Barriers and Facilitators of Ambient Assisted Living Systems: A Systematic Literature Review.

Ambient Assisted Living Systems (AALSs) use information and communication technologies to support care for the growing population of older adults. AALSs focus on providing multidimensional support to families, primary care facilities, and patients to improve the quality of life of the elderly. The literature has studied the qualities of AALSs from different perspectives; however, there has been little discussion regarding the operational experience of developing and deploying such systems. This paper presents a literature review based on the PRISMA methodology regarding operational facilitators and barriers of AALSs. This study identified 750 papers, of which 61 were selected. The results indicated that the selected studies mentioned more barriers than facilitators. Both barriers and facilitators concentrate on aspects of developing and configuring the technological infrastructure of AALSs. This study organizes and describes the current literature on the challenges and opportunities regarding the operation of AALSs in practice, which translates into support for practitioners when developing and deploying AALSs.

Framework for Simultaneous Indoor Localization, Mapping, and Human Activity Recognition in Ambient Assisted Living Scenarios.

Indoor localization and human activity recognition are two important sources of information to provide context-based assistance. This information is relevant in ambient assisted living (AAL) scenarios, where older adults usually need supervision and assistance in their daily activities. However, indoor localization and human activity recognition have been mostly considered isolated problems. This work presents and evaluates a framework that takes advantage of the relationship between location and activity to simultaneously perform indoor localization, mapping, and human activity recognition. The proposed framework provides a non-intrusive configuration, which fuses data from an inertial measurement unit (IMU) placed in the person's shoe, with proximity and human activity-related data from Bluetooth low energy beacons (BLE) deployed in the indoor environment. A variant of the simultaneous location and mapping (SLAM) framework was used to fuse the location and human activity recognition (HAR) data. HAR was performed using data streaming algorithms. The framework was evaluated in a pilot study, using data from 22 people, 11 young people, and 11 older adults (people aged 65 years or older). As a result, seven activities of daily living were recognized with an F1 score of 88%, and the in-door location error was 0.98 ± 0.36 m for the young and 1.02 ± 0.24 m for the older adults. Furthermore, there were no significant differences between the groups, indicating that our proposed method works adequately in broad age ranges.

Human Activity Recognition Data Analysis: History, Evolutions, and New Trends.

The Assisted Living Environments Research Area-AAL (Ambient Assisted Living), focuses on generating innovative technology, products, and services to assist, medical care and rehabilitation to older adults, to increase the time in which these people can live. independently, whether they suffer from neurodegenerative diseases or some disability. This important area is responsible for the development of activity recognition systems-ARS (Activity Recognition Systems), which is a valuable tool when it comes to identifying the type of activity carried out by older adults, to provide them with assistance. that allows you to carry out your daily activities with complete normality. This article aims to show the review of the literature and the evolution of the different techniques for processing this type of data from supervised, unsupervised, ensembled learning, deep learning, reinforcement learning, transfer learning, and metaheuristics approach applied to this sector of science. health, showing the metrics of recent experiments for researchers in this area of knowledge. As a result of this article, it can be identified that models based on reinforcement or transfer learning constitute a good line of work for the processing and analysis of human recognition activities.

Quality of Life and Functioning of People With Mental Disorders Who Underwent Deinstitutionalization Using Assisted Living Facilities: A Cross-Sectional Study.

CONTEXT: People with mental disorders can acquire long-term disabilities, which could impair their functioning and quality of life (QoL), requiring permanent care and social support. Systematic data on QoL and functioning, which could support a better management of these people, were not available. OBJECTIVE: To analyze the QoL, level of functioning and their association with sociodemographic and clinical factors of people with mental disorders who underwent deinstitutionalization using assisted living facilities. METHODS: A Cross-sectional study was conducted between July 2018 and July 2019, through interviews using the World Health Organization Quality of Life (WHOQOL-BREF) to determine the QoL scores, and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to determine the level of functioning. All adults (≥18 years old) with mental disorders, who underwent deinstitutionalization, users of assisted living facilities and assisted by the Psychosocial Assistance Centers III, in a city in the state of São Paulo, Brazil, were selected. For statistical analysis of the associated factors, Student's t-test was used for dichotomous variables and ANOVA for polynomial variables. Pearson correlation coefficient was used to measure the association between QoL and functioning scores. RESULTS: Out of 359 people who underwent deinstitutionalization with mental disorders, 147 met the eligibility criteria. The mean total score for the WHOQOL-BREF was 66.5 ± 13.4 and the mean score for WHODAS 2.0 was 10.4 ± 7.6. An association was found between people who were studying (n = 65.8; 95%CI, 63.5-68.1 vs. n = 73.9; 95%CI, 67.5-80.3; p = 0.04) and better WHOQOL-BREF QoL scores or WHODAS 2.0 levels of functioning (n = 10.9; 95%CI, 9.6-12.2 vs. n = 5.1; 95%CI, 2.5-7.7; p = 0.01). A weak negative correlation (r = 0.41) emerged between higher QoL scores and functioning improvement. CONCLUSION: This study indicates that the QoL of the sample is associated by their functioning levels, which, in turn, may reflect on their social interactions. Public policies that favor interventions increasing socialization of this population can result in better health outcomes. The QoL and functioning scores provide valuable insights to develop public policies more suited to this population profile.

