FATORES DE RISCO E DE PROTEÇÃO À SAÚDE E A VIDA EM ADOLESCENTES DEFICIENTES VISUAIS

A condição da deficiência é observada ao longo da história da humanidade. Informações, da Organização Mundial da Saúde e do Brasil, mostram a existência no país de 3,6 milhões de pessoas com deficiências visuais, sendo 900 mil cegos e 2,7 milhões de pessoas com baixa visão. A evolução da deficiência visual está relacionada às questões, como o crescimento populacional, dificuldades econômicas, aumento da expectativa de vida, escassez de serviços especializados e falhas na prevenção. Os participantes, deste estudo, foram adolescentes com deficiência visual, possuidores de baixa visão. Foram investigados os fatores de risco e de proteção a saúde e a vida e a avaliação da qualidade de vida. O método de investigação é exploratório e descritivo, com abordagem qualitativa e quantitativa, uma obtida com a aplicação de uma escala de autopreenchimento, que aborda a percepção dos sujeitos sobre a qualidade de vida e a outra, a partir de entrevistas individuais. As análises dos dados obtidos apresentam, que a Qualidade de Vida é percebida e avaliada por eles, positivamente, pois, não existem indicadores negativos nesta questão. Os domínios com maior predominância foram o físico e o psicológico, em que se sobressaiu em comparação aos domínios das relações sociais e meio ambiente. Em relação aos riscos, observamos que existe maior vulnerabilidade em relação à locomoção em espaço público, o nível de deficiência, a superproteção materna e familiar, a dificuldade no processo de ensino aprendizagem, isolamento, fazer escolhas, bebidas alcoólicas e sexualidade. Relatam que lidam com esses riscos por meio da estimulação dos demaissentidos, pelo uso e estimulação da visão residual, boa, meio de uma boa saúde, integração grupal, utilização dos discursos disponíveis, como tecnologia e Braille e por meio da religiosidade. Revelam que a proteção ocorre a partir da auto-estima, do suporte social, por meio de amigos e familiares, pelos professores e um processo de ensino/aprendizagem adequado a esta condição, além do lazer. As expectativas para o futuro envolvem trabalho e estudo, além de questões de desenvolvimento pessoal, profissional e social. Os adolescentes, com deficiência visual, pesquisados, buscam mais autonomia e oportunidades para atravessar os desafios desta complexa etapa do ciclo vital da mesma forma que os demais adolescentes

CARACTERÍSTICAS PSICOSSOCIAIS E DE PERSONALIDADE DE ADOLESCENTES INFRATORES EM CUMPRIMENTO DE MEDIDA SOCIOEDUCATIVA

Para atingir os objetivos propostos, ou seja, levantar e descrever indicadores socioculturais de uma amostra de adolescentes em cumprimento de medida socioeducativa, e descrever características psicológicas e de personalidade dos adolescentes infratores, num estudo que pesquisou adolescentes em cumprimento de medida socioeducativa. O trabalho foi realizado em duas as etapas: na primeira, os 47 adolescentes participaram de uma entrevista semidirigida; na segunda, dez desses adolescentes foram selecionados e submetidos a um instrumento projetivo para investigação de aspectos da personalidade: o “desenho da Figura Humana” de Machower, adaptado por Van Kolck (1956; 1984). A discussão teórica dos resultados baseou-se numa abordagem psicanalítica pós-freudiana para a compreensão da adolescência tanto como fase do desenvolvimento humano como dos comportamentos antissociais. Os resultados do estudo corroboraram a teoria advinda da literatura psicológica que aborda padrões comuns no período da adolescência, fase em que ocorre um complexo de fatores individuais da maturidade biológica associados ao meio social/cultural e que, por sua vez, estabelecem relações com as instâncias psicológicas ou psíquicas do sujeito junto com as características específicas de cada indivíduo. Na busca da compreensão desses padrões comuns da amostra dos adolescentes infratores utilizados no presente estudo, foram levantados dados do perfil psicossocial, cultural e demográfico; dos aspectos psicossociais e aspectos psicodinâmicos e de características de personalidade. A título de conclusão, o estudo destacou a problemática do adolescente em conflito com a lei, associada às questões sociais, de saúde mental, além do desenvolvimento psíquico, sinalizando a necessidade de ações psicoprofiláticas voltadas para população infantil, jovem, agrupamentos familiares e para a comunidade que representa seu entorno.

