Social support networks of users of crack cocaine and the role of a Brazilian health program for people living on the street: A qualitative study.

This cross-sectional qualitative study analyzed characteristics of social support for users of crack cocaine and the role of "Consultório na Rua" (CR), or "Office in the Street," a Brazilian program for people living on the street. Data were collected using 1) ethnographic field observations during the delivery of services from this program, 2) in-depth interviews with 17 users of crack cocaine, and 3) a focus group with professionals from CR. To analyze data, we used content analysis and analytical categories based on Social Network Analysis (SNA) theoretical statements. Results showed that family, peers, community members, and professionals from CR were the main social support providers. Participants mentioned receiving material, informational, and emotional support from CR members. It was observed that CR had a welcoming and inclusive approach, but CR team members identified challenges related to stigma directed toward people who use substances and live on the street. CR assumed a central role in the health and social assistance of users of crack cocaine living on the street, providing an important link to healthcare and social services. However, initiatives related to motivation to receive mental health services, treatment, or social reintegration were not observed in conjunction with this program.

Violence, drugs, and psychiatric disorders: news from the Brazilian press.

The aim of this study is to describe the way that the Brazilian press reports on episodes of violence involving people with substance-related problems or psychiatric disorders. To develop this documentary study, we analyzed news reports from September 2009 to August 2015 in two major Brazilian newspaper who make their published articles available electronically in the Lexis Nexis Academic® database. The analyses were conducted using descriptive statistics and association tests. We identified 269 news stories related to these themes during the study period. The reported events occurred mainly in São Paulo and Rio de Janeiro, and 68% of the stories suggested a causal relationship between substance use or mental illness and violence. A marked minority (10%) of the stories made reference to prevention or treatment for the conditions studied. We concluded that the Brazilian press issues incomplete reports on episodes of violence involving people with substance-related problems or psychiatric disorders, emphasizing the relationships between these conditions and potential danger, particularly in cases involving drugs.

Evaluation of the losartan solubility in the biowaiver context by shake-flask method and intrinsic dissolution.

This study aimed at evaluating the shake-flask use as a universal method to evaluate drug solubility in a biowaiver context as proposed by FDA, EMA and ANVISA. The solubility of losartan was determined in three buffers using the shake-flask method, intrinsic dissolution (ID) and Quantum Chemistry. Moreover, the evaluation of a losartan dissolution profile from coated tablets was conducted. The losartan low solubility in pH 1.2 and high solubility in pH 6.8 were observed using the shake-flask method. However, the solubility results using ID demonstrated its high solubility in pH 1.2 and 6.8. It was not possible to find conclusive results regarding the solubility of the drug in pH 4.5. The studies conducted by Quantum Chemistry provide molecular and electronic data that helped understand the losartan solvation in different pH values. Our experimental results defined that losartan can be classified as a low-solubility drug. In addition, this work shows that shake-flask cannot be a universal method of solubility studies in biowaiver context. Individual analysis will be necessary. The intrinsic dissolution should be considered as a complementary method.

The use of benzodiazepines by women cared for at a Family Health Unit.

OBJECTIVE: Estimate the prevalence of benzodiazepine use by adult women at a Family Health Unit and identify the risk factors associated with this usage. METHOD: Quantitative cross-sectional study that employed secondary data developed at a Family Health Unit in the state of São Paulo, Brazil. We collected the data from the following sources: medical charts, registration forms, and the archive of prescriptions from the pharmacy at the referred health unit. We employed the chi-squared, Student's t, and Mann-Whitney tests, as well as logistic regression analysis. RESULTS: We identified 81 benzodiazepine users amongst 1,094 adult women (7.4%). Regarding the risk factors, the comparison between the groups of benzodiazepine users (n = 64) and non-users (n = 70) showed that having a chronic disease and using other psychotropic drugs were significantly associated with the use of benzodiazepines. CONCLUSION: The prevalence found was lower than the described in previous studies performed in Primary Health Units. The group that must receive greater attention regarding the consumption of benzodiazepines is that of middle-aged women or older, with low education levels, and chronic illnesses.

Evaluation of social support and stress in nursing students. / Avaliação do apoio social e estresse em estudantes de enfermagem.

