Quantum biochemical analysis of the binding interactions between a potential inhibitory drug and the Ebola viral glycoprotein.

Ebola virus disease (EVD) causes outbreaks and epidemics in West Africa that persist until today. The envelope glycoprotein of Ebola virus (GP) consists of two subunits, GP1 and GP2, and plays a key role in anchoring or fusing the virus to the host cell in its active form on the virion surface. Toremifene (TOR) is a ligand that mainly acts as an estrogen receptor antagonist; however, a recent study showed a strong and efficient interaction with GP. In this context, we aimed to evaluate the energetic affinity features involved in the interaction between GP and toremifene by computer simulation techniques using the Molecular Fractionation Method with Conjugate Caps (MFCC) scheme and quantum-mechanical (QM) calculations, as well as missense mutations to assess protein stability. We identified ASP522, GLU100, TYR517, THR519, LEU186, LEU515 as the most attractive residues in the EBOV glycoprotein structure that form the binding pocket. We divided toremifene into three regions and evaluated that region i was more important than region iii and region ii for the formation of the TOR-GP1/GP2 complex, which might control the molecular remodeling process of TOR. The mutations that caused more destabilization were ARG134, LEU515, TYR517 and ARG559, while those that caused stabilization were GLU523 and ASP522. TYR517 is a critical residue for the binding of TOR, and is highly conserved among EBOV species. Our results may help to elucidate the mechanism of drug action on the GP protein of the Ebola virus and subsequently develop new pharmacological approaches against EVD.Communicated by Ramaswamy H. Sarma.

Quantum biochemistry description of PI3Kα enzyme bound to selective inhibitors.

The PI3K class I is composed of four PI3K isoforms that serve as regulatory enzymes governing cellular metabolism, proliferation, and survival. The hyperactivation of PI3Kα is observed in various types of cancer and is linked to poor prognosis. Unfortunately, the development inhibitors selectively targeting one of the isoforms remains challenging, with only few agents in clinical use. The main difficulty arises from the high conservation among residues at the ATP-binding pocket across isoforms, which also serves as target pocket for inhibitors. In this work, molecular dynamics and quantum calculations were performed to investigate the molecular features guiding the binding of selective inhibitors, alpelisib and GDC-0326, into the ATP-binding pocket of PI3Kα. While molecular dynamics allowed crystallographic coordinates to relax, the interaction eergy between each amino acid residues and inhibitors was obtained by combining the Molecular Fractionation with Conjugated Caps scheme with Density Functional Theory calculations. In addition, the atomic charge of ligands in the bound and unbound (free) was calculated. Results indicated that the most relevant residues for the binding of alpelisib are Ile932, Glu859, Val851, Val850, Tyr836, Met922, Ile800, and Ile848, while the most important residues for the binding of GDC-0326 are Ile848, Ile800, Ile932, Gln859, Glu849, and Met922. In addition, residues Trp780, Ile800, Tyr836, Ile848, Gln859 Val850, Val851, Ile932 and Met922 are common hotspots for both inhibitors. Overall, the results from this work contribute to improving the understanding of the molecular mechanisms controlling selectivity and highlight important interactions to be considered during the rational design of new agents.Communicated by Ramaswamy H. Sarma.

Estigma e injustiça epistêmica: experiência de adoecimento e tratamento no CAPS AD III sob a ótica do usuário / Stigma and epistemic injustice: experience of illness and treatment at CAPS AD III from the user's perspective

Resumo Este artigo parte de uma pesquisa qualitativa que busca dar voz aos usuários, tornando-os atores através de uma pesquisa participativa. Trouxe à tona discursos estigmatizados e experiências afetadas pela perda de credibilidade testemunhal, conceito introduzido por Miranda Fricker como injustiça epistêmica. Todos os dados foram gerados através de um modelo de entrevista (MINI) no primeiro momento da pesquisa. No segundo momento, foi feita uma pesquisa participativa sob a lógica do cuidado que requer uma prática baseada na sensibilidade em relação às experiências do mundo dos usuários participantes. Diante desta perspectiva, ter voz emergiu como ponto essencial, e é nessa lógica que a pesquisa realizada no CAPS AD III, para que os usuários fizessem parte de uma abordagem participativa, teve a intenção de produzir mudanças.

Abstract This article is part of a qualitative research that seeks to give users a voice, making them actors through participatory research. It brought up stigmatized discourses and experiences affected by the loss of credibility, a concept introduced by Miranda Fricker as epistemic injustice. All data were generated through an interview model (MINI) in the first stage of the research, in the second moment, a participatory research was carried out under the logic of care that requires a practice based on sensitivity in relation to the experiences of the participating users in the world. Given this perspective, having a voice emerged as an essential point, and it is in this logic that the research carried out at CAPS AD III, so that users were part of a participatory approach, had the intention of producing changes.

Gênero e cuidado na Atenção Psicossocial: o cotidiano de mulheres cuidadoras em um CAPS no Rio de Janeiro / Gender and Care in Psychosocial Attention: the everyday lives of women caregivers in a CAPS in Rio de Janeiro

Este trabalho buscou analisar as relações de cuidado no mandato da Atenção Psicossocial, considerando a centralidade de figuras femininas como principais cuidadoras de usuários da RAPS. Entendendo que a gestão desse cuidado é compartilhada com o Estado, partimos da hipótese de que a reformulação da política de saúde mental se ancora e reforça a histórica feminilização do cuidado, fortemente racializada e atravessada por desigualdades de classe e territórios. O objetivo geral desta pesquisa foi investigar o processo de familiarização e feminização do cuidado com RPB a partir de um trabalho etnográfico em um CAPS, observando o cotidiano de mulheres cuidadoras nesse serviço. Entre os objetivos específicos, buscou-se investigar a relação entre elas na gestão do cuidado em saúde mental, apontando para as discussões entre gênero, cuidado e trabalho, observando aproximações e distanciamentos entre categorias nativas e analíticas. Além disso, buscou-se refletir sobre a relação entre a política de saúde mental e a gestão estatal do cuidado enquanto mecanismos de regulação de gênero. As análises foram realizadas a partir da observação participante em um CAPS III do município do Rio de Janeiro. A pesquisa de campo privilegiou os espaços coletivos do CAPS, em especial a convivência e as atividades coletivas que contavam com a participação dos cuidadores, como a assembleia do CAPS, o grupo de família e o grupo de suporte de pares. Os achados da pesquisa apontam para a forma como essas mulheres, em seus distintos lugares sociais, respondem a esse mandato, criando relações de aliança e suporte mútuo, incluindo a ampliação de suas redes de apoio e cuidado no território, mas também compostas por tensões e disputas discursivas, sustentando a aposta política do cuidado dos sujeitos em sofrimento psíquico na comunidade. (AU)