A (R)EXISTÊNCIA DAS VOCACIONADAS AO MINISTÉRIO PASTORAL BATISTA: DESCORTINANDO A RELAÇÃO ENTRE AS PASTORAS BATISTAS DE SÃO PAULO E A NÃO FILIAÇÃO NA ORDEM DOS PASTORES BATISTAS DO BRASIL EM SÃO PAULO (OPBB-SP)

O contexto batista é predominantemente marcado por lideranças masculinas, destinando às mulheres apenas lugares e comportamentos socialmente estabelecidos, como a casa, o cuidado, a maternidade, a submissão, entre outras características que enfatizam a hierarquia de gênero. Mesmo diante do desenvolvimento econômico e da ocupação que as mulheres estão conquistando no campo público, a igreja e principalmente as igrejas batistas, permanecem fundadas em alicerces que exaltam o poder masculino em detrimento do lugar que deve ser ocupado pelas mulheres, ou seja, onde elas decidirem atuar. Caso elas decidam atuar num campo predominantemente masculino, terão que lidar com a desconstrução de um pensamento socialmente permeado de dominação masculina e com a árdua construção de um pensamento que vise a igualdade de gênero. O objeto desta pesquisa é o ministério pastoral feminino no contexto batista brasileiro. O texto analisa o discurso das Pastoras Batistas do Estado de São Paulo e o discurso dos líderes da Ordem dos Pastores Batistas de São Paulo (OPBB-SP) a respeito do ministério pastoral feminino e a não filiação de mulheres na OPBB-SP. A importância deste trabalho é a de demostrar as relações de micro poder existentes entre pastores e pastoras e concomitantemente as desigualdades dentro do contexto batista com relação ao ministério pastoral feminino. Essa afirmação se consolida por meio das análises das entrevistas semiestruturadas que realizei na pesquisa de campo, com sete pastoras batistas do Estado de São Paulo, bem como com três líderes da OPPB-SP. Esta é uma pesquisa qualitativa, em que foram analisados documentos oficiais da igreja, como pautas de convenções, atas, sites institucionais, periódicos e documentos não oficiais encontrados em redes sociais, blogs, jornais online, entre outros. Posso afirmar que as pastoras batistas estão se mobilizando para cumprir sua vocação, usando argumentos transcendentes que impedem qualquer pessoa de desafiar ou duvidar de seu chamado pastoral, pois: “O vento sopra onde quer; ouve-se o ruído, mas não sabes de onde vem, nem para onde vai. Assim acontece com aquele(a) que nasceu do Espírito.” (João 3.8).

Avaliação da qualidade da assistência à mulher e ao filho durante o parto normal

The practices developed in the everyday life of obstetric services are sometimes out of step with the recommendations of the public health policies. Accordingly, this research had the objective of assessing the quality of the care provided to women and children during cases of natural childbirth in municipal public maternity wards of the city of Natal/RN, Brazilian Northeast. We developed a cross-sectional and quantitative study in two maternity wards that provide care actions to pregnant women at regular risk (maternity wards A and B). The participants were 314 puerperal women who were treated during the period between April and July 2014, whose children were born alive, through transpelvic way, with spontaneous or induced beginning of labor and that showed physical and emotional conditions to respond to the proposed questions. The data collection instrument was constructed on the basis of the recommendations of the World Health Organization focused on the care of normal childbirth and validated by skilled judges, and the final version has obtained optimum agreement (k = 0,96; IVC = 0,99). Associated with these recommendations, we used three indicators: percentage of women with induced labor or subjected to elective cesarean section (Indicator A); percentage of women served by a qualified health professional during labor and childbirth (Indicator B); and Bologna Index (Indicator C). The research obtained a favorable opinion of the Research Ethics Committee from the Federal University of Rio Grande do Norte, under the nº 562.313 and Certificate of Presentation for Ethics Appreciation: 25958513.0.0000.5537. The analysis of categories related to the recommendations of the World Health Organization was conducted by means of absolute and relative frequency and the Chi-square Pearson’s and Fisher’s exact tests made the comparison of the differences observed between the two maternity wards. Furthermore, we calculated the percentage of the indicators A and B and with the results of the Indicator C, the quality was assessed as follows: the closer to 5, the better will be the quality, and the closer to 0, the worst will be the quality, and the Mann-Whitney U test was used to compare the differences of the obtained averages. The significance level of 5% was considered in all statistical tests. The differences between the maternity wards were identified with regard to the provision of liquids orally (p=0,018), stimulus for non-supine positions (p=0,002), existence of partograph (p=0,001), support or welcoming by health professionals (p= 0,047), intravenous infusion (p<0,001), supine position (p<0,001), use of oxytocin (p<0,001), food and liquid restriction (p= 0,002) and, lastly, the fact of the touch is performed by more than 1 examiner (p=0,011). The indicators A and B showed percentages of 13,09% and 100%, respectively. The overall average of the Indicator C was equal to 2,07 (± 0,74). There was a statistically significant difference between the averages of the maternity wards (p<0,001). The care actions provided during the process of labor and childbirth is inappropriate, especially in the maternity ward B. It is necessary to implement improvements and redesign the obstetric model in force

