Dinâmica familiar, morte dos pais e saúde da criança

It is well known among health professionals, especially those working in Primary Health Care (PHC), the configuration and dynamics directly influence family health conditions of each component of the nuclear family and vice versa. Some events during the family´s life cycle are crucial in this regard, including: birth of a new child, unemployment, divorce, change of residence, violence and the presence of family members with chronic health conditions. One particular event is extremely important: a family member´s death, and the death of a parent seems to be one of the worst sceneries accordingly

Mental Stress and Exercise Training Response: Stress-sleep Connection may be Involved

Universidade Federal de São Paulo, Dept Prevent Med, Ctr Mindfulness & Hlth Promot, São Paulo, BrazilWashington Univ, Sch Med, Div Cardiol, Heart Rate Variabil Lab, St Louis, MO USAUniversidade Federal de São Paulo, Dept Prevent Med, Ctr Mindfulness & Hlth Promot, São Paulo, BrazilWeb of Scienc

Effects of single weekly bout of exercise on cell proliferation during the rat colon carcinogenesis

There is evidence that the risk of colon cancer is reduced by appropriate levels of physical exercise. However, the effects of single weekly bout of exercise are largely unknown. Our aim was to verify the effects of exercise once a week (1d-wk-1) and daily exercise training (5d-wk-1) in rats treated with the carcinogen 1-2- Dimethyl-hydrazine (DMH). Forty-two Wistar rats were used in the experiment. The groups G1 and G2 were sedentary (controls), the groups G1A and G2A were submitted 1d-wk-1 of swimming, and G1B and G2B were submitted 5d-wk-1 of swimming training for 8 weeks. The groups G2, G2A and G2B were treated with DMH two weeks after the start of exercise protocols. The rats were sacrificed three days after the swimming protocols and the colon was processed for immunohistochemistry with staining of proliferating cell nuclear antigen (PCNA). A statistical analysis was performed by Anova test, followed by a post hoc Tukey’s (p\u3c0.05). The G2B presented a significant reduction of the PCNA-Li (PCNA-Labeling index) of the epithelium of the intestinal mucosa when compared with the G2 (p\u3c0.001), showing a PCNA-Li similar to the group G1. The group G2A presented a reduction of the PCNA-Li when compared with the group G2 (0.05436 to 0.01760, p\u3c0.001); however it still remained higher than group in the group G1. From our findings, we conclude that a single weekly bout of exercise significantly attenuate the DMH-related increase in epithelial cell proliferation during the rat colon carcinogenesis, but in a less intensive proportion than the daily exercise training

Perceived Stress Latent Factors and the Burnout Subtypes: A Structural Model in Dental Students

Background: Students of health-professions suffer high levels of stress and burnout. the aim of the present study was to evaluate the relationship between perceived stress latent factors ('tenseness' and 'frustration') and the features ('overload', 'lack of development' and 'neglect') of the three burnout subtypes ('frenetic', 'under-challenged' and 'worn-out', respectively), in a sample of Spanish dental students.Methods: the study employed a cross-sectional design. A sample of Spanish dental students (n = 314) completed the 'Perceived Stress Questionnaire' and the 'Burnout Clinical Subtype Questionnaire Student Survey'. the associations among variables were observed by means of structural equation modelling using the unweighted least squares method from polychoric correlations.Results: Strong associations among perceived stress factors and the burnout characteristics were observed, although a distinct pattern of relations was observed for each burnout subtype. the 'overload' was moderately and positively associated with both 'tenseness' (0.45), and 'frustration' (0.38) dimensions of perceived stress; the 'lack of development' was positively associated with the 'frustration' dimension (0.72), but negatively associated with 'tenseness' (-0.69); the 'neglect' showed a weaker positive associated with 'frustration' (0.41), and a small negative association with 'tenseness' (-0.20). the model was a very good fit to the data (GFI = 0.96; RSMR = 0.07; AGFI = 0.96; NFI = 0.95; RFI = 0.95).Conclusions: the stress factors of 'frustration' and 'tenseness' seems to be related in a distinct way to the burnout subtypes in Spanish dental students. This finding suggests that intervention programs specifically tailored to these subtypes may be a promising future direction.Research Network on Preventative Activities and Health Promotion, Aragon Health Sciences Institute, Faculty of Health and Sports (University of Zaragoza)Faculty of Medicine and Dentistry (University of Santiago de Compostela)Fac Hlth & Sport Sci, Huesca, SpainUniversidade Federal de São Paulo UNIFESP, Dept Prevent Med, São Paulo, BrazilUniv Bristol, Sch Social & Community Med, Bristol, Avon, EnglandUniv New S Wales, Ctr Res Excellence Mental Hlth & Sustance Use, Sidney, BC, CanadaUniv Balearic Isl, Inst Univ Invest Ciencies Salut IUNICS, Mallorca, SpainUniv Zaragoza, Miguel Servet Univ Hosp, Zaragoza, SpainPrimary Care Prevent & Hlth Promot Res Network Re, Zaragoza, SpainUniversidade Federal de São Paulo UNIFESP, Dept Prevent Med, São Paulo, BrazilResearch Network on Preventative Activities and Health Promotion, Aragon Health Sciences Institute, Faculty of Health and Sports (University of Zaragoza): RD06/0018/0017Web of Scienc

