Perfil dos usuários de um centro de atenção psicossocial infantojuvenil da grande São Paulo, Brasil

INTRODUÇÃO: os Centros de Atenção Psicossocial Infantojuvenil (CAPSi) constituem ponta de lança das ações da Reforma Psiquiátrica Brasileira e têm por finalidade o atendimento de crianças e adolescentes com transtornos psíquicos graves. O objetivo é caracterizar o perfil dos usuários de um CAPSi, considerando sexo, idade, hipótese diagnóstica, origem do encaminhamento, inserção escolar e motivo de consulta. MÉTODO: por meio de um protocolo, foram coletados dados da totalidade de prontuários ativos de uma unidade da Grande São Paulo - cento e três - no mês de janeiro de 2008. RESULTADOS: a maioria dos usuários atendidos está na faixa etária de cinco a quinze anos (68,9 por cento) e é do sexo masculino (61,2 por cento). O grupo de transtornos de comportamento e transtornos emocionais corresponde a 21,4 por cento, seguido pelos transtornos do desenvolvimento global (16,2 por cento) e retardo mental (10,5 por cento). A maioria dos usuários foi encaminhada pelo Conselho Tutelar (22,3 por cento) e tiveram como principal motivo da consulta queixas neuromotoras (17,5 por cento), escolares (15,5 por cento) e sociocomportamentais (14,6 por cento). CONCLUSÕES: o número elevado de crianças com problemas neuromotores pode indicar características específicas da instituição estudada que absorveu pacientes e profissionais de um antigo serviço de reabilitação. O grande número de questões relevantes não encontradas apontam para a falta de padronização dos prontuários

O difícil acesso a serviços de média complexidade do SUS

O acesso aos serviços de média complexidade tem sido apontado, por gestores e pesquisadores, como um dos entraves para a efetivação da integralidade do SUS. Este artigo teve o objetivo de avaliar mecanismos utilizados pela gestão do SUS, no município de São Paulo, para garantir acesso à assistência de média complexidade, durante o período de 2005 a 2008. Optou-se pela estratégia de estudo de caso, utilizando as seguintes fontes de evidência: entrevistas com gestores; grupo focal com usuários e observação participante. Utilizouas técnica de análise temática, a partir do referencial teórico da integralidade da assistência, na dimensão da organização de serviços. Buscou-se descrever os caminhos percorridos pelos usuários para acessar os serviços da média complexidade, a partir da visão dos gestores e dos próprios usuários. A média complexidade foi identificada, pelos gestores, como o "gargalo" do SUS e um dos principais obstáculos para a construção da integralidade. Para enfrentar essa situação, o gestor municipal investiu na informatização dos serviços, como medida isolada e, ainda, sem considerar a necessidade dos usuários. Sendo assim, essa incorporação tecnológica teve pouco impacto na melhoria do acesso, o que se confirmou no relato dos usuários. Discute-se que para o enfrentamento de um problema tão complexo são necessárias ações articuladas, tanto no âmbito da política de saúde, quanto da organização dos serviços, bem como a (re)organização do processo de trabalho em todos os níveis do sistema de saúde

Saúde bucal e cuidado odontológico: representações sociais de mães usuárias de um serviço público de saúde

Objetivo: identificar as representações sociais de mães de crianças da faixa etária de zero a cinco anos de idade do Núcleo de Saúde da Família IV, em Ribeirão Preto-SP, procurando saber o que pensam sobre saúde bucal e tratamento odontológico. Método: trata-se de pesquisa qualitativa, sendo utilizada a entrevista semi-estruturada para a coleta dos dados e a análise de conteúdo. Resultados: constatou-se grande dificuldade das mães em se expressar a respeito do que é, para elas, saúde. Para essas mães a saúde bucal está relacionada com normas de higiene e dietéticas e também com a ida ao dentista, restringindo-se na preocupação com a estética e pouco com a função. Já em relação ao tratamento odontológico, a grande maioria demonstrou apresentar medo, causado pela sua experiência anterior com o tratamento. A assistência particular está associada à pontualidade e ao atendimento da maneira desejada enquanto o tratamento oferecido pelo setor público à demora e à falta de equipamentos e materiais. A humanização no atendimento e competência do profissional emergiram como dois aspectos importantes, e podem estar determinando a decisão de ir ou não ao dentista. Conclusões: A expressão saúde bucal foi associada à assistência odontológica. O atendimento pelo setor privado foi referido como o que mais se aproxima do tipo ideal de assistência odontológica