Um estudo sobre o perfil sexual e reprodutivo das adolescentes de um serviço de referência no município de Natal/RN

Adolescence is seen as a phase of life marked by a series of physical and behavioral changes, which leads to certain risk situations, such as early sexual activity, pregnancy and the occurrence of sexually transmitted diseases. Based on this statement, this research aimed generally: meet the sexual and reproductive adolescents of a reference service in Natal profile. Specifically describe the socioeconomic, sexual and reproductive individual and family characteristics of the population in question, but also verify possible association between pregnancy and age of onset of sexual activity with the socioeconomic aspects. The sectional study conducted in the database from the records of 463 adolescents seeking care in a referral center in Sexual and Reproductive Health in the period March 2011 to June 2012. The data collected were subjected to analysis by Excel 2007 and Statistical Package for Social Sciences (SPSS) 17.0. For data analysis, descriptive statistics, with absolute numbers and percentages was used, and its presentation by means of distribution and frequency tables. Results showed that the parents of these adolescents (65.7% - father; 57.8% - mother), had primary education; family income less than two minimum wages (66.2%); any type of chemical dependency in the family (33.5%) and presence of domestic violence (20.6%). A higher probability of pregnancy was verified when the mother had only primary education (26.3%), persons other than the father or mother contributed to family income (33.3%) and (26%) when there was substance abuse in the family early onset of sexual activity was observed when the mother had primary education (57.3%), persons other than the father or mother contributed to family income (63.1%) and the use of drugs / alcohol as a problem family (67.6%). It was concluded that such vulnerabilities appear as a reflection of the low social status of these young people, aggravated by emotional inheritance that is offered to every individual from birth. These findings may perhaps, support public health surveillance policies for adolescents in several areas

Efeito agudo do exercício aeróbio vigoroso sobre as funções executivas em adolescentes

Executive functions are determinant cognitive processes for student success, since they execute and control complex cognitive activities such as reasoning, planning and solving problems. The development of the executive functions performances begin early at childhood going through the adolescence until adulthood, concomitant with the neuroanatomical, functional and blood perfusion changes over the brain. In this scenario, exercise has been considered an important environmental factor for neurodevelopment, as well as for the promotion of cognitive and brain health. However, there are no large scientific studies investigating the effects of a single vigorous aerobic exercise session on executive functions in adolescents. Objective: To verify the acute effect of vigorous aerobic exercise on executive functions in adolescents. Methods: A randomized controlled trial (RCT) with crossover design was used. 20 pubescent from both sexes/gender with age between 10 and 16 years were submitted to two sessions of 30min each: 1) The aerobic exercise session intensity was between 65 and 75% of heart rate reserve, in which 5min for warm-up, 20min at the target intensity and 5min of cool down; and 2) control session watching cartoons. The computerized Stroop test – Testinpacs and trail making test were used to evaluate the inhibitory control and cognitive flexibility assessment respectively, before and after both experimental and control sessions. The reaction time (RT) and number of errors (n) of Stroop test were recorded. The total time (TT) and the number of errors (n) of the trail making test were also recorded. Results: The control session’s RT did not present significant differences in the Stroop test. On the other hand, the exercise session’s RT decreased significantly (p<0.01) after the session. The number of errors made at the Stroop test had no significant differences in control and exercise sessions. The ΔTT of trail making test of exercise session was significantly (p<0.001) lower than the control session’s. Errors made in trail making test did not show significant differences between control and exercise sessions. Additionally, there was significant and positive association among the Stroop test ΔRT of exercise session with xiii chronological age (r= 0.635, p=0.001; r 2 = 0.404, p=0.003) and sexual maturation (rs= 0.580, p=0.007; r 2 = 0.408, p=0.002). Differently, there was no association among the control session ΔRT and chronological age (r= – 0.144, p=0.273; r 2 = 0.021, p=0.545) or sexual maturation (rs= –0.155, p=0.513; r 2 = 0.015, p=0.610). Conclusion: Vigorous aerobic exercise seems to improve acutely executive functions in adolescents. The effect of exercise on inhibitory control performance was associated to pubertal stage and chronological age. In other words, the benefits of exercise were more evident in early adolescence (↑ ΔRT) and its magnitude decreases along the growing up process.

