Repositório RCAAP

The present study uses linear and non-linear diffusion index models to produce one-stepahead forecast of quarterly Brazilian Agricultural GDP growth rate. These factors are latent variables that represent a common property from the explanatory variables, then allowing a considerably reduction of its number in econometric models elaborated to attend the main objective of this work. For in such a way, 83 variables had been used associates to the sectors internal and external collected from IPEA and more 10 climates variables collected from INMET.

CARVALHO , Evelyn Benevides. O papel do pai na fobia e na neurose obsessiva: o Pequeno Hans e o Homem dos ratos em Freud e em Lacan. 2006. 151f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2006.

OLIVEIRA , Fábio Porto de. Utopia, esperança e resistência: um estudo sobre a práxis libertadora na política pública de esporte e lazer de Fortaleza. 2009. 317f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2009.

Prevention is an effective means for working with HIV / AIDS and the church as a network of community health is a setting conducive to the cultural construction of adolescents with regard to the adoption of safe sexual behaviors, it adopts cautious to demonstrate the value of sex with responsibility and especially with respect to self and other. The study has as main objective to promote a critical and reflective area facing the HIV / AIDS with teens who are part of a group of the Catholic Church in the city of Tianguá-Ceará, based on the thought of Paulo Freire. This is a research- action, carried out between May and August 2009. The subjects were ten adolescents placed in youth groups of Catholic Charismatic Renewal. The instruments for data collection used a form of interview, participant observation, photographic records, filming and recording in the field diary. As the method and technique were used Circles of Culture to articulate the collective dimension of interactive research in the development of action research. Thus were carried out eight circles of culture constructed in accordance with the following steps: discovery of the Universe individual and collective problematization and theory, deconstruction of theoretical concepts and practice, collective (re) construction, summary of the experience, evaluation of each circle and one final assessment for these periods was necessary to select the themes and creating situations for questioning in accordance with the perceived reality. The circles considered the assumptions of the Paulo Freire method, such as: dialogue, participation, theoretical and practical value of knowledge, respect for culture, access to content relating to the reality and autonomy to carry out choices based on critical reflection of the reality . The analysis and interpretation of results have concentrated on the discussion of the data, according to the sequence of circles considering the experience of the group and the dialogue with the literature carried out by the researcher. In this sense the adolescents reflected on the themes: HIV / AIDS, chastity, sexuality and prevention in the religious context, moments that led to the deconstruction and (re) construction of concepts and (pre) concepts. The completion of the circle of culture as educational and investigative strategy with adolescents from the church is awakening to the influence that the church plays in this group when its teachings are related to teaching of the chastity and fidelity understood as behaviors to be adopted and the resulting means of preventing HIV / AIDS , the silencing of the church about sexuality, the devaluation of information on condom use by adolescents and recognition of the need for more knowledge that address the issues that emerged in the study. Therefore nurses need to use methodologies that promote emancipatory dialogue founded on the trust and respect between teacher / student, strengthening a relationship of friendship to the reflection about the adoption of safe sexual behaviors in adolescents in the church.

Due to its relevance for public health, the red reflex test, also known as little eye test, has become an established strategy to prevent infant blindness within a multi professional team work, involving the nurse in particular. Applied technologies in this context constitute a useful tool for the professional and their use has to be stimulated aiming the assistance improvement. The main goal of this work is to assess a color gradient projected to measure the red reflex test in newborns regarding contents and appearance validation, accordance among different observers and nurse’s opinion on the tool applicability after its use. This is a methodological research, quantitative, whose data acquisition happened between May and August 2010 in two methodological steps. Firstly, the proposed instrument was analyzed by three judges. These specialists gave their opinions by means of an evaluation questionnaire in the Likert scale format. The survey covered subjects like goals, structure and presentation, appearance and relevance. In order to quantify their opinions, the answers were restricted to five levels: Absolutely adequate; Adequate with little observations; Partially adequate; Inadequate; It does not apply. In the second step, after collecting the answers and taking into account suggestions from the specialists, we checked the test accordance among different nurses in the color gradient application top the red reflex test. This was made by using a sixty newborns sample. These neonates were in the low risk neonatal sector of a reference public maternity hospital in Fortaleza. Each newborn was examined by two examiners (the researcher and a nurse) simultaneously and independently. The data were treated within PASW 18.0 software. The gradient reliability was calculated by means of the intraclass correlation coefficient. Adjustments were applied to the instrument until its approval. Regarding the contents and appearance evaluation, the judges agreed about the excessive number of gradient colors and they suggested the elimination of several similar patterns. They also recommended to reconsider those patterns with a white center since they could be confused with an altered reflex. Additional suggestions from the specialists pointed to the inclusion of a new color in the instrument as well as a new title to the gradient: color gradient for the little eye test. Most of the answers from the judges were between Absolutely adequate and Adequate with little observations. The specialists considered the developed technology as a complimentary to the practice of the red reflex test, as well as a useful tool for training of professionals to do this test. Good reliability indices were observed (0,928 e 0,894). Such numbers were estimated by the intraclass correlation coefficient. After these considerations, the color gradient was shown to be a valid technology suitable to be considered as a pedagogical tool and as a useful additional instrument on the visual health care. It is expected that the knowledge constructed in this work results in a positive impact on the red reflex test propagation and application.

