High Security Settings in Flanders: An Analysis of Discharged and Long-Term Forensic Psychiatric Patients.

Background: Two Forensic Psychiatric Centres (FPC) were implemented the last decade in Flanders in Ghent (2014) and Antwerp (2017). FPCs are forensic institutions for forensic psychiatric patients with a high recidivism risk and a high security need. The objective of FPCs is to create a care process with sufficient flow (from high to lower forms of security), and transitions (from specialized forensic care to regular psychiatric care). Aims: To examine the characteristics of the high security population in FPCs, treatment length, number of discharges, and discharge locations and to determine the profile of long-term patients within an FPC. Methods: A retrospective file study of an admission cohort of 654 patients admitted to FPC Ghent or FPC Antwerp was conducted. Sociodemographic, clinical, judicial and risk characteristics were analyzed. Bivariate analyses were used to test the difference between two groups: the group that was discharged to a lower security level vs. the group of long-term patients. Results: Most patients had psychosis and personality disorders, while comorbidity was also high. Judicial histories were extensive, with many sexual index offenses. During a 6-year follow-up period, the number of referrals back to prison was low. Nearly a third of the population was discharged to a setting with a lower security level. Long-term patients typically presented with more personality disorders, higher psychopathy traits and higher risk scores and were more frequently subjected to coercive measures during treatment. Conclusions: The Flemish FPC population is characterized by a high proportion of sex offenders as well as a high proportion of personality-disordered patients. It is this last group, and the group with elevated psychopathy traits, who remain for longer than expected and is difficult to resocialize. This study further highlights the need for clear criteria to assess the conditions of these long-term patients in Flanders.

More than Half: Multiracial Families in the World War II Japanese American Incarceration Camps.

In this first-person commentary, the author, an art historian, recounts family explorations of multiraciality and discrimination through her family's literal journey to 10 camps where Japanese Americans were incarcerated during a period of xenophobia following the bombing of Pearl Harbor in 1942. In addition to Japanese immigrants (Issei) who were banned from becoming U.S. citizens and their American-born children (Nisei), multiracial spouses and children with partial Japanese ancestry were also imprisoned. The War Relocation Authority (WRA) created a series of rules that applied to interracial married couples and multiracial children. Children with Japanese fathers were considered "more than half" Japanese with the belief that the male head of the household would establish and observe the family's cultural values and practices. Multiracial children with White fathers were treated more sympathetically stemming from a desire to protect them from absorbing Japanese customs and ideas. Within the camps, multiracial families were subject to ostracization by families of Japanese descent as well as military personnel. The author's children, upon entering public school, endured inquiries, taunts, and microagressions from peers. As parents, the author and her spouse, a fine art photographer, visited the camp locations to understand this dark period of U.S. to explore and document the places, talk with their children about their multiracial identities, and enable growth through experience and knowledge. All of the camps are in desolate locations and most are in ruins, but lingering discrimination from this egregious historical period exist and they affected the author's children.

O Iluminismo tardio no cemitério dos vivos: o manicômio judiciário na fronteira da reforma psiquiátrica brasileira / The late enlightenment in the cemetery of the living: The judicial asylum on the border of the Brazilian psychiatric reform / El Iluminismo tardío en el cementerio de los vivos: el manicomio judicial en la frontera de la reforma psiquiátrica brasileña

O artigo objetiva analisar os saberes e práticas dos operadores do direito e da psiquiatria em relação à Unidade Psiquiátrica de Custódia e Tratamento e seu lugar no contexto da Reforma Psiquiátrica brasileira. Analisa os argumentos que fundamentam as medidas de internação do ponto de vista jurídico e psiquiátrico e as soluções viáveis para o problema do manicômio judiciário frente ao imperativo da desinstitucionalização trazido pelo novo paradigma de Atenção Psicossocial. A investigação, pautando-se nos postulados da Análise Institucional, detectou como esses saberes e práticas atravessam o espaço institucional, moldando-o como um conjunto molar enrijecido e praticamente indiferenciado de outras estruturas prisionais comuns, diante da falência completa de um projeto terapêutico direcionado ao louco infrator.

The article's objective is to analyze the knowledge and practice of operators of laws and psychiatry in relation of Custody and Treatment Psychiatric Unit (UPCT in Brazilian Portuguese) and your place in the context of psychiatric Brazilian reform. It analyses the arguments that base the internment measures from the judiciary and psychiatric perspective, and the possible solutions to the judiciary asylum towards the mandatory of uninstitucionalization obliged from the new social attention paradigm. The research, based on Insitutional analysis postulates, detected how this knowledge and practice pass through the institutional space, shaping it like a stiffened molar set and practically non different of the regular prison structures, faced with the total failure of the therapeutics projects directed to the insane transgressor.

