ABSTRACT
O objetivo desse estudo é compreender a percepção de adolescentes de Coletivo ProJovem sobre território usado e efetivação de direitos. Trata-se de pesquisa exploratória com metodologia qualitativa desenvolvida com oito adolescentes de Coletivo de município do interior de Minas Gerais. A construção de dados ocorreu com a técnica de grupo focal e a metodologia Photo Voice. A análise de conteúdo temática guiou o tratamento dos dados. A metodologia qualitativa permitiu o envolvimento dos adolescentes na reflexão sobre as vulnerabilidades presentes no território. O estudo permitiu a apreensão de diversas percepções sobre o território usado e os modos como, no limiar entre vulnerabilidades, violências e direitos, os adolescentes produzem sociabilidades e elaboram seus projetos de vida. Os resultados evidenciam que a promoção da saúde de adolescentes requer a superação de preconceitos e a criação de espaços de escuta e empoderamento dos sujeitos, fundamentais para a reformulação de políticas e programas sociais.
The objective of this study is to understand the perception of adolescents of ProJovem Collective about the territory used and effectiveness of rights. This is an exploratory research with a qualitative methodology developed with eight adolescents from the Minas Gerais municipality. The data construction occurred with the focus group technique and the Photo Voice methodology. The thematic content analysis guided the datas treatment. The qualitative methodology permitted the adolescents to be involved in the reflection on the vulnerabilities present in the territory. The study allowed the apprehension of diverse perceptions about the used territory and the ways how, on the threshold between vulnerabilities, violence and rights, the adolescents produce sociabilities and elaborate their life projects. The results evinced that the adolescents health promotion requires the overcoming of prejudices and the creation of spaces for listening and empowerment of the subjects, fundamental to the reformulation of social policies and programs.
ABSTRACT
O objetivo desse estudo é compreender a percepção de adolescentes de Coletivo ProJovem sobre território usado e efetivação de direitos. Trata-se de pesquisa exploratória com metodologia qualitativa desenvolvida com oito adolescentes de Coletivo de município do interior de Minas Gerais. A construção de dados ocorreu com a técnica de grupo focal e a metodologia Photo Voice. A análise de conteúdo temática guiou o tratamento dos dados. A metodologia qualitativa permitiu o envolvimento dos adolescentes na reflexão sobre as vulnerabilidades presentes no território. O estudo permitiu a apreensão de diversas percepções sobre o território usado e os modos como, no limiar entre vulnerabilidades, violências e direitos, os adolescentes produzem sociabilidades e elaboram seus projetos de vida. Os resultados evidenciam que a promoção da saúde de adolescentes requer a superação de preconceitos e a criação de espaços de escuta e empoderamento dos sujeitos, fundamentais para a reformulação de políticas e programas sociais.
The objective of this study is to understand the perception of adolescents of ProJovem Collective about the territory used and effectiveness of rights. This is an exploratory research with a qualitative methodology developed with eight adolescents from the Minas Gerais municipality. The data construction occurred with the focus group technique and the Photo Voice methodology. The thematic content analysis guided the datas treatment. The qualitative methodology permitted the adolescents to be involved in the reflection on the vulnerabilities present in the territory. The study allowed the apprehension of diverse perceptions about the used territory and the ways how, on the threshold between vulnerabilities, violence and rights, the adolescents produce sociabilities and elaborate their life projects. The results evinced that the adolescents health promotion requires the overcoming of prejudices and the creation of spaces for listening and empowerment of the subjects, fundamental to the reformulation of social policies and programs.