This research objectified to outline the epidemiological and socio-economical profile of the Centre of Psychosocial Attention (CAPS)’s users in the municipality of Fortaleza, Ceará, based on their handbooks. It was an epidemiological study which was carried out in three CAPS located in Regional Executive Secretariats (SER III, IV and VI). The data was produced through the elaboration of a questionnaire which included the following aspects: identification and socio-demographical data, personal previous history, family previous history, pathological previous history, symptomatology, types of therapeutic activities and evolution. Based on 385 handbooks, the users’ profile was built up. Socio-demographical profile: 60,1% were female; 63,4% of the patients were between 20 and 49 years old; 43,9% of the patients finished Junior high school; 69,5% have an income between 1 and 4 minimal wages; 15,4% have the pension from the retirement as the main income; 71,9% are Catholics; 92,6% live in houses. Personal, familiar and pathological record: 40,5% presented psychical alterations in their childhood; 45,4% of the studied patients’ parents presented a psychical alteration during the life; 60% of the studied patients presented conflicts in familiar relationship; 53,9% have been interned in clinical hospitals; 15,9% had the insomnia as the main symptomatologic complaint; 18,5% of the patients had as the main factor of the crises, a beloved’s death; 39,4% had Neurotic Disturbances as the main diagnosis; 91% of the cases had the psychopharmacos as the main chosen treatment; 30,5% used the ansiolitics as the first chosen drug; 56% of the patients had other forms of approach such as individual attendance; in 9% of the cases, this attendance was carried out by a psychologist. From the obtained data we can conclude that: most users are female; the age group considered productive was present with more than 60% in both genders; most part of the patients who frequent the CAPS have low income, primary education, live with pension from retirement and more than 90% live in houses; more than 40% had disturbances in other phases of life; more than 50% have been interned in clinical hospitals; most of them has insomnia as the main symptomatologic complaint and 91% had the psychopharmacology as the only form of treatment. Considering the data, we can infer that CAPS takes shape of the structure of attention to people that present any kind of mental suffering, what is recognized by the health team itself. But we can also infer that the principles of the Psychiatric Reform were not always attended, considering this service as one of the provisions of the net of mental health attention. This type of service objectifies to actuate as a strategic provision in the building of the community net of care, developing community therapeutic projects turned to the integral attention to the users and their families, propitiating integration between health services, users, community and social net of support (BRASIL 2004). Through the results of this study, it is considered that a lot must be reviewed by managers and workers of the net of mental health attention, trying to advance in the achievements which were achieved up to now and guaranteed by Law. The building of a new net of mental health attention is more than the mere amplification in the number of services. It requires the building of new knowledge and practices based on the paradigm proposed by the Psychiatric Reform, changing the focus of attention from the disease to the person in mental suffering, in all the complexity resulting from this condition. Although this study contemplates only three services, the reality showed here provides subsidy to rethink the CAPS as an important provision in the implementation of the net of mental health attention in Ceará.

