Brain changes in neuroimaging of adult patients with vitamin D deficiency: systematic review protocol.

INTRODUCTION: Brain abnormalities detected through neuroimaging are described in patients with vitamin D deficiency, however, it is still not clear which cerebral alterations are more frequent and characteristic in this population. Thus, this review aims to identify and classify which are the main and most frequent brain changes found by neuroimaging in patients with vitamin D deficiency. METHODS AND ANALYSIS: The study protocol was constructed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the leading research question was formulated through Population, Intervention, Comparator, Outcome, Setting. The evidence will be researched at the following electronic databases: PubMed, PsycINFO, Scopus, Web of Science and EMBASE. Two researchers will work in the selection, analysis and inclusion phases of the articles. In the case of divergence, a third-party reviewer will be contacted. The following studies will be included: (1) cohort studies, case-control studies and cross-sectional studies; (2) studies carried out on patients with serum 25-hydroxyvitamin D levels below 30 ng/mL; (3) studies conducted with an adult population; (4) studies using neuroimaging methods. Articles considered eligible will be analysed by the Newcastle-Ottawa Quality Assessment Scale/cross-section studies to evaluate study quality. The survey will be conducted from June to December 2022. ETHICS AND DISSEMINATION: The identification of the main and most frequent brain alterations found through neuroimaging in patients with vitamin D deficiency can guide professionals as to the identification which of the main cerebral pathologies detected through neuroimaging are related to vitamin D deficiency, in choosing more sensitive and specific neuroimaging tests to detect these brain changes, in addition to emphasising the importance of monitoring and maintaining adequate serum levels of vitamin D, in order to reduce possible cognitive sequelae. Results will be announced at national and international conferences. PROSPERO REGISTRATION NUMBER: CRD42018100074.

Teleconsultation in the prevention and control of older persons' health with regard to the COVID-19 pandemic: study protoco / Teleconsulta para prevenção e controle da saúde do idoso frente à pandemia de COVID-19: protocolo do estudo

OBJECTIVE: To report the following study protocol: "Prevention program for older persons' health care focusing on the COVID-19 pandemic in the city of Recife ­ PE." METHODS: An action research study will be conducted with 151 older people of both sexes residing in the 8 health districts of Recife, Brazil. A teleconsultation service will be used to converse with participants. Activities will be organized into 2 moments: diagnosis and intervention. A guided conversation strategy will be used, dealing with issues related to coronavirus disease 2019 (COVID-19) prevention; social isolation; thoughts, emotions, and spirituality; family and community support; and personal development and ground rules for everyday life. The intervention with each older person will happen weekly for 12 weeks and will be characterized by listening to them and exchanging knowledge with the aim of bonding and optimizing adherence and compliance to COVID-19 prevention and control measures. Our data analysis will follow 3 approaches: cross-sectional (multivariate regression model), quasi-experimental (analysis of standardized residuals), and qualitative (interview and content analysis). EXPECTED RESULTS AND RELEVANCE: The construction of scientific knowledge is a key strategy when faced with the great challenge to global collective health presented by the COVID-19 pandemic. Data generated in this study may contribute to the improvement of knowledge, attitudes, and preventive practices, as well as to a good acceptance of the prevention program by older participants.'

OBJETIVO: Apresentar o protocolo "Programa de prevenção para a saúde do idoso com foco na pandemia de COVID-19 no município do Recife ­ PE". METODOLOGIA: Um estudo de pesquisa-ação será conduzido com 151 idosos de ambos os sexos que residem nos 8 distritos sanitários de Recife, Brasil. Um serviço de teleconsulta será usado para comunicação com os participantes. As atividades serão organizadas em 2 momentos: diagnóstico e intervenção. Uma estratégia de conversa guiada será adotada para com os idosos, tratando de temas relacionados à prevenção de COVID-19; isolamento social; pensamentos, emoções e espiritualidade; família e suporte comunitário; desenvolvimento pessoal; e regras básicas para o cotidiano. A intervenção com cada idoso ocorrerá uma vez por semana por 12 semanas, sendo caracterizada pela escuta e troca de conhecimentos com o objetivo de gerar um vínculo e otimizar a aderência e observância de medidas de prevenção e controle de COVID-19. A análise de dados seguirá 3 abordagens: transversal (modelo de regressão multivariada), quase-experimental (análise de resíduos padronizados), e qualitativa (entrevista e análise de conteúdo). RESULTADOS ESPERADOS E RELEVÂNCIA: A construção do conhecimento científico é uma estratégia chave frente ao grande desafio para a saúde coletiva global representado pela pandemia de COVID-19. Dados gerados por este estudo podem contribuir para a melhoria do conhecimento, atitudes, e medidas de prevenção, além de uma boa aceitação do programa de prevenção por parte dos participantes idosos.

