Qualificação da atenção ao usuário de saúde mental em Matutina - Minas Gerais: Projeto de intervenção

O aumento na prevalência de transtornos mentais e utilização e abuso de psicofármacos são fenômenos globais. A partir deste entendimento este trabalho teve como objetivo elaborar um plano de intervenção para reestruturar o modelo de atenção ao usuário de Saúde Mental em Matutina, Minas Gerais. O instrumento utilizado para elaboração do plano de intervenção foi o Planejamento estratégico situacional, o qual visa formular uma estratégia para orientar as diferentes visões dos atores sociais para solução de um dado problema. Os nós críticos identificados para compor o plano de ação foram: ausência de longitudinalidade do cuidado; sistema de confecção de receitas de medicamento contínuo; hábitos e estilo de vida prejudicados; déficit na atuação das agentes de saúde; a cultura institucional vigente; e pouco conhecimento sobre população adscrita. Para êxito do plano operativo todos os atores sociais tem importância única e somente à partir da soma de seus esforços é que pode resultar uma mudança positiva e duradoura para a saúde da comunidade

Saúde mental na atenção básica: projeto piloto sobre apoio matricial na rede SUS - Campo do Meio (MG)

Nos últimos anos o desenvolvimento da Estratégia Saúde da Família (ESF) e a implantação dos novos serviços substantivos em saúde mental - especialmente os Centros de Atenção Psicossocial (CAPS) significam um progresso indiscutível da política do Sistema Único de Saúde (SUS). No ambulatório Padre Chico de Campo do Meio - MG observa-se, nos últimos anos, a necessidade de organizar o atendimento aos pacientes portadores de transtornos mentais na atenção básica já que a unidade de saúde além de conter uma Equipe da ESF também possui atendimento psiquiátrico. Esse trabalho tem como objetivo propor um Projeto Piloto de Matriciamento em Saúde Mental a fim de organizar e melhorar a qualidade dos atendimentos em saúde mental na atenção básica. Para fundamentar a proposta foi efetuada uma revisão bibliográfica utilizando a base de dados da BVS (Biblioteca Virtual em Saúde), publicações, leis e portarias do Ministério da Saúde. O projeto foi pautado nos princípios fundamentais do Sistema Único de Saúde (SUS) e pela Reforma Psiquiátrica Brasileira com o intuito de garantir o acesso ao tratamento e a integração dos portadores de transtornos mentais à comunidade local.

Saúde mental na Atenção Primária em Saúde: Proposta de um plano de intervenção para o município de Espinosa - MG

A mudança do modelo assistencial no campo da saúde mental segundo as diretrizes da reforma psiquiátrica brasileira está ancorada em uma legislação que concebe a atenção primária como um elo importante da rede para garantir um cuidado mais acolhedor, integral e humanizado. No entanto, verifica-se que o atendimento aos usuários portadores de sofrimento mental na atenção básica configura-se como um problema pela falta de habilidade/capacitação do profissional, a ausência de vinculo entre o usuário, familiares e a equipe do programa saúde da família, o não reconhecimento por parte da equipe, de que o usuário portador de sofrimento mental está sob sua responsabilidade. Diante desta situação, este trabalho teve como objetivo elaborar um plano de intervenção em saúde mental com ações e recomendações para os profissionais da Atenção Primária em Saúde no município de Espinosa - MG. Para sua realização foi feito um levantamento sobre o tema da saúde mental e a atenção primária em saúde nas bases de dados SCIELO, Biblioteca Virtual em Saúde (BVS). A implementação da assistência humanizada de saúde mental na ESF do município de Espinosa e a aplicação do plano de intervenção proposto neste trabalho contempla tanto os aspectos técnicos como os relativos à promoção da saúde, assistência, reabilitação social,abordagem da família, cuidado psicossocial, quanto aqueles relativos à humanização das práticas para acompanhar as mudanças propostas pela reforma psiquiátrica brasileira. Essas ações servirão de roteiro para auxiliar os profissionais a planejar e implementar o processo de trabalho na atenção primária em saúde, no âmbito da saúde mental.