El artículo objetiva analizar los saberes y las prácticas de los profesionales del derecho y de la psiquiatría en relación con la Unidad Psiquiátrica de Custodia y Tratamiento y su lugar en el contexto de la Reforma Psiquiátrica brasileña. Analiza los argumentos que fundamentan las medidas de internación del punto de vista jurídico y psiquiátrico y las soluciones viables para el problema del manicomio judicial frente al imperativo de la desinstitucionalización transmitido por el nuevo paradigma de Atención Psicosocial. La investigación, pautándose en los postulados del Análisis Institucional, detectó como esos saberes y prácticas cruzan el espacio institucional, moldeándolo como un conjunto molar endurecido y prácticamente indiferenciado de otras estructuras penitenciarias comunes, delante de la quiebra completa de un proyecto terapéutico direccionado al loco infractor.

Internação compulsória e vida em cena: subjetividades em descompasso / Involuntary commitment and life on the scene: subjectives out of step / Ingreso obligatorio y vida en escena: subjetividades en descompaso

Este artigo apresenta resultados parciais de uma pesquisa que teve por objetivo analisar vidas submetidas à internação compulsória por meio de determinação judicial. Trata-se de uma abordagem qualitativa, que utilizou entrevista despadronizada com sete jovens residentes numa comunidade terapêutica de uma cidade do interior do Espírito Santo. Observou-se, pelos relatos, que as estratégias de regulamentação da vida, seja pela judicialização, seja pela medicalização, expressam o registro biopolítico sobre corpos de sujeitos que fogem da padronização dominante. Tais práticas revelam a expressão da captura dos modos de subjetivação e das formas de subjetividade, determinando-lhes um lugar no qual a vida se mantenha reificada na perspectiva da lógica capitalística.(AU)

This article presents the partial results of a research that aimed to analyze the lives of individuals subjected to involuntary commitment by judicial determination. This qualitative research included data collected by means of unstructured interviews conducted with seven young people living in a Therapeutic Community in a city from the countryside of Espírito Santo. The reports indicate that life regulation strategies, whether through judicialization or medicalization, express the biopolitical record over the bodies of subjects who escape dominant standards. Such practices express the capture of modes of subjectivation and forms of subjectivity, determining a place where life is reified in the perspective of capitalist logic.(AU)

Este artículo presenta los resultados de una investigación cuyo objetivo fue analizar las vidas insertados en un ingreso obligatorio por orden judicial. Este es un estudio cualitativo, que utilizó entrevista sin patrón con siete jóvenes residentes en una comunidad terapéutica de una ciudad en Espírito Santo (Brasil). A partir de la información de los informes, se observó que las estrategias de regulación de la vida, ya sea la legalización o la medicalización, son un registro biopolítico sobre cuerpos de sujetos que no siguen la norma dominante. Estas prácticas revelan la expresión de la captura de los modos y las formas de subjetividad, que determina un lugar donde la vida se mantiene cosificada en vista de la lógica capitalista.(AU)

A judicialização das internações compulsórias na saúde mental: gestão e intersetorialidade / The judicialization of compulsory hospitalizations in health. mental: management and intersectoriality

O estudo buscou identificar os casos de judicialização de internações compulsórias da saúde mental do município de Betim, Minas Gerais, no período de 2017 a 2019, visando estabelecer um fluxo de ações intersetoriais entre a justiça de 1o grau e a Secretaria Municipal de Saúde / Secretaria de Assistência Social, otimizando assim, a destinação de recursos financeiros ora empregados em cumprimento às decisões judiciais. Optou-se pela abordagem qualitativa, de pesquisa documental, com base nos dados primários contidos nos bancos de dados públicos e normativas do Município de Betim. Observou-se que, a judicialização do tratamento pacientes com transtorno mental se dá pelo não investimento nesse tipo de tratamento no município, visto que, o que poderia ser de fato menos dispendioso para a prefeitura se torna um valor a ser pago pelo município de forma inesperada e a qualquer momento, pela possibilidade de surgimento de nova judicialização para o custear o tratamento de algum outro paciente do município. Conclui-se que o transtorno psiquiátrico, embora seja estudado em todo o país, necessita de um aprofundamento com a finalidade de suavizar o sofrimento de pacientes e familiares. Foi observada a desassistência desses pacientes, ocasionando assim que as famílias buscassem o tratamento para os seus entes de forma judicial, o que poderia ser evitado se houvesse o investimento necessário por parte da prefeitura em questão.