A questão social na França contemporânea: uma experiência de pesquisa

A França passou por conflitos urbanos em seus bairros populares. Incidentes com a polícia marcados pela morte de um morador, geralmente jovem ou adolescente, são seguidos por manifestações violentas: quebra-quebras, incêndios de carros e/ou estabelecimentos públicos e privados, enfrentamentos com a polícia. Nos conflitos da "banlieue" francesa podem ser percebidos elementos comuns a eventos ingleses e/ou americanos de outras décadas.OBJETIVO: consiste em identificar a percepção e as representações de moradores sobre suas condições de vida e saúde na França.MÉTODO: pesquisa qualitativa realizada em Les Aubiers, bairro popular de Bordeaux, nos anos de 2002 e 2005. A população de moradores desse bairro e é composta principalmente por imigrantes ou fanceses de origem estrangeira, provenientes de diferentes locais: África do Norte, África Sub-Sahariana, Turquia, Portugal , Ilha de Reunião. Os indicadores sociais e econômicos apresentam níveis significativamente mais baixos do que os de outros bairros de Bordeaux, acompanhando as tendências encontradas nas outras "banlieues". Entre esses indicadores, a taxa de desemprego, principalmente entre jovens, é alarmante (40 por cento).RESULTADOS E DISCUSSÃO: as políticas sociais deveriam ser mais voltadas para os indivíduos do que para o território, pois este só poderá ser transformado pelos primeiros e não o contrário. Um bairro e uma população estigmatizados, estão contemplados por uma ampla política social. Ainda que passível de crítica, não se pode ignorar a existência de esforços sistematicos de integração, nem a existência de políticas sociais. Se elas são inadequadas, trata-se de ampliar o espaço de discusão para sua reforma. Trata-se de saber qual a disposição das sociedades contemporâneas, como um todo, para lutar contra as inequidades e segregações

Mobility and social network effects on extremist opinions

Understanding the emergence of extreme opinions and in what kind of environment they might become less extreme is a central theme in our modern globalized society. A model combining continuous opinions and observed discrete actions (CODA) capable of addressing the important issue of measuring how extreme opinions might be has been recently proposed. In this paper I show extreme opinions to arise in a ubiquitous manner in the CODA model for a multitude of social network structures. Depending on network details reducing extremism seems to be possible. However, a large number of agents with extreme opinions is always observed. A significant decrease in the number of extremists can be observed by allowing agents to change their positions in the network.

A produção social do conhecimento na sociedade da informação

This work is an approach to some problems and challenges to a contemporary social construction of knowledge from some paradoxes generated around the concepts of knowledge, information, culture and information society. The article proposes to think over problems about a common sense concept which is that the technologies would automatically release the man from repetitive work and would allow the access to information and knowledge. In this sense, it points out to the importance of cultural mediation and information activities in the field of Information Science.

Ovariole structure and oogenesis in queens and workers of the stingless bee Melipona quadrifasciata (Hymenoptera: Apidae, Meliponini) kept under different social conditions

The high variability in the reproductive biology of stingless bees makes them very amenable for comparative studies with other eusocial bee taxa. We investigated the structural organization of the ovaries of Melipona quadrifasciata queens and workers kept under different social conditions by analyzing their general histology, mitotic activity, and microfilament organization. The overall dynamics of ovarian activity were similar in the two castes, and at emergence their ovarioles contained a previtellogenic follicle. Stingless bees and honey bees differ in the structural organization in the lower germarium, but they have in common synchronized mitotic activity and putative germ line stem cells in the terminal filament. Unlike honey bees, stingless bee workers lay trophic eggs in addition to reproductive eggs. The overall similarities in oogenesis between the two taxa suggest that the decision to form trophic eggs should only occur in the late stages of oogenesis.

