Análise SWOT no setor de vigilância epidemiológica do município de Teresópolis (RJ): relato de experiência realizada pelo PET-Saúde / SWOT analysis in the epidemiological surveillance sector in the municipality of Teresópolis (RJ): experience report carried out by PET-Saúde / Análisis SWOT en el sector de monitoreo epidemiológico en la ciudad de Teresópolis, Rio de Janeiro: informe de experiencia realizado por PET-Saúde

Frente ao trabalho administrativo do sistema de saúde pública pautado em métodos tradicionais, torna-se necessário a implementação de estratégias facilitadoras para o planejamento das ações em saúde. O diagnóstico situacional (DS) e a análise SWOT auxiliam no ordenamento do pensamento e na implementação de ações efetivas, assim minimizando os desafios que perpassam o campo de atuação. O objetivo deste estudo foi realizar um diagnóstico situacional do Serviço de Vigilância Epidemiológica do município de Teresópolis (RJ). Trata-se de um relato de experiência de estudantes e profissionais da saúde pertencentes ao Programa de Educação pelo Trabalho para Saúde (PET-Saúde) e inseridos no cenário da vigilância epidemiológica local. Para suporte teórico, realizou-se uma busca nas bases PubMed, Scholar Google e SciELO. Forças, fraquezas, oportunidades e ameaças foram observadas a partir do DS realizado, tanto de fatores referentes ao ambiente interno como de fatores externos, possibilitando recomendações para melhor atuação e avanço organizacional. A vivência no território viabilizou o planejamento de estratégias que, além de serem empregadas na divisão de vigilância epidemiológica, abrangessem os serviços de saúde externos, assim alcançando as fragilidades laborais e garantindo atitudes resolutas para o serviço de epidemiologia do munícipio. O PET-Saúde mostrou-se uma grande oportunidade para o pensar e agir em saúde. A partir da percepção dos estudantes e profissionais envolvidos, ações foram ponderadas tanto para os fatores intrínsecos, que podem ser executadas de maneira direta pela equipe, quanto para os fatores extrínsecos, que demandam medidas indiretas para serem resolvidas, sendo revertidas em ganho para a população.

Dealing with the administration work of the public health system based in traditional methods, the implementation of strategies to ease the plans of actions in health is needed. The situational diagnosis (SD) and the SWOT analysis support the alignment of ideas and the implementation of effective actions, thus minimizing the challenges that pervade this field of action. This study aims to carry out a situational diagnosis of the epidemiological surveillance service of the Teresopolis (RJ) municipality. This is an experience report of students and health professionals belonging to the Program of Education for the Health Work (PET-Saúde) and inserted in the scenario of local epidemiological surveillance. For theoretical support, a search was carried out in the bases PubMed, Scholar Google, and SciELO. Strengths, weaknesses, opportunities, and threats were observed from the SD carried out, both from factors related to the internal environment and from external factors, allowing recommendations for better performance and organizational advancement. Living in the territory made it possible to plan strategies that, in addition to being used in the epidemiological surveillance division, covered external health services, thus addressing labor weaknesses and guaranteeing resolute attitudes towards the municipality's epidemiology service. The PET-Saúde was a great opportunity for thinking and acting in health. From the perspectives of the involved students and professionals, actions were planned both aiming at the inner factors, which can be executed in a direct manner by the team, and at the external factors which demand indirect measurements to be resolved, which turn into gains for the population.

