As comunidades terapêuticas e as reminiscências do modelo manicomial : análise à luz dos parâmetros interamericanos de direitos humanos

Orientadora: Melina Girardi FachinMonografia (graduação) - Universidade Federal do Paraná, Setor de Ciências Jurídicas, Curso de Graduação em DireitoInclui referênciasResumo: O objetivo do presente trabalho é verificar se as características e práticas das comunidades terapêuticas (CTs) no Brasil estão em acordo ou desacordo com as obrigações do Estado brasileiro perante o Sistema Interamericano de Direitos Humanos (SIDH) no contexto de assistência à saúde mental. Para tanto, realizou-se revisão da jurisprudência da Corte Interamericana de Direitos Humanos para extração dos parâmetros de proteção dos direitos humanos das pessoas sob assistência em saúde mental. Em um segundo momento, foi realizada pesquisa documental e bibliográfica sobre o contexto da política de atenção à saúde mental no Brasil e sobre as características e práticas das CTs. A partir disso, verificou-se que o caso Ximenes Lopes Vs. Brasil trouxe importantes parâmetros sobre o respeito e a garantia dos direitos humanos das pessoas sob assistência em saúde mental, os quais foram reafirmados e acrescidos de outros parâmetros protetivos no caso Guachalá Chimbo e outros Vs. Equador. Ademais, constatou-se que o modelo de atenção em saúde mental implementado a partir da reforma psiquiátrica contribui para a proteção dos direitos humanos das pessoas sob assistência em saúde mental conforme os parâmetros do SIDH; contudo, a partir de 2016, houve um claro retrocesso na implementação da reforma, o que se deu concomitantemente ao fortalecimento das CTs. Isso indica um cenário em que o modelo manicomial recupera espaço na política nacional de atenção em saúde mental, sobretudo no que toca à atenção de pessoas que fazem uso problemático de substâncias psicoativas, público alvo das CTs. As características e práticas dessas instituições, além de trazerem reminiscências do modelo manicomial, violam diversas obrigações do Estado brasileiro perante o SIDH no contexto de assistência à saúde mental. Assim, concluiu-se pela necessidade de uma devida regulamentação, bem como da fiscalização rigorosa e regular dessas instituições para que se garanta o respeito aos direitos humanos das pessoas nelas acolhidasAbstract: The purpose of this study is to examine whether the characteristics and practices of therapeutic communities (CTs) in Brazil align or conflict with the obligations of the Brazilian state under the Inter-American Human Rights System in the context of mental health care. To achieve this, a review of Inter-American Human Rights jurisprudence was conducted to extract standards for the protection of human rights for individuals under mental health care. Subsequently, documentary and bibliographical research was conducted on the context of mental health care policy in Brazil and on the characteristics and practices of CTs. It was found that the case of Ximenes Lopes vs. Brazil provided important standards regarding the respect and guarantee of human rights for individuals under mental health care, which were reaffirmed and further developed in the case of Guachalá Chimbo and others vs. Ecuador case. Additionally, it was observed that the mental health care model implemented since the psychiatric reform contributes to the protection of human rights for individuals under mental health care in accordance with the parameters of the IACHR. However, since 2016, there has been a clear regression in the implementation of the reform, coinciding with the strengthening of CTs. This indicates a scenario in which the asylum model regains prominence within the national mental health care policy, especially regarding the care of individuals with problematic substance use, the target population of CTs. The characteristics and practices of these institutions, reminiscent of the asylum model, violate various obligations of the Brazilian state under the IACHR in the context of mental health care. Thus, it is concluded that there is a need for proper regulation, as well as rigorous and regular monitoring of these institutions to ensure respect for the human rights of the individuals they serve

Availability and stability of soluble fluoride content in commercial fluoride dentifrices available in Uruguay

The aim of this study was to evaluate the availability and stability of soluble fluoride fraction in commercial fluoride toothpastes available in Uruguay. Methods: Fourteen fluoride toothpastes from four different manufacturers were analyzed. Randomized and blinded analyses were performed in duplicate for each dentifrice at the time of purchase (fresh samples) and after 12 months of storage at room temperature (aged samples). Total fluoride and total soluble fluoride concentrations were measured using a fluoride specific electrode. Results: Total fluoride concentrations in all of the products were lower than the F levels specified by the manufacturers. Total soluble fluoride fractions were lower than the total fluoride concentrations in fresh samples of five toothpastes and in aged samples of ten toothpastes (p < 0.05). Three toothpastes had insufficient and unstable total soluble fluoride fractions (< 60%) and five toothpastes had only unstable total soluble fluoride fractions (<1000 ppm) after 12 months. Conclusion: Based on the results of this study, it can be concluded that from fourteen Uruguayan commercial fluoride toothpastes analyzed in this study, three toothpastes have insufficient and unstable chemically active F fractions and five other toothpastes have the lack of stability which may compromise their efficacies. Review the guidelines on fluoride dentifrices in Uruguay is necessary, in order to ensure optimum benefit for population