The study sought to identify the cases of judicialization of compulsory hospitalizations of mental health in the municipality of Betim, Minas Gerais, in the period from 2017 to 2019, in order to establish a flow of intersectoral actions between the trial court and the Municipal Health Secretariat / Social Assistance department, thus optimizing the allocation of financial resources now employed in compliance with court decisions. We opted for a qualitative approach, of documentary research, based on primary data contained in public databases and norms of the Municipality of Betim. It was observed that the judicialization of the treatment of patients with metal disorder is due to the lack of investment in this type of treatment in the city, since what could be less expensive for the city becomes an amount to be paid by the city unexpectedly and at any time, due to the possibility of a new judicialization to pay for the treatment of another patient in the city. We conclude that the psychiatric disorder, although it has been studied all over the country, needs to be further studied in order to ease the suffering of patients and their families. The non-assistance of these patients was observed, thus causing the families to seek treatment for their loved ones in court, which could be avoided if there were the necessary investment by the city government in question.

Hospitalization costs and their determining factors among patients undergoing kidney transplantation: a cross-sectional descriptive study

ABSTRACT BACKGROUND: Cost evaluation is a key tool in monitoring expenditure for budget management. It increases the efficiency of possible changes through identifying potential savings and estimating the resources required to make such changes. However, there is a lack of knowledge of the total cost of hospitalization up to the clinical outcome, regarding patients admitted for kidney transplantation. Likewise, there is a lack of data on the factors that influence the amounts spent by hospital institutions and healthcare systems. OBJECTIVES: To describe the costs and determining factors relating to hospitalization of patients undergoing kidney transplantation. DESIGN AND SETTING: Cross-sectional descriptive study with a quantitative approach based on secondary data from 81 patients who were admitted for kidney transplantation at a leading transplantation center in southern Brazil. METHODS: The direct costs of healthcare for patients who underwent kidney transplantation were the dependent variable, and included personnel, expenses, third-party services, materials and medicines. The factors that interfered in the cost of the procedure were indirect variables. The items that made up these variables were gathered from the records of the internal transplantation committee and from the electronic medical records. The billing sector provided information on the direct costs per patient. RESULTS: The estimated total cost of patients' hospitalization was R$ 1,257,639.11 (US$ 571,010.44). Out of this amount, R$ 1,237,338.31 (US$ 561,793.20) was paid by the Brazilian National Health System and R$ 20,300.80 (US$ 9,217.24) by the transplantation center's own resources. The highest costs related to the length of hospital stay and clinical complications such as sepsis and pneumonia. CONCLUSIONS: The costs of hospitalization for kidney transplantation relate to the length of hospital stay and clinical complications.

Evolução do perfil das internações psiquiátricas pelo Sistema Único de Saúde em Minas Gerais, Brasil, 2001-2013 / The evolution of the profile of psychiatric admissions via the Unified Health System in Minas Gerais, Brazil, 2001-2013

Resumo O objetivo deste artigo é analisar a evolução no perfil das internações psiquiátricas pelo Sistema Único de Saúde em hospitais psiquiátricos do Estado de Minas Gerais entre 2001 e 2013. Os dados foram obtidos através do Departamento de Informática do SUS. A análise de tendência deu-se através de procedimentos de regressão, em que o ano foi variável independente e as variáveis dependentes foram as características dos pacientes (sexo, idade, diagnóstico) e das internações (localidade, natureza jurídica do hospital, tempo de permanência). Foram incluídas 202. 188 internações em 25 hospitais. Houve alterações significativas no perfil nosológico das internações psiquiátricas, com elevação da proporção das internações por transtornos ligados ao abuso de substâncias e redução por transtornos psicóticos. O estudo se insere no contexto da reforma da assistência à saúde mental em Minas Gerais, produzindo informações relevantes para subsidiar as políticas de saúde mental na direção à universalização, humanização e superação das desigualdades de acesso aos serviços de saúde.

Abstract The scope of this article is to analyze the evolution of the profile of psychiatric admissions via the Unified Health System in psychiatric hospitals of the State of Minas Gerais, Brazil, between 2001 and 2013. Data were obtained from the Information Technology Department of the Unified Health System. The analyses of trends were conducted by regression procedures, in which the independent variable was the year, and the dependent variables were the patients (sex, age, diagnosis) and admission characteristics (city, hospital administrative status, length of internment). A total of 202,188 admissions to 25 hospitals were appraised. There were significant changes in the diagnostic profiles of psychiatric admissions during the period under scrutiny, notably an increase in the proportion of admissions for substance abuse-related disorders and a reduction for psychotic disorders. This study is in tune with the context of the reform of mental healthcare in Minas Gerais, providing relevant input to support the mental health policies towards universalization, humanization and the overcoming of inequalities in access to health services.

