Utility of a multidimensional recovery framework in understanding lived experiences of Chilean and Brazilian mental health service users

The understanding and application of recovery, despite its potential benefits for mental health services, is still in its incipient development in Latin America. Psychiatric reform in the region has been broadly known and discussed; yet, the recovery framework requires further exploration. Whitley and Drake (2010) suggested a recovery framework including five dimensions: clinical, existential, functional, physical, and social, offering a comprehensive perspective of the recovery process. The present study aimed to explore Chilean and Brazilian users’ perspectives on recovery identifying their endorsement of these five dimensions. Twenty-four users and six peer support workers were interviewed on their experiences with the Critical Time Intervention-Task Shifting (CTI-TS) carried out in Santiago (Chile) and in Rio de Janeiro (Brazil). Using a framework analysis approach focused on the users’ recovery process, we examined the utility of Whitley & Drake’s recovery framework in Chile and Brazil. Results showed that: 1. The framework was applicable to this population; 2. For Chilean and Brazilian users, dimensions were intertwined and influenced by salient processes (i.e., continuum of care, centrality of functioning and social life); and 3. Cultural values, stigma, and social determinants (e.g., housing, welfare) were mentioned as crucial factors affecting  treatment and recovery but had not been sufficiently accounted for in the framework. A reinterpretation of the framework was proposed based on Chilean and Brazilian users’ lived experiences. Findings add to the international literature on recovery by increasing the social validity of the multidimensional framework and expanding its utility to diverse populations.La comprensión y aplicación del concepto de recuperación, a pesar de sus posibles beneficios para los servicios de salud mental, aún se encuentra en incipiente desarrollo en América Latina. Si bien la reforma psiquiátrica en la región ha tenido algunos avances, el marco de la recuperación no ha sido suficientemente explorado. Whitley y Drake (2010) sugirieron un marco conceptual integral para la recuperación que incluye cinco dimensiones: clínica, existencial, funcional, física y social. El presente estudio tuvo como objetivo explorar las perspectivas de los usuarios chilenos y brasileños sobre la recuperación identificando su adscripción y aplicabilidad de estas cinco dimensiones. Se entrevistó a treinta participantes de la Intervención en Momento Crítico-Delegación de Funciones (CTI-TS) realizada en Santiago (Chile) y en Río de Janeiro (Brasil) sobre sus experiencias de recuperación. Se exploró la aplicabilidad del marco de Whitley y Drake al contexto de Chile y de Brasil. Los resultados mostraron que: 1. El marco era aplicable a esta población; 2. Las dimensiones presentaban un tipo particular de entrelazamiento y estaban influenciadas por una serie de procesos tales como la continuidad en el proceso de atención/cuidado/autocuidado, y sobresalía la funcionalidad y la esfera social; 3. Los valores culturales, el estigma y los determinantes sociales emergieron como factores cruciales que afectan el tratamiento y la recuperación. Se propuso una reinterpretación del esquema referencial. Los hallazgos representan un aporte a la literatura internacional sobre recuperación al aumentar la validez de este marco referencial multidimensional y su aplicabilidad a diversas poblaciones

Patrimônio Cultural e escrita da história:a hipótese do documento na prática do Iphan nos anos 1980

In the 1980s, technicians from the Institute for National Artistic and Historical Heritage (Iphan) began to look to the academic discipline of History for arguments to support the selection of heritage assets that went beyond the grandiose. Engaging actors and concepts from France’s historiography they justified listing buildings and urban ensembles with characteristics that did not fit into the colonial-based national identity narratives used by the institution in its early decades. During this time, sites such as Laguna (in Santa Catarina State), Cuiabá (in Mato Grosso State), Morro da Conceição and XV de Novembro Square (in the City of Rio de Janeiro), among others, were preserved not only for the historical value of their buildings, but also for their potential as a source of history. New preservation rationales for immovable assets were developed; these sought to circumvent the concepts set out in the provisions of Decree-Law No. 25/37, striving instead to protect sites and places according to their documental value. This article aims to discuss the city as a document, retrieving the concepts of document from Social History and Brazilian historiographical practices in their relationship with the preservation of built heritage. We will seek to examine how cities and their architecture were treated as sources by the field of preservation in Brazil, as well as to understand the theoretical discourse and the authors mentioned herein, such as Marc Bloch and Jacques Le Goff, and the studies of the urban centers where such rationale was put to practice, most notably Laguna, in Santa Catarina.Na década de 1980, técnicos do Instituto do Patrimônio Histórico e Artístico Nacional (Iphan) passaram a utilizar argumentos do campo disciplinar da história para justificar a seleção do patrimônio para além dos cânones da excepcionalidade. Mobilizando autores e conceitos da Escola dos Annales, justificavam tombamentos de conjuntos urbanos cujas características não se enquadravam nas narrativas de identidade nacional via colonial praticadas nas primeiras décadas da Instituição. Laguna/SC, Cuiabá/MS, Morro da Conceição e Praça XV de Novembro no Rio de Janeiro, por exemplo, serão preservados não somente pelo valor histórico das suas edificações, mas também pela sua potencialidade como fonte histórica. Elaboram-se, então, argumentos de preservação de bens imóveis que buscavam driblar os conceitos do aporte legal do Decreto-lei no 25/37, buscando proteger sítios e lugares por seu valor documental. O artigo discute as relações entre escrita da história e preservação do patrimônio cultural, tendo como foco o caso de Laguna/SC. Pretende-se compreender de que maneira a proteção legal foi justificada a partir do inédito entendimento da cidade como documento por meio do estudo do processo de tombamento, seus estudos técnicos e as mobilizações teóricas do campo da história social e de autores como Marc Bloch e Jacques Le Goff

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (>59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P <.001). Overall motor and cognitive performance (P <.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P <.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P <.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P <.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Núcleos de Ensino da Unesp: artigos 2007

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq