Hydrogels in the treatment of rheumatoid arthritis: drug delivery systems and artificial matrices for dynamic in vitro models.

Rheumatoid arthritis (RA) is an autoimmune and chronic inflammatory disorder that mostly affects the synovial joints and can promote both cartilage and bone tissue destruction. Several conservative treatments are available to relieve pain and control the inflammation; however, traditional drugs administration are not fully effective and present severe undesired side effects. Hydrogels are a very attractive platform as a drug delivery system to guarantee these handicaps are reduced, and the therapeutic effect from the drugs is maximized. Furthermore, hydrogels can mimic the physiological microenvironment and have the mechanical behavior needed for use as cartilage in vitro model. The testing of these advanced delivery systems is still bound to animal disease models that have shown low predictability. Alternatively, hydrogel-based human dynamic in vitro systems can be used to model diseases, bypassing some of the animal testing problems. RA dynamic disease models are still in an embryonary stage since advances regarding healthy and inflamed cartilage models are currently giving the first steps regarding complexity increase. Herein, recent studies using hydrogels in the treatment of RA, featuring different hydrogel formulations are discussed. Besides, their use as artificial extracellular matrices in dynamic in vitro articular cartilage is also reviewed.

A review of research advances on disinfection strategies for biofilm control in drinking water distribution systems.

The presence of biofilms in drinking water distribution systems (DWDS) is responsible for water quality deterioration and a possible source of public health risks. Different factors impact the biological stability of drinking water (DW) in the distribution networks, such as the presence and concentration of nutrients, water temperature, pipe material composition, hydrodynamic conditions, and levels of disinfectant residual. This review aimed to evaluate the current state of knowledge on strategies for DW biofilm disinfection through a qualitative and quantitative analysis of the literature published over the last decade. A systematic review method was performed on the 562 journal articles identified through database searching on Web of Science and Scopus, with 85 studies selected for detailed analysis. A variety of disinfectants were identified for DW biofilm control such as chlorine, chloramine, UV irradiation, hydrogen peroxide, chlorine dioxide, ozone, and others at a lower frequency, namely, electrolyzed water, bacteriophages, silver ions, and nanoparticles. The disinfectants can impact the microbial communities within biofilms, reduce the number of culturable cells and biofilm biomass, as well as interfere with the biofilm matrix components. The maintenance of an effective residual concentration in the water guarantees long-term prevention of biofilm formation and improves the inactivation of detached biofilm-associated opportunistic pathogens. Additionally, strategies based on multi-barrier processes by optimization of primary and secondary disinfection combined with other water treatment methods improve the control of opportunistic pathogens, reduce the chlorine-tolerance of biofilm-embedded cells, as well as decrease the corrosion rate in metal-based pipelines. Most of the studies used benchtop laboratory devices for biofilm research. Even though these devices mimic the conditions found in real DWDS, future investigations on strategies for DW biofilm control should include the validity of the promising strategies against biofilms formed in real DW networks.

Chlorinated cyanurates and potassium salt of peroxymonosulphate as antimicrobial and antibiofilm agents for drinking water disinfection.

The understanding of microbial susceptibility to disinfectants is an important step to provide drinking water (DW) of adequate microbiological quality. In drinking water distribution systems (DWDS) the application of disinfectants is the main approach to control microorganisms. Although chlorine has been commonly used for DW treatment, the increase of microbial resistance and the production of harmful disinfection by-products promote the necessity to seek new alternatives. This study evaluated the antimicrobial activity of sodium dichloroisocyanurate (NaDCC), trichloroisocyanuric acid (TCCA), and pentapotassium bis(peroxymonosulphate) bis(sulphate) (OXONE) against two emerging pathogens isolated from DW, Acinetobacter calcoaceticus and Stenotrophomonas maltophilia. Free chlorine from calcium hypochlorite was used for comparison. The dose and time-responses against planktonic bacteria were performed as well as the assessment of the effects on membrane integrity. Moreover, the effects against 48 h-old biofilms formed on polyvinyl chloride and stainless steel were evaluated in terms of biofilm culturability and removal. Minimum bactericidal concentrations of 2.1 and 3.1 mg/L for NaDCC, 2.5 and 3.8 mg/L for TCCA, 340 and 690 mg/L for OXONE, and 0.80 and 1.0 mg/L for free chlorine alone were obtained against S. maltophilia and A. calcoaceticus, respectively. The kinetic modeling revealed that NaDCC and TCCA caused similar inactivation rates and the time for first log reduction by OXONE was less than 10 min, for both bacteria. All the disinfectants triggered significant bacterial cytoplasmic membrane destabilization, even at sub-lethal concentrations. A 30 min treatment with the disinfectants allowed a reduction in the biofilm culturability up to 5 log. OXONE was the disinfectant with the best efficiency against both bacterial biofilms. However, none of the disinfectants caused significant biofilm removal (reduction < 1 log cells/cm2). This study highlights NaDCC, TCCA, and OXONE as promising alternatives to free chlorine for DW disinfection, particularly for planktonic growth control and biofilm culturability reduction.

Repurposing ibuprofen to control Staphylococcus aureus biofilms.

Drug repurposing arises as an interesting alternative to overcome the limited efficacy of current available antibiotics by reducing time, cost and risk associated with drug innovation. In this study, the activity of ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), was evaluated on the control of pre-established adhered cells (2 h) and 24 h old biofilms of Staphylococcus aureus. Bacterial adhesion was performed by S. aureus CECT 976, while biofilm formation was also performed by the antibiotic-resistant strains: SA1199B, RN4220 and XU212. The treatment with ibuprofen promoted metabolic reductions up to 80% and total loss of culturability of adhered cells and 24 h old biofilms. Ibuprofen demonstrated moderate efficacy to remove biofilms of S. aureus CECT 976 (removal ≤ 40%), but did not display removal action against the antibiotic-resistant strains. Antibacterial activity (inhibitory and bactericidal) and mode of action of ibuprofen were also assessed using different bacterial physiological indices. Minimum inhibitory and bactericidal concentrations of the four S. aureus strains ranged between 500 and 2000 mg L-1 and 1400 - >2000 mg L-1, respectively. After S. aureus CECT 976 incubation with ibuprofen, cell permeation to propidium iodide, release of intracellular potassium and changes on cell surface hydrophobicity were observed. The overall results, demonstrate that ibuprofen can control S. aureus planktonic and sessile growth, with strong destabilizing and disrupting action on the cytoplasmic membrane.

A violência, as mulheres e o Estado: dificuldades e estratégias / Violence, women and the State: difficulties and strategies

Este artigo é parte de uma pesquisa de mestrado que teve como objetivo caracterizar a Rede de Enfrentamento à Violência Contra às Mulheres em um município do Centro-Oeste do Rio Grande do Sul, Brasil. O acesso às participantes ocorreu a partir da estratégia de amostragem Bola de Neve. O estudo contou com 11 participantes provindas de diferentes esferas da Rede de Enfrentamento municipal. Foram analisadas as principais dificuldades e estratégias relatadas pelas participantes no trabalho de Enfrentamento à violência contra a mulher. Como principais dificuldades, foram apontadas: a falta de investimento do Estado, a desestruturação/fragmentação da Rede e a individualização/pessoalização do trabalho prestado. Como principais estratégias: a formação de vínculos pessoais de trabalho e o desenvolvimento do trabalho voluntário para suprir as lacunas. As conclusões apontam para uma rede despolitizada, fragilizada e distante de seus ideais garantidores da cidadania.

Entre a benesse e o direito: as políticas de atendimento à população em situação de rua na América Latina / Entre el favor y el derecho: las políticas de asistencia a la población en la situación de calle en Latinoamérica / Between favor and right: Policies to Assist the Homeless Population in Latin America

RESUMO O presente trabalho analisou a literatura científica sobre políticas sociais e população em situação de rua nos países latino-americanos. Foram analisados 51 artigos buscados nas bases de dados Scielo, Lilacs e Redalyc, a partir da palavra-chave 'População em Situação de Rua', que apresentam experiências e reflexões acerca do atendimento a esse segmento na Argentina, Brasil, Chile, Colômbia e Cuba. Identificou-se que, apesar de perfis semelhantes, trata-se de um segmento bastante heterogêneo. As principais ênfases sobre as políticas sociais foram nas áreas da assistência social e saúde, e estas ainda tendem para o assistencialismo. Contudo, houve avanços na criação de legislações, serviços e políticas para a garantia de direitos. Enfim, nota-se a necessidade de aprofundar a discussão acerca da determinação produtora da desigualdade social e o avanço na implementação de políticas sociais que visem possibilitar o real acesso aos direitos sociais por esta população.