Frente al trabajo administrativo del sistema de salud pública pautado en métodos tradicionales, es necesario la implementación de estrategias y herramientas facilitadoras para la planificación de las acciones en salud. El diagnóstico situacional (DS) y el análisis SWOT auxilian en el ordenamiento del pensamiento y en la implementación de acciones resolutivas, minimizando así los desafíos que permean el campo de acción. El objetivo de este estudio es efectuar un diagnóstico situacional del servicio de Monitoreo Epidemiológico del municipio de Teresópolis, en Rio de Janeiro (Brasil). Este es un informe de experiencia de estudiantes y profesionales de la salud, pertenecientes al Programa de Educación por el Trabajo para la Salud (PET-Saúde), insertos en el escenario de monitoreo epidemiológico local. Para el marco teórico se realizó una búsqueda en las bases PubMed, Google Scholar y SciELO. A partir del DS realizado se observaron fortalezas, debilidades, oportunidades y amenazas, tanto de factores relacionados con el ambiente interno como de factores externos, lo que permitió hacer recomendaciones para un mejor desempeño y avance organizacional. Vivir en el territorio permitió planificar estrategias que, además de ser utilizadas en la división de monitoreo epidemiológico, cubrieron los servicios de salud externos, atendiendo así las debilidades laborales y garantizando actitudes resolutivas hacia el servicio de epidemiología del municipio. El PET-Saúde se mostró una gran oportunidad para pensar y actuar en salud. A partir de la percepción de los estudiantes y profesionales implicados en el diagnóstico situacional, se plantean acciones resolutivas, tanto para los factores intrínsecos que pueden ser ejecutados de forma directa por el equipo como para los factores extrínsecos que exigen medidas indirectas para ser resueltos, convirtiéndose en ganancias para la población.

Can mental practice adjunct in the recovery of motor function in the upper limbs after stroke? A systematic review and meta-analysis.

BACKGROUND: Studies indicate that mental practice can be an adjuvant rehabilitation, improving motor functions. AIM: To synthesize the evidence on the intervention with the mental practice for the rehabilitation of the upper limb after stroke in the context of a dependent task. METHODS: The review was registered on the PROSPERO with protocol number: CRD42020166624. We searched the PubMed, Medline, Embase, Central, PEDro, and Web of Science from randomized clinical trials from 1975 to 2022. A literature review was conducted with 13 studies that synthesized findings on mental practice such as adjuvant rehabilitation in the recovery of the upper limb after stroke based on Fugl-Meyer Assessment (FMA) Motor and action research arm test (ARAT) scores. RESULTS: The sample size was 232 were part of the intervention group and 180 of the control group. The findings no showed results in favor of mental practice after stroke accordingly to ARAT and FMA Motor scores (P > 0.05). CONCLUSION: Current evidence does not support the use of the mental practice to increase the recovery of the upper limb after stroke, although the evidence is conflicting for some aspects of the technique.

Open monitoring meditation alters the EEG gamma coherence in experts meditators: The expert practice exhibit greater right intra-hemispheric functional coupling.

AIM: This study investigated the differences in frontoparietal EEG gamma coherence between expert meditators (EM) and naïve meditators (NM). MATERIAL AND METHODS: This is a cross-sectional study with a sample of twenty-one healthy adults divided under two groups (experts meditators vs. naive-meditators), with analyzing the intra-hemispheric coherence of frontoparietal gamma oscillations by electroencephalography during the study steps: EEG resting-state 1, during the open presence meditation practice, and EEG resting-state 2. RESULTS: The findings demonstrated greater frontoparietal EEG coherence in gamma for experts meditators in the Fp1-P3, F4-P4, F8-P4 electrode pairs during rest 1 and rest 2 (p ≤ 0.0083). In addition, we evidenced differences in the frontoparietal EEG coherence for expert meditators in F4-P4, F8-P4 during the meditation (p ≤ 0.0083). CONCLUSION: Our results can support evidence that the connectivity of the right frontoparietal network acts as a biomarker of the enhanced Open monitoring meditation training.

Methylphenidate decreases the EEG mu power in the right primary motor cortex in healthy adults during motor imagery and execution.

This study investigated the effects of dopaminergic drugs on the EEG mu power during motor imagery, action observation, and execution. This is a double-blind, crossover study with a sample of 15 healthy adults under placebo vs. methylphenidate vs. risperidone conditions during motor imagery, action observation, and execution tasks. The participants had drug dosage adjustment based on body weight/dose (mg/kg). We also analyzed the mu band power by electroencephalography during the study steps. The main result is the interaction between the condition and task factors for the C3 and C4 electrodes, with decreasing EEG mu power in the methylphenidate when compared to risperidone (p ≤ 0.0083). Our results can indicate that the methylphenidate decreases the neurophysiological activity in the central cortical regions during the perceptual experience of tasks with or without body movement.

Dopaminergic drugs alter beta coherence during motor imagery and motor execution in healthy adults.