Social Networks Shape the Transmission Dynamics of Hepatitis C Virus

Hepatitis C virus (HCV) infects 170 million people worldwide, and is a major public health problem in Brazil, where over 1% of the population may be infected and where multiple viral genotypes co-circulate. Chronically infected individuals are both the source of transmission to others and are at risk for HCV-related diseases, such as liver cancer and cirrhosis. Before the adoption of anti-HCV control measures in blood banks, this virus was mainly transmitted via blood transfusion. Today, needle sharing among injecting drug users is the most common form of HCV transmission. Of particular importance is that HCV prevalence is growing in non-risk groups. Since there is no vaccine against HCV, it is important to determine the factors that control viral transmission in order to develop more efficient control measures. However, despite the health costs associated with HCV, the factors that determine the spread of virus at the epidemiological scale are often poorly understood. Here, we sequenced partial NS5b gene sequences sampled from blood samples collected from 591 patients in Sao Paulo state, Brazil. We show that different viral genotypes entered Sao Paulo at different times, grew at different rates, and are associated with different age groups and risk behaviors. In particular, subtype 1b is older and grew more slowly than subtypes 1a and 3a, and is associated with multiple age classes. In contrast, subtypes 1a and 3b are associated with younger people infected more recently, possibly with higher rates of sexual transmission. The transmission dynamics of HCV in Sao Paulo therefore vary by subtype and are determined by a combination of age, risk exposure and underlying social network. We conclude that social factors may play a key role in determining the rate and pattern of HCV spread, and should influence future intervention policies.

Social interaction as a heuristic for combinatorial optimization problems

We investigate the performance of a variant of Axelrod's model for dissemination of culture-the Adaptive Culture Heuristic (ACH)-on solving an NP-Complete optimization problem, namely, the classification of binary input patterns of size F by a Boolean Binary Perceptron. In this heuristic, N agents, characterized by binary strings of length F which represent possible solutions to the optimization problem, are fixed at the sites of a square lattice and interact with their nearest neighbors only. The interactions are such that the agents' strings (or cultures) become more similar to the low-cost strings of their neighbors resulting in the dissemination of these strings across the lattice. Eventually the dynamics freezes into a homogeneous absorbing configuration in which all agents exhibit identical solutions to the optimization problem. We find through extensive simulations that the probability of finding the optimal solution is a function of the reduced variable F/N(1/4) so that the number of agents must increase with the fourth power of the problem size, N proportional to F(4), to guarantee a fixed probability of success. In this case, we find that the relaxation time to reach an absorbing configuration scales with F(6) which can be interpreted as the overall computational cost of the ACH to find an optimal set of weights for a Boolean binary perceptron, given a fixed probability of success.

The development of social tourism in Brazil

This article reflects on the origins and development of social tourism in Brazil, with particular reference to the socio-economic conditions in the country. It discusses the theoretical conceptualisation of social tourism and its implementations in the non-European context. The case study presented here is based on a secondary bibliographical research of existing definitions and an in-depth analysis of the political conditions that have framed its development. More particularly, this article will discuss public initiatives since the Labour Party gained power in Brazil in 2003. Apart from public sector involvement in social tourism, this article also examines the role of the third sector in provision. The example of Social Service of Commerce will be presented. This article will conclude by evaluating the phenomenon of social tourism in Brazil, highlighting where progress has been made and which are the key challenges that need to be overcome.

Street children and their relationship with the police

Background: This paper explores and analyses the experiences of school-age street children. It specifically addresses the relationship of the street children who live on the streets of Sao Paulo (a large Brazilian metropolis), in relation to their experiences, with the policemen. Methods: The paper is a secondary analysis of date previously collected in 1999. The data were collected through individual semi-structured interviews, with 14 school-age children frequenting two city public refuges, with their legal guardians` consent. The text from transcribed interviews was organized according to the validity norms of `thematic analysis`, a technique of contents analysis method. The decomposing and reconstructing process of that analysis gave rise to thematic categories (among which `the police category`) that represented the reconstruction of the difficulties faced by the children in their development. Results and discussion: The children portrayed the police as an enemy, a fearful figure and one of the most agonizing street experiences. Rarely did the police have a positive image to them. According to the children, police violence occurs in three forms: through systematic police persecution in an effort to remove the children from the streets against their will; actions that had the deliberate intent to humiliate them with verbal or physical aggression; and through alleged sexual abuse, revealed by the children in a veiled manner. The authority that is supposedly intended to protect them is portrayed as one of the most feared social agents. Conclusion: The reported hostile behaviour of the policemen shows the state of vulnerability of those children living on the street. This situation must be focused like a health problem because it causes injury to development of children. Nurses can help them through organizing assistance to children in situation of personal and social risk in the school nursing and health institution.

