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1.
J Phys Chem A ; 125(1): 243-250, 2021 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-33355445

RESUMO

The UV-vis absorption and magnetic circular dichroism spectra of naphthalene and some of its derivatives have been simulated at the Coupled Cluster Singles and Approximate Doubles (CC2) level of theory, and at the Time-Dependent Density Functional Theory (TD-DFT) level using the B3LYP and CAM-B3LYP functionals. DFT and CC2 predict in general opposite energetic ordering of the Lb and La transitions (in gas phase), as previously observed in adenine. The CC2 simulations of UV and MCD spectra show the best agreement with the experimental data. Analysis of the Cartesian components of the electric dipole transition strengths and the magnetic dipole transition moment between the excited states have been considered in the interpretation of the electronic transitions and the Faraday B term inversion among the naphthalene derivatives.

2.
Philos Trans A Math Phys Eng Sci ; 375(2108)2017 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-29084890

RESUMO

Quantum phase slips (QPS) are the primary excitations in one-dimensional superfluids and superconductors at low temperatures. They have been well characterized in most condensed-matter systems, and signatures of their existence have been recently observed in superfluids based on quantum gases too. In this review, we briefly summarize the main results obtained on the investigation of phase slips from superconductors to quantum gases. In particular, we focus our attention on recent experimental results of the dissipation in one-dimensional Bose superfluids flowing along a shallow periodic potential, which show signatures of QPS.This article is part of the themed issue 'Breakdown of ergodicity in quantum systems: from solids to synthetic matter'.

3.
Acta Reumatol Port ; 41(2): 158-61, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27606476

RESUMO

Eosinophilic granulomatosis with polyangitis (EGPA) is an uncommon ANCA-associated systemic small-vessel necrotizing vasculitis. At times, EGPA presenting manifestations can be very different from the usually recognized disease patterns. We report a 52-year-old female patient with 3 years history of itching. During the time occurred a chronic skin lichenification on her legs and gradually developed a full-blown ANCA-MPO positive EGPA in combination with blood hypereosinophilia, eosinophilic vasculitis at skin biopsy, subclinical asthma and chronic rhinosinusitis.


Assuntos
Síndrome de Churg-Strauss/complicações , Granulomatose com Poliangiite/complicações , Líquen Plano/etiologia , Doença Crônica , Síndrome de Churg-Strauss/diagnóstico , Feminino , Granulomatose com Poliangiite/diagnóstico , Humanos , Pessoa de Meia-Idade
4.
Biol Psychol ; 82(3): 308-11, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19766162

RESUMO

AIM: Today the most important problem in the work place is psychological abuse, which may affect the health because of high levels of stress and anxiety. There is evidence that most psychiatric disorders are associated with increased oxidative stress but nothing is reported about the presence of oxidative stress in mobbing victims. METHODS: This study has been carried out in a group of 19 patients affected by workplace mobbing-due adjustment disorders, in comparison with 38 healthy subjects, to evaluate whether oxidative stress may be induced by mobbing. RESULTS: Serum levels of protein carbonyl groups and of nitrosylated proteins, biological markers of oxidative stress conditions, were higher than those measured in healthy subjects. CONCLUSIONS: These findings may contribute to a better understanding of the redox homeostasis dysregulation occurring in victims of workplace mobbing.


Assuntos
Transtornos de Adaptação/sangue , Biomarcadores/sangue , Carbonilação Proteica/fisiologia , Proteínas/metabolismo , Local de Trabalho/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/fisiologia , Comportamento Social , Estatísticas não Paramétricas , Estresse Psicológico/sangue
5.
J Phys Chem B ; 111(9): 2372-6, 2007 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-17298092

RESUMO

By combined light scattering and circular dichroism measurements (CD), we have investigated the coil-to-globule transition of the thermosensitive polymer poly(N-isopropylacrylamide) (pNIPAAm) copolymerized with a 1/10 fraction of valine- or leucine-derived groups randomly positioned along the chains. The comonomers provide the pNIPAAm chains with chirality, electric charge, and increased hydrophobicity. For valine-derived copolymers, the coil-globule transition is basically unmodified with respect to pNIPAAm, whereas doping with leucine-derived groups significantly lowers the transition temperature and makes the transition discontinuous. We find the CD signal of the chiral comonomers to cleanly depend on the local chain density. We interpret this behavior as an effect of the whole chain conformation on the conformations accessible to the chiral groups.


