Entrepreneurship in the Favela: Negotiating Precarity and Mental Health During Covid-19.

This paper aims to explore the impact of the COVID-19 pandemic on the health and mental health of necessary entrepreneurs in Brasilian favelas, the social problems they experienced and implications for public health social work. The study used structured in-person interviews within selected Favela's, with a sample size of 721 entrepreneurs, aged between 16-70 years. All participants both worked and were resident in 15 out of the 27 Brasilian federal states. The bespoke questions explored socio-demographic questions, sought information on their entrepreneurship, health and administered the Warwick-Edinburgh Mental Wellbeing Scale for Health. The results highlighted that many entrepreneurs have engaged in this form of enterprise due to economic necessity, with 64% of women and 43.6% of men identifying increased levels of anxiety through the pandemic, with the presence of children in the family being statistically significant (p ≤ 0.05 chi-square test) for anxiety. Of the 9.8% sample respondents have accessed the health care service and for women with children, the impact of the pandemic accentuated existing problems of childcare and patriarchy. We conclude by highlighting the importance of universal and accessible health and mental health support and care, their ongoing accessibility, along with the importance of social work during crisis.

Retrocessos no financiamento da Ciência, Tecnologia e Inovação no Brasil: o caso do CNPq / Setbacks in the Science, Technology and Innovation financing in Brazil: the CNPq case

Resumo: O artigo analisa o financiamento do Programa de Ciência, Tecnologia e Inovação do CNPq, entre os anos de 2013 e 2021, evidenciando a direção dos recursos e as prioridades assumidas antes e após a Emenda Constitucional 95/2016. É uma pesquisa documental, de abordagem quantitativa e análise estatística descritiva. Evidenciamos tendência decrescente dos gastos - em 2021 correspondeu a 43% do gasto de 2013. A redução de recursos para a ciência impede o Brasil de avançar na produção de conhecimentos.

Abstract: The article analyzes the financing of the Science, Technology and Innovation Program of CNPq, between the years 2013 and 2021, showing the direction of resources and the priorities assumed before and after the Constitutional Amendment 95/2016. It is a documentary research, with a quantitative approach and descriptive statistical analysis. We evidence a decreasing trend in spending - in 2021 it corresponded to 43% of spending in 2013. The reduction of resources for science prevents Brazil from advancing in the production of knowledge.

Religious therapeutic communities: between salvation by faith and the denial of its principles. / Comunidades terapêuticas religiosas: entre a salvação pela fé e a negação dos seus princípios.

The growth of Brazilian therapeutic communities points to a return to the asylum paradigm, with public funding for hospitalizations based on labor therapy and religious conversion. The relationship between these institutions and government sectors has expanded since 2013 in the state of Espírito Santo, Brazil. Given this scenario, we aimed to analyze, through this qualitative research, the role of religious therapeutic communities in the treatment of individuals with problematic drug use, focusing on the impact of the religious methods employed in these places. To this end, we conducted semi-structured interviews with 28 individuals who had been treated in these places. The interviews were held for six months and subsequently transcribed in full. The data were analyzed using the Discourse Analysis. The subjects' statements widely differed: 13 reported that institutions had an essential role in their treatment and pointed out that religious methods helped them, while 15 argued that institutions were inefficient in their treatment and religious methods were ineffective. The study elucidated the need for inspection of these institutions and stirred a reflection concerning their suitability as publicly funded places to treat the drug user population.

O avanço das comunidades terapêuticas no Brasil aponta para um retorno ao paradigma manicomial, com financiamento público para internações baseadas em laborterapia e conversão religiosa. No Espírito Santo, a relação entre essas instituições e setores do governo se amplia a partir de 2013. Diante deste cenário, objetivamos analisar, por meio desta pesquisa qualitativa, o papel das comunidades terapêuticas religiosas no tratamento de indivíduos em uso abusivo de drogas, focalizando no impacto dos métodos religiosos empregados nestes locais. Para isso, realizamos entrevistas semiestruturadas com 28 indivíduos egressos de internações nestes locais. As entrevistas foram realizadas durante seis meses e, posteriormente, transcritas na íntegra. Os dados foram analisados por meio da Análise do Discurso. Os discursos dos sujeitos oscilaram: 13 referiram que as instituições tiveram um importante papel em seus processos de tratamento e que os métodos religiosos os ajudaram; e 15 defenderam que as instituições não foram eficientes em seus tratamentos e que os métodos religiosos nada contribuíram. O estudo elucidou a necessidade de fiscalização destas instituições, bem como reflexão sobre a pertinência das mesmas como locais financiados publicamente para o tratamento da população usuária de drogas.