Tele-education applied to human communication health to cope with triple epidemics in the state of Pernambuco, Brazil: an experience report / Tele-educação em saúde da comunicação humana para o enfrentamento da tríplice endemia em Pernambuco, Brasil: um relato de experiência

ABSTRACT Objective: to evaluate the implementation of tele-education sessions for health professionals working in primary care and at Family Health Support Centers, addressing the repercussions of triple endemics to human communication health in the state of Pernambuco, Brazil. Methods: following approval from the ethics committee, an experience report was performed, in partnership with a telehealth center. The methods involved three steps: 1- creation of a flowchart for the implementation phases; 2- offer of educational sessions; 3- evaluation of satisfaction on the part of the public. Results: the implementation process consisted of five phases: institutional partnership, training, planning, offering of service and evaluation. Seven educational sessions were held, with a total of 175 viewings. Regarding satisfaction, 100% of the participants considered the topics interesting and that the learning experience was important to their professional qualification. Most of them (86%), reported feeling secure regarding the retention of the knowledge acquired. Conclusion: the implementation of the tele-education service had repercussions on statewide views and was approved by 100% of the participants, constituting a promising, easily accessible, comprehensive proposal in the continued education of health professionals working in primary care and at Family Health Support Centers.

RESUMO Objetivo: avaliar o processo de implantação de sessões de tele-educação para os profissionais que atuam na Atenção Primária à Saúde e nos Núcleos de Apoio à Saúde da Família, com temáticas voltadas para as repercussões da tríplice endemia na saúde da comunicação humana no estado de Pernambuco, Brasil. Métodos: relato de experiência, desenvolvido após aprovação do Comitê de Ética, em parceria com um Núcleo de Telessaúde. O percurso metodológico envolveu três etapas: 1- criação do fluxograma das fases de implantação; 2- oferta das sessões educativas; 3- Avaliação da satisfação pelo público. Resultados: o processo de implantação foi constituído por cinco fases: Parceria institucional; Capacitação; Planejamento; Oferta do serviço e Avaliação da ação. Foram realizadas sete sessões educativas. O total de acessos incluiu 175 visualizações. Na análise da satisfação, 100% consideraram as temáticas interessantes e que as contribuições oriundas dessa aprendizagem foram importantes para a qualificação profissional. A maioria (86%) referiu se sentir segura quanto à retenção/apreensão do tema exposto. Conclusão: a implantação do serviço de Tele-educaçao proposto repercutiu em visualizações em todo estado e foi aprovada por 100% dos participantes, constituindo uma proposta de fácil acesso, abrangente e promissora no processo de educação permanente para os profissionais que atuam na APS e nos NASF's.

Behavior of self-inflicted violence in patients with bipolar disorder: A systematic review protocol.

BACKGROUND: Studies aimed at understanding the higher risk profiles for self-inflicted violence in individuals with BD become essential as a possible predictive risk measure for the presence of suicidal behavior, corroborating the expressive reduction of suicide deaths in young people who are in psychic suffering. METHODS: The protocol was constructed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA-P) and the research question was constructed using guidelines from the Population Intervention Comparator Outcome Setting (PICOS) strategy. A third reviewer will be contacted, and two studies will be included in the selection, analysis and inclusion phases of the articles, in case of divergence, a third reviewer will be contacted. (1) methodological design studies of cohorts, case-control and cross-sectional; (2) Diagnosis of Bipolar disorder according to Diagnostic and statistical Manual of mental disorders V; (3) Studies with adult population and (4) Studies that consider at least one type of self-inflicted violence as a variable. The articles considered eligible will be analyzed by New Castle - Ottawa quality assessment scale/cross section studies (NOS) to evaluate the quality of the studies. RESULTS: The identification of the characteristics of self-harm may subsidize professionals who work in the treatment of bipolar disorder with greater attention to these practices and monitoring of possible suicidal behaviors. CONCLUSION: This study may represent one of the initial measures of evaluation on these correlations, which will allow to protocol the guidelines in the field of practice and contribute to improvements in public health indexes.

