Therapeutic Project at Extra-Hospital Mental Health Services: a critical reflection on the elaboration and management of services' therapeutic projects

Based on a study conducted in Ribeirao Preto, SP, Brazil in extra-hospital mental health services that addressed the organization of these services, therapeutic projects and the inclusion of psychosocial rehabilitation in health actions available, a theoretical-critical reflection concerning the development process of the therapeutic projects by the services' teams is presented. The qualitative study was conducted in an outpatient clinic and a Psychosocial Care Center. Data were collected through semi-structured interviews and focal groups. Data analysis was based on the hermeneutic dialectic philosophy of Jurgen Habermas according to the techniques of reconstruction and interpretation. Data analysis revealed that professionals have difficulty developing and managing therapeutic projects. Health actions are made available without being concretely supported by a proposal guiding the service's practical activities. The therapeutic projects are referred by professionals as the result of guidelines provided by management levels or technical orientations inherent to each profession but not as an activity that represents a philosophy of work of the health team. When the therapeutic project is focused on as a type of consensus that results from a communicative action directed to a mutual and intersubjective understanding among the members of the mental health extra-hospital team, the difficulties of the services' team dialogically organizing themselves to collectively construct the therapeutic project is evidenced.

Molecular chemistry and the missing mass problem in planetary nebulae

Context. Detections of molecular lines, mainly from H-2 and CO, reveal molecular material in planetary nebulae. Observations of a variety of molecules suggest that the molecular composition in these objects differs from that found in interstellar clouds or in circumstellar envelopes. The success of the models, which are mostly devoted to explain molecular densities in specific planetary nebulae, is still partial however. Aims. The present study aims at identifying the influence of stellar and nebular properties on the molecular composition of planetary nebulae by means of chemical models. A comparison of theoretical results with those derived from the observations may provide clues to the conditions that favor the presence of a particular molecule. Methods. A self-consistent photoionization numerical code was adapted to simulate cold molecular regions beyond the ionized zone. The code was used to obtain a grid of models and the resulting column densities are compared with those inferred from observations. Results. Our models show that the inclusion of an incident flux of X-rays is required to explain the molecular composition derived for planetary nebulae. We also obtain a more accurate relation for the N(CO)/N(H-2) ratio in these objects. Molecular masses obtained by previous works in the literature were then recalculated, showing that these masses can be underestimated by up to three orders of magnitude. We conclude that the problem of the missing mass in planetary nebulae can be solved by a more accurate calculation of the molecular mass.

Work and Inter-subjectivity: a theoretical reflection on its dialectics in the field of health and nursing

This theoretical reflection intends to show the inter-subjective relationship that takes place in health and nursing practices under the following theoretical perspectives: Institutional Analysis, Psychodynamics of Labor and the Theory of Communicative Action, with an emphasis on the latter. Linking these concepts to the Marxist approach to work in the field of health emerges from recognizing the need for its continuous reconstruction-in this case, with a view to understand the interaction and communication intrinsic to work in action. The theory of Communicative Action seeks to consider these two inextricable dimensions: work as productive action and as interaction. The first corresponds to instrumental action based on technical rules with a production-guided rationale. The second refers to the interaction that takes place as communicative action and seeks understanding among subjects. We assume that adopting this theoretical perspective in the analysis of health and nursing practices opens new possibilities for clarifying its social and historical process and inter-subjective connections.

Planetary nebulae and determination of the bulge-disk boundary

In this paper, a sample of planetary nebulae in the Galaxy's inner-disk and bulge is used to find the galactocentric distance that optimally separates these two populations in terms of their abundances. Statistical distance scales were used to investigate the distribution of abundances across the disk–bulge interface, while a Kolmogorov–Smirnov test was used to find the distance at which the chemical properties of these regions separate optimally. The statistical analysis indicates that, on average, the inner population is characterized by lower abundances than the outer component. Additionally, for the α-element abundances, the inner population does not follow the disk's radial gradient toward the Galactic Center. Based on our results, we suggest a bulge–disk interface at 1.5 kpc, marking the transition between the bulge and the inner disk of the Galaxy as defined by the intermediate-mass population.