefore, this study objected to perform an analysis on the risk perception on the population living in social environmental vulnerable places in order to understand what is the way this population realize the risks they are exposed to and what are the outbrave strategies the develop. The first analyzed area was Complexo Passo da Pátria for the flooding risk problematic and then the Cidade Nova neighborhood threatened by the dunes slides. The areas locate, respectively, in the West and East zones of Natal-RN. Using an interview screenplay adapted from risk perception researches from different brazilian cities, it was collected primarily data on the variables: perception, evaluation and choice, safety threshold, adjustment, decision and participation. Due to the studied areas characteristics the qualitative approach adjusted itself to the difficulties for accessing the areas. The studied places characterize for its insecure situation like selling/using drugs, robbery and murder among others. Due to this situation the interviewed individuals were the ones that could be found more accessibly and available in the moment and the interviews were made in the community leader presence of each area. Through the discourse of the respondents analysis it was able to conclude that the interviewed population is exposed to a high vulnerability grade and risks. However it was identified substantial differences between the perception and risks of Complexo Passo da Pátria and bairro Cidade Nova, because in the first area the intervied ones can recognize the high risk they are exposed to in a more emphatic way to the interviewed ones for the Cidade Nova neighborhood. Furthermore, there is a heavy dissatisfaction for the population of the two places about the city hall positions relating to the present problems in the studied areas. It was also identified the strategy development of acquaintanceship with the risk in the research places beyond a feeling of belonging and affection between the dwellers and the places, yet it was more evident for Complexo Passo da Pátria. Though this analysis it was possible to understand and perceptions and the behavior of the individuals or social groups facing the risks as acceptance and rejection of determined risks beyond adaptation measures of living together with the persistence presence of risks. Therefore, qualitative nature researches emphasizing the perception approach are in the fundamental importance in the studies about risks making it possible to offer aids to the urban planning and management in the implement of effective preventive measures and compatible with the population aims

Protozoários de vida livre em dois trechos da bacia hidrográfica do rio pirangi (RN): relações com a educação em ciências e preservação

The vast hidric wealth of Brazil gets its watersheds more susceptible to impacts that compromise the water quality, affecting the ecosystem stability of aquatic environments. The decrease in the quality of water resources also results in a decrease of its multiple uses, especially in tourist areas of the coast, where the continuous flow of people to these sites increases even further the probability of inappropriate behavior of both tourists and local residents. Studies regarding the microbiological communities are still scarce, especially on the free-living protozoa that play unique roles in the food chain of aquatic ecosystems. Due to the large role played by this group of microorganisms in aquatic environments, the present study aimed at identifying the genus and species of free-living protozoa present in two sections of the Pium River, east coast of Rio Grande do Norte, making an association between the its occurrence and trophic conditions of the environment in which they are, also checking the bioindicator capacity of these organisms in water quality. It also aimed to conduct a survey with students to identify the main difficulties regarding the knowledge of free-living protozoa and hydric transmission diseases in two public schools near the river studied in the Pium district, county of Parnamirim. The survey was analyzed by means of questionnaires at both schools. Students identified several activities developed Pium river, highlighting its multifunctionality and importance to the region. A total of 76 taxa of free-living protozoa was recorded, of these, 33 were ciliates, 19 flagellates and 24 sarcodia. The spatial and temporal patterns of these organisms to both points studied revealed the bioindicator potentiality of some effective species identified. However, knowledge about the free-living protozoa proved quite lagged, presenting misconceptions that show them as pathogenic organisms exclusively, totally disregarding their ecological role. In order to remedy the flaws existing in students in relation to the functional role of protozoa, workshops were planned on these microorganisms while also addressing issues related to hydric transmission diseases through lectures, recreational activities and interactive presentations. These practical activities of Science Education had the goal of bringing students the context of local water resources, aiming to promote a greater clarification regarding of the functional role of free-living protozoa in aquatic environments

Processos sócio-ambientais relacionados às situações de degradação na região do Rio Doce, Natal/RN

Natal is a medium-sized coastal city (800.000 inhabitants), capital of the State of Rio Grande do Norte, in the Northeast of Brazil. According to statistics published by the IBGE (2000), the area of Natal that stretches from Redinha to Lagoa Azul holds about 12% of the municipal population. Part of this area is bordered by a watercourse, the Rio Doce, which has been afflicted by a range of socio-environmental problems over the years. This study was carried out with the aims of 1) identifying the socio-environmental processes related to urban expansion, with an emphasis on those causing environmental degradation in this region; b) analysing the perception of the target population in relation to the environment it occupies; and c) determining the socioeconomic profile of the local residents and the sanitary facilities available to them. A survey was carried out by conducting interviews and completing questionnaires with the residents to assess the situation both qualitatively and quantitatively in the communities of Caiana, Pajussara Sítio, Gramoré Povoado and Gramoré Sítio, as well as by conducting bibliographical and documentary research. It was discovered that the sanitary conditions of the riverside dwellers are precarious and only 1% of the houses in the suburbs mentioned are connected to the public sewers. It was established that the Rio Doce is intensively exploited through the extraction of sand for the building trade, irrigation of riverside vegetable plots and use of the water for bathing, washing of clothes and leisure. It was also found that about 40% of the population resident in this area has migrated from the rural zone, which is one of the factors rendering it difficult for them to adapt to the urban setting. Such information can be of use to the authorities in the environmental planning of these districts and their sustainable development