This study aimed to analyse the care relationships within the framework of Psychosocial Attention, considering the central role of female figures as primary caregivers for users of the Psychosocial Care Network (RAPS). Understanding that the management of this care is shared with the State, we hypothesized that the reformulation of mental health policy is grounded in and reinforces the historical feminization of caregiving, strongly influenced by racialization and intersected by class and territorial inequalities. The overall objective of this research was to investigate the process of familiarization and feminization of care within the RAPS through an ethnographic study in a CAPS, observing the daily lives of women caregivers in this service. Among the specific objectives, we sought to investigate their role in mental health care management, pointing out the discussions regarding gender, care, and labor, while observing convergences and divergences between native and analytical categories. Furthermore, we aimed to reflect on the relationship between mental health policy and state management of care as mechanisms for gender regulation. The analyses were conducted through participant observation in a CAPS III in the municipality of Rio de Janeiro. The field research focused on the collective spaces of the CAPS, particularly interactions and collective activities involving caregivers, such as the CAPS assembly, family group, and peer support group. The research findings highlight how these women, from diverse social backgrounds, respond to this caregiving mandate, forming alliances and mutual support relationships, including the expansion of their support and care networks within the community. These relationships, however, also involve tensions and discursive disputes, underpinning the political commitment to providing care for individuals experiencing psychological distress within the community. (AU)

A precarização do trabalho e a saúde dos profissionais de um Centro de Atenção Psicossocial / The precarization of the work and health of professionals in a Psychosocial Care Center

Este estudo traz dados de uma pesquisa de doutorado que objetivou conhecer a relação entre a precarização do trabalho e a saúde dos profissionais de um Centro de Atenção Psicossocial (CAPS). Trata-se de uma pesquisa de cunho qualitativo no campo da Saúde do Trabalhador. Foram realizadas entrevistas individuais semiestruturadas e observações sistemáticas com os trabalhadores. A partir dos depoimentos e das observações, foram percebidos problemas de ordem de gestão e de recursos materiais e humanos necessários para o bom funcionamento do serviço que geraram preocupação e sofrimento aos profissionais. Um outro componente que também colaborou para a precarização do trabalho desses profissionais foi o trabalho terceirizado. Além disso, os profissionais expressaram suas experiências e seu cotidiano de trabalho por meio de sofrimento, angústia e dificuldades para realização do trabalho. O sofrimento do trabalhador da saúde mental também tem suas particularidades, inerentes ao próprio tipo de trabalho, visto que tais profissionais estão expostos ao sofrimento e à dor de outras pessoas

This study brings data from a doctoral research which aimed to understand the relationship between the precarization of the work and the health of professionals from Psychosocial Care Center (CAPS). The study is qualitative research in the field of Occupational Health. Semi-structured individual interviews were carried out as well as systematic observation of the workers. Based on the interviewees' testimonies and analyzes, some management problems as well as lack of material and human resources necessary for the correct functioning of the service were noticed, which caused concern and suffering on the workers. Another component that also contributed to the precarious work of these professionals was outsourced work. Besides, workers expressed their experiences and their daily work through suffering, anguish, and difficulties in performing their work correctly. The suffering of mental health professionals also has its particularities, inherent to the type of work itself, since they are constantly exposed to other people's suffering and pain

In-vitro NLRP3 functional test assists the diagnosis of cryopyrin-associated periodic syndrome (CAPS) patients: A Brazilian cooperation.

OBJECTIVE: To report our five-years experience on the use of NLRP3 inflammasome functional assays in the differential diagnosis of Brazilian patients with a clinical suspicion of CAPS. PATIENTS AND METHODS: The study included 9 patients belonging to 2 families (I, II) and 7 unrelated patients with a clinical suspicion of AID according to Eurofever/PRINTO classification, recruited between 2017 and 2022. The control group for the NLRP3 functional assay consisted of 10 healthy donors and for the CBA cytokines measurement of 19 healthy controls. Patients underwent clinical evaluation, genetic and functional analysis. RESULTS: All members of the family I received the diagnosis of Muckle-Wells Syndrome (MWS), carried the NLRP3 Thr348Met variant and resulted positive for the functional assay. The 2 patients of the family II resulted negative for the mutational screening but positive for the functional assay compatible with a MWS clinical phenotype. In 2 unrelated patients with NLRP3 mutations, including a novel mutation (Gly309Val, Asp303His), a positive functional test confirmed the clinical diagnosis of NOMID. 3 unrelated MWS and 1 FCAS patients resulted negative to the genetic screening and positive for the functional test. One patient with a FCAS-like phenotype harbored the NLRP12 His304Tyr variant confirming the diagnosis of FCAS2. CONCLUSION: The NLRP3 inflammasome functional assay can assist the clinical diagnosis of CAPS even in patients with unknown genetic defects.

The impact of a healthy checkout intervention on fruit and vegetable 'micro-pack' purchases in New Mexico.

