Análise do trabalho de referência em Centros de Atenção Psicossocial

OBJETIVO: Analisar como os usuários, familiares e trabalhadores de centros de atenção psicossocial avaliam o trabalho da equipe e dos profissionais de referência nesses serviços. MÉTODOS: Pesquisa qualitativa, baseada no paradigma construtivista e na hermenêutica Gadameriana. Foram analisados dois ciclos de grupos focais constituídos por profissionais, usuários e familiares de usuários de todos os centros de atenção psicossocial da cidade de Campinas (SP), em 2006. RESULTADOS: O trabalho de referência foi avaliado como um arranjo que produz efeitos terapêuticos e contribui na eficácia da organização do trabalho. Entretanto, foram relatados riscos de centralização de poder, praticada pelos profissionais de referência, e sofrimento do trabalhador, que pode sentir-se excessivamente responsabilizado pelo caso que referencia. CONCLUSÕES: Os efeitos do arranjo equipes/profissionais de referência sobre os pacientes embasam-se em aspectos emocionais ligados à confiabilidade, à constância e integralidade de cuidados. No entanto, tais aspectos também apresentam problemas relacionais, principalmente quanto à onipotência, que pode envolver o trabalhador

Estudo do comportamento biológico de biomaterial xenogénico em defeito ósseo crítico

Dentre as várias opções de biomateriais para a regeneração óssea, os de origem xenogénica são considerados como uma das alternativas ao autoenxerto, devido às suas propriedades biológicas e físico-químicas, além da grande disponibilidade, e de seu uso contribuir com a diminuição da morbilidade ao indivíduo. Vários autores consideram o BioOss®, uma hidroxiapatite bovina, como padrão de excelencia entre os biomateriais de substituição óssea independentemente de sua forma ser macro ou microgranular, apesar do tamanho da partícula ser também um fator importante nas reações tissulares envolvidas na neoformação óssea. O presente estudo teve como objetivo verificar o comportamento biológico de BioOss® na forma microgranular, com partículas entre 0,25 a 1,00 mm e 0,4 a 0,6 mm, implantadas em defeito ósseo crítico nos grupos GB e GBS, respectivamente, e analisados comparativamente a um controlo negativo, GC, com defeito preenchido apenas por coágulo sanguíneo, avaliados nos pontos biológicos de 15 e 45 dias. Como resultados, no grupo GC, ocorreu neoformação óssea reacional restrita às bordas e presença de tecido fibroso na área do defeito. Nos grupos GB e GBS, observou-se mínima reação inflamatória, abundante angiogênese e alguma osteogênese, além das bordas, ao longo do defeito, em continuidade à dura-máter. Como conclusão, o BioOss® foi biocompatível, promoveu osteogênese por osteocondução e integrou-se parcialmente ao osso neoformado, com melhores resultados para o grupo GBS

Academic Performance Of Students Who Underwent Psychiatric Treatment At The Students' Mental Health Service Of A Brazilian University

University students are generally at the typical age of onset of mental disorders that may affect their academic performance. We aimed to characterize the university students attended by psychiatrists at the students' mental health service (SAPPE) and to compare their academic performance with that of non-patient students. DESIGN AND SETTING: Cross-sectional study based on review of medical files and survey of academic data at a Brazilian public university. METHODS: Files of 1,237 students attended by psychiatrists at SAPPE from 2004 to 2011 were reviewed. Their academic performance coefficient (APC) and status as of July 2015 were compared to those of a control group of 2,579 non-patient students matched by gender, course and year of enrolment. RESULTS: 37% of the patients had had psychiatric treatment and 4.5% had made suicide attempts before being attended at SAPPE. Depression (39.1%) and anxiety disorders/phobias (33.2%) were the most frequent diagnoses. Severe mental disorders such as psychotic disorders (3.7%) and bipolar disorder (1.9%) were less frequent. Compared with non-patients, the mean APC among the undergraduate patients was slightly lower (0.63; standard deviation, SD: 0.26; versus 0.64; SD: 0.28; P = 0.025), but their course completion rates were higher and course abandonment rates were lower. Regarding postgraduate students, patients and non-patients had similar completion rates, but patients had greater incidence of discharge for poor performance and lower dropout rates. CONCLUSION: Despite the inclusion of socially vulnerable people with severe mental disorders, the group of patients had similar academic performance, and in some aspects better, than, that of non-patients.1351232

Clinical functions of the reference work with psychotic patients: a winnicottian reading