Comunidades terapêuticas religiosas: entre a salvação pela fé e a negação dos seus princípios / Religious therapeutic communities: between salvation by faith and the denial of its principles

Resumo O avanço das comunidades terapêuticas no Brasil aponta para um retorno ao paradigma manicomial, com financiamento público para internações baseadas em laborterapia e conversão religiosa. No Espírito Santo, a relação entre essas instituições e setores do governo se amplia a partir de 2013. Diante deste cenário, objetivamos analisar, por meio desta pesquisa qualitativa, o papel das comunidades terapêuticas religiosas no tratamento de indivíduos em uso abusivo de drogas, focalizando no impacto dos métodos religiosos empregados nestes locais. Para isso, realizamos entrevistas semiestruturadas com 28 indivíduos egressos de internações nestes locais. As entrevistas foram realizadas durante seis meses e, posteriormente, transcritas na íntegra. Os dados foram analisados por meio da Análise do Discurso. Os discursos dos sujeitos oscilaram: 13 referiram que as instituições tiveram um importante papel em seus processos de tratamento e que os métodos religiosos os ajudaram; e 15 defenderam que as instituições não foram eficientes em seus tratamentos e que os métodos religiosos nada contribuíram. O estudo elucidou a necessidade de fiscalização destas instituições, bem como reflexão sobre a pertinência das mesmas como locais financiados publicamente para o tratamento da população usuária de drogas.

Abstract The growth of Brazilian therapeutic communities points to a return to the asylum paradigm, with public funding for hospitalizations based on labor therapy and religious conversion. The relationship between these institutions and government sectors has expanded since 2013 in the state of Espírito Santo, Brazil. Given this scenario, we aimed to analyze, through this qualitative research, the role of religious therapeutic communities in the treatment of individuals with problematic drug use, focusing on the impact of the religious methods employed in these places. To this end, we conducted semi-structured interviews with 28 individuals who had been treated in these places. The interviews were held for six months and subsequently transcribed in full. The data were analyzed using the Discourse Analysis. The subjects' statements widely differed: 13 reported that institutions had an essential role in their treatment and pointed out that religious methods helped them, while 15 argued that institutions were inefficient in their treatment and religious methods were ineffective. The study elucidated the need for inspection of these institutions and stirred a reflection concerning their suitability as publicly funded places to treat the drug user population.

Alterações cardíacas em pacientes durante o primeiro ano de hemodiálise crônica: foco em preditores de fibrilação atrial / Cardiac changes in patients during the first year of chronic hemodialysis: focus on predictors of atrial fibrillation

