Gênero e direito ao acompanhante no espaço do pré-natal

O artigo problematiza as percepções das gestantes, dos acompanhantes e dos profissionais de saúde acerca dodireito ao acompanhante no pré-natal de uma unidade pública de saúde do Rio de Janeiro, partindo do pressuposto deque a informação sobre o mesmo é pouco conhecida pela população, assim como, pouco socializada pelos profissionais.Os marcos teóricos que nortearam o estudo assentaram-se na percepção de que a Lei do Acompanhante traduz um direito,o qual articula-se ao campo dos direitos sexuais e reprodutivos, objeto de intensa luta do movimento feminista. Juntoa este debate torna-se fundamental desenvolver a análise de gênero, a qual repercute diretamente nas possibilidades elimites para assegurar, na prática, o direito ao acompanhante. Um achado do trabalho foi a presença, no grupo entrevistado,de uma maioria de homens acompanhantes, o que favoreceu a problematização do papel destes, não apenas comoajudantes das mulheres, mas como sujeitos na saúde reprodutiva

Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial

Background Recent open-label trials show that psychedelics, such as ayahuasca, hold promise as fast-onset antidepressants in treatment-resistant depression. Methods To test the antidepressant effects of ayahuasca, we conducted a parallel-arm, double-blind randomized placebo-controlled trial in 29 patients with treatment-resistant depression. Patients received a single dose of either ayahuasca or placebo. We assessed changes in depression severity with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating scale at baseline, and at 1 (D1), 2 (D2), and 7 (D7) days after dosing. Results We observed significant antidepressant effects of ayahuasca when compared with placebo at all-time points. MADRS scores were significantly lower in the ayahuasca group compared with placebo at D1 and D2 (p = 0.04), and at D7 (p < 0.0001). Between-group effect sizes increased from D1 to D7 (D1: Cohen's d = 0.84; D2: Cohen's d = 0.84; D7: Cohen's d = 1.49). Response rates were high for both groups at D1 and D2, and significantly higher in the ayahuasca group at D7 (64% v. 27%; p = 0.04). Remission rate showed a trend toward significance at D7 (36% v. 7%, p = 0.054). Conclusions To our knowledge, this is the first controlled trial to test a psychedelic substance in treatment-resistant depression. Overall, this study brings new evidence supporting the safety and therapeutic value of ayahuasca, dosed within an appropriate setting, to help treat depression. This study is registered at http://clinicaltrials.gov (NCT02914769)

A percepção dos estudantes de graduação sobre a atuação do “doutor palhaço” em um hospital universitário - doi: 10.5020/18061230.2012.s25

Objectives: To understand how students perceive the humanization of health, as well as the contributions of Project Y “clown doctors” in academic and hospital routine, identifying the relevance of this group through the construction of new paradigms. Methods: The study involved qualitative dimension, with the participation of medical students / interns in psychology and pediatric ward from a university hospital in Fortaleza - CE, Brazil. From March to July 2009, ten interviews were performed, recorded and fully transcribed and analyzed by interpretative network, comprising the categories: knowing the Project Y: different forms cognizable; role of Project Y in the hospital environment: the perception of this strategy in view of the spectators; humanization in health: the look of the future professional. The interpretive framework includes concepts related to health promotion activities, based in the humanization of care performed by graduate students in training. Results: Students have known Project Y from the observation of the activities performed in the infirmaries and to realize the smiles of children during the integration with the clowns. Reported that the visits, as well as diminishing the stress of children, caregivers and assist in the recovery of patients, also act in humane training of health professionals and contributes to the practice of multidisciplinarity. Conclusions: The respondents believe that Project Y can positively influence the training of health professionals, expanding interdisciplinary practice and providing complete pain relief of the patient. Thus, enhances communication of those who share the hospital environment and relieve human suffering.Compreender como os estudantes percebem a humanização da saúde, bem como as contribuições do Projeto Y “doutores-palhaços” na formação acadêmica e na rotina hospitalar, identificando a relevância do grupo neste meio na construção de novos paradigmas. Métodos: Estudo envolveu dimensão qualitativa, com participação de acadêmicos de medicina/psicologia e estagiários da enfermaria pediátrica de um Hospital Universitário, Fortaleza – CE, Brasil. Foram realizadas, no período de março a julho de 2009, dez entrevistas individuais gravadas e transcritas na íntegra que foram analisadas por rede interpretativa, composta pelas categorias: conhecendo o Projeto Y: diferentes formas percebidas; atuação do Projeto Y no ambiente hospitalar: a percepção dessa estratégia na visão dos espectadores; a humanização na saúde: o olhar do futuro profissional. O referencial interpretativo contempla concepções relativas a atividades de promoção à saúde, embasadas na humanização da assistência, desempenhadas por estudantes de graduação em formação.Resultados: Os estudantes conheceram o Projeto Y a partir da observação das atividades realizadas nas enfermarias e ao perceberem os sorrisos das crianças durante a integração com os palhaços. Relatam que as visitas diminuem o estresse das crianças, dos acompanhantes e auxiliam na recuperação dos doentes, atua também na formação humanizada do profissional de saúde, considerada essencial, e contribui para a prática da multidisciplinaridade.Conclusões: Os entrevistados acreditam que o Projeto Y pode influenciar positivamente na formação do profissional de saúde, ampliando a prática interdisciplinar e proporcionando alívio à dor integral do paciente. Dessa forma, aprimora a comunicação daqueles que partilham o ambiente hospitalar e alivia o sofrimento humano