OBJECTIVE: Produce sold as plastic-wrapped packs of two to four individual items (i.e., produce micro-packs) that are low cost and placed at checkout may appeal to shoppers with budget constraints and provide a second chance to purchase items available elsewhere in the store. This study examined the impact of an intervention that placed produce micro-packs at checkout and promoted them in grocery stores across New Mexico, USA. DESIGN: This quasi-experimental study placed produce micro-packs at checkout end-caps in thirteen stores (group 1), with eight stores serving as controls (group 2) from 1 July 2019 through 31 January 2020 (first phase). The intervention was extended to group 2 stores from 1 February 2020 through 30 June 2020 (second phase). Cashiers were directed to upsell the micro-packs to Special Supplemental Nutrition Program for Women, Infants, and Children recipients who had unspent cash value benefits for produce purchases. SETTING: Twenty-one grocery stores across New Mexico. PARTICIPANTS: Twenty-one produce items sold as micro-packs in stores from July 2019 through June 2020. RESULTS: A random effects model showed that the daily sales of micro-packs increased by 47 % during each intervention period. Group 2 stores had lower sales than group 1 stores during the first phase of the intervention. Once extended to group 2 stores, sales of micro-packs in those stores increased and sales in group 1 stores continued at the higher level. CONCLUSIONS: Placing produce micro-packs at checkout may increase produce sales and support health promotion efforts by public and private stakeholders.

Pesquisa participativa sob a lógica do cuidado: análise compartilhada em um CAPS AD / Participatory research under the logic of care: Shared analysis in a CAPS AD / La recherche participative sous la logique du soin: analyse partagée dans un CAPS AD / Investigación participativa bajo la lógica del cuidado: análisis compartido en un CAPS AD

A pesquisa procurou explorar as experiências de adoecimento com base no ponto de vista dos usuários de um CAPS AD III. A metodologia empregada neste estudo se baseia em um desenho qualitativo e se divide em duas etapas. Na primeira, foi realizada uma entrevista semiestruturada com os participantes — Entrevista Narrativa de Adoecimento McGill-MINI —, e, na segunda, os participantes foram parte integrante do processo de validação, análise dos resultados e elaboração do arcabouço temário. Os resultados anunciam narrativas atravessadas por desamparo psíquico, abandono familiar, perdas e falta de credibilidade, efeito de um processo excludente em que a droga se sobrepõe ao sujeito. A pesquisa participativa sob a lógica do cuidado (Tangvald-Pedersen & Bongaardt, 2016) possibilitou um diálogo reflexivo acerca da experiência de adoecimento aproximando pesquisadores e participantes, que são como diferentes contadores de histórias, permitindo que a tessitura do fenômeno descrito pudesse enriquecer a compreensão uns dos outros.

Resumos This research explores the experiences of illness from the point of view of users of a CAPS AD III. Based on a qualitative design, the study comprised two stages: in the first, a Narrative Interview of Illness McGill-MINI, a semi-structured interview protocol, was carried out with the participants; in the second, the participants took part in the validation process, analysis of results and elaboration of the thematic framework. The results reveal narratives crossed by psychic helplessness, family abandonment, losses, and lack of credibility — the effect of an excluding process in which the drug overrides the subject. Participatory research under the logic of care (Tangvald-Pedersen & Bongaardt, 2016) enabled a reflective dialogue on the experience of illness, bringing together researchers and participants as different storytellers, allowing the weaving of the phenomenon to enrich their mutual understanding.

Cette recherche explore les expériences de la maladie du point de vue des utilisateurs d'un CAPS AD III. Basée sur un design qualitatif, l'étude s'est déroulée en deux étapes : dans la première, un entretien narratif semi-structurée (Narrative Interview of Illness McGill-MINI) a été réalisée avec les participants; dans la seconde, les participants ont pris part au processus de validation, d'analyse des résultats et d'élaboration du cadre thématique. Les résultats révèlent des récits traversés par l'impuissance psychique, l'abandon familial, les pertes et le manque de crédibilité — l'effet d'un processus d'exclusion dans lequel la drogue chevauche le sujet. La recherche participative sous la logique du soin (Tangvald-Pedersen & Bongaardt, 2016) a permis un dialogue réflexif sur l'expérience de la maladie, réunissant chercheurs et participants comme des différents conteurs, permettant au tissage du phénomène d'enrichir leur compréhension mutuelle.

La investigación buscó explorar las experiencias de enfermedad a partir del punto de vista de los usuarios de CAPS AD III. La metodología utilizada en este estudio se basa en un diseño cualitativo y se divide en dos etapas. En la primera, se realizó una entrevista semiestructurada con los participantes — Entrevista Narrativa de Enfermedad McGill-MINI — y, en la segunda, los participantes fueron parte integral del proceso de validación, análisis de resultados y elaboración del marco temático. Los resultados anuncian narrativas atravesadas por el desamparo psíquico, el abandono familiar, las pérdidas y la falta de credibilidad, efecto de un proceso excluyente en el que la droga se superpone al sujeto. La investigación participativa bajo la lógica del cuidado (Tangvald-Pedersen & Bongaardt, 2016) permitió un diálogo reflexivo sobre la experiencia de la enfermedad, reuniendo a investigadores y participantes, que son como diferentes narradores, permitiendo que la tesitura del fenómeno descrito pudiera enriquecer la comprensión de cada uno.

Quantum Biochemistry Screening and In Vitro Evaluation of Leishmania Metalloproteinase Inhibitors.

Leishmanolysin, also known as major promastigote protease (PSP) or gp63, is the most abundant surface glycoprotein of Leishmania spp., and has been extensively studied and recognized as the main parasite virulence factor. Characterized as a metalloprotease, gp63 can be powerfully inactivated in the presence of a metal chelator. In this study, we first used the structural parameters of a 7-hydroxycoumarin derivative, L1 compound, to evaluate the theoretical-computational experiments against gp63, comparing it with an available metal chelator already described. The methodology followed was (i) analysis of the three-dimensional structure of gp63 as well as its active site, and searching the literature and molecular databases for possible inhibitors; (ii) molecular docking simulations and investigation of the interactions in the generated protein-ligand complexes; and (iii) the individual energy of the gp63 amino acids that interacted most with the ligands of interest was quantified by ab initio calculations using Molecular Fraction with Conjugated Caps (MFCC). MFCC still allowed the final quantum balance calculations of the protein interaction to be obtained with each inhibitor candidate binder. L1 obtained the best energy quantum balance result with -2 eV, followed by DETC (-1.4 eV), doxycycline (-1.3 eV), and 4-terpineol (-0.6 eV), and showed evidence of covalent binding in the enzyme active site. In vitro experiments confirmed L1 as highly effective against L. amazonensis parasites. The compound also exhibited a low cytotoxicity profile against mammalian RAW and 3T3 cells lines, presenting a selective index of 149.19 and 380.64 µM, respectively. L1 induced promastigote forms' death by necrosis and the ultrastructural analysis revealed disruption in membrane integrity. Furthermore, leakage of the contents and destruction of the parasite were confirmed by Spectroscopy Dispersion analysis. These results together suggested L1 has a potential effect against L. amazonensis, the etiologic agent of diffuse leishmaniasis, and the only one that currently does not have a satisfactory treatment.

A Prática dos Psicólogos nos Centros de Atenção Psicossocial em diferentes estados brasileiros

O Centro de Atenção Psicossocial é um serviço de atendimento de saúde mental originalmente criado para ser substitutivo às internações em hospitais psiquiátricos no Brasil, cuja consonância de prática com a Reforma Psiquiátrica precisa ser constantemente avaliada. Em resposta a essa demanda, a presente pesquisa objetivou explorar e apresentar a realidade da prática profissional de psicólogos nesses centros, comparando sua consonância com a Reforma Psiquiátrica. Realizou-se uma pesquisa mista, em diferentes estados brasileiros, com amostra não probabilística de 104 psicólogos atuantes nos CAPS, que responderam um questionário com perguntas abertas e fechadas, respectivamente compreendidas por investigação qualitativa com análise de conteúdo e investigação quantitiva com estatística descritiva. Os resultados mostram que as teorias psicológicas mais utilizadas pelos participantes são Psicanálise e Terapia Cognitivo Comportamental, com menor representatividade de teorias contemporâneas. Prevalecem atendimentos individuais, grupais e visitas domiciliares ou institucionais. As atividades objetivam a reinserção social, o tratamento psicoterapêutico e a melhora das condições de vida e autonomia. Trabalham prioritariamente em equipe e com ações no território e intersetoriais. Sinalizam ainda desafios em sua prática, como a insuficiência de recursos humanos, desafios na capacitação dos profissionais, divergências de pensamento e de atuação dos membros da equipe, excesso de trabalho, além de condições de trabalho e salário insatisfatórias. Conclui-se que a maioria dos psicólogos possui uma prática convergente com os ideais do novo modelo de cuidado em saúde mental.

The Psychosocial Care Center is a mental health care service originally created to be a substitute for hospitalizations in psychiatric hospitals in Brazil, whose practice consonance with the Psychiatric Reform needs to be constantly evaluated. In response to this demand, the present research aimed to explore and present the reality of the professional practice of psychologists in these centers, comparing its consonance with the Psychiatric Reform. A mixed research was carried out in different Brazilian states, with a non-probabilistic sample of 104 psychologists, who answered a questionnaire with open and closed questions, respectively comprised of qualitative research with content analysis and quantitative research with descriptive statistics. The results show that most used psychological theories by the participants are Psychoanalysis and Cognitive Behavioral Therapy, with a smaller representation of contemporary theories. Individual and group attendance prevail, as well as home or institutional visits. The activities aim at social reintegration, psychotherapeutic treatment, and the improvement of living conditions and autonomy. They work primarily in teams and through intersectoral and in territory actions. They also indicate challenges in their practice, such as insufficient human resources, challenges in the training of professionals, divergences in the thinking and performance of team members, overwork, in addition to unsatisfactory working conditions and salary. It is possible to conclude that most psychologists have a convergent practice with the ideals of the new model of mental health care.

El Centro de Atención Psicosocial es un servicio de atención de salud mental creado originalmente para ser un sustituto de las hospitalizaciones en hospitales psiquiátricos de Brasil, cuya práctica en consonancia con la Reforma Psiquiátrica necesita ser evaluada constantemente. En respuesta a esta demanda, la presente investigación tuvo como objetivo explorar y presentar la realidad de la práctica profesional de los psicólogos en estos centros, comparando su consonancia con la Reforma Psiquiátrica. Se realizó una investigación cuantitativa y cualitativa en diferentes estados brasileños, con una muestra no probabilística de 104 psicólogos, que respondieron a un cuestionario con preguntas abiertas y cerradas, compuestas respectivamente por investigación cualitativa con análisis de contenido e investigación cuantitativa con estadística descriptiva. Los resultados muestran que las teorías psicológicas más utilizadas por los participantes son el psicoanálisis y la terapia cognitiva conductual, con menos representación de las teorías contemporáneas. Prevalecen las visitas individuales, grupales y domiciliarias o institucionales. Las actividades tienen como objetivo la reinserción social, el tratamiento psicoterapéutico y la mejora de las condiciones de vida y la autonomía. Trabajan principalmente en equipos, con acciones en el territorio y intersectoriales. También señalan desafíos en su práctica, tales como recursos humanos insuficientes, desafíos en la formación de profesionales, divergencias de pensamiento y desempeño de los miembros del equipo, exceso de trabajo, además de condiciones laborales y salariales insatisfactorias. Se concluye que la mayoría de los psicólogos tienen una práctica convergente con los ideales del nuevo modelo de atención de salud mental.

Incidências da psicanálise no contexto da saúde mental: o sujeito em questão / Incidences of psychoanalysis in the context of mental health: the subject in question

RESUMO: Este trabalho tem o objetivo de discutir as incidências do laço social como instância que comparece em ato no trabalho do psicanalista, no contexto da saúde mental, e assegura um lugar de sujeito para usuários de Centro de Apoio Psicossocial - CAPS. Para o percurso metodológico, foram adotados o método qualitativo, referencial teórico psicanalítico, breve apresentação e discussão de um caso clínico. O resultado aponta para a necessidade de construção do laço social como possibilidade para o emergir do sujeito a partir de uma invenção sustentada em um discurso que estabelecerá um meio de regulação de gozo.

Abstract: This work aims to discuss the incidence of the social bond as an instance that is present in the psychoanalyst's work, in the context of mental health, and ensures a place of subject for users of the Psychosocial Support Center. For the methodological path, the qualitative method, psychoanalytic theoretical framework, brief presentation and discussion of a clinical case was adopted. The result points to the need to build the social bond as a possibility for the subject to emerge, based on an invention sustained in a discourse that will establish a means of regulating enjoyment.