Fundamentos dos cuidados com crianças e adolescentes: um olhar sobre o Rio Grande do Norte entre 1964 e 1988

Childhood and adolescence care has frequently caused theoretical and methodological discussions. At national level, the way of dealing with this public has always been on the agenda, either by maintaining a paternalistic treatment, or by coercive and repressive expression with which this public is treated. Given the above, this research presents a thorough study of social policies focused on children and adolescents in Brazil, with the overall purpose of investigating how this process of implementation of public policies for poor children and adolescents in the state of Rio Grande do Norte was. In previous studies, it was identified that there are no official records regarding the policy implementation process for this population in the state of Rio Grande do Norte. A retrospective study about the care towards children and adolescents in Brazil was held. It ranged from the XXVIII century, through the period of assistance, until the historical period in which the child started to be considered from the perspective of a policy. Thus, a certain period was framed, so that, through the historical research method, this study could focus on gathering data about the attention focused on childhood and adolescence in the state of Rio Grande do Norte, between the years 1964 and 1988. Data was listed from newspaper files that circulated in the state during period mentioned above. This time framing corresponds to the regency of the National Policy of Child Welfare. In the state of Rio Grande do Norte, the implementation of institutions such as FUNBERN and then FEBEM did not differ from the national standard, since many projects and care programs for poor children and teenagers were executed in this period. The implementation of these institutions revealed the concern of the state in solving the problem of “minors” regarding to situations of abandonment or "delinquency" which they were involved with. However, the kind of protection provided by the state toward this population was based on the current ideology that supported the political system at the time: the military dictatorship. Thus, the main way to provide care to this population was through its institutionalization, through taking children to daycare centres and adolescents to “reeducational” institutes for “minors”.

Avaliação do ganho de peso de bebês prematuros em relação ao leite materno cru e leite pasteurizado

This study aims to evaluate the weight gain of premature newborns fed with breast milk from their mothers' from those that are fed with breast milk from the milk bank. The research is the quantitative, descriptive and observational kind. It was conducted in the Neonatal Intensive Care Unit and Housing from the Maternity Hospital Escola Januário Cicco (MEJC), that is a reference for high risk pregnancy and birth in Rio Grande do Norte. The premature newborns included were following these parameters: gestational age from 26 to 37 weeks, initially hospitalized at UTIN, with oral diet, by means by gavage, cup and/or suction. Studies with premature newborns with a zero diet longer than seven days or complications that interfered in the evaluation of weight gain were excluded from this study. The sample was selected for convenience and had data of all newborns hospitalized at UTIN from the May to June of 2014 time period, followed to their discharge, ended by August of 2014 and had the inclusion parameters of the study. From the period of the data collection, 60 premature newborns entered the maternity and 39 of those were the sample of research. The project was approved by the Research Ethics Committee from UFRN, under CAAE nº 0699.0.000.294-11. The data was analyzed by means of descriptive and deduced statistics. The results indicated that the involved in the study, were born from mother with average age of 25,36 years, with less than nine years education 21 (53,8%), had the family income less than a minimum wage 24 (61,5%). Among the newborn, the female gender predominated 20 (51,3%), had cesarean delivery 25 (64,1%), had moderate prematurity 29 (74,5%), more of 1.500g 22 (556,4%). The birth weight average was 1.608,49g. The total of diets were 9.994, and an average of 256 for each newborn, in a 32,12 days of hospitalization time period. Most of the diet supplies were from the breast milk bank (50,34%), however 56,4% of the newborns had most of the diet from their mothers' milked breast milk. It was detected that 38,5% of the newborns had, in some given moment, artificial milk. The daily weight gain average of all newborns was 2,59g, but 35% of them had an average above 10g per day. From the newborn's group (n=25) that had medium weight gain, only 9 of them (36,0%) received mainly their own mothers' milked breast milk. It's been conclusive that most of the premature newborns gained weight predominantly from diets from the breast milk of the Milk Bank, showing the need of a bigger incentive to exclusive breast feeding.