Perfil epidemiológico de idosos com fraturas diversas, atendidos nos hospitais brasileiros: uma revisão de literatura / Epidemiological profile of elderly with diversified fractures, attended to in Brazilian hospitals: a literature review / Perfil epidemiológico de ancianos con fracturas varias, atendidosen hospitales brasileños: una revisión de literatura

Objetivou-se demonstrar o perfil epidemiológico de idosos com fraturas diversas, hospitalizados no Brasil, assim como a caracterização dessas fraturas. Trata-se de revisão de literatura mediante publicações no período entre 2007 e 2018, compondo uma amostra de 20 estudos selecionados. Evidenciou-se a fratura do fêmur em idosas, decorrente de queda da própria altura, com período de internação hospitalar entre uma e três semanas. Concluiu-se que é fundamental conhecer o perfil epidemiológico de idosos hospitalizados com fraturas para direcionar políticas públicas e dotação orçamentária.

The objective was to demonstrate the epidemiological profile of elderly with various fractures, hospitalized in Brazil, as well as the characterization of these fractures. It is a review of the literature through publications in the period between 2007 and 2018, composing a sample of 20 selected studies. The fracture of the femur in the elderly was evidenced due to fall of the height itself with a hospital stay of between one and three weeks. It was concluded that it is fundamental to know the profile of elderly hospitalized with fractures to direct public policies and budget allocation.

Se objetivó demostrar el perfil epidemiológico de los ancianos com fraturas diversas hospitalizados en Brasil, así como la caracterización de estas fracturas. Se trata de uma revisión de literatura mediante publicaciones en el período entre 2007 y 2018, componiendo una muestra de 20 estudios seleccionados. Se evidenció la fractura del fémur en ancianas derivada de caída de la propia altura con período de internación hospitalaria entre una y tres semanas. Se concluyó que es fundamental conocer el perfil de ancianos hospitalizados con fracturas para direccionar políticas públicas y dotación presupuestaria.

Internações por condições sensíveis a atenção primária em municípios de uma regional de saúde / Hospitalization for primary care sensitive conditions in cities of a regional health network

O presente estudo teve por objetivo analisar a efetividade do acesso ao atendimento na atenção primária por meio do levantamento dos números de internamentos por condições sensíveis a atenção primária ocorridos nos municípios com menos de 100% de cobertura da estratégia saúde da família na 8ª Regional de Saúde do Paraná. Ademais, buscou-se encontrar relação entre a cobertura da estratégia saúde da família com o número de internamentos por condições sensíveis a atenção primária. Trata-se de um estudo ecológico com dados secundários do Ministério da Saúde. Diante dos resultados encontrados pode-se observar que nos municípios de Francisco Beltrão, Ampére e Dois Vizinhos, foi identificado relação entre o aumento da cobertura da estratégia saúde da família e a diminuição de internamentos por condições sensíveis a atenção primária, contudo, apenas para Francisco Beltrão essa correlação foi forte e significativa. Neste aspecto, se faz necessário incentivar estudos que visem a avaliação dos serviços de saúde para embasar as decisões dos gestores em relação aos investimentos nos serviços de atenção primária a saúde, objetivando promover a oferta de serviços de qualidade e resolutivos. (AU)

The present study aimed to analyze the effectiveness of access to care in primary care facilities by collecting numbers of hospitalizations for sensitive primary care conditions in municipalities with less than 100% coverage of the family health strategy in the 8th Regional Health Network of Paraná. In addition, we sought to find a relationship between the coverage of the family health strategy and the number of hospitalizations due to conditions sensitive to primary care. In view of the results found, it can be observed that in the municipalities of Francisco Beltrão, Ampére and Dois Vizinhos, a relation between the increase in coverage of the family health strategy and the reduction of admissions due to sensitive primary care conditions was identified. However, only in the city of Francisco Beltrão this correlation was strong and significant. Thus, it is necessary to encourage studies aimed at evaluating health services to support the decisions of managers in relation to investments in primary health care services, aiming to promote the provision of quality and resolutive services. (AU)

The Application of the Technique in the Protection of PCI / 昆明医科大学学报

Objective To explore the treatment of percutaneous coronary intervention (PCI), and to comparatively study on the protection of side support by using the active and passive expansion technique.Method 78 patients with coronary artery disease were protected by using balloon technique, there were two groups: the active expansion group (n=41) and the side support balloon (n=37), the TIMI classification、myocardial perfusion rating (MBG), TIMI myocardial perfusion rating (TMP) and the incidence of marginal vascular interlayer were observed and analyzed. Results After the main support was put in, the proportion of patients with side branches of TIMI、 MBG and TMP was at level 3 and the proportion of patients with active balloon expansion was 93％, the margin expansion group was 84％, the difference was not statistically significant (P＞0.05); the incidence of intersecting vascular interlayer in active dilatation group was 24％, the margin expansion group was 8％, and there were statistical differences (P＜0.05). Conclusions Using the technique of holding balloon to protect the side branches, both the active expansion of the side support balloon and the expansion of the side support balloon can significantly reduce the risk of the main stent placement in the posterior branch of the blood vessel, however the incidence of side branch vascular interlayer was lower.