Use of alternative care sites during the COVID-19 pandemic in the city of Buenos Aires, Argentina.

OBJECTIVES: In large cities, where a large proportion of the population live in poverty and overcrowding, orders to stay home to comply with isolation requirements are difficult to fulfil. In this article, the use of alternative care sites (ACSs) for the isolation of patients with confirmed COVID-19 or persons under investigation (PUI) in the City of Buenos Aires during the first wave of COVID-19 are described. STUDY DESIGN: This is a cross-sectional study. METHODS: All patients with COVID-19 and PUI with insufficient housing resources who could not comply with orders to stay home and who were considered at low clinical risk in the initial triage were referred to refurbished hotels in the City of Buenos Aires (Ciudad Autónoma de Buenos Aires [CABA]). ACSs were divided into those for confirmed COVID-19 patients and those for PUI. RESULTS: From March to August 2020, there were 58,143 reported cases of COVID-19 (13,829 of whom lived in slums) in the CABA. For COVID-19 positive cases, 62.1% (n = 8587) of those living in slums and 21.4% (n = 9498) of those living outside the slums were housed in an ACS. In total, 31.1% (n = 18,085) of confirmed COVID-19 cases were housed in ACSs. In addition, 7728 PUI were housed (3178 from the slums) in an ACS. The average length of stay was 9.0 ± 2.5 days for patients with COVID-19 and 1.6 ± 0.7 days for PUI. For the individuals who were housed in an ACS, 1314 (5.1%) had to be hospitalised, 56 were in critical care units (0.22%) and there were 27 deaths (0.1%), none during their stay in an ACS. CONCLUSIONS: Overall, about one-third of all people with COVID-19 were referred to an ACS in the CABA. For slum dwellers, the proportion was >60%. The need for hospitalisation was low and severe clinical events were rare. This strategy reduced the pressure on hospitals so their efforts could be directed to patients with moderate-to-severe disease.

Reference architectures for ambient assisted living: a scoping review protocol.

INTRODUCTION: For the first time in human history, the number of older people will be higher than the number of children. The prevalence of chronic diseases, such as hypertension, cardiovascular disease, diabetes and mental disorders in older adults is high. Given that, it is essential to make usage of related technology to provide improved health conditions and reduce the costs for promoting ageing in place, and that is precisely the aim of Ambient Assisted Living technology. Considering that these systems provide significant benefit to a vast number of stakeholders, can be applied to the functional diversity of application domains and have high economic and social impacts, it is essential to create reusable and interoperable platforms and standards that are able to deal with the heterogeneity of applications and domains. In this sense, reference architectures have been proposed and evaluated. A comprehensive scoping review concerning the reference architectures must clarify specific aspects, such as what the main domains are and how the solutions effectively deal with them. METHODS: This scoping review will follow the methodology framework defined in 'Scoping studies: advancing the methodology'. In this methodological framework, six stages are proposed for scoping review studies: identifying the research question; identifying relevant studies; study selection; charting the data; collating, summarising and reporting the results; and consultation. The research questions aim to investigate what are the motivations, stakeholders, benefits, domains, approaches, architectural components and governance aspects of the proposed reference architectures and models. The team will focus on the Scopus Document Search, PubMed (MEDLINE), IEEE Xplore Digital Library, ACM Digital Library and Science Direct electronic research databases. The search query is a combination of terms related to Ambient Assisted Living AND Reference Architecture. ETHICS AND DISSEMINATION: This is a scoping review study and there is no requirement for ethical approval, as primary data will not be collected. The results from this scoping review will be published in a peer-reviewed journal and reported at scientific meetings. We intend to share the results with the International Standards and Conformity Assessment - SyC AAL from Canada to use the review as a basis for establishing an assessment model of reference architectures.

Hardware for Recognition of Human Activities: A Review of Smart Home and AAL Related Technologies.

Activity recognition (AR) from an applied perspective of ambient assisted living (AAL) and smart homes (SH) has become a subject of great interest. Promising a better quality of life, AR applied in contexts such as health, security, and energy consumption can lead to solutions capable of reaching even the people most in need. This study was strongly motivated because levels of development, deployment, and technology of AR solutions transferred to society and industry are based on software development, but also depend on the hardware devices used. The current paper identifies contributions to hardware uses for activity recognition through a scientific literature review in the Web of Science (WoS) database. This work found four dominant groups of technologies used for AR in SH and AAL-smartphones, wearables, video, and electronic components-and two emerging technologies: Wi-Fi and assistive robots. Many of these technologies overlap across many research works. Through bibliometric networks analysis, the present review identified some gaps and new potential combinations of technologies for advances in this emerging worldwide field and their uses. The review also relates the use of these six technologies in health conditions, health care, emotion recognition, occupancy, mobility, posture recognition, localization, fall detection, and generic activity recognition applications. The above can serve as a road map that allows readers to execute approachable projects and deploy applications in different socioeconomic contexts, and the possibility to establish networks with the community involved in this topic. This analysis shows that the research field in activity recognition accepts that specific goals cannot be achieved using one single hardware technology, but can be using joint solutions, this paper shows how such technology works in this regard.