BACKGROUND: Motor Imagery (MI) represents the cognitive component of the movement and recruits dopaminergic systems. OBJECTIVE: To investigate the role of dopaminergic system through the action of methylphenidate and risperidone over beta coherence during execution, action observation and motor imagery. METHODS: Electroencephalography (EEG) data were recorded before and after the substance intake. For statistical analysis, a three-way ANOVA was used to identify changes in beta coherence induced by the group, task and the moment variables. Statistical significance was set at p≤0.007. RESULTS: We found a main effect for group for C3/CZ, and a main effect for task for CZ/C4 pairs of electrodes. Furthermore, significant differences were found in the post-drug administration between groups for C3/CZ pair of electrodes, and between task for C4/CZ pair of electrodes. CONCLUSION: The administration of methylphenidate and risperidone was able to produce electrocortical changes of the cortical central regions, even when featuring antagonistic effects on the dopaminergic pathways. Moreover, the execution task allowed beta-band modulation increase.

Dopaminergic drugs alter beta coherence during motor imagery and motor execution in healthy adults / Drogas dopaminérgicas alteram a coerência beta durante a imagética motora e a execução motora em adultos saudáveis

Abstract Background: Motor Imagery (MI) represents the cognitive component of the movement and recruits dopaminergic systems. Objective: To investigate the role of dopaminergic system through the action of methylphenidate and risperidone over beta coherence during execution, action observation and motor imagery. Methods: Electroencephalography (EEG) data were recorded before and after the substance intake. For statistical analysis, a three-way ANOVA was used to identify changes in beta coherence induced by the group, task and the moment variables. Statistical significance was set at p≤0.007. Results: We found a main effect for group for C3/CZ, and a main effect for task for CZ/C4 pairs of electrodes. Furthermore, significant differences were found in the post-drug administration between groups for C3/CZ pair of electrodes, and between task for C4/CZ pair of electrodes. Conclusion: The administration of methylphenidate and risperidone was able to produce electrocortical changes of the cortical central regions, even when featuring antagonistic effects on the dopaminergic pathways. Moreover, the execution task allowed beta-band modulation increase.

Resumo Introdução: A imagética motora (IM) representa o componente cognitivo do movimento e recruta os sistemas dopaminérgicos. Objetivo: Investigar o papel do sistema dopaminérgico por meio da ação do metilfenidato e da risperidona sobre a coerência em beta durante a execução, observação de ação e imagética motora. Métodos: Os dados de eletroencefalografia (EEG) foram registrados antes e depois da ingestão das substâncias. Para a análise estatística, uma ANOVA de três vias foi utilizada para identificar mudanças na coerência beta induzidas pelas variáveis grupo, tarefa e momento. A significância estatística foi estabelecida em p≤0,007. Resultados: Encontramos um efeito principal para o grupo C3/CZ e um efeito principal para a tarefa nos pares de eletrodos CZ/C4. Além disso, diferenças significativas foram encontradas após a administração da droga entre os grupos para o par de eletrodos C3/CZ e entre tarefa para o par de eletrodos C4/CZ. Conclusão: A administração de metilfenidato e risperidona foi capaz de produzir alterações eletrocorticais das regiões somatomotoras, mesmo apresentando efeitos antagônicos nas vias dopaminérgicas. Além disso, a tarefa de execução provocou maior modulação da banda beta.

How high level of anxiety in Panic Disorder can interfere in working memory? A computer simulation and electrophysiological investigation.

Panic disorder (PD) is characterized by repeated and unexpected attacks of intense anxiety, which are not restricted to a determined situation or circumstance. The coherence function has been used to investigate the communication among brain structures through the quantitative EEG (qEEG). The objective of this study is to analyze if there is a difference in frontoparietal gamma coherence (GC) between panic disorder patients (PDP) and healthy controls (HC) during the Visual oddball paradigm; and verify if high levels of anxiety (produced by a computer simulation) affect PDP's working memory. Nine PDP (9 female with average age of 48.8, SD: 11.16) and ten HC (1 male and 9 female with average age of 38.2, SD: 13.69) were enrolled in this study. The subjects performed the visual oddball paradigm simultaneously to the EEG record before and after the presentation of computer simulation (CS). A two-way ANOVA was applied to analyze the factors Group and the Moment for each pair of electrodes separately, and another one to analyze the reaction time variable. We verified a F3-P3 GC increased after the CS movie, demonstrating the left hemisphere participation during the anxiety processing. The greater GC in HC observed in the frontal and parietal areas (P3-Pz, F4-F8 and Fp2-F4) points to the participation of these areas with the expected behavior. The greater GC in PDP for F7-F3 and F4-P4 pairs of electrodes assumes that it produces a prejudicial "noise" during information processing, and can be associated to interference on the communication between frontal and parietal areas. This "noise" during information processing is related to PD symptoms, which should be better known in order to develop effective treatment strategies.

