Informação na judicialização da saúde: o protótipo JUDJe / Information in the judicialization of health: the JUDJe prototype / Información en la judicialización de la salud: el prototipo JUDJe

O fenômeno da judicialização da saúde carece de dados organizados e comparáveis entre estudos sobre o tema. Diversas fontes, recortes prévios e intermediários geram resultados conflitantes e de difícil repro-dução. Esta nota argumenta a necessidade de definir um padrão/elemento comum nos processos judiciais em saúde, propondo o sistema JUDJe, que utiliza o Diário de Justiça Eletrônico para extrair, organizar e classificar esses dados. O JUDJe gerou um banco de dados aberto com 100 mil movimentações processuais sobre casos de câncer. Defende mais qualidade e conexão dos dados, e mais acesso a esses últimos, pro-movendo equidade e visão multidimensional. Propõe a "judicialização 2.0" com dados em rede conectando saúde e direito.

The phenomenon of health judicialisation lacks organised and comparable data between studies on the subject. Different sources, previous and intermediate pieces of information generate conflicting results that are difficult to reproduce. This note argues the need to define a common standard/element in health lawsuits and proposes the JUDJe system, using the online Official Gazette to extract, organize and classify such data. JUDJe generated an open geo-referenced database with 100 thousand legal proceedings on cancer cases. It advocates more quality and connection of data, and more access to them, promoting equity and a multidimensional vision. It proposes a "judicialization 2.0" connecting the health and law domains.

El fenómeno de la judicialización de la salud carece de datos organizables y comparables entre los estudios sobre el tema. Diferentes fuentes, cortes previos y intermedios generan resultados contradictorios y dificiles de reproduzir. Esta nota argumenta la necesidad de definir un elemento común/estándar en los procesos judiciales de salud, proponiendo el sistema JUDJe, que utiliza el Diario Oficial Electrónico de Justicia para extraer, organizar y clasificar esos datos. El JUDJe generó una base de datos abiertos georreferenciada con 100 mil actuaciones judiciales sobre casos de cáncer. Defiende más calidad y conexión de datos, y más acceso a esos últimos, promoviendo la equidad y una visión multidimensional. Propone la "judicialización 2.0" con datos en red que conecten salud y derecho.

The diary in the intensive care unit: Concept analysis.

INTRODUCTION: Admission to an intensive care unit can cause sequelae to both patients and family members. In some countries, the use of diaries is a preventive action. AIM: This research proposes to critically examine the concept of 'Intensive Care Unit Diary' by analysing the current state of the scientific literature to develop a precise conception of this phenomenon in nursing practice, since there are multiple unknowns regarding its use and content. METHOD: A bibliographic search was carried out in the PubMed, Cochrane Library, Scopus and CINAHL databases in January 2023. The terms used to search for their use and definitions in the databases included Nurse, Concept analysis, Family, Uci Diary, Patient Critical, Intensive Care Unit. We use Wilson's concept analysis, later developed by Walker and Avant. RESULTS: The concept analysis shows that the 'ICU Diary' is a record made in colloquial language by health workers and relatives of the patient admitted to the intensive care unit. Aimed at the patient, with an empathic and reflective style, which offers a narrative of the process, daily life and the conduct or behaviour of the patient during his stay. It is a therapeutic tool led by nurses accepted by patients, families and professionals. Its use benefits the recovery process, reducing post-traumatic stress in family members and patients. It favours communication and the bond between nurses, family members and patients, helping to express feelings and emotions. CONCLUSIONS: The concept of 'UCI Diary' is complex. Through Wilson's model, a clarification of the concept has been achieved, creating a starting point for more precise research on this phenomenon and its effects on patients, family members, professionals and the health system.

Concepciones y prácticas de autocuidado de adolescentes: registros cualitativos en diarios personales / Concepções e práticas de autocuidado de adolescentes: registros qualitativos em diários pessoais / Conceptions and practices of adolescent self-care: qualitative recordings in personal diaries

Objetivo: Conocer el concepto y las prácticas de autocuidado entre adolescentes en edad escolar en el contexto de la pandemia de COVID-19.Método: Se trata de un estudio cualitativo, que utilizó las directrices del COREQ para la construcción del relato. Participaron en la investigación 17 adolescentes y la recopilación de datos se realizó mediante la técnica del diario personal. Los datos se sometieron a un análisis temático.Resultados: Los participantes describieron el fenómeno del autocuidado en función de los antecedentes, los atributos y las consecuencias de la pandemia. Los conceptos de autocuidado y salud a menudo superaban las necesidades de cuidados para la supervivencia. Se observó que las conductas de autocuidado entre los adolescentes eran multidimensionales y con influencias de los niveles individual, relacional y sistémico, siendo mediadas por contextos existenciales. También se registraron las experiencias de déficit de autocuidado.Consideraciones finales: Los resultados de este estudio pueden proporcionar subsidios para modelos de apoyo a los profesionales de la salud para fomentar el autocuidado en la adolescencia. (AU)

Objetivo: Conhecer o conceito e as práticas de autocuidado entre adolescentes em idade escolar no contexto da pandemia da COVID-19. Método: Trata-se de um estudo qualitativo, que utilizou as diretrizes do COREQ para a construção do relato. Participaram da pesquisa 17 adolescentes e a coleta de dados ocorreu por meio da técnica do diário pessoal. Os dados foram submetidos à análise temática. Resultados: O fenômeno autocuidado foi descrito pelos participantes de acordo com antecedentes, atributos e consequências da pandemia. Concepções de autocuidado e saúde ultrapassaram, muitas vezes, necessidades de cuidado para sobreviver. Notou-se que os comportamentos de autocuidado entre os adolescentes eram multidimensionais e com influências de níveis individual, relacional e sistêmico, sendo mediados pelos contextos existenciais. Vivências de déficits de autocuidado também foram registradas. Considerações finais: Os resultados contidos nesse estudo podem oferecer subsídios para modelos de apoio a profissionais de saúde para estimularem o autocuidado na adolescência. (AU)

Objective: To know the concept and practices of self-care among school-aged adolescents in the context of the COVID-19 pandemic. Method: This qualitative study used COREQ guidelines to construct the report. Seventeen adolescents participated, and data collection occurred through the personal diary technique. The data were submitted to thematic analysis. Results: The participants described the self-care phenomenon according to antecedents, attributes, and consequences of the pandemic. Conceptions of self-care and health often went beyond care needs for survival. Self-care behaviors among adolescents were noted to be multidimensional, with influences from individual, relational, and systemic levels and mediated by existential contexts. Experiences of self-care deficits were also recorded. Final considerations: The results may offer subsidies for support models for health professionals to stimulate adolescent self-care. (AU)

Factibilidad de implementación del diario como herramienta de humanización en una unidad de cuidados intensivos / Feasibility of the implementation of the diary as a humanization tool at an Intensive Care Unit