Assuntos
Resinas Acrílicas/química , Aminoácidos/química , Biofísica/métodos , Físico-Química/métodos , Dicroísmo Circular , Luz , Conformação Molecular , Polímeros/química , Ligação Proteica , Espalhamento de Radiação , Estereoisomerismo , Temperatura , Valina/química
6.
G Ital Med Lav Ergon ; 29(3 Suppl): 538-9, 2007.
Artigo em Italiano | MEDLINE | ID: mdl-18409819

RESUMO

The aim of our study is the comparison between two different biological exposure index, trans-trans-muconic acid (t,t-MA) and S-phenylmercapturic acid (S-PMA), that are minor metabolites of benzene, in the exposure to low concentrations of benzene, to estimate which shows better correlation with the environmental exposure. The study has been conducted upon a sample of 105 male workers in a petrolchemical plant in Sicily. The environmental monitoring data has shown exposure levels within acceptable limits compared with TLV, and these levels have been confirmed by biological monitoring data. The comparison between biomarkers didn't point out particular differences and this data is probably connected to low found levels of exposure.


Assuntos
Acetilcisteína/análogos & derivados , Benzeno , Exposição Ocupacional/análise , Ácido Sórbico/análogos & derivados , Acetilcisteína/urina , Benzeno/administração & dosagem , Benzeno/metabolismo , Biomarcadores/análise , Humanos , Masculino , Ácido Sórbico/análise
7.
G Ital Med Lav Ergon ; 29(3 Suppl): 608-10, 2007.
Artigo em Italiano | MEDLINE | ID: mdl-18409861

RESUMO

The activity of roadman is not much knowed. The evalutation of the risk evidences the noise and vibrations as the principal polluter. The aim of our study is to go into the knowledge of the working risk of that job. The study was leaded on a sample of 287 roadmen. It was carried out an evalutation of noise exposure of the workers and a biologic evaluation that included: Medical check. Othorhin.laryngoiatric examination. Audiometric examination. Impedenzometric examination. The audiometric exam was conduced in a silent box and with a acoustic rest at least 16 h. The audiometric test were classified in conformity with Merluzzi-Pira-Bosio method. The phonometric evaluations point out, in roadmans examinated, hight exposure to noise with mean Lep d > 90 db. Biological evaluation, through medical check, showed data similar with that of a general group homogeneous for age and sex. Audiometric evaluation showed a noise acoustic trama in 60% of sample. Inpedenzometric exam confirmed the absence of transmissive damage in almost whole sample. In conclusion we can adfirm that noise is a strong factor for roadmen, with evident damage to exposed workers.


Assuntos
Ruído Ocupacional/efeitos adversos , Exposição Ocupacional/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco
8.
G Ital Med Lav Ergon ; 29(3 Suppl): 811-2, 2007.
Artigo em Italiano | MEDLINE | ID: mdl-18409975

RESUMO

The objective of the study is evalutation of the risk for ticks strings on foresters. The sample constituted by 325 foresters belong to Messina province as been submitted to medical examination venous tests. Whole sample had to answer to a questionnaire to consider. The prevalence of systemic and skin reactions and we have dose Immunoglobulines versus Brucella Melitensis, Rickettsie Conorii e Borrelia Burgdorferi. The results showed that the 19% has declared past stings of tick, and 4.9% reported symptoms probably deriving to a past infections determined by inquired microorganisms. The serum tests showed that 70% was positive for all microorganisms, instead only 31%. Was never infected by inquired microorganisms. In conclusion our study shows that zoonos is risk linked to stings of tick is relatively high in foresters.