Unsupervised Human Activity Recognition Using the Clustering Approach: A Review.

Currently, many applications have emerged from the implementation of software development and hardware use, known as the Internet of things. One of the most important application areas of this type of technology is in health care. Various applications arise daily in order to improve the quality of life and to promote an improvement in the treatments of patients at home that suffer from different pathologies. That is why there has emerged a line of work of great interest, focused on the study and analysis of daily life activities, on the use of different data analysis techniques to identify and to help manage this type of patient. This article shows the result of the systematic review of the literature on the use of the Clustering method, which is one of the most used techniques in the analysis of unsupervised data applied to activities of daily living, as well as the description of variables of high importance as a year of publication, type of article, most used algorithms, types of dataset used, and metrics implemented. These data will allow the reader to locate the recent results of the application of this technique to a particular area of knowledge.

Quinze anos depois: serviços residenciais terapêuticos frente à portaria 106/2000 / Quince años después: servicios residenciales terapéuticos ante la ordenanza 106/2000 / Fifteen years on: residential treatment services and ordinance 106/2000

RESUMO Introdução: os serviços residenciais terapêuticos (SRTs), instituídos pela Portaria 106/2000, oferecem moradia a egressos de hospitais psiquiátricos no processo de desinstitucionalização e devem seguir as determinações legais, com o objetivo de promover a reabilitação psicossocial. Objetivo: descrever e analisar 11 SRTs do estado de São Paulo, Brasil, a partir da portaria/GM nº 106 de 11 de fevereiro de 2000. Método: estudo quantitativo-descritivo que utilizou como instrumento de coleta um questionário autopreenchido por um profissional-chave de cada serviço. Os dados foram organizados de acordo com os núcleos de informação e analisados de forma estatístico-descritiva. Resultados: os SRTs estudados cumprem a maior parte das determinações nos aspectos relacionados ao funcionamento e organização, como: serem de natureza pública, cadastrados no SUS, integrados à rede de saúde mental e número de moradores por casa; por outro lado, quanto às visitas de acompanhamento estaduais e municipais, o estado realizava pouco mais da metade e os municípios, abaixo disso; mais da metade das casas situava-se fora da comunidade; muitos não recebiam auxílio financeiro a que tinham direito. Discussão: os SRTs precisam de mais acompanhamento das autoridades estaduais e municipais, oportunizando melhorias de funcionamento para os serviços; as casas fora da comunidade dificultam o convívio comunitário e o objetivo de reabilitação psicossocial; o BPC-LOAS pode ser recebido por todos os usuários, fomentando mais autonomia financeira. Conclusão: a adequação dos aspectos que ainda não correspondem aos instituídos pela portaria pode aprimorar os serviços, principalmente na busca pela reabilitação psicossocial.

RESUMEN INTRODUCCIÓN: los servicios residenciales terapéuticos (SRT), instituidos por la Ordenanza 106/2000, en el proceso de desinstitucionalización y con el objetivo de promover la rehabilitación psicosocial, ofrecen alojamiento a pacientes que recibieron alta de internación psiquiátrica. Esos servicios deben cumplir con los requisitos legales. Objetivo: describir y analizar 11 SRT en el estado de São Paulo, Brasil, ante la Ordenanza / GM No. 106 del 11 de febrero de 2000. Método: estudio cuantitativo-descriptivo con datos recogidos a través de un cuestionario autoadministrado por un profesional clave de cada servicio. Los datos se organizaron de acuerdo con los núcleos de información y se analizaron de forma estadísticamente descriptiva. Resultados: los SRT analizados cumplen con la mayoría de las determinaciones en aspectos relacionados con el funcionamiento y la organización, tales como: ser de carácter público, registrado en el SUS , integrado en la red de salud mental y cantidad de residentes por hogar; por otro lado, con respecto a las visitas de seguimiento estatales y municipales, el estado realizó algo más de la mitad y los municipios por debajo de eso; más del 50% de las casas estaba fuera de la comunidad; muchos no recibían la ayuda financiera a la que tenían derecho. Discusión: los SRT necesitan más monitoreo por parte de las autoridades estatales y municipales, con miras a brindar oportunidades de mejora en el funcionamiento de los servicios; las casas fuera de la comunidad obstaculizan la vida comunitaria y el objetivo de la rehabilitación psicosocial; el beneficio BPC de la ley LOAS puede ser recibido por todos los usuarios, promoviendo mayor autonomía financiera. Conclusión: la adecuación de aspectos que aún no se corresponden con los establecidos por la ordenanza podría mejorar los servicios, especialmente en la búsqueda de rehabilitación psicosocial.

