Da colônia agrícola ao hospital-colônia: configurações para a assistência psiquiátrica no Brasil na primeira metade do século XX From the agricultural colony to the hospital-colony: configurations for psychiatric care in Brazil in the first half of the twentieth century

Discute os sentidos do modelo institucional das colônias na assistência psiquiátrica no Brasil, considerando suas diferentes configurações no contexto das políticas públicas de saúde na primeira metade do século XX. Toma como fio condutor a Colônia Juliano Moreira, fundada em 1924 no Rio de Janeiro. Demonstra o significado atribuído à concepção de colônia agrícola e sua importância na formatação da Colônia Juliano Moreira, para compreender como o ideário da colônia agrícola foi traduzido na concepção de hospital-colônia a partir dos anos 1940, quando essa instituição sofreu processo de acentuada expansão de sua estrutura física e de seus recursos terapêuticos.<br>The meanings given to the institutional model of the colonies in psychiatric care in Brazil are assessed, duly considering their different configurations in the context of public health policies in the first half of the twentieth century. The central thread of this analysis is the case of the Colônia Juliano Moreira, an institution founded in 1924 in Rio de Janeiro. It seeks to show the meaning attributed to the concept of agricultural colony and its importance in shaping the Colônia Juliano Moreira, in order to understand how the ideological precept of agricultural colony was translated into the concept of hospital-colony from the 1940s onwards, when this institution experienced a steady process of marked expansion of its physical structure and its therapeutic resources

Efeito residual do lodo de esgoto na produtividade do milho safrinha Residual effect of sewage sludge on off-season corn yield

Das opções de disposição final do lodo de esgoto, a reciclagem agrícola tem sido uma das mais utilizadas em diversos países desenvolvidos, sendo considerada a forma mais adequada em termos técnicos, econômicos e ambientais. Este trabalho teve por objetivo avaliar o efeito residual do lodo de esgoto na produtividade do milho safrinha, após dois anos de aplicação consecutiva desse resíduo em um Latossolo Vermelho eutroférrico. O experimento foi realizado em campo, em delineamento em blocos ao acaso com três repetições, e os tratamentos foram os seguintes: testemunha e adubações com lodo de esgoto nas doses de 6, 12, 24 e 36 t ha-1 (peso de matéria seca). Houve efeito residual do uso do lodo de esgoto caleado na produtividade de milho safrinha; a dose de 36 t ha-1 foi estatisticamente superior às doses de 6 e 12 t ha-1.<br>Among the possibilities of final disposal of sewage sludge, agricultural recycling has become one of the most widely used in several developed countries, and is considered the most appropriate in technical, economical and environmental terms. This study aimed at evaluating the sewage sludge residual effect on off-season corn yield on an Eutroferric Red Latossol (Oxisol). The field experiment was in a randomized block design with three replications, with treatments consisting of increasing doses of sewage sludge (0, 6, 12, 24 and 36 t ha-1, on a dry weight basis), applied in the two previous cropping seasons.. The residual effect of the application of lime-stabilized sewage sludge increased the yield of off-season corn; the grain yield under a rate of 36 t ha-1 was statistically higher than those under 6 and 12 t ha-1

Uma história de conceitos na saúde pública: integralidade, coordenação, descentralização, regionalização e universalidade A history of public health concepts: integrity, coordination, decentralization, regionalization, and universality

O Sistema Único de Saúde conferiu visibilidade a uma série de conceitos próprios da organização de sistemas de saúde. Entre eles a integralidade, que delimita fronteiras comuns com quase todos os demais princípios do Sistema, tem sido objeto de ampla literatura no Brasil. Com base em extensa revisão de fontes primárias e secundárias, este artigo apresenta uma recuperação histórica dos conceitos de integralidade, descentralização, regionalização e universalidade - ideias e conceitos que em grande parte se conformam e se interligam no ideário da organização dos serviços sanitários pelo modelo dos Centros de Saúde distritais.<br>Brazil's Unified Health System (Sistema Único de Saúde) has highlighted a series of concepts specific to the organization of healthcare systems. Among these, integrity - which shares boundaries with almost all other System principles - has been the object of much academic production in Brazil. Based on an extensive review of primary and secondary sources, the article offers a historical recovery of the concepts of integrity, decentralization, regionalization, and universality - ideas and concepts that in good measure are shaped by and interlinked with the set of ideals of the organization of sanitary services according to the district health centers model

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author