Desafios e oportunidades de repensar o processo de trabalho em Vigilância Sanitária: um relato de experiência

Introduction: This is an experience report based on the learning process at work as a tool to overcome difficulties experienced by health surveillance workers. Objective: To list the challenges and possibilities for improving health surveillance actions, based  on a critical reflection of the work process itself. Method: The report was prepared  from records and observations of debates conducted at meetings held between workers. Results: The group meetings created a dialogical space within the daily workspace,  allowing enriching discussions about the health surveillance work processes. Conclusions: The dialogue spaces enabled a critical reflection of the work process and made health surveillance workers able to recognize the challenges and propose alternatives for their own professional performance.Introdução: Trata-se de um relato de experiência pautado no processo de aprendizagem no trabalho como ferramenta para superação de dificuldades vivenciadas por trabalhadores da área de vigilância sanitária. Objetivo: Elencar os desafios e as possibilidades para o aprimoramento das ações de vigilância sanitária, a partir da  reflexão crítica do próprio processo de trabalho. Método: O relato foi elaborado a  partir de registros e observações de debates realizados em reuniões realizadas entre os trabalhadores. Resultados: As reuniões em grupo criaram um espaço dialógico dentro do espaço cotidiano de trabalho permitindo discussões enriquecedoras sobre os processos de trabalho em vigilância sanitária. Conclusões: Os espaços de diálogos possibilitaram uma reflexão crítica do processo de trabalho e fizeram com que os trabalhadores de vigilância sanitária fossem capazes de reconhecer os desafios e propor alternativas para a sua própria atuação profissional

Maternidad entre rejas.

El presente ejercicio investigativo tiene como objetivo comprender la forma en que una madre que se encuentra privada de su libertad en la Cárcel Pedregal de la ciudad de Medellín asumiría la condición de verse separada de su hijo después de generarse un vínculo de apego entre ambos. El estudio está soportado bajo tres ejes temáticos: el vínculo de apego, la separación y el rol materno, estudiado desde una perspectiva psicológica. El enfoque a partir del cual se desarrolla la investigación es cualitativo y, en consecuencia, el método más acorde con el planteamiento de la pregunta es el estudio de caso. Mediante ese tipo metodológico se busca dar respuesta a la pregunta planteada, en la que el foco de atención se centra en la posición psicológica de una mujer que se encuentra privada de su libertad y que muy pronto debe separarse de su hija con la cual existe un vínculo de apego. El estudio arrojó como resultado que entre la madre y su hija existe un vínculo de apego seguro, y siente que, al darse la separación con su hija, va a experimentar una situación de gran tristeza, angustia y desolación; La privación de la libertad tiene gran impacto en las madres y en los menores, dentro del sistema carcelario se recibe un trato diferente, lo cual impide ejercer la maternidad de una manera adecuada; el estado anímico de la madre al estar en prisión no es óptimo, lo cual es trasmitido a su hijo/a

Maternidad entre rejas.

El presente ejercicio investigativo tiene como objetivo comprender la forma en que una madre que se encuentra privada de su libertad en la Cárcel Pedregal de la ciudad de Medellín asumiría la condición de verse separada de su hijo después de generarse un vínculo de apego entre ambos. El estudio está soportado bajo tres ejes temáticos: el vínculo de apego, la separación y el rol materno, estudiado desde una perspectiva psicológica. El enfoque a partir del cual se desarrolla la investigación es cualitativo y, en consecuencia, el método más acorde con el planteamiento de la pregunta es el estudio de caso. Mediante ese tipo metodológico se busca dar respuesta a la pregunta planteada, en la que el foco de atención se centra en la posición psicológica de una mujer que se encuentra privada de su libertad y que muy pronto debe separarse de su hija con la cual existe un vínculo de apego. El estudio arrojó como resultado que entre la madre y su hija existe un vínculo de apego seguro, y siente que, al darse la separación con su hija, va a experimentar una situación de gran tristeza, angustia y desolación; La privación de la libertad tiene gran impacto en las madres y en los menores, dentro del sistema carcelario se recibe un trato diferente, lo cual impide ejercer la maternidad de una manera adecuada; el estado anímico de la madre al estar en prisión no es óptimo, lo cual es trasmitido a su hijo/a

Mental Health Research in the Global Era: Training the Next Generation

Psychiatric disorders are among the leading cause of disability worldwide, yet fewer than 25 % of affected individuals are estimated to have access to treatment. In many low-income settings, it is estimated that less than 10 % of affected individuals are able to access basic mental health care and, even when they do, it is often below minimum ethical and clinical standards. The discipline of global mental health is dedicated to reducing mental health disparities within and between countries by preventing mental disorders and improving access to psychiatric treatment, particularly in low-resource settings. The global partnership model for mental health research is based on the idea that investigators from high- and low-resource settings work collaboratively to identify and address barriers and facilitators to mental well-being across diverse settings

Prácticas comunitarias de resistencia social que han desarrollado los habitantes del sector “El Morro” del barrio Moravia frente a los procesos de desalojo desplegados desde la Administración Municipal de Medellín.