Self-efficacy assessment tools for individuals with depression: protocol for a systematic review of the literature.

INTRODUCTION: Depression is a common debilitating disease that affects individuals in all age groups. The impact of the diagnosis extends beyond the individual, with negative effects on mental health, physical health and social well-being. Self-efficacy has been referenced as an important aspect to the prognosis of mood disorders by conferring co-responsibility to the affected individual to face his/her health problems. Several assessment tools are found in the literature for measuring self-efficacy, but it is not yet clear which of these measures are more applicable to individuals with mood disorders, particularly depression. Thus, the aim of present study is to propose a systematic review to examine the psychometric properties and applicability of assessment tools designed to measure self-efficacy in individuals with symptoms and/or a diagnosis of depression. METHODS AND ANALYSIS: This protocol is reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement and the review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The evaluation of the psychometric properties of the health outcome measures will be conducted according to COSMIN guidelines. Two independent reviewers will perform the electronic searches in the PubMed, Web of Science, PsycInfo, SCOPUS and CINAHL databases, followed by the use of the 'snowball' strategy. The inclusion criteria will be (1) instrument validation studies, (2) developed with individuals of any age (3) with symptoms or a diagnosis of depression. Two independent reviewers will analyse the titles and abstracts of the articles retrieved during the search for pre-selection, followed by full-text analyses to determine inclusion in the review based on the eligibility criteria. Cases of a divergence of opinion will be resolved by a third reviewer. Descriptive analysis of the articles will be performed (data on participants, characteristics, psychometric properties and clinical usefulness of the assessment tools). ETHICS AND DISSEMINATION: The proposed systematic review will provide information on assessment tools employed to measure self-efficacy with regard to coping with depression, offering data on the psychometric properties, strong and weak points, and clinical applicability. As a secondary analysis of the literature, the approval of an ethics committee is not required. PROSPERO REGISTRATION NUMBER: CRD42017078707.

Risk of behaviour suggestive of opioid abuse: a protocol for a systematic review of validated assessment tools.

INTRODUCTION: Opioid use patterns of individuals with non-cancer pain are influenced by the behavioural dynamics of the individual in managing and properly following the prescription. The use of assessment tools for measuring the risk of behaviour suggestive of opioid abuse is important for health professionals who provide care to individuals with non-cancer pain. The aim of the proposed review is to analyse the psychometric properties of tools for measuring the risk of behaviour suggestive of opioid abuse in adults with non-cancer pain. METHODS AND ANALYSIS: The review process will be based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. The Consensus-Based Standards for the Selection of Health Measurement Instruments will be used to analyse the assessment tools. Two independent reviewers will perform the literature search and analysis procedures. Searches will be performed on PubMed, Web of Science, Cochrane, Scopus, and Cumulative Index to Nursing and Allied Health Literature databases, and the 'snowball' strategy will be employed. The inclusion criteria will be (1) validation studies, (2) assessment tools designed exclusively for measuring the risk of behaviour suggestive of opioid abuse and (3) assessment tools designed for evaluation of adults with chronic non-cancer pain. The titles and abstracts of the studies retrieved from the databases will be analysed for the preselection of articles, which will be submitted to a full-text analysis to define the final sample. Divergence of opinion between two reviewers will be resolved by consulting a third reviewer. ETHICS AND DISSEMINATION: The review will offer an overview of assessment tools available for measuring the risk of behaviour suggestive of opioid abuse, which is relevant to reducing the risk of deaths due to abusive consumption and for clinical management of adults with chronic non-cancer pain. PROSPERO REGISTRATION NUMBER: CRD42018081577.

Educational actions in human communication health: telehealth contributions in primary care / Ações educativas em saúde da comunicação humana: contribuições da telessaúde na atenção primária

ABSTRACT Objective: to characterize educational actions related to human communication health produced at the Tele-Health Center for health professionals in primary care. Methods: a cross-sectional study was conducted at the Tele-Health Center at the Federal University of Pernambuco Clinical Hospital. Educational actions produced by tele-consultants between 2008 and 2014 linked to the health of human communication were considered. Data collection was conducted in two phases. In the first phase, the data were explored and educational actions were selected based on the title and the relationship with human communication. In the second phase, each action was observed and evaluated for content. The data were analyzed using descriptive statistics. Results: a few educational actions related to human communication health were concentrated in 2014. Throughout the period analyzed, the actions were restricted to the field of language and concentrated on the education issue as well as the strategic area of child and adolescent health. The most frequent occupational category among the tele-consultants was nursing. Conclusion: a small number of educational actions addressing the health of human communication was produced and the participation of speech therapists remains incipient.