Quality of child health care in the family health strategy

OBJECTIVE: to verify the quality of child health care in the Family Health Strategy (FHS) in a state capital of Northeastern Brazil. METHODS: a descriptive study using a quantitative approach was carried out in 2010 with 66 primary care (PC) teams represented by their doctors and nurses. The survey used part of the Evaluation for Quality Improvement of the Family Health Strategy² (AMQ), a self-rating instrument of the Brazilian Ministry of Health which evaluates the FHS actions and services and classifies them by the following quality-based standards of care: Elementary, undergoing development, Consolidated, Good or Advanced. RESULTS: 84.1% of the FHS-teams rated themselves as providing "Elementary" actions and services, and 47.7% of them considered that they provided "Advanced" ones. The health teams with less than four years of implementation rated themselves better. CONCLUSION: these findings suggest that most of the FHC-teams are providing care with an elementary standard of quality, and indicate that better quality child care is apparently delivered with by teams with less time of implementation

An Updated Portrait of the Portuguese Web

This study presents an updated characterization of the Portuguese Web derived from a crawl of 48 million contents belonging to all media types (2.5 TB of data), performed in March, 2008. The resulting data was analyzed to characterize contents, sites and domains. This study was performed within the scope of the Portuguese Web Archive.POSC/EU, UMI

Development of standards for education and training in family and community medidcine - contributions by WONCA IberoAmerica (CIMF)

The WONCA Education Working Party (WEP) is developing a set of standards for medical student education, postgraduate training in family medicine / general practice and continuing professional development for family doctors. At this point the contributions by WONCA world regions are very important, and for this reason the main objective of this report is to present the standards developed by the Iberoamerican WONCA Region (CIMF). To be comprehensive and effective, standards should reflect regional realities and so the contributions from CIMF may reinforce and strengthen the key initiative of WEP and the implementation of the standards throughout the world. (C) 2010 Elsevier Espana, S.L. All rights reserved.Universidade Federal de São Paulo, São Paulo, BrazilUniv Puerto Rico, San Juan, PR 00936 USAUniv Prov Rio de Janeiro UERJ, Rio de Janeiro, BrazilFlinders Univ S Australia, Adelaide, SA, AustraliaUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Validation of the Spanish versions of the long (26 items) and short (12 items) forms of the Self-Compassion Scale (SCS)

Background: Self-compassion is a key psychological construct for assessing clinical outcomes in mindfulness-based interventions. the aim of this study was to validate the Spanish versions of the long (26 item) and short (12 item) forms of the Self-Compassion Scale (SCS).Methods: the translated Spanish versions of both subscales were administered to two independent samples: Sample 1 was comprised of university students (n = 268) who were recruited to validate the long form, and Sample 2 was comprised of Aragon Health Service workers (n = 271) who were recruited to validate the short form. in addition to SCS, the Mindful Attention Awareness Scale (MAAS), the State-Trait Anxiety Inventory-Trait (STAI-T), the Beck Depression Inventory (BDI) and the Perceived Stress Questionnaire (PSQ) were administered. Construct validity, internal consistency, test-retest reliability and convergent validity were tested.Results: the Confirmatory Factor Analysis (CFA) of the long and short forms of the SCS confirmed the original six-factor model in both scales, showing goodness of fit. Cronbach's a for the 26 item SCS was 0.87 (95% CI = 0.85-0.90) and ranged between 0.72 and 0.79 for the 6 subscales. Cronbach's a for the 12-item SCS was 0.85 (95% CI = 0.81-0.88) and ranged between 0.71 and 0.77 for the 6 subscales. the long (26-item) form of the SCS showed a test-retest coefficient of 0.92 (95% CI = 0.89-0.94). the Intraclass Correlation (ICC) for the 6 subscales ranged from 0.84 to 0.93. the short (12-item) form of the SCS showed a test-retest coefficient of 0.89 (95% CI: 0.87-0.93). the ICC for the 6 subscales ranged from 0.79 to 0.91. the long and short forms of the SCS exhibited a significant negative correlation with the BDI, the STAI and the PSQ, and a significant positive correlation with the MAAS. the correlation between the total score of the long and short SCS form was r = 0.92.Conclusion: the Spanish versions of the long (26-item) and short (12-item) forms of the SCS are valid and reliable instruments for the evaluation of self-compassion among the general population. These results substantiate the use of this scale in research and clinical practice.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Miguel Servet Hosp, Aragon Inst Hlth Sci I CS, Dept Psychiat, Zaragoza, SpainPrimary Care Prevent & Hlth Promot Res Network Re, Zaragoza, SpainBit&Brain Technol, Zaragoza, Spain12 Octubre Res Inst, Madrid, SpainUniv Zaragoza, Fac Hlth Sci & Sports, Huesca, SpainLozano Blesa Univ, Clin Hosp, Zaragoza, SpainUniversidade Federal de São Paulo UNIFESP, Escola Paulista Med, Dept Prevent Med, Ctr Mindfulness & Hlth Promot, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Escola Paulista Med, Dept Prevent Med, Ctr Mindfulness & Hlth Promot, São Paulo, BrazilWeb of Scienc