ABSTRACT Introduction: Residential treatment services (RTSs), instituted by Ordinance 106/2000, offer housing to those discharged from psychiatric hospitals in the process of deinstitutionalization and must follow certain legal requirements, with the aim of promoting psychosocial rehabilitation. Objective: describe and analyze 11 RTSs in the state of São Paulo, Brazil, based on Ordinance/GM (Minister's office) No. 106 of February 11, 2000. Method: quantitative-descriptive study using a self-administered questionnaire to collect data from a key professional from each service. The data were organized according to information core and analyzed using descriptive statistics. Results: the RTSs studied comply with most of the determinations in aspects related to functioning and organization, such as: being public in nature, registered with the SUS, part of the mental health network and number of residents per household; on the other hand, regarding state and municipal monitoring visits, the state carried out just over half and municipalities, fewer than that; more than half of the houses were outside the community; many did not receive financial aid to which they were entitled. Discussion: the RTSs require more monitoring by state and municipal authorities, providing opportunities for improvements to the functioning of the services; houses outside the community hinder community living - the aim of psychosocial rehabilitation; all users are entitled to BPC-LOAS (Social Care Benefits), promoting greater financial autonomy. Conclusion: adjusting aspects that still do not comply with the ordinance could improve services, especially in the search for psychosocial rehabilitation.

Residências terapêuticas: a percepção de moradores acerca de autonomia, relacionamentos e contratualidade / Therapeutic residences: residents' perception of autonomy, relationships and contractuality

Objetivo: Analisar a vivência dos moradores de uma residência terapêutica no município de Teresina. Metodologia: Estudo descritivo com abordagem qualitativa, realizado em residência terapêutica com cinco moradores que ali viviam por no mínimo 6 meses, por meio de entrevista semiestruturada, que através da análise de conteúdo segundo Minayo gerou três categorias: os moradores e relacionamento com seus pares e comunidade; os moradores e o poder de contratualidade; os moradores e sua autonomia. Resultados: Os moradores relataram que recebem bons cuidados e sentem-se acolhidos, além de boa convivência com os cuidadores. Em relação à comunidade, houve inicialmente resistência, contudo, a dificuldade foi superada. Quanto à autonomia e contratualidade, a negociação é quase incipiente. Em seu cotidiano há horários préestabelecidos para atividades cotidianas e próprias da casa que são determinadas pela responsável da Residência Terapêutica. Sobre o benefício recebido do Governo Federal, há permissão dos moradores para a coordenadora da residência administrar seus pecunhos. Conclusão: Sugere-se formulação ou reformulação da dinâmica da moradia, capacitação dos cuidadores, permanente avaliação da autonomia dos moradores possível para cada caso e um maior trabalho para que, de fato, a reinserção social se concretize.

Objective: To analyze the experience of residents of a therapeutic residence in the municipality of Teresina. Methodology: it is a descriptive study with qualitative approach, conducted in therapeutic residence with five residents who lived there for at least 6 months, through semi-structured interview using Minayo's content analysis which generated three categories: residents and relationship with their peers and community; residents and the power of contractuality; the residents and their autonomy. Results: Residents reported that they receive good care and feel welcomed, as well as having good contact with caregivers. Regarding the community, there was initially resistance, however, the difficulty was overcome. About autonomy and contractuality, negotiation is almost incipient. In your daily life there are pre-established times for daily activities and the house that are determined by the head of the Therapeutic Residence. Regarding the benefit received from the Federal Government, residents are allowed to the residence coordinator to administer their pecuniary. Conclusion: It is suggested the formulation or reformulation of housing dynamics, caregivers training, permanent assessment of the residents' autonomy possible for each case and a greater work to actually bring about social reintegration.

Commercial Devices-Based System Designed to Improve the Treatment Adherence of Hypertensive Patients.

This paper presents an intelligent system designed to increase the treatment adherence of hypertensive patients. The architecture was developed to allow communication among patients, physicians, and families to determine each patient's rate assertion of medication intake time and their self-monitoring of blood pressure. Concerning the medication schedule, the system is designed to follow a predefined prescription, adapting itself to undesired events, such as mistakenly taking medication or forgetting to take medication on time. When covering the blood pressure measurement, it incorporates best medical practices, registering the actual values in recommended frequency and form, trying to avoid the known "white-coat effect." We assume that taking medicine precisely and measuring blood pressure correctly may lead to good adherence to the treatment. The system uses commercial consumer electronic devices and can be replicated in any home equipped with a standard personal computer and Internet access. The resulting architecture has four layers. The first is responsible for adding electronic devices that typically exist in today's homes to the system. The second is a preprocessing layer that filters the data generated from the patient's behavior. The third is a reasoning layer that decides how to act based on the patient's activities observed. Finally, the fourth layer creates messages that should drive the reactions of all involved actors. The reasoning layer takes into consideration the patient's schedule and medication-taking activity data and uses implicit algorithms based on the J48, RepTree, and RandomTree decision tree models to infer the adherence. The algorithms were first adjusted using one academic machine learning and data mining tool. The system communicates with users through smartphones (anytime and anywhere) and smart TVs (in the patient's home) by using the 3G/4G and WiFi infrastructure. It interacts automatically through social networks with doctors and relatives when changes or mistakes in medication intake and blood pressure mean values are detected. By associating the blood pressure data with the history of medication intake, our system can indicate the treatment adherence and help patients to achieve better treatment results. Comparisons with similar research were made, highlighting our findings.