Assuntos
Mordeduras e Picadas/epidemiologia , Carrapatos , Animais , Anticorpos Antibacterianos/sangue , Mordeduras e Picadas/sangue , Mordeduras e Picadas/microbiologia , Borrelia burgdorferi/imunologia , Brucella melitensis/imunologia , Humanos , Pessoa de Meia-Idade , Rickettsia conorii/imunologia , Fatores de Risco
9.
Phys Rev Lett ; 97(1): 015002, 2006 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-16907381

RESUMO

First experimental measurements are presented for the kink instability in a linear plasma column which is insulated from an axial boundary by finite sheath resistivity. An instability threshold below the classical Kruskal-Shafranov threshold, axially asymmetric mode structure, and rotation are observed. These are accurately reproduced by a recent kink theory, which includes axial plasma flow and one end of the plasma column that is free to move due to a non-line-tied boundary condition.

10.
Arch Gerontol Geriatr ; 40(1): 1-5, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15531018

RESUMO

Aging of the Italian population resulted in a net increase of the cardiovascular pathologies, and the correlated disabilities. In addition, the cardiovascular diseases represent actually in Italy the most frequent cause of death. With advancing age, both the heart and the blood vessels undergo numerous morphological and functional modifications, which are reducing the functional reserves of these organs. The present study looked for correlation between the cardiac functionality and the cognitive, as well as affective functions. Furthermore, we evaluated the functional variations of the autonomy and autosufficiency of the same patients. We had 171 enrolled subjects (108 women and 63 men), all above the age of 70 years. Based on the classification of the New York Heart Association (NYHA), 85 of these patients (35 men and 50 women) had a II class (Group A), and 86 of them (28 men and 58 women) a III NYHA class of heart function (Group B). We included only patients who did not have any cerebrovascular event yet, and were not bed-ridden. The psychometric performance has been evaluated by using the mini-mental state examination (MMSE), the geriatric depression scale (GDS), the activities of daily living (ADL) and the instrumental activities of daily living (IADL) scales. Cardiac functions have been measured by Doppler echocardiography, in M-mode. The Group A (of mean age 71 +/- 3 years) displayed ventricular ejection fraction (VEF) values in average of 43 +/- 4%, MMSE scores 27 +/- 2; GDS scores 14 +/- 3; IADL 6 +/- 1, and ADL = 6, i.e., maintained a complete autosufficiency. The Group B (mean age 74 +/- 4 years) displayed VEF values in average of 26 +/- 3%, MMSE scores 23 +/- 4; GDS scores 22 +/- 3; IADL 4 +/- 2, and ADL = 4 +/- 1, i.e., had a reduced autosufficiency. These results confirm that also the heart pays a toll for aging: the myocardial contractility becomes significantly altered, meaning the loss of cardiac functions itself. These morpho-functional heart alterations are accompanied by decreased psychometric performances during aging, with consequent reductions of cognitivity, affectivity, autosufficiency and autonomy, involving a complex decrease of the quality of life.


Assuntos
Afeto/fisiologia , Idoso/fisiologia , Idoso/psicologia , Envelhecimento/fisiologia , Cognição/fisiologia , Coração/fisiologia , Atividades Cotidianas , Feminino , Avaliação Geriátrica , Humanos , Masculino , Autonomia Pessoal , Psicometria , Autoeficácia
11.
Eur Rev Med Pharmacol Sci ; 8(2): 97-102, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15267123