Desafio do ensino e das competências em saúde no modelo psicossocial nos centros de atenção psicossocial álcool e drogas / Challenge of teaching and health skills in the psychosocial model in psychosocial care centers for alcohol and drugs

O objetivo deste artigo é apresentar a análise documental sobre a formação e a educação continuada e permanente de profissionais de saúde que atuam em Centros de Atenção Psicossocial - Álcool e Drogas. Trata-se de uma pesquisa com estratégias metodológicas mistas: a) análise de documentos governamentais sobre o ensino superior e a aprendizagem em serviço; b) entrevistas semiestruturadas com os profissionais; análise de conteúdos e triangulação dos dados. Entre os resultados identificaram-se alguns avanços no ensino superior em saúde e na educação permanente como as políticas setoriais. Concluiu-se que ainda é baixo o incentivo à educação continuada e permanente nos serviços e na efetividade do cuidado, causados pelas fragilidades da formação e ao reduzido investimento econômico nos serviços, dificultando a inclusão de tecnologias inovadoras necessárias ao implemento da política de saúde mental.

The objective of this study is to reflect on the higher education in health of the psychosocial model and the competences of professionals in the Psychosocial Care Centers for Alcohol and Drugs. The method was qualitative, through the theoretical study of government documents on higher education and in-service learning and empirical with interviews with professionals. Analyzed the contents and triangulated the results. Results show advances in higher education in health and permanent education through sectoral policies. However, the incentive in the reality of services and consequences in the effectiveness of care is still low. Weaknesses in training and service scenario make it difficult to include innovative technologies corresponding to mental health policy.

Optimization of homoeopathy in the management of post-traumatic stress disorder, the aftermath of COVID-19 pandemic: a retrospective case series

Psychological fragility caused to human life has been the largest aftermath of the pandemic posing a raised public health concern globally. This psychological impact is identified as Post-Traumatic Stress Disorder (PTSD) which was the most commonly diagnosed psychological disorder during this pandemic. These cases, if left untreated and unidentified may take a devastating transformation into psychotic disorders and cause gross damage to the individual and the community by disrupting human relations. Keeping in view the beneficial role of Homoeopathy in dealing with psychological disorders based on its philosophy and previous studies, a clinical case series of 10 PTSD cases successfully treated with Homoeopathy during this pandemic are presented here. 10 cases of PTSD consulted during the first wave of pandemic diagnosed based on the clinical picture analogous to PTSD cluster symptomatology from Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) and objectively through Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) were treated with Homoeopathic intervention. Homeopathic medicine was prescribed based on the totality of each case through repertorization and in consultation with the sourcebooks of Homoeopathic Materia Medica (HMM). The cases were followed monthly for clinical improvement and every three months using the CAPS-5 score. The outcome was assessed after six months clinically and objectively through the CAPS-5 score. At the end of one year, further to assess the casual attribution of clinical outcome to homoeopathic intervention, validated MONARCH (Modified Naranjo Criteria for Homoeopathy) tool was utilized. The 10 diagnosed PTSD cases showed marked improvement assessed after one year of Homoeopathic treatment. Significant improvement was found in the clinical picture affirmed through CAPS-5 score and MONARCH tool. Homoeopathic medicines showed a significantly beneficial role in the management of PTSD during the pandemic in the presented 10 cases. Further validation through well-designed clinical trials is warranted.

SNPs in a Large Genomic Scaffold Are Strongly Associated with Cr1R, Major Gene for Resistance to White Pine Blister Rust in Range-Wide Samples of Sugar Pine (Pinus lambertiana).

Sugar pine, Pinus lambertiana Douglas, is a keystone species of montane forests from Baja California to southern Oregon. Like other North American white pines, populations of sugar pine have been greatly reduced by the disease white pine blister rust (WPBR) caused by a fungal pathogen, Cronartium ribicola, that was introduced into North America early in the twentieth century. Major gene resistance to WPBR segregating in natural populations has been documented in sugar pine. Indeed, the dominant resistance gene in this species, Cr1, was genetically mapped, although not precisely. Genomic single nucleotide polymorphisms (SNPs) placed in a large scaffold were reported to be associated with the allele for this major gene resistance (Cr1R). Forest restoration efforts often include sugar pine seed derived from the rare resistant individuals (typically Cr1R/Cr1r) identified through an expensive 2-year phenotypic testing program. To validate and geographically characterize the variation in this association and investigate its potential to expedite genetic improvement in forest restoration, we developed a simple PCR-based, diploid genotyping of DNA from needle tissue. By applying this to range-wide samples of susceptible and resistant (Cr1R) trees, we show that the SNPs exhibit a strong, though not complete, association with Cr1R. Paralleling earlier studies of the geographic distribution of Cr1R and the inferred demographic history of sugar pine, the resistance-associated SNPs are marginally more common in southern populations, as is the frequency of Cr1R. Although the strength of the association of the SNPs with Cr1R and thus, their predictive value, also varies with geography, the potential value of this new tool in quickly and efficiently identifying candidate WPBR-resistant seed trees is clear.

Hospitalization due to mental and behavioral disorders caused by use of alcohol and psychoactive substances among older adults and elderly people in Brazil: a cross-sectional study

ABSTRACT BACKGROUND: It has been estimated that 17% of individuals aged 50 years or older suffer from addiction to legal or illegal drugs. Use of alcohol and psychoactive substances has been correlated with several diseases, e.g. psychiatric conditions and cardiovascular and sexual dysfunctions. Objective: To discuss the Brazilian profile of mental and behavioral disorders caused by use of alcohol and psychoactive substances among older adults and elderly people, over the period from 2008 to 2019. DESIGN AND SETTING: Cross-sectional study conducted among Brazilians aged 50 years or older. METHODS: Hospitalization due to mental and behavioral disorders caused by use of alcohol and psychoactive substances was assessed through data obtained from the National Health System Department of Informatics (Departamento de Informática do Sistema Único de Saúde, DATASUS). RESULTS: Decreasing and steady trends of hospitalization due to mental and behavioral disorders caused by use of alcohol among both men and women at all ages were observed. Similar trends were reported for all age ranges among men and women aged 60 years and older. In contrast, a slight increase was seen among women aged 50 to 59 years. CONCLUSION: These data are crucial for qualifying mental healthcare for older adults and elderly people and for planning mental health services.