Propiedades psicométricas de la escala de bienestar psicológico

Durante muchos años, la psicología se ha dedicado a estudiar aquello que se encuentra mal, débil y dañado; y se dejó de lado la idea de un individuo completo y la posibilidad de construir fortaleza en una persona (Seligman, 2002). Es a partir de esta realidad, en donde nace el constructo de bienestar psicológico. En el contexto peruano, hay ciertas pruebas que miden dicha variable; sin embargo, suelen ser muy largas para ciertos tipos de poblaciones. Es por ello, que la presente investigación tuvo como objetivo reportar las propiedades psicométricas de la Escala de Bienestar Psicológicas de Díaz et al. (2006) conformada por 29 ítems. La prueba fue aplicada a 397 personas residentes de Lima Metropolitana cuyas edades oscilan entre los 18 y 72 años de edad. Se proporcionan evidencias de validez vinculadas al contenido de la prueba a través de un criterio de jueces conformado por once expertos. A partir de la calificación dada por los jueces, se estimó el coeficiente V de Aiken de .70 como valor mínimo aceptable para cada ítem. Asimismo, se reportan evidencias de validez vinculadas a la estructura interna de la prueba, por medio del análisis factorial exploratorio utilizando el método ULS de Jöreskog (1977) para extraer el número de factores y el método de rotación oblicua Promin (Lorenzo-Seva, 1999). Luego de aplicar las estrategias mencionadas, se encontró una estructura unidimensional. Por último, se obtuvieron las evidencias de confiabilidad de las puntuaciones mediante el método de consistencia interna al obtener el coeficiente de omega de .96 y el error estándar de medición (EEM = .134)

Análisis de la Escala de Bienestar Psicológico para Adultos usando el modelo de respuesta graduada

The Psychological Well-Being Scale for Adults (BIEPS-A) was proposed as a multidimensional measure of psychological well-being. The present study hypothesized that the BIEPS-A is an essentially unidimensional measure and, therefore, can be analysed with unidimensional item response theory models. We examined data from 1016 Peruvian undergraduates (Mage = 20.56, 50% women) and found support for our unidimensionality hypothesis. Thus, the graded response model was applied to the BIEPS-A items. All of them performed acceptably only at low levels of the construct, while they performed poorly at average and higher levels of psychological well-being. The implications of these findings are discussed and suggestions for future developments are also offered.La Escala de Bienestar Psicológico para Adultos (BIEPS-A) fue propuesta como una medida multidimensional de bienestar psicológico. El presente estudio planteó la hipótesis de que la escala BIEPS-A es una medida esencialmente unidimensional y, por lo tanto, puede analizarse con modelos unidimensionales de la teoría de respuesta a los ítems. Examinamos datos de 1016 estudiantes universitarios peruanos (Medad = 20.56, 50 % mujeres) y encontramos apoyo para nuestra hipótesis de unidimensionalidad. Por lo tanto, el modelo de respuesta graduada se aplicó a los ítems de la escala BIEPS-A. Todos ellos funcionaron de manera aceptable solo a niveles bajos del constructo, mientras que se desempeñaron mal a niveles promedio y más altos de bienestar psicológico. Se discuten las implicaciones de estos hallazgos y también se ofrecen sugerencias para futuros desarrollos

Joint effect of physical activity and sedentary behaviour on cardiovascular risk factors in Chilean adults

Background: To investigate the associations between combined categories of moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) with markers of adiposity and cardiovascular risk in adults. Methods: Overall, 5040 participants (mean age 46.4 years and 59.3% women) from the cross-sectional Chilean National Health Survey 2009–2010 were included in this study. MVPA and SB were measured using the Global Physical Activity questionnaire. Four categories were computed using MVPA- and SB-specific cut-offs (‘High-SB &#38; Active’, ‘Low-SB &#38; Active’, ‘High-SB &#38; Inactive’ and ‘Low-SB &#38; Inactive’). Results: Compared to the reference group (‘High-SB &#38; Inactive’), those in ‘High-SB &#38; Active’ and ‘Low-SB &#38; Active’ were less likely to have an obese BMI (OR: 0.67 [0.54; 0.85], P = 0.0001 and 0.74 [0.59; 0.92] P = 0.0007, respectively) and less likely to have metabolic syndrome (OR: 0.63 [0.49; 0.82], P &lt; 0.0001 and 0.72 [0.57; 0.91], P = 0.007), central obesity (OR: 0.79 [0.65; 0.96], P = 0.016 and 0.71 [0.59; 0.84], P &lt; 0.0001), diabetes (OR: 0.45 [0.35; 0.59], P &lt; 0.0001 and 0.44 [0.34; 0.56], P &lt; 0.0001) and hypertension (OR: 0.52 [0.43; 0.63], P &lt; 0.0001 and 0.60 [0.50; 0.72], P &lt; 0.0001), respectively. Conclusions: Being physically active and spending less time in SBs was associated with lower adiposity and improvements in cardiovascular risk factors