RESUMO

The identification of risk factors for osteoporosis has been an essential step towards the understanding of the onset of the disease as well as of the osteoporosis-related fractures due to bone fragility. The present study has been aimed at assessing whether a correlation may exist between the increment in bone mass, consequent to an antiresorption therapy, and the reduction in the incidence of fractures. Moreover, the possibility that such a reduction might result from the action of other factors, such as the changes in bone microstructure, has been investigated. A total of 2,000 osteoporotic women (mean age: 68 +/- 9 years) were enrolled in the study and divided at random into 4 treatment groups. Each group received one of the following treatments: Alendronate 10 mg/daily (1,000 patients), Clodronate 100 mg/weekly i.m. (800 patients), Risedronate 5 mg/dailt (100 patients), and Raloxifene 60 mg/daily (100 patients). Clinical evaluation was based on bone mineral density (BMD) assay on lumbar vertebrae (L1-L4) by means of a DEXA (Lunar DPX) mineralometer, as well as on the incidence of fractures following both 12- and 24-month treatment periods. The results showed an overlapping pattern in patients treated with Alendronate or Risedronate, namely a significant increment in BMD after a 24-month treatment period, whereas such an increment in BMD was less evident in patients receiving either Clodronate or Risedronate after a 24-month treatment period. In addition, a total of 18 osteoporosis-related fractures were observed during the entire study period; 10 out of 18 fractures occurred in the Alendronate treated group, whereas the remaining 8 fractures were observed in the Clodronate treated group. Fourteen fractures were detected in patients over 80-year old, whereas the remaining 4 occurred in patients aged from 70 to 79 years and appeared to be independent of both the T-score assigned and the BMD increment obtained as a result of the therapy. Such findings suggest that the plain monitoring of BMD appears not to be adequate to anticipate clearly the danger of the probable onset of additional fractures, while the higher incidence of fractures in patients over 80-year old evidences that "old age" has to be considered the most serious risk factor for osteoporosis, since it is also the real responsible factor for changes taking place in bone microstructure.


Assuntos
Idoso/fisiologia , Reabsorção Óssea/tratamento farmacológico , Reabsorção Óssea/prevenção & controle , Ácido Etidrônico/análogos & derivados , Fraturas Ósseas/prevenção & controle , Osteoporose/tratamento farmacológico , Idoso de 80 Anos ou mais , Alendronato/administração & dosagem , Alendronato/farmacocinética , Alendronato/uso terapêutico , Densidade Óssea/efeitos dos fármacos , Reabsorção Óssea/diagnóstico , Cálcio/administração & dosagem , Cálcio/farmacocinética , Cálcio/uso terapêutico , Ácido Clodrônico/administração & dosagem , Ácido Clodrônico/farmacocinética , Ácido Clodrônico/uso terapêutico , Esquema de Medicação , Ácido Etidrônico/administração & dosagem , Ácido Etidrônico/farmacocinética , Ácido Etidrônico/uso terapêutico , Feminino , Fraturas Ósseas/complicações , Fraturas Ósseas/tratamento farmacológico , Humanos , Osteoporose/complicações , Osteoporose/diagnóstico , Cloridrato de Raloxifeno/administração & dosagem , Cloridrato de Raloxifeno/farmacocinética , Cloridrato de Raloxifeno/uso terapêutico , Ácido Risedrônico , Fatores de Tempo , Vitamina D/administração & dosagem , Vitamina D/farmacocinética , Vitamina D/uso terapêutico
12.
Arch Gerontol Geriatr Suppl ; (9): 271-7, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15207424

RESUMO

The role of the free radicals in aging has been in center of research for long years. It is assumed that with advancing age, damaging effects of oxygen free radicals might be accumulated in the organisms on all components, especially on the DNA and the mitochondria. In addition, because of the decreased efficiency of the antioxidant systems, the oxidative mechanisms prevail in numerous age-dependent diseases, such as the arterio -sclerosis, Parkinson and Alzheimer diseases. The present study was aimed at revealing an eventual correlation between the free radical levels and the psychophysical health state of an ultraoctagenarian East-Sicilian population living in institutes or at home. Our study population consisted of 125 ultraoctagenarian subjects, 62 of them were institutionalized and 63 living outside the institutes. The free radical effects were measured by using the free radical analytical system (FRAS) assessing the derivatives of reactive oxygen metabolites(D-ROMs). The results are expressed in units of Caratelli (U-CARR). The psycho-physical state of the subjects was estimated by means of the mini mental state examination(MMSE), geriatric depression scale (GDS), activities of daily living (ADL) and instrumental activities of daily living (IADL). The nutritional state and the physical activity of the subjects were evaluated through the mini nutritional assessment (MNA) and the physical performance test (PPT). All studied parameters underwent a correlation analysis of Pearson. Statistically significant negative correlation was found between the free radical levels and the cognitive performance (p < 0.0001), as well as the levels of autonomy and autosufficiency,the physical activity in the total population (p < 0.01). These correlations were even more expressed in the institutionalized subjects. Statistically significant positive correlation seems to exist between the free radical levels and the nutritional status (p < 0.001). These studies revealed some important differences between the institutionalized and noninstitutionalized population. The levels of oxygen free radicals were higher in the former group, indicating a stronger oxidative stress, influencing the psychophysical state of the elderly subjects. This may have negative consequences on the quality and duration of the life. It is difficult to define the exact role of free radicals in the determination of aging pattern,but they may be considered without any doubt as true "markers" of an enhanced oxidative stress, accompanying a non-successful aging process.