Objetivos: Detecção precoce de alterações cardíacas, em especial de preditores de fibrilação atrial (FA), em pacientes renais crônicos dialíticos, permitem condutas terapêuticas que podem impactar na morbimortalidade cardiovascular desses pacientes. Descrevemos alterações elétricas e estruturais cardíacas nos pacientes durante o 1º ano de hemodiálise (HD). Métodos: Estudo observacional, transversal, prospectivo, em pacientes entre 20 e 80 anos, renais crônicos, pertencentes a serviços públicos de São Paulo, divididos pelo tempo de início de hemodiálise: grupo 1: 1 a 6 meses; grupo 2: 7 a12 meses. Coletados dados sociodemográficos, mórbidos, eletrocardiograma de repouso, Holter 48h, ecocardiograma transtorácico e exames de sangue pré e pós hemodiálise ( função renal, eletrólitos, bicarbonato e inflamatórios). Analisados por teste T student e Qui-quadrado. Resultados: 73 pacientes, hipertensos, predomínio homens, quinquagenários, escolaridade fundamental, brancos, não solteiros, procedentes da região sudeste metropolitana, com multimorbidades e polifarmácia. Grupo 2 apresentou maior idade (p=0,007), morbidades (p=0,04), medicações (p=0,02), preditores de FA caracterizados por extrassístoles ventriculares ( p=0,02), aumento dos volumes e diâmetros ventriculares e átrio esquerdo (todos p≤0,001), alteração do bicarbonato pré e pós hemodiálise (p<0,01). Grupo 1 apresentou maiores alterações eletrolíticas pós hemodiálise (p≤0,03). Conclusão: Além da hipertensão arterial, tempo de hemodiálise, acidose metabólica próxima dos limites de referência, associaram-se precocemente à progressiva disfunção sisto-diastólica de câmaras esquerdas cardíacas e preditores de fibrilação atrial, em especial o volume sistólico final, predominantemente no 2º semestre do início de hemodiálise. Sugere-se Holter e Ecocardiograma a partir do 7º mês de hemodiálise e controles mais rígidos de acidose para essa população.

Objectives: Early detection of cardiac alterations in chronic renal patients on hemodyalisis (HD), especially atrial fibrillation (AF) predictors, allows therapeutic approaches that can impact their cardiovascular prognosis. We describe electrical and structural cardiac alterations in patients during the 1st year of hemodyalisis. Methods: Observational, cross-sectional, prospective study. Chronic kidney patients on dyalisis aged between 20 and 80 years, wihout atrial fibrillation, from public hemodyalisis services were divided by the time of hemodyalisis onset: group 1: 1 to 6 months; group 2: 7 to 12 months. Sociodemographic and morbid data, electrocardiogram at rest, Holter 48h, transthoracic echocardiogram and pre and post hemodialysis blood tests (kidney function, electrolytes and inflammatory tests) were collected. Data analyzed by Chi-square and Student T tests. Results: 73 hypertensive patients, predominantly men, aged in their fifties, elementary school, white, not single, from the metropolitan southeast region, with multimorbidities and polypharmacy were analyzed. Group 2 presented more age (p<0.01), morbidities (p=0.04), medications (p=0.02), atrial fibrillation, predictors especially ventricular extrasystoles (VES, p=0.02), increased left venticular and atrium volumes and diameters (all p≤0.001) and lower bicarbonate before and after hemodyalisis (both p≤0,01). Group 1 presented more changes in eletrolytes (p≤0.03). Conclusion: In addition to arterial hypertension, hemodyalisis duration was associated to systolic and diastolic dysfunction of the left cardiac chambers, atrial fibrillation predictors especially end-systolic volume (ESV) and mild acidosis, in the 2nd semestre predominantly. Holter and echocardiography are suggested from the 7th month of hemodyalisis onset and tighter metabolic control in this population

Mortalidad materna en Brasil y Cuba: estudio comparativo / Maternal mortality in Brazil and Cuba: comparative study

Introducción: La mortalidad materna constituye un problema de salud pública a nivel internacional. Su comportamiento es expresión del funcionamiento integral de los sistemas de salud, así como, del avance de los derechos sexuales y reproductivos de las mujeres. Objetivo: Comparar los indicadores de mortalidad materna de Brasil y Cuba en el periodo 2005-2017. Métodos: La metodología implementada responde a un análisis de tipo documental. Se utilizaron como fuentes de información las principales bases de datos del Departamento de Informática del Sistema Único de Salud de Brasil, y los anuarios estadísticos publicados por el Ministerio de Salud Pública de Cuba y la Oficina Nacional de Estadística e Información. Resultados: La meta sobre mortalidad materna dentro de los Objetivos de Desarrollo Sustentable es un requisito actualmente cumplido por los dos países. En Cuba, las cifras de la Razón de Mortalidad Materna se mantienen con valores siempre inferiores a los del propio país en el año 2005; no obstante, a partir de 2013 muestran un comportamiento creciente. En Brasil, por su parte, son superiores a las de Cuba y nunca disminuyen en relación con el año 2005, y presentan una marcada tendencia creciente. Conclusiones: Los programas de salud materna analizados para Brasil y Cuba muestran avances y desafíos diferenciados. El comportamiento de los indicadores analizados reafirma la necesidad de intensificar las acciones para la reducción de los óbitos maternos en los dos países, con más urgencia para Brasil(AU)

