Influence of the Sao Paulo State innovative models on Brazil's mental health policy

Objective: to analyze the influence of two Sao Paulo State experiences in the choice of psychosocial care centers as guiding service providers for the national mental health policy. Method: qualitative, exploratory, and descriptive study using oral history as a methodology and theoretical reference. Results: eight professionals involved in the deployment of the mental health policy in the cities of Santos and Sao Paulo between the years 1989 and 1992 were interviewed. Data were analyzed after treating the narratives and grouping the most significant content. Two central themes emerged: development of the local-regional model, and the model's influence on the choice of the psychosocial care center. Conclusion: due to greater insertion of the Santos experience group in the spheres of the federal government, its influence on the choice of the substitute model was higher in ideological terms, whereas the Sao Paulo model had its influence restricted for political reasons.Objetivo: analisar a influência de duas experiências paulistas na escolha do centro de atenção psicossocial como serviço norteador da política nacional de Saúde Mental. Método: pesquisa qualitativa, exploratório-descritiva que utilizou a história oral. Resultados: foram entrevistados oito profissionais envolvidos na implantação da política de Saúde Mental dos municípios de Santos e São Paulo (1989 a 1992). Os dados foram analisados após tratamento das narrativas e agrupamento dos conteúdos mais significativos. Emergiram dois eixos temáticos: desenvolvimento do modelo loco regional e influência do modelo na escolha do centro de atenção psicossocial. Conclusão: devido à maior inserção do grupo da experiência santista nas esferas do governo federal, sua influência na escolha do modelo substitutivo foi maior na dimensão ideológica, e o modelo paulistano teve influência restrita por razões político-partidárias.Univ Fed Sao Paulo, Sao Paulo Sch Nursing, Postgrad Program Nursing, Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo Sch Nursing, Postgrad Program Nursing, Sao Paulo, BrazilWeb of Scienc

Gestão de processos administrativos em uma empresa de energia

Orientador : Joel Souza e SilvaProjeto Técnico (especialização) - Universidade Federal do Paraná, Setor de Ciências Sociais Aplicadas, Curso de Especialização em Gestão da QualidadeInclui referência

Cryptococcus neoformans and C. gattii isolates from both HIV-infected and uninfected patients: antifungal susceptibility and outcome of cryptococcal disease

One of the factors causing treatment failure in cryptococcosis is the resistance of Cryptococcus spp. to antifungal drugs, which has motivated the susceptibility assessment of isolates from patients with cryptococcosis, different clinical conditions and infections outcomes. Clinical isolates of Cryptococcus spp. from three different groups of patients were studied in the present investigation: 19 HIV-positive patients with relapsing and/or refractory meningitis (Group 1), 30 HIV-positive patients who experienced a single and limited episode of cryptococcosis (Group 2), and 19 HIV-negative patients with cryptococcosis (Group 3). Eighty C. neoformans var. grubii isolates and 7 C. gattii isolates were studied. The minimum inhibitory concentration (MIC) of amphotericin B, azole drugs and flucytosine was determined for Cryptococcus spp. by broth microdilution test and E-test. The MIC50 and MIC90 were 0.25 and 0.50 µg/mL for amphotericin B, 4.0 and 8.0 µg /mL for fluconazole, 0.06 and 0.25 µg/mL for itraconazole, 0.25 and 0.50 µg/mL for voriconazole, and 8.0 and 16.0 µg/mL for flucytosine, respectively. Amphotericin B and itraconazole showed higher MICs for C. neoformans var. grubii and C. gattii, respectively. The MICs of fluconazole and itraconazole obtained with the E-test were higher than those obtained with broth microdilution. Isolates from non-HIV coinfected were less sensitive to the azoles. There was no difference in the susceptibility of C. neoformans var. grubii isolates from patients with a favorable or unfavorable outcome or along the episodes of relapsing and/or refractory meningitis

The mãori language nest program: voices of language and culture revitalization in Aotearoa, New Zealand

