As ações em saúde mental nos Núcleos de Apoio à Saúde da Família - NASF

The National Police for Basic Care (PNAB), regulated by ordinance nº2488 from October 2011, restates the Family Health Strategy (ESF) as a priority to the expansion, consolidation and qualification of basic attention to health matters in Brazil. In order to bring it about, city counsellors along with other federal entities ought to ordinate their work process deepening principals, directions and fundaments of Basic Care (AB). Besides ESF, the new PNAB expatiates on the Family Health Support Centres (NASF), reaffirming their role on broadening the scope of basic care actions and their improvements, ratifying their ability to share knowledge and support Basic Care professionals. All this considered, the purpose of this work is to investigate how NASF is currently structured in João Pessoa and what has been achieved by it on what concerns to mental health. Its main objectives are to analyse the practices of mental health professionals that are part of NASF teams and if they differ from what has been developed by the other members of the teams; to discuss the articulation of NASF in managing mental health measures on what concerns to internal organisatio n and to the city health network; to identify strategies used to organise such measures on mental health in Basic Care. To reach such goals, individual interviews have taken place two city health managers and four of NASF professionals that participated on the Mental Health Office as representatives of their sanitary districts. Also a focal group formed by various supporters of NASF was created, contemplating the diversity of professional categories involved with the teams and sanitary districts. It was possible to identify in NASF, in João Pessoa, an organisation based by the matrix support in which both management and basic care demands reflect a series of actions developed alongside with ESF. Amongst such actions, matrixing, home visits and the Singular Therapeutic Project (PTS) stand out. These activities have been discussed on the focal group and integrate the daily work of all NASF supporters despite their professional categories. NASF presents itself as a powerful strategy to SUS proper qualification and support to strengthen Basic Care and broaden family health teams‟actions.

Ohjaus ja oppilaiden urapohdinta. Turkulaisten peruskoulun päättöluokkalaisten ohjauskokemukset urapohdinnan selittäjinä

Tutkimuksessa selvitetään turkulaisten peruskoulun päättöluokkalaisten urapohdintaeroja ja sitä, miten oppilaiden arviot opettajien ja oppilaanohjaajien toteuttamasta ohjauksesta ovat yhteydessä heidän urapohdintaansa. Tutkimuksen kohdejoukkona ovat ensi sijassa yleisopetusta antavien suomenkielisten peruskoulujen yhdeksäsluokkalaiset. Tutkimus on poikkileikkaustutkimus, jossa tarkastellaan oppilaiden kokemuksia ohjauksen saatavuudesta ja hyödyllisyydestä sekä urapohdinnasta peruskoulun päättyessä. Tutkimusaineisto koottiin yhteishaun jälkeen huhti–toukokuussa 2014. Vuoden 2004 perusopetuksen opetussuunnitelman perusteista johdettujen väittämien avulla selitetään urapohdinta-mittarin sisältämien muuttujien vaihtelua. Taustamuuttujina käytetään oppilaiden koti- ja koulutaustaa. Urapohdinta-mittari on johdettu CIP-teoriasta (Cognitive Information Processing) ja muokattu CTI-mittarista (Career Thoughts Inventory). Tutkimusaineisto (N = 887) on koottu Webropol-kyselyn avulla. Oppilaiden urapohdintaa mitattiin neljän summamuuttujien avulla. Mittariston 48 väittämästä muodostettiin urapohdinta-summamuuttuja. Tämän lisäksi urapohdinnan osa-alueita arvioitiin sitoutuminen-, epävarmuus- ja konflikti-summamuuttujan avulla. Sitoutuminen-summamuuttuja mittasi sitä, miten vaikeaksi oppilas koki yhteen ura- ja jatkokoulutusvalintaan sitoutumisen. Epävarmuus-summamuuttuja mittasi päätöksenteon epävarmuutta ja konflikti-summamuuttuja vaikeutta tasapainoilla omien ajatusten ja toisaalta merkittäviksi koettujen läheisten ajatusten välillä. Kaikkien opettajien ohjaustyön näkökulmasta parhaiten hyvää urapohdintatulosta, jatkokoulutukseen sitoutumista ja päätöksentekovarmuutta ennustivat oppilaan hyvät kokemukset yhteistoiminnasta, hänen myönteinen suhtautumisensa koulunkäyntiin ja opintosuoritukset. Myös itseohjautuvuus oli tilastollisesti merkitsevässä yhteydessä urapohdintaan. Itseohjautuvuus-summamuuttuja mittasi sitä, oliko oppilas kokenut, että ohjaukselle asetetut tavoitteet saavutettiin. Opettajien tulisi kiinnittää ohjauksessaan huomiota hiljaisiin ja vähän huomiota vaativiin oppilaisiin ja tukea kaikkien oppilaiden toimintakykyä. Opinto-ohjaajan taas tulisi panostaa oppilaan itsetuntemuksen kehittämiseen ja valmiuteen toimia suunnitelmallisesti. Toisen asteen nivelvaiheohjauksen painopiste tulisi siirtää päättöluokkaa varhaisemmaksi. Tutkimustulos ei tue ajatusta, että tehostettu oppilaanohjaus kohdennettaisiin opintomenestyksen mukaan, koska heikkoja urapohtijoita oli kaikissa keskiarvosanaluokissa. Opinto-ohjaajien tulisi panostaa tieto- ja viestintätekniikan hyödyntämiseen ja tehostaa koko koulun työelämäyhteistyötä.