The falls occurrence represents a serious health problem for aged. Therefore the factors involved must be continuous assess in order to improve the aged life quality. The aim was to investigate the falls occurrence in the last six months at elderly with and without stroke and to identify the intrinsic and extrinsic factors involved. A case-control study carried at three Beneficent Associations of Rehabilitation from Ceará and a Reference Center of Social Worker in Fortaleza city from January to April 2010. A case group and three control groups were established with 15 elderly paired off by sex, age, falls occurrence in the last six months and stroke occurrence. It was used a form organized in four parts with the objective to characterize the patient, actual intrinsic and extrinsic conditions, falls occurrence and environment factors involved. The data were gathered with the Research Ethical Committee approval and when the elderly were enlightened at the collected data unit about the aim of the research, and the patient signing of authorization term. The data obtained was analyzed by Predictive Analysis Software 18.0. The groups were mainly composed by women, retired people, persons with partners, low school grade and low financial income. The elderly with stroke presented an average of 1,4 occurrence in an average period of 5,6 years and the main consequence was hemiparesis. As far as statistical associated variables concern, the followings were here highlighted: Use of antihypertensive among the groups with falls despite the occurrence of a stroke; Use of ACE inhibitor at aged with stroke whom were fallers or not; Foot alterations between the case group and people without falls neither stroke. Besides the variables Decreased strength at lower members, excess of home furniture, Gait difficulty and Impaired physical mobility was found in all association among the fallers participants with stroke and those without stroke neither falls. Gait difficulty and Impaired physical mobility were statistically associated between the case group and people without stroke and fall occurrence. The Barthel index, daily instrumental life activities, Geriatric scale and Tinetti scale, besides right hand grip strength, also found statistical association between the case group and aged without stroke fallers or not. The falls occurred mostly in the morning, in bright environment without handrail or objects, in rough and dry floor, use of rubber slippers. It was not verified to be the stroke an event associated to falls, a fact that strengthens the multifarious cause relation. The variables involved with fall event were strongly related to intrinsic factors involved with the balance issue. The extrinsic factors, however, could be easily modified. Therefore health professionals should routinely assess all fall variables involved in order to improve the life quality of elderly people.

A Estratégia Saúde da Família (ESF) aparece no cenário da saúde mental como espaço estratégico para o acolhimento das pessoas em sofrimento mental pela possibilidade de articulação de formas de integração entre usuário, família, redes de suporte social da comunidade e serviços de saúde. A realidade, no entanto, ainda demonstra pouca aproximação das ações em saúde mental na Atenção Básica pelos profissionais, exigindo estratégias que visualizem a situação e encaminhem propostas de atuação. Tais recursos apresentam-se como tecnologias leves de cuidado que viabilizam o “empoderamento” dos sujeitos, sendo os círculos de cultura um desses exemplos. Esta pesquisa objetivou possibilitar espaço de círculo de cultura quanto à abordagem em saúde mental sob a perspectiva da equipe da ESF. Pesquisa-ação desenvolvida junto a 22 profissionais de duas equipes da ESF do Município de Juazeiro do Norte – CE - Brasil, utilizando como referencial metodológico os círculos de cultura, propostos por Paulo Freire. A produção dos dados se deu, inicialmente, por meio de visitas de campo, contando como instrumentos um roteiro de entrevista semi-estruturada e a observação não sistemática com registro em diário de campo. Em seguida, foram realizados seis círculos de cultura, nos quais foram abordaram aspectos da integralidade do cuidado em saúde, do histórico da loucura, as novas abordagens em saúde mental, desde a Reforma Psiquiátrica, a interface da saúde com a doença mental e a integração entre saúde mental e ESF. A análise foi realizada pela triangulação dos dados sob o referencial teórico da atual Política Nacional de Saúde Mental e da Reforma Psiquiátrica. Nos encontros com os profissionais, as concepções sobre a saúde mental centralizaram-se no adoecimento, determinando ações fragmentadas e relacionadas ao encaminhamento e prescrição medicamentosa. Nos momentos subsequentes, os participantes visualizam as relações entre a saúde e a doença mental, entre os fatores sociais, culturais e biológicos imbricados no sofrimento mental, vislumbrando aspectos intersetoriais que trouxessem repercussões para a prática. Com isso, os participantes conjecturaram formas de intervir pelo adequado acolhimento da demanda, o reconhecimento das problemáticas e a organização dos recursos presentes para atuar no sentido da promoção da saúde mental, prevenção de agravos e assistência dos casos de sofrimento mental da comunidade. Os círculos de cultura em saúde mental permitiram a aproximação dos participantes com elementos desconhecidos no campo da saúde mental, seguida da problematização das demandas locais e reflexão quanto às possibilidades de atuação com os recursos da comunidade e do serviço. Assim, foi possibilitado o “empoderamento” dos indivíduos, por meio da sensibilização diante às questões em saúde mental, fortalecendo os vínculos entre a equipe e os conhecimentos para acolher situações de saúde mental como campo de assistência na Atenção Básica.