Objetivo: valorar la factibilidad de implementar el diario como herramienta de humanización en una unidad de cuidados intensivos (UCI) médica de Cataluña sin experiencia previa, en términos de acogida, satisfacción y continuidad de la medida por los profesionales de Enfermería, pacientes y familiares.Método: estudio piloto realizado durante 15 semanas con pacientes ingresados >72 horas en la UCI, sedados y con ventilación mecánica invasiva ≥ 48 horas. Se llevaron a cabo tres fases: 1) Formación a los profesionales de Enfermería, 2) Implementación del diario, y 3) Evaluación de la percepción de la herramienta por parte de los tres grupos con cuestionarios anónimos creados ad hoc.Resultados: se diseñó un diario en papel y se impartieron a los profesionales de Enfermería siete sesiones formativas previas. Se escribieron ocho diarios (uno por paciente) y en seis se insertaron fotografías. Se entregaron cuestionarios a 35 enfermeras, nueve familiares y seis pacientes. Un 83% de las enfermeras consideró que el diario se podría implementar en un futuro, a un 83% de pacientes les gustó leer un diario sobre el día a día de su estancia y a un 89% de los familiares les ayudó a expresar sus pensamientos y emociones. Un 40% de las enfermeras consideró que las fotografías podían resultar traumáticas para el paciente, mientras que a la mayoría de los familiares y pacientes no les pareció así.Conclusiones: este estudio piloto concluye que resulta factible implantar el diario en la UCI. Todos los participantes consideraron que es una herramienta que humaniza los cuidados, mejora la comunicación, la comprensión y la información. (AU)

Objective: to assess the feasibility of implementing the diary as a humanization tool at a clinical Intensive Care Unit (ICU) in Catalonia, without previous experience, in terms of acceptance, satisfaction and continuity of the measure by Nursing professionals, patients and relatives.Method: a pilot study conducted during 15 weeks with patients hospitalized >72 hours at the ICU, under sedation and with invasive mechanical ventilation for ≥ 48 hours. There were three stages: 1) Training for Nursing staff, 2) Implementation of the diary, and 3) Evaluation of the perception of the tool by the three groups, with anonymous questionnaires designed ad hoc.Results: a printed diary was designed, and Nursing professionals received seven training sessions previously. Eight diaries were written (one per patient), and photographs were inserted in six of them. Questionnaires were handed out to 35 nurses, nine relatives and six patients. 83% of the nurses considered that the diary could be implemented in the future, 83% of patients enjoyed reading a diary about the day to day of their hospital stay, and it helped 89% of relatives to express their thoughts and emotions. 40% of nurses considered that photographs could be upsetting for patients, while the majority of relatives and patients thought otherwise.Conclusions: the conclusion of this pilot study is that it is feasible to implement the diary at the ICU. All participants considered that this is a tool that humanizes care, and improves communication, understanding and information. (AU)

La relación profesionales-pacientes en tiempos de reforma. Un análisis socio-histórico con perspectiva de género del periódico ABC en los años ochenta / The doctor-patient relationship in times of reform. A socio-historical and gender analysis of the abc newspaper in the 1980s

El artículo analiza la representación de la relación médico-paciente en artículos publicados en el periódico ABC y explora la producción de significados de género del encuentro terapéutico durante los años ochenta, una etapa de renovación y cambios estructurales en la asistencia sanitaria española. El análisis histórico del discurso periodístico en ABC reveló la proyección social de una relación médico-paciente como acto humanitario y de amor, según los testimonios de los médicos que contribuyeron al debate en este medio y que, con frecuencia, mostraron su resistencia ante la reforma sanitaria y la preocupación por los cambios estructurales, así como por la organización y calidad de la asistencia. La crítica a la desnaturalización y burocratización de la relación médico-paciente fue secundada, a partir de 1984, por pacientes y periodismo especializado. Sus opiniones contrarias a la Ley de Sanidad de 1986 se agudizaron ante el amparo que la norma daba a los derechos de los pacientes. Las líneas discursivas conservadoras del ABC reflejaron la resistencia simbólica ante la reforma sanitaria, la moralización de la salud-enfermedad, la hegemonía de la profesionalización médica masculina y la invisibilización y subalternidad de las mujeres sanitarias.(AU)

The article analyzes the representation of the doctor-patient relationship in articles published in ABC newspaper and explores the production of gender meanings of the therapeutic encounter during the eighties, a period of renewal and structural changes in Spanish health care. The historical analysis of ABC journalistic discourse revealed the social projection of a doctor-patient relationship as a humanitarian act of love, according to the testimonies of the doctors. They frequently showed their resistance to health reform and concern for the changes in structural reorganization and quality of care. From 1984, patients and some journalists also criticize the bureaucratization of the doctor-patient relationship. The protection that the 1986 Health Law gave to the patients’ rights increased published opinions against the Health Law. The conservative discursive lines of the ABC reflected the symbolic resistance to health reform, the moralization of health-disease, the hegemony of male medical professionalization and the invisibility and subalternity of female health workers.(AU)

Sleep and day-to-day PTSD symptom variability: an ecological momentary assessment and actigraphy monitored study in trauma-exposed young adults.

BACKGROUND: Disrupted sleep and post-traumatic stress disorder (PTSD) are bi-directionally linked and have been found to mutually reinforce each other on a day-to-day basis. However, most of the previous research has focused on subjective measures of sleep only. OBJECTIVE: Here, we investigated the temporal relationship between sleep and PTSD symptoms using both subjective (sleep diary) and objective measures of sleep (actigraphy). METHODS: Forty-one non-treatment seeking, trauma exposed young adults (age M = 24.68, SD = 8.15) with a range of PTSD symptom severities (PTSS, 0-53 on PCL-5) were recruited. Participants completed two surveys per day over four weeks to measure day-time PTSD symptoms (i.e. PTSS and number of intrusions) and night-time sleep subjectively, while wearing an actigraphy watch to measure sleep objectively. RESULTS: Linear mixed models revealed that subjectively reported sleep disruptions were associated with elevated next-day PTSS and increasing number of intrusive memories both within and between participants. Similar results were found for daytime PTSD symptoms on night-time sleep. However, these associations were not found using objective sleep data. Exploratory moderator analyses including sex (male vs. female) found that these associations differed in strength between sexes but were generally in the same direction. DISCUSSION: These results were in line with our hypothesis with regards to the sleep diary (subjective sleep), but not actigraphy (objective sleep). Several factors which have implications on both PTSD and sleep, such as the COVID-19 pandemic and/ or sleep-state misperception, may be potential reasons behind those discrepancies. However, this study had limited power and needs to be replicated in larger samples. Nonetheless, these results add to the current literature about the bi-directional relationship between sleep and PTSD and have clinical implications for treatment strategies.