Trayectoria de una joven reclusa en relación con el consumo de drogas y condicionamientos de género / Trajectory of a young female inmate in relation to drug use and gender-based constraints

RESUMEN Este texto se propone analizar aspectos socioculturales en relación con la trayectoria de consumo habitual de sustancias psicoativas de una joven reclusa. La joven se encontraba en un centro de reclusión para menores en Medellín, donde se realizaron entrevistas y observación participante. Se evidenció la importancia de aspectos relativos al género como elemento protector y también de riesgo. Finalmente, se presentan algunos elementos relativos al proceso de desintoxicación mientras cumplía su sanción en internamiento.(AU)

ABSTRACT This text aims to analyze socio-cultural aspects in relation to the trajectory of habitual consumption of psychoactive substances of a young inmate. The young woman was in a detention center for minors in Medellin, Colombia, where interviews were conducted and participant observation was carried out. From there, the importance of aspects related to gender as a protective and risk elements was evident. Finally, this study presents some elements related to the detoxification process while she was following her sanction in internment.(AU)

How family members of mentally ill offenders experience the internment measure and (forensic) psychiatric treatment in Belgium: A qualitative study.

Mentally ill offenders in Belgium can be subjected to mandated care under an "internment measure" if they are viewed as a danger to society. This study investigated how family members of mentally ill offenders experience this internment measure and view the (forensic) psychiatric treatment of their relative. Semi-structured interviews were conducted with 24 relatives and analysed using Nvivo 11. Six different themes emerged: (1) the criminal offence and the internment measure as an additional stigma, (2) ambivalent feelings towards the judicial system, (3) prison is not the right place to be, (4) mental health support as an answer to problems, (5) fight a losing battle, and (6) while there is life there is hope. The experiences of family members indicate the need for improved treatment guidelines that allow earlier compulsory interventions to prevent crime and preferential admission to (forensic) psychiatric facilities rather than prisons. In addition, family members expressed the need for better communication from mental health professionals and the judicial system during the process and greater availability of peer support.

Levantamento do perfil das vítimas de acidentes motociclísticos internadas em um hospital público de Santa Catarina / Survey of the profile of victims of motorcycle accidents admitted to a public hospital in Santa Catarina

Os motociclistas são as vítimas de trauma fechado mais frequentemente atendidas nas emergências dos Hospitais. O estudo teve como objetivo investigar o perfil das vítimas de acidentes motociclísticos internadas em um Hospital Público de Santa Catarina. Trata-se de uma pesquisa descritiva, documental e com abordagem quantitativa desenvolvida em um Hospital, mediante utilização de técnica de análise de registros institucionais em 271 prontuários de vítimas de acidentes motociclísticos internadas entre dezembro de 2014 e julho de 2015. Os resultados mostram que a maioria das vítimas são homens (77,5%), solteiros (52,8%), com média de idade de 32 anos. O tipo de colisão mais frequente foi moto com carro e ocorreram no período noturno. As lesões mais comuns foram as fraturas dos membros inferiores. A média dos custos das internações hospitalares foi de R$ 2.095,00 e o custo total dessas internações foi de R$ 540.660,60. Conclui-se que homens na faixa de idade de maior produção humana são as vítimas mais acometidas nos acidentes motociclísticos com lesões graves como fraturas, necessitando de tratamento cirúrgico e maior tempo de internação hospitalar resultando em altos custos. Ações preventivas e de educação no trânsito devem ser realizadas continuamente, com ênfase aos riscos associados a esse tipo de transporte, lesões e custos gerados.