RESUMO Objetivo: caracterizar as ações educativas relacionadas à temática da saúde da comunicação humana, produzidas no Núcleo de Telessaúde para os profissionais de saúde da Atenção Primária. Métodos: trata-se de um estudo de corte transversal realizado no Núcleo de Telessaúde do Hospital das Clinicas da Universidade Federal de Pernambuco. Foram considerados objetos do estudo as ações educativas produzidas pelos teleconsultores, entre 2008 e 2014, vinculadas à temática saúde da comunicação humana. A coleta de dados foi realizada em duas fases: na primeira, o banco de dados foi explorado e as ações educativas, que apresentavam relação com saúde da comunicação humana, selecionadas pelo título. Na segunda fase cada ação educativa foi assistida quanto ao seu conteúdo. Os dados foram analisados por técnicas de estatística descritivas. Resultados: foram poucas as ações educativas relacionadas à saúde da comunicação humana, restritas praticamente a área da linguagem, concentradas no eixo temático da educação e na área estratégica da saúde da criança e do adolescente. A categoria profissional mais expressiva entre os teleconsultores foi a enfermagem. Conclusão: as ações educativas que tratem da saúde da comunicação humana são reduzidas e a participação do fonoaudiólogo ainda é incipiente

Assessment tools for the measurement of the self-efficacy of drug users: protocol for a systematic review.

INTRODUCTION: The abuse of alcohol and other drugs is a worldwide problem, the treatment of which poses a challenge to healthcare workers. OBJECTIVE: This study presents a proposal for a systematic review to analyse the psychometric properties of assessment tools developed to measure the self-efficacy of drug users with regard to resisting the urge to take drugs in high-risk situations. METHODS AND ANALYSIS: The guiding question was based on PICOS (Population Intervention Comparator Outcome Setting), and the report of the methods of review protocol was written in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Searches will be performed in the PsycINFO, Cochrane, Pubmed, Web of Science, SCOPUS and CINAHL databases, followed by the use of the 'snowball' strategy. The inclusion criteria for the articles will be (1) assessment tool validation studies; (2) assessment tools developed to measure self-efficacy; (3) quantitative measures; (4) measures designed for use on adults; (5) data from self-reports of the participants; (6) studies involving a description of psychometric properties of the measures; and (7) studies that explain how the level of self-efficacy is scored. The search, selection and analysis will be performed by two independent reviewers. In cases of a divergence of opinion, a third reviewer will be consulted. The COSMIN checklist will be used for the appraisal of the methodological quality of the assessment tools and the certainty of the evidence in the articles (risk of bias) will be analysed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. ETHICS AND DISSEMINATION: This protocol does not require ethical approval. However, this protocol is part of the thesis entitled Drug-Taking Confidence Questionnaire for use in Brazil, presented for obtaining a doctorate in neuropsychiatry and behavioural sciences from the Federal University of Pernambuco, and has received approval from the human research ethics committee of the Federal University of Pernambuco (reference number: 1.179.162).The results will be disseminated to clinicians and researchers through peer-reviewed publications and conferences. PROSPERO REGISTRATION NUMBER: CRD42017068555.

Identificação de aspectos associados à tentativa de suicídio por envenenamento / Identification ofaspects associated with attempted suicide by poisoning

RESUMO Objetivo Identificar as condições psiquiátricas e aspectos sociobiodemográficos associados à tentativa de suicídio. Métodos A amostra foi constituída por 240 pacientes de ambos os sexos, com idade entre 18 a 68 anos, dos quais 120 pacientes compuseram o grupo controle e 120 o grupo experimental. Os instrumentos utilizados foram um questionário sociobiodemográfico e o Mini International Neuropsychiatric Interview (MINI). Resultados Observou-se maior presença de estressores no grupo experimental, sendo os principais a vivência de uma separação afetiva e a existência de conflitos familiares, e a condição psiquiátrica mais frequente na população estudada foi o transtorno de ansiedade generalizada e a mais associada ao comportamento suicida foi a depressão maior. Conclusões Os resultados acrescentam a importância de investigar a presença do transtorno de ansiedade generalizada como mais um fator de vulnerabilidade ao suicídio.