Elevated day-time PTSD symptom severity (PTSS) and more frequent intrusive memories were generally associated with subjectively reported disruptions in sleep and vice versa, but not with objective measures of sleep.While longer subjective sleep duration predicted reductions in PTSS and shorter sleep onset latency predicted reduced numbers of intrusions the next day, reduced daytime PTSS was only associated with reductions in distress associated with nightmares during the following night.Exploratory analyses showed that sex (men vs. women) moderated the bi-directional relationships between night-time sleep and day-time PTSD symptoms with longer sleep onset latency and lower sleep efficiency being related to worse PTSD symptoms the next day in women, but was not associated with men.

Utilização do diário de quedas como ferramenta de monitoramento das quedas em pessoas com doença de Parkinson: uma revisão sistemática / Use of fall diary as a fall monitoring tool in people with Parkinson's disease: a systematic review

As quedas em pessoas com Doença de Parkinson (DP) são fatores limitantes e incapacitantes, sua compreensão é complexa dada a natureza multifatorial. Neste contexto uma ferramenta, o diário de quedas, pode ser alternativa significante na compreensão deste evento. Objetivo: Avaliar a utilização do diário de quedas como ferramenta de monitoramento das quedas em pessoas com DP. Métodos: Trata-se de uma revisão sistemática de literatura que teve a seguinte questão norteadora: o diário de quedas é uma ferramenta adequada para monitorar as quedas em pessoas com DP? A busca nas bases de dados Pubmed, Medline, PEDro, Web of Science, Scopus e Cochrane Library foi realizada entre os meses de janeiro a março de 2022. A revisão foi registrada na plataforma PROSPERO sob o número de registro: CRD42018099127. Resultados: 192 estudos foram recuperados nas bases de dados, após adoção dos critérios de inclusão e exclusão, 6 estudos foram incluídos nesta revisão, a variável diário de quedas foi descrita sumariamente nos estudos analisados e extraído informações do que deveria conter em um diário de quedas. Conclusão: A análise permitiu concluir que os diários de quedas são ferramentas importantes para registro e compreensão do evento queda em pessoas com DP, no entanto, carecem de padronização

Falls in people with Parkinson's disease (PD) are limiting and disabling factors, their understanding is complex given their multifactorial nature. In this context, a tool, the fall diary, can be a significant alternative in understanding this event. Objective: Evaluate the use of the fall diary as a tool to monitor falls in people with PD. Methods: This is a systematic literature review that had the following guiding question: is the fall diary an adequate tool to monitor falls in people with PD? The search in Pubmed, Medline, PEDro, Web of Science, Scopus and Cochrane Library databases was carried out between January and March 2022. The review was registered on the PROSPERO platform under registration number: CRD42018099127. Results: A total of 192 studies were retrieved from the databases, after adopting the inclusion and exclusion criteria, 6 studies were included in this review, the daily variable of falls was briefly described in the analyzed studies and information was extracted from what it should contain in a falls diary. Conclusion: The analysis allowed us to conclude that fall diaries are important tools for recording and understanding the fall event in people with PD, however, they lack standardization

O papel dos diários intestinais na consulta de gastrenterologia / The role of bowel diaries in a "real-life" setting

ABSTRACT Background Despite the potential advantages of patients' self-recordings of bowel habits in lower digestive disorders, few studies evaluate the relevance of clinical information obtained through bowel diaries in clinical practice. Objective The main objective of this study was to evaluate the role of bowel diaries as an auxiliary diagnostic tool in lower gastrointestinal disorders consultations. Methods In this cross-sectional study, at the end of their gastroenterology consultation, patients were questioned about their bowel habits and gastrointestinal symptoms. The bowel diary was then filled by the patients at home for 2 weeks. The data collected from the clinical interview and from the bowel diaries were analyzed. Results Fifty-three patients participated in the study. Patients underestimated the number of their bowel movements (BM) in the interviews compared with the bowel diaries (P=0.007). There was a poor agreement between stool consistencies described in the interviews and recorded in the diaries (k=0.281). Patients overestimated their straining during evacuation in the interviews compared with the diaries (P=0.012). Regarding the subgroups' analysis, patients with proctological disorders described less BM in their interviews (P=0.033). Straining during evacuation was higher in the interviews of patients without proctological disorders (P=0.028) and in the interviews of more educated patients (P=0.028). Conclusion Overall, there were discrepancies between the clinical interview and the bowel diary regarding the number of BM, the stool consistency and straining. Bowel diaries are therefore a relevant instrument as a complement to the clinical interview to objectify patients' complaints and treat functional gastrointestinal disorders more adequately.

RESUMO Contexto: Apesar das potenciais vantagens do diário intestinal como complemento à entrevista clínica, raros estudos avaliam a relevância da informação clínica obtida a partir de diários intestinais na prática clínica. Objetivo Os principais objetivos deste estudo foram avaliar o papel do diário intestinal como ferramenta diagnóstica numa consulta dedicada a patologia digestiva baixa. Métodos Foi realizado um estudo transversal, num período de 3 meses, em que no final das consultas os pacientes foram entrevistados relativamente a dados demográficos, antecedentes clínicos e hábitos e sintomas intestinais. Em seguida, foi solicitado o auto-preenchimento de um diário intestinal durante 2 semanas. Foram comparadas as respostas obtidas na entrevista clínica com os registos dos diários intestinais. Resultados: Cinquenta e três pacientes participaram no estudo. A frequência de evacuações reportada nas entrevistas clínicas e nos diários intestinais dos pacientes foi significativamente diferente (P=0,007). Verificou-se apenas uma concordância mínima entre a consistência das fezes descrita nas entrevistas e registada nos diários (κ=0,281). Em relação ao esforço evacuatório os pacientes sobrestimaram o seu esforço ao evacuar nas entrevistas (P=0,012). Adicionalmente, verificou-se que pacientes com doenças proctológicas descreveram menos evacuações nas suas entrevistas (P=0,033). A descrição do esforço durante a evacuação foi superestimada nas entrevistas de pacientes sem distúrbios proctológicos (P=0,028) e de pacientes com um nível mais elevado de educação (P=0,028). Conclusão: Globalmente verificaram-se discrepâncias entre a entrevista clínica e o diário intestinal dos pacientes em relação ao número de dejeções, à consistência das fezes e ao esforço evacuatório. Assim, esta ferramenta revelou-se uma potencial mais-valia na prática clínica diária, permitindo objetivar as queixas e consequentemente tratar os pacientes de forma mais adequada.