Motorcycle riders are the victims o closed trauma more frequently attended in hospital emergencies. This study had as aim to investigate the motorcycle accident victims' profile admitted in a public hospital in Santa Catarina. This is a descriptive and documental research with qualitative approach carried out in a hospital using the technique of institutional report analysis in 271 motorcycle accident victim reports admitted from December 2014 to July 2015. The results showed that most victims are male (77.5%), single (52.8%), with medium age at 32 years old. The most frequent kind of collision was between motorcycle and car and they occurred in the night time. Most common lesions were fractures of lower members. The cost average of the hospital internment was R$ 2.905,00 (Brazilian currency) and the total cost was R$ 540.660,60. We concluded that men in the most human production age range are the most affected victims with serious injuries, like fractures and necessity of surgical treatment and longer time of hospital internment, resulting in high costs. Preventive actions and traffic education should be performed continuously, with emphasis in associated risks to this kind of transportation, injuries and costs generated.

A Família no contexto da hospitalização: revisão sistemática / The family in the context of hospitalization: a systematic revision / La familia en el context de hospitalización: revisión sistemática

A pesquisa objetivou apresentar uma revisão sistemática de artigos científicos sobre a família no contexto da hospitalização. Nas bases de dados (Lilacs, Medline, IBECS, PsycINFO, Wiley Interscience, Pubmed, Web of Science) buscou-se selecionar os estudos empíricos publicados entre 2007-2012. Foram construídas categorias para analisar estes estudos: família e criança hospitalizada, família e adulto hospitalizado, família e idoso hospitalizado. Estas pesquisas enfatizam a vivência de familiares, avaliação de estresse e estratégias de enfrentamento, e a relação equipe de saúde e família. Foram identificados maior número de publicações sobre família e criança hospitalizada, e estes estudos apresentam as alterações que ocorrem na dinâmica familiar, diante da situação de doença e hospitalização. Existe a necessidade da atenção integral à família do paciente hospitalizado para promover o acolhimento e minimizar o sofrimento ocasionado pelo processo de hospitalização. Estes resultados das pesquisas sobre famílias de pacientes hospitalizados auxiliam a construção de propostas de avaliação e intervenção psicológica. (AU)

The research aimed to present a bibliometric study of scientific articles about the family in the context of hospitalization. From queries in databases (Lilacs, Medline, IBECS, PsycINFO, Wiley Interscience, Pubmed, Web of Science) was able to select the empirical studies published between 2007-2012. Categories were built to analyze these studies: family and child hospitalized, family and adult hospitalized, family and elderly hospitalized. These studies emphasize the family experience, evaluation of the levels of stress and coping strategies, and relationship team of health and family. The studies highlight changes that occur in family dynamics on the disease situation and hospitalization of a member. There is a need for comprehensive care family of hospitalized patients to promote the acceptance and minimize the suffering caused by the process of hospitalization. These results of research on families of hospitalized patients build proposals for evaluation and psychological intervention. (AU)

La investigación pretende presentar un estudio bibliométrico de los artículos científicos sobre la família en el contexto de hospitalización. De las consultas sobre bases de datos (Lilacs, Medline, IBECS, PsycINFO, Wiley Interscience, Pubmed, Web of Science) fue posible seleccionar los estudios empíricos publicados entre 2007-2012. Categorías fueron construidos para analizar estos estudios: familia y niño hospitalizado, familia y adulto hospitalizado, familia y personas de edad avanzada hospitalizados. Estos estudios enfatizan la experiencia de los familiares, la evaluación de estrategias de estrés y afrontamiento y relación equipo de salud y familia. Mayor cantidad de publicaciones sobre la familia y el niño hospitalizado, y estos estudios ponen de relieve los cambios que ocurren en la dinámica familiar ante la situación de enfermedad y hospitalización. Estos resultados de la investigación sobre las familias de los pacientes hospitalizados ayudan a construir propuestas para la evaluación e intervención psicológica. (AU)

Environmental, dietary and case-control study of Nodding Syndrome in Uganda: A post-measles brain disorder triggered by malnutrition?

Nodding Syndrome (NS) is an epileptic encephalopathy characterized by involuntary vertical head nodding, other types of seizures, and progressive neurological deficits. The etiology of the east African NS epidemic is unknown. In March 2014, we conducted a case-control study of medical, nutritional and other risk factors associated with NS among children (aged 5-18years) of Kitgum District, northern Uganda (Acholiland). Data on food availability, rainfall, and prevalent disease temporally related to the NS epidemic were also analyzed. In NS Cases, the mean age of reported head nodding onset was 7.6years (range 1-17years). The epidemiologic curve of NS incidence spanned 2000-2013, with peaks in 2003 and 2008. Month of onset of head nodding was non-uniform, with all-year-aggregated peaks in April and June when food availability was low. Families with one or more NS Cases had been significantly more dependent on emergency food and, immediately prior to head nodding onset in the child, subsistence on moldy plant materials, specifically moldy maize. Medical history revealed a single significant association with NS, namely prior measles infection. NS is compared with the post-measles disorder subacute sclerosing panencephalitis, with clinical expression triggered by factors associated with poor nutrition.