Festa na escola e a autopoiese do lazer

This study shows the problem of school party and its relations with the perspective of leisure autopoiesis in the lives of students living in student housing. It has aimed to describe and interpret the most meaningful leisure experiences in daily life of a student housing and the ludopoietic processes for the humanescent self-education. From the theoretical assumptions supporting the development of this research have highlighted: Education by Freire (1996); Embodiment by Pierrakos (1990); Leisure by Dumazedier (1999); Party by Duvignaud (1983), Playful by Schiller (2002), Working by Freinet (1998), Autopoiesis by Maturana and Varela (2001), belonging to each day by Certeau (1994). A qualitative study adopts the principles of existential action research, in an ethnofenomenological perspective. As a methodology, we use the metaphor of sowing covering the planting, flowering, harvest and new planting. The scenario was to sow the Escola Agrícola de Jundiaí - RN. Twenty-five students residing in the school participated in research from 2007 to 2008, which involved more actively in the development of an extension project for the implementation of recreational and leisure experiences in that institution. The main instruments used for the construction of data collection were: participant observation, questionnaire, interview, game sand and photographs. The process of data analysis with the ethnofenomenological principles emphasized the following points: experientiality, indexicality, reflexivity, self-organizability, adoptability, archetypal and humanescenciality. New meanings of ludopoietic flowering of seed "party school" were revealed, and you can see the emergence of autopoietic leisure as a big green tree, able to sprout in soil properly fertilized to produce wonderful fruit of joie de vivre

Sociodemographic and clinical characteristics, causal factors and evolution of a group of patients with chronic urticaria-angioedema

CONTEXTO E OBJETIVO: Urticária-angioedema crônico é enfermidade freqüente, complexa e multicausal. O objetivo foi estudar as características sociodemográficas, clínicas, os fatores causais, agravantes e a evolução da enfermidade. TIPO DE ESTUDO E LOCAL: Descritivo e prospectivo, realizado no ambulatório de Dermatologia da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp). MÉTODOS: Foram avaliados pacientes com diagnóstico de urticária-angioedema crônico através de dados sociodemográficos, anamnese, exames dermatológico, clínico e laboratorial, com ênfase nos fatores causais, agravantes e na evolução da enfermidade. RESULTADOS: 125 pacientes foram incluídos, 95 mulheres e 30 homens. Predominaram mulheres de 30 a 40 anos e homens de 10 a 20 anos. A idade média foi de 35 anos para as mulheres e 32 anos para os homens. Predominaram pacientes de raça branca, residentes em zona urbana e casados. O tempo médio de doença foi de 45,6 meses e de cada lesão foi de 5,6 horas. A metade dos casos tinha surtos diariamente e associação de urticária com angioedema. Não houve horário preferencial de aparecimento dos surtos, mas o noturno foi o horário de piora mais citado. A causa foi esclarecida em 37,6%, predominando as infecções. O estresse foi o agravante mais referido. O tempo médio de acompanhamento foi de 11,7 meses e 60% evoluíram para o controle, 32% melhoraram, 9% mantiveram-se inalterados e um caso piorou. CONCLUSÕES: Urticária-angioedema ocorreu mais em mulheres de meia-idade. A causa foi esclarecida em um terço dos pacientes e metade deles teve controle da doença em aproximadamente um ano.

Soroprevalência da infecção chagásica em moradores de municípios da região de Botucatu, Estado de São Paulo

O objetivo deste estudo foi o de procurar evidências da transmissão vetorial da doença de Chagas, nos domicílios e peridomicílios de indivíduos residentes em municípios da região de Botucatu, que tiveram xenodiagnóstico positivos. Foram estudados 58 indivíduos e foi coletada amostra do sangue para a realização de exames laboratoriais. Os resultados deste estudo mostraram que os indivíduos, de ambos os grupos, tinham baixa escolaridade e exerciam profissões que não exigiam qualificações técnicas. Houve discreto predomínio de indivíduos do sexo feminino. Quando comparadas às condições anteriores, verificou-se que houve discreta melhora nas condições de habitação, por outro lado, houve aumento de moradores em zona rural. Os indivíduos nascidos antes de 1983, apresentaram conhecimento e contato com triatomídeo estaticamente mais elevado quando comparado com os nascidos a partir 1983. A análise e comparação dos resultados das sorologias, referentes aos hemaglutinação passiva indireta, imunofluorescência indireta e ensaio imunoenzimático, mostrou que o ELISA apresentou maior sensibilidade. Os resultados deste estudo mostram que a população nascida a partir de 1983 não conhecia o vetor transmissor da doença de Chagas.