Saúde Mental na Atenção Primária: tecendo ferramentas de abordagem familiar

Este estudo de caso objetiva realizar análise das relações dos sujeitos com transtorno mental, a partir de ferramentas de abordagem familiar, no município de Tianguá - Ceará, Brasil, no período de abril a junho de 2015. As informações foram coletadas por meio de uma entrevista e diário de campo, durante visita ao lar, também mapeadas e analisadas a partir das seguintes ferramentas de avaliação familiar: tipologia, genograma, ecomapa e P.R.A.C.T.I.C.E. O núcleo familiar é composto por quatro membros, sendo Rosa uma deficiente auditiva (mãe e provedora da família) e três filhos com transtorno mental: o Cravo (esquizofrenia), o Girassol (transtorno mental severo) e a Margarida (deficiente mental), que vivem em situação de extrema vulnerabilidade social, segundo a Escala de Risco Familiar Coelho-Savassi (ERF-CS). Os resultados evidenciaram um arranjo monoparental feminino, escore 32 da ERF-CS, com interação social frágil e relações familiares conflituosas e distantes, acentuadas pela descompensação mental e falta de apoio multiprofissional especializado. O estudo mostra a importância do uso de ferramentas de abordagem familiar para potencializar práticas e fortalecer o papel ordenador da ESF/APS. Contudo, diante de casos complexos, sozinha, a ESF/APS não consegue efetivar a integralidade, requerendo, portanto, apoio matricial da rede especializada, proporcionando mais autonomia aos sujeitos.Este estudio de caso tiene como objetivo realizar análisis de las relaciones de los sujetos con trastorno mental, a partir de herramientas de abordaje familiar, en el municipio de Tianguá - Ceará, Brasil, en el período de abril a junio de 2015. Las informaciones fueron recolectadas por medio de una entrevista y diario de campo, durante visita al hogar, también mapeadas y analizadas a partir de las siguientes herramientas de evaluación familiar: tipología, genograma, ecomapa y P.R.A.C.T.I.C.E. El núcleo familiar está compuesto por cuatro miembros, siendo Rosa una deficiente auditiva (madre y proveedora de la familia) y tres hijos con trastorno mental: Clavel (esquizofrenia), Girasol (trastorno mental severo) y Margarita (deficiente mental), que viven en situación de extrema vulnerabilidad social, según la Escala de Riesgo Familiar Coelho-Savassi (ERF-CS). Los resultados evidenciaron un núcleo monoparental femenino, escore 32 de la ERF-CS, con interacción social frágil y relaciones familiares conflictivas y distantes, acentuadas por la descompensación mental y falta de apoyo multiprofesional especializado. El estudio muestra la importancia del uso de herramientas de abordaje familiar para potenciar prácticas y fortalecer el papel ordenador de la ESF/APS. Sin embargo, delante de casos complejos, solamente, la ESF/APS no consigue hacer efectiva la integralidad, requiriendo, por lo tanto, apoyo matricial de la red especializada, proporcionando más autonomía a los sujetos.The objective of this case study is to conduct analysis of the relations of individuals with mental disorders, with the use of family approach tools in the municipality of Tianguá - Ceará, Brazil, from April to June 2015. The information was collected through interviews and field diary, during home visits; followed by mapping and analysis of family assessment tools: typology, genogram, ecomap and impaired (mother and provider of the family) and three children had mental disorders: Carnation (Schizophrenia), Sunflower (severe mental disorder) and Margaret (mentally handicapped). This family lives in extreme social vulnerability according to the Coelho-Savassi Family Risk Scale (ERF-CS). The results showed a female single parent arrangement, scoring 32 at ERF-CS with frail social interaction and distant family relations, marked by mental decompensation and lack of specialized multidisciplinary support. The study shows the importance of using family approach tools to enhance practices and strengthen the role of the FHS/PHC. However, in view of complex cases alone, the FHS/PHC cannot be effective, requiring, therefore, matrix support of specialized network which provides more autonomy to the subjects