Introduction: Maternal mortality is a public health problem at the international level. Its behavior is an expression of the comprehensive functioning of health systems, as well as the advancement of women's sexual and reproductive rights. Objective: Compare the maternal mortality indicators of Brazil and Cuba in the period 2005-2017. Methods: The implemented methodology responds to a documentary analysis. The main databases of the Department of Informatics of the Unified Health System of Brazil, and the statistical yearbooks published by the Ministry of Public Health of Cuba and the National Office of Statistics and Information were used as sources of information. Results: The target on maternal mortality within the Sustainable Development Goals is a requirement currently met by both countries. In Cuba, the figures for the Maternal Mortality Ratio remain at values always lower than those of the country itself in 2005; however, as of 2013 they show an increasing behavior. In Brazil, on the other hand, they are higher than those of Cuba and never decrease in relation to 2005, and present a marked growing trend. Conclusions: The maternal health programs analyzed for Brazil and Cuba show differentiated progress and challenges. The behavior of the indicators analyzed reaffirms the need to intensify actions to reduce maternal deaths in both countries, with more urgency for Brazil(AU)

The COVID-19 pandemic, emergency aid and social work in Brazil.

This essay reflects on the implementation of federal government emergency aid in Brazil in the context of the COVID-19 pandemic, highlighting elements from the work of Social Workers in the context of growing demand for the supply of material provisions. Economic and social conditions in Brazil have particularities that impact the operationalisation of this benefit, which is aimed at the poor, that add complexity and impose limits. When considering the structural limits set, this context imposes challenges on the work of Social Workers. The need to reconnect and enhance the struggle for social rights is emphasised through the different strategies of the working class.

Gastos com internações compulsórias por consumo de drogas no estado do Espírito Santo / Expenditures on compulsory hospitalizations due to drug use in the state of Espírito Santo

RESUMO A internação compulsória pelo consumo de drogas vem sendo problematizada no campo da política de saúde mental e expressa a luta entre os princípios do Sistema Único de Saúde (SUS)/princípios da Reforma Psiquiátrica versus os interesses privados de remanicomialização. O artigo objetiva analisar os gastos com internações compulsórias por consumo de drogas realizadas pela Secretaria de Estado da Saúde do Espírito Santo (ES), entre 2014-2019, buscando identificar a sua destinação. Apresenta breves reflexões sobre o direito à saúde e a disputa pelo fundo público. Trata-se de pesquisa documental com levantamento de dados no Portal de Transparência do ES. Foram utilizadas a análise estatística descritiva e a análise de conteúdo categorial. Os dados evidenciam as disputas pelo Fundo público e que isso não é um processo evidente para a sociedade. Os embates entre Executivo e Judiciário em torno do direito de acesso ao tratamento da saúde são pontos que precisam ser problematizados.

ABSTRACT Compulsory hospitalization due to drug use has been questioned in the Mental Health Policy and expresses the struggle between the principles of Unified Health System (SUS)/Psychiatric Reform versus the private interests about remanicomialization. This paper analyses expenditures on compulsory hospitalizations due to drug use carried out by the State Health Secretariat of Espírito Santo (ES) between 2014 and 2019 and aims to identify its allocation. It outlines brief reflections on the right to health and the disputes over public funds. This is documentary research with data gathered from the ES Transparency Portal. Descriptive statistical analysis and categoric content analysis were used. The data show disputes over public funds and that this is not a transparent process to society. The struggles between the Executive and the Judiciary over the right of access to health treatment are points that must be discussed.

Anthropometry, bioimpedance and densitometry: Comparative methods for lean mass body analysis in elderly outpatients from a tertiary hospital.

OBJECTIVES: To evaluate lean mass index (LMI) measured by bioimpedance (BIA) and anthropometry compared to densitometry (DXA) in elderly outpatients from a tertiary care hospital. METHODS: Participants were over 60-year-old men, presenting no dementia or disability, from a tertiary geriatric ambulatory. LMI obtained by BIA, anthropometry and DXA were submitted to Baumgartner, Janssen and Delmonico calculations respectively. Sarcopenia was calculated as LMI by DXA and handgrip strength. Data were analyzed by T student's test, ANOVA for repeated measures and pos hoc Bonferroni test, Pearson's correlation test, regression equation and Bland Altman analysis, ROC curve and contingency table 2 × 2 for sensitivity, specificity and predictive values. RESULTS: A total of 92 participants completed the study. Most of them were married, aged 72.9 ± 6.6, lived a sedentary lifestyle, presented multiple morbidities, and in use of polypharmacy. Appendicular lean mass was lower in sarcopenic participants when compared to that in nonsarcopenic ones (20.2 kg/m2 and 23 kg/m2 respectively, p < 0.0001). BIA sensitivity, specificity and correlation to DXA were 37%, 98% and r = 0.81 (p < 0.001), and for anthropometry 67%, 92% and r = 0.77 (p < 0.0001) respectively. Bland Altman's analysis showed congruence between methods and DXA (anthropometry: bias = -0,05 ± 0,66, limits of agreement (LoA) = -1.37 and 1.26; BIA: bias = 2,2; LoA = 0,7 and 3,7). CONCLUSION: Aging and multiple chronic and degenerative morbidities affect LM in vulnerable elderly patients. Both anthropometry and BIA, are accurate to measure LMI independently in this population but Anthropometry presented better agreement to DXA than Bioimpedance and has the advantage of lower price, easier application and cheaper equipment to be applied.

Exposure to fine particles increases blood pressure of hypertensive outdoor workers: A panel study.

BACKGROUND: Hypertension and air pollution are two important risk factors for cardiovascular morbidity and mortality. Although several studies suggest that air pollution has a significant impact on blood pressure, studies on long-term effects are sparse and still controversial. OBJECTIVE: To evaluate the effects of exposure of outdoor workers to different levels of traffic-generated PM2.5 on blood pressure. DESIGN: This is an observational panel study. PARTICIPANTS: 88 non-smoking workers exposed to different concentrations of air pollution were evaluated weekly along four successive weeks. MEASUREMENTS: In each week, personal monitoring of 24-h PM2.5 concentration and 24-h ambulatory blood pressure were measured. The association between blood pressure variables and PM2.5, adjusted for age, body mass index, time in job, daily work hours, diabetes, hypertension and cholesterol was assessed by means of multiple linear regression models fitted by least squares. RESULTS: Exposure to PM2.5 (ranging from 8.5 to 89.7 µg/m3) is significantly and consistently associated with an increase in average blood pressure. An elevation of 10 µg/m3 in the concentration of PM2.5 is associated with increments of 3.9 mm Hg (CI 95% = [1.5; 6.3]) in average systolic 24-h blood pressure for hypertensive and/or diabetic workers. CONCLUSION: Exposure to fine particles, predominantly from vehicular traffic, is associated with elevated blood pressure in hypertensive and/or diabetic workers.

Kidney injury and other complications related to colonoscopy in inpatients at a tertiary teaching hospital.