RESUMEN En el estudio se analizó la literatura científica sobre políticas sociales y población en situación de calle en los países latinoamericanos. Se analizaron 51 artículos buscados en las bases Scielo, Lilacs y Redalyc, a partir de la palabra clave 'Población en Situación de Calle', presentando experiencias y reflexiones acerca de la atención a ese segmento en Argentina, Brasil, Chile, Colombia y Cuba. A pesar de perfiles similares, se trata de un segmento bastante heterogéneo. Los principales énfasis fueron en las áreas de la asistencia social y salud, y éstas todavía tienden hacia el asistencialismo. Hubo avances en la creación de legislaciones, servicios y políticas para la garantía de derechos. En fin, se nota la necesidad de profundizar la discusión sobre la determinación productora de la desigualdad social y el avance en la implementación de políticas sociales que apunte a permitir el verdadero acceso a los derechos sociales por esta población.

ABSTRACT. The present study analyzed the scientific literature on social policies and the homeless population in Latin American countries. We analyzed a total of 51 articles from a search in the databases Scielo, Lilacs and Redalyc using the keyword 'População em Situação de Rua', presenting experiences and reflections about the service to this segment in Argentina, Brazil, Chile, Colombia and Cuba. Despite similar profiles, it is a very heterogeneous segment. The main emphases on social policies were in the areas of social assistance and healthcare, and these still tend towards welfarism. However, progress has been made in the creation of legislation, services and policies for guaranteeing rights. Finally, there is a need to deepen the discussion about the productive determination of social inequality and the progress in the implementation of social policies that aim to enable real access to social rights by this population.

Desafios da atuação dos psicólogos nos CREAS do Rio Grande do Norte / Psychologist's working challenges in CREAS in Rio Grande do Norte

O presente estudo objetiva discutir os aspectos contextuais que condicionam e possibilitam a prática profissional do psicólogo no campo da Assistência Social, utilizando como recorte a fala dos psicólogos que atuam nos Centros de Referência Especializados de Assistência Social (CREAS) do estado do Rio Grande do Norte (RN). Coloca-se em debate a atuação do psicólogo nesses espaços, pensando a sua contribuição na consolidação da política pública em questão. A análise dos dados demonstra a necessidade da construção de uma identidade do psicólogo como trabalhador social, apontando para a importância de mudanças no corpo conceitual e técnico da Psicologia.

This paper aims to discuss about contextual aspects that can determine and enable psychological professional exercise in Social Welfare area, using as data the speech of psychologists who work at the Centro de Referência Especializado de Assistência Social (CREAS) from the state of Rio Grande do Norte (RN). It debates the psychologist's performance in these new spaces, thinking about their contribution for the consolidation of this Social Welfare policy. Analysis shows the need of building an identity of psychologist as a social worker, pointing to the importance of changes in the conceptual and technical framework of Psychology.

O Psicólogo no Campo do Bem-Estar Social: atuação junto às famílias e indivíduos em situação de vulnerabilidade e risco social no Centro de Referência de Assistência Social (CRAS) / The psychologist in the field of social social rights: acting with individuals and families in situation of vulnerability and social risk in CRAS

O presente estudo teve como objetivo estudar a atuação do psicólogo noCentro de Referência de Assistência Social (CRAS), a fim de identificar aspráticas desenvolvidas por esses profissionais, caracterizando-as no tocante às ferramentas teórico-metodológicas utilizadas, e investigar se essas práticas estão de acordo com as determinações e diretrizes da PolíticaNacional de Assistência Social (PNAS). A estratégia de investigação utilizadapara a coleta dos dados foi uma entrevista semiestruturada emprofundidade, realizada com os psicólogos. Entre os principais resultados, verificou-se. Constatou-se um campo de trabalho complexo e permeado de contradições, que oscila entre a garantia de direitos e a manutenção de velhas práticas e dificuldades historicamente presentes na Política de Assistência Social, sendo o psicólogo diretamente afetado por essaambiguidade e incerteza, somadas às lacunas da sua formação profissionalno trato à questão social Questão Social e à demanda diversificada dessapolítica, exigindo deste profissional, principalmente, ações multiprofissionaise intersetoriais...