OBJECTIVE: To analyze the perception of stress and social support of nursing students considering the number of supporters and the satisfaction with them. METHOD: Quantitative, cross-sectional study performed with nursing students from a public university in the state of São Paulo, Brazil. We used the Stress Evaluation in Nursing Students scale and the Social Support Questionnaire. We performed the chi-squared test and analyzed the structure of the support network using software Gephi version 0.9.1. RESULTS: 192 students participated. Family and friends were the most mentioned supporters. Despite counting on a low number of supporters, most participants were satisfied with the perceived support. The students presented high intensity of stress in the "professional training" domain. Furthermore, the students who were pleased with the perceived social support presented low intensity of stress in accomplishing the theoretical activities of the undergraduate course. CONCLUSION: The creation of more welcoming spaces in the academic environment, the qualification of the social support, and the employment of strategies to improve the transition from the student stage to the professional stage are important recommendations that will contribute for positive outcomes regarding the coping with student stress.

Meaning of Pharmacological Treatment for Families of People With Depression.

Medication adherence is related to patient satisfaction with family support. This research aimed to understand the meaning of pharmacotherapy to families of people with major depressive disorder. This qualitative study employed Grounded Theory and Symbolic Interactionism. Seventeen families of people with depression from a Brazilian clinic were included. Data was collected from 2013 to 2014, using open interviews, which were analyzed by open, axial, and selective coding. Medication represented "Tranquility and worry" because it re-established tranquility in family routine, but generated concerns. Thus, families were conflicted and ambivalent about medications, and they interfered with the promotion or impairment of adherence.

Clinical and socio-demographic characteristics of patients at a rehabilitation center for chemical dependency. / Características clínico y sociodemográficas de los pacientes de un centro de rehabilitación para las adicciones.

OBJECTIVE: Identify the socio-demographic and clinical characteristics of a sample of chemically dependent people undergoing treatment at a daytime ambulatory care center specialized in treating chemical dependency in Lima, Peru, and describe their dropout rates. METHOD: Quantitative, descriptive, and exploratory study based on secondary data. The instrument used was the individual notification record from the information system for the treatment demand. RESULTS: The demand was composed mostly of young, single men who were unemployed or underemployed. The most common diagnosis was dependency on cocaine-based drugs and the age of the onset of use was between 15 and 19 years. The dropout rate was 85%, and 48% remained in treatment for only one day. CONCLUSION: The results highlight important factors to be considered in the evaluation of public policies on prevention, treatment, and supply control. We recommend more inclusive and participatory public policies.

Folic acid: a biopharmaceutical evaluation.

The aqueous solubility and drug product dissolution are important factors that determine the rate and extent of drug absorption from immediate release solid oral dosage forms. The aim of this article was to perform a folic acid biopharmaceutical study to evaluate the biowaiver of new products containing folic acid. We studied the solubility of its raw material and the dissolution profile of two commercially available products. Three different buffers (pH 1.2, 4.5 and 6.8) were used as the media of the solubility and dissolution tests (apparatus II, at 50 rpm and 900 mL of medium volume). We found that folic acid solubility and its release from tablets are pH dependent. The dissolution profiles of both tablets were compared by dissolution efficiency (%), using t-test or variance analysis (ANOVA). The dissolution profiles obtained for the two products at pH 1.2 medium were similar (p > 0.05), but they were dissimilar at pH 4.5 and 6.8 (p < 0.05). Furthermore, we could observe differences between all the dissolution profiles of folic acid for each product at three different dissolution media used. The results showed that physicochemical characteristics of folic acid affect its dissolution and absorption making it difficult to take a decision on their biowaiver based on BCS.

Is there scientific relevance to the plot of films and documentaries about eating disorders?

OBJECTIVES: to analyze films and documentaries about eating disorders from the last twenty years, identifying the way they approach the topic as well as their relevance for didactic use in teaching the health field. METHODS: a descriptive study, whose data collection was carried out on the main streaming and video platforms, resulting in the survey of 60 media. Of these, only 25 had audio/subtitles in Portuguese (inclusion criteria). scientific relevance was analyzed considering psychopathological and epidemiological aspects of these disorders. A questionnaire about the plot, characters and descriptive data analysis were used. RESULTS: most media were dramas about female teenagers who tried to conform to beauty stereotypes, whose symptoms portrayed converged with current medical diagnostic manuals. CONCLUSIONS: in practical terms, a classificatory list of 11 media was prepared that could be used as a teaching resource for teaching this topic in the health field.