This article features interviews with five Mãori teachers who have been  directly involved with Mãori education for many years. They present their ideas and practices concerning  both Kohanga Reo, the successful language nest program which has been key for the revitalization and regeneration of the Mãori language, in New Zealand, and Kura Kaupapa, the Mãori primary and secondary education program.  Mãori language nest, language endangerment, language revitalization. R e s u m o : Este artigo apresenta entrevistas com cinco professores Mãori que têm estado diretamente envolvidos com a educação Mãori por muitos anos. Eles apresentam suas idéias e práticas sobre Kohanga Reo, o programa bem sucedido de ninho de língua, que tem sido fundamental para a revitalização e regeneração da língua Mãori, na Nova Zelândia e também sobre Kura Kaupapa, o programa Mãori de educação primária e secundária.Este artigo apresenta entrevistas com cinco professores Mãori que têm estado diretamente envolvidos com a educação Mãori por muitos anos. Eles apresentam suas idéias e práticas sobre Kohanga Reo, o programa bem sucedido de ninho de língua, que tem sido fundamental para a revitalização e regeneração da língua Mãori, na Nova Zelândia e também sobre Kura Kaupapa, o programa Mãori de educação primária e secundária.&nbsp

Influence of Body Height on Oral and Pharyngeal Transit Time of a Liquid Bolus in Healthy Volunteers

Swallowing duration may be influenced by several factors. The effect of body height on oral-pharyngeal bolus transit has not been clearly elucidated. The hypothesis of this investigation was that height has influence on oral-pharyngeal transit time of a liquid bolus. Videofluoroscopic assessment of swallowing was performed on 40 healthy volunteers: 20 "tall" (171 cm to 207 cm) and 20 "short" (152 cm to 170 cm) subjects, 10 men and 10 women in each group. Each subject performed three swallows of 10 mL of liquid barium bolus. The following parameters were measured: oral transit time (OTT): time from the beginning of tongue tip movement at incisors to arrival of the bolus tail at the fauces; pharyngeal transit time (PTT): time between the arrival of the bolus tail at fauces and complete passage of the bolus tail through the upper esophageal sphincter (UES); pharyngeal clearance (PC): time between the arrival of the bolus head at fauces to complete passage of the bolus tail through the UES; UES opening (UESO): time between the arrival of the bolus head at the UES to complete passage of the bolus tail through the UES; duration of hyoid movement (HM): time interval between the onset and the end of hyoid movement; oral-pharyngeal transit time (OPTT): time from the beginning of tongue tip movement at incisors until complete passage of the bolus tail through the UES. The statistical analysis was done by a linear model with mixed effects. Correlation between height and swallowing events duration was assessed by Spearman's correlation coefficient (r). In women OTT, PC, HM and OPTT were longer in tall than in short subjects, what was not seen in men. In women there was a positive correlation between OTT, PTT and OPTT and height. Men (mean height: 177 cm) had longer PTT and PC than women (mean height: 166 cm). In women, oral and pharyngeal transit time of a 10 mL liquid bolus were influenced by height and was longer in taller subjects

FATORES POLÍTICO-IDEOLÓGICOS ASSOCIADOS À ESCOLHA DO MODELO DE ASSISTÊNCIA DA REFORMA PSIQUIÁTRICA BRASILEIRA

RESUMO Estudo histórico objetivou analisar fatores associados à escolha do centro de atenção psicossocial como serviço estruturante da reforma psiquiátrica, segundo percepção de assessores à frente da área de saúde mental no período 1980-1990. Utilizou-se Metodologia da História Oral. Coleta de dados realizada por meio de entrevistas com posterior análise temática. Discussão e análise focalizaram as políticas de saúde mental existentes no período e legislação específica. Resultados mostraram que a percepção sobre os fatores associados à escolha do modelo substitutivo esteve ligada à criação de rede de relações de poder de caráter político partidário. Rede constituída por profissionais da área de saúde mental envolvidos com setores específicos tanto do movimento de luta antimanicomial como do Partido dos Trabalhadores e com acesso ao Ministério da Saúde. Concluiu-se que o financiamento federal e escolhas políticas foram decisivos para escolha do modelo assistencial

Videofluoroscopic analysis of different volumes of liquid bolus swallowing in healthy individuals: comparison between height and sex