This article discusses the findings of a survey on the therapeutic functions of a clinical-organizational arrangement called patient care teams or professionals from the perspective of psychotic patients treated in community mental health services. A qualitative and participative methodology was used; data were collected in two focus group cycles including 10 Community Mental Health service patients and indepth interviews of another eight patients. Data discussion is based on references from public health and Winnicottian psychoanalysis. The patients state that the patient care professionals know them deeply and perform as mediators in their social, family and work relationships. Those statements meet the proposals of Winnicott's theory for the treatment of psychosis, in which it is essential to offer individuals emotional support so that they may take ownership of their experiences and manage these in a personal manner.O artigo apresenta os resultados de uma pesquisa acerca das funções terapêuticas do arranjo clínico-organizacional denominado equipes ou profissionais de referência, segundo a perspectiva de pacientes psicóticos, em tratamento nos Centros de Atenção Psicossocial. A metodologia adotada foi qualitativa e participante, sendo a coleta de dados feita em dois ciclos de grupos focais com dez pacientes inseridos naqueles Centros e entrevistas em profundidade com outros oito pacientes. Para discussão dos dados foram utilizados referenciais da saúde coletiva e da psicanálise winnicottiana. Os pacientes explicam que os profissionais de referência os conhecem profundamente e realizam a função de mediação de suas relações sociais, familiares e laborais. Essas explicações são consonantes com as propostas que a teoria winnicottiana faz para o tratamento da psicose, no qual é imprescindível a oferta de suporte afetivo para que o sujeito se aproprie de suas vivências e possa administrá-las de um modo pessoal.51952

Análise do trabalho de referência em Centros de Atenção Psicossocial

OBJECTIVE: To analyze how psychosocial care center users, family members and workers assess related work by reference team and professionals. METHODS: Qualitative research based on Constructivist Paradigm and Gadamerian Hermeneutics. Two cycles of focus groups consisting of professionals, users and users' family members from all psychosocial care centers in the city of Campinas (Southeastern Brazil), in 2006, were analyzed. RESULTS: Reference work was assessed as an arrangement that has therapeutic effects and contributes to the work organization efficacy. However, risks related to power centralized by reference professionals and to workers' suffering, as these may feel overly responsible for the case they are reference for, were reported. CONCLUSIONS: The effects of the "reference team/professionals" arrangement on patients are based on emotional aspects associated with reliability, constancy and integrality of care. In contrast, such aspects also show relationship problems, especially as regards omnipotence, which may involve the worker.OBJETIVO: Analizar como los usuarios, familiares y trabajadores de centros de atención psicosocial evalúan el trabajo de equipo y de los profesionales de referencia en esos servicios. MÉTODOS: Se realizó una investigación cualitativa, con base en el paradigma constructivista y en la hermenéutica Gadameriana. Se analizaron dos ciclos de grupos focales constituidos por profesionales, usuarios y familiares de usuarios de todos los centros de atención psicosocial de la ciudad de Campinas (Sureste de Brasil), en 2006. RESULTADOS: El trabajo de referencia fue evaluado como un arreglo que produce efectos terapéuticos y contribuye en la eficiencia de la organización del trabajo. Así mismo, se relataron riesgos de centralización de poder, practicada por los profesionales de referencia, y el sufrimiento del trabajador, que se puede sentir excesivamente responsabilizado por el caso de referencia. CONCLUSIONES: Los efectos del arreglo equipo/profesionales de referencia sobre los pacientes se basan en aspectos emocionales unidos a la confianza, la constancia y a la integridad de cuidados. Sin embargo, tales aspectos también presentaron problemas de relación, principalmente con la omnipotencia, que puede envolver el trabajador.OBJETIVO: Analisar como os usuários, familiares e trabalhadores de centros de atenção psicossocial avaliam o trabalho da equipe e dos profissionais de referência nesses serviços. MÉTODOS: Pesquisa qualitativa, baseada no paradigma construtivista e na hermenêutica Gadameriana. Foram analisados dois ciclos de grupos focais constituídos por profissionais, usuários e familiares de usuários de todos os centros de atenção psicossocial da cidade de Campinas (SP), em 2006. RESULTADOS: O trabalho de referência foi avaliado como um arranjo que produz efeitos terapêuticos e contribui na eficácia da organização do trabalho. Entretanto, foram relatados riscos de centralização de poder, praticada pelos profissionais de referência, e sofrimento do trabalhador, que pode sentir-se excessivamente responsabilizado pelo caso que referencia. CONCLUSÕES: Os efeitos do arranjo equipes/profissionais de referência sobre os pacientes embasam-se em aspectos emocionais ligados à confiabilidade, à constância e integralidade de cuidados. No entanto, tais aspectos também apresentam problemas relacionais, principalmente quanto à onipotência, que pode envolver o trabalhador

High chromosomal instability in workers occupationally exposed to solvents and paint removers

