The Pleural Mesothelioma Cases and Mortality in Portugal in 2014-2020: A Descriptive Study.

BACKGROUND: The incidence and mortality of pleural mesothelioma (PM) reflect the production and consumption of asbestos over time. However, despite the current global concern, these data remain to be known. OBJECTIVE: Our aim was to carry out a descriptive analysis of PM cases and mortality from some Portuguese databases between 2014 and 2020. METHODS: A retrospective observational study was carried out between 2014 and 2020. Data on the number of PM cases were provided by the Portuguese Cancer Registry, and data on mortality were from the Portuguese Death Certificate Information System. RESULTS: Between 2014 and 2020, 315 cases of PM were reported, with 222 (70.5%) men. The average age of patients was 72.1, with the highest number of cases in patients aged >70 years (n = 198; 62.9%). The highest number of cases was reported in 2018 (n = 62; 19.7%). Regarding mortality, 169 deaths were reported, with 126 (74.6%) men and mostly in individuals aged >70 years (n = 109; 64.5%). It is estimated that around 520 years of potential life were lost. The highest number of deaths occurred in 2015 (n = 33; 19.5%). CONCLUSION: It is mandatory to reinforce the need for surveillance programs that allow us to gather real and reliable data and eliminate asbestos-related diseases.

Responses of soil microbiome to copper-based materials (nano and bulk) for agricultural applications: An indoor-mesocosm experiment.

The foreseen increasing application of copper-based nanomaterials (Cu-NMs), replacing or complementing existing Cu-agrochemicals, may negatively impact the soil microbiome. Thus, we studied the effects on soil microbiome function and composition of nano copper oxide (nCuO) or copper hydroxide NMs in a commercial (Kocide®3000) or a lab-synthetized formulation (nCu(OH)2) or bulk copper hydroxide (Cu(OH)2-B), at the commonly recommended Cu dose of 50 mg(Cu)kg-1 soil. Microbial responses were studied over 28 days in a designed indoor mesocosm. On day-28, in comparison to non-treated soil (CT), all Cu-treatments led to a reduction in dehydrogenase (95% to 68%), arylsulfatase (41% to 27%), and urease (40% to 20%) activity. There was a 32% increase in the utilization of carbon substrates in the nCuO-treatment and an increased abundance of viable bacteria in the nCu(OH)2-treatment (75% of heterotrophic and 69% of P-solubilizing bacteria). The relative abundance of Acidobacteria [Kocide®3000, nCuO, and Cu(OH)2-B treatments] and Flavobacteriia [nCu(OH)2-treatment] was negatively affected by Cu exposure. The abundance of Cu-tolerant bacteria increased in soils treated with Kocide®3000 (Clostridia) and nCu(OH)2 (Gemmatimonadetes). All Cu-treated soils exhibited a reduced abundance of denitrification-related genes (0.05% of nosZ gene). The DTPA-extractable pool of ionic Cu(II) varied among treatments: Cu(OH)2-B > Kocide®3000 âˆ¼ nCuO>nCu(OH)2, which may explain changes on the soil microbiome composition, at the genera and OTU levels. Thus, our study revealed that Cu-materials (nano and bulk) influence the soil microbiome with implications on its ecological role. It highlights the importance of assessing the impact of Cu-materials under dynamic and complex exposure scenarios and emphasizes the need for specific regulatory frameworks for NMs.

Death Unpreparedness Due to the COVID-19 Pandemic: A Concept Analysis.

The COVID-19 pandemic imposed changes upon the capacity of healthcare systems, with significant repercussions on healthcare provision, particularly at end-of-life. This study aims to analyze the concept map of death unpreparedness due to the COVID-19 pandemic, capturing the relationships among the attributes, antecedents, consequences, and empirical indicators. Walker and Avant's method was used to guide an analysis of this concept. A literature search was performed systematically, between May 2022 and August 2023, using the following electronic databases on the Elton Bryson Stephens Company (EBSCO) host platform: Medical Literature Analysis and Retrieval System Online (Medline), Psychological Information Database (PsycINFO), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Cochrane Library, and Nursing and Allied Health Collection. Thirty-four articles were retrieved. The unexpected and unpredictable impositions associated with inexperience and unskillfulness in dealing with COVID-19 configured challenges for healthcare professionals, family/caregivers, and even the dying person. Nine key attributes emerged in three main domains: (1) Individual: (a) disease-related conditions, (b) separation distress, and (c) scarcity of death and grief literacy; (2) Relational: (a) Dying alone, (b) poor communication, and (c) existential issues; and (3) Contextual: (a) disrupted collective mourning and grieving, (b) disrupted compassionate care and, (c) pandemic social stigma. This study contributed a full definition of death unpreparedness in a global pandemic scenario such as COVID-19. In this sense, feeling unprepared or unready for death brought new challenges to the bioecological resources of those affected. It is essential to embrace strategies capable of providing emotional and spiritual support in the dying process and to respect patient wishes. The lessons learned from COVID-19 should be applied to events with a comparable impact to minimize their consequences.

