Operação Bororos: vivências de saúde, educação e cultura na Chapada dos Guimarães

Trabalho apresentado no II Congresso Nacional do PROJETO RONDON, realizado em Florianópolis, SC, no período de 23 a 25 de setembro de 2015 - Universidade Federal de Santa Catarina.Introdução: O Projeto Rondon é um programa interministerial, coordenado pelo Ministério da Defesa, que visa integrar e desenvolver ações comunitárias em regiões com maiores índices de pobreza e exclusão social, bem como áreas isoladas do território nacional necessitadas de maior aporte de bens e serviços. Em parceira com as universidades, o projeto pretende contribuir com a formação do universitário como cidadão, integrá-lo ao processo de desenvolvimento nacional por meio de ações participativas sobre a realidade do país. Além disso, visa consolidar no universitário o sentido de responsabilidade social coletiva, em prol da cidadania estimulando a produção de projetos coletivos locais, em parceria com as comunidades, com foco na capacitação de agentes multiplicadores, estimulando ações que valorizem o cidadão, a cultura local e promovam o intercâmbio de informações. Com esse espírito, a Instituição de Ensino Superior (IES) desenvolveu um plano de trabalho, aprovado para execução no município de Chapada dos Guimarães, estado do Mato Grosso, durante a Operação Bororos, no período de 10 a 26 de julho de 2015. Objetivo: Descrever as atividades realizadas no município, direcionadas aos profissionais de saúde, educação, assistência social e à comunidade em geral. Metodologia: A descrição se dará a partir do registro documental e fotográfico das atividades desenvolvidas e das avaliações feitas pelos participantes. Resultados: Foram realizadas 22 atividades de cultura, comunicação, saúde e educação, por meio de oficinas teórico-práticas, simpósios, mutirão de saúde e rodas de conversa, com participação de 293 pessoas. A maior parte das atividades foi concentrada na área urbana do município, em escolas, creches, centros culturais, praças e feiras ao ar livre. Observaram-se benefícios à comunidade com a troca de saberes e informações ofertadas pelos universitários, uma vez que agregaram novos subsídios para o trabalho cotidiano, seja dos multiplicadores ou dos cidadãos em geral que tiveram acesso às atividades desenvolvidas. Conclusão: O Projeto Rondon consolida-se como oportunidade única para os universitários colocarem em prática os conhecimentos adquiridos ao longo de suas vivências acadêmicas em prol da sociedade. Observou-se a necessidade de adequação das atividades priorizando-se as populações rurais caracterizadas como mais vulneráveis

The biological basis and clinical significance of hormonal imprinting, an epigenetic process

The biological phenomenon, hormonal imprinting, was named and defined by us (Biol Rev, 1980, 55, 47-63) 30 years ago, after many experimental works and observations. Later, similar phenomena were also named to epigenetic imprinting or metabolic imprinting. In the case of hormonal imprinting, the first encounter between a hormone and its developing target cell receptor—usually at the perinatal period—determines the normal receptor-hormone connection for life. However, in this period, molecules similar to the target hormone (members of the same hormone family, synthetic drugs, environmental pollutants, etc), which are also able to bind to the receptor, provoke faulty imprinting also with lifelong—receptorial, behavioral, etc.,—consequences. Faulty hormonal imprinting could also be provoked later in life in continuously dividing cells and in the brain. Faulty hormonal imprinting is a disturbance of gene methylation pattern, which is epigenenetically inherited to the further generations (transgenerational imprinting). The absence of the normal or the presence of false hormonal imprinting predispose to or manifested in different diseases (e.g., malignant tumors, metabolic syndrome) long after the time of imprinting or in the progenies

Schizophrenia: do all roads lead to dopamine or is this where they start? Evidence from two epidemiologically informed developmental rodent models

The idea that there is some sort of abnormality in dopamine (DA) signalling is one of the more enduring hypotheses in schizophrenia research. Opinion leaders have published recent perspectives on the aetiology of this disorder with provocative titles such as ‘Risk factors for schizophrenia—all roads lead to dopamine' or ‘The dopamine hypothesis of schizophrenia—the final common pathway'. Perhaps, the other most enduring idea about schizophrenia is that it is a neurodevelopmental disorder. Those of us that model schizophrenia developmental risk-factor epidemiology in animals in an attempt to understand how this may translate to abnormal brain function have consistently shown that as adults these animals display behavioural, cognitive and pharmacological abnormalities consistent with aberrant DA signalling. The burning question remains how can in utero exposure to specific (environmental) insults induce persistent abnormalities in DA signalling in the adult? In this review, we summarize convergent evidence from two well-described developmental animal models, namely maternal immune activation and developmental vitamin D deficiency that begin to address this question. The adult offspring resulting from these two models consistently reveal locomotor abnormalities in response to DA-releasing or -blocking drugs. Additionally, as adults these animals have DA-related attentional and/or sensorimotor gating deficits. These findings are consistent with many other developmental animal models. However, the authors of this perspective have recently refocused their attention on very early aspects of DA ontogeny and describe reductions in genes that induce or specify dopaminergic phenotype in the embryonic brain and early changes in DA turnover suggesting that the origins of these behavioural abnormalities in adults may be traced to early alterations in DA ontogeny. Whether the convergent findings from these two models can be extended to other developmental animal models for this disease is at present unknown as such early brain alterations are rarely examined. Although it is premature to conclude that such mechanisms could be operating in other developmental animal models for schizophrenia, our convergent data have led us to propose that rather than all roads leading to DA, perhaps, this may be where they start

The sustainability of Lean in pediatric healthcare: a realist review

Abstract Background Lean is a quality improvement management system from the Toyota manufacturing industry. Since the early 2000’s, Lean has been used as an intervention for healthcare improvement. Lean is intended to reduce costs and improve customer value through continuous improvement. Despite its extensive use, the contextual factors and mechanisms that influence the sustainability of Lean in healthcare have not been well studied. Realist synthesis is one approach to “unpack” the causal explanations of how and why Lean is sustained or not in healthcare. We conducted a realist synthesis using the context (C) + mechanim (M) = outcome (O) heuristic, to further develop and refine an initial program theory with seven CMO hypotheses, on the sustainability of Lean efforts across pediatric healthcare. Methods Our search strategy was multi-pronged, iterative, and purposeful in nature, consisting of database, gray literature, and contact with three healthcare organizations known for Lean implementation. We included primary research studies, published and unpublished case studies or reports, if they included Lean implementation with a pediatric focus and sustainability outcome. We used the Normalization Process Theory and the National Health Services Sustainability Model, an operational definition for Lean and a comprehensive definition for sustainability as guidance for data extraction and analysis. Our initial program theory with was refined using a blend of abductive and retroductive analytical processes. Results We identified six published primary research studies, two published quality improvement case studies, and three unpublished quality improvement case reports. Five CMO hypotheses from our initial program theory were substantially supported after synthesis, “sense-making and value congruency,” “staff engagement and empowerment,” and the “ripple effect” or causal pathway between Lean implementation outcomes that served as facilitating or hindering contexts for sustainability. Overall, there was variation with the conceptualization and measurement of sustainability. Conclusions This study is the first to examine Lean sustainability in pediatric healthcare using realist methods. Future research should examine whether the predictors of implementation are the same or different to sustainability and evaluate the underlying mechanisms that influence the sustainability of Lean. There is also a need for research to develop and test conceptual models and frameworks on sustainability. Systematic review registration PROSPERO-CRD42015032252