Alpha power oscillation in the frontal cortex under Bromazepam and Modafinil effects / Oscilações da potência alfa no córtex frontal sob influência do Bromazepam e Modafinil

ABSTRACTObjective Our aim was to investigate and compare the neuromodulatory effects of bromazepam (6 mg) and modafinil (200 mg) during a sensorimotor task analyzing the changes produced in the absolute alpha power.Method The sample was composed of 15 healthy individuals exposed to three experimental conditions: placebo, modafinil and bromazepam. EEG data were recorded before, during and after the execution of the task. A three-way ANOVA was applied, in order to compare the absolute alpha power among the factors: Group (control, bromazepam and modafinil) Condition (Pre and Post-drug ingestion) and Moment (pre and post-stimulus).Results Interaction was found between the group and condition factors for Fp1, F4 and F3. We observed a main effect of moment and condition for the Fp2, F8 and Fz electrodes.Conclusion We concluded that drugs may interfere in sensorimotor processes, such as in the performance of tasks carried out in an unpredictable scenario.

RESUMOObjetivo Investigar e comparar os efeitos neuromoduladores do bromazepam (6mg) e modafinil (200mg), durante a prática de uma tarefa sensoriomotora, analisando as modificações produzidas na potência absoluta de alfa.Método A amostra foi composta por 15 indivíduos saudáveis, expostos a três condições experimentais: Placebo, modafinil e bromazepam. Dados eletroencefalográficos foram registrados antes, durante e após a execução da tarefa motora. Um ANOVA three-way foi aplicado para comparar a potência absoluta de alfa nos fatores Grupo (controle, bromazepam e modafinil), Condição (Pré e Pós ingestão da droga) e Momento (Pré e Pós estimulo).Resultados Verificou-se interação entre os fatores grupo e condição para os eletrodos Fp1, F4 e F3. Observamos um efeito principal para momento e condição nos eletrodos Fp2, F8 e Fz.Conclusão Concluímos que as drogas, podem interferir em processos sensoriomotores, como no desempenho de tarefas executadas em um cenário imprevisível.

Alpha power oscillation in the frontal cortex under Bromazepam and Modafinil effects.

OBJECTIVE: Our aim was to investigate and compare the neuromodulatory effects of bromazepam (6 mg) and modafinil (200 mg) during a sensorimotor task analyzing the changes produced in the absolute alpha power. METHOD: The sample was composed of 15 healthy individuals exposed to three experimental conditions: placebo, modafinil and bromazepam. EEG data were recorded before, during and after the execution of the task. A three-way ANOVA was applied, in order to compare the absolute alpha power among the factors: Group (control, bromazepam and modafinil) Condition (Pre and Post-drug ingestion) and Moment (pre and post-stimulus). RESULTS: Interaction was found between the group and condition factors for Fp1, F4 and F3. We observed a main effect of moment and condition for the Fp2, F8 and Fz electrodes. CONCLUSION: We concluded that drugs may interfere in sensorimotor processes, such as in the performance of tasks carried out in an unpredictable scenario.

The effects of bromazepam over the central and frontal areas during a motor task: an EEG study.