A identificação dos principais diagnósticos de enfermagem presentes nos pacientes com Angina Instável contribui para o conhecimento do perfil de respostas humanas destes pacientes, colaborando para o planejamento de intervenções mais adequadas, viabilizando a sistematização da assistência de enfermagem. O objetivo deste estudo foi analisar o perfil de diagnósticos de enfermagem apresentado por pessoas com Angina Instável internadas em um hospital especializado em doenças cardíacas. A população foi composta pelos clientes portadores do diagnóstico de Angina Instável, sob atendimento nesse hospital. Trata-se de estudo descritivo do tipo transversal, com abordagem de análise quantitativa. Foram avaliados 57 pacientes com Angina Instável, no período de janeiro a outubro de 2006. O instrumento de coleta foi um formulário preenchido durante entrevista e exame físico. Estes pacientes são predominantemente do sexo masculino, com média de idade de 61 anos, sem companheiro, originários do interior do estado do Ceará e procedentes da capital do estado. Têm renda familiar próxima a 650 reais, tendo estudado por volta de quatro anos, pertencentes à religião católica e a maioria está aposentada. O tempo de internamento desses pacientes até a coleta dos dados foi de, em média, cinco dias e estavam, em sua maioria, no primeiro episódio de Angina Instável. Verificamos que as principais características clínicas de base foram: Hipertensão Arterial, Fumo, Cateterismo cardíaco anterior e Menopausa. A média da Relação Cintura-Quadril desses indivíduos estava dentro do risco considerado alto, independente do sexo e da idade e a maior parte dos pacientes estava acima do peso ideal para a altura e a compleição corporal. Constatamos que esses pacientes apresentavam em média, cinco diagnósticos de enfermagem, doze características definidoras, quatro fatores relacionados, e sete fatores de risco. Examinamos que os diagnósticos de enfermagem mais freqüentes eram decorrentes do quadro anginoso ou favoreciam seu surgimento, sendo o diagnóstico de Risco de quedas o mais presente. Os fatores relacionados mais presentes eram relacionados aos diagnósticos de Dor aguda, Intolerância à atividade, Padrão de sono perturbado e Estilo de vida sedentário. Neste estudo tivemos a oportunidade de identificar aspectos do cuidado ao paciente anginoso possíveis de serem aprimorados, por meio da análise dos diagnósticos de enfermagem. Isso pode contribuir para conscientizar e incentivar a enfermagem na execução de mais estudos científicos não só com relação à Angina Instável, mas também alusivos a outras doenças isquêmicas miocárdicas, além de nortear a assistência de enfermagem à população.

Sexually Transmitted Diseases (STD) are considered an occupational risk for prostitutes, and they can be prevented with the use of condom. A conscientization about its importance through health education is necessary, as it is the most efficient strategy in STD/Aids prevention, what will bring changes in behavior, values and attitudes. In face of all this problematic situation of prostitution and its relation with STD, we got interested in understanding the work carried out by the prostitutes from the Association of Prostitutes from Ceará - APROCE concerning STD/Aids prevention. In this context, this study objectified to analyze the educational work carried out by the prostitutes from APROCE concerning STD and Aids prevention, and to verify if this Health Education estimulates reflexion, criticism and behavior change, or if it is only an information provider. This way, we awakened to the relation between the object of study and the theoretical approach based on Paulo Freire’s reflexions, considering that “change”, together with “conscientization”, is a “theme generator” of Paulo Freire’s theoretical practice. It is a qualitative research inspired in Paulo Freire’s theory and practice, and analyzed according to the Critical Theory. The data were grouped according to the stages they were collected: Observing Social Educators and Dialoguing with Social Educators. Later, the second part was divided in two categories: the profile and the dialogue with social educators. In the dialogue with social educators their feelings about the work done were identified, as well as the main difficulties; the facilitator points; how they perceive their results; and the most and least important points of their work. Therefore, we can conclude that being aware of the importance of STD and Aids prevention and changing behavior are not easy tasks because many factors interfere in prostitutes’ lives. The Health Education strategies used by the Association are not estimulating reflexion, criticism and behavior change as expected, but it has given a great step, as they provide information and condom to prostitutes. And, as it is an action that has happened for some years, many women have already changed behavior. More efficient strategies and projects must be carried out so that conscientization and change happen in a shorter period of time. For the obtention of this aim, Health Education methodological strategies in STD/Aids prevention for prostitutes were elaborated