Exploring Professional Practice Environments and Organisational Context Factors Affecting Nurses' Adoption of Evidence-Based Practice: A Scoping Review.

This scoping review, conducted within the Joanna Briggs Institute (JBI) framework, analysed the recent literature (January 2018 to March 2023) addressing factors inherent to professional practice environments and organisational contexts influencing nurses' adoption of evidence-based practice (EBP). This review included studies involving nurses regardless of sector, practice setting, and scope of practice. A systematic search was undertaken across the PubMed, Web of Science, CINAHL, and MEDLINE databases, as well as the EThOS, OATD, and RCAAP platforms. The extracted textual elements underwent a content analysis, resulting in a coding structure established through an inductive approach that categorised information into main categories and subcategories linked by similarity and thematic affinity. Forty-one studies were included, revealing four main categories of factors impacting EBP adoption by nurses: (1) organisational dynamics, (2) management and leadership, (3) teamwork and communication, and (4) resources and infrastructure. The study's limitations acknowledge the subjective nature of categorisation, recognising potential variations based on individual perspectives despite adopting procedures to minimise the risk of bias. The results provide a substantial foundation for developing interventions to cultivate environments conducive to EBP adoption by nurses, thereby enhancing the integration of evidence into nurses' professional practice contexts. This review was prospectively registered on the Open Science Framework (registration no. osf.io/e86qz).

Conhecimento dos agentes comunitários de saúde sobre o aleitamento materno / Knowledge of community health workers about breastfeeding / Conocimiento de los trabajadores comunitarios de la salud sobre la lactancia materna

Objetivo: analisar o conhecimento sobre aleitamento materno e os fatores associados a esse entendimento entre agentes comunitários de saúde. Método: estudo quantitativo, descritivo-analítico, transversal, realizado com 153 ACS de Senhor do Bonfim, Bahia. Para a verificação das variáveis associadas ao conhecimento sobre aleitamento, realizou-se análise bivariada (Odds Ratio, Intervalo de Confiança 95% e Testes Qui-quadrado/Fisher) e análise ajustada através da Regressão Logística Múltipla (Stepwise). Resultados: o estudo mostrou que os agentes comunitários de saúde apresentam elevado nível de conhecimento sobre aleitamento materno. Houve associação entre o conhecimento sobre aleitamento materno e ter filhos, trabalhar na Estratégia de Saúde da Família, ter participado de capacitação e alto conhecimento sobre as atribuições gerais da profissão. Conclusão: Os profissionais possuem adequado entendimento sobre a temática. Todavia, importantes equívocos foram observados e caso repassados para a comunidade podem prejudicar a instalação e manutenção do aleitamento materno(AU)

Objective: to analyze knowledge about breastfeeding and the factors associated with this understanding among community health agents. Method: quantitative, descriptive-analytical, cross-sectional study, carried out with 153 CHAs from Senhor do Bonfim, Bahia. To verify the variables associated with knowledge about breastfeeding, bivariate analysis was carried out (Odds Ratio, 95% Confidence Interval and Chi-square/Fisher Tests) and adjusted analysis using Multiple Logistic Regression (Stepwise). Results: the study showed that community health agents have a high level of knowledge about breastfeeding. There was an association between knowledge about breastfeeding and having children, working in the Family Health Strategy, having participated in training and high knowledge about the general responsibilities of the profession. Conclusion: Professionals have an adequate understanding of the topic. However, important mistakes were observed and, if passed on to the community, they could harm the installation and maintenance of breastfeeding(AU)