Ubiquitous and ambient-assisted living eHealth platforms for Down's syndrome and palliative care in the Republic of Panama: A systematic review.

In this work, the authors present two eHealth platforms that are examples of how health systems are migrating from client-server architecture to the web-based and ubiquitous paradigm. These two platforms were modeled, designed, developed and implemented with positive results. First, using ambient-assisted living and ubiquitous computing, the authors enhance how palliative care is being provided to the elderly patients and patients with terminal illness, making the work of doctors, nurses and other health actors easier. Second, applying machine learning methods and a data-centered, ubiquitous, patient's results' repository, the authors intent to improve the Down's syndrome risk estimation process with more accurate predictions based on local woman patients' parameters. These two eHealth platforms can improve the quality of life, not only physically but also psychologically, of the patients and their families in the country of Panama.

O significado de morar em um serviço residencial terapêutico / El significado de vivir en uno servicio residencial terapéutico / The meaning of living in a residential service therapeutic

Objetivo: descrever o significado de morar em um Serviço Residencial Terapêutico na perspectiva de egressos de internação psiquiátrica. Método: trata-se de uma pesquisa qualitativa, realizada com 13 moradores de duas Residências Terapêuticas. Os dados foram obtidos por meio de entrevista em profundidade e analisados por meio da técnica de análise de conteúdo. Resultados: emergiram duas categorias que ilustram a visão dos moradores: Residência Terapêutica: um lugar de direitos e escolhas; Residência Terapêutica: um lar ou uma casa de passagem? Conclusão: os moradores relatam satisfação e reconhecem a Residência Terapêutica como um espaço para uma vida mais independente. Devido à marcante herança asilar enfrentam dificuldades para apropriar-se de um espaço para chamar de seu, progressivamente retomam a vida em comunidade e enfrentam desafios para empoderar-se e fazer escolhas. Como um dos dispositivos do processo de Reabilitação Psicossocial a Residência Terapêutica representa um espaço para construção da autonomia, independência e inclusão social de pessoas com transtornos mentais.

Objective: to describe the meaning of living in a Residential Therapy Service in view of psychiatric hospitalization graduates.Method: This is a qualitative research conducted with 13 residents of two Therapeutic Residences. Data were obtained through indepthinterviews and analyzed using content analysis technique. Results: Two categories emerged that illustrate the vision ofresidents: Housing therapy: a place of rights and choices; Home Therapy: a home or halfway house? Conclusion: residents reportedsatisfaction and recognize the Therapeutic Residence as a space for a more independent life. Because of the remarkable heritageasylum face difficulties in appropriating a space to call their own, gradually resume community life and face challenges to empowerthemselves and make choices. As one of the devices of the Psychosocial Rehabilitation process Therapeutic Residence is a space forthe construction of autonomy, independence and social inclusion of people with mental disorders.

Objetivo: describir el significado de vivir en un Servicio de Terapia Residencial en vista de los graduados de hospitalización psiquiátrica. Método: Se trata de una investigación cualitativa realizada con 13 residentes de dos residencias. Los datos seobtuvieron a través de entrevistas en profundidad y analizados mediante la técnica de análisis de contenido. Resultados: emergieron dos categorías que ilustran la visión de los residentes: Residencia Terapéutica: un lugar de derechos y decisiones; Residencia Terapéutica: un hogar o una casa pasaje? Conclusión: Los residentes informaron satisfacción y reconocen la ResidenciaTerapéutica como un espacio para una vida más independiente. Debido a las notables dificultades cara patrimonio de asilo en la apropiación de un espacio que puedan llamar suyo, reanudar gradualmente la vida en comunidad y se enfrentan a los retos dehacerse valer y hacer elecciones. Como uno de los dispositivos del proceso de Rehabilitación Psicosocial la Residencia Terapéuticaes un espacio para la construcción de la autonomía, la independencia y la inclusión social de las personas con trastornos mentales.

Quem são os moradores de residências terapêuticas? Perfil de usuários portadores de transtornos mentais desinstitucionalizados / Who are the residents of therapeutic residential services? Profile of de-institutionalized patients with mental disorders

RESUMO Este artigo teve como objetivo caracterizar o perfil sociodemográfico e clínico de moradores de Serviços Residenciais Terapêuticos (SRT). Trata-se de um estudo transversal, censitário, com 190 moradores de SRT de Recife (PE), analisando as variáveis de perfil sociodemográfico e o histórico psiquiátrico. Observou-se que os moradores se caracterizam, em sua maioria, por homens, solteiros, idosos, analfabetos e histórico de múltiplos e longos internamentos psiquiátricos. Conclui-se que as condutas iatrogênicas praticadas no hospital deixaram sequelas importantes em diversos aspectos da vida dos usuários e tornaram-se numa dívida social que ainda precisa ser paga pela sociedade.

ABSTRACT This article aimed to characterize the sociodemographic and clinical profile of residents of Therapeutic Residential Services (TRS). A cross-sectional, census-based study was carried out with 190 TRS residents from Recife (PE), Brazil. Data collection occurred on an individual basis in TRS. Most of the residents are men, unmarried, elderly, illiterate and with history of various and long-term psychiatric hospitalizations. The iatrogenic conducts practiced in the hospital have left important sequels in several aspects of the life of users and have become a social debt that is yet to be paid by society.