O território, as redes e suas (im)potências: o cuidado aos usuários de álcool e outras drogas em um CAPSad / The territory, the networks and their (im)potencies: care for users of alcohol and other drugs in a CAPSad

No presente trabalho, buscamos realizar uma análise das potencialidades e possibilidades do CAPS ad como oferta de cuidado às pessoas que fazem uso prejudicial de álcool e outras drogas e sua atuação junto à rede, a partir do relato de uma experiência em um CAPS ad de um município localizado no interior do estado de São Paulo. Trata-se de um recorte de uma pesquisa de mestrado, na qual utilizamos a Cartografia como opção metodológica. Como principal desafio encontrado, apresentamos os desencontros da rede, tanto em seus protocolos quanto no olhar para o uso de álcool e outras drogas. Evidenciamos, também, as potencialidades e inventividades que possibilitam a criação de redes/rizomas autônomas das redes dominantes, as quais operam intensificando os efeitos do modo capitalista de produção. Compreendemos, portanto, o CAPS ad como um arranjo institucional provisório, ou como uma estratégia, que, em suas ofertas, pode tornar-se/fazer-se rede de emancipação, assim como um rizoma, suscetível a modificações constantes. A potência da Atenção Psicossocial está, assim, na dimensão inventiva presente nas relações e nos encontros e no rompimento com os processos fragmentadores do cuidado, de modo a garantir a ampliação do acesso aos serviços para as pessoas que tanto sofrem com os efeitos de uma sociedade como a nossa.(AU)

In the present work, we seek to carry out an analysis of the potential and possibilities of CAPS ad as an offer of care to people who make harmful use of alcohol and other drugs and its performance with the network, from an experience report in a CAPS ad of a city located in the interior of the state of São Paulo. This is an excerpt from a master's research, in which we used Cartography as a methodological option. As the main challenge encountered, we present the network's mismatches, both in its protocols and in the look at the use of alcohol and other drugs. We also evidenced the potentialities and inventiveness that make possible the creation of networks/rhizomes autonomous of the dominant networks, which operate intensifying the effects of the capitalist mode of production. We understand, therefore, the CAPS ad as a provisional institutional arrangement, or as a strategy, which, in its offerings, can become a network of emancipation, as well as a rhizome, susceptible to constant changes. The power of Psychosocial Care is, therefore, in the inventive dimension present in relationships and encounters and in breaking with the fragmenting processes of care, in order to guarantee the expansion of access to services for people who suffer so much from the effects of a society like ours.(AU)

En el presente trabajo buscamos realizar un análisis de las potencialidades y posibilidades de los CAPS ad como oferta de atención a personas que hacen uso nocivo de alcohol y otras drogas y su desempeño con la red, a partir del relato de una experiencia. en un anuncio de CAPS de un municipio ubicado en el interior del estado de São Paulo. Este es un extracto de una investigación de maestría, en la cual utilizamos la Cartografía como opción metodológica. Como principal desafío encontrado, presentamos los desajustes de la red, tanto en sus protocolos como en la mirada al uso de alcohol y otras drogas. También evidenciamos las potencialidades y la inventiva que posibilitan la creación de redes/rizomas autónomos de las redes dominantes, que operan intensificando los efectos del Modo de Producción Capitalista. Entendemos, por lo tanto, el anuncio de CAPS como un arreglo institucional provisional, o como una estrategia, que, en sus ofertas, puede convertirse en una red de emancipación, así como en un rizoma, susceptible de cambios constantes. El poder de la Atención Psicosocial está, entonces, en la dimensión inventiva presente en las relaciones y encuentros y en la ruptura con los procesos de fragmentación del cuidado, para garantizar la ampliación del acceso a los servicios de las personas que tanto sufren los efectos de una sociedad. como la nuestra.(AU)

A persistência da institucionalização em tempos de reforma psiquiátrica: etnografia sobre casos acompanhados por CAPS da cidade do Rio de Janeiro / The persistence of institucionalization in times of psichiatric reform: an ethnography about cases accompained by CAPS in the city of Rio de Janeiro

De acordo com os líderes da reforma psiquiátrica italiana, a desinstitucionalização envolve não só a retirada dos pacientes dos hospitais psiquiátricos, como também a desconstrução da lógica manicomial e a construção de uma rede territorial substitutiva, que, no Brasil, tem o Centro de Atenção Psicossocial (CAPS) como base principal. A criação ou reformulação de estabelecimentos que reatualizam a tutela sobre a loucura demonstra que este processo vem encontrando desafios. Apesar de se tratarem em CAPS, alguns usuários têm sido institucionalizados em asilos, clínicas/hospitais privados, comunidades terapêuticas, "Residências" particulares e CAPS III. O objetivo da presente pesquisa foi analisar os fatores que vêm convergindo para este fenômeno tanto no plano das redes de saúde e intersetorial - com foco no CAPS - quanto no da família e da comunidade. Para tanto, foi feita uma etnografia sobre nove casos de quatro CAPS das três Redes de Atenção Psicossocial (RAPS) do município do Rio de Janeiro: Centro-Sul, Zona Norte e Zona Oeste. As entrevistas, leituras de prontuários e visitas às instituições e serviços demonstraram que os principais fatores envolvidos nos processos de neoinstitucionalização são: crise, imaginário manicomial, desarticulação e precarização das redes de saúde e intersetorial, equipes reduzidas e número insuficiente de serviços territoriais, despolitização, institucionalização dos CAPS, baixa capacidade de acolhimento à crise, sobrecarga familiar e expectativa sobre a família, falta de um suporte regular aos familiares e de projetos de moradia voltados aos usuários cujos cuidadores morreram, envelheceram, adoeceram ou não estão disponíveis para uma moradia compartilhada.

