scholarly journals Discussão de casos e rodas de conversa: instrumentos para a melhoria do atendimento de pessoas com transtorno ou deficiência, envolvendo saúde mental, na Defensoria Pública do Estado de São Paulo / Case discussions and conversations: instruments to improve the assistance to people with mental health disorders or disabilities in the Public Defender's office of the State of São Paulo

2021 ◽  
Vol 7 (4) ◽  
pp. 35015-35036
Author(s):  
Eleonora Nanni Lucenti ◽  
Rachel de Miranda Taveira ◽  
Teresa Cristina Endo
2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Joseph ◽  
H Sankar ◽  
D Nambiar

Abstract The fourth target of Sustainable Development Goal (SDG) 3 advocates for the promotion of mental health and wellbeing. The Indian state of Kerala is recognized for its gains in health and development but has substantial burden of mental health ailments. Historical analysis is vital to understand the pattern of mental health morbidity. The current study focusses on comparable estimates available from three largescale population-based surveys in India to explore trends in prevalence of mental health disorders over the years and map resources and infrastructure available for mental health care in Kerala. We undertook a secondary analysis of national demographic surveys from 2002 to 2018 which reported information on mental health and availability of health infrastructure and human resources. Data were collated and descriptive analyses were conducted. We compared the national and state level estimates over the years to study the trend in the prevalence of mental health disability. The prevalence of mental retardation and intellectual disability in Kerala increased from 194 per hundred thousand persons in 2002 to 300 per hundred thousand persons in 2018, two times higher to the national average. The prevalence of mental illness increased from 272 per hundred thousand people to 400 per hundred thousand people in sixteen years. The prevalence was higher among males (statistical significance was not indicated) in mental illness and mental retardation. 2018 data showed that the public sector had 0.01 hospitals and 5.53 beds per hundred thousand persons available for mental health treatment. Results showed a substantial increase in mental health illness over the 16-year study period that has affected males and females, as well as all social classes of the state. The current health infrastructure and human resources in the public sector of the state are inadequate to meet the current burden of the problem and to ensure universal access to care for its population. Key messages The trend in prevalence of mental health disorders in the state is increasing across the years. There is a mismatch between the extend of the problem and resources available in public sector.


Author(s):  
Alessandra Freire Reis ◽  
Odaléia Telles Marcondes Machado Queiroz

A discussão sobre a concessão das unidades de conservação é extremamente importante e tem gerado polêmica no Estado de São Paulo, devido à aprovação da Lei Nº 16.260, de 29 de junho de 2016, que “autoriza a Fazenda do Estado a conceder a exploração de serviços ou o uso, total ou parcial, de áreas em próprios estaduais”. A pesquisa e o debate sobre o tema são fundamentais para compreensão e reflexão das possibilidades e consequências da escolha deste caminho para as UCs, ainda que estes devessem anteceder a tomada de decisão. As atividades turísticas e de lazer estão dentre os principais serviços a serem concedidos a iniciativa privada nos Parques Estaduais. Embora essas atividades estejam dentre os objetivos deste tipo de categoria de UC é preeminente ressaltar que a conservação deve nortear a gestão. O Estado é responsável por proteger importantes fragmentos de Mata Atlântica e Cerrado, em áreas com diferentes tipos de ocupação e pressão. Para tanto, necessita de investimento em pessoal capacitado, infraestrutura e equipamentos, além do apoio e diálogo com comunidades tradicionais, que tenham relação com as áreas. O que se observa atualmente é a precarização dos serviços prestados, em que os servidores públicos não têm plano de carreira e os guarda-parques, funcionários primordiais para essas áreas, estão se extinguindo e com eles todo um rico conhecimento. A maioria dos gestores é comissionada e em alguns casos não tem formação adequada para função. A fiscalização é terceirizada e patrimonial deixando que a Floresta propriamente dita, fique a mercê de usos indevidos e inadequados como ocupação irregular, extração de flora, caça, depósito de entulhos, entre outros. É fato que as atividades de uso público realizadas atualmente estão aquém das possibilidades dos parques. A concessão de serviços como alimentação, hospedagem, aluguel de equipamentos e implantação de estruturas para atividades de ecoturismo podem sim ser uma alternativa para dinamizar o uso desses espaços e gerar recursos. Há diversos exemplos de sucesso no exterior e no Brasil, que podem ser inspiradores. Porém, é necessário fundamentalmente que o Estado assuma a responsabilidade legal de salvaguardar as UCs, valorizando a carreira dos servidores públicos investindo em concursos e capacitações. Somente com uma estrutura organizacional fortalecida será possível conduzir com eficiência processos de concessão, que contribuam com a otimização de uso adequado desses espaços. As UCs fornecem serviços ambientais imensuráveis e dentre eles estão às oportunidades turismo, lazer e recreação. Tourism Concessions in Protected Areas of São Paulo state (Brazil): reflections, opportunities and challenges ABSTRACT The discussion on the concession of protected areas is extremely important and has generated controversy in the State of São Paulo, due to the approval of the draft law Nº 16.260, that "authorizes the State Treasury to grant the exploitation of services or use of all or part of areas in state themselves." Research and debate on the subject are fundamental to understanding and reflection of the possibilities and consequences of choosing this way for protected area, even if they were to precede decision-making. Tourist and leisure activities are among the main services to be granted to private initiative in the State Parks. Although these activities are among the goals of that category of PA is paramount to emphasize that conservation should guide the management. The State is responsible for protecting important fragments of Atlantic Forest and Savannah, in areas with different types of occupation and pressure. Therefore, it needs investment in trained personnel, infrastructure and equipment, and support and dialogue with traditional communities that relate to the areas. What we currently see is the precariousness of services, where public servants have no career plan and park rangers, primary staff to these areas, they are dying off and with them a whole wealth of knowledge. Most managers are commissioned and in some cases do not have adequate training to function. The inspection is outsourced and property letting the forest itself, be at the mercy of undue and inappropriate uses such as illegal occupation, flora extraction, hunting, debris deposit, among others. It is true that the public use activities currently performed are beyond the means of the parks. The concession of services such as food, lodging, equipment rental and implementation of ecotourism activities to structures can indeed be an alternative to boost the use of these spaces and generate resources. There are many examples of success in Brazil and abroad, which can be inspiring. However, it is fundamentally necessary that the State assumes the legal responsibility to safeguard the protected areas, enhancing the careers of public servants investing in competitions and training. Only with a strengthened organizational structure will be possible to drive efficiently concession processes that contribute to the optimization of appropriate use of these spaces. PAs provide immeasurable environmental services and among them are the opportunities tourism, leisure and recreation. KEYWORDS: State Parks; Public Use; Management; Conservation.