Objetivo: analizar el conocimiento sobre lactancia materna y los factores asociados a ese entendimiento entre agentes comunitarios de salud. Método: estudio cuantitativo, descriptivo-analítico, transversal, realizado con 153 ACS del Senhor do Bonfim, Bahía. Para verificar las variables asociadas al conocimiento sobre lactancia materna, se realizó análisis bivariado (Odds Ratio, Intervalo de Confianza del 95% y Pruebas Chi-cuadrado/Fisher) y análisis ajustado mediante Regresión Logística Múltiple (Stepwise). Resultados: el estudio demostró que los agentes comunitarios de salud tienen un alto nivel de conocimiento sobre la lactancia materna. Hubo asociación entre conocimiento sobre lactancia materna y tener hijos, trabajar en la Estrategia Salud de la Familia, haber participado en capacitaciones y alto conocimiento sobre las responsabilidades generales de la profesión. Conclusión: Los profesionales tienen un conocimiento adecuado del tema. Sin embargo, se observaron errores importantes que, de transmitirse a la comunidad, podrían perjudicar la instalación y el mantenimiento de la lactancia materna(AU)

Landing wise program: feasibility study protocol for Parkinson's disease.

Regardless of the benefits of fall prevention programs, people with Parkinson's disease (PD) will still fall. Therefore, it is crucial to explore novel therapeutic approaches that are well-accepted and effective for addressing fall risk and the fear of falls among this population. The present study aims to assess the feasibility of the Landing Wise program as a therapeutic intervention for reducing the fear of falling in people with PD. A mixed-methods study will be conducted using convenience sampling to recruit 20 people with PD with a moderate concern of falling from a Parkinson's Patients Association. In addition to usual care, participants will attend 2 days per week, 90 min group sessions for 8 weeks. The intervention combines group cognitive behavioral intervention with the training of safe landing strategies. Feasibility will be assessed by six key domains (recruitment strategy and rates, enrollment, retention, acceptability, reasons for decline/withdrawal, and adverse events). Quantitative data will be analyzed using descriptive statistics to characterize the sample, followed by inferential statistics to evaluate differences in the Short Falls Efficacy Scale-International Scale, Movement Disorder Society Unified Parkinson's Disease Rating Scale, Timed Up Go, 6-Minutes Walking Distance, and fall frequency and severity scores between baseline and final assessment. Qualitative data will be analyzed using an inductive thematic analysis process. There is a growing interest in developing new effective therapeutic approaches for people with PD. If proven program feasibility, this study precedes a randomized controlled trial to establish the effectiveness of the Landing Wise program.

Unveiling the molecular mechanisms and developmental consequences of mercury (Hg) toxicity in zebrafish embryo-larvae: A comprehensive approach.

Mercury (Hg) is a global contaminant affecting aquatic ecosystems' health. Chronic exposure to Hg has shown that the normal development of zebrafish embryo-larvae is affected. However, the molecular mechanisms behind the toxicity of Hg on fish embryonic development are still poorly understood. This work aimed to investigate the effects of Hg exposure on zebrafish embryo-larvae using a combined approach at individual (mortality, embryo development and locomotor behavior) and biochemical (neurotoxicity and oxidative stress enzymatic activities and protein phosphatase expression) levels. The Fish Embryo Toxicity assay followed the Organization for Economic Cooperation and Development Guideline 236 and used a concentration range between 13 and 401 µg Hg/L. Lethal and developmental endpoints were examined at 24, 48, 72 and 96 hpf. Biochemical markers, including Acetylcholinesterase (AChE), Catalase (CAT), Glutathione Reductase (GR), and Glutathione-S-Transferase (GST) activities and, for the first time, the expression of the protein phosphatase 1 gamma (PP1γ) was assessed after 24, 48, 72 and 96 h of exposure to 10 and 100 µg Hg/L. The behavioral effects of a sublethal range of Hg (from 0.8 to 13 µg Hg/L) were assessed using an automated video tracking system at 120 hpf. Several developmental abnormalities on zebrafish embryos and larvae, including pericardial edema, spin and tail deformities and reduced rate of consumption of the yolk sac, were found after exposure to Hg (LC50 at 96 hpf of 139 µg Hg/L) with EC50 values for total malformations ranging from 22 to 264 µg Hg/L. After 96 hpf, no significant effects were observed in the CAT and GR activities. However, an increase in the GST activity in a concentration and time-dependent manner was found, denoting possible stress-related adaptation of zebrafish embryos to deleterious effects of Hg exposure. The AchE activity showed a response pattern in line with the behavioral responses. At the lowest concentration tested, no significant effects were found for the AChE activity, whereas a decrease in AChE activity was observed at 100 µg Hg/L, suggesting that exposure to Hg induced neurotoxic effects in zebrafish embryos which in turn may explain the lack of equilibrium found in this study (EC50 at 96 hpf of 83 µg Hg/L). Moreover, a decrease in the PP1γ expression was found after 96 h of exposure to 10 and 100 µg Hg/L. Thus, we suggest that Hg may be an inhibitor of PP1γ in zebrafish embryos-larvae and thus, along with the alterations in the enzymatic activity of GST, explain some of the developmental malformations observed, as well as the lack of equilibrium. Hence, in this study, we propose the use of PP1 expression, in combination with apical and biochemical endpoints, as a precursor for assessing Hg's toxic mechanism on embryonic development.

Interventions to Minimize Medication Error by Nurses in Intensive Care: A Scoping Review Protocol.

Medication errors represent a concern for healthcare organizations due to their negative consequences. In the nursing context, these errors represent a threat to the quality of care and patient safety. Many factors have been identified as potential causes for these errors in intensive care units. A scoping review will be developed to identify interventions/strategies to minimize the occurrence of medication errors by nurses, considering the Joanna Briggs Institute (JBI) methodology. A search will be conducted in the EbscoHost (CINAHL Complete and MEDLINE), Embase and PubMed databases. Data analysis, extraction and synthesis will be carried out by two reviewers independently. This review will attempt to map which interventions are more specific to minimizing medication error by nurses in intensive care and to recognize which factors influence this type of error to mitigate practices that may lead to error. This protocol acts as the framework for a scoping review in the strategy to map the interventions and which factors contribute to the medication error by intensive care nurses. This study was prospectively registered with the Open Science Framework on 21 April 2023 with registration number DOI 10.17605/OSF.IO/94KH3.

Toxicokinetics of silver and silver sulfide nanoparticles in Chironomus riparius under different exposure routes.

Engineered nanoparticles released into surface water may accumulate in sediments, potentially threatening benthic organisms. This study determined the toxicokinetics in Chironomus riparius of Ag from pristine silver nanoparticles (Ag NPs), a simulating aged Ag NP form (Ag2S NPs), and AgNO3 as an ionic control. Chironomid larvae were exposed to these Ag forms through water, sediment, or food. The potential transfer of Ag from larvae to adult midges was also evaluated. Results revealed higher Ag uptake by C. riparius upon exposure to Ag2S NPs, while larvae exposed to pristine Ag NPs and AgNO3 generally presented similar uptake kinetics. Uptake patterns of the different Ag forms were generally similar in the tests with water or sediment exposures, suggesting that uptake from water was the most important route of Ag uptake in both experiments. For the sediment bioaccumulation test, uptake was likely a combination of water uptake and sediment particles ingestion. Ag uptake via food exposure was only significant for Ag2S NPs. Ag transfer to the terrestrial compartment was low. In our environmentally relevant exposure scenario, chironomid larvae accumulated relatively high Ag concentrations and elimination was extremely low in some cases. These results suggest that bioaccumulation of Ag in its nanoparticulate and/or ionic form may occur in the environment, raising concerns regarding chronic exposure and trophic transfer. This is the first study determining the toxicokinetics of NPs in Chironomus, providing important information for understanding chironomid exposure to NPs and their potential interactions in the environment.

Increased oyster aquaculture in the Sado Estuary (Portugal): How to ensure ecosystem sustainability?

Aquaculture is one of the fastest growing sectors in the world. However, this may come with a cost, as increasing aquatic production is likely to impose changes in the environment. To ensure ecosystem sustainability, it is essential to think on this larger scale. This study aims to use the Delft3D model suite to evaluate the ecological carrying capacity for bivalve production in the Sado Estuary (Portugal), under present and future conditions (2050). Scenarios for increased oyster production resulted in reductions of chlorophyll a associated with increased nutrient concentrations. In the most extreme production scenario, which considered an increase of 100 ha in production area, a predicted decrease of 90 % in phytoplankton biomass was observed. Climate change (CC) was incorporated as an increase in sea level and water temperature, as well as a reduction in river flow. Under present oyster production conditions, CC revealed contrasting patterns, i.e. an increase in chlorophyll a concentrations and a reduction in nutrients. These results suggest that CC has a positive effect in counteracting the impacts of increased oyster production, however further research is necessary. All scenarios point to reduced dissolved oxygen concentrations, highlighting the need to monitor this parameter. Given the difficulty in defining what are unacceptable impacts to the ecosystem it would be prudent to include a socio-ecological framework in the future, in order to integrate ecosystem services and the perception of local stakeholders.