ABSTRACT
INTRODUCCIÓN: El diagnóstico de los Trastornos del Espectro Autista (TEA) es clínico y complejo por la dificultad de interpretar los síntomas, las frecuentes comorbilidades, la heterogeneidad clínica y la ausencia de indicadores específicos. Múltiples instrumentos se han desarrollado para su evaluación, destacando la Escala de Observación para el Diagnóstico del Autismo (ADOS) y la Entrevista para Diagnóstico de Autismo, versión revisada (ADI-R); la sensibilidad y especificidad de estos tests es alta, más aún si se utilizan en conjunto. OBJETIVO: Evaluar la utilidad de ADI-R y ADOS como herramientas complementarias para el diagnóstico de TEA, en particular cuando resultan discrepantes del diagnóstico clínico. METODOLOGÍA: Estudio retrospectivo, de revisión de registro clínico de 44 pacientes (36 varones), de edad promedio 6,7 años, por sospecha de TEA entre 6/2015-05/2017. Se aplicó ADI-R+ADOS-2, siendo ciega respecto a la hipótesis clínica inicial. El diagnóstico definitivo se plantea tras el seguimiento de largo plazo (6-58 meses). RESULTADOS: En 37 de 44 pacientes, el diagnóstico clínico inicial fue TEA; en los 7 restantes otros diagnósticos de trastornos del neurodesarrollo y psiquiátricos. ADI-R+ADOS-2 fueron concordantes con el diagnóstico clínico en 39(89%), en 7 descartando y en 32 confirmando el diagnóstico de TEA, añadiendo en estos últimos el grado de severidad. En 5 casos hubo discordancia entre el diagnóstico clínico inicial y los tests; en los 5 casos el especialista planteó TEA y los tests lo refutaron, comprobándose tras la evolución en largo plazo lo planteado por los test en 4 casos y por el clínico en 1 caso. Los más frecuentes diagnósticos diferenciales fueron Trastorno de Comunicación Social, Trastorno por déficit de atención e hiperactividad comórbido con Trastorno del desarrollo de lenguaje y Trastornos ansiosos. CONCLUSIONES: El diagnóstico de TEA debe ser clínico, hecho por un médico especialista que considere una multiplicidad de variables. ADI-R+ADOS2 resultaron herramientas complementarias útiles, particularmente en los casos en que descartaron TEA, instando al equipo tratante a la búsqueda de diagnósticos diferenciales.
INTRODUCTION: The diagnosis of the autism spectrum disorders (ASD) is clinically and complex because of the difficulty of interpreting symptoms, frequent comorbidities, the clinical heterogeneity and the lack of specific indicators. Many instruments have been developed for evaluation, of which we highlight the scale of observation for the diagnosis of autism (ADOS) and the interview for diagnosis of autism, revised (ADI-R); the sensitivity and specificity of these tests is high, even more when they are used together. OBJECTIVE: To evaluate the usefulness of ADI-R and ADOS as complementary tools for the diagnosis of ASD, particularly when they are discrepant from the clinical diagnosis. METHODS: This is a retrospective study, a review of the clinical records of 44 patients (36 male), average age 6.7 years, with a suspicion of ASD between June 2015- May 2017. ADIR+ADOS-2 were applied blindly to the initial clinical hypothesis. The definitive diagnosis is certified after a long-term follow-up (6-58 months). RESULTS: In 37 of 44 patients the initial clinical diagnosis was ASD; in the remaining 7 other psychiatric and neurodevelopmental disorders were diagnosed. ADI-R+ADOS-2 were concordant with the clinical diagnosis in 39 (89%), excluding 7 and in 32 confirming the diagnosis of ASD, adding the degree of severity in the latter. In 5 cases there was discrepancy between the initial clinical diagnosis and tests; in these 5 cases the specialist suspected ASD and the tests disproved it; after the long-term follow-up the test's diagnosis was confirmed in 4 of the 5 cases, and in the remaining case the clinical diagnosis was confirmed. The most frequent differential diagnoses were social communication disorder, attention deficit hyperactivity disorder comorbid with language development disorder, and anxious disorders. CONCLUSIONS: The diagnosis of ASD should be clinical and made by a medical specialist who considers a multiplicity of variables. ADI-R+ADOS2 were complementary tools, particularly in cases in which ASD was rejected, urging the treating team to search for differential diagnosis.