Reproductive performance of Santa Inês ewes fed protected fat diet

O objetivo deste trabalho foi avaliar o desempenho reprodutivo de ovelhas Santa Inês alimentadas com dieta suplementada com gordura protegida. Os intervalos do parto ao primeiro estro clínico e à concepção, a taxa de gestação, a prolificidade, o peso vivo e a condição corporal foram determinados. Depois do parto, 60 ovelhas e seus cordeiros foram pesados e distribuídos aleatoriamente em três tratamentos com base na idade, peso corporal e número de cordeiros nascidos. Os tratamentos consistiram de dieta controle ou da dieta controle mais 30 g de gordura protegida, do parto aos 25 dias pós‑parto (Sup25), ou aos 60 dias pós‑parto (Sup60). Das 60 ovelhas avaliadas, 93,3% retornaram ao estro, e 74,5% ficaram prenhes, com taxa de parição de 73,53% e intervalo de parto de 196,5 dias. O período médio do parto até o primeiro estro foi de 32,4, 27,2 e 35,5 dias, para as ovelhas alimentadas com a dieta controle, Sup25 e Sup60, respectivamente. Os intervalos do parto até a concepção foram de 45,2, 46,5 e 45,2 dias, e as dietas com suplementação não apresentaram diferenças em comparação ao tratamento controle. A suplementação com gordura protegida para ovelhas da raça Santa Inês, bem nutridas, não melhora seu desempenho reprodutivo.The objective of this work was to evaluate the reproductive performance of Santa Inês ewes fed a diet supplemented with protected fat. Intervals from lambing to first clinical estrus and to conception, conception rate, prolificacy, live weight and body condition were determined. After lambing, 60 ewes and their offsprings were weighted and randomly assigned to three treatments, based on age, body weight and number of born lambs. Treatments consisted of: control diet, or control diet plus 30 g of protected fat, from lambing to day 25 of post‑lambing (Sup25), or to day 60 of post‑lambing (Sup60). Out of 60 evaluated ewes, 93.3% returned to estrus, and 74.5% got pregnant, with 73.53% lambing rate and 196.5 days lambing interval. The average periods from lambing to first estrus were 32.4, 27.2 and 35.5 days for ewes fed the control diet, Sup25, and Sup60, respectively. The intervals from lambing to conception were 45.2, 46.5 and 45.2 days, and the supplemented diets did not show differences in comparison to the control diet. Supplementation with protected fat to well-nourished Santa Inês ewes does not improve their reproductive performance

Inquérito sobre o HIV entre HSH no Brasil em 2016 usando respondent-driven sampling (RDS) : descrição dos métodos e dos diagnósticos do RDS

Introdução: Este artigo detalha os métodos utilizados na segunda Pesquisa Nacional de Vigilância Biológica e Comportamental (BBSS) do HIV, sífilis e hepatite B e C entre os homens que fazem sexo com homens no Brasil. Métodos: O método Respondent-driven Sampling (RDS) foi utilizado em 12 cidades em 2016. A amostra foi iniciada com cinco a seis sementes em cada cidade. Testes rápidos para o HIV, sífilis e Hepatite B e C foram oferecidos aos participantes. O software RDS Analyst com o estimador de amostragem sucessiva (SS) de Gile foi utilizado para ajustar os resultados como recomendado, gerando um peso para cada indivíduo para análises. Osdados das 12cidades foram unidos em um único banco e analisados usando as ferramentas de dados complexos do Stata 14.0, com cada cidade sendo tratada como seu próprio estrato. Resultados: A duração da coleta de dados variou de 5,9 a 17,6 semanas e 4.176 homens foram recrutados nas 12 cidades. Dois sites não alcançaram o tamanho da amostra alvo devido a uma demora de seis meses na aprovação local do Comitê de Ética. Todas as cidades atingiram a convergência na principal variável estudada (HIV). Conclusão: O BBSS foi representativo e concluído conforme planejado e dentro do orçamento. A descrição dos métodos aqui é mais detalhada do que o habitual, devido às novas ferramentas e requisitos de diagnóstico das novas diretrizes do STROBE-RDS.Introduction: This paper details the methods used in the second national Biological and Behavioral Surveillance Survey (BBSS) of HIV, syphilis, and hepatitis B and C among men who have sex with men in Brazil. Methods: Respondent-driven sampling (RDS) was used in 12 cities in 2016. The targeted sample size was initiated with five to six seeds in each city. HIV, syphilis, and Hepatitis B and C rapid tests were offered to participants. RDS Analyst with Gile’s successive sampling (SS) estimator was used to adjust results as recommended and a weight for each individual was generated for further analysis. Data for the 12 cities were merged and analyzed using Stata 14.0 complex survey data tools with each city treated as its own stratum. Results: Duration of data collection varied from 5.9 to 17.6 weeks. 4,176 men were recruited in the 12 cities. Two sites failed to achieve targeted sample size due to a six-month delay in local IRB approval. No city failed to reach convergence in our major outcome variable (HIV). Conclusion: The comprehensive BBSS was completed as planned and on budget. The description of methods here is more detailed than usual, due to new diagnostic tools and requirements of the new STROBE-RDS guidelines

A social and ecological assessment of tropical land uses at multiple scales: the Sustainable Amazon Network