EXISTENTIAL OBSESSIONS: A CASE REPORT OF A POSTPARTUM OBSESSIVE COMPULSIVE DISORDER.

Existential obsessions (EO) are an uncommon type of obsessive thought, also described as philosophical or ruminative obsessions. In Obsessive Compulsive Disorder (OCD) with postpartum onset, the clinical picture frequently counts with intrusive thoughts about infant harm and compulsions of verification.

Psicotrópicos: uso por estudantes universitários antes e durante a pandemia de doença por coronavírus 2019 / Psicotrópicos: uso por estudiantes universitarios antes y durante la pandemia de enfermedad del coronavirus 2019 / Psychotropics: use by college students before and during the coronavirus disease 2019 pandemic

Objetivo: descrever a utilização de psicotrópicos por estudantes universitários antes e durante a pandemia de doença por coronavírus 2019. Métodos: estudo transversal com 464 estudantes que frequentaram uma disciplina ofertada durante a pandemia. Utilizou-se um questionário via Google Forms com questões autoaplicáveis. As informações coletadas foram transferidas para o Microsoft Excel 2007 e analisadas no software Statistical Package for the Social Sciences 25.0. Resultado: 37,3% referiram fazer uso de psicotrópicos antes ou durante a pandemia. Destes, mais de 80,0% relataram fazer uso antes e 17,5% iniciaram após o início da pandemia, sendo a maioria do sexo feminino, solteiras e cursando o primeiro ou o último semestre da graduação. Os antidepressivos foram os mais utilizados pelos participantes (64,0%). Conclusões: a prevalência do uso de psicotrópicos entre estudantes pode ter se acentuado na pandemia. O desenvolvimento de programas e políticas voltadas à promoção e cuidado à saúde mental dos universitários é necessário.(AU)

Objective: to describe the use of psychotropic drugs by university students before and during the 2019 coronavirus disease pandemic. Method: cross-sectional study with 464 students who attended a course offered during the pandemic. A questionnaire was used via Google Forms with self- administered questions. The collected information was transferred to the Microsoft Excel 2007 and analyzed in the Statistical Package for the Social Sciences 25.0 software. Result: 37.3% reported using psychotropic drugs before or during the pandemic. Of these, more than 80.0% reported using it before and 17.5% started after the beginning of the pandemic, the majority being female, single, and attending the first or last semester of graduation. Antidepressants were the most used by participants (64.0%). Conclusions: the prevalence of psychotropic use among students may have increased during the pandemic. The development of programs and policies aimed at promoting and caring for the mental health of university students is necessary.(AU)

Objetivo: describir el uso de psicofármacos por parte de estudiantes universitarios antes y durante la pandemia de la enfermedad por coronavirus 2019. Método: estudio transversal con 464 estudiantes que asistieron un curso ofrecido durante la pandemia. Se utilizó un cuestionario en Google Forms con preguntas autoadministradas. La información recolectada fue transferida al Microsoft Excel 2007 y analizada en el software Statistical Package for the Social Sciences 25.0. Resultado: el 37,3% informó usar psicofármacos antes o durante la pandemia. De estos, más del 80,0% reportaron usarlo antes y el 17,5% iniciaron después, siendo la mayoría mujeres, solteras y cursando el primer o último semestre de graduación. Los antidepresivos fueron los más utilizados por los participantes (64,0%). Conclusiones: la prevalencia del consumo de psicotrópicos entre estudiantes puede haber aumentado durante la pandemia. Es necesario el desarrollo de programas y políticas dirigidas a promover y cuidar la salud mental de estudiantes universitarios.(AU)

Obsesiones existenciales: Un caso de tratorno obsesivo compulsivo posparto / Existential obsessions: A case of postpartum obsessive compulsive-compulsive disorder