Effect of an Online Intervention on Nursing Students' Alcohol Consumption and Social Support.

OBJECTIVE: This research aimed to evaluate the impact of custom-developed software on nursing students' alcohol consumption and perception of social support. METHOD: A quasi-experimental study was conducted with 88 students in the early years of nursing courses at a Brazilian public university. The members of the intervention group (n = 40) participated in a lecture delivered by a nurse and used online software developed based on cognitive behavioral techniques and social skills training. The members of the control group (n = 48) participated only in the lecture. Data on alcohol consumption profiles and social support characteristics were collected. Descriptive statistics, an analysis of variance test, and the Dunnett's test were utilized for data analysis. RESULTS: Alcohol consumption decreased in both groups without significant differences between them. However, in terms of frequency of use, binge drinking, and the number of drinks consumed, a significant decrease occurred among participants in the intervention group. Regarding social support, both groups showed an increase in satisfaction with support and a decrease in the number of supporters. This reduction was less pronounced in the intervention group than in the control group. CONCLUSION: This investigation presents relevant results that suggest the potential of using online technologies as supplemental materials for promoting students' mental health.

Psychosocial impacts of the COVID-19 pandemic among settled women: A longitudinal study.

OBJECTIVE: to analyze the psychosocial impacts of the COVID-19 pandemic among Brazilian women from rural settlements. METHOD: this is a quantitative and longitudinal study conducted with 13 settled women. The data were collected between January 2020 and September 2021 using questionnaires on the perception of the social environment (quality of life, social support, self-efficacy), common mental disorder symptoms and sociodemographic aspects. The data were analyzed using descriptive statistics, cluster analysis and variance analysis. RESULTS: intersecting vulnerability conditions were identified that possibly intensified the challenges arising from the pandemic. The Quality of Life physical domain fluctuated differently and inversely according to the mental disorder symptoms. As for the psychological domain, at the end of the segment, an increase over time was identified in the entire sample, as the women's perception was better than before the pandemic. CONCLUSION: worsening of the participants' physical health deserves to be highlighted and, probably, it can be related to the difficulty accessing health services in this period as well as to the fear of contamination. Despite this, the participants were emotionally resilient throughout the period, including signs of improvement in terms of psychological aspects, suggesting a possible effect of the community organization of the settlement.

Expansion of Psychosocial Care Centers and their relationship with health and human rights.

OBJECTIVE: To analyze the factors associated with the expansion of the number of Brazilian Psychosocial Care Centers (CAPS) considering aspects related to the general health scenario and the institutionalization of human rights. METHODS: An analytical document-based study, developed between February 2020 and May 2022, whose secondary data on the 27 Brazilian capitals were collected on platforms in the public domain, based on the time series from 2015 to 2020. Indicators were listed based on health system infrastructure and quality of life. For data analysis, descriptive statistics, Pearson's correlation test and Student's t test were used. RESULTS: The capitals that expanded the number of CAPS in the analyzed period were the ones that presented the greatest political-legal framework for the protection of human rights. CONCLUSION: The results suggest that the greater the commitment of governments in favor of human rights, the greater the investment for CAPS expansion.

Genograma e ecomapa como estratégias lúdicas de ensino de enfermagem na Atenção Primária à Saúde.

OBJECTIVES: to report the experience using ludic strategies for the teaching-learning in the elaboration of the genogram and ecomap; and the use of these instruments by Nursing students in the Primary Health Care services. METHODS: an experience report of the discipline Integrity of Care I (Integralidade do Cuidado I), of the Nursing School of Ribeirao Preto. Problems scenarios were created to approach the genogram and ecomap, comprising different family arrangements, represented by pedagogic puppets. RESULTS: students actively participated, held collective discussions, elaborated genogram, and ecomap, identified the type of family, and the stages of the vital cycle, providing increased dynamics and interactivity. Subsequently, in supervised activities in Primary Health Care services, students elaborated the genogram and ecomap to monitor a family. FINAL CONSIDERATIONS: the use of ludic strategies propitiates the teamwork, active interaction of the group, and the creativity. The articulation between theory and practice resulted in a significant learning.