Science has a critical role to play in guiding more sustainable development trajectories. Here, we present the Sustainable Amazon Network (Rede Amazonia Sustentavel, RAS): a multidisciplinary research initiative involving more than 30 partner organizations working to assess both social and ecological dimensions of land-use sustainability in eastern Brazilian Amazonia. The research approach adopted by RAS offers three advantages for addressing land-use sustainability problems: (i) the collection of synchronized and co-located ecological and socioeconomic data across broad gradients of past and present human use; (ii) a nested sampling design to aid comparison of ecological and socioeconomic conditions associated with different land uses across local, landscape and regional scales; and (iii) a strong engagement with a wide variety of actors and non-research institutions. Here, we elaborate on these key features, and identify the ways in which RAS can help in highlighting those problems in most urgent need of attention, and in guiding improvements in land-use sustainability in Amazonia and elsewhere in the tropics. We also discuss some of the practical lessons, limitations and realities faced during the development of the RAS initiative so far.Keywords: Social–ecological systems, Tropical forests, Land use, Interdisciplinary research, Sustainability, Trade-off

Anti-HIV-1 seroreactivity and HIV transmission route[R1]

Made available in DSpace on 2010-08-23T16:58:49Z (GMT). No. of bitstreams: 3 license.txt: 1848 bytes, checksum: 9bb8f65f67107ba6a95f9f2a8ded1f54 (MD5) LANDMANN_BASTOS_Anti-HIV Seroreactivity_1999.pdf: 115488 bytes, checksum: 822ef0044d528414151cf2fc097db530 (MD5) LANDMANN_BASTOS_Anti-HIV Seroreactivity_1999.pdf.txt: 37638 bytes, checksum: c02649157725807b912ca746ee5f1d54 (MD5) Previous issue date: 1999Made available in DSpace on 2010-11-04T14:20:09Z (GMT). No. of bitstreams: 3 LANDMANN_BASTOS_Anti-HIV Seroreactivity_1999.pdf.txt: 37638 bytes, checksum: c02649157725807b912ca746ee5f1d54 (MD5) LANDMANN_BASTOS_Anti-HIV Seroreactivity_1999.pdf: 115488 bytes, checksum: 822ef0044d528414151cf2fc097db530 (MD5) license.txt: 1848 bytes, checksum: 9bb8f65f67107ba6a95f9f2a8ded1f54 (MD5) Previous issue date: 1999Research supported by the FIOCRUZ Integrated AIDS Program PIAF, World Bank 063:94, CNPq 520922:95-6 and CNPq:MRC(Canada).Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Centro Centro de Informação Cientifica e Tecnológica. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Centro de Informação Cientifica e Tecnológica Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Centro de Informação Cientifica e Tecnológica. Rio de Janeiro, RJ, BrasilUniversidade Estadual do Rio de Janeiro. NEPAD. Rio de Janeiro, RJ, BrasilHospital Geral de Nova Iguaçu. Rio de Janeiro, RJ, BrasilHospital dos Servidores do Estado. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, BrasilBackground: antibody binding assays carried out by our group have consistently indicated a higher reactivity of sera from male HIV-1 infected individuals. This study was carried out in order to analyze the importance of gender, route of transmission, disease progression and HIV-1 genotype in seroreactivity assays. Study design: specificity of antibody binding was studied in plasma of 247 HIV-1 seropositive individuals belonging to patient groups of pregnant women, injecting drug users (IDUs) and recent seroconvertors, resident in Rio de Janeiro, RJ. Recognition of synthetic peptides corresponding to antigenically important epitopes in the envelope of HIV-1 (gp41 immunodominant epitope, V3 loop, V2 loop and gp41 735–752 epitope) was determined. Results: the immunodominant gp41 peptide (amino acids 594–613, HIV-1 MN sequence) was recognized by 85% of all plasma tested. Reactivity with the gp41 735–752 peptide and gp120 V2 loop peptides was low but quite variable, being generally more often specific to a Brazilian V2 peptide used than to the HIV-1 MN derived V2 peptide. The overall recognition of the different V3 peptides tested varied from 41 to 76%. Patients with more advanced disease showed a more frequent reactivity with the peptides studied than did asymptomatic patients. Statistically significant differences in peptide recognition were observed by multiple logistic analyses comparing plasma derived from individuals infected by blood or sexual HIV transmission, adjusting for disease progression and gender. Plasma from individuals infected by sexual transmission showed lower peptide recognition than did plasma from individuals infected through HIV positive blood. Association attempts between seroreactivity and genotype indicated that plasma derived from patients infected with HIV-1 of the F subtype showed highest recognition of heterologous V3 peptides, as well as a slightly more frequent recognition of the non-V3 peptides tested. Recognition of homologous peptides was generally higher than recognition of heterologous peptides. Differences were most pronounced between the prototypical HIV-1 B subtype and the Brazilian B′′ variant of this subtype but almost non-existent between the HIV-1 B and F subtypes. Conclusions: individual gender was shown to be a confounder when investigating the relationships of peptide reaction to HIV-1 route of transmission through multivariate statistical methods: patients infected by blood transmission (IDU) present higher frequency of peptide recognition than individuals infected by sexual HIV-1 transmission. Plasma from individuals infected with the B′′ variant (GWG) of B subtype HIV-1 showed lower heterologous peptide recognition than that from HIV-1 B (GPG) or F infected individuals