OBJECTIVES: To describe clinical complications related to colonoscopy in inpatients with multiple diseases. Among the known complications, acute kidney injury was the primary focus. METHODS: This was an observational retrospective study of 97 inpatients. Data relating to age; gender; comorbidities; current medication; blood tests (renal function, blood glucose and LDL cholesterol levels); length of hospital stay; indication, results, and complications of colonoscopies; and time to the development of kidney injury were collected between June 2011 to February 2012. RESULTS: A total of 108 colonoscopies (9 screening and 88 diagnostic) were conducted in 97 patients. Renal injury occurred in 41.2% of the patients. The univariate analysis revealed that kidney injury was related to the use of diuretics, statins, calcium channel blockers, and angiotensin converting enzyme inhibitor; however, the multivariate analysis showed that only the use of diuretics was associated with kidney injury. The occurrence of kidney injury and the time to its development were independent of the previous glomerular filtration rate as calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. CONCLUSIONS: The use of diuretics was the only independent variable associated with the development of kidney injury in inpatients with multiple comorbidities who underwent colonoscopy. The occurrence of kidney injury and the time to its development were independent of previous CKD-EPI-based assessments of renal function. These results highlight the increased risk of colonoscopy in such patients, and its indication should be balanced strictly and perhaps avoided as a screening test.

Workers of São Paulo city, Brazil, exposed to air pollution: Assessment of genotoxicity.

Air pollution affects all major urban centers, particularly megacities with populations greater than 10 million people. Vehicular and industrial emissions are among the most important sources of air pollutants in these cities. Air pollution composition, dose, and time of exposure can cause differential effects on human health. We have evaluated the genotoxic effects of air pollution (PM2.5 and NO2) on São Paulo city workers. Fifty-seven male individuals, 28-66 years old, with occupational exposure to air pollution, participated in this study; all worked daily outdoor shifts in São Paulo. Participants were recruited from three occupations: traffic controllers (n = 18); taxi drivers (n = 21); and workers at the Forestry Institute (n = 18). These workers were classified into two groups based on their workplace locations: Downtown Group (DT): traffic controllers and taxi drivers; Outskirts of Town Group (OT): workers at the Forestry Institute. Individual samplers of air pollution (Harvard air impactor) were used to collect PM2.5 and NO2 pollutants. Genotoxicity analysis (micronucleus test) was performed on buccal mucosa epithelial cells and peripheral blood lymphocytes. PM2.5 concentrations were significantly different between the groups (DT = 32.92 µg m-3, OT = 25.77 µg m-3; p = 0.03); however, no difference was observed in NO2 concentrations. Micronucleus frequencies in both buccal mucosa (DT = 2.78%, OT = 1.16%; p < 0.0001) and in peripheral lymphocytes (DT = 1.51%, OT = 0.73%; p < 0.0001) were significantly different between the groups. We observed a direct correlation between the individual dose of PM2.5 and micronucleus frequency in the buccal mucosa (p = 0.0021). Our results indicate that workers in the most urban areas of São Paulo are exposed to higher concentrations of PM2.5 and showed higher micronucleus frequencies in both buccal mucosa and lymphocytes.

Kidney injury and other complications related to colonoscopy in inpatients at a tertiary teaching hospital

OBJECTIVES: To describe clinical complications related to colonoscopy in inpatients with multiple diseases. Among the known complications, acute kidney injury was the primary focus. METHODS: This was an observational retrospective study of 97 inpatients. Data relating to age; gender; comorbidities; current medication; blood tests (renal function, blood glucose and LDL cholesterol levels); length of hospital stay; indication, results, and complications of colonoscopies; and time to the development of kidney injury were collected between June 2011 to February 2012. RESULTS: A total of 108 colonoscopies (9 screening and 88 diagnostic) were conducted in 97 patients. Renal injury occurred in 41.2% of the patients. The univariate analysis revealed that kidney injury was related to the use of diuretics, statins, calcium channel blockers, and angiotensin converting enzyme inhibitor; however, the multivariate analysis showed that only the use of diuretics was associated with kidney injury. The occurrence of kidney injury and the time to its development were independent of the previous glomerular filtration rate as calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. CONCLUSIONS: The use of diuretics was the only independent variable associated with the development of kidney injury in inpatients with multiple comorbidities who underwent colonoscopy. The occurrence of kidney injury and the time to its development were independent of previous CKD-EPI-based assessments of renal function. These results highlight the increased risk of colonoscopy in such patients, and its indication should be balanced strictly and perhaps avoided as a screening test.

