Prontuários, para que servem?: representação dos coordenadores de equipe dos capsi a respeito do valor e da utilidade dos prontuários

INTRODUÇÃO: o artigo procura compreender como os Coordenadores dos Centros de Atenção Psicossocial Infantojuvenil (CAPSi) do Estado de São Paulo percebem o valor e a utilidade dos prontuários do usuários do serviço. Atualmente, os prontuários obedecem a claros princípios éticos. São muitas as pesquisas que se utilizam de prontuários e vários os estudos que se propõem a aperfeiçoá-los uma vez que são considerados ferramenta de primeira importância no âmbito da saúde. Cabe, entretanto, indagar se esses instrumentos são valorizados e se suas utilidades percebidas pelas equipes de saúde mental no exercício real de suas práticas. O trabalho descreve e analisa as percepções dos Coordenadores dos CAPSi-SP a respeito da utilidade dos prontuários para a equipe de saúde e para os usuários. MÉTODO: foi entrevistado um Coordenador de cada um dos 19 dos CAPSi do Estado de São Paulo. As respostas foram analisadas de acordo com os procedimentos clássicos da Análise de Conteúdo. RESULTADOS: os prontuários são percebidos como valiosos instrumentos de trabalho e sua importância destacada como instrumento de intervenção e de acompanhamento clínicos. Sua relevância é assinalada como dispositivo que possibilita a articulação e a comunicação dos membros das equipes técnicas dos CAPSi. Por outro lado, não é percebida qual a utilidade que eles teriam para o usuário. A contradição nos níveis de importância alocada à utilidade dos prontuários quando se trata da equipe técnica ou dos usuários enseja uma discussão aprofundada sobre a natureza da clínica em saúde mental praticada nos CAPSi

Insights on the Milky Way bulge formation from the correlations between kinematics and metallicity

Context. Two main scenarios for the formation of the Galactic bulge are invoked, the first one through gravitational collapse or hierarchical merging of subclumps, the second through secular evolution of the Galactic disc. Aims. We aim to constrain the formation of the Galactic bulge through studies of the correlation between kinematics and metallicities in Baade's Window (l = 1 degrees, b = -4 degrees) and two other fields along the bulge minor axis (l = 0 degrees, b = -6 degrees and b = -12 degrees). Methods. We combine the radial velocity and the [Fe/H] measurements obtained with FLAMES/GIRAFFE at the VLT with a spectral resolution of R = 20 000, plus for the Baade's Window field the OGLE-II proper motions, and compare these with published N-body simulations of the Galactic bulge. Results. We confirm the presence of two distinct populations in Baade's Window found in Hill et al. (2010, A&A, submitted): the metal-rich population presents bar-like kinematics while the metal-poor population shows kinematics corresponding to an old spheroid or a thick disc. In this context the metallicity gradient along the bulge minor axis observed by Zoccali et al. (2008, A&A, 486, 177), visible also in the kinematics, can be related to a varying mix of these two populations as one moves away from the Galactic plane, alleviating the apparent contradiction between the kinematic evidence of a bar and the existence of a metallicity gradient. Conclusions. We show evidence that the two main scenarios for the bulge formation co-exist within the Milky Way bulge.

Local atomic structure in tetragonal pure ZrO(2) nanopowders

The local atomic structures around the Zr atom of pure (undoped) ZrO(2) nanopowders with different average crystallite sizes, ranging from 7 to 40 nm, have been investigated. The nanopowders were synthesized by different wet-chemical routes, but all exhibit the high-temperature tetragonal phase stabilized at room temperature, as established by synchrotron radiation X-ray diffraction. The extended X-ray absorption fine structure (EXAFS) technique was applied to analyze the local structure around the Zr atoms. Several authors have studied this system using the EXAFS technique without obtaining a good agreement between crystallographic and EXAFS data. In this work, it is shown that the local structure of ZrO(2) nanopowders can be described by a model consisting of two oxygen subshells (4 + 4 atoms) with different Zr-O distances, in agreement with those independently determined by X-ray diffraction. However, the EXAFS study shows that the second oxygen subshell exhibits a Debye-Waller (DW) parameter much higher than that of the first oxygen subshell, a result that cannot be explained by the crystallographic model accepted for the tetragonal phase of zirconia-based materials. However, as proposed by other authors, the difference in the DW parameters between the two oxygen subshells around the Zr atoms can be explained by the existence of oxygen displacements perpendicular to the z direction; these mainly affect the second oxygen subshell because of the directional character of the EXAFS DW parameter, in contradiction to the crystallographic value. It is also established that this model is similar to another model having three oxygen subshells, with a 4 + 2 + 2 distribution of atoms, with only one DW parameter for all oxygen subshells. Both models are in good agreement with the crystal structure determined by X-ray diffraction experiments.