Las obsesiones existenciales (OE) son un tipo poco comúnde pensamiento obsesivo, también descrito como obsesionesfilosóficas o reflexivas. En el Trastorno Obsesivo-Compulsivo(TOC) con inicio en el posparto, el cuadro clínico frecuentementepresenta pensamientos intrusivos sobre el daño infantil ycompulsiones de verificación. Presentamos un caso inusualde una paciente con TOC de inicio posparto, que presentabaOE. El caso destaca la importancia de explorar activamente lasintomatología, para un diagnóstico diferencial acertado. Enparticular, en el posparto, un diagnóstico psiquiátrico correctotiene importantes implicaciones terapéuticas y pronósticas. (AU)

Existential obsessions (EO) are an uncommon type of obsessivethought, also described as philosophical or ruminative obsessions.In Obsessive Compulsive Disorder (OCD) with postpartum onset,the clinical picture frequently counts with intrusive thoughtsabout infant harm and compulsions of verification. We reportan unusual case of a patient with postpartum onset OCD,who presented with EO. The case highlights the importanceof actively exploring the symptomatology, for an accuratedifferential diagnosis. In particular, in the postpartum period,a correct psychiatric diagnosis has significant therapeutic andprognostic implications. (AU)

Nursing Care in Peripheral Intravenous Catheter (PIVC): Protocol of a Best Practice Implementation Project.

BACKGROUND: The use of a peripheral intravenous catheters (PIVC) is a common invasive practice in healthcare settings. It is estimated that about 70% of people with PIVCs will develop associated complications, such as infections. It is the consensus that best practices could reduce the appearance of such complications and reduce the length of stay in hospital. METHODS: A project will be applied to implement the best approach in peripheral venous catheterization, provided by clinical nurses from an inland hospital in Portugal. The Joanna Briggs Institute methodology will be used on evidence implementation projects, which will be developed in three phases. First, a baseline audit will be performed. The second phase implements corrective measures, and the third phase is a follow-up audit. CONCLUSIONS: This project will improve the practice of the nursing team on peripheral venous catheterization nursing cares, positively influencing the quality of nursing care and patient safety. The implementation and dissemination of this project could boost its replication in other centres.

Microplastic Fibers Increase Sublethal Effects of AgNP and AgNO3 in Daphnia magna by Changing Cellular Energy Allocation.

The effects of combined exposure to microplastics and contaminants are still not completely understood. To fill this gap, we assessed the effects of polyethylene terephthalate microplastic fibers (100 mg/L; 360 µm average length) on the toxicity of silver nanoparticles (AgNPs; 32 nm) and silver nitrate (AgNO3 ; 0.1-10 µg Ag/L) to Daphnia magna. Acute immobilization (median effect concentration [EC50]) and cellular energy allocation (CEA; ratio between available energy and energy consumption) were determined in neonates (<24 h old) and juveniles (7 d old), respectively. The 48-h EC50 for AgNP and AgNO3 (2.6 and 0.67 µg Ag/L, respectively) was not affected by the presence of microplastic fibers (2.2 and 0.85 µg Ag/L, respectively). No decrease in the available energy was observed: lipid, carbohydrate, and protein contents were unaffected. However, a significant increase in energy consumption was observed in animals exposed to AgNO3 (250% compared with control) and to the combination of microplastic fibers with AgNP (170%) and AgNO3 (260%). The exposure to microplastic fibers alone or in combination with both Ag forms decreased the CEA (values were 55-75% of control values). Our results show that after short-term exposure (48 h), microplastic fibers increased Ag toxicity at a subcellular level (i.e., CEA), but not at the individual level (i.e., immobilization). These results highlight the importance of combining different levels of biological organization to fully assess the ecotoxicological effects of plastics in association with environmental contaminants. Environ Toxicol Chem 2022;41:896-904. © 2021 SETAC.

Prevalence of psychotropic drug use and conformity of therapeutic dose among mental health users.

OBJECTIVES: to identify the prevalence of psychotropic drug use according to their Anatomical Therapeutic Chemical classification among Psychosocial Care Center users and assess their prescription compliance based on the recommended therapeutic dose. METHODS: this is an analytical study, based on documents, from the study of 389 records between September 2017 and May 2018. Associations between the presence of underdose or overdose and participants' characteristics were assessed using the chi-square test, adopting a significant value of p <0.05. RESULTS: the most used drugs were antipsychotics (74.7%), 16.0% of users with at least one medication with a dose below the therapeutic level and another 3.6% above the recommended therapeutic dose. CONCLUSIONS: greater nonconformities in the prescribed dose were related to antihistamines, antipsychotics and antidepressants, with underdosage associated with females and overdose with the report of hearing voices.