Graduação e pós-graduação em serviço social no Brasil / Undergraduate and graduate studies programs in social work in Brazil

Este artigo analisa a expansão da graduação e da pós-graduação em Serviço Social no Brasil, caracterizando as convergências e divergências entre os dois níveis de formação nos últimos 15 anos. Trata-se de pesquisa documental com base em dados disponíveis nos sites do Ministério da Educação e da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. A graduação em Serviço Social é ofertada, atualmente, por 575 Instituições, distribuídas pelas cinco regiões brasileiras, com concentração no Sudeste e no Sul. Essas Instituições são, em sua maioria, privadas e disponibilizam tanto a modalidade presencial quanto a modalidade a distância. A pós-graduação segue um fluxo de expansão diferente. É vinculada sobretudo às instituições públicas, com oferta de ensino presencial e maior quantitativo de doutores entre seus docentes.

This article examines the expansion of undergraduate and graduate programs in Brazil, characterizing the convergences and divergences between the two educational levels in the last 15 years. This is a document study based on data available on the websites of the Ministry of Education and the Coordination for the Improvement of Higher Education Personnel (CAPES). Undergraduate studies in social work are currently offered by 575 institutions, distributed among Brazil's five geographical regions, particularly in the Southeast and South. These institutions are for the most part private and provide both classroom-based and distance learning formats. Graduate studies programs continue to expand at a different pace. They are primarily linked to public institutions, with classroombased teaching and a higher number of PhD holders among their professors.

GTSP1 expression in non-smoker and non-drinker patients with squamous cell carcinoma of the head and neck.

INTRODUCTION: The main risk factors for head and neck squamous cell carcinoma (HNSCC) are tobacco and alcohol consumption and human papillomavirus (HPV) infection. However, in a subset of patients, no risk factors can be identified. Glutathione S-transferase π (GTSP1) is a carcinogen-detoxifying enzyme that is activated by exposure to carcinogens, and it is associated with a reduction in response to toxic therapies. We studied the expression of GTSP1 in tumor and non-tumor tissue samples from patients with and without these risks to identify whether GTSP1 expression differs according to exposure to carcinogens. MATERIALS AND METHODS: Non-smoker/non-drinker (NSND) and smoker/drinker (SD) patients were matched according to age, gender, tumor site, TNM stage, grade and histological variants to establish 47 pairs of patients who have been previously tested for HPV. GTSP1 immunostaining was analyzed using a semi-quantitative method with scores ranging from 0 to 3 according to the area of immunostaining. RESULTS: GTSP1 expression was detected in the tumors of both groups. GTSP1 expression was higher in the non-tumor margins of SD patients (p = 0.004). There was no association between GTSP1 expression and positivity for HPV. No differences in survival were observed according to GTSP1 staining in tumors and non-tumor margins. CONCLUSION: This study showed that GTSP1 was expressed in tumors of HNSCC patients regardless of smoking, drinking or HPV infection status. The difference in GTSP1 expression in non-tumor margins between the two groups may have been due to two possible reasons. First, elevated GTSP1 expression in SD patients might be the result of activation of GTSP1 in response to exposure to carcinogens. Second, alternatively, impairment in the detoxifying system of GTSP1, as observed by the reduced expression of GTSP1, might make patients susceptible to carcinogens other than tobacco and alcohol, which may be the underlying mechanism of carcinogenesis in the absence of risk factors.

Perfil das assistentes sociais dos Institutos Federais de Educação, Ciência e Tecnologia do Brasil / Profile of the social workers working in the Federal Institutes of Education, Science and Technology

Resumo: Este artigo analisa o perfil das assistentes sociais dos Institutos Federais de Educação. Pesquisa quantitativa com todas assistentes sociais dos Institutos, com análise estatística descritiva. Os resultados apontam uma profissional qualificada (3% são doutoras), cuja inserção intensificou-se a partir de 2009. A principal demanda da instituição aos assistentes sociais é a execução do Programa de Assistência Estudantil. A demanda por profissionais de Serviço Social nos Institutos aumentará nos próximos anos, requerendo problematizações à luz da política de educação.