Relação entre função sexual, sintomatologia depressiva e qualidade de vida em mulheres grávidas

INTRODUCTION: Human sexuality is recognized as one of the pillars of quality of life. In women, sexual function is influenced throughout life by many factors that can lead to the appearance of changes in the cycle of sexual response, and hence the quality of life (QOL). Pregnancy is a period of change, leaving them physically and mentally vulnerable, which may affect sexual function and quality of life during pregnancy. OBJECTIVE: To investigate the relationship between sexual function, presence of depressive symptoms and quality of life in pregnant women. METHODS: The study included 207 pregnant women attending prenatal examination of the Maternity Divine Love, Parnamirim / RN and the participants of the Course for Pregnant Women of the Department of Physical Therapy at UFRN (central campus). Initially it was applied, a questionnaire containing questions about sociodemographic, gynecological and obstetric data, as well as body and sexual self-knowledge. Sexual function was assessed using the Sexual Function Index Female (Female Sexual Function Index - FSFI). To assess the quality of life, we used the Quality Index Ferrans Life & Powers mom. The presence of depressive symptoms was verified by applying the Beck Depression Inventory. The Shapiro-Wilk test for normality was carried variables, Mann-Whitney test for carrying out the comparisons and the Wilcoxon test for comparing the monthly sexual frequency before and during pregnancy. Multiple linear regression was used to verify the relationship between sexual function, depressive symptoms and quality of life. We used the Spearman correlation to check correlation between the variables. Ap value <0.05 was adopted. RESULTS: Sexual function and depressive symptoms were related quality of life (R2 = 0.30, p <0.001). Depression had a moderate negative correlation with quality of life (0.53; p <0.001), whereas sexual function showed a positive correlation with low quality of life (0.22; p = 0.001). The planning of pregnancy, education and income shown to influence depression scores. With respect to sexual function, it was seen that during pregnancy, a reduction in the monthly frequency of sexual partner (Z = -10.56; p <0.001). Among the sexual domain, just the pain, showed a statistically significant difference compared between the second and third quarter (Z = -1.91, p <0.05). The score of the quality of life of women with sexual dysfunction was xvii significantly lower than that pregnant women without dysfunction (Z = -2.87, p = 0.004). Conclusion: Sexual function and the presence of depressive symptoms are related to the quality of life of pregnant women.

Pressão de sono e perfil acadêmico de estudante de medicina do 1º período da UFRN

Academic demands, new social context, new routines and decrease of the parental control, are factors that may influence the sleep pattern of freshman students at the University. Medical students from the Federal University of Rio Grande do Norte (UFRN) have a full-time course, subjects with high-level content, and, at the first semester, classes begin at 7 a.m. This group composed by young adults who still suffering with delayed sleep phase, common in adolescence, indicating that this class schedule can be inappropriate at this age. The reduction of nocturnal sleep during school days, and the attempt to recover sleep on free days – social jet lag (JLS), suggests that in the first semester, students suffer from high sleep pressure. High sleep pressure may reflect on cognitive tasks and performance. Therefore, the aim of this study was to investigate the relationship between sleep pressure and the academic profile of medical students from the first semester of UFRN, characterizing this population socio-demographically and investigating possible impacts on therestactivity rhytm and academic performance. A sample of 88 students, healthy men and women awswered the following questionnaires: Pittsburgh Sleep Quality (PSQI), Epworth Sleepiness Scale (ESS), Horne & Ostberg Chronotype (HO), Munich Chronotype (MCTQ) and “Health and Sleep” adapted. Actigraphy was used during 14 days to make actogramas and obtain non-parametric variables of the rest-activity rhythm and the grades of the morning schedule were used as academic performance. The JLS was used as a measure of sleep pressure. Statistics significance level was 95%. The population was sociodemographic homogeneous. Most students have healthy lifestyle, practice physical activity, use car to go to the university and take between 15 and 30 minutes for this route. Regarding CSV, most were classify as intermediate (38.6%) and evening (32%) chronotypes, needs to nap during the week, suffer daytime sleepiness and have poor sleep quality. 83% of the sample has at least 1h JLS, which led us to divide into two groups: Group <2h JLS (N = 44) and Group ≥ 2h JLS (N = 44). The groups have differences only in chronotype, showing that most evening individuals have more JLS, however, no differences were found in relation to sociodemographic aspect, rest-activity rhythm or academic performance. The homogeneity of the sample was limited to compare the groups, however, is alarming that students already present in the first half: JLG, poor sleep quality and excessive daytime sleepiness, which can be accentuated through the university years, with the emergence of night shifts and increased academic demand. Interventionsaddressingthe importance of good sleep habits and the change of the class start time are strategies aimed to improve student’s health.

