The discourse about adherence of chemically dependent adolescents to treatment in a public health institution

A promoção da adesão ao tratamento da dependência química (DQ) tem se mostrado um desafio em diversos contextos, em especial no caso de adolescentes, relacionando-se a pressupostos sobre quem são estes, o que se entende por dependência e qual é seu tratamento. Foram entrevistados doze profissionais de um serviço de atenção à DQ da região de Ribeirão Preto (SP), abordando os significados por eles atribuídos aos temas adolescência, uso de substâncias/dependência e seu tratamento e adesão a ele. Observou-se por parte dos entrevistados a consideração de diversos determinantes na explicação da adolescência, com a predominância, contudo, de argumentos individualizantes acerca do tema. A DQ foi entendida como uma perda pelo indivíduo do controle sobre si, implicando uma consideração do tratamento como a busca por favorecer reflexões sobre o papel do uso de substâncias em sua vida. Houve por parte dos entrevistados um discurso crítico na busca por fatores institucionais, da equipe e externos a estes na explicação da adesão ao tratamento. São discutidas as inter-relações das formações discursivas com a literatura sobre os temas abordados e suas implicações para o tratamento da DQ.Promoting adherence to chemical dependence (CD) treatment has been a challenge in several contexts, especially regarding adolescents. Such challenge has been related to assumptions about who adolescents are, what is understood by dependence and about its treatment. Twelve professionals from a CD outpatient service in the region of Ribeirão Preto (SP) were interviewed about the meanings they attributed to the following subjects: adolescence, substance use/abuse and its treatment and adherence to such treatment. It was observed that the interviewees considered several determinants for explaining adolescence; however, there was a predominance of individualizing arguments regarding this subject. Chemical Dependence was understood as the individual's loss of self-control; consequently the aim of the treatment was favoring this individual's reflection about the role of substance use in his/her life. The interviewees showed a critical discourse, seeking for institutional and staff-related factors as well as for external factors to explain treatment adherence. The discourses of the interviewees are discussed in terms of their interrelations with the literature about the subjects approached in the interviews and its implications for CD treatment

Proposta di strategie di gestione sostenibile della risorsa idrica, in ambiente mediterraneo, finalizzata agli interventi per la lotta alla desertificazione (Sardinia NW, Italy)

This paper is concerned with the methodological approach and preliminary results of a study conducted on the sustainable management of water resources aimed ultimately at defining measures for combating desertification. The primary object is to explore and develop models and strategies for innovative and sustainable water resources management solutions, adopting a multidisciplinary approach, at the drainage and/or hydrogeological basin scale in a Mediterranean context, using a case study from a pilot area in Sardinia as a basis. Criteria for selecting the pilot area were dictated by the need for specific features such as the presence of surface waterbodies (rivers, channels, dams, etc.), of confined and unconfined aquifers and of urban agglomerates and productive activities, thus with competing water demands. An area was identified in the NW part of Sardinia, in the Nurra region, specifically the basin draining into the Calich lagoon. A multidisciplinary research project has been drawn up and tested for the purpose of collecting the necessary information required for developing integrated and sustainable water resource management solutions, also taking into consideration recently enforced legislation

Caratterizzazione tipologica dei rapporti tra fenomeni di desertificazione ed acque superficiali e sotterranee, osservati e studiati in Sardegna

This study has been carried out within a broader research project, RIADE, concerned with the characterization of the types of relationships existing between desertification processes and surfaceand groundwater observed and investigated in Objective 1 regions. The underlying assumption is that the deteriorating quality and diminishing quantity of a region’s water resources impact negatively on the development of all living things and on human organization, and thus represent a basic indicator of desertification, intended in its broadest sense as the degradation of bioproductive land. By re-processing the scientific results obtained for Sardinia during this project, we have developed a reference framework for the systematic representation of the types found, qualitatitive/quantitative natural or anthropogenic degradation phenomena/processes of water resources in Sardinia. Two distinct criteria have been adopted for the typological categorization of the deteriorating quality and diminishing quantity of water, both divorced from the environmental and regional context in which they occur.The first criterion is based on an analysis of water quantity and quality and on the “pollutant type”, along the lines suggested by the Italian Research Council’s National Group for Hydrogeological Disaster Protection (GNDCI); the second criterion uses the DPSIR model adopted by the European Environmental Agency (EEA), which defines five indicator categories for the state and evolution of the environmen