VALENTIM, Farley Janusio Rebouças. Havia um CAPS no meio do caminho: adoecimento mental, narrativa e produção de sentido. 2011. 143 f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2011.

Given the greater vulnerability to acquisition of Sexually Transmitted Diseases (STD)/HIV by women prisoners, decided to develop the study. It is an evaluative study of type Knowledge, Attitude and Practice (KAP) held in a female prison in the state of Ceará, with the following objectives: Assess the knowledge, attitude and practice regarding the use of prisoners male and female condoms as a measure prevention of STD/HIV; Verify the sociodemographic, sexual, reproductive and lifestyle habits of prisoners; Investigate vulnerability factors in prisoners; Associate predictor variables with the knowledge, attitude and practice of male and female condoms by prisoners; Compare the knowledge and attitude to the practice of male and female condoms by prisoners. Search with quantitative approach, involving a sample of 155 prisoners. Data collection was conducted from January to March 2010. The instrument included data on sociodemographics, sexual, reproductive and lifestyle habits. Then we applied the KAP survey about condoms, adapted from research Brenna et al. (2001). The data were compiled, stored and associated in the Statistical Package for Social Sciences (SPSS) version 17.0. The chi-square test was used as statistical tool. The sociodemographic profile pointed to a majority of young Brazilian, single, low education level and family income, trapped for drug trafficking. The history of sexual precocity revealed the occurrence of first sexual intercourse, stability and little variety of sexual partners. However, drug use, be male or female prisoner, and has tattoos/ piercings were the principal characteristics of the partnerships. The homo/ bisexuality and prostitution was attended by about 35%. STDs acquired before or after the arrest showed low percentages, 13.5% and 5.8% respectively. Only 15% were granted the right to conjugal visits. Smoking habits, alcoholism, and illicit drug use were presented in more than 60% of women. Knowledge about condoms proved to be superficial. Although they had heard of and/ or correctly knew the reasons for use, 120 (77.4%) couldn’t report three necessary cares for the proper use of male condoms and 143 (92.3%) females. Were diagnosed less favorable attitudes about the use of female and during oral sex. The practice proper condom had little representation, particularly females. Homosexuality, gender issues, lack of knowledge and access difficulties represented obstacles. The attitude was significantly associated with the variables age and age of first sexual intercourse. The proper use of condoms and the history of prostitution were statistically associated. The components of the KAP didn’t showed statistical associations between them. Therefore, knowledge and attitudes weren’ot adequate enough to ensure appropriate practices. Possible clarifications are in the context of difficulties in negotiating the use of the partners, restricting access and the "illegality" that occur in homosexual relations. Strengthening the autonomy of individuals, as the essence of the educational process, and consider the knowledge and opinions, should bring together the contexts of environmental vulnerability, social, cultural and emotional.