Plano de ação para melhoria da Atenção em Saúde Mental na Unidade Básica de Saúde Urbana no município de Girau do Ponciano - Alagoas

Esta pesquisa foi realizada e desenvolvida no ano de 2013, em Girau do Ponciano/AL. O objetivo do estudo foi propor um plano de intervenção com vistas à melhoria do acompanhamento voltado aos indivíduos com funcionamento psicótico da UBS de Girau do Ponciano. Os dados foram obtidos pela secretaria de saúde do município e a partir da análise dos prontuários dos pacientes que pertenciam ao Grupo de Saúde Mental e que realizavam acompanhamento e tratamento no serviço de saúde em estudo. Foram identificados através da análise desses dados os fatores que trazem os problemas mais críticos e impedem aos profissionais de saúde oferecer aos usuários uma qualidade adequada de atendimento ao paciente de saúde mental. Destacaram o acompanhamento do sujeito com transtorno mental pela unidade básica de saúde e ressaltaram a importância das práticas de educação em saúde na rede de saúde mental

Taurine Supplementation Increases K(atp) Channel Protein Content, Improving Ca2+ Handling And Insulin Secretion In Islets From Malnourished Mice Fed On A High-fat Diet.

Pancreatic β-cells are highly sensitive to suboptimal or excess nutrients, as occurs in protein-malnutrition and obesity. Taurine (Tau) improves insulin secretion in response to nutrients and depolarizing agents. Here, we assessed the expression and function of Cav and KATP channels in islets from malnourished mice fed on a high-fat diet (HFD) and supplemented with Tau. Weaned mice received a normal (C) or a low-protein diet (R) for 6 weeks. Half of each group were fed a HFD for 8 weeks without (CH, RH) or with 5% Tau since weaning (CHT, RHT). Isolated islets from R mice showed lower insulin release with glucose and depolarizing stimuli. In CH islets, insulin secretion was increased and this was associated with enhanced KATP inhibition and Cav activity. RH islets secreted less insulin at high K(+) concentration and showed enhanced KATP activity. Tau supplementation normalized K(+)-induced secretion and enhanced glucose-induced Ca(2+) influx in RHT islets. R islets presented lower Ca(2+) influx in response to tolbutamide, and higher protein content and activity of the Kir6.2 subunit of the KATP. Tau increased the protein content of the α1.2 subunit of the Cav channels and the SNARE proteins SNAP-25 and Synt-1 in CHT islets, whereas in RHT, Kir6.2 and Synt-1 proteins were increased. In conclusion, impaired islet function in R islets is related to higher content and activity of the KATP channels. Tau treatment enhanced RHT islet secretory capacity by improving the protein expression and inhibition of the KATP channels and enhancing Synt-1 islet content.

A New Extraction Approach To Correct The Effect Of Apparent Increase In The Secoiridoid Content After Filtration Of Virgin Olive Oil.

In the current study, a new approach has been developed for correcting the effect that moisture reduction after virgin olive oil (VOO) filtration exerts on the apparent increase of the secoiridoid content by using an internal standard during extraction. Firstly, two main Spanish varieties (Picual and Hojiblanca) were submitted to industrial filtration of VOOs. Afterwards, the moisture content was determined in unfiltered and filtered VOOs, and liquid-liquid extraction of phenolic compounds was performed using different internal standards. The resulting extracts were analyzed by HPLC-ESI-TOF/MS, in order to gain maximum information concerning the phenolic profiles of the samples under study. The reduction effect of filtration on the moisture content, phenolic alcohols, and flavones was confirmed at the industrial scale. Oleuropein was chosen as internal standard and, for the first time, the apparent increase of secoiridoids in filtered VOO was corrected, using a correction coefficient (Cc) calculated from the variation of internal standard area in filtered and unfiltered VOO during extraction. This approach gave the real concentration of secoiridoids in filtered VOO, and clarified the effect of the filtration step on the phenolic fraction. This finding is of great importance for future studies that seek to quantify phenolic compounds in VOOs.

Interface Between Intellectual Disability And Mental Health: Hermeneutic Review.

A literature review was conducted aiming to understand the interface between the Intellectual Disability and Mental Health fields and to contribute to mitigating the path of institutionalizing individuals with intellectual deficiencies. The so-called dual diagnosis phenomenon remains underestimated in Brazil but is the object of research and specific public policy internationally. This phenomenon alerts us to the prevalence of mental health problems in those with intellectual disabilities, limiting their social inclusion. The findings reinforce the importance of this theme and indicate possible diagnostic invisibility of the development of mental illness in those with intellectual disabilities in Brazil, which may contribute to sustaining psychiatric institutionalization of this population. 