2006 ◽  
Vol 40 (2) ◽  
pp. 304-309 ◽  
Author(s):  
Raquel Jales Leitão ◽  
Marcos Bosi Ferraz ◽  
Ana Cristina Chaves ◽  
Jair J Mari

OBJECTIVE: To estimate the direct costs of schizophrenia for the public sector. METHODS: A study was carried out in the state of São Paulo, Brazil, during 1998. Data from the medical literature and governmental research bodies were gathered for estimating the total number of schizophrenia patients covered by the Brazilian Unified Health System. A decision tree was built based on an estimated distribution of patients under different types of psychiatric care. Medical charts from public hospitals and outpatient services were used to estimate the resources used over a one-year period. Direct costs were calculated by attributing monetary values for each resource used. RESULTS: Of all patients, 81.5% were covered by the public sector and distributed as follows: 6.0% in psychiatric hospital admissions, 23.0% in outpatient care, and 71.0% without regular treatment. The total direct cost of schizophrenia was US$191,781,327 (2.2% of the total health care expenditure in the state). Of this total, 11.0% was spent on outpatient care and 79.2% went for inpatient care. CONCLUSIONS: Most schizophrenia patients in the state of São Paulo receive no regular treatment. The study findings point out to the importance of investing in research aimed at improving the resource allocation for the treatment of mental disorders in Brazil.


2016 ◽  
Vol 47 (4) ◽  
pp. 436-444 ◽  
Author(s):  
Katarzyna A. Knopp

Abstract This study investigates the relationship between EI and the state of mental health of unemployed persons. Gender differences were also identified in terms of mental health and its correlation with EI. A sample of 160 Polish unemployed persons aged 35 to 45 years filled in self-descriptive measures of EI and mental health. Significant gender differences were found - unemployed women were characterised by a greater intensity of mental health disorders than unemployed men. EI was negatively correlated with mental health disorders, but the correlations were few and weaker than expected. However, when unemployed persons with a low, average and high EI were compared, it turned out that participants with a low EI were characterised by a significantly worse condition of mental health than participants with a average or high EI.


2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Juliana de Souza Rosa ◽  
Patrick de Abreu Cunha Lopes ◽  
Bárbara Tisse da Silva ◽  
Heloá Santos Faria da Silva ◽  
...  