The nursing diagnoses identification in renal transplant patients is an adequate and important instrument, because it provides an own nursing language, facilitates the communication between the professional and the patient and defines the nurse competence working scope. This study aimed to analyze the nursing diagnoses distribution presents in renal transplanted patients of an academic hospital of Fortaleza. The population was formed by the renal transplanted who are accompanied in the renal transplant ambulatory of this hospital. It was a cross-sectional study of exploratory and descriptive character. Fifty eight renal transplant patients were evaluated between months of december/04 and april/05. The data collection instruments were: an interview script and a physical exam. The results show the masculine sex predominance, with age average about 40 years, the majority being married, with average about 2 children. The origin was of the countryside cities of the Ceará or of other country states, they had familiar income of four minimum wages on an average, they did not use any contraceptive method. The majority was retired, with low education, catholic, without alcoholic drink and tobacco use. They had a medium duration of 52 dialysis months, mostly the hemodilysis. The most had as renal graft donor a corpse and average six year and half of transplant. Were identified 39 nursing diagnoses, 10 of which above of percentil 75, with the presence of six domains of the 12 investigated. Regarding the associations among nursing diagnoses, we find relation between sleep Pattern disturbed and sexual Dysfunction, sleep Pattern disturbed and ineffective sexuality Patterns, sexual Dysfunction and ineffective sexuality Patterns. In the diagnoses disturbed sensory Perception: visual and disturbed sensory Perception: auditory were found media differences with the age and time of dialysis respectively. The first diagnosis manifested itself in renal transplanted patients with more advanced age. The second diagnosis was present in patients with larger time of dialysis. We realize that the nursing diagnoses study provided us a larger knowledge of these patients’ reality, contributing for a possible implementation of effective nursing actions for the resolution of the identified problems. This can contribute to guide the nursing assistance to the renal transplanted and to provide a better life quality to this clientele.

A dor é frequente em crianças com paralisia cerebral (PC), sendo provável que a lesão altere a capacidade de compreender e comunicar a dor. Objetivamos compreender a vivência da mãe/cuidadora frente à dor da criança com paralisia cerebral. Estudo descritivo, qualitativo realizado no Núcleo de Tratamento e Estimulação Precoce (NUTEP) com 21 mães/cuidadoras de crianças com diagnóstico de PC tetraparética espástica, selecionadas a partir de uma amostra não-probabilística intencional por saturação de dados, durante o mês de novembro de 2010. Utilizamos, como suporte metodológico, a Teoria de Enfermagem Humanística, seguindo as fases da enfermagem fenomenológica de Paterson e Zderad: preparação da enfermeira para vir-a-conhecer; a enfermeira conhece intuitivamente o outro; a enfermeira conhece cientificamente o outro; a enfermeira sintetiza de forma complementar as realidades conhecidas e a sucessão interna da enfermeira a partir de muitos para um único paradoxal. Para a coleta de dados, preparamo-nos previamente através de leituras, introspecção, ambientação no local do estudo e interação com as mães. Em seguida, efetivamos a coleta de dados através da observação participante e da entrevista semi-estruturada, registrada por gravador. Para a análise, realizamos leituras exaustivas dos depoimentos, seguidas de leitura analítica para síntese e comparação das realidades conhecidas a partir das quais emergiram as seguintes categorias: reações da criança com paralisia cerebral tetraparética espástica à dor: o chamado de ajuda; a singularidade do diálogo da criança com paralisia cerebral tetraparética espástica; reações das mães à dor da criança tetraparética espástica e ausência de dor na criança com paralisia cerebral tetraparética espástica. As principais reações à dor evidenciadas por relatos das mães/cuidadoras foram irritação, agitação, choro, testa franzida, mudanças no movimento e no tônus muscular da criança. Percebemos que a comunicação não verbal da criança no momento da dor expressa as manifestações comportamentais, enquanto que a comunicação verbal através do autorrelato complementa as alterações comportamentais com base na confirmação da presença de dor e suas características. As mães/cuidadoras reagem, identificando se realmente a dor está presente na criança, bem como procurando sua localização. Para tanto, realizam a observação, o toque, avaliam as mudanças de comportamento, alterações nas expressões faciais e questionam a criança onde é a fonte da dor, quando esta consegue indicar ou comunicar-se verbalmente e para aliviar a dor oferecem medicamentos, promovem massagem, fornecem conforto, carinho e contato, e quando não percebem melhora procuram a opinião e ajuda médica. A maioria das mães/cuidadoras expressou que se sentem com vontade de chorar, preocupadas, tristes, angustiadas, desesperadas, nervosas e, em geral, descrevem o momento em que seu filho está com dor como horrível, sendo uma das piores situações vivenciadas no cuidado. Assim, concluímos que a vivência materna frente à dor da criança com paralisia cerebral tetraparética espástica se estabelece por meio da interação contínua entre a díade mãe-criança, quando ocorre identificação das reações comportamentais e vocalizações, caracterizando a comunicação, e da realização de medidas de alívio farmacológicas e não-farmacológicas, envolvidas por sentimentos da mãe que perpassam a preocupação, medo, angústia e culpa.