Violence against women: a study of the reports to police in the city of Itapevi, Sao Paulo, Brazil

Background: violence against women is a serious problem caused by the social construction of feminineness and masculineness that results in the domination of women by men. Public policies on gender have recently been developed in order to confront the problem. But what exactly are the problems faced by women? Purposes: to survey and analyse cases of violence against women reported to the police, as recorded at the Police Stations for Women`s Defence (PSWDs), and to reconstruct the procedures that women must go through in order to denounce their aggressors. Methodology: this quantitative, exploratory and descriptive study was undertaken during 2006-2007 in the city of Itapevi, Sao Paulo metropolitan region, Brazil. As there is no PSWD data were collected from police reports from PSWDs of neighbouring cities. Findings: malicious physical injury (49%) and threats (42%) were the most commonly reported types of violence. The victims were aged between 20 and 49 years (93%). Almost all of the aggressors (97%) were men and most had an intimate relationship with their victim. The use of alcoholic beverages was linked to approximately 25% of the cases. Conclusion: women who are victims of domestic violence in Itapevi report that going through PSWDs of neighbouring cities is a difficult, isolated, long and expensive process that often, provides no institutional protection. Implications for practice: there is an urgent requirement for judicial-assistance and support close to home in order to provide a quality service and follow-up for these women and their aggressors; to provide training for the professionals called to attend them at police stations; and for a caring attitude from health-care professionals.,0 2010 Elsevier Ltd. All rights reserved.

Maternal decision on obtaining prenatal care: a study in Brazil

Objective: to address the social aspects of pregnancy and the views of pregnant women regarding prenatal assistance in Brazil. Design: this qualitative study was focused on describing the Social Representations of prenatal care held by pregnant women. The discourse of the collective subject (DCS) framework was used to analyse the data collected, within the theoretical background of social representations, as proposed and developed by Serge Moscovici. Participants and setting: 21 pregnant women who were users of the publicly funded Brazilian unified health-care system and resided in the area served by its family health programme in a low- to middle-income neighbourhood on the outskirts of Campo Grande, the capital of the state of Mato Grosso do Sul, in southwestern Brazil. Data were collected by conducting in-depth, face-to-face interviews from January to October 2006. Findings: all participants were married. Formal education of the participants was less than five years in four cases, between five and eight years in six cases, and greater than 11 years in 10 cases. Nine participants had informal jobs and earned up to US$ 200 per month, four paricipants had administrative jobs and earned over US$ 500 per month, and eight participants did not work. No specific racial/ethnic background predominated. Lack of adherence to prenatal care allowed for the identification of two DCS themes: `organisation of prenatal care services` and `lifestyle features`. Key conclusions: the respondents were found to have negative feelings about pregnancy which manifest as many fears, including the fear of harming their children`s health, of being punished during labour, and of being reprimanded by health-care professionals for overlooking their prenatal care, in addition to the insecurity felt towards the infant and self. Implications for practice: the findings reveal that communication between pregnant women and healthcare professionals has been ineffective and that prenatal care has not been effective for the group interviewed-features that are likely to be found among other low- to middle-income groups living elsewhere in Brazil. (C) 2009 Elsevier Ltd. All rights reserved.

Social behaviour of collared peccaries (Pecari tajacu) under three space allowances

Captive breeding of peccaries is on the increase in neotropical countries. Few studies, however, have reported behavioural responses of wild animals under farmed conditions. Therefore, the aim of this study was to evaluate the effects of space allowance on the occurrence of social behaviour patterns on farmed collared peccary (Pecan tajacu). We observed three herds of collared peccaries each containing eight acquainted individuals. Using a 3 x 3 Latin square design, herds were allocated, in a random order, to one of the three experimental enclosures, each with a different size. 375, 750 and 1,500 m(2) of total available area, each with three wooden shelters. We recorded all the occurrences of selected positive and agonistic behavioural patterns that occurred 90 min before and during feeding Enclosure size had a significant effect on agonistic patterns of peccaries during feeding, in that more agonistic behaviour was observed in smaller spaces We also found that shelter usage increased as space decreased Differing space allowances, however, did not have an effect on the occurrence of positive interactions that were more frequent before compared to during feeding. We concluded that enclosure size had an effect on the expression of agonistic be and the use of shelters by collared peccaries Thus, animal welfare can be improved by adopting at least 187 5 m(2) per peccary. In addition, our study also confirmed the importance of shelter areas in collared peccary husbandry.