OBJECTIVE: The volume of swallowed bolus affects the pharyngeal transit duration. The sex and corporal height of individuals may likely influence this effect. The aim of this investigation was to determine the influence of sex and corporal height on the pharyngeal transit modification produced by the swallowed bolus volume. METHODS: Forty healthy volunteers, 20 men and 20 women, including tall (10 men and 10 women, corporal height: 1.71--2.07m) and short (10 men and 10 women, corporal height: 1.52--1.70m) persons, ranging in age between 20 and 50 years, were included in the study. Videofluoroscopic evaluation of swallowing was performed with the subjects in the sitting position. Each individual swallowed three 5 mL and three 10 mL boluses of liquid barium in a random sequence. The durations of oral transit, pharyngeal transit, pharyngeal clearance, hyoid movement, upper esophageal sphincter opening and oral-pharyngeal transit were evaluated. RESULTS: In men and women, and in taller and shorter individuals, the increase of the swallowed liquid bolus volume from 5 mL to 10 mL causes a faster transit of the bolus tail from the oral-pharyngeal transition to the upper esophageal sphincter and an increase in the duration of the upper esophageal sphincter opening, with similar alteration in men and women and in taller and shorter individuals. CONCLUSION: An increase in the swallowed liquid bolus volume from 5 mL to 10 mL causes a faster pharyngeal bolus transit and a longer bolus transit through the upper esophageal sphincter, with similar alterations in men and women and in shorter and taller individuals

Eficácia de um grupo psicoeducacional com cuidadores de pessoas com demência

CONTEXTO: O uso de intervenções direcionadas ao cuidador objetiva a informação e a criação de estratégias de enfrentamento para o manejo das dificuldades causadas pela demência. OBJETIVOS: Avaliar a relação entre a participação em um grupo psicoeducacional e a diminuição da sobrecarga e dos sintomas depressivos e ansiosos de cuidadores de pessoas com demência. MÉTODOS: Cuidadores (n = 18) avaliados longitudinalmente no momento linha de base e após seis meses de participação em grupo psicoeducacional. Utilizaram-se: Estadiamento Clínico das Demências (CDR), Questionário de Atividades Funcionais de Pfeffer (PFEFFER), Escala Cornell de Depressão na Demência (CORNELL), Escala de Avaliação da Qualidade de Vida na Doença de Alzheimer (QdV-DA), Inventário Neuropsiquiátrico (NPI), Inventário de Sobrecarga de Zarit (ZARIT), Inventário de Depressão de Beck (BDI) e Inventário de Ansiedade de Beck (BAI). RESULTADOS: No momento linha de base foi encontrada correlação entre a sobrecarga e sintomas depressivos dos cuidadores (p = 0,048). A análise das diferenças entre os dois momentos encontrou diminuição dos sintomas depressivos dos cuidadores no segundo momento (p = 0,011). Não foram encontradas diferenças significativas nas demais variáveis. CONCLUSÃO: Os grupos psicoeducacionais podem ser considerados intervenções eficazes na diminuição dos sintomas depressivos de cuidadores de pessoas com demência.BACKGROUND: The use of intervention strategies aimed at dementia caregivers objectives the information and the creation of coping strategies to deal with the difficulties caused by dementia. OBJECTIVES: To assess the correlation between the participation in a psychoeducational group and the decrease of burden, and depressive and anxious symptoms of caregivers of people with dementia. METHODS: Caregivers (n = 18) assessed in a longitudinal study at baseline and after six months of participation in a psychoeducational group. There were used the Clinical Dementia Rating (CDR), Pfeffer Functional Activities Questionnaire (PFAQ), Cornell Scale for Depression in Dementia (CSDD), Quality of Life Scale in Alzheimer' Disease (QoL-AD), Neuropsychiatric Inventory (NPI), Zarit Burden Interview (ZBI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). RESULTS: In the baseline, there was correlation between the burden and the caregivers' depressive symptoms (p = 0.048). The analysis of the differences between the baseline and the second moment has shown a decrease in caregivers' depressive symptoms in moment 2 (p = 0.011). There were no significant differences in the other variables. DISCUSSION: Psychoeducational groups can be considered efficient interventions on the decrease of the depression of caregivers of people with dementia