According to the leaders of the Italian psychiatric reform, deinstitutionalization involves not only the removal of patients from psychiatric hospitals, but also the deconstruction of the asylum logic and the construction of a substitutive territorial network, which, in Brazil, has the Psychosocial Care Center (CAPS) as the main base. The creation or reformulation of establishments that update the guardianship over madness demonstrates that this process has been facing challenges. Despite being treated in CAPS, some users have been institutionalized in nursing homes, private clinics/hospitals, therapeutic communities, private "Residences" and CAPS III. The objective of the present research was to analyze the factors that have been converging on this phenomenon both at the level of health and intersectoral networks - with a focus on CAPS - and at the level of the family and the community. Therefore, an ethnography was carried out on nine cases of four CAPS from the three Psychosocial Care Networks (RAPS) in the municipality of Rio de Janeiro: South-Center, North Zone and West Zone. The interviews, readings of patient records and visits to institutions and services showed that the main factors involved in the processes of neo-institutionalization are: crisis, asylum imaginary, disarticulation and precariousness of health and intersectoral networks, reduced teams and insufficient number of territorial services, depoliticization, institutionalization of CAPS, low capacity to embrace the crisis, family overload and expectations about the family, lack of regular support for family members and housing projects aimed at users whose caregivers died, aged, became ill or are not avaiable for shared housing.

Dar lugar à palavra: reverberações da clínica com imigrantes bolivianos num CAPS infantojuvenil / Dando paso a la palabra: reverberaciones de la clínica con inmigrantes bolivianos en un CAPS / Give place to the word: reverberations of the clinic with bolivian immigrants at a CAPS / Faire place aux mots: réverbérations de la clinique avec des immigrants boliviens dans un CAPS

A chegada de crianças filhas de imigrantes bolivianos no CAPS infantojuvenil Mooca vem ocorrendo com maior frequência. Essas crianças chegam ao serviço com queixas de problemas do desenvolvimento, destacando-se atraso na fala e dificuldade na interação, muitos com a hipótese diagnóstica de autismo interrogada. Neste artigo, apresentaremos um grupo terapêutico com imigrantes, que possibilitou um espaço de acolhimento para crianças e famílias e a abertura para narrar e elaborar sobre vivências de sofrimento, desenraizamento e solidão. Buscaremos ampliar as leituras possíveis para os problemas do desenvolvimento apresentados pelas crianças, interrogando como podem estar relacionados à experiência de imigração e seus efeitos sociopolíticos na subjetividade. Por fim, discutiremos como a demanda social por diagnósticos responde à razão psiquiátrica contemporânea e não à demanda de cuidado e escuta das crianças

La llegada de hijos de inmigrantes bolivianos a los CAPS para niños y jóvenes de Mooca viene ocurriendo cada con mayor frecuencia. Estos niños llegan al servicio con retraso en el habla y el desarrollo y dificultad en la interacción, muchos ya con la hipótesis diagnóstica de autismo. Aquí presentaremos un grupo terapéutico con inmigrantes, con un espacio de acogida para niños y familias y la apertura para narrar y elaborar experiencias de sufrimiento, desarraigo y soledad. Buscaremos ampliar las posibles lecturas de los retrasos presentados, cuestionando cómo pueden estar relacionados con la experiencia de la inmigración y sus efectos sociopolíticos en la subjetividad. Finalmente, discutiremos cómo la demanda social de diagnósticos responde a la psiquiatría y no a la demanda de cuidado y escucha de los niños

The arrival of children of Bolivian immigrants at CAPS juvenile Mooca (Psychological Support Center) with speech and developmental delays, has severely increased over time. These children arrive at the center with speech delays, isolation, impairments in social cognition and behavioral, many of them hypothetically diagnosed with autism. In this article, we'll introduce a specific therapeutic group of immigrants that collaborated to describe experiences of suffering, cultural uprooting and loneliness. We will try to broaden the possible reasons for delay in development demonstrated by children, interrogating how it could be related to the immigration experience and its subjective social-political effects. Lastly, we will discuss how the social demand for diagnoses respond to psychiatric reasons as opposed to careand listening to children's necessities

L'arrivée d'enfants fils d'immigrants boliviens chez le CAPS des enfants et des jeunes Mooca est plus fréquente. Ces enfants viennent avec retard dans la parole et dans le développement, des difficultés d'interaction, plusieurs parmi eux avec l'hypothèse diagnostique de autisme. Ici, nous présentons un groupe thérapeutique avec des immigrants, avec un espace d'accueil aux enfants et aux familles, ainsi que l'ouverture pour raconteur et élaborer les vécus de survie et de souffrance, de déracinement et de solitude. Nous chercherons à élargir les lectures possibles des retards présentés par les enfants, en étudiant la relation avec l'expérience d'immigration et ses effets sociopolitiques sur la subjectivité. Nous discutons, de quelle façon la demande sociale les diagnostiques répond à la psychiatrie et non à la demande de soins et d'écoute des enfants

Vivências de profissionais de um centro de atenção psicossocial infantil voltadas para usuários com autismo / Experiences of professionals from a child psychosocial care center aimed at users with autism

Introdução: os Transtornos do Espectro Autista (TEA) são considerados, em uma perspectiva biomédica, transtornos mentais e do desenvolvimento que afetam principalmente crianças em fase de desenvolvimento. No Brasil, o local de referência para tratamento e acompanhamento destes usuários é o Centro de Atenção Psicossocial Infantil (CAPSi). No entanto, muitos profissionais de saúde apresentam dificuldade em desenvolver planos de cuidados que sejam específicos para o tratamento global do paciente com TEA, o que inclui a família e suas dinâmicas. Objetivo Geral: compreender as vivências dos profissionais de um CAPSi voltadas para usuários com autismo. Método: trata-se de uma pesquisa qualitativa com o referencial teórico-filosófico da sociologia fenomenológica de Alfred Schutz. O campo de estudo foi o CAPSi do município de Novo Hamburgo, Rio Grande do Sul. A coleta de informações ocorreu entre maio e novembro de 2021 com sete profissionais de saúde que atuam no campo de estudo, por meio de entrevista fenomenológica, sendo realizada análise fenomenológica de acordo com o referencial da sociologia fenomenológica. O projeto respeitou os aspectos éticos relacionados a pesquisas com seres humanos, utilizou Termo de Consentimento Livre e Esclarecido e foi aprovado pelo Comitê de Ética em Pesquisa ­ CEP da Universidade Federal do Rio Grande do Sul ­ UFRGS (CAAE 40447920.3.0000.5347). Resultados: foram agrupados em quatro categorias: Concepções sobre o TEA; Relação da equipe do CAPSi com as Redes de Apoio; Ações dos profissionais no CAPS; e Intenções dos profissionais nas ações voltadas para usuários com TEA. Considerações Finais: pode-se perceber que os motivos e intenções que levam os profissionais a atuarem e a trabalharem, a partir das demandas dos usuários no CAPSi, de modo multiprofissional ­ discutindo os casos em equipe, incluindo a família no plano de cuidados e utilizando o brincar e atividades em grupo ­ estão diretamente relacionados ao desenvolvimento de habilidades sociais, de interação e de atividades de vida diária do usuário. Espera-se que este estudo contribua para o embasamento profissional com vistas à melhoria dos atendimentos frente às demandas dos usuários com TEA e suas famílias.