The present study aimed to studying the psychologist action in the Reference Center of Social Assistance (CRAS), to identify the practices developed by these professionals, characterizing such practices with regard to the theoretical methodological tools used and to investigate if these practices are in accordance with provisions and guidelines of National Policy of Social Assistance (PNAS). The investigation strategies used to collect data was a semi-structured interview in-depth conducted with the psychologists. Among the main results it was verified a complex work field and full of contradictions, which oscillates between the guarantee of rights and themaintenance of old practices and difficulties historically present in the Social Assistance Policy, being the psychologist directly affected by this ambiguity and uncertainty, added to the gaps in their professional formation in dealing with social issues and to the diversified demand of this policy, requiring, mainly, multidisciplinary and intersectoral actions...

As atitudes sexuais, contraceptivas, o lócus de controle da saúde e a autoestima em estudantes do ensino superior / Sexual and contraceptives attitudes, the locus of health control and self-esteem among higher education students / Las actitudes sexuales, contraceptivas, el locus de control de La salud y la autoestima de los estudiantes de enseñanza superior

Analisar as relações entre as atitudes sexuais, contraceptivas, o lócus de controle da saúde e a autoestima nos estudantes de uma instituição de ensino superior privado. Métodos: Estudo descrito e correlacional, de abordagem quantitativa, realizado numa escola de ensino superior da região de Lisboa, com 152 estudantes do 1º e 4º anos dos cursos de licenciatura em Enfermagem, Fisioterapia, Cardiopneumologia e Radiologia. Utilizou-se como instrumento de pesquisa um questionário com as seguintes escalas de avaliação: ?atitudes sexuais?, ?atitudes contraceptivas?, ?lócus de controle da saúde? e ?autoestima?.Os dados obtidos foram submetidos à análise descritiva e inferencial. Resultados: A maioria dos estudantes (90,7%; n=138) já teve relações sexuais. As atitudes sexuais foram influenciadas pelo gênero (p=0,0035), e não pelo início da atividade sexual ou pelo ano de curso (p>0,05). As atitudes contraceptivas estavam relacionadas ao ano que os estudantes frequentavam (p=0,031) e ao gênero (p=0,029). O lócus de controle externo, em média, foi mais elevado nas raparigas (29,2) que nos rapazes (30,1). A autoestima aumentou com a idade dos estudantes (p=0,003). Conclusão: É necessário um investimento em educação sexual no ensino superior, pois os jovens vivem os seus dias inseridos no ambiente escolar, passando pouco tempo junto das famílias. A universidade deve assumir uma posição especial no desenvolvimento do conceito de sexualidade baseado na perspetiva holística do ser humano, promovendo a educação sexual como fundamental na construção da identidade humana e imprescindível na promoção da saúde...

To analyze the relationship between sexual and contraceptive attitudes, the locus of health control and self-esteem among students of a private institution of higher education. Methods: Descriptive and correlational study with a quantitative approach, performed in a higher education school in Lisbon, with 152 students, from the 1st to the4th year of undergraduate courses in Nursing, Physiotherapy, Cardiopneumology and Radiology. As research instrument, it was used a questionnaire with rating scales on ?sexual attitudes?, ?contraception attitudes?, ?locus of health control? and ?self-esteem?. The data obtained was analyzed using descriptive and inferential statistics. Results: The majority of students (90.7%) have already had sexual intercourse. Sexual attitudes were influenced by gender (p=0.0035), but not by the start of sexual activity or by the course?s year (p>0.05). Contraceptive attitudes were related to the year that students attended (p=0.031) and to gender (p=0.029). The external locus of control, on average, was higher among girls (29.2) than boys (30.1). The self-esteem increased with the student?s age (p=0.003). Conclusion: Investment in the area of sexual education is needed in the undergraduate programs, since the young people live their days in the school setting, spending little time with their families. The university should assume a special position in the development of the concept of sexuality based on the holistic perspective of the human being, promoting sexual education as essential in the construction of human identity and fundamental for health promotion...