ABSTRACT Objective To identify psychiatric conditions and socio-bio-demographic aspects associated with attempted suicide. Methods The sample consisted of 240 patients of both sexes, aged 18 to 68 years, 120 patients comprised the control group and the experimental group 120. The instruments used were a socio-bio-demographic questionnaire and the Mini International Neuropsychiatric Interview (MINI). Results A higher presence of stressors in the experimental group, the main ones being the experience of an emotional separation and the existence of family conflicts, the most common psychiatric condition in the population studied was generalized anxiety disorder and more associated with suicidal behavior it was major depression. Conclusions These results add the importance of investigating the presence of generalized anxiety disorder as another suicide vulnerability factor.

Telefonoaudiologia como estratégia de educação permanente na atenção primária à saúde no Estado de Pernambuco / Telespeech therapy as a continued education strategy in primary health care in the state of Pernambuco, Brazil

RESUMO Objetivo: descrever a implantação e o nível de satisfação dos usuários sobre ações de tele-educação, relacionadas à saúde da comunicação humana. Métodos: relato de experiência que envolveu a realização de dez sessões de seminários transmitidos por webconferência, em um Núcleo de Telessaúde de Pernambuco. O público-alvo foi composto por profissionais que atuam na Atenção Primária à Saúde. A coleta de dados foi conduzida mediante entrevista estruturada, via contato telefônico com os participantes dos seminários. Foram consideradas as seguintes variáveis: temáticas das sessões, média de pontos conectados, município participante, categoria profissional e nível de satisfação do participante. Os dados foram analisados por frequência simples e média aritmética. Resultados: a média de pontos conectados nas dez sessões foi de 3,77. Participaram profissionais da área da enfermagem, medicina, fonoaudiologia e profissionais de nível técnico - Agentes Comunitários de Saúde. 100% do público considerou os temas muito interessantes, além de relevante à profissão. Todos referiram satisfação com as ações de tele-educação. Conclusões: a implantação da Telefonoaudiologia em Pernambuco iniciou-se pela capacitação da equipe, planejamento, oferta e avaliação das ações de tele-educação, voltadas para a temática da saúde da comunicação humana.

ABSTRACT Purpose: to describe the implementation and level of satisfaction of users on tele-education actions related to the health of human communication. Methods: an experience report that involved ten sessions of web conferencing seminars in the Telehealth Center in Pernambuco. The target audience was composed of professionals who work in Primary Health Care. Data collection was conducted through a structured interview by telephone with the seminar participants. The following variables were considered: thematic of the sessions, the average of connected points, the participating municipality, professional category and level of satisfaction of the participants. Data were analyzed by simple frequency and arithmetic average. Results: the average of points connected in the ten sessions was 3.77. Practitioners from the nursing, medical, speech-language areas and technical level professionals (Community Health Agents) participated. 100% of the subjects regarded the themes as very interesting, and relevant to their profession. All of them reported satisfaction with the tele-education actions. Conclusions: the implementation of telespeech therapy in Pernambuco began by training the team, planning, offering and evaluating the actions of tele-education, focused on the health issue of human communication.

Orientações e estratégias para a promoção da saúde vocal

Este seminário comemorativo aborda a voz, numa perspectiva da grande relevância dessa como ferramenta de comunicação elencando também os cuidados que devem ser adotados para a preservação da saúde vocal.

Segunda opinião formativa: a gagueira é considerada patológica a partir de que idade?

A gagueira é um distúrbio dos padrões normais de tempo e fluência da fala. Este distúrbio é caracterizado por repetições frequentes ou prolongações de sons ou sílabas. O fonoaudiólogo no atendimento atentará quanto à interferência da gagueira e poderá orientar o início da terapia de linguagem.