PSYCHOSOCIAL REHABILITATION IN ASSISTED HOUSING IN BRAZIL AND PORTUGAL / LA REHABILITACIÓN PSICOSOCIAL EN LA VIVIENDA ASISTIDA EN BRASIL Y PORTUGAL / REABILITAÇÃO PSICOSSOCIAL EM MORADIAS ASSISTIDAS NO BRASIL E EM PORTUGAL

O objetivo desta pesquisa é discutir como as Moradias Terapêuticas para usuários com transtorno mental, nos municípios de Miranda do Corvo-Portugal e de Volta Redonda-Brasil contribuem com o processo de reabilitação psicossocial das pessoas com sofrimento psíquico. Estudo de perspectiva histórica, cujas fontes foram leis, resoluções e relatórios oficiais e depoimentos de enfermeiros, psicólogos e assistentes sociais. Constatou-se que, embora em ambos os municípios a intenção seja a desinstitucionalização das pessoas com sofrimento psíquico, em Miranda do Corvo-Portugal a gestão financeira e administrativa é de responsabilidade de uma Fundação e, em Volta Redonda-Brasil, essa gestão fica sob os auspícios do poder executivo municipal, além de se observar em Miranda do Corvo a adoção de normas disciplinares em função no excesso de usuários. Conclui-se que a crise econômica em Portugal interferiu na política de expansão de Moradias Terapêuticas para uma quantidade de usuários que não permite intervenção mais individualizada.

El objetivo de esta investigación es analizar cómo las Casas Terapéuticas para los usuarios con trastornos mentales en los municipios de Miranda do Corvo-Portugal y Volta Redonda-Brasil contribuyen a la rehabilitación psicosocial de las personas con sufrimiento mental. Estudio de perspectiva histórica, cuyas fuentes históricas fueron leyes, resoluciones e informes oficiales y declaraciones de enfermeras, psicólogos y trabajadores sociales. Se encontró que en ambos municipios la intención es la desinstitucionalización de las personas con sufrimiento mental, en Miranda do Corvo-Portugal la gestión financiera y administrativa es responsabilidad de una fundación y, en Volta Redonda-Brasil esta gestión es auspiciada por el ejecutivo municipal, además de observar en Miranda del Corvo-Portugal la adopción de medidas disciplinarias en función de exceso de los usuarios. Se concluye que la crisis económica en Portugal ha interferido con la política de expansión de las Casas Terapéuticas en cuanto al número de usuarios que no permite la intervención más individualizada.

The purpose of this research is to discuss how the Therapeutic Housing for service users with mental disorders in the municipalities of Miranda do Corvo (Portugal) and Volta Redonda (Brazil) contributes to the psychosocial rehabilitation of people with psychological problems. The study has a historical perspective and its sources were laws, resolutions and official reports, and statements from nurses, psychologists and social workers. It was verified that although in both municipalities the intention is the deinstitutionalization of people with psychological distress, in Miranda do Corvo (Portugal) the financial and administrative management is the responsibility of a foundation, while in Volta Redonda (Brazil), this management is under the auspices of the municipal executive department. Furthermore, it was noted that in Miranda do Corvo, disciplinary rules were adopted due to the excessive number of service users. It is concluded that the economic crisis in Portugal hindered the Therapeutic Houses expansion policy as it resulted in a number of users that does not allow more individualized intervention.

Older adult drivers living in residential care facilities.

Residential care facilities (RCF) provide assistance to older adults who cannot live independently, but it is unclear whether these residents have retired from driving. Here, we characterize older adults living in RCFs who still drive from a national cross-sectional survey of residents (2010 National Survey of Residential Care Facilities), representing ~733,000 adults living in RCFs such as assisted living facilities and personal care homes. Key resident characteristics were health, function, mobility and community activity indicators, which could be associated with increased driving risk. Of 8,087 residents, 4.5% (95%CI=3.9-5.1) were current drivers. Many drivers were older than 80 years (74%, 95%CI=67-79), in very good health (31%, 95%CI=25-38) or good health (35%, 95%CI=29-42), and had a median of two medical conditions. Most were independent with activities of daily living, though some needed assistance with walking and used gait devices. Given these results, RCF staff and healthcare providers need a heightened awareness of factors associated with driving risk to promote safety of older drivers and provide resources for likely transition to other transportation.