Background: Polyradiculoneuritis is considered to be the biggest cause of flaccid paralysis in the world and even after the progression phase, some patients may present with disabling residual deficits, both sensory and motor. Objectives: Analyze the current panorama of treatment procedures for acute demyelinating polyradiculoneuritis performed in the State of São Paulo and correlate the current epidemiology with the results obtained. Methods: A literature review and an observational, descriptive and transversal data collect on treatment for acute demyelinating polyradiculoneuritis, available at DATASUS from January 2008 to December 2020, and articles available at Scielo and PubMed. Results: There were 7,917 hospitalizations, representing a total expenditure of R$ 9,392,552.04, 2009 being the year with the highest number of hospitalizations (809) and 2017 with the highest amount spent during the period (R$ 967,284.65). 805 are elective and 7,109 are urgent, with 1,736 occurring in the public sector and 3,506 in the private sector. All of them were considered medium complexity. The total mortality rate was 1.57, corresponding to 124 deaths, 2019 being the year with the highest mortality rate, 2.94, and 2015 with the lowest rate, 0.53. The mortality rate for elective procedures was 0.99 compared to 1.63 for urgent procedures, whereas in the public sector it was 1.61 compared to 1.23 for the private sector. The average total hospital stay was 8.3 days, with an average cost of R$ 1,186.38. Conclusion: It is important to correctly notify the procedures performed, improving the epidemiological analysis and directing investments in health more appropriately.


2022 ◽  
Vol 18 (1) ◽  
pp. 209-238
Author(s):  
Gabriel Batista Mota

This work promotes an initial analysis, about the teaching knowledge about LGBTphobia present within the public education system, carried out based on the data acquired through anonline survey conducted in the second half of 2019 with teachers from the state schools of the São Paulo and which aimed to investigate the level of knowledge of these professionals about LGBTphobic bullying in the educational sphere of São Paulo. The methodological resources used in the data collection were of a quantitative nature and the phase of preparation of this article made use of the qualitative and bibliographic. As a result, it was concluded that LGBTs are the main target group of discriminationin public schools of the state of São Paulo, in addition to the little knowledge and skill of teachers on issues involving sexualitiesand prejudice in contemporary's Brazil.


2017 ◽  
Vol 11 (2) ◽  
pp. 188
Author(s):  
Cláudia Souza Passador ◽  
Joao Luiz Passador ◽  
Julio Araujo Carneiro da Cunha

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Juan Stuardo Yazlle Rocha ◽  
Rosane Aparecida Monteiro ◽  
Marizélia Leão Moreira

OBJECTIVE To describe the migration flows of demand for public and private hospital care among the health regions of the state of Sao Paulo, Brazil. METHODS Study based on a database of hospitalizations in the public and private systems of the state of Sao Paulo, Southeastern Brazil, in 2006. We analyzed data from 17 health regions of the state, considering people hospitalized in their own health region and those who migrated outwards (emigration) or came from other regions (immigration). The index of migration effectiveness of patients from both systems was estimated. The coverage (hospitalization coefficient) was analyzed in relation to the number of inpatient beds per population and the indexes of migration effectiveness. RESULTS The index of migration effectiveness applied to the hospital care demand flow allowed characterizing health regions with flow balance, with high emigration of public and private patients, and with high attraction of public and private patients. CONCLUSIONS There are differences in hospital care access and opportunities among health regions in the state of Sao Paulo, Brazil.


2021 ◽  
Vol 9 (207) ◽  
pp. 1-31
Author(s):  
Bruna Serafim Teixeira

The motivation for the public service of civil servants is an essential factor for the pursuit of public ends with a view to guaranteeing social welfare, the ultimate objective of the State. In this context, public servants are inserted as guarantors of this purpose, and the motivating factors and those that generate dissatisfaction must be constantly analyzed by the decisionmaking managers of the Administration bodies. Based on the study by Perry (1996), adapted for the Brazilian scenario in an unprecedented study carried out by Moraes (2017), the Public Service Motivation (PSM) scale was used to measure the motivation for the public service of the civil servants of the social security agency of the State of São Paulo, as well as analyzing, by the quantitative method, motivating factors, as well as causes of dissatisfaction, relevant to the provision of public service. It was found that factors such as salary and difficulty in career progression are causes that, in addition to generating dissatisfaction, are capable of affecting motivation, which prevails among civil servants at the beginning of their careers and in technical positions, with less autonomy, responsibility and education level. In this sense, it is necessary to adopt measures capable of supplying or minimizing such effects in order to increase the levels of motivation and satisfaction for the public service, which are able to increase the effectiveness and productivity in the provision of the public service. Measures such as a fairer and more attractive career progression plan, greater autonomy and power to participate in decision-making can favor this scenario.


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