Estigma social no comportamento suicida: reflexões bioéticas / Social stigma in suicidal behavior: bioethical reflections / Estigma social en el comportamiento suicida: reflexiones bioéticas

Foi realizada uma revisão integrativa sobre o tema do estigma social imposto aos indivíduos que tentaram suicídio, trazendo à tona reflexões a partir da perspectiva bioética. A pesquisa foi conduzida em bases de dados eletrônicas. Foram incluídos apenas artigos de revistas científicas revisadas por pares com resumos disponíveis. Não houve limites quanto ao ano de publicação e idioma. Na primeira fase de busca, 272 manuscritos foram encontrados. Após a leitura dos textos completos, apenas 22 foram incluídos no estudo. Diante das limitações da pesquisa, acredita-se que o estudo aprofundado do estigma no comportamento suicida pode contribuir significativamente para o tratamento de pacientes que se submeteram à tentativa. Conclui-se que o estudo desse assunto apresenta ampla gama de discussões bioéticas, por ser um fenômeno que afeta aspectos relacionados à autonomia e à proteção da pessoa.

An integrative review on the theme of the social stigma imposed on individuals who have attempted suicide was conducted bringing to the fore reflections from a perspective of bioethics. The research was conducted in electronic databases. Only scientific articles by peer reviewed scientific journals with available abstracts were included. There were no limits to the year and language of publication. Two hundred and twenty-seven manuscripts were found in the first phase of the search. Only 22 complete texts were included in the study after the complete texts had been read. Despite the limitations of the research, it is believed that deeply studying the stigma of suicide can contribute significantly to patients who have attempted suicide. It is concluded that the study of this topic represents a range of bioethical discussions, forming, as it does, part of a phenomenon that affects aspects related to the autonomy and protection of the person.

Fue realizada una revisión integrativa sobre el tema del estigma social impuesto a los individuos que intentaron suicidarse trayendo a tono algunas reflexiones a partir de la perspectiva de la bioética. La investigación fue conducida a partir de bases de datos electrónicas. Fueron incluidos sólo los artículos de revistas científicas, revisadas por pares, con resúmenes disponibles. No hubo límites en relación al año de publicación y al idioma. 272 manuscritos fueron encontrados en la primera fase de búsqueda. Luego de la lectura de los textos completos, sólo 22 fueron incluidos en el estudio. Frente a las limitaciones de la investigación, se cree que el estudio profundo del estigma en el comportamiento suicida puede contribuir significativamente para el tratamiento de pacientes que se sometieron a un intento. Se concluye que el estudio de esta temática presenta una amplia gama de discusiones bioéticas, por ser parte de un fenómeno que afecta aspectos relacionados a la autonomía y a la protección de la persona.

Risk factors of suicide attempts by poisoning: review / Fatores de risco para tentativa de suicídio por envenenamento: revisão

Introduction: Suicide, a complex and universal human phenomenon, is a major public health problem. This study reviewed the literature about the major risk factors associated with suicide attempts by poisoning. Methods: An integrative review of the literature was performed in databases (LILACS, PubMed and MEDLINE) to search for studies published between 2003 and 2013, using the following keywords: suicide, attempted; poisoning; risk factors. Inclusion criteria were: original study with abstract, sample of adults, and attempted suicide by poisoning in at least 50% of the study population. Results: Two hundred and nineteen studies were retrieved and read by two independent examiners, and 22 were included in the study. The main risk factors for suicide attempts by poisoning were female sex, age 15-40 years, single status, little education, unemployment, drug or alcohol abuse or addiction, psychiatric disorder and psychiatric treatment using antidepressants. Conclusion: Further prospective studies should be conducted to confirm these risk factors or identify others, and their findings should contribute to planning measures to prevent suicide attempts (AU)

Introdução: O suicídio é um fenômeno humano complexo, universal e que representa um grande problema de saúde pública. Diante disso, o presente estudo tem por objetivo revisar a literatura acerca dos principais fatores de risco associados à tentativa de suicídio por envenenamento. Método: Foi realizada uma revisão integrativa em bases de dados (LILACS, PubMed e MEDLINE). A pesquisa focou artigos publicados entre os anos de 2003 a 2013, utilizando os seguintes descritores: suicide, attempted; poisoning; risk factors. Foram considerados os seguintes critérios de inclusão: ser artigo original, com resumo disponível, amostra composta por adultos, e que pelo menos 50% da população do estudo tenham tentado o suicídio por envenenamento. Resultados: Foram selecionados 219 artigos. Após a leitura por dois pesquisadores independentes, 22 foram incluídos na revisão. Os principais fatores de risco encontrados para a tentativa de suicídio por envenenamento foram: gênero feminino, idade entre 15 a 40 anos, estado civil solteiro, baixa escolaridade, desemprego, abuso/dependência de substancias e/ou álcool, ser acometido por transtorno psiquiátrico e estar em tratamento psiquiátrico com uso de antidepressivo. Conclusão: Considera-se que pesquisas adicionais, bem como a ampliação de estudos prospectivos, deverão ser realizadas para a confirmação ou identificação de novos fatores de risco. Estas medidas objetivam contribuir para o planejamento e prevenção da tentativa e do suicídio (AU)

Risk factors of suicide attempts by poisoning: review.