El principal propósito de este ejercicio académico de investigación, es conocer las prácticas comunitarias de resistencia social que han desarrollado los habitantes del sector “El Morro” del barrio Moravia frente a los procesos de desalojo desplegados desde la Administración Municipal de Medellín , dicho proceso académico se llevó a cabo metodológicamente por medio de la técnica de la entrevista semiestructurada la cual permitió identificar las prácticas comunitarias que se han generado en el territorio, develar los procesos de resistencia social y además identificar la relación que existe entre prácticas comunitarias y resistencia social frente a los procesos de desalojo en el sector “El Morro” así mismo, se concluye que las practicas comunitarias de resistencia social son más que acciones características de la comunidad, son una muestra de la construcción política desde el conocimiento empírico de los sujetos que demuestran que a través de conocimiento y empoderamiento de las comunidades se llega al cambio social y en el caso de “El Morro” a evitar los desalojos, es decir, a la permanencia en el territorio

Prácticas comunitarias de resistencia social que han desarrollado los habitantes del sector “El Morro” del barrio Moravia frente a los procesos de desalojo desplegados desde la Administración Municipal de Medellín.

El principal propósito de este ejercicio académico de investigación, es conocer las prácticas comunitarias de resistencia social que han desarrollado los habitantes del sector “El Morro” del barrio Moravia frente a los procesos de desalojo desplegados desde la Administración Municipal de Medellín , dicho proceso académico se llevó a cabo metodológicamente por medio de la técnica de la entrevista semiestructurada la cual permitió identificar las prácticas comunitarias que se han generado en el territorio, develar los procesos de resistencia social y además identificar la relación que existe entre prácticas comunitarias y resistencia social frente a los procesos de desalojo en el sector “El Morro” así mismo, se concluye que las practicas comunitarias de resistencia social son más que acciones características de la comunidad, son una muestra de la construcción política desde el conocimiento empírico de los sujetos que demuestran que a través de conocimiento y empoderamiento de las comunidades se llega al cambio social y en el caso de “El Morro” a evitar los desalojos, es decir, a la permanencia en el territorio

Suicide and suicide risk

Although recent years have seen large decreases in the overall global rate of suicide fatalities, this trend is not reflected everywhere. Suicide and suicidal behaviour continue to present key challenges for public policy and health services, with increasing suicide deaths in some countries such as the USA. The development of suicide risk is complex, involving contributions from biological (including genetics), psychological (such as certain personality traits), clinical (such as comorbid psychiatric illness), social and environmental factors. The involvement of multiple risk factors in conveying risk of suicide means that determining an individual’s risk of suicide is challenging. Improving risk assessment, for example, by using computer testing and genetic screening, is an area of ongoing research. Prevention is key to reduce the number of suicide deaths and prevention efforts include universal, selective and indicated interventions, although these interventions are often delivered in combination. These interventions, combined with psychological (such as cognitive behavioural therapy, caring contacts and safety planning) and pharmacological treatments (for example, clozapine and ketamine) along with coordinated social and public health initiatives, should continue to improve the management of individuals who are suicidal and decrease suicide-associated morbidity

Personality disorders and suicide attempts in unipolar and bipolar mood disorders