Low Energy Implications of Minimal Superstring Unification

We study the phenomenological implications of effective supergravities based on string vacua with spontaneously broken N=1 supersymmetry by dilaton and moduli $F$-terms. We further require Minimal String Unification, namely that large string threshold corrections ensure the correct unification of the gauge couplings at the grand unification scale. The whole supersymmetric mass spectrum turns out to be determined in terms of only two independent parameters, the dilaton-moduli mixing angle and the gravitino mass. In particular we discuss the region of the parameter space where at least one superpartner is ``visible" at LEP2. We find that the most likely candidates are the scalar partner of the right-handed electron and the lightest chargino, with interesting correlations between their masses and with the mass of the lightest higgs. We show how discovering SUSY particles at LEP2 might rather sharply discriminate between scenarios with pure dilaton SUSY breaking and mixed dilaton-moduli breaking.Comment: 11 pages, LaTEX, psfig, 8 figure

SIXTH GENERATION INNOVATION MODEL: DESCRIPTION OF A SUCCESS MODEL

This article describes an innovation model based on concepts of continuous improvement, a key component of quality management, an internal innovative milieu and a work environment that encourages all company personnel to engage in innovation of all kinds and continuously. The features of this model identify it as a sixth-generation innovation model. First of all the article describes the different generations and highlights their main characteristics. Despite the differences between them, all emphasize radical innovations and ignore incremental innovations. This model serves for both types, but focuses its efforts on incremental innovations for creating a continuous flow of innovations, which is a means of understanding the concept of continuous improvement applied to the company as a whole. Thus, this model builds a bridge between innovation management and quality management

Dynamics and Stability of Carbon Nanotubes

The low-frequency oscillations and energy localization of Single-Walled Carbon Nanotubes (SWNTs) are studied in the framework of the Sanders-Koiter shell theory. The circumferential flexure modes (CFMs) are analysed. Simply supported, clamped and free boundary conditions are considered. Two different approaches are proposed, based on numerical and analytical models. The numerical model uses in the linear analysis a double mixed series expansion for the displacement fields based on Chebyshev polynomials and harmonic functions. The Rayleigh-Ritz method is applied to obtain approximate natural frequencies and mode shapes. In the nonlinear analysis, the three displacement fields are re-expanded by using approximate eigenfunctions. An energy approach based on Lagrange equations is considered in order to obtain a set of nonlinear ordinary differential equations, which is solved by the Runge-Kutta numerical method. The analytical model considers a reduced version of the Sanders-Koiter shell theory obtained by assuming small circumferential and tangential shear deformations. These two assumptions allow to condense the longitudinal and circumferential displacement fields into the radial one. A nonlinear fourth-order partial differential equation for the radial displacement field is derived, which allows to calculate the natural frequencies and to estimate the nonlinearity effect. An analytical solution of this equation is obtained by the multiple scales method. The previous models are validated in linear field by means of comparisons with experiments, molecular dynamics simulations and finite element analyses retrieved from the literature. The concept of energy localization in SWNTs is introduced, which is a strongly nonlinear phenomenon. The low-frequency nonlinear oscillations of the SWNTs become localized ones if the intensity of the initial excitation exceeds some threshold which depends on the SWNTs length. This localization results from the resonant interaction of the zone-boundary and nearest nonlinear normal modes leading to the confinement of the vibration energy in one part of the system. The value of the initial excitation corresponding to this energy confinement is referred to as energy localization threshold. The effect of the aspect ratio on the analytical and numerical values of the energy localization threshold is investigated; different boundary conditions are considered