[Generic drugs in Brazil: historical overview and legislation]. / Medicamentos genéricos no Brasil: panorama histórico e legislação.

The Brazilian generic drugs policy was implemented in 1999 with the aim of stimulating competition in the market, improve the quality of drugs and improve the access of the population to drug treatment. The process of implementing this policy allowed the introduction and discussion of concepts that had never before been used in the context of drug registration in Brazil: bioavailability, bioequivalence, pharmaceutical equivalence, generic drugs, biopharmaceutical classification system, biowaiver. The present article provides definitions for these concepts in the context of Brazilian legislation as well as a historical and chronological description of the implementation of the generic drugs policy in Brazil, including a list of current generic drug legislation. This article contributes to the understanding of the Brazilian generic drugs policy and facilitates the search for information concerning the legal requirements for registration of drugs in Brazil.

Mental health actions and nurse's work.

OBJECTIVE: to analyze the perception of nurses and other members of the patient care team about nurses' actions in mental health care. METHODS: the study was conducted with professionals from mental health services in the interior of the state of São Paulo. The data collected through semi-structured interviews, a questionnaire with closed questions and a focus group were submitted to content analysis. RESULTS: the participants referred mainly to the nursing care with the body and physical health, but also identified the nurse as a "gateway" for care, facilitator and integrator of actions and as the professional who has more contact with the user. Final considerations: although the stereotype of nursing as "body caregiver" refers to the beginnings of psychiatric nursing, the perception of the participants showed aspects that suggest a change in relation to the role traditionally attributed to this profession.

Freedom-deprived women: social representations of prison, violence, and their consequences.

OBJECTIVE: To understand the social representations that women deprived of their freedom have of imprisonment, violence, and their consequences. METHOD: An exploratory-descriptive qualitative study with 15 women from a female penitentiary in the State of São Paulo, Brazil. Semistructured interview was used. Data submitted to thematic content analysis and interpreted under Social Representations. RESULTS: Categories identified: "Enclosed and abandoned in the prison environment": loss of contact with relatives, difficulties living in prison, and right to be reinserted into society. "Imprisoned in a cycle of social inequality": lack of support, access to education and employment opportunities, leading them to engage in new illicit activities and consequent imprisonment. FINAL CONSIDERATIONS: The social representations of prisoners suggest that they perceive themselves to be doubly "imprisoned", either from the objective point of view, as an individual deprived of freedom; or subjective, as citizens who have their rights disrespected and their possibilities of rehabilitation limited by the prison system.

Psychosocial care network: managers' perception and tensions of the field.

OBJECTIVE: to analyze the perception of workers and managers about the psychosocial care network in a medium-sized municipality in the inlands of the state of Minas Gerais. METHOD: qualitative, descriptive and exploratory study involving twelve participants from different points of the network. The semi-structured interviews were analyzed in the light of Pierre Bourdieu's framework of constructionist structuralism. RESULTS: the actions offered by the services were based on the perspectives of resocialization, user embracement, group and multiprofessional care, and on approaches to harm reduction, recreation and daily organization. These were configured as the network resources/capital. Tensions were identified in family embracement and in relationships between families and users, as well as in the prejudice towards people with mental disorders. Final considerations: the social agents were willing to contribute to processes of change in order to overcome the focus on specialties, the lack of training of some teams, lack of infrastructure and of some components, especially those related to leisure and community life.

Nursing students: medication use, psychoactive substances and health conditions.

OBJECTIVE: to assess the use of nonprescription psychoactive medications and their associations with psychoactive substance use and health aspects among nursing students. METHOD: a cross-sectional study conducted with 182 students at a nursing school in the city of Vale do Ribeira, Brazil. Sociodemographic information, screening for alcohol, tobacco and other drug use, information on physical and mental health and physical activity practices were assessed. RESULTS: more than half of the students (79.2%) used psychoactive drugs without prescription, with a predominance of monthly consumption. Consumption of these drugs was found to be associated with alcohol use, binge drinking, smoking and illicit drug use. CONCLUSION: the findings have implications for the implementation of health promotion strategies among nursing students, in view of lifestyle changes.