The present study investigates the influence of bromazepam while executing a motor task. Specifically, we intend to analyze the changes in alpha absolute power under two experimental conditions, bromazepam and placebo. We also included analyses of theta and beta frequencies. We collected electroencephalographic data before, during, and after motor task execution. We used a Two Way ANOVA to investigate the condition (PL × Br6 mg) and moment (pre and post) variables for the following electrodes: Fp1, Fp2, F7, F3, Fz, F4, F8, C3, CZ and C4. We found a main effect for condition on the electrodes FP1, F7, F3, Fz, F4, C3 and CZ, for alpha and beta bands. For beta band we also found a main effect for condition on the electrodes Fp2, F8 and C4; for theta band we identified a main effect for condition on C3, Cz and C4 electrodes. This finding suggests that the motor task did not have any influence on the electrocortical activity in alpha, and that the existing modifications were a consequence due merely to the drug use. Despite its anxiolytic and sedative action, bromazepam did not show any significant changes when the individuals executed a finger extension motor task.

The effects of bromazepam over the central and frontal areas during a motor task: an EEG study / Os efeitos do bromazepam nas áreas corticais central e frontal durante execução de uma tarefa motora: um estudo de EEG

The present study investigates the influence of bromazepam while executing a motor task. Specifically, we intend to analyze the changes in alpha absolute power under two experimental conditions, bromazepam and placebo. We also included analyses of theta and beta frequencies. We collected electroencephalographic data before, during, and after motor task execution. We used a Two Way ANOVA to investigate the condition (PL × Br6 mg) and moment (pre and post) variables for the following electrodes: Fp1, Fp2, F7, F3, Fz, F4, F8, C3, CZ and C4. We found a main effect for condition on the electrodes FP1, F7, F3, Fz, F4, C3 and CZ, for alpha and beta bands. For beta band we also found a main effect for condition on the electrodes Fp2, F8 and C4; for theta band we identified a main effect for condition on C3, Cz and C4 electrodes. This finding suggests that the motor task did not have any influence on the electrocortical activity in alpha, and that the existing modifications were a consequence due merely to the drug use. Despite its anxiolytic and sedative action, bromazepam did not show any significant changes when the individuals executed a finger extension motor task.

O presente estudo investiga a influência do bromazepam durante a execução de uma tarefa motora. Especificamente, pretende-se analisar as mudanças na potência absoluta de alfa sob duas condições experimentais, bromazepam e placebo. Nós também incluímos as analises das frequências teta e beta. Foram coletados dados eletroencefalográficos antes, durante e depois da execução da tarefa motora. Usamos uma Anova de 2 fatores para investigar a condição (PL × Br6 mg) e variáveis no momento (pré e pós) para os seguintes eletrodos: Fp1, Fp2, F7, F3, Fz, F4, F8, C3, C4 e CZ. Encontramos um efeito principal para a condição e eletrodos FP1, F7, F3, Fz, F4, C3 e CZ para alfa e beta. Para beta também foi encontrado um efeito principal para condição nos eletrodos Fp2, F8 e C4; para theta nós identificamos um efeito principal para condition em C3, Cz e C4. Este achado sugere que a tarefa motora não tem qualquer influência sobre a atividade eletrocortical alfa e que as modificações existentes foram uma consequência devido o uso de drogas. Apesar de sua ação ansiolítica e sedativa, o bromazepam não apresentou mudança significativa quando os indivíduos executaram uma tarefa motora.

Contribuições da equipe multiprofissional de saúde no Programa Saúde da Família (PSF): uma atualização da literatura / Contributions of the multiprofessional health team in the Family Health Program (FHP): an update of the literature

Introdução: Ações de saúde realizadas em equipe promovem a formação de redes de relações e rompem visões individualistas, além de permitirem o estabelecimento do respeito, vínculo entre profissionais e uma abordagem resolutiva. Objetivos: Verificar a contribuição da equipe multiprofissional no PSF e discutir dificuldades apresentadas por essa interação. Material e Métodos: Pesquisa bibliográfica em português utilizando as bases de dados Scielo e Lilacs, cujosartigos relacionados compreendem o período entre 1997 e 2007. Resultados: A multidisciplinaridade mostrou-se benéfica, pois permite criar idéias que serão discutidas por diferentes visões, levando a crer que essa modalidade é útil para a atual condição de saúde no País. Contudo, essa inter-relação profissional é pouco alcançada. Conclusão: A multidisciplinaridade é capaz de gerar organização social e um desempenho profissional mais adequado. A inserção de novos profissionais nas equipes básicas ainda não é fundamentada pela literatura, o que demonstra carência de projetos neste âmbito.