To study the burden of the caregivers of the patients affected by stroke contributes to the improvement of nursing care by making it more skilled and geared to the needs of this population. The objective was to evaluate the main burden of family caregivers of the patients with stroke. Cross-sectional study was conducted from January to April 2010. It was carried out in Fortaleza-Ceará, Brazil, in 2010, at Home Care Program. Established themselves as inclusion criteria: be the principal family caregiver and pursue such activity for at least two months. Caregivers who were unable to give information about the health-disease patients, and caregivers of stroke patients who had mental disorders, and other neurological diseases, were alcoholics or drug addicts were excluded. We interviewed 61 caregivers in relation to demographic data, activities performed, presence of pain, assessment of financial expenditures, the presence of psychiatric symptoms through Self Report Questionnaire (SRQ-20), cognitive evaluation by Mini-Mental State Examination (MMSE) and evaluation of the burden of care for the Caregiver Burden Scale (CBS). Patients were asked about the sociodemographic, health history, degree of dependence in the Activities of the Daily Living (basic and instrumental) and cognitive evaluation (MMSE) and anthropometric evaluation was performed. The data were compiled in the Excel software and analyzed through the SPSS program, version 15.0. The level of significance considered was 5% (p<0.05). All the ethical recommendations were fulfilled. It was found that most caregivers were female (93.4%), married (52.5%) and daughters of the patient with stroke (50.8%), they had not another occupation (82%), they had family support to engage in the activity of caring and had good schooling. The caregivers exerted on the caregiver for at least 27 months and 18 hours per day devoted to his family. Patients were primarily female (59%), elderly, bedridden, with a low educational level, other events of stroke, highly dependent, low cognitive level (95.1%). Depending on the observed, the caregivers had health problems such as hypertension, diabetes mellitus, dyslipidemia and osteoporosis. Many caregivers complained of pain after engaging in this activity. Others presented with psychological distress (44.3%). As for the activities performed, they understood, above all, self-care activities. Besides taking care of the patients, they took care of children or grandchildren. Changes in daily routine and emotional status were reported. Despite the above problems, it was observed that caregivers performed the care, especially for pleasure (70.5%). In relation to the burden it was found an average of 2.36 (± 0.59) on CBS, superior national and international studies. That burden suffered higher impact when the caregivers have higher scores on the SRQ-20, in the absence of a secondary caregiver, and when the caregivers reported that they had noticed any change in their body and health, and when the patient was taking several medications daily. The findings underscore the need for nursing staff to act not only with patients affected by stroke, but also on prevention and health promotion and their caregivers who are burdened.

BERTINI , Fátima Maria Araújo. Centro da cidade de Fortaleza, lugar das transformações: o idoso e os afetos implicados. 2006. 183f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2006.

The prevalence of type 2 mellitus diabetes has increased worldwide, mostly in children and adolescents. The objective was investigating the prevalence of risk factors for type 2 mellitus diabetes in adolescents from public state schools in the city of Fortaleza-Ce. From February to March, 2006 a transversal study was carried through with 720 individuals from both genders between the ages of 14 and 19, enrolled in twelve state schools. A form was used to record identification data, socio-demographical features, food habits, physical activity and leisure practice, in addition to the measurement of weight, height, capillary glucose and arterial pressure. Results highlighted that 59.3% were girls, 10.3% were overweight, 2.6% were obese, 75.3% were sedentary, 91.1% had a family income not higher than 3 minimum wages, 8.3% presented capillary glucose with doubtful rates and 42.1% elevated arterial pressure levels. Food consumption of four or more times a week was statistically significant in rice (95.8%; p=0.0001), bread (85.8%; p= 0.0001), beans (75%; p= 0.0001) and meat (60.6%; p= 0.0001); besides that, 92.7% had from three to six meals a day. From the sample stating there was diabetes in the family, 13.6% mentioned the parents as diabetes carriers. Women practiced less physical activity than men (p= 0.000) and presented a higher percentage of doubtful glucose (p=0.004), but they had a smaller relative number of elevated arterial pressure (p=0.000); regarding overweight / obesity there was a statistically significant association with gender (p=0.840). Overweight was higher between the ages of 14 to 15 (11.1%, p=0.003) and obesity between the ages of 16 to 17(3.3%, p=0.003). Whereas sedentariness was also higher between the ages of 16 to 17 (80.8%, p=0.049). As observed, capillary glucose had no association in a statistically significant manner, with age (p= 0.453%). The risk factors association for type 2 mellitus diabetes (overweight, sedentariness, capillary glucose and elevated pressure levels) was mostly found in girls between the ages of 16 to 17.