Effect Of Aloe Vera Application On The Content And Molecular Arrangement Of Glycosaminoglycans During Calcaneal Tendon Healing.

Although several treatments for tendon lesions have been proposed, successful tendon repair remains a great challenge for orthopedics, especially considering the high incidence of re-rupture of injured tendons. Our aim was to evaluate the pharmacological potential of Aloe vera on the content and arrangement of glycosaminoglycans (GAGs) during tendon healing, which was based on the effectiveness of A. vera on collagen organization previously observed by our group. In rats, a partial calcaneal tendon transection was performed with subsequent topical A. vera application at the injury site. The tendons were treated with A. vera ointment for 7 days and excised on the 7(th) , 14(th) , or 21(st) day post-surgery. Control rats received ointment without A. vera. A higher content of GAGs and a lower amount of dermatan sulfate were detected in the A. vera-treated group on the 14(th) day compared with the control. Also at 14 days post-surgery, a lower dichroic ratio in toluidine blue stained sections was observed in A. vera-treated tendons compared with the control. No differences were observed in the chondroitin-6-sulfate and TGF-β1 levels between the groups, and higher amount of non-collagenous proteins was detected in the A. vera-treated group on the 21(st) day, compared with the control group. No differences were observed in the number of fibroblasts, inflammatory cells and blood vessels between the groups. The application of A. vera during tendon healing modified the arrangement of GAGs and increased the content of GAGs and non-collagenous proteins.

Root Canal Content From Primary Endodontic Infection And Upregulation Of Gelatinases In Fibroblast Cells.

To investigate endotoxin levels from primary endodontic infections before and after chemomechanical preparation (CMP) and to determine their antigenicity against 3T3 fibroblasts through gelatinolytic activity of matrix metalloproteinases (MMPs). Twenty-four root canals with primary endodontic infection and apical periodontitis were selected. Samples were collected using paper points before (S1) and after chemomechanical preparation (CMP) (S2). The limulus amebocyte lysate assay was used for endotoxin measurement. Fibroblasts were stimulated with root canal contents for 24 h. Supernatants of cell cultures stimulated with root canal contents were collected after 24 h to determine the levels of MMP-2 and MMP-9 gelatinolytic activity using the zymography technique. Friedman and Wilcoxon tests were used to compare the amount of endotoxin before (S1) and after CMP (S2) (P < 0.05). Data obtained from gelatinolytic activity were analysed using anova and Tukey's tests (P < 0.05). Endotoxin was recovered in 100% of the samples. There was a significant reduction in endotoxin levels after CMP (P < 0.05). A correlation was found between the levels of endotoxins and MMP-2 expression (P < 0.05). Root canal contents of initial samples (S1) induced significantly greater MMP-2 expression by fibroblasts when compared to S2 and the nonstimulated group (P < 0.05). No gelatinolytic activity of MMP-9 was observed in S1, S2 and control group. Root canal contents from primary endodontic infections had gelatinolytic activity for MMP-2. Moreover, CMP was effective in reducing endotoxin levels and their antigenicity against fibroblasts on gelatinolytic activity.

The Biopsychosocial Spiritual Model Applied To The Treatment Of women With Breast Cancer, Through Rime Intervention (relaxation, mental Images, Spirituality).

This postdoctoral study on the application of the RIME intervention in women that had undergone mastectomy and were in treatment, aimed to promote psychospiritual and social transformations to improve the quality of life, self-esteem and hope. A total of 28 women participated and were randomized into two groups. Brief Psychotherapy (PB) (average of six sessions) was administered in the Control Group, and RIME (three sessions) and BP (average of five sessions) were applied in the RIME Group. The quantitative results indicated a significant improvement (38.3%) in the Perception of Quality of Life after RIME according to the WHOQOL, compared both to the BP of the Control Group (12.5%), and the BP of the RIME Group (16.2%). There was a significant improvement in Self-esteem (Rosenberg) after RIME (14.6%) compared to the BP of the Control Group (worsened 35.9%), and the BP of the RIME Group (8.3%). The improvement in well-being, considering the focus worked on (Visual Analog Scale), was significant in the RIME Group (bad to good), as well as in the Control Group (unpleasant to good). The qualitative results indicated that RIME promotes creative transformations in the intrapsychic and interpersonal dimensions, so that new meanings and/or new attitudes emerge into the consciousness. It was observed that RIME has more strength of psychic structure, ego strengthening and provides a faster transformation that BP, therefore it can be indicated for crisis treatment in the hospital environment.