Experiência e representação da escuta de vozes na expressão cotidiana / Experiencia y representación de escuchar voces y el expressión cotidiana / Experience and representation of hearing voices in the everyday expression

RESUMO. Escutar vozes ainda é considerado por profissionais da saúde como alucinação auditiva, uma experiência perturbadora que ocorre em condições de doença, reconhecida como uma sintomatologia psicopatológica de alteração da realidade. Entretanto, esta postura dificulta o acolhimento da pessoa que vivencia este fenômeno. O objetivo deste estudo foi de conhecer na literatura científica sobre a experiência e a representação da escuta de vozes na expressão cotidiana. O método utilizado foi de revisão narrativa, em fontes pesquisadas em periódicos. Encontramos 30 artigos em português e inglês, no período de 2003 a 2018, utilizando os descritores saúde mental, esquizofrenia, ouvidores de vozes e cotidiano. Os dados foram organizados em uma planilha temática e analisados com foco na narrativa da linguagem e apresentados descritivamente. A literatura estudada apresentou dois tipos de representação da escuta de vozes: a caracterização e tipologia da vivência, e como processo subjetivo de uma experiência biográfica. Entre os resultados identificamos a caracterização da experiência de ouvir vozes associada a vivências traumáticas e com consequências nas atividades laborativas, como o trabalho e a vida social, com um cotidiano ausente de papéis ocupacionais, reconhecendo esta pessoa apenas pela sua condição de doença mental. Ressaltamos a necessidade de estudos empíricos que abordem a compreensão da escuta de vozes, com foco fenomenológico da experiência do mundo da vida das pessoas, para a compreensão do reconhecimento no cotidiano de papéis ocupacionais, como também auxiliar nas práticas terapêuticas no cuidado em saúde mental.

RESUMEN. Los profesionales de la salud todavía consideran que escuchar voces es una alucinación auditiva, una experiencia perturbadora que ocurre en condiciones de enfermedad, reconocida como un síntoma psicopatológico de alteración de la realidad. Tal posición hace que sea difícil aceptar la experiencia del oyente de voz. Sin embargo, esta postura dificulta la recepción de la persona que experimenta este fenómeno. El objetivo de este estudio fue indagar en la literatura científica sobre la experiencia y representación de escuchar voces en la expresión cotidiana. El método utilizado fue la revisión narrativa, de fuentes investigadas en revistas. Encontramos 30 artículos en portugués e inglés, de 2003 a 2018, usando las palabras clave salud mental, esquizofrenia, oyentes y la vida cotidiana. Los datos se organizaron en una hoja de cálculo temática y se analizaron con un enfoque en la narrativa del lenguaje y se presentaron descriptivamente. La literatura estudiada presenta dos tipos de representación de la escucha de voces: la caracterización y tipología de la experiencia, y como el proceso subjetivo de una experiencia biográfica. Entre los resultados, identificamos la caracterización de la experiencia de escuchar voces asociadas con experiencias traumáticas y con consecuencias en las actividades laborales, como el trabajo y la vida social, con una ausencia diaria de roles ocupacionales, reconociendo a esta persona solo por su condición de enfermedad mental. Hacemos hincapié en la necesidad de estudios empíricos que aborden la comprensión de escuchar voces, con un enfoque fenomenológico en la experiencia de las personas del mundo de la vida, para comprender el reconocimiento de los roles ocupacionales en la vida cotidiana, así como ayudar en las prácticas terapéuticas en la atención de la salud mental.

ABSTRACT. Hearing voices is still considered by health professionals as auditory hallucination, a disturbing experience that occurs in conditions of illness, recognized as a psychopathological symptom of altering reality. Such a position makes it difficult to accept the voice hearer's experience. However, this posture makes it difficult to reception the person who experiences this phenomenon. The objective of this study was to find out in the scientific literature about the experience and representation of hearing voices in everyday expression. The method used was narrative review, from sources researched in periodical. We found 30 articles in Portuguese and English, from 2003 to 2018, using the keywords mental health, schizophrenia, voice hearers and everyday life. The data were organized in a thematic spreadsheet and analyzed with a focus on the language narrative and presented descriptively. The studied literature presented two types of representation of hearing to voices: the characterization and typology of the experience, and as the subjective process of a biographical experience. Among the results, we identified the characterization of the experience of hearing voices associated with traumatic experiences and with consequences in work activities, such as work and social life, with a daily absence of occupational roles, recognizing this person only because of his condition of mental illness. We emphasize the need for empirical studies that address the understanding of hearing to voices, with a phenomenological focus on people's experience of the world of life, for an understanding of the recognition of occupational roles in everyday life, as well as assisting in therapeutic practices in mental health care.

Diários de luto: um diálogo entre psicanálise e literatura em tempos de pandemia / Mourning Diaries: a dialogue between psychoanalysis and literature amidst a pandemic

Diante do negacionismo do governo brasileiro, que levou ao aumento exponencial do número de mortos pela COVID-19, aborda-se o trabalho de luto como um elemento no contexto das catástrofes coletivas que favorece uma tomada de posição política coletiva e uma elaboração subjetiva das situações traumáticas. Destaca-se, em seguida, como o luto comparece na literatura como uma estratégia de subjetivação do que foi perdido, sobretudo por meio da escrita de diários. Com base nos elementos teóricos de Freud sobre o luto e de Ferenczi acerca da apropriação do traumático, analisam-se três livros-diários de autores que descrevem o trabalho de luto (Rolland Barthes, Boris Fausto e Neal Peart). Verifica-se nesses textos como o luto promove um rearranjo das memórias, enodando o individual e o coletivo, o exterior e o interior, convocando um testemunho. Ele também favorece uma estabilização pulsional e narcísica, possibilitando novos endereçamentos e a construção de um projeto de vida futuro. Ao final, como contraponto ao desrespeito do governo federal em relação ao luto dos que perderam familiares e amigos durante a pandemia, reforça-se o dever de reconhecer o luto, valorizá-lo e oferecer suporte para a sua realização como estratégia política de promoção da saúde mental.

Faced with the Brazilian government's negationist attitude which led to the exponential increase of deaths by COVID-19, the work of mourning is approached, in this work, as an element in the context of collective catastrophes that favors a political stance and a subjective elaboration of traumatic situations. We will then underline how mourning appears in literature as a strategy of subjectivation of what has been lost, especially through the writing of diaries. Based on the theoretical elements of Freud on mourning and Ferenczi on the appropriation of the traumatic, three diaries by authors who describe the work of mourning (Rolland Barthes, Boris Fausto and Neal Peart) are analyzed. It can be seen in these texts how mourning promotes a rearrangement of memories, entangling the individual and the collective, the exterior and the interior, calling for testimony. It also favors instinctual and narcissistic stabilization, enabling new approaches and the construction of a future life project. In the end, as a counterpoint to the federal government's disrespect for the grief of those who lost relatives and friends during the pandemic, the duty to recognize grief, to value it and to offer support for its realization is highlighted as a political strategy to promote the mental health.

Headache: what to ask, how to examine, and what scales to use. Recommendations of the Spanish society of neurology's headache study group.