Ungraduate students view on the presence of clown-doctors at the University Hospital

Objectives: To understand how students perceive the humanization of health, as well as the contributions of Project Y “clown doctors” in academic and hospital routine, identifying the relevance of this group through the construction of new paradigms. Methods: The study involved qualitative dimension, with the participation of medical students / interns in psychology and pediatric ward from a university hospital in Fortaleza - CE, Brazil. From March to July 2009, ten interviews were performed, recorded and fully transcribed and analyzed by interpretative network, comprising the categories: knowing the Project Y: different forms cognizable; role of Project Y in the hospital environment: the perception of this strategy in view of the spectators; humanization in health: the look of the future professional. The interpretive framework includes concepts related to health promotion activities, based in the humanization of care performed by graduate students in training. Results: Studentshave known Project Y from the observation of the activities performed in the infirmaries and to realize the smiles of children during the integration with the clowns. Reported that the visits, as well as diminishing the stress of children, caregivers and assist in the recovery of patients, also act in humane training of health professionals and contributes to the practice of multidisciplinarity. Conclusions: The respondents believe that Project Y can positivelyinfluence the training of health professionals, expanding interdisciplinary practice and providing complete pain relief of the patient. Thus, enhances communication of those who share the hospital environment and relieve human suffering

Monitoring and performance of participatory indicators of traditional systems of production of yerba mate in the Centro-Sul and in the Vale do Iguaçu, Paraná, Brazil

The traditional system of yerba mate production (STPEM) presents the Mixed Ombrophilous Forest of southerner Brazil, characterized as agroforestry systems, that roots are related to the management of the faxinal and caívas. Whereas the implicit complexity in the coverage of these systems, in environmental, economic, socials, and cultural dimensions, this survey lens to analyze the initial monitoring and the performance of these traditional systems of production, in municipalities of Paraná state, through the participative construction of indicators. The field research happened in two stages: the first, as of the monitoring of a workshop conducted in the city of União da Vitória, attended by farmers and representatives from several institutions related to the Yerba Mate Observatory, in partnership with the university researchers. In this event, through the collective construction of an accessible and utility indicators system by the handlers of STPEM, technical parameters were created linking the scientific knowledge to the farmers’ traditional knowledge. This process allows the measurement of the amplitude of the systems in their principal dimensions, enabling monitoring and monitoring over time, future comparisons related to the evolution of systems. The second stage refers to the application of these macro indicators in twelve families of rural properties located in four municipalities (Inácio Martins, Rebouças, Biturunaand São Mateus do Sul). Results demonstrate strengths and limitations in STPEM, highlighting that the monitored systems contribute effectively with the conservation of the Mixed Ombrophilous Forest, promoting benefits to properties and surroundings, as water issue emphasized by farmers surveyed. The indicator system realization, constructed with the social actors, opens an interlocution space with the public policies, considering local realities and needs, often only known by the farmers themselves and stimulating new research agendas.Os sistemas tradicionais de produção de erva-mate (STPEM), presentes da Floresta Ombrófila Mista do sul do Brasil, se caracterizam como sistemas agroflorestais, cujas raízes se vinculam aos manejos de faxinais e caívas. Considerando a complexidade implícita na abrangência destes sistemas, em dimensões ambientais, econômicas, sociais e culturais, este estudo objetiva analisar o monitoramento inicial e o desempenho dos sistemas tradicionais de produção de erva-mate, em municípios do estado do Paraná, por meio da construção participativa de indicadores. A pesquisa de campo ocorreu em duas etapas: a primeira, a partir do acompanhamento de uma oficina realizada no município de União da Vitória, a qual contou com a presença de agricultores e representantes de diversas instituições vinculadas ao Observatório da Erva-mate em parceria com pesquisadores de universidades. Neste evento, por meio da construção coletiva de um sistema de indicadores acessível e utilizável pelos manejadores dos STPEM, foram criados parâmetros técnicos vinculando conhecimentos científicos aos saberes tradicionais dos agricultores. Este processo permite avaliar a amplitude dos sistemas nas suas principais dimensões, possibilitando o acompanhamento e o monitoramento ao longo do tempo, para futuras comparações relacionadas à evolução dos sistemas. A segunda etapa se refere à aplicação destes macroindicadores em doze famílias de propriedades rurais localizadas em quatro municípios (Inácio Martins, Rebouças, Bituruna e São Mateus do Sul). Os resultados demonstram os pontos fortes e as limitações nos STPEM, destacando-se que os sistemas monitorados contribuem efetivamente com a conservação da Floresta Ombrófila Mista, promovendo benefícios para as propriedades e entorno, como na questão hídrica enfatizada pelos agricultores pesquisados. A efetivação de um sistema de indicadores construído com os atores sociais abre espaços de interlocução com as políticas públicas, considerando as realidades e necessidades locais, muitas vezes conhecidas apenas pelos próprios agricultores e estimulando novas agendas de pesquisa

Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression : a randomized placebo-controlled trial

Recent open-label trials show that psychedelics, such as ayahuasca, hold promise as fast-onset antidepressants in treatment-resistant depression. To test the antidepressant effects of ayahuasca, we conducted a parallel-arm, double-blind randomized placebo-controlled trial in 29 patients with treatment-resistant depression. Patients received a single dose of either ayahuasca or placebo. We assessed changes in depression severity with the Montgomery-angstrom sberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating scale at baseline, and at 1 (D1), 2 (D2), and 7 (D7) days after dosing. We observed significant antidepressant effects of ayahuasca when compared with placebo at all-time points. MADRS scores were significantly lower in the ayahuasca group compared with placebo at D1 and D2 (p = 0.04), and at D7 (p < 0.0001). Between-group effect sizes increased from D1 to D7 (D1: Cohen's d = 0.84; D2: Cohen's d = 0.84; D7: Cohen's d = 1.49). Response rates were high for both groups at D1 and D2, and significantly higher in the ayahuasca group at D7 (64% v. 27%; p = 0.04). Remission rate showed a trend toward significance at D7 (36% v. 7%, p = 0.054). Conclusions To our knowledge, this is the first controlled trial to test a psychedelic substance in treatment-resistant depression. Overall, this study brings new evidence supporting the safety and therapeutic value of ayahuasca, dosed within an appropriate setting, to help treat depression494655663CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPES466760/2014; 479466/2011677/2012; 1577/201

JMJD1A, H3K9me1, H3K9me2 and ADM expression as prognostic markers in oral and oropharyngeal squamous cell carcinoma

<div><p>Aims</p><p>Jumonji Domain-Containing 1A (JMJD1A) protein promotes demethylation of histones, especially at lysin-9 of di-methylated histone H3 (H3K9me2) or mono-methylated (H3K9me1). Increased levels of H3 histone methylation at lysin-9 (H3K9) is related to tumor suppressor gene silencing. <i>JMJD1A</i> gene target Adrenomeduline (ADM) has shown to promote cell growth and tumorigenesis. JMJD1A and ADM expression, as well as H3K9 methylation level have been related with development risk and prognosis of several tumor types.</p><p>Methods and results</p><p>We aimed to evaluate JMJD1A, ADM, H3K9me1 and H3K9me2expression in paraffin-embedded tissue microarrays from 84 oral and oropharyngeal squamous cell carcinoma samples through immunohistochemistry analysis. Our results showed that nuclear JMJD1A expression was related to lymph node metastasis risk. In addition, JMJD1A cytoplasmic expression was an independent risk marker for advanced tumor stages. H3K9me1 cytoplasmic expression was associated with reduced disease-specific death risk. Furthermore, high H3K9me2 nuclear expression was associated with worse specific-disease and disease-free survival. Finally, high ADM cytoplasmic expression was an independent marker of lymph node metastasis risk.</p><p>Conclusion</p><p>JMJD1A, H3K9me1/2 and ADM expression may be predictor markers of progression and prognosis in oral and oropharynx cancer patients, as well as putative therapeutic targets.</p></div