O vivido de moradores em serviços residenciais: possibilidades terapêuticas para reabilitação psicossocial / The living experience of residents in residential services: therapeutic possibilities for psychosocial rehabilitation

Este estudo objetivou compreender o vivido de moradores de Serviços Residenciais Terapêuticos. Trata-se de pesquisa qualitativa realizada com nove sujeitos, egressos de instituições psiquiátricas em Teresina. Os discursos foram obtidos por meio de entrevista durante o período de dezembro de 2010 a janeiro de 2011. Na análise utilizaram-se os conceitos de ser-com e curiosidade, do filósofo Martim Heidegger. Os discursos apontaram o significado do vivido como liberdade e interpretados como curiosidade. A liberdade significada pelo cuidar da moradia, de ir ao cinema, viajar, estudar. A curiosidade desvelada quando o morador tem a possibilidade de conhecer o novo que vem ao seu encontro. Deste modo, os passeios, o cuidar da casa, fazer compras e cuidar de si trazem uma lógica de cuidado almejada pela reforma psiquiátrica que permite a reinserção social, o direito à cidadania e autonomia. A liberdade e a curiosidade produzem estímulos à compreensão e à superação dos longos períodos de internação psiquiátrica, possibilitando novos processos de subjetivação para além dos muros manicomiais.

This study aimed to understand the living experience of residents in Residential Therapeutic Services. This was a qualitative study involving nine individuals who had been treated in psychiatric institutions in Teresina. The speeches were obtained through interviews between December of 2010 and January of 2011. The analysis used the concepts of being-with and curiosity, from the philosopher Martin Heidegger. The speeches showed freedom as the meaning of living and were interpreted as curiosity. Freedom was related with taking care of the living space, going to the movies, traveling, studying. Curiosity was unveiled when the resident has the possibility of knowing the new that comes his way. Thus, the walking, housekeeping, shopping, and self-caring bring a longed caring logic through the psychiatric reform that allows for social reinsertion, and citizenship and autonomy rights. Freedom and curiosity produce stimuli for the understanding and overcoming long periods of psychiatrichospitalization, enabling new processes of subjectivation beyond the walls of psychiatric wards

Possibilidades de atuação da enfermagem em saúde mental: contribuições no processo de implantação das Residências Terapêuticas no município de VoltaRedonda – Rio de Janeiro (2006-2011) / Possibilities of action of mental health nursing: contributions in the deployment process of Therapeutic Residences in Volta Redonda - Rio de Janeiro (2006-2011)

Estudo histórico – social, que tem como objeto a participação do enfermeiro noprocesso de implantação de Residências Terapêuticas para portadores detranstornos mentais no município de Volta Redonda – RJ. Objetivos: descrever ascircunstâncias de implantação das Residências Terapêuticas, em Volta Redonda –RJ; analisar a participação do enfermeiro na rede de apoio às ResidênciasTerapêuticas, em Volta Redonda – RJ e discutir como a enfermagem, envolvida comas Residências Terapêuticas, contribuiu para o processo de reabilitação psicossociale o resgate da cidadania da pessoa em sofrimento psíquico no município de VoltaRedonda – RJ. As fontes primárias se constituíram de documentos escritos e orais,enquanto que as fontes secundárias, de acervo bibliográfico existente sobre areferida temática. Os achados foram classificados, contextualizados e analisados àluz dos conceitos de Norbet Elias em sua obra “Os Estabelecidos e os Outsiders –Sociologia das relações de poder a partir de uma pequena comunidade”, na qualtraz as noções de seres individuais e grupais, processo estigmatizante e relações depoder. Além destes, foram utilizados para fundamentar a análise os conceitos quenortearam a Reforma Psiquiátrica: desospitalização, desinstitucionalização,reinserção social, reabilitação psicossocial e cidadania. Os resultados evidenciaramque o processo de implantação de Residências Terapêuticas, como consequênciado fechamento da instituição manicomial Casa de Saúde Volta Redonda possibilitoutransformações para usuários, profissionais e sociedade de Volta Rendonda. Aparticipação do enfermeiro foi importante para a implantação, consolidação eexpansão do Serviço Residencial Terapêutico (SRT) em Volta Redonda....

Historical - social study , which focuses the participation of nurses in theimplementation of therapeutic residences for people with mental disorders in the cityof Volta Redonda process - RJ . Objectives: To describe the circumstances ofdeployment of Therapeutic Residences in Volta Redonda - RJ ; analyze theparticipation of nurses in supporting the Therapeutic Residences in Volta Redondanetwork - RJ and discuss how nursing involved with Therapeutic Residences,contributed to the process of psychosocial rehabilitation and recovery of citizenshipof the person in psychological distress in the city of Volta Redonda - RJ...

Estudio social, que se centra la participación de las enfermeras en la aplicación delas residencias terapéuticas para las personas con trastornos mentales en la ciudadde Volta Redonda - proceso - Histórico RJ . Objetivos: Describir las circunstanciasdel despliegue de las Residencias Terapéuticas en Volta Redonda - RJ ; analizar laparticipación de las enfermeras en el apoyo a las Residencias Terapéuticas en redVolta Redonda - RJ y discutir cómo la enfermería involucrados con ResidenciasTerapéuticas , contribuyó a la proceso de rehabilitación psicosocial y recuperaciónde la nacionalidad de la persona en los trastornos psicológicos en la ciudad de VoltaRedonda - RJ...