INTRODUCCIóN: La cefalea es el motivo de consulta neurológico más prevalente en los distintos niveles asistenciales, donde la anamnesis y exploración son primordiales para realizar un diagnóstico y tratamiento adecuados. Con la intención de unificar la atención de esta patología, el Grupo de Estudio de Cefalea de la Sociedad Española de Neurología (GECSEN) ha decidido elaborar unas recomendaciones consensuadas para mejorar y garantizar una adecuada asistencia en Atención Primaria, Urgencias y Neurología. METODOLOGíA: El documento es práctico, sigue el orden de la dinámica de actuación durante una consulta: anamnesis, escalas que cuantifican el impacto y la discapacidad y exploración. Además, finaliza con pautas para realizar un seguimiento adecuado y un manejo de las expectativas del paciente con el tratamiento pautado. CONCLUSIONES: Esperamos ofrecer una herramienta que mejore la atención al paciente con cefalea para garantizar una asistencia adecuada y homogénea a nivel nacional.

¿Qué preguntar, cómo explorar y qué escalas usar en el paciente con cefalea? Recomendaciones del Grupo de Estudio de Cefalea de la Sociedad Española de Neurología / Headache: What to ask, how to examine, and which scales to use. Recommendations of the Spanish Society of Neurology's Headache Study Group

Introducción: La cefalea es el motivo de consulta neurológico más prevalente en los distintos niveles asistenciales, donde la anamnesis y exploración son primordiales para realizar un diagnóstico y tratamiento adecuados. Con la intención de unificar la atención de esta patología, el Grupo de Estudio de Cefalea de la Sociedad Española de Neurología (GECSEN) ha decidido elaborar unas recomendaciones consensuadas para mejorar y garantizar una adecuada asistencia en atención primaria, urgencias y neurología. Metodología: El documento es práctico, sigue el orden de la dinámica de actuación durante una consulta: anamnesis, escalas que cuantifican el impacto y la discapacidad y exploración. Además, finaliza con pautas para realizar un seguimiento adecuado y un manejo de las expectativas del paciente con el tratamiento pautado. Conclusiones: Esperamos ofrecer una herramienta que mejore la atención al paciente con cefalea para garantizar una asistencia adecuada y homogénea a nivel nacional. (AU)

Introduction: Headache is the most common neurological complaint at the different levels of the healthcare system, and clinical history and physical examination are essential in the diagnosis and treatment of these patients. With the objective of unifying the care given to patients with headache, the Spanish Society of Neurology's Headache Study Group (GECSEN) has decided to establish a series of consensus recommendations to improve and guarantee adequate care in primary care, emergency services, and neurology departments. Methods: With the aim of creating a practical document, the recommendations follow the dynamics of a medical consultation: clinical history, physical examination, and scales quantifying headache impact and disability. In addition, we provide recommendations for follow-up and managing patients’ expectations of the treatment. Conclusions: With this tool, we aim to improve the care given to patients with headache in order to guarantee adequate, homogeneous care across Spain. (AU)

Creating our own Black Books: keeping a journal as a loom of life.

Jung's The Black Books are annotations of his inner world after his process of self-experimentation, which he called his 'confrontation with the unconscious'. They preceded The Red Book in which, as a scribe, he reworked his initial notes and drawings. This was the raw material for the work that Jung developed over the rest of his life. From his experimentation, he formulated the method of active imagination and the concept of the transcendent function, a psychological function that creates symbols and integrates the unconscious contents in consciousness. Jung invites us, with his experience, to write and paint our own Black Books and to explore our inner images. With this proposal to keep a journal as a loom of life, we welcome his invitation, which allows us to weave and integrate the visible and invisible substances of our lives. Our intention for the journalling is to provide a space for the unfolding of the individuation process. In Jung's invitation we see that a life that does not confront itself cannot be realized as such.

Les Livres Noirs de Jung sont des annotations sur son monde intérieur suite à son processus d'expérimentation sur lui-même, qu'il a appelé sa « confrontation avec l'inconscient ¼. Ils ont précédé le Livre Rouge dans lequel, comme un scribe, il retravailla ses notes et dessins initiaux. Ce fut le matériel brut pour le travail que Jung développa jusqu'à la fin de sa vie. A partir de son expérimentation, il formula la méthode d'imagination active et le concept de fonction transcendante, une fonction psychologique qui crée des symboles et intègre les contenus inconscients dans la conscience. Par son expérience Jung nous invite à écrire et à peindre nos propres Livres Noirs et à explorer nos images intérieures. Avec cette proposition de tenir un journal en tant que métier à tisser de la vie, nous accueillons son invitation, qui nous permet de tisser et d'intégrer les substances visibles et invisibles de nos vies. Notre intention dans cette expérience de tenir un journal est de fournir un espace pour le déploiement du processus d'individuation. Dans l'invitation de Jung nous voyons qu'une vie qui ne se confronte pas à elle-même ne peut pas se réaliser en tant que telle.

Los Libros Negros de Jung son anotaciones de su mundo interno tras su proceso de auto experimentación, al que denominó su "confrontación con lo inconsciente". Estos antecedieron al Libro Rojo, en el que como un escriba reelaboraba sus notas y dibujos iniciales. Esta fue la materia prima del trabajo que Jung desarrolló por el resto de su vida. A partir de su experimentación formuló el método de la imaginación activa y el concepto de la función transcendente, función psicológica creadora de símbolos e integradora de contenidos inconscientes en la conciencia. Jung nos invita con su experiencia a escribir nuestros propios Libros Negros y a explorar nuestras imágenes interiores. Con nuestra propuesta de llevar un diario como telar de la vida hemos acogido esta invitación, que nos permite, tejer e integrar la sustancia visible e invisible de nuestras vidas. Nuestra intención con el diario es facilitar un espacio para el desenvolvimiento del proceso de individuación. En la invitación de Jung vemos que una vida que no se confronte consigo misma, no se puede realizar como tal.

Os Livros Negros de Jung são anotações de seu mundo interior após seu processo de autoexperimentação, que ele chamou de seu "confronto com o inconsciente". Eles precederam o Livro Vermelho no qual, como escriba, ele reformulou suas notas e desenhos iniciais. Esta foi a matéria-prima para o trabalho que Jung desenvolveu pelo resto de sua vida. A partir de sua experimentação, ele formulou o método da imaginação ativa e o conceito de função transcendente, uma função psicológica que cria símbolos e integra os conteúdos inconscientes na consciência. Jung nos convida, com sua experiência, a escrever e pintar nossos próprios Livros Negros e explorar nossas imagens internas. Com esta proposta de manter um diário como um tear da vida, saudamos seu convite, que nos permite tecer e integrar as substâncias visíveis e invisíveis de nossas vidas. Nossa intenção para o diário é fornecer um espaço para o desdobramento do processo de individuação. No convite de Jung, vemos que uma vida que não se confronta não pode ser realizada como tal.