Is there scientific relevance to the plot of films and documentaries about eating disorders? / ¿Tiene relevancia científica la trama de películas y documentales sobre trastornos alimentarios? / Há pertinência científica no enredo dos filmes e documentários sobre transtornos alimentares?

ABSTRACT Objectives: to analyze films and documentaries about eating disorders from the last twenty years, identifying the way they approach the topic as well as their relevance for didactic use in teaching the health field. Methods: a descriptive study, whose data collection was carried out on the main streaming and video platforms, resulting in the survey of 60 media. Of these, only 25 had audio/subtitles in Portuguese (inclusion criteria). scientific relevance was analyzed considering psychopathological and epidemiological aspects of these disorders. A questionnaire about the plot, characters and descriptive data analysis were used. Results: most media were dramas about female teenagers who tried to conform to beauty stereotypes, whose symptoms portrayed converged with current medical diagnostic manuals. Conclusions: in practical terms, a classificatory list of 11 media was prepared that could be used as a teaching resource for teaching this topic in the health field.

RESUMEN Objetivos: analizar películas y documentales sobre trastornos alimentarios de los últimos veinte años, identificando la forma en que abordan el tema, así como su relevancia para su uso didáctico en la enseñanza del campo de la salud. Métodos: estudio descriptivo, cuya recolección de datos se realizó en las principales plataformas de streaming y video, dando como resultado la encuesta a 60 medios. De estos, sólo 25 tenían audio/subtítulos en portugués (criterios de inclusión). Se analizó la relevancia científica considerando aspectos psicopatológicos y epidemiológicos de estos trastornos. Se utilizó un cuestionario sobre la trama, los personajes y el análisis de datos descriptivos. Resultados: la mayoría de los medios fueron dramas sobre mujeres adolescentes que intentaban ajustarse a estereotipos de belleza, cuyos síntomas retratados convergían con los manuales de diagnóstico médico vigentes. Conclusiones: en términos prácticos, se elaboró un listado clasificatorio de 11 medios que podrían ser utilizados como recurso didáctico para la enseñanza de este tema en el campo de la salud.

RESUMO Objetivos: analisar filmes e documentários sobre transtornos alimentares dos últimos vinte anos, identificando o modo como abordam a temática, bem como sua pertinência para o uso didático no ensino do campo da saúde. Métodos: estudo descritivo, cuja coleta de dados foi realizada nas principais plataformas de streaming e vídeos, resultando no levantamento de 60 mídias. Dessas, apenas 25 tinham áudio/legenda em português (critério de inclusão). A pertinência científica foi analisada considerando aspectos psicopatológicos e epidemiológicos desses transtornos. Utilizaram-se um questionário sobre o enredo, as personagens e análise descritiva dos dados. Resultados: a maioria das mídias eram dramas sobre adolescentes do sexo feminino que tentavam adequar-se aos estereótipos de beleza, cujos sintomas retratados convergiam com os manuais de diagnósticos médicos atuais. Conclusões: em termos práticos, elaborou-se uma lista classificatória de 11 mídias que poderão ser utilizadas como recurso didático para o ensino desse tema no campo da saúde.

Patient safety in primary health care and polypharmacy: cross-sectional survey among patients with chronic diseases.

OBJECTIVE: to characterize and determine the polypharmacy prevalence in patients with chronic diseases and to identify the factors associated, in order to improvement of pharmaceutical care focused on patient safety. METHODS: cross-sectional study included 558 patients, covered by primary health care, using a household and structured questionnaire. We analyzed the data on polypharmacy and its clinical and socioeconomic factors. Poisson regression analysis with robust variance was applied, with results expressed in prevalence ratio. RESULTS: the results showed that polypharmacy (consumption of four or more drugs) was of 37.6%. The prevalence ratio analyses identified independent variables associated with polypharmacy: age (3.05), economic strata (0.33), way of medication acquisition through a combination of out-of-pocket and Brazilian public health system (1.44), diabetes and hypertension (2.11), comorbidities (coronary artery disease 2.26) and hospital admission (1.73). In the analyses, inappropriate medication use of the 278 patients (≥ 65 years) was associated with polypharmacy (prevalence ratio 4.04). CONCLUSION: polypharmacy study becomes an opportunity to guide the strategies for the patient safety to promote the medication without harm in chronic diseases.