Assuntos
Envelhecimento/psicologia , Encéfalo/metabolismo , Demência/epidemiologia , Demência/metabolismo , Radicais Livres/metabolismo , Serviços de Assistência Domiciliar , Institucionalização , Estresse Oxidativo/fisiologia , Idoso , Idoso de 80 Anos ou mais , Área Programática de Saúde , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/reabilitação , Demência/diagnóstico , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Institucionalização/estatística & dados numéricos , Masculino , Testes Neuropsicológicos , Índice de Gravidade de Doença , Sicília/epidemiologia , Inquéritos e Questionários
13.
Arch Gerontol Geriatr ; 33(3): 265-71, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-15374023

RESUMO

This study was aimed at evaluating the correlation between bone mineral density (BMD) and the psychophysical health status in an elderly study population (62 subjects, mean age 84+/-5 years, 21 males and 41 females), institutionalized (Group A) in various structures of Pozzallo, a marine locality of the Ragusa Province in Sicily. BMD was measured by using ultrasonography of the calcanear area (T-score, Z-score, stiffness). The alterations of the cognitive and affective spheres as well as the levels of autonomy and autosufficiency were estimated by means of psychometric scales like mini-mental state examination (MMSE), geriatric depression scale (GDS), activities of daily living (ADL) and instrumental activities of daily living (IADL). Other biological, social and health-related factors, such as age, sex, body weight and height, nutritional and drug-taking habits, physical activity and previous pathologies, were also considered. These variables were compared to those obtained in a similar, but non-institutionalized controls (Group B) of 63 subjects (mean age 85+/-2 years, 27 males and 36 females), being similar in number and age distribution, frequenting the Geriatric Day Center of the same locality. Statistical analysis revealed significant differences between Groups A and B: the BMD was considerably lower, but also the cognitive and affective performances were strongly reduced in Group A. These findings can be attributed to decreased psychosensorial stimuli and lost interest of the patients in Group A, resulting in a lower physical activity, accompanying the depressive state, and may represent the first signs of a decreased intellectual performance, which can later be transformed into dementia. The functional abilities and the levels of autonomy are also reduced, risking the loss of autosufficiency. Also, the drug usage was different in Group A: more sedative-hypnotics and anticoagulants were consumed. As regards the polymorbidities, arterial hypertension and consequent chronic renal failure, hepatopathies and thyreopathies were most frequent, these latter two being more frequent in the Group A.

14.
Eur Rev Med Pharmacol Sci ; 5(4): 123-6, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-12067079

RESUMO

Twenty patients affected by fever of unknown origin (FUO), due to a likely infection of the muscular or skeletal tissues, were studied by a Total Body scan with a monoclonal antibody fragment (Leukoscan) labelled with Tc-99m. The diagnostic procedure helped reach a final diagnosis in 8 out of the 20 patients because it identified the focus of the infection of the muscles or bones in joint proximity. Our data show that Leukoscan deserves to become a first line diagnostic procedure in the diagnostic algorithm for the evaluation of patients with FUO.


Assuntos
Anticorpos Monoclonais , Febre de Causa Desconhecida/diagnóstico por imagem , Infecções/complicações , Doenças Musculoesqueléticas/diagnóstico por imagem , Compostos Radiofarmacêuticos , Idoso , Anticorpos Monoclonais Murinos , Feminino , Febre de Causa Desconhecida/etiologia , Humanos , Masculino , Doenças Musculoesqueléticas/etiologia , Cintilografia
15.
J Mol Graph Model ; 18(2): 153-62, 169-71, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10994519