Qualidade da Atenção à Saúde da Criança na Estratégia Saúde da Família

AbstractObjective: to verify the quality of child health care in the Family Health Strategy (FHS) in a state capital of Northeastern Brazil. Methods: a descriptive study using a quantitative approach was carried out in 2010 with 66 primary care (PC) teams represented by their doctors and nurses. The survey used part of the Evaluation for Quality Improvement of the Family Health Strategy² (AMQ), a self-rating instrument of the Brazilian Ministry of Health which evaluates the FHS actions and services and classifies them by the following quality-based standards of care: Elementary, undergoing development, Consolidated, Good or Advanced. Results: 84.1% of the FHS-teams rated themselves as providing “Elementary” actions and services, and 47.7% of them considered that they provided “Advanced” ones. The health teams with less than four years of implementation rated themselves better. Conclusion: these findings suggest that most of the FHC-teams are providing care with an elementary standard of quality, and indicate that better quality child care is apparently delivered with by teams with less time of implementation.ResumoObjetivo: verificar a qualidade da atenção à saúde da criança pelas equipes da Estratégia Saúde da Família (ESF) em Capital do Nordeste do Brasil. Método: trata-se de um estudo transversal, descritivo, com abordagem quantitativa, realizado durante o ano de 2010, por meio de inquérito com os profissionais médicos e enfermeiros de 66 equipes da ESF de Maceió-AL, estratificadas por tempo de funcionamento em anos. Utilizou-se parte do instrumento de auto-avaliação denominado Avaliação para Melhoria da Qualidade da Estratégia Saúde da Família (AMQ) do Ministério da Saúde, especificamente as questões referentes às ações e atividades realizadas no campo de atenção à “saúde da criança”, dentro da dimensão “atenção à saúde”. Resultados: os padrões elementares de qualidade foram encontrados em 84,1% das ações realizadas. Os padrões considerados avançados apresentaram o menor percentual de conformidade entre todas as equipes (47,7%). Quanto ao tempo de implantação da ESF, as equipes com menos de quatro anos tenderam a relatar melhores padrões de qualidade. Conclusões: os achados sugerem que as ações de saúde da criança estão sendo realizadas em melhor conformidade nas equipes com menos tempo de implantação, e que a grande maioria das equipes ainda estão atendendo a padrões considerados menos avançados em termos de qualidade

The Family Physician: to be or not to be? Dilemmas related to career choice

A Estratégia Saúde da Família é responsável por reorganizar o Sistema Único de Saúde brasileiro por meio da Atenção Primária. O aumento substancial de programas e vagas para residência em Medicina de Família e Comunidade, ocorrido desde 2002, é uma das estratégias para suprir o crescente mercado de trabalho correspondente. Entretanto, menos da metade dessas vagas são ocupadas. A literatura brasileira apresenta poucas evidências sobre o motivo desta baixa procura. Alguns países que optaram pelo fortalecimento da Atenção Primária em seu sistema de saúde também experimentam uma crise aparente na escolha desta carreira pelos egressos médicos. Neste ensaio, revisamos algumas questões envolvidas nesta escolha, apontando sua complexidade e a necessidade de investigações sistematizadas sobre as motivações dos alunos de graduação em optarem ou não por esta especialidade médica, particularmente no Brasil.The Family Health Strategy is responsible for supporting the reorganization of Brazil's Unified National Health System (SUS) through primary care. A substantial increase in available residency positions in family and community medicine is one of the main strategies for supplying the growing professional demand related to this health policy. However, few medical students have chosen the family health career in recent years, and more than half of the vacancies remain unoccupied. The Brazilian literature shows little evidence to explain this fact. Some countries with a strong background in primary health care have also experienced a crisis in the primary care career choice. The current article discusses several arguments involved in this issue, emphasizing its complexity and the need for more scientific data concerning undergraduate students' motivations in choosing this medical specialty as compared to others, particularly in Brazil