Aborto: um fenômeno sem lugar – uma experiência de plantão psicológico a mulheres em situação de abortamento

The present paper discusses the experience of a psychological emergency attendance in Maternidade Escola Januário Cicco (MEJC) in Natal and has as main objective to investigate the limits and possibilities of this practice in offering psychological care to women in abortion situation. The Ministry of Health considers the abortion a serious medical problem in Brazil and acknowledge the repercussions it causes in personal life and between the women’s family, most of all among the younger ones, in fully productive and reproductive age, that if not supported may suffer deep psychological and physical wounds. This research inserts itself in the field of psychological practices in institutions, by many ways, and aim to offer, by different approaches, among then the psychological emergency attendance, a psychological attention at the institutions. This attention refers to a care during the suffering at the time of crisis and in the many ways that the problem is present. The results were analyzed at a heideggerian hermeneutics optics, which search a determined aspect of reality that intends to know/understand, accompanied by the man’s own movement in existence. The cartography and the logbook were chosen in narrative form as a resource to allow the approximation of daily experience. The emergency psychological attendance was realized on curettage setor of MEJC between march of 2013 and february 2014 at tuesdays and Thursdays from 9h to 12h. The existential plot unveiled at this experience showed some possibilities and limits of emergency psychological attendance as studied. Among the possibilities, the emergency attendance helped the women that suffered an abortion to find new meanings, as: realize the need to self-care; see in the attendance a way to cope with the lost or other issues in their life’s; to enlarge the possibilities of her choice; to rethink her sex e reproductive life, and rethink her relationships and life projects. The attendance has proven itself as a health care mechanism showing the women the need to search for the necessary condition to self-care and to question what in that environment was saw as natural. The attendance showed itself as a suitable practice to the health care demand by creating/inventing ways of meet the woman needs. The attendance promoted an opening at the technical horizons of women’s, what was realized when the complaints moved past the physical health. As refered to the limits, some needs was beyond the emergency attendance service and demanded forwarding to regular psychological care or others specialized services. The service was not able to attend all of the demands of the sector. The attendance did not touched the medical staff to its need or made a change in posture to act beyond the technicality. The attendance, although has not made change in this context, was able to show the main difficulties, like the lack on prepare of the medical staff to deal with the abortion past beyond the technical procedure and the precariousness of the infrastructure of the services offered. At last, the attendance represented a shelter to the women in abortion situation, allowing the suffering to have a place.

A inserção da família no processo socioeducativo de adolescentes em privação de liberdade