De las tertulias a la conspiración: la disputa por la belleza y las amistades peligrosas de Alejandro Malaspina en Madrid / From gatherings to conspiracy: the dispute about beauty and Alejandro Malaspina´s dangerous liaisons in madrid

Este artículo revisa el periodo transcurrido por Malaspina en Madrid tras su “viaje alrededor del mundo”, hasta su detención en noviembre de 1795. A la luz de fuentes hasta ahora ignoradas por la historiografía malaspiniana, se analiza la participación de Malaspina en una disputa literaria en el Diario de Madrid, donde llegó a publicar bajo seudónimo cuatro cartas filosóficas sobre la belleza que constituyen un antecedente directo de su Meditación filosófica, su obra más personal, escrita en presidio tras su arresto. Por último, se analiza la relación de Malaspina con su vecina madrileña Fernanda O’Connock, marquesa de Matallana, mujer vinculada a la oposición política a Godoy y destacada agente conspiradora contra el primer ministro en dicho periodo, quien muy posiblemente tuvo un papel mucho más activo de lo que hasta ahora se le había reconocido en la conspiración Malaspina. (AU)

This article reviews the period spent by Malaspina in Madrid after his “voyage around the world”, until his arrest in November 1795. Exploring sources hitherto ignored by Malaspinian historiography, the article focuses on Malaspina’s participation in a literary dispute which took place in the Diario de Madrid, where he published under pseudonym four philosophical letters on Beauty. These letters constitute the direct antecedent of his Meditation on Beauty, his most personal work, written in prison after his arrest. Lastly, the paper analyses Malaspina’s relationship with his neighbour in Madrid, Fernanda O’Connock, Marchioness of Matallana, a woman linked to the political opposition to Manuel Godoy and an outstanding conspirator agent against the Prime Minister, who very possibly played a much more active role than previously recognised in the so-called “Malaspina conspiracy”.(AU)

Symptom variability in outpatients with COPD and validation of the Colombian COPD Symptom Variability Instrument (EPOC-CoVaSy) / Variabilidad de síntomas en pacientes ambulatorios con EPOC y validación del Instrumento Colombiano de Variabilidad de Síntomas en EPOC (EPOC-CoVaSy)

Abstract Introduction: The variability of respiratory symptoms in chronic obstructive pulmonary disease (COPD) is considered to be low or nonexistent. However, some authors state that there may be fluctuations. Objectives: To describe symptom variability in patients with COPD throughout the day and night for four weeks using a patient diary, and to validate a questionnaire created for such purpose (Colombian Self-Ad -ministered Instrument of Symptom Variability in COPD - EPOC-CoVaSy). Materials and methods: Cohort study conducted in 96 patients with COPD treated between June and December 2016 at the Centro de Atención Pulmonar - CAP in Barranquilla, Colombia, who filled out a patient diary for four weeks and, after this period, the self-administered EPOC-CoVaSy instrument. Independence and comparison of frequencies of categorical and continuous variables were established using the chi- square and the Fisher ' s exact tests and the Pearson's correlation coefficient, respectively. A MANO-VA was performed using linear regression models to determine the correlations between the results of the diary and the instrument. Results: Participants' mean age was 73.3±8.3 years and 71.87% were male. According to the analysis of the diaries, the mean scores (visual analog scale) for all symptoms and the performance of activities of daily living ranged between 0.5 and 2.5, being higher in the morning (mean scores between 1.5 and 2.5) than in the afternoon and night (mean scores between 0.5 and 1.5); however, symptom variability was minimal. These results were similar to those obtained in the EPOC-CoVaSy instrument, demonstrating a high correlation between both instruments that allowed to confirm that EPOC-CoVaSy is a useful instrument to measure such variability. Conclusions. Based on the findings of the present study, it can be concluded that there is a slight variability in COPD symptoms throughout the day, which should be considered when establishing treatment regimens for this disease. Likewise, it was determined that the EPOC-CoVaSy instrument is valid to measure such variability in Colombian patients with COPD.

Resumen Introducción. Se considera que la variabilidad de los síntomas respiratorios de la enfermedad pulmonar obstructiva crónica (EPOC) es baja o inexistente. Sin embargo, algunos autores afirman que se pueden presentar fluctuaciones. Objetivos. Describir la variabilidad de síntomas en pacientes con EPOC a lo largo del día y la noche durante cuatro semanas mediante un diario del paciente, y validar un cuestionario desarrollado para tal fin (Instrumento Colombiano Autoadministrado de Variabilidad de Síntomas en EPOC: EPOC-CoVaSy). Materiales y métodos. Estudio de cohorte realizado en 96 pacientes con EPOC atendidos entre junio y diciembre de 2016 en el Centro de Atención Pulmonar - CAP, en Barranquilla, Colombia, quienes diligenciaron un diario del paciente durante cuatro semanas y, luego de este periodo, el instrumento autoadministrado EPOC-CoVaSy. La independencia y comparación de frecuencias de las variables categóricas y continuas se establecieron mediante las pruebas % 2 y exacta de Fisher y el coeficiente de correlación de Pearson, respectivamente. Se realizó un MANOVA, utilizando modelos de regresión lineal, para determinar las correlaciones entre los resultados del diario y el instrumento. Resultados. La edad promedio de los participantes fue 73.3±8.3 años y 71.87% eran hombres. Según el análisis de los diarios, los puntajes promedio (escala visual analógica) para todos los síntomas y el desempeño de actividades diarias oscilaron entre 0.5 y 2.5, siendo más altos en la mañana (puntajes promedio entre 1.5 y 2.5) que en la tarde y noche (puntajes promedio entre 0.5 y 1.5); sin embargo, esta variabilidad fue mínima, lo que coincidió con los resultados obtenidos en el EPOC-CoVaSy, evidenciándose una alta correlación entre ambos instrumentos que permitió confirmar que la herramienta diseñada es útil para medir dicha variabilidad. Conclusiones. Con base en los hallazgos del presente estudio, se puede concluir que existe una leve variabilidad en los síntomas de EPOC a lo largo del día, la cual debe considerarse a la hora de establecer esquemas de tratamiento para esta enfermedad. Asimismo, se estableció que el EPOC-CoVaSy es válido para medir dicha variabilidad en la población colombiana con EPOC.

Uma formação pedagógico-reflexiva em psicologia: análise de diários de aprendizagem / A pedagogical-reflexive experience at a Psychology course: analysis of learning logs / Una formación pedagógica-reflexiva en Psicología: análisis de diarios de aprendizaje

O presente artigo buscou, através da análise de diários de aprendizagem, discutir a respeito das possibilidades que uma formação universitária em psicologia que seja acolhedora e promotora de reflexões pode ter na formação de estudantes de psicologia. Foram analisados treze diários redigidos por estudantes do sexto semestre de um curso de graduação em Psicologia matriculados em uma disciplina relacionada à Abordagem Centrada na Pessoa de um Centro Universitário do Centro-Oeste brasileiro. Os diários foram escritos tendo como base a concepção de Versão de Sentido, com uma escrita livre após as aulas. Foi utilizada a Análise Temática e, a partir dela emergiram seis temas que demonstraram a importância da construção de um espaço acadêmico dialógico que promova as condições facilitadoras para o desenvolvimento pessoal e profissional.