Active commuting is associated with a lower risk of obesity, diabetes and metabolic syndrome in Chilean adults

Background: There is limited evidence on how active commuting is associated with health benefits in developing countries. The aim of this study therefore was to investigate the associations between active commuting and markers of adiposity and cardiometabolic risk in the Chilean adult population. Methods: In total, 5157 participants from the Chilean National Health Survey 2009–10 were included in this cross-sectional study. Active commuting was measured using the Global Physical Activity Questionnaire (GPAQ v2). Body mass index (BMI) and waist circumference (WC) were measured and used to define obesity and central obesity. Type 2 diabetes (T2D) and metabolic syndrome were determined using WHO and updated ATPIII-NCEP criteria, respectively. Results: The main finding of this study is that a 30 min increase in active commuting is associated with lower odds for BMI &gt; 25.0 kg m−2 (0.93 [95% CI: 0.88–0.98, P = 0.010]). Similarly, the odds for central obesity was 0.87 [0.82–0.92, P &lt; 0.0001]. Similar associations were found for T2D (0.81 [0.75–0.88], P &lt; 0.0001) and metabolic syndrome (OR: 0.86 [0.80–0.92], P &lt; 0.0001). Conclusion: Our findings show that active commuting is associated with lower adiposity and a healthier metabolic profile including lower risk for obesity, diabetes and metabolic syndrome

Integraltion of Chaco-Paraná and Paraná basins terrestrial gravity data using GOCE geopotential model: a Major Proterozoic to Cambrian suture revealed

The Chaco-Paraná basin (CPB) is located mostly in the north-eastern Argentina, covering an area of approximately 700,000 km2 in a lowland region (~100 m a.s.l.), known as Chacopampean plain. The average sediment thickness of the basin is 4,000 m, and along the Las Breñas fault zone the sediment thickness may reach more than 6,000 m. The Paraná basin (PB) is located in south Brazil, covering an area of over 1,000,000 km2 and its cumulative sediment and basalt thickness reaches up to 7,000 m. The topography over the PB is more irregular and has an average altitude of 700 m around its borders and of 300 m along the Paraná River. (...)CAPES - Mincyt Project 234/13CNPqSECIT

Diagrama de redes y ruta crítica aplicado al casco estructural de una edificación escolar

El diagrama de redes y ruta crítica es un método de planificación utilizado desde 1956 en diversos sectores, no solo en el de construcción. Su eficiencia y simplicidad ha sido tal que hasta la fecha actual se mantiene el uso de este método. Mediante la elaboración del presente documento, se quiere comprobar la capacidad de sintetización y orden que esta ofrece; así mismo, evaluar la eficiencia de aplicación en proyectos mayores a un nivel y constatar que es una excelente herramienta de control y seguimiento en proyectos de construcción. Así mismo, el desarrollo de la investigación contempla la elaboración del diagrama de redes y ruta crítica para la etapa del casco estructural del proyecto de un pabellón escolar. Se plantean tres escenarios: bajo condiciones normales, con un retraso en partidas que afectan la duración total del proyecto y por último asumiendo de igual forma el retraso del segundo modelo, pero, reasignando recursos, modo tal que los rendimientos sean mayores y concluya el proyecto en el tiempo planificado (duración del primer modelo). Como resultados se obtuvieron los siguientes tiempos de ejecución: para el primer caso 146 días, para el segundo caso 150 días y para el tercer caso, de igual modo que el primero, 146 días. Cabe destacar que el estudio se apoya en el uso de programas informáticos de planificación como S10 y Project; los cuales permiten que la elaboración de este método sea sencilla y rápida, volviéndolo aún más eficaz y adaptable en el tiempo

Linear, Non-Conjugated Cyclic and Conjugated Cyclic Paraphenylene under Pressure

The n-paraphenylene family comprises chains of phenylene units linked together by C-C bonds that are between single- and double-bonded, and where n corresponds to the number of phenylene units. In this work, we compare the response of the optical properties of different phenylene arrangements. We study linear chains (LPP), cyclic systems (CPPs), and non-conjugated cyclic systems with two hydrogenated phenylenes (H4[n]CPP). Particularly, the systems of interest in this work are [6]LPP, [12]- and [6]CPP and H4[6]CPP. This work combines Raman and infrared spectroscopies with absorption and fluorescence (one- and two-photon excitations) measured as a function of pressure up to maximum of about 25 GPa. Unprecedented crystallographic pressure-dependent results are shown on H4[n]CPP, revealing intramolecular ¿-¿ interactions upon compression. These intramolecular interactions justify the H4[n]CPP singular optical properties with increasing fluorescence lifetime as a function of pressure