Background: Painters are exposed to an extensive variety of harmful substances like aromatic hydrocarbons used as solvents and paint removers, some of which have shown clastogenic activity. These substances constitute a complex mixture of chemicals which contain well-known genotoxicants, such as Benzene, Toluene and Xylene. Thus, chronic occupational exposure to such substances may be considered to possess genotoxic risk. In Colombia the information available around the genotoxic damage (Chromosomal and DNA damage) in car paint shop workers is limited and the knowledge of this damage could contribute not only to a better understanding of the carcinogenic effect of this kind of substances but also could be used as biomarkers of occupational exposure to genotoxic agents. Results: In this study, the genotoxic effect of aromatic hydrocarbons was assessed in peripheral blood lymphocytes of 24 workers occupationally exposed and 24 unexposed donors, by using Cytogenetic analysis and comet assay. A high frequency of Chromosomal alterations was found in the exposed group in comparison with those observed in the unexposed group. Among the total of CAs observed in the exposed group, fragilities were most frequently found (100 %), followed by chromosomal breaks (58 %), structural (41.2 %) and numerical chromosomal alterations (21 %). Numerical chromosomal alterations, fragilities and chromosomal breaks showed significant differences between exposed and unexposed groups. Among the fragilities, fra(9)(q12) was the most frequently observed. DNA damage index was also significantly higher in the exposed group compared to the unexposed group (p < 0.000). Conclusions: Our results revealed that occupational exposure to aromatic hydrocarbons is significantly associated with Chromosomal and DNA damage in car paint shops workers and are also indicative of high chromosomal instability. The high frequency of both Chromosomal Alterations and DNA Damage Index observed in this study indicates an urgent need of intervention not only to prevent the increased risk of developing cancer but also to the application of strict health control and motivation to the use of appropriate protecting devices during wor

Analysis of patient referral teams in mental health: a clinical management perspective

The study used a qualitative, evaluative, and participant methodology based on Gadamer's hermeneutics and the constructivist paradigm. The aim was to analyze the arrangement called patient care teams for treatment of psychotic patients in the context of Community Mental Health Services (CMHS). Data were collected in two cycles of 18 focus groups including health professionals, users, and family members at six CMHS III, including eight in-depth interviews with users of these services and two workshops aimed at developing a guide to evaluate CMHS practices. The arrangement's functions were described, emphasizing that the referral teams serve as clinical management levels, fostering follow-up of patients' unique needs in the field, through interdisciplinary work. This requires sustaining an ethical stance based on respect for otherness and clinical case work-up.Esse trabalho utilizou uma metodologia qualitativa, avaliativa e participante, baseada na Hermenêutica Gadameriana e no paradigma construtivista. O objetivo foi analisar o arranjo denominado equipes de referência, em relação ao tratamento de pacientes psicóticos, no contexto dos Centros de Atenção Psicossocial (CAPS). A coleta de dados foi feita em dois ciclos de 18 grupos focais, compostos por profissionais, usuários e familiares de usuários de seis CAPSIII, por oito entrevistas em profundidade, desenvolvidas com usuários desses serviços, e por duas oficinas de construção de um guia para avaliação das práticas dos CAPS. Foram indicadas as funções do arranjo, destacando que as equipes de referência se constituem como instâncias de gestão da clínica, propiciando o acompanhamento no campo das necessidades singulares do paciente, através do trabalho interdisciplinar. Para isso, devem sustentar um posicionamento ético baseado no respeito à alteridade e na construção do caso clínico.1153116

Desempenho Acadêmico De Alunos Que Se Submeteram A Tratamento Psiquiátrico No Serviço De Saúde Mental Para Estudantes De Uma Universidade Brasileira

University students are generally at the typical age of onset of mental disorders that may affect their academic performance. We aimed to characterize the university students attended by psychiatrists at the students&#8217; mental health service (SAPPE) and to compare their academic performance with that of non-patient students. DESIGN AND SETTING: Cross-sectional study based on review of medical files and survey of academic data at a Brazilian public university. METHODS: Files of 1,237 students attended by psychiatrists at SAPPE from 2004 to 2011 were reviewed. Their academic performance coefficient (APC) and status as of July 2015 were compared to those of a control group of 2,579 non-patient students matched by gender, course and year of enrolment. RESULTS: 37% of the patients had had psychiatric treatment and 4.5% had made suicide attempts before being attended at SAPPE. Depression (39.1%) and anxiety disorders/phobias (33.2%) were the most frequent diagnoses. Severe mental disorders such as psychotic disorders (3.7%) and bipolar disorder (1.9%) were less frequent. Compared with non-patients, the mean APC among the undergraduate patients was slightly lower (0.63; standard deviation, SD: 0.26; versus 0.64; SD: 0.28; P = 0.025), but their course completion rates were higher and course abandonment rates were lower. Regarding postgraduate students, patients and non-patients had similar completion rates, but patients had greater incidence of discharge for poor performance and lower dropout rates. CONCLUSION: Despite the inclusion of socially vulnerable people with severe mental disorders, the group of patients had similar academic performance, and in some aspects better, than, that of non-patients.1351232