Should inpatients be adjusted by their complexity and severity for efficiency assessment? Evidence from Portugal.

Hospital efficiency analysis depends largely on the model specifications. This study discusses the importance of the case-mix index (CMI) to homogenize the sample of inpatient discharges. It proposes a new index where they are classified by service, since it is usual to have lack of data to compute the CMI and this can influence the credibility of results. Data from the Portuguese national diagnosis-related group (DRG) database was utilized. Three different approaches are developed in this paper, based on locally convex order-m method as well as on translog functions. The first one correlates the efficiency with different inpatients weighting schemes, by using the Nadaraya-Watson method. The second approach compares different frontiers that have been computed using the different weighting schemes. Finally, by using bootstrap, the paper investigates whether the inclusion of severity/ complexity-related variables in the model statistically modifies the results. It has been shown that, under the Portuguese healthcare framework, if the model is environment corrected (which should include epidemiological and main political/ structural health reforms variables), then the severity adjustment of inpatients is pointless. The employment of an inpatient-weighting scheme, such as the CMI, may introduce significant frontier shift, thus its absence is not recommended in productivity evolution analyzes. The CMI shifts the efficiency frontier, but not the relative position of units against it (the last scenario if exogenous variables are present).

Dromokaition Psychiatric Hospital of Athens: from its establishment in 1887 to the era of deinstitutionalization.

Dromokaition Psychiatric Hospital opened its doors in 1887, following the donation made by Zorzis Dromokaitis from the island of Chios. Private donations and all forms of charities had contributed to a large extent in the establishment of hospitals across Greece, during the late 19th and the early 20th century. Dromokaition was one of them but it was also unique, as it was the first psychiatric hospital in Athens, admitting patients from every part of the country. This paper aimed at highlighting the long service of the institution through the different historical periods the country went through. We present the chronicle of its foundation, the development of its inner structure, and the medical and organizational influences which it received, along the way. The therapeutic methods used during the first decades of its operation reflected the corresponding European standards of the time. As a model institution from its foundation, it followed closely the prevailing European guidelines, throughout its historical path, either as an independent institution or as an integrated one within the National Health Service.

La internación psiquiátrica por razón penal en España: ejecución de la medida en el ámbito penitenciario / Psychiatric internment for criminal reasons in Spain: measure enforcement or implementation in the prison environment / O internamento psiquiátrico devido à razão penal na Espanha: execução da medida no âmbitopenitenciário

La inimputabilidad o semiimputabilidad del sujeto aquejado de un trastorno psíquico que comete una infracción penal, es asumida por la mayoría de las naciones desde antiguo, aunque las respuestas penales ante tal tipo de conductas difieren de manera considerable. El objetivo es analizar la ejecución de medidas de seguridad privativas de libertad (internación/internamiento) en España, para sujetos inimputables del delito por razón de trastorno psíquico y para aquellos con trastorno psíquico sobrevenido a la sentencia. El Método seguido ha consistido en estudiar la normativa aplicable a dichas medidas y la práctica de su ejecución, con especial mención a la implementación de determinados programas de tratamiento. Los resultados obtenidos ponen de relieve la existencia de un aceptable marco normativo, que incluye numerosas alternativas al internamiento, y el éxito del Programa de "Salidas Terapéuticas". Se concluye que: a) el marco legal es el adecuado, aunque demanda reformas en la esfera del control judicial; b) es plausible continuar con el programa de salidas de pacientes, y c) es preciso reforzar los mecanismos y recursos de rehabilitación social pospenitenciaria.

The unimputability or semi-unimputability of a patient with a psychic disorder having committed a criminal offense has been assumed by must nations for a long time, although the judicial responses in the face of such kind of conducts differ in a very significant way. The objective here is to analyze the enforcement of security measures involving deprivation of liberty (internment/detention) in Spain for unimputable individuals, i.e. not subject to criminal liability because of their psychic disorder and for those with some sudden mental illness subsequent to the sentence. The method followed here has consisted of studying the legislation or rules applicable to any such measures and their, with particular reference to the implementation of certain treatment programs. The results obtained highlight the existence of an acceptable normative framework including a good number of alternative measures to detention, as well as the success of the "salidas terapéuticas" (therapeutical leaves of absence or releases from the detention premises). It has been concluded that: a) the legal framework is the appropriate, although it calls for reforms within the judicial control sphere; b) the continuation of the patients' leaves of absence program is commendable and plausible, and c) it is necessary to reinforce post-rehabilitation mechanisms and resources.