This master thesis has the main goal investigate how families are inserted in the socioeducational process of teenagers who are undergoing social measures of liberty deprivation. The specific objectives are: to characterize the family´s living together of adolescents deprived of their freedom and their families, from the actions and routines of the socio-educational system; to assess the professional working links in the context of socio-education, in order to care and strengthening families of the adolescents; to investigate how families evaluate the operation of socio-educational process in which adolescents are met. Method: to achieve the proposed objectives, data collection occurred in complementary steps: the first phase took place from visits to socioeducational units of liberty deprivation of RN, and dialogues with professionals working in socio-education. Subsequently, action research stage was carried out, from the insertion of the researcher in the extension project Family and the struggle for the effectiveness of the National Socio Service System, that aimed to strengthen monitoring the adolescents socio-education by their families, and had as methodology the conversation circles and thematic workshops. Lastly, were performed reading and analysis of the references to the family in the Individual Care Plans (PIAs) for adolescents. The information gathered was recorded in field diaries and subjected to thematic content analysis. This research was guided by the Marxist theoretical framework, structured on the understanding of the involvement of adolescents with illegal acts as a development and expression of the social question. From this theoretical framework, the prevailing view in the capitalist society of adolescents in conflict with the law as individuals who are treated by means of repression and segregation and the weakness of social policies is questioned, both in the execution of their own socioeducational measures as the articulation of network services for adolescent protection and strengthening your family. Results: in relation to the operation of the socioeducational system in RN in general, it was observed a state of unhealthy physical spaces and institutional practices that violate human rights, idleness and lack of access to social rights, and criminalization and institutionalization of poor young people and their families. With regard to family´s living together, it was noticed great distance between principles and guidelines recommended by the SINASE, about acquaintanceship and family strengthening, and every day practices of socio-education in RN: serious violations were observed that undermine the family´s living together, as the distance between the socio-educational units of deprivation of liberty and the cities where families live; absence, irregularity and poor conditions in carrying out the family visits; lack of conjugal visits; restricted and unarticulated actions for the care and strengthening of the families of adolescents, most of whom live in poverty or extreme poverty. Finally, it was found a number of blamefully and punishments to the family, including practices such as inward inspection (visual inspection while naked and squant), plus a series of violence and omissions care that sick family members and weaken the links between adolescents and their families.

Avaliação comparativa da eficácia dos meios de diagnóstico das vulvovaginites: implantação de tecnologia no ensino prático da ginecologia

Inaccurate diagnosis of vulvovaginitis generates inadequate treatments that cause damages women's health. Objective: evaluate the effectiveness of methods when diagnosing vulvovaginitis. Method: a cross-sectional study was performed with 200 women who complained about vaginal discharge. Vaginal smear was collected for microbiological tests, considering the gram stain method as gold standard. The efficacy of the available methods for diagnosis of vaginal discharge was assessed (sensitivity, specificity, positive predictive value and negative predictive value). Data were inserted to Graphpad Prism 6, for statistical analysis. Results: the following results were obtained: wet mount for vaginal candidiasis: sensitivity = 31%; specificity = 97%; positive predictive value (PPV) = 54%; negative predictive value (NPV) =93%; accuracy = 91%. Wet mount for bacterial vaginosis: sensitivity = 80%; specificity =95%; positive predictive value (PPV) = 80%; negative predictive value (NPV) = 95%; accuracy = 92%. Syndromic approach for bacterial vaginosis: sensitivity = 95%; specificity=43%; positive predictive value (PPV) =30%; negative predictive value (NPV) = 97%; accuracy = 54%. Syndromic approach for vaginal candidiasis: sensitivity = 75%; specificity =91%; positive predictive value (PPV) = 26%; negative predictive value (NPV) = 98%; accuracy = 90%. Pap smear for vaginal candidiasis: sensitivity = 68%, specificity = 98%; positive predictive value (PPV) = 86%; negative predictive value (NPV) =96%; accuracy = 96%. Pap smear for bacterial vaginosis: sensitivity = 75%; specificity = 100%; positive predictive value (PPV) = 100%; negative predictive value (NPV) =94%; accuracy = 95%. There was only one case of vaginal trichomoniasis reported – diagnosed by oncological cytology and wet mount – confirmed by Gram. The syndromic approach diagnosed it as bacterial vaginosis. From the data generated and with support on world literature, the Maternidade Escola Januário Cicco’s vulvovaginitis protocol was constructed. Conclusion: Pap smear and wet mount showed respectively low and very low sensitivity for vaginal candidiasis. Syndromic approach presented very low specificity and accuracy for bacterial vaginosis, which implies a large number of patients who are diagnosed or treated incorrectly.