The present article aimed, through the analysis of learning diaries, to discuss about the possibilities that a psychology university degree which promotes reflection and shelters students' thoughts and emotions can have in the training of psychology students. Were analyzed thirteen learning logs written by students of the sixth semester of an undergraduate degree course in Psychology enrolled in a discipline related to the Person Centered Approach.The logs were written based on the Sense's Version, after each class, with indication of free writing. Thematic Analysis was used, and from it six themes emerged that demonstrated the importance of building an academic context that promotes the facilitating conditions for personal and professional development.

El presente artículo buscó, a través del análisis de diarios de aprendizaje, discutir acerca de las posibilidades que una formación universitaria en psicología que sea acogedora y promotora de reflexiones puede tener en la formación de estudiantes de psicología. Se analizaron trece diarios redactados por estudiantes del sexto semestre de un curso de graduación en Psicología matriculados en una disciplina relacionada al Enfoque Centrado en la Persona. Los diarios fueron escritos teniendo como base la concepción de Versión de Sentido, con una escritura libre después de las clases. Se utilizó el Análisis Temático y, a partir de ella surgieron seis temas que demostraron la importancia de la construcción de un espacio académico dialógico que promueve las condiciones facilitadoras para el desarrollo personal y profesional.

[UPOINT phenotypic classification of a sample of female patients with bladder pain syndrome: Results of a national multicentric observational study.] / Clasificación fenotípica UPOINT de una muestra de mujeres con síndrome de dolor vesical: resultados de un estudio observacional multicéntrico nacional.

OBJECTIVES: To study the possibility of classifying patients with BPS by UPOINT phenotypes and their correlation with the results of different BPS diagnostic tools. MATERIAL AND METHODS: Epidemiological, observational, longitudinal and multicentric study performed according to clinical practice. A total of 319 women with BPS were included, 79 with new diagnosis and 240 in follow-up. Sociodemographic and clinical data were collected together with results of cystoscopy, biopsy and physical examination. Patients completed a 3-day Bladder Diary (3dBD) and Patient Reported Outcomes (PROs). All the patients were classified according to the 6 UPOINT domains and their distribution was described according to the clinical history, diagnostic tests, urinary symptoms and PROs' scores. RESULTS: 92.8% of the patients had affectation in more than one phenotype, however, there were no remarkable differences in the clinical and sociodemographic variables according to the number of affected domains. The percentage of patients with 3C classification was higher in the urinary (8.2%), organ-specific (9.0%) and neurological (10.9%) phenotypes. Around 90% had high voiding frequency, regardless of the phenotype. The improvement reported by the PROs was superior in the neurological and tenderness phenotypes. The worst scores were associated with a greater number of affected domains. CONCLUSIONS: The present study is the first one carried out in Spain on a phenotypic classification of women with BPS, with data from routine clinical practice. The results point out that patients with several domains affected present more affectation on the BPS, worse HRQo Land higher anxiety.

OBJETIVOS: Estudiar la posibilidad de clasificar a las pacientes con SDV por los fenotipos UPOINT y su correlación con los resultados de otras herramientas diagnósticas para SDV. MATERIAL Y MÉTODOS: Estudio epidemiológico, observacional, longitudinal y multicéntrico realizado según la práctica clínica habitual. Se incluyeron 319 mujeres con SDV, 79 de nuevo diagnóstico y 240 en seguimiento. Se recogieron datos sociodemográficos y clínicos y resultados de la cistoscopia, biopsia y exploración física. Las pacientes cumplimentaron un diario miccional de 3 días y los Patient Reported Outcomes (PROs). Todas las pacientes fueron clasificadas según los 6 dominios UPOINT y se describió su distribución según la historia clínica, pruebas diagnósticas, síntomas urinarios y las puntuaciones de los PROs. RESULTADOS: El 92,8% de las pacientes tenían afectación en más de un fenotipo, sin embargo, no hubo diferencias destacables en las variables clínicas y sociodemográficas según el número de dominios afectados. El porcentaje de pacientes con clasificación 3C fue mayor en los fenotipos urológico (8,2%), órgano-específico (9,0%) y neurológico (10,9%). Alrededor del 90% presentaron frecuencia miccional elevada, independientemente del fenotipo. La mejoría reportada por los PROs fue superior en los fenotipos neurológico y tenderness. Las peores puntuaciones se asociaron a un mayor número de dominios afectados. CONCLUSIONES: El presente estudio es el primero realizado en España sobre una clasificación fenotípica de mujeres con SDV, basándose en datos de práctica clínica habitual. Los resultados obtenidos señalan una tendencia a que pacientes con afectación de varios dominios fenotípicos presentan mayor afectación por el SDV, peor CVRS y mayor ansiedad.

Clasificación fenotípica upoint de una muestra de mujeres con síndrome de dolor vesical: resultados de un estudio observacional multicéntrico nacional / Upoint phenotypic classification of a sample of women with bladder pain syndrome: results of a national multicenter observational study

Objetivos: Estudiar la posibilidad declasificar a las pacientes con SDV por los fenotiposUPOINT y su correlación con los resultados de otrasherramientas diagnósticas para SDV.Material y métodos: Estudio epidemiológico, observacional, longitudinal y multicéntrico realizado segúnla práctica clínica habitual. Se incluyeron 319 mujerescon SDV, 79 de nuevo diagnóstico y 240 en seguimiento. Se recogieron datos sociodemográficos y clínicosy resultados de la cistoscopia, biopsia y exploraciónfísica. Las pacientes cumplimentaron un diario miccional de 3 días y los Patient Reported Outcomes (PROs).Todas las pacientes fueron clasificadas según los 6 dominios UPOINT y se describió su distribución según lahistoria clínica, pruebas diagnósticas, síntomas urinariosy las puntuaciones de los PROs. Resultados: El 92,8% de las pacientes tenían afectación en más de un fenotipo, sin embargo, no hubodiferencias destacables en las variables clínicas y sociodemográficas según el número de dominios afectados.El porcentaje de pacientes con clasificación 3C fue mayor en los fenotipos urológico (8,2%), órgano-específico(9,0%) y neurológico (10,9%). Alrededor del 90% presentaron frecuencia miccional elevada, independiente-mente del fenotipo. La mejoría reportada por los PROsfue superior en los fenotipos neurológico y tenderness.Las peores puntuaciones se asociaron a un mayor número de dominios afectados.Conclusiones: El presente estudio es el primerorealizado en España sobre una clasificación fenotípicade mujeres con SDV, basándose en datos de prácticaclínica habitual. Los resultados obtenidos señalan unatendencia a que pacientes con afectación de variosdominios fenotípicos presentan mayor afectación por elSDV, peor CVRS y mayor ansiedad.(AU)