INTRODUCTION: Suicide, a complex and universal human phenomenon, is a major public health problem. This study reviewed the literature about the major risk factors associated with suicide attempts by poisoning. METHODS: An integrative review of the literature was performed in databases (LILACS, PubMed and MEDLINE) to search for studies published between 2003 and 2013, using the following keywords: suicide, attempted; poisoning; risk factors. Inclusion criteria were: original study with abstract, sample of adults, and attempted suicide by poisoning in at least 50% of the study population. RESULTS: Two hundred and nineteen studies were retrieved and read by two independent examiners, and 22 were included in the study. The main risk factors for suicide attempts by poisoning were female sex, age 15-40 years, single status, little education, unemployment, drug or alcohol abuse or addiction, psychiatric disorder and psychiatric treatment using antidepressants. CONCLUSION: Further prospective studies should be conducted to confirm these risk factors or identify others, and their findings should contribute to planning measures to prevent suicide attempts.

Identificação da disfunção temporomandibular (DTM) em usuários de dispositivo de proteção auditiva individual (DPAI) / Identification of the temporomandibular (TMD) dysfunction in users of individual auditory protective devices (IAPD)

OBJETIVO: descrever e classificar a presença de disfunção temporomandibular em trabalhadores usuários de equipamentos de proteção auditiva individual. MÉTODO: tratou-se de um estudo transversal descritivo, com caráter observacional, desenvolvido em uma indústria de tintas. A população foi composta por 46 funcionários de ambos os sexos (com 94,44 por cento do gênero masculino) com idade entre 20 a 50 anos (idade media de 36,24 anos), expostos a ruído intenso (90 dBNA) que faziam uso de equipamento de proteção individual auditiva tipo concha. Na coleta de dados foram realizados os seguintes procedimentos: triagem fonoaudiológica das funções orais, avaliação clínica otorrinolaringológica e diagnóstico de disfunção temporomandibular ao exame clínico. Os dados foram analisados pela estatística descritiva. RESULTADOS: a queixa predominante foi dor na região que envolve a orelha e articulação temporomadibular. Observou-se que 87 por cento apresentaram diagnóstico positivo de DTM, em que 83 por cento tinham dor miofacial, 11 por cento dor miofacial com limitação de abertura oral e 6 por cento apresentaram diagnóstico de dor miofacial associada a deslocamento de disco com redução de abertura. CONCLUSÕES: a maioria dos trabalhadores apresentou disfunção de ordem muscular. Ressalta-se a importância de considerar a possibilidade da influência deste equipamento sobre o aparecimento ou intensificação do transtorno mencionado.

PURPOSE: to describe and classify the presence of temporomandibular joint disorders in workers using individual hearing protection equipment. METHOD: this is a transversal descriptive study, with observational character, developed in a paint industry. The population was composed of 46 employees of both genders (94.44 percent of which were male) aged between 20 and 50 years (average 36.24-year old), exposed to hazardous noise (90 dBNA) that had been using personal protective equipment (ear muff). In collecting the data, the following procedures were made: speech pathology screening of the oral functions, otorhinolaryngological evaluation and diagnosis of temporomandibular joint dysfunction by using a clinical examination. Data were analyzed using descriptive statistics. RESULTS: the main complaint was pain around the ear and temporomandibular joint. It was observed that 87 percent showed a positive diagnosis of TMD while 83 percent had myofacial pain, 11 percent myofacial pain with oral opening limitation and 6 percent showed myofacial pain diagnosis associated with disc displacement with reduction. CONCLUSIONS: the majority of the screened workers showed dysfunctions of muscular order. The possibility that the use of this equipment may influence the occurrence or intensification of the mentioned dysfunction must be emphasized.