JESUINO, Filipe de Menezes. O delírio paranóico nos sistemas de Freud e Jung: contribuições mútuas e contrastes. 2008. 177 f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2008.

Pregnant women’s access to a decent, humanized and qualified service is not only a right, but a women’s necessity. The Health Department expresses and makes official through regulations, the intention of investing in attention to pregnancy, childbirth and post-delivery, establishing the Program of Humanization in Prenatal and Birth (PHPN). It is an unprecedented program, as a deep search in literature did not identify any other program like PHPN. Besides, it is a proposal of intervention for a country that is in process of development; it offers directives for the different instances of assistance; it describes the minimum conditions for the attention with financial incentive connected to the execution of such conditions; and it suggests an information system (SISPRENATAL), with offers the local administrator to monitor progress and challenges and to correct imperfections. In this context, it was decided to carry out the present study which had as a general objective to evaluate the quality of prenatal assistance in Ceará from the implementation of PHPN on. The specific objectives were to evaluate process indicators of PHPN generator in the SISPRENATAL in the State; to analyze specific aspects of the nurse’s performance in the prenatal attention, informed in the SISPRENATAL; and to identify the financial income produced by PHPN to the state of Ceará. The study was characterized as exploratory and descriptive and its universe was the Health System of Ceará. Part of the data was collected in the Information Department of the Health State Secretariat through a search in the Prenatal Information System (SISPRENATAL). The other part was collected in the Coordination of Control and Evaluation of the same Secretariat. The process indicators served as supplementary information to analyze the quality of prenatal assistance in Ceará, between June, 2001 and August, 2006. Throughout these six years 691.001 live born infants (NV) were notified in the SISPRENATAL. However, only 312.507 registrations of pregnant women were notified, that is, 44,4% of NV, including pregnant women with pregnancy age until 120 days from 2001 to 2003, and from then on women with all pregnancy ages. It was observed a continuous increase in the indicators of pregnant women’s early registration (<120 days) in the program, from 88,3%, in 2001, to 96,4%, in 2006. In the evaluation of all conditions determined in Component I of PHPN, together, which defines a better quality of prenatal assistance, the percentage reached 15,67% of registered pregnant women. This result was about 50% superior to the result found in the Country, considering that the conclusion of this indicator in national level was about 10,12% in the same period. It was demonstrated that nurses act extensively in prenatal assistance of basic health units of the State, because 95% of pregnant women’s registration and 88% of post-delivery service were carried out by this professional. Concerning the financial aspect, when we verify the difference of the value of the actions which were carried out and informed at the BPA of the municipalities but were not approved, we have a State total value of R$ 323.040,00. It is noticeable by this value the possible lack of interest or even the lack of Knowledge that governors have when solving problems that produce the disapproval of information and block the collection of resources, what decreases the possibility of greater progress in this area. In conclusion, it was possible to notice through this study that it is necessary to intensify the discussions among professionals, governors and community about progress and challenges in each municipality, in each area of PSF, in other to promote a visualization of several necessities in prenatal assistance and look for possible and effective solutions. It is unacceptable that the area of care which is so necessary and considered many times a priority by public policies suffer because of negligence and absence of basic guarantees like the realization of essential lab exams, anti-tetanus immunization and post-delivery service. This is a reality detected in Ceará and also described in the national scenery. We have to recognize the active role of the nurse in this area of care and that it is urgent that governors of the municipality appropriate the financing process of PHPN and minimize missed opportunities to obtain financial resources for the Health Local System.

PINHEIRO , Francisco Pablo Huascar Aragão. A arte e a brincadeira e suas interfaces com a dramatização em psicologia comunitária: um estudo de processos de mediação simbólica. 2008. 110f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2008.