Objetives: To study the possibility ofclassifying patients with BPS by UPOINT phenotypesand their correlation with the results of different BPS diagnostic tools.Materials and methods: Epidemiological, observational, longitudinal and multicentric study performed according to clinical practice. A total of 319 women withBPS were included, 79 with new diagnosis and 240in follow-up. Sociodemographic and clinical data werecollected together with results of cystoscopy, biopsyand physical examination. Patients completed a 3-dayBladder Diary (3dBD) and Patient Reported Outcomes(PROs). All the patients were classified according to the6 UPOINT domains and their distribution was describedaccording to the clinical history, diagnostic tests, urinarysymptoms and PROs’ scores.Results: 92.8% of the patients had affectation in morethan one phenotype, however, there were no remarkable differences in the clinical and sociodemographicvariables according to the number of affected domains.The percentage of patients with 3C classification washigher in the urinary (8.2%), organspecific (9.0%) andneurological (10.9%) phenotypes. Around 90% hadhigh voiding frequency, regardless of the phenotype.The improvement reported by the PROs was superior inthe neurological and tenderness phenotypes. The worstscores were associated with a greater number of affected domains. Conclusions: The present study is the first one carried out in Spain on a phenotypic classification of women with BPS, with data from routine clinical practice. Theresults point out that patients with several domains affected present more affectation on the BPS, worse HRQoLand higher anxiety.(AU)

Evaluation of patient quality care in Spain in prevention of nausea and vomiting induced by chemotherapy.

OBJECTIVE: To characterise current management of chemotherapy-induced nausea and vomiting in Spain, as well as professional adherence to antiemetic guidelines. MATERIALS AND METHODS: Retrospective observational study. A multicenter has been designed including 360 patient case files from 18 hospitals. The involvement of pharmacists and nurses was studied, and also indicators of structure, process, and selected outcomes previously recruited from antiemetic guidelines. RESULTS: We found 94.4% of hospitals used a written protocol for managing chemotherapy-induced nausea and vomiting and only 44.4% had educational programs for patients regarding this. Patients were prescribed antiemetic prophylactic treatment for delayed emesis in varying degree between highly and moderately emetogenic chemotherapy (77.8% and 58.9%, respectively). Dexamethasone was the most prescribed antiemetic drug for patients receiving highly and moderately emetogenic chemotherapy (98.3% and 90%, respectively), followed by ondansetron (68.9% and 95%, respectively). Nursing was more involved than pharmacy units in evaluating emetic risk factors in patients (64.7% vs 21.4%), and tracking symptom onset (88.2% vs 57.1%) and adherence to treatment (94.1% vs 28.6%). Pharmacy units were more involved than nursing in choosing the antiemetic treatment (78.6% vs 47%). CONCLUSIONS: Although antiemetic guidelines were used by all hospitals, there were differences in management of chemotherapy-induced nausea and vomiting. Increased education directed towards patients and oncology professionals is needed to improve adherence.

Migração e mobilidade pendular em municípios do aglomerado de confecções das mesorregiões Agreste de Pernambuco e Borborema da Paraíba / Migration and commuting in municipalities of the garment industry cluster in the Agreste of Pernambuco and Borborema of Paraíba Mesoregions / Migración y viaje a diario en municipios del clúster de la industria de confección de las mesorregiones Agreste de Pernambuco y Borborema de Paraíba

O objetivo deste artigo é avaliar indicadores de migração e mobilidade pendular da população residente em municípios selecionados de Pernambuco e da Paraíba, onde está localizado um aglomerado de confecções, paralelamente à evolução de indicadores da população ocupada em atividades econômicas que caracterizam o recorte territorial. A análise baseia-se nos microdados dos Censos Demográficos de 1991, 2000 e 2010. Os municípios foram classificados em três grupos, em função da trajetória histórica para o desenvolvimento do aglomerado e da participação da população em atividades de produção e comercialização de vestuário e acessórios. Verificou-se que, no período considerado, a população do aglomerado aumentou sua participação nos respectivos estados em função da atratividade migratória, fato confirmado pelos resultados do saldo migratório, mas com diferenças importantes entre os grupos. Também foi observado crescimento da participação da população ocupada nas atividades referidas. Foram encontradas evidências do transbordamento das atividades vinculadas às confecções dos municípios centrais para os municípios periféricos do aglomerado. Por fim, evidenciou-se a ampliação de movimentos pendulares para trabalho, juntamente com a maior integração dos municípios do aglomerado em função desses movimentos e dos fluxos migratórios.

This article aims to evaluate migration and commuting indicators of the resident population in selected municipalities of Pernambuco and Paraíba, where a cluster of garment industry and trade is located, in parallel to the evolution of indicators of population occupied in economic activities that characterize the territory. The analysis is based on the Demographic Census data of 1991, 2000, and 2010. The municipalities were classified into three groups according to the historical relevance to the cluster development and the proportion of the population occupied in activities related to the garment industry and trade. It was found that the total population of the cluster increased its participation in the corresponding states due to migration inflows, a fact confirmed by the net migration rate, but with important differences between municipalities. There was also increasing participation of those occupied in the referred activities. Evidence was found of the overflow of activities linked to the garment industry from the economic center to the cluster's peripheral municipalities. Finally, the expansion and increase of work commuting flows were observed, together with the greater integration of the municipalities in the cluster due to the current configuration of commuting and migratory flows.

Este artículo tiene como objetivo evaluar indicadores de migración y desplazamientos de la población residente en municipios seleccionados de Pernambuco y Paraíba, donde se ubica un clúster de industria y comercio de la confección, en paralelo a la evolución de indicadores de la población ocupada en actividades económicas que caracterizan el territorio. El análisis se basa en los datos de los censos demográficos de 1991, 2000 y 2010. Los municipios fueron clasificados en tres grupos según su relevancia histórica en el desarrollo del clúster y la proporción de la población ocupada en actividades relacionadas con la industria y el comercio de la confección. Se encontró que la población total del clúster aumentó su participación en los estados correspondientes debido a los flujos migratorios, hecho confirmado por la tasa neta de migración, pero con importantes diferencias entre municipios. También hubo una participación creciente de los ocupados en las actividades referidas. Se encontró evidencia del desbordamiento de actividades vinculadas a la industria de la confección desde el centro económico hacia los municipios periféricos del clúster. Finalmente, se observó la expansión y el aumento de los viajes a diario para trabajar, junto con la mayor integración de los municipios en el clúster debido a la configuración actual de los flujos migratorios y de viajes a diario para trabajo.