RESUMO

Using the theoretical Ramachandran (phi, psi) maps reported in the literature for sucrose in vacuo and in aqueous solution, we constructed a two-degrees of freedom model in which the glucose and fructose units are substituted by pseudo-atoms. The complete dynamics of this model is studied numerically at fixed energies. Use is made of the graphic method of the Poincaré surfaces of section in phase space and of the Lissajous maps in configuration space. The reduction to just two degrees of freedom allows one to deal with all initial conditions in phase space, whereas the results of molecular dynamics calculations with all internal degrees of freedoms and with the explicit consideration of solvent molecules are taken into account via effective kinetic and potential energy terms. The conformational isomerization mechanism is investigated by singling out the most reactive trajectories in phase space that are associated with the so-called reactive islands and with the resonances found between the phi and psi motions.


Assuntos
Simulação por Computador , Glicosídeos/química , Glicosídeos/metabolismo , Sacarose/química , Sacarose/metabolismo , Configuração de Carboidratos , Isomerismo
16.
Chirality ; 12(4): 180-90, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10790188

RESUMO

Two theoretical models for the interpretation of the existing data of CH-stretching overtones' vibrational circular dichroism data are presented. The first model is based on the quantum mechanical Van Vleck contact transformation theory and is applied to the full vibrational problem, the second is based on classical trajectories calculations, by which we treat a simplified three-degrees of freedom Hamiltonian. The latter allows one to derive a qualitative but efficacious picture of the behavior of coupled anharmonic oscillators. In this framework, we analyze the Poincare Surfaces of Section, and calculate the Fourier Cross Spectra of coupled CH-stretchings. Values for the harmonic frequencies and anharmonicities are derived from absorption spectra in the near infrared on partially deuterated compounds. The effect of large amplitude, low-frequency puckering or twisting modes on the ensemble of coupled CH-stretching is taken into account. Copyright 2000 Wiley-Liss, Inc.

18.
Cad Saude Publica ; 15 Suppl 2: 15-28, 1999 Nov.
Artigo em Português | MEDLINE | ID: mdl-10578074

RESUMO

This paper analyzes the results of a follow-up study and evaluation of the Specialization Course in Public Health administered from 1993 to 1995 by the Department of Preventive and Social Medicine at the School of Medical Sciences, Universidade de Campinas, Brazil. The study was conducted during the course and with a follow-up several months later. Students reported on their professional activities, difficulties and facilities in performing them, and their commitment to the public health services in which they worked. They also expounded on their needs and expectations regarding specialized training in public health. At the end of the required course load (first semester) and the optional courses (second semester), students evaluated the course content's relevance, their own understanding, and the strengths and weaknesses of the respective teaching strategies. Finally, six and eight months after the courses, the professionals evaluated how they were able to apply their new knowledge to their work. Various research instruments were used, including group dynamics, individual questionnaires, and focal groups, comprising a broad methodological approach. A single sample of individuals was thus studied at different moments with regard to this experience.


Assuntos
Educação Médica Continuada , Educação de Pós-Graduação em Medicina , Saúde Pública/educação , Brasil , Currículo , Feminino , Grupos Focais , Seguimentos , Educação em Saúde , Serviços de Saúde/normas , Humanos , Masculino , Inquéritos e Questionários , Fatores de Tempo
19.
Wis Med J ; 94(4): 197-202, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-7785285
20.
Cad Saude Publica ; 10(4): 481-90, 1994 Dec.
Artigo em Português | MEDLINE | ID: mdl-14676934

RESUMO

This article describes a series of experiences in the area of Health Education. The experiences, carried out with groups of health professionals working in institutions, begin with the social relationships in which these professionals are involved in their day-to-day work, in contact with other social agents and groups. One of the basic assumptions is that social relationships are an important aspect of the public health services provided to the population. As a result, health workers need specific training in this area to develop and improve their professional performance. The experiences show the importance of making theoretical and methodological approaches (like Educational Psychodrama and the Arvoredo Method) available to these workers. Those who have participated in such training programs have considerably improved their professional/social skills. One of the basic tenets of these approaches is the constant search for autonomy, as an essential element for people to increase awareness of themselves as individuals and as citizens, be they health care professionals or users. The experiences and methods described in this article may serve as one way of reducing the serious gaps in today's public health services.

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