Abstract: This article analyzes the profile of the social workers working in the Federal Institutes of Education. It is a quantitative research comprising all the social workers of the Institutes, together with the descriptive statistical analysis. The results show that they are qualified professionals (3% of them have a PhD degree), and their insertion was intensified from 2009. The main demand of the institution to the social workers is to carry out the Student Assistance Program. The demand for social workers in the Institutes will increase in the next years, requiring some questioning in the light of education policy.

An analysis of the federal funding for mental health care in Brazil.

This article analyzes spending on mental health by the Brazilian Ministry of Health between 2001 and 2014. It is documental research of the Brazilian Ministry of Health's databases. It analyzes the data using descriptive statistical analysis. Total spending on mental health for the period 2001 to 2014 shows a percentage increase in resources destined for outpatient care, but this increase is a reallocation from hospital services to community-based services and total resources for the mental health program remain at an average of 2.54% of the total health budget. Within outpatient expenditure, spending on medications remains high. Professionals committed to psychiatric reform fight to guarantee that a small fraction of the surplus appropriated by the state is directed towards social policies.

Association between Traffic Air Pollution and Reduced Forced Vital Capacity: A Study Using Personal Monitors for Outdoor Workers.

BACKGROUND: The effects of outdoor air pollution on lung function in adults are still controversial. OBJECTIVE: Evaluate the effects of exposure to different levels of traffic-generated PM2.5 on workers' lung functions in São Paulo, Brazil. METHODS: To cover a wide range of exposures, 101 non-smoking workers from three occupations (taxi drivers, traffic controllers, and forest rangers) were selected for the study. After clinical evaluation, the participants were scheduled to attend four consecutive weekly visits in which they received a 24-hour personal PM2.5 sampler and had lung function tests measured on the following day. The association between the spirometric variables and the averaged PM2.5 levels was assessed using robust regression models adjusted for age, waist circumference, time at the job, daily work hours, diabetes or hypertension and former smoking habits. RESULTS: Relative to workers in the lowest exposed group (all measures < 25 µg/m3), those with the highest level of exposure (all measures > 39.6 µg/m3) showed a reduction of predicted FVC (-12.2%; CI 95%: [-20.0% to -4.4%]), a marginal reduction of predicted FEV1 (-9.1%; CI 95%: [-19.1% to 0.9%]) and an increase of predicted FEF25-75%/FVC (14.9%; CI 95%: [2.9% to 26.8%]) without changes of FEV1/FVC. CONCLUSIONS: Exposure to vehicular traffic air pollution is associated with a small but significant reduction of FVC without a reduction of FEV1/FVC.

Chemical composition modulates the adverse effects of particles on the mucociliary epithelium.

OBJECTIVE: We compared the adverse effects of two types of real ambient particles; i.e., total suspended particles from an electrostatic precipitator of a steel mill and fine air particles from an urban ambient particulate matter of 2.5 µm, on mucociliary clearance. METHOD: Mucociliary function was quantified by mucociliary transport, ciliary beating frequency and the amount of acid and neutral mucous in epithelial cells through morphometry of frog palate preparations. The palates were immersed in one of the following solutions: total suspended particles (0.1 mg/mL), particulate matter 2.5 µm 0.1 mg/mL (PM0.1) or 3.0 mg/mL (PM3.0) and amphibian Ringer's solution (control). Particle chemical compositions were determined by X-ray fluorescence and gas chromatography/mass spectrometry. RESULTS: Exposure to total suspended particles and PM3.0 decreased mucociliary transport. Ciliary beating frequency was diminished by total suspended particles at all times during exposure, while particulate matter of 2.5 µm did not elicit changes. Particulate matter of 2.5 µm reduced epithelial mucous and epithelium thickness, while total suspended particles behaved similarly to the control group. Total suspended particles exhibited a predominance of Fe and no organic compounds, while the particulate matter 2.5 µm contained predominant amounts of S, Fe, Si and, to a lesser extent, Cu, Ni, V, Zn and organic compounds. CONCLUSION: Our results showed that different compositions of particles induced different airway epithelial responses, emphasizing that knowledge of their individual characteristics may help to establish policies aimed at controlling air pollution.