Vibration Localization of Imperfect Circular Cylindrical Shells

none4noThe goal of the present paper is the analysis of the effect of geometric imperfections in circular cylindrical shells. Perfect circular shells are characterized by the presence of double shell-like modes, i.e., modes having the same frequency with modal shape shifted of a quarter of wavelength in the circumferential direction. In presence of geometric imperfections, the double natural frequencies split into a pair of distinct frequencies, the splitting is proportional to the level of imperfection. In some cases, the imperfections cause an interesting phenomenon on the modal shapes, which present a strong localization in the circumferential direction. This study is carried out by means of a semi-analytical approach compared with standard finite element analyses.openPellicano, Francesco; Zippo, Antonio; Barbieri, Marco; Strozzi, MatteoPellicano, Francesco; Zippo, Antonio; Barbieri, Marco; Strozzi, Matte

Estratégias de intervenção em pacientes com doenças crônicas : ações para conscientização e melhoria na adesão do paciente em uma região do município de Capitão Leônidas Marques

Orientadora : Profª. Ms. Emanuela Carla dos SantosMonografia (especialização) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Curso de Especialização em Atenção BásicaInclui referênciasResumo : Introdução: O tratamento da enfermidade crônica para ser efetivo depende da adequada orientação médica e da correta condução do paciente, porém, o problema surge quando muitos usuários não seguem corretamente as orientações e prescrições médicas caracterizando-se como um grande problema para a saúde do próprio paciente e para a saúde pública. Objetivos: Os objetivos do presente trabalho são aumentar a eficácia dos tratamentos instituídos pelo médico na Unidade de Saúde após verificar se as orientações e/ou prescrições médicas são adequadas e de fácil entendimento aos usuários,também quais enfermidades apresentam maiores taxas de abandono no tratamento e quais pacientes tem maiores dificuldades na compreensão das orientações ou prescrições. Método: O método utilizado foi a pesquisa-açãoa partir da aplicação de um questionário onde buscou-se conhecer o perfil epidemiológico da população assistida e em sua decorrência executou-se um plano de intervenção. Resultado: Dentre as ações desenvolvidas, priorizou-se a realização de palestras educativas, com ênfase nas enfermidades crônicas de maior prevalência, elaboração e distribuição de folhetos de recomendações, que devem ser entregues aos hipertensos e diabéticos no momento da prescrição junto com as receitas médicas e a distribuição de uma caixa organizadora de medicamentos, confeccionadas artesanalmente. Tornou-se evidente que a forma mais eficiente de melhorar a qualidade de vida dos pacientes é promovendo mudanças no estilo de vida e melhorando a adesão no tratamento. Palavras-chave: Adesão terapêutica. Doenças crônicas. Educação em saúde. Promoção da saúde. Estratégia de saúde da família

Validade do TAT no Brasil: Questões Teóricas e Metodológicas

Although the Thematic Apperception Test (TAT) is popular in Brazil, showing evidences of its validity remains a challenge. In the present article, we discuss such issue by analyzing the definition of the TAT as a projective method and a psychological test, its use by different theoretical traditions, relations between nomothetic and idiographic analysis levels, limitations of Classical Test Theory for evaluating the instrument’s properties, and challenges regarding research and practice with the instrument in Brazil. We advocate that overcoming a traditional view of projective techniques, using multidimensional methods and performing wider empirical studies on norms and validation evidences with multicenter databases may allow more secure and informed practices with the instrument among researchers and practitioners in the country.Apesar da popularidade do Teste de Apercepção Temática (TAT) no Brasil, a demonstração de evidências de sua validade ainda permanece um desafio. No presente artigo, discutimos essa questão problematizando a definição do TAT como método projetivo e teste psicológico, abordando seu uso por diferentes correntes teóricas, relações entre os níveis nomotético e idiográfico de análise, limitações da Teoria Clássica dos Testes para avaliar suas propriedades, bem como os desafios na pesquisa e prática com o instrumento no país. Defendemos que superar a visão tradicional sobre as técnicas projetivas, utilizar métodos multidimensionais e realizar estudos empíricos mais amplos (sejam normativos ou de validação, usando bancos de dados multicêntricos) pode assegurar práticas melhor informadas com o instrumento para pesquisadores e profissionais