RCAAP Repository

The Enterococcus are Gram-positive cocci catalase negative - which inhabit the gastrointestinal, and genitourinary tract. They are identified manually and the procedure is based on the classic of Facklam, by semi-authomatized and automatized systems as well as by Molecular Biology. Due to the diversity of identification methods and aiming to verify the concordance among some methods, it was accomplished the identification of 62 bacteria strains proceeding from the collection of the Centro Especializado em Micologia Médica (CEMM) of the Federal University of Ceará, in Brazil. They were presumably identified as Enterococcus sp. e Enterococcus faecalis by the Facklam scheme. This study was begun with the identification for two manual methods, modified from the Facklam scheme – Modified 1 and Modified 2- and semi-automatized – API 20 Strep. For the inconsistent results definition we used the semi-automatized – BBL and the Molecular Biology- PRC. The Franklin scheme identified 16% (10) as strains of the genre Enterococcus sp. and 52% (84) as E. faecalis. The Modified Scheme 1 presented the following identification: 82, 2% (51) E. faecalis, 9, 7% (6) E. mundtii and 8, 1% (5) E. gallinarum. The Modified 2 identified 98, 4% (61) E. faecalis and 1, 6% (1) E. gallinarum. The API 20 Strep identified 51,6% (32) E. faecalis, 19,4% (12) A viridans, 13,0% (8) E. avium, 4,8% (3) S. agalactiae, 3,2% (2) E. faecium, 1,6% (1) S. acidominimus, 1,6% (1) Leuconoctocc sp., 1,6% (1) S. uberis, 1,6% (1) A. adiacens and1,6% (1) unacceptable. It was made the selection of 10 sample (strains), among them, the ones numbered (05, 13, 15, 20, 27, 31, 32, 33, 50 and 60), which presented discordant results among the systems Modified 1, Modified 2 and API 20 Strep to be identified by BBL Crystal and by PCR. The BBL identified 6 samples as E. faecium, including the control- strain E. faecalis ATCC 29212 and did not identify 4 samples. In the PCR, one sample did not amplify and 9 were identified as Streptococcus spp. One sample was identified as positive for the genre Enterococcus, but it did not for the species E. faecalis and 1 (one) was amplified for the species S. agalactiae. None of the samples presented were positive for the species E. gallinarum. The control-sample – E. faecalis ATCC 29212 – was correctly amplified. With the analysis of the results, it was noticed that there was identification concordance of the 62 strains in 84% of the samples among the manual systems (Facklam, Modified 1 and Modified 2) and in 52% of the samples among the manual and semi-automatized systems (API 20 Strep). In 10 samples with disagreeing results there was no identification concordance among the manual systems, API 20 Strep and the BBL. A PCR agreed with the manual systems and the BBL and did not agree with the API 20 step, in genre, in one sample. Correlating the PCR with the API 20 Strep, there was agreement, in genre, in 01 sample and disagreement with the other systems.

Coccidiodomycosis is a disease caused by dimorphic fungi of the Coccidioides genus – C. immitis and C. posadasii – which afflicts people and various animals, such as cattle, goats, rodents and dogs. It is restricted to the Americas and cases have been reported in the state of Ceará only since 1995. The infection generally results from inhaling the infectious structures arthroconidia -of the fungus. In its parasitic phase, the microorganisms responsible for the clinical signs of the disease have a spherical shape. Most cases are asymptomatic, and respiratory problems are the most common symptoms in patients that are clinically affected. The disease’s diagnosis is based on microbiological techniques such as direct examination of clinical specimens and culturing, but these procedures require specialized biosecurity level 3 facilities because the microorganism falls in biological class 3. The immunological approach appears promising because it does not require manipulation of the fungi and can be performed in various laboratories equipped for routine mycological tests. The aim of this work is to outline the clinical and laboratory profile of the cases of coccidiodomycosis that occurred in the state of Ceará between 1995 and 2007 and to report experiments to obtain antigenic fractions from fractioning Antígeno total of C. posadasii, as a possible means for immunodiagnosis of the disease. A total of 19 cases of the disease were cataloged in the study period. All the patients were young men with respiratory symptoms, except for one case. All but one of the patients reported they engaged in recreational hunting of armadillos. The laboratory approach in these cases consisted of microbiological examination combined with molecular, immunological, histopathological techniques or animal experiments. The protein fractioning of Antígeno total of C. posadasii produced three antigenic fractions with different protein content, electrophoretic profile and immunoreactivity according to the Western blotting technique. The 60-90% fraction showed an immunoreactive band of approximately 30 to 40 KDa, recognizable by sera from patients with coccidiodomycosis, but showed crossreactivity with some sera from patient with histoplasmosis. This protein band, in subsequent studies, can be characterized and purified for potential use as a tool for immunodiagnosis of the disease.

Enterococcus faecalis has been suggested to be an important etiological agent in endodontic failure. It has been found in the root canal system in a perceptual ranging from 22% to 77% and it has been associated to organisms structured in biofilms. The aim of the present study was to evaluate, in vitro, the effectiveness of endodontic sealers, 2.5% sodium hypochlorite, and 0.5% Lippia sidoides essential oil in eliminating E. faecalis biofilms. Clinical material was collected from 37 patients with root canal chronic infections and 14 Enterococcus faecalis strains were isolated (37.8%). Biofilms from a reference (ATCC) and a clinical multirresistant strain (isolate 12 ) were grown for 8 days. This period was selected based on a chronological study of the Enterococcus faecalis biofilm development through Atomic Force Microscopy. It was verified that there was a significant reduction of the bacteria number when the biofilms were exposed to the endodontic sealers related to the control for the two tested strains (p<0.001). Analyzing the ATCC strain, it was seen that the Epiphany® endodontic sealer presented similar action compared to Endofill® (p>0.05), similar result was found for Isolate 12. When the strains susceptibilities against the sealers was compared it was verified that the isolate 12 was less susceptible than the ATCC strain (p<0.001). It was verified that the 0.5% essential oil solution of Lippia siodides presented a similar action to 2.5% sodium hypochlorite when the biofilm of ATCC strain and isolate 12 were exposed for 10 minutes to this substances (p<0.001). Comparing the susceptibility of the two strains to the solutions tested, there was no difference between them (p>0.05)

The gastric cancer is the fourth more frequent cancer, and the second cause of death for cancer in the world, recording approximately 934 thousand of new cases and 700 thousand of deaths a year. In Brazil, the gastric cancer is the sixth more frequent malignant tumor. In the Northeast area, it is the second more frequent cancer among the men and fourth among the women. In the state of Ceara, it is the third more frequent neoplasia. Among the infectious agents, the bacterium Helicobacter pylori (H. pylori), which is considered carcinogenic agent of the group I, has been pointed in the last decades because of the connection with activated chronic gastritis, with the development of peptic ulcers and duodenais, and the increase of the risk of gastric cancer. Besides the presence, genetic variation of the strains of H. pylori seems to influence in the seriousness of the disease caused by infection. The pathogenic character is given by the presence, in some cepas, of the called cag pathogenicity island, cag-PAI; one gene fragment of 35-40 Kb strain specific, which possess a series of genes associates to a virulent type IV secretion apparatus. Moreover, another gene, called vacA, it is presented as an important virulence factor. Despite these associations does not have still a direct relation enters the presence of these genes with the tumorigenic process. One of the possible explanations is the presence of other genes that contribute for fenotype more serious or malignant, mainly associates cag-PAI. In this context, the present study objectified to investigate the frequency of H. pylori genotyped how much the alelics variants of vacA the presence of the genes cagA, cagE and virB11 and its association with the clinic- pathological dates of gastric adenocarcinoma of one population of the Ceara State. For in such a way, 101 cases of gastric adenocarcinoma (68 men and 33 women), gotten of two hospitals of Fortaleza, had been analyzed by PCR how much to the presence of H. pylori and the studied genes. The distribution of the gastric cancer by sex, anatomical sites and the histopatologic analysis, in general way, had reproduced the trends of world-wide literature. The bacterium was present in 93% of the analyzed cases. The genes of H. pylori had presented the following frequencies: vacAs1m1 (75,5%), vacAs1m2 (13,8%), vacAs2m1 (4,6%), vacA s2m2 (6,5%), cagA (64,9%), cagE (53,2%) and virB11 (60,6%). These data are the first ones in world-wide literature citing the frequency of virB11 and as for the gene cagE in gastric cancer and indicate a circulating variation of strains how much the presence of these genes when compared these data with the ones of other gastric diseases. The most frequent combination was vacAs1m1cagA(+)cagE(+)virB11(+), found in 36,2% of the analyzed cases, being considered strain more pathogenic. The integrity of cag-PAI was verified in 38,3% of the cases, when considered the three studied markers, however, considering at least one marker of right side (cagA and/or cagE) and the marker of the left side (virB11), the frequency was of 56,4%. The distribution of the genotypes of H. pylori in groups demonstrated that the biggest frequency of strains considered more pathogenic was in tumors of the gastric antrum, did not have predilection of the genotypic variations for none of the histologic types, besides verifying it high frequency of more pathogenic strains in tumor stage II and IV, demonstrating to the participation of H. pylori in gastric carcinogenesis.

The main objective of this thesis was to investigate the factors determining success in an aptitude test for admission in a public bank in the Northeast of Brazil. The data set is based in a questionnaire for 232,771 Candidates which is composed of the result of the test and a number of questions about some attributes of the candidate. Attributes selected were personal monthly income; household monthly income; education level; type of school attended (public or private); marital status; occupation and age. A logit model was used to estimate a regression of success in the test against the attributes defined above. Results of the estimated model show that all the coefficients but marital status were significant and with the expected sign. The marginal effects inform that a high school level (a requirement to take the test) had the strongest and negative impact on the probability of success. Specification tests for functional form and unobserved heterogeneity show that the model was correctly specified.

What is called a price puzzle is a positive and persistent response of in ation to a unit shock in the interest rate's innovation. Using a VAR to analyse monetary policy in Brazil, this paper comes to the conclusion that when nonlinearities in the data were considered, most of this e ect vanishes. This is done rstly by checking if the series are unit root processes or nonlinear trend stationary. After that a nonparametric co-trending analysis was applied. The test result favored a common nonlinear trend between in ation and the interest rate, which seems to a ect the system innovation analysis, inducing most of the price puzzle e ect.

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.