Estudo comparativo entre antipsicóticos atípicos no tratamento da esquizofrenia e sua influência na qualidade de vida dos pacientes

Schizophrenia is a severe and persistent mental illness; diagnosis occurs mainly during adolescence. The pharmacological treatment is done with typical and atypical antipsychotics. Atypical have the advantage of reduced extrapyramidal effects, which make them promising for the treatment of schizophrenia, furthermore, they have shown significant metabolic and hormonal changes. The objective of this study was to evaluate the influence of atypical antipsychotics, olanzapine and risperidone on the quality of life and on their adverse effects in schizophrenic patients. For this we analyzed the quality of life of patients with implementation of EuroQol-5D-3L instrument and performing biochemical and hormonal tests, blood pressure measurement, and measurement of anthropometric indices, besides the application of Ugvalg scales for Kliniske Undersgelser (UKU) and Simpson-Angus, who evaluated the side effects caused by drugs. Data were analyzed using the Student t test and chi-square test, with 5% significance level. The results showed that the EuroQol the antipsychotic olanzapine causes significant losses associated with personal care (p <0.001). Comparing the two groups of antipsychotics, the average years of quality-adjusted life, known per QALY was favorable for the risperidone group (p <0.032). The results of olanzapine and risperidone groups were compared. In terms of socioeconomic, it was observed that men used, the prevalent form, olanzapine (p <0.008); this same group showed the following results significantly unfavorable, related to anthropometric variables: waist circumference (p <0.01), hip circumference (p <0.02), weight (p <0.02) and blood pressure (p <0.04). The biochemical and hormonal analyzes showed that olanzapine resulted in losses related to the following variables: triglycerides (p <0.04), HDL cholesterol in men (p < 0.02) and cortisol (p < 0.01). In risperidone users, the only negative value was prolactin (p < 0.04). Regarding the analysis of the Simpson-Angus scale, the group treated with olanzapine was handicapped because the average total scores for olanzapine was 0.38, while for risperidone was 0.11 (p < 0.02). In the UKU scale, the following results were obtained also unfavorable for the olanzapine group: fatigue (P <0.02), dystonia (p <0.01) and tremor (p <0.03). According to the UKU scale, the side effects present in the risperidone group included: gynecomastia (p <0.01), ejaculatory dysfunction (p <0.02) and erectile dysfunction (p <0.02). It was concluded that olanzapine users had the worst score of quality of life, higher metabolic risks associated with overweight and inadequate lipid profile and greater tendency to extrapyramidal manifestations. However, risperidone users were more likely to adverse reactions due to hormonal changes.

Avaliação do ensino da obstretícia e da assistência ao parto sob a percepção dos graduandos em medicina e enfermagem na Universidade Federal do Rio Grande do Norte

OBJETIVE: To evaluate the perception of Medical and Nursing students of Medicine and Nursing graduation courses at the Federal University of Rio Grande do Norte (UFRN), on obstetrics teaching and labor assistance in the context of the maternal care provided by the Maternity Hospital Januário Cicco (MEJC) and contribute to curricular updating planning of teaching obstetrics, in accordance with the principles of humanization. METHODS: It was conducted a study of cross-cutting approach and qualitative and quantitative descriptive method, with students in medicine and nursing of UFRN, who were attending or had been attended the midwifery disciplines medicine; and women's health in nursing. The data were collected through a questionnaire with objective and subjective questions, and stored in a database, spreadsheet software Excel / Office 2010 with all the variables. RESULTS: We interviewed 169 students, 118 of medical school and 51 from the nursing program, of which 46.75% were male and 53.25% female. The largest number of medical respondents is the 11th period (40.67%), and nursing, on 10, (43.15%). These students witnessed 1,073 births, and (61.8%) vaginal deliveries. The obstetricians were the most performed vaginal deliveries (40%). Nurses performed only (8.13%). The assistance provided to women during the process of labor and delivery, was configured as suitable for 87.58% of respondents and these glimpsed humane conduct. Students who performed deliveries, 76.27% were medical and 11.76% were nursing. All had guidance while doing them. A total of 19.50% medical students reported that there is a prejudice against vaginal delivery, particularly for the humanized birth, unlike all nursing students (100%) who reported that there is this prejudice. Most students (73%) showed preference for vaginal delivery, especially nursing students. On the knowledge of myths in relation to vaginal delivery, 60.35% answered that they know some. CONCLUSION: This study presents itself as a highly relevant, since the results may contribute to curricular changing and updating related to obstetrics teaching, but also serve as a resource for analysis of humanization practices that should be developed in educational institutions and which are recommended by the Ministry of Health.