Liquid polymorphism, order-disorder transitions and anomalous behavior: A Monte Carlo study of the Bell-Lavis model for water

The Bell-Lavis model for liquid water is investigated through numerical simulations. The lattice-gas model on a triangular lattice presents orientational states and is known to present a highly bonded low density phase and a loosely bonded high density phase. We show that the model liquid-liquid transition is continuous, in contradiction with mean-field results on the Husimi cactus and from the cluster variational method. We define an order parameter which allows interpretation of the transition as an order-disorder transition of the bond network. Our results indicate that the order-disorder transition is in the Ising universality class. Previous proposal of an Ehrenfest second order transition is discarded. A detailed investigation of anomalous properties has also been undertaken. The line of density maxima in the HDL phase is stabilized by fluctuations, absent in the mean-field solution. (C) 2009 American Institute of Physics. [doi:10.1063/1.3253297]

Sobre a imagem rousseauniana da lei acima dos homens

Entre o verbete sobre economia política, de 1755, e o Contrato social, de 1762, a noção rousseauniana de lei passa de "voz celeste" para "declaração da vontade geral". Pretende-se defender aqui a proposição de que tal mudança na definição de lei de um escrito para o outro não implica contradição. Para tanto, será analisada a presença da imagem da "lei acima dos homens" em diversos textos do Cidadão de Genebra, sobretudo no capítulo "Do legislador" no livro II do Contrato, a fim de mostrar-se que ela corresponde a um mesmo princípio de oposição entre a liberdade, associada ao dever de obediência, e a escravidão, associada ao impulso das paixões, expressando-se de modos particulares nos diversos momentos da obra de Rousseau.

Health in Brazil 6 Health conditions and health-policy innovations in Brazil: the way forward

Brazil is a large complex country that is undergoing rapid economic, social, and environmental change In this Series of six articles, we have reported important improvements in health status and life expectancy, which can be ascribed largely to progress in social determinants of health and to implementation of a comprehensive national health system with strong social participation. Many challenges remain, however. Socioeconomic and regional disparities are still unacceptably large, reflecting the fact that much progress is still needed to improve basic living conditions for a large proportion of the population. New health problems arise as a result of urbanisation and social and environmental change, and some old health issues remain unabated. Administration of a complex, decentralised public-health system, in which a large share of services is contracted out to the private sector, together with many private insurance providers, inevitably causes conflict and contradiction. The challenge is ultimately political, and we conclude with a call for action that requires continuous engagement by Brazilian society as a whole in securing the right to health for all Brazilian people.

Imprints of fast-rotating massive stars in the Galactic Bulge

The first stars that formed after the Big Bang were probably massive(1), and they provided the Universe with the first elements heavier than helium (`metals`), which were incorporated into low-mass stars that have survived to the present(2,3). Eight stars in the oldest globular cluster in the Galaxy, NGC 6522, were found to have surface abundances consistent with the gas from which they formed being enriched by massive stars(4) (that is, with higher alpha-element/Fe and Eu/Fe ratios than those of the Sun). However, the same stars have anomalously high abundances of Ba and La with respect to Fe(4), which usually arises through nucleosynthesis in low-mass stars(5) (via the slow-neutron-capture process, or s-process). Recent theory suggests that metal-poor fast-rotating massive stars are able to boost the s-process yields by up to four orders of magnitude(6), which might provide a solution to this contradiction. Here we report a reanalysis of the earlier spectra, which reveals that Y and Sr are also over-abundant with respect to Fe, showing a large scatter similar to that observed in extremely metal-poor stars(7), whereas C abundances are not enhanced. This pattern is best explained as originating in metal-poor fast-rotating massive stars, which might point to a common property of the first stellar generations and even of the `first stars`.

The effect of a single supernova explosion on the cuspy density profile of a small-mass dark matter halo

Some observations of galaxies, and in particular dwarf galaxies, indicate a presence of cored density profiles in apparent contradiction with cusp profiles predicted by dark matter N-body simulations. We constructed an analytical model, using particle distribution functions (DFs), to show how a supernova (SN) explosion can transform a cusp density profile in a small-mass dark matter halo into a cored one. Considering the fact that an SN efficiently removes matter from the centre of the first haloes, we study the effect of mass removal through an SN perturbation in the DFs. We find that the transformation from a cusp into a cored profile occurs even for changes as small as 0.5 per cent of the total energy of the halo, which can be produced by the expulsion of matter caused by a single SN explosion.

Bayesian Estimation of the Logistic Positive Exponent IRT Model

A Bayesian inference approach using Markov Chain Monte Carlo (MCMC) is developed for the logistic positive exponent (LPE) model proposed by Samejima and for a new skewed Logistic Item Response Theory (IRT) model, named Reflection LPE model. Both models lead to asymmetric item characteristic curves (ICC) and can be appropriate because a symmetric ICC treats both correct and incorrect answers symmetrically, which results in a logical contradiction in ordering examinees on the ability scale. A data set corresponding to a mathematical test applied in Peruvian public schools is analyzed, where comparisons with other parametric IRT models also are conducted. Several model comparison criteria are discussed and implemented. The main conclusion is that the LPE and RLPE IRT models are easy to implement and seem to provide the best fit to the data set considered.