A inimputabilidade ou o semiimputabilidade do sujeito afetado por uma doença mental que comete uma infração penal, é assumida pela maioria das naçõeshámuito tempo, embora as respostas penais perante tal tipo de condutas difiram de jeito considerável. O objetivo é analisar a execução de medidas de segurança privativas da liberdade (internamento) em Espanha, para sujeitos inimputáveis do crime por causa da doença mental e para aquelas com doença mental acontecida apos à sentença. O Método seguido consistiu estudar a norma aplicável a estas medidas e à prática de sua execução, com menção especial à implementação de determinados programas do tratamento. Os resultados obtidos evidenciam a existência de um quadro normativo aceitável, que inclui alternativas numerosas ao internamento, e o sucesso do programa de "saídasterapêuticas". Conclui-se que: a) o quadro legal é certo, embora precisam-se reformas na esfera do controle judicial; b) é razoável continuar com o programa das saídas dos pacientes, e c) é preciso reforçar os mecanismos e os recursos da reabilitação social pospenitenciaria.

Medida socioeducativa de internação: dos corpos dóceis às vidas nuas / Socio-educational internment measure: from docile bodies to naked Lives / Medida socioeducativa de internación: de los cuerpos dóciles a las vidas desnudas

O presente artigo tem como objetivo a problematização dos modos pelos quais a tecnologia disciplinar, presente nas medidas socioeducativas de internação direcionadas aos jovens em conflito com a lei, vem sendo operacionalizada. Tomamos como fio condutor as reflexões de Michel Foucault e Giorgio Agamben para problematizar a vida enquanto objeto político a ser governado para determinado fim e que sofre intervenções não apenas para seu fortalecimento, mas que levam à desproteção jurídica e à morte política, ou mesmo biológica. A investigação se desenvolveu em três momentos metodológicos: oitiva de audiências na Vara da Infância e da Juventude, visita a uma unidade educacional de internação e leitura de processos jurídicos e das normativas legais voltadas para a população em questão. Assim, por meio do que encontramos na pesquisa, entende-se que a tecnologia disciplinar, do modo que vem sendo utilizada nas medidas socioeducativas de internação, assemelha-se mais a um dispositivo de controle com o objetivo meramente de docilizá-los, reduzindo o sujeito à vida nua; isto é, como mero corpo biológico que sofre efeitos de uma ação, do que propriamente um método socioeducativo como estabelecem o Estatuto da Criança e do Adolescente e o Sistema Nacional de Atendimento Socioeducativo...

This article aims to discuss the ways in which technology disciplinary, present in socio-educational measures targeted at young people who have conflicts with the law, has been operationalized. We take as a guiding principle the considerations of Michel Foucault and Giorgio Agamben to discuss life as a political object to be ruled over for a particular purpose and which suffers not only interventions to strengthen them, but that lead to legal unprotection and political, or even biological, death. The research was developed in three moments: eighth hearing of the Childhood and Youth Judicial Court, visit to an educational unit of internment, and reading of legal cases and legal norms aimed at the population in question. Thus, through what we found in the research, one understands that disciplinary technology, the way it has been used in educational internment measures, resembles more of a control mechanism with the goal of merely pacifying them, reducing the subject to a naked life; that is, as a mere biological body that suffers the effects of an action, rather than an educational method as is established by the Statute of Children and Adolescents and the National System of Educational Assistance...

El presente artículo tiene como objetivo la problematización de los modos por los cuales la tecnología disciplinaria, presente en las medidas socioeducativas de internación dirigidas a los jóvenes en conflicto con la ley, viene siendo operacionalizada. Tomamos como hilo conductor las reflexiones de Michel Foucault y Giorgio Agamben para problematizar la vida como objeto político a ser gobernado para determinado fin y que sufre intervenciones no unicamente para su fortalecimiento, sino que llevan a la desprotección jurídica y a la muerte política, o incluso biológica. La investigación se desarrolló en tres momentos metodológicos: audición de audiencias en la Vara de la Infancia y de la Juventud, visita a una unidad educacional de internación y lectura de procesos jurídicos y de las normativas legales orientadas para la población en cuestión. Así pues, por medio de lo que encontramos en la pesquisa, se entiende que la tecnología disciplinaria, del modo que viene siendo utilizada en las medidas socioeducativas de internación, se asemeja más a un dispositivo de control con el objetivo meramente de tornar dócil al sujeto, reduciéndolo a la vida desnuda; o lo que es lo mismo, como mero cuerpo biológico que sufre efectos de una acción, más que propiamente un método socioeducativo como establecen el Estatuto de los Niños y Adolescentes y el Sistema Nacional de Atención Socioeducativa...