Background: Comorbid personality disorders may predispose patients with mood disorders to suicide attempts (SAs), but factors mediating this effect are not well known. Methods: Altogether 597 patients from three prospective cohort studies (Vantaa Depression Study, Jorvi Bipolar Study, and Vantaa Primary Care Depression Study) were interviewed at baseline, at 18 months, and in VDS and PC-VDS at 5 years. Personality disorders (PDs) at baseline, number of previous SAs, life-charted time spent in major depressive episodes (MDEs), and precise timing of SAs during follow-up were determined and investigated. Results: Overall, 219 (36.7%) patients had a total of 718 lifetime SAs; 88 (14.7%) patients had 242 SAs during the prospective follow-up. Having any PD diagnosis increased the SA rate, both lifetime and prospectively evaluated, by 90% and 102%, respectively. All PD clusters increased the rate of new SAs, although cluster C PDs more than the others. After adjusting for time spent in MDEs, only cluster C further increased the SA rate (by 52%). Mediation analyses of PD effects on prospectively ascertained SAs indicated significant mediated effects through time at risk in MDEs, but also some direct effects. Limitations: Findings generalizable only to patients with mood disorders. Conclusions: Among mood disorder patients, comorbid PDs increase the risk of SAs to approximately two-fold. The excess risk is mostly due to patients with comorbid PDs spending more time in depressive episodes than those without. Consequently, risk appears highest for PDs that most predispose to chronicity and recurrences. However, also direct risk-modifying effects of PDs exist. (C) 2015 Elsevier B.V. All rights reserved.Peer reviewe

Suicidal Plans and Attempts Among Adolescents in Mongolia: Urban Versus Rural Differences

Background: Although 75% of suicides occur in low- and middle-income countries, few studies have examined suicidal behaviors among young people in these countries. Aims: This study aimed to examine what individual characteristics were associated with suicidal plans and attempts among Mongolian youth and whether suicidal risks and behaviors varied by urban and rural locations. Method: Logistic regression analyses were utilized to investigate suicidal plans and attempts among 5,393 adolescents using the Global Student Health Survey – 2013. Results: Adolescents who lived in urban areas were at higher risk for suicidal plans and behaviors than those who lived in rural areas; however, the patterns of suicidal risks were similar. Specifically, individual characteristics, such as being female, feeling lonely and worried, smoking cigarettes, drinking alcohol, and having fights at school, were associated with suicidal plans and behaviors regardless of the residential places. Limitations: A number of important variables have not been included in the questionnaire such as depression, family and parental support, household income, family constructs etc. Conclusion: Given the comparable patterns of risk between urban and rural adolescents and the relatively high rates of suicidal plans and attempts, similar mental health services and interventions are necessitated for both urban and rural areas

Characterization of lipid rafts in human platelets using nuclear magnetic resonance: A pilot study

Lipid microdomains (‘lipid rafts’) are plasma membrane subregions, enriched in cholesterol and glycosphingolipids, which participate dynamically in cell signaling and molecular trafficking operations. One strategy for the study of the physicochemical properties of lipid rafts in model membrane systems has been the use of nuclear magnetic resonance (NMR), but until now this spectroscopic method has not been considered a clinically relevant tool. We performed a proof-of-concept study to test the feasibility of using NMR to study lipid rafts in human tissues. Platelets were selected as a cost-effective and minimally invasive model system in which lipid rafts have previously been studied using other approaches. Platelets were isolated from plasma of medicationfree adult research participants (n=13) and lysed with homogenization and sonication. Lipid-enriched fractions were obtained using a discontinuous sucrose gradient. Association of lipid fractions with GM1 ganglioside was tested using HRP-conjugated cholera toxin B subunit dot blot assays. 1H high resolution magic-angle spinning nuclear magnetic resonance (HRMAS NMR) spectra obtained with single-pulse Bloch decay experiments yielded spectral linewidths and intensities as a function of temperature. Rates of lipid lateral diffusion that reported on raft size were measured with a two-dimensional stimulated echo longitudinal encode-decode NMR experiment. We found that lipid fractions at 10–35% sucrose density associated with GM1 ganglioside, a marker for lipid rafts. NMR spectra of the membrane phospholipids featured a prominent ‘centerband’ peak associated with the hydrocarbon chain methylene resonance at 1.3 ppm; the linewidth (full width at half-maximum intensity) of this ‘centerband’ peak, together with the ratio of intensities between the centerband and ‘spinning sideband’ peaks, agreed well with values reported previously for lipid rafts in model membranes. Decreasing temperature produced decreases in the 1.3 ppm peak intensity and a discontinuity at ~18 °C, for which the simplest explanation is a phase transition from Ld to Lo phases indicative of raft formation. Rates of lateral diffusion of the acyl chain lipid signal at 1.3 ppm, a quantitative measure of microdomain size, were consistent with lipid molecules organized in rafts. These results show that HRMAS NMR can characterize lipid microdomains in human platelets, a methodological advance that could be extended to other tissues in which membrane biochemistry may have physiological and pathophysiological relevance