The quality of rapid HIV testing in South Africa: an assessment of testers’ compliance.

Background: The aim of this study was to assess the quality of rapid HIV testing in South Africa. Method: A two-stage sampling procedure was used to select HCT sites in eight provinces of South Africa. The study employed both semi-structured interviews with HIV testers and observation of testing sessions as a means of data collection. In total, 63 HCT sites (one HIV tester per site) were included in the survey assessing qualification, training, testing practices and attitudes towards rapid tests. Quantitative data was analysed using descriptive statistics and qualitative data was content analysed. Results: Of the 63 HIV testers, 20.6% had a nursing qualification, 14.3% were professional counsellors, 58.7% were lay HIV counsellors and testers and 6.4% were from other professions. Most HIV testers (87.3%) had had a formal training in testing, which ranged between 10-14 days, while 6 (9.5%) had none. Findings revealed sub-standard practices in relation to testing. These were mainly related to non-adherence to testing algorithms, poor external quality control practices, poor handling and communication of discordant results. Conclusion: Quality of HIV rapid testing may be highly compromised through poor adherence to guidelines as observed in our study.

Councellors' Experience During Training and Home Based HIV Councelling and Testing in Zomba District, Malawi

Introduction In 2007, St Luke’s Mission Hospital initiated a district-wide Door to Door HIV counselling and testing (HCT) programme in Zomba district. The intent of the programme was to provide quality HCT services to people in their homes and effectively those found to be HIV positive referred to appropriate services. Methodology This was a cross sectional study using a questionnaire consecutively administered to a sample of 105 counsellors who had resided in the community for a period of over one year. The questionnaire sought to establish, knowledge gained, experiences and recommendations on how the programme has been implemented and assist running of similar future programmes. Data analysis was done manually using both qualitative and quantitative methodologies. Results We report that nearly 23% of the counsellors thought that during their training as a door to door HTC councelor they had benefited in learning to working with communities; an aspect they found to be highly applicable in discharge of their duties. The major setbacks during the training were lack daily allowances, less amount of time spent on understanding child councelling and the manual used was diffucult to follow. Over 32% of the councellors were satisfied with the participation of their clients during pre-test counselling sessions, however, the major challenge they had was the misconception that they were blood suckers, a view reported by nearly 17% of the counsellors. Close to 72% reported not to have met any problems during post-test counselling compared to 24% who reported to have found challenges. Conclusion The study has revealed that there is a need to re-look child children counselling especially in training door to door HCT counsellors. It has also revealed the prevalent allowance culture despite the benefits of training. The common challenges were refusal of test Results and failure to understand discordance. Misconceptions may still exist in the community regarding anything dealing with removing blood. There is still need for more information regarding discordance especially among couples in the community.