Analizar las relaciones entre las actitudes sexuales, contraceptivas, el locus de control de la salud y la autoestima de los estudiantes de una institución privada de enseñanza superior. Métodos: Estudio descripto y de correlación, de abordaje cuantitativo realizado en una escuela de enseñanza superior de La región de Lisboa con 152 estudiantes del 1º y 4º años de los cursos de licenciatura en Enfermería, Fisioterapia, Cardioneumología y Radiología. Se utilizó como instrumento de investigación um cuestionario con las siguientes escalas de evaluación: ?actitudes sexuales?, ?actitudes contraceptivas?, ?locus de control de La salud? y ?autoestima?. Los datos obtenidos fueron sometidos al análisis descriptivo y de inferencia. Resultados: La mayoría de los estudiantes (90,7%; n=138) ya tuvieron relaciones sexuales. Las actitudes sexuales fueron influenciadas por el gênero (p=0,0035) y no por el inicio de la actividad sexual o por El año del curso (p>0,05). Las actitudes contraceptivas estuvieron relacionadas al año en el cual los estudiantes se encontraban (p= 0,031) y al género (p=0,029). El locus de control externo, em media, fue más elevado en las mujeres (29,2) que en los hombres (30,1). La autoestima aumentó con la edad de los estudiantes (p=0,003). Conclusión: Es necesario una inversión en educación sexual de la enseñanza superior pues los jóvenes viven sus días em el ambiente escolar quedándose poco tiempo junto a sus familias. La universidad debe asumir una posición especial en el desarrollo del concepto de sexualidad basado en la perspectiva holística del ser humano promoviendo la educación sexual como fundamental para la construcción de la identidad humana e imprescindible para la promoción de la salud...

O ambulatório de saúde mental no contexto sa reforma psiquiátrica em Natal, RN / The mental health ambulatory in psychiatric reform context in the city of Natal, RN

A Reforma Psiquiátrica brasileira estabelece o ambulatório de saúde mental como dispositivo substitutivoao manicômio, apto a ressocializar seus usuários. O objetivo deste artigo é descrever o trabalho desenvolvidono único ambulatório especializado em saúde mental do município de Natal, RN, discutindo a sua adequaçãoà proposta assistencial estabelecida pela Reforma Psiquiátrica. Os dados foram coletados por meio deobservação participante e entrevistas semiestruturadas com profissionais que participaram do processo deimplantação e de estruturação do serviço. Esses dados indicam que o ambulatório realiza atividades terapêuticas e ressocializadoras conduzidas por uma equipe multiprofissional (psiquiatras, psicólogas, terapeuta ocupacional, auxiliar de enfermagem e arte-educadora), oferecendo cuidados efetivos aos seus usuários. É capaz deacolher as manifestações de sofrimentos dos usuários e prioriza o respeito à individualidade destes,incentivando-os à ressocialização e ao exercício da autonomia. Portanto, pode-se afirmar que o ambulatório citado alcança bons resultados no tratamento ao qual é especializado e se configura como um serviço congruente à proposta da Reforma Psiquiátrica brasileira. A despeito disso, subsistem algumas questões que demandam equacionamento. A carência de profissionais, os problemas de acessibilidade e a necessidade daefetivação da rede integrada de serviços de saúde mental, são algumas das questões discutidas.

The Brazilian Psychiatric Reform establishes the mental health ambulatory as an alternative device to asylums, capable of resocializing its users. The purpose of this paper is to describe the work developed at the only mental health ambulatory in Natal, RN, discussing its congruity with the assistance policy defined by the Brazilian Psychiatric Reform. Data were collectedusing participative observation and semi-structured interviews with the professionals who participated in the process of implementing and structuring the service. These data point out that in the ambulatory, groups, therapeutic workshops and resocializing activities are conducted by a multiprofessional staff composed by psychiatrists, psychologists, an occupationaltherapeutist, a nurse´s aide and an art educator, offering the required attention to its users. The ambulatory is capable of dealing with the users’ indications of suffering and prioritizes respectfor the individuality, encouraging the users resocialization and autonomy. Therefore, it is possible to conclude that this ambulatory has achieved success regarding the services offered and that itis consistent with the Psychiatric Reform guidelines. Notwithstanding, some problems remain unsolved. Issues such as the shortage of professionals, problems related with the usersaccessibility, and the urgency to establish an integrated mental health network are discussed.