Proinflammatory Activity Of Primarily Infected Endodontic Content Against Macrophages After Different Phases Of The Root Canal Therapy.

This study investigated the presence of target bacterial species and the levels of endotoxins in teeth with apical periodontitis. Levels of inflammatory mediators (interleukin [IL]-1β and tumor necrosis factor [TNF]-α) were determined after macrophage stimulation with endodontic content after different phases of endodontic therapy using different irrigants. Thirty primarily infected root canals were randomly assigned into 3 groups according to the irrigant used for root canal preparation (n = 10 per group): GI: 2.5% sodium hypochlorite, GII: 2% chlorhexidine gel, and GIII (control group): saline solution. Root canal samples were taken by using paper points before (s1) and after root canal instrumentation (s2), subsequently to 17% EDTA (s3), after 30 days of intracanal medication (Ca[OH]2 + saline solution) (s4), and before root canal obturation (s5). Polymerase chain reaction (16S recombinant DNA) and limulus amebocyte lysate assay were used for bacterial and endotoxin detection, respectively. Macrophages were stimulated with the root canal contents for IL-1β/TNF-α measurement using enzyme-linked immunosorbent assay. Porphyromonas gingivalis (17/30), Porphyromonas endodontalis (15/30), and Prevotella nigrescens (11/30) were the most prevalent bacterial species. At s1, endotoxins were detected in 100% of the root canals (median = 32.43 EU/mL). In parallel, substantial amounts of IL-1β and TNF-α were produced by endodontic content-stimulated macrophages. At s2, a significant reduction in endotoxin levels was observed in all groups, with GI presenting the greatest reduction (P < .05). After a root canal rinse with EDTA (s3), intracanal medication (s4), and before root canal obturation (s5), endotoxin levels reduced without differences between groups (P < .05). IL-1β and TNF-α release decreased proportionally to the levels of residual endotoxin (P < .05). Regardless of the use of sodium hypochlorite or CHX, the greatest endotoxin reduction occurs after chemomechanical preparation. Increasing steps of root canal therapy associated with intracanal medication enhances endotoxin reduction, leading to a progressively lower activation of proinflammatory cells such as macrophages.

Brazilian multicentre study of common mental disorders in primary care: rates and related social and demographic factors

Mental health problems are common in primary health care, particularly anxiety and depression. This study aims to estimate the prevalence of common mental disorders and their associations with socio-demographic characteristics in primary care in Brazil (Family Health Strategy). It involved a multicenter cross-sectional study with patients from Rio de Janeiro, São Paulo, Fortaleza (Ceará State) and Porto Alegre (Rio Grande do Sul State), assessed using the General Health Questionnaire (GHQ-12) and the Hospital Anxiety and Depression Scale (HAD). The rate of mental disorders in patients from Rio de Janeiro, São Paulo, Fortaleza and Porto Alegre were found to be, respectively, 51.9%, 53.3%, 64.3% and 57.7% with significant differences between Porto Alegre and Fortaleza compared to Rio de Janeiro after adjusting for confounders. Prevalence proportions of mental problems were especially common for females, the unemployed, those with less education and those with lower incomes. In the context of the Brazilian government's moves towards developing primary health care and reorganizing mental health policies it is relevant to consider common mental disorders as a priority alongside other chronic health conditions.

Desenvolvimento de equações generalizadas para estimativa da coordenação motora em crianças e adolescentes portadores de deficiencia mental

Universidade Estadual de Campinas . Faculdade de Educação Física

Atividade motora adaptada : o conhecimento produzido nos programas Stricto Sensu em Educação Física no Brasil

Universidade Estadual de Campinas . Faculdade de Educação Física

Pedagogia do esporte : organização, sistematização, aplicação e avaliação de conteúdos esportivos na educação não formal = Sport pedagogy : organization, systematization and application of sports content in non-formal education

Universidade Estadual de Campinas . Faculdade de Educação Física