Introduction: Autism Spectrum Disorders (ASD) are considered, in a biomedical perspective, mental and developmental disorders that mainly affect children in the development phase. In Brazil, the reference place for the treatment and monitoring of these users is the Centro de Atenção Psicossocial Infantil ­ CPCC (Child Psychosocial Care Center). However, many health professionals find it difficult to develop care plans that are specific to the global treatment of the patient with ASD, which includes the family and its dynamics. Objective: to understand the experience of professionals from a CPCC aimed at users with autism. Method: this is a qualitative research with the theoretical-philosophical framework of Alfred Schutz's phenomenological sociology. The field of study was the CPCC in Novo Hamburgo, Rio Grande do Sul. The collection of information took place between May and November 2021 with seven health professionals who work in the field of study, through a phenomenological interview, with a phenomenological analysis being carried out according to the framework of phenomenological sociology. The project respected the ethical aspects related to research with human beings and was approved by the Comitê de Ética em Pesquisa - REC (Research Ethics Committee) of the Universidade Federal do Rio Grande do Sul ­ UFRGS (CAAE 40447920.3.0000.5347). Results: the results were grouped into four categories: Conceptions about ASD; Relationship between the CPCC team and the Support Networks; Professional actions at CPCC; and Intentions of professionals in actions aimed at users with ASD. Final Considerations: It can be seen that the reasons and intentions that lead professionals to act and work, based on the demands of users at CPCC, in a multiprofessional way - discussing cases in a team, including the family in the care plan and using play and group activities ­ are directly related to the development of social skills, interaction and activities of daily living of the user. It is hoped that this study will contribute to the professional foundation with a view to improving care in the face of the demands of users with ASD and their families.

Grupo de mulheres: um lugar de escuta clínica para mulheres em um centro de atenção psicossocial / Women's group: a place of clinical listening in a psychosocial care center / Grupo de mujeres: un lugar de escucha clinica en un centro de atención psicosocial

O presente artigo tem como objetivo compartilhar a experiência de um Grupo Psicoterapêutico de Mulheres, trabalho de psicoterapia grupal realizado em um Centro de Atenção Psicossocial (CAPS). Ao relatar a história do grupo de mulheres, pretendemos abordar as seguintes temáticas: os desafios da clínica na rede de atenção psicossocial e como o grupo de mulheres enfrentou os fracassos e se tornou um espaço de elaboração de luto, fortalecimento de singularidades, bem como de abertura para novas possibilidades de vida; desta forma, reafirmando o potencial dos grupos terapêuticos para sustentação da clínica nos dispositivos públicos de saúde. Percebemos que o potencial terapêutico do grupo de mulheres consiste em proporcionar um lugar de contar e recontar suas histórias. Neste espaço, elas podem compartilhar identificações e integrar-se nas diferenças. Permite-se falar de suas perdas, dores, estigmas e da relação com o fracasso. O processo psicoterapêutico favorece processos de elaboração e ressignificação, tornando possível vislumbrar e, inclusive, construir um recomeço. Pretende-se que esta reflexão vá ao encontro de outros terapeutas de grupo, em outros serviços de saúde, tecendo assim uma rede de reflexões e conhecimento sobre a clínica e a temática de grupos e instituições.

This article aims to share the experience of a Psychotherapeutic Group for Women, a group psychotherapy work carried out in a Psychosocial Care Center (CAPS). In reporting the history of the group of women, we intend to address the following themes: the challenges of the clinic in the psychosocial care network and how the group of women faced the failures and became a space for the elaboration of mourning, strengthening of singularities, as well as openness to new life possibilities; thus, reaffirming the potential of the therapeutic groups to support the clinic in public health devices. We realized that the therapeutic potential of the group of women is to provide a place to tell and retell their stories. In this space, they can share identifications and integrate themselves into differences. It allows you to talk about your losses, pains, stigmas and the relationship with failure. The psychotherapeutic process favors processes of elaboration and reframing, making it possible to see and even build a new beginning. It is intended that this reflection will meet other group therapists, in other health services, thus weaving a network of reflections and knowledge about the clinic and the theme of groups and institutions.

Este artículo tiene como objetivo compartir nuestra experiencia con el Grupo de Mujeres, que es un trabajo de psicoterapia grupal realizado en un Centro de Atención Psicosocial. Al informar su historia, pretendemos abordar los desafíos de la clínica en la Red de Atención Psicosocial y cómo tal grupo se enfrentó a los fracasos para convertirse en un espacio para la elaboración del dolor, el fortalecimiento de las singularidades y la apertura a nuevas posibilidades de vida, reafirmando el potencial de los grupos terapéuticos para apoyar la clínica en dispositivos de salud pública. Encontramos que el potencial terapéutico del Grupo de Mujeres es proporcionar un lugar para contar y volver a contar historias. En este espacio, sus participantes pueden compartir identificaciones y agregar diferencias. En él, ellas se permiten hablar sobre sus pérdidas, dolores y estigmas y sobre su relación con el fracaso. El proceso psicoterapéutico favorece la elaboración y la reformulación, lo que permite vislumbrar e incluso construir un nuevo comienzo. Pretendemos que esta reflexión resuene entre otros terapeutas grupales, en otros servicios de salud, tejiendo así una red de reflexiones y conocimientos sobre la clínica y el tema de grupos e instituciones.