A influencia de fatores ambientais na qualidade de vida e na sintomatologia de criancas com rinite alergica / The impact of environmental factors on quality of life and symptoms of children with allergic rhinitis

A rinite alérgica é uma inflamação da mucosa nasal, induzida pela exposição a alérgenos, responsável por impacto negativo sobre a capacidade cognitiva dos afetados. OBJETIVO: Correlacionar a média da qualidade de vida de crianças e adolescentes com sintomas de rinite alérgica com a presença de fatores ambientais domiciliares relatados na literatura como desencadeantes das crises alérgicas. MÉTODO: Estudo de coorte histórica com corte transversal no qual foram convidadas a participar 120 crianças e adolescentes com manifestações clínicas de rinite alérgica, as quais foram divididas em dois grupos, de acordo com a quantidade de fatores ambientais inadequados em seus domicílios. Aplicou-se, então, o questionário PedsQL 4.0 para quantificação da qualidade de vida com posterior comparação entre os grupos. RESULTADOS: Não foi encontrada diferença significante (p > 0,05) na média dos escores do questionário PedsQL ao comparar a qualidade de vida dos participantes com a presença dos fatores ambientais inadequados avaliados no estudo, porém, notou-se maior incidência de manifestações alérgicas nas crianças com maior número desses fatores. CONCLUSÃO: Os fatores ambientais inadequados estudados não tiveram relação com a qualidade de vida dos pacientes. No entanto, a análise das moradias e sintomatologia dos mesmos sugere que o ambiente interferiu no aparecimento das manifestações alérgicas. .

Allergic rhinitis is an inflammation of the nasal mucosa caused by exposure to allergens, which impairs the cognitive capabilities of the affected. OBJECTIVE: To correlate the mean scores of quality of life of children and adolescents with symptoms of allergic rhinitis and the presence of household environmental factors described in the literature as allergy triggers. METHOD: This cross-sectional retrospective cohort study included 120 children and adolescents presenting clinical manifestations of allergic rhinitis. The subjects were divided into two groups based on the number of allergy-triggering environmental factors seen in their households. Scale PedsQL 4.0 was used to quantify quality of life and allow further comparisons between groups. RESULTS: No statistically significant differences (p > 0.05) were seen in the PedsQL mean scores when participant quality of life was analyzed vis-a-vis triggering environmental factors. However, the incidence of allergy manifestations was higher in children exposed to more environmental factors. CONCLUSION: The studied environmental factors were not correlated with patient quality of life. However, the analysis of patient households and symptoms indicates the environment played a role in the onset of allergy events. .

Servico residencial terapeutico: o olhar do usuario / Servicio terapéutico residencial: la mirada del usuario / Therapeutic residential service: the user's perspective

OBJECTIVE: This paper studied the daily life of residents of Therapeutic Residential Services (TRS) discharged after long-term psychiatric internments. The objective was to describe the residents' social reintegration process of residents, considering the TRS model. METHODS: This is a qualitative study, whose subjects were residents of TRS. Data analysis followed the principle of thematic content analysis. RESULTS: The therapeutic project envisioned by the staff of the Therapeutic Residential Service is in accordance with the recommendations in the epistemological paradigms of Psychosocial Rehabilitation. CONCLUSION: The interviews revealed the experience of living outside the mental hospital, showing the reconstruction of this subject as a social being, in practical terms, with some residents who circulates through the neighborhood, talks to neighbors, while others argue with peers and are intolerant of colleagues.

Este estudo teve como objeto o cotidiano de moradores de Serviços Residenciais Terapêuticos (SRT) egressos de internações psiquiátricas de longa permanência e, como objetivo, descrever o processo de reinserção social dos moradores considerando o modelo de SRT. MÉTODOS: Trata-se de um estudo de natureza qualitativa, cujos sujeitos foram moradores de SRT. A análise dos dados seguiu o princípio da análise de conteúdo temática. RESULTADOS: Constatou-se que o projeto terapêutico vislumbrado pela equipe do Serviço Residencial Terapêutico aproximase do preconizado pelos paradigmas epistemológicos da Reabilitação Psicossocial. CONCLUSÃO: As entrevistas permitiram a aproximação da vivência fora do manicômio, sendo possível perceber a reconstrução desse sujeito enquanto ser social. Em termos práticos, tem-se um morador que circula pelo bairro, conversa com os vizinhos, mas também há aquele que discute com os pares, é intolerante com os colegas.

OBJETIVO: Este estudio tiene como objeto el cotidiano de habitantes de Servicios Residenciales Terapéuticos (SRT) oriundos de estancias psiquiátricas de larga permanencia y como objetivo, describir el proceso de inserción social de los habitantes considerando la plantilla de SRT. MÉTODOS: Se trata de un estudio cualitativo, cuyos sujetos eran los residentes de SRT. El análisis de los datos siguió el principio de análisis de contenido temático. RESULTADOS: Se constató que el proyecto terapéutico previsto por el equipo del SRT se acerca del preconizado por los paradigmas epistemológicos de la Rehabilitación Psicosocial. CONCLUSIÓN: Las entrevistas permitieron el acercamiento de vivir fuera del hospital psiquiátrico, siendo posible percibir la reconstrucción de ese sujeto mientras un ser social, en términos prácticos, se tiene un habitante que circula por el barrio, habla con los vecinos, pero también hay aquel que discute con los pares, es intolerante con los compañeros.