Evaluation of Ongoing Participation of People with Schizophrenia in a Mutual Support Group as a Complementary Intervention to Outpatient Psychiatric Treatment.

This study aims to evaluate a group of people with schizophrenia undergoing outpatient treatment and who participate in a mutual support intervention, compared to another group of people with the same diagnosis, but attending only the usual outpatient treatment. This is a prospective study, with two measurements between six months. The mutual support group was initially composed of 16 people and the treatment as usual group was composed of 15 people. Clinical (medication adherence and functioning) and Recovery (hope, well-being, recovery and internalized stigma) outcomes were assessed. Nonparametric tests were used to verify differences in measurements between groups and between two moments. A higher level of internalized stigma and a decrease in the adherence to drug treatment in the treatment as usual group were verified. When comparing the pre-post difference between groups, there was a greater increase in adherence to drug treatment in the mutual support group. Our data point to more favorable results in the mutual support group, showing that ongoing participation in these groups is an important tool for the recovery process and for the treatment itself.

Interface entre regulação em saúde e equidade: revisão integrativa da literatura / Interface between healthcare regulation and equity: an integrative review of the literature* / Interrelación entre regulación en salud y equidad: revisión integrativa de la literatura

Este artigo tem por objetivo apresentar a interface entre a Regulação em Saúde e o princípio da equidade segundo a literatura científica da área de saúde, de 2008 a 2015. Trata-se de uma revisão integrativa da literatura, a partir de duas bases de dados, realizada em junho de 2016. Foram analisados 15 estudos que atenderam aos critérios de inclusão. A síntese do conhecimento foi feita por duas categorias de análise: 1) "Equidade e Acesso" e 2) "Reforma de sistemas de saúde". A Regulação em Saúde é compreendida como importante ferramenta para promoção da equidade. Os serviços de saúde devem priorizar o atendimento de usuários com maiores riscos, permitindo que todos tenham adequados níveis de saúde, a partir de ofertas de serviços distintos, segundo as necessidades individuais. Temas como equidade, acesso e financiamento foram pontos fortes considerados nos processos de reforma dos sistemas de saúde (AU).

This article aims to present the interface between Healthcare Regulation and the principle of equity, according to the scientific literature from the area of health, from 2008 to 2015. It is an integrative review of the literature, based on two databases, undertaken in June 2016. A total of 15 studies which met the inclusion criteria were analyzed. The knowledge was summarized in two categories of analysis: 1) "Equity and Access" and 2) "Reform of health systems". Healthcare Regulation is understood as an important instrument for promoting equity. The health services must prioritize the attendance of service users with greater risks, allowing all to have adequate levels of health, based on the offering of distinct services, according to individual needs. Issues such as equity, access and financing were strong points considered in the processes of reform of health systems (AU).

Artículo con el objetivo de presentar la interrelación entre la Legislación de Salud y el principio de equidad en el área de salud según la literatura científica, de 2008 a 2015. Revisión integrativa de la literatura, partiéndose de dos bases de datos, realizada en junio de 2016. Fueron analizados 15 estudios que atendieron los criterios de inclusión. La síntesis del conocimiento se ejecutó en dos categorías de análisis: 1) "Equidad y Acceso" y 2) "Reforma de sistemas de salud". La Legislación en Salud constituye una importante herramienta para la promoción de la equidad. Los servicios de salud deben priorizar la atención de usuarios con mayores riesgos, permitiendo que todos cuenten con niveles de salud adecuados, a partir de ofertas de servicios distintos, según las necesidades individuales. Temas como equidad, acceso y financiamiento fueron puntos fuertes considerados en los procesos de reforma de los sistemas de salud (AU).

The matrix approach to mental health care: Experiences in Florianopolis, Brazil.

This article reports on the experience of a matrix approach to mental health in primary health care. Professionals who work in the Family Health Support Nuclei, Núcleos de Apoio à Saúde da Família, pointed to challenges of this approach, especially regarding the difficulties of introducing pedagogic actions in the health field and problems related to work relationships. As the matrix approach and its practice are new aspects of the Brazilian Unified Health System, the academic knowledge must walk hand in hand with everyday professional practice to help improve the quality of the services offered in this context.

[Social representation of the community therapist in the Brazilian Unified Health System]. / Representação social do terapeuta comunitário na rede SUS.

The approval of the National Policy of Integrative and Complementary Practices fosters the provision of Community Therapy in the Brazilian Unified Health System (SUS). This initiative seeks to develop the necessary competencies to attend to the psychosocial demands in the professionals and the community leadership and to build support networks in order to extend the efficacy of Primary Health Care. This study aims to describe the social representation on the community therapist prepared by health care professionals employed at SUS. Semi-structured interviews were conducted with 27 professionals who were trained in Community Therapy in 2009 by the State Health Department of Santa Catarina in partnership with the Ministry of Health. Data analysis was carried out by descending hierarchical classification. The results revealed that there is a social representation among the professionals regarding what it signifies to be a community therapist, seen as someone who humanizes interpersonal relations in the health care sector. However, Primary Health Care professionals still subscribe to a less horizontalized group practice model than professionals working at the secondary level of care, represented in this study by the Psychosocial Care Centers (CAPS).

[Street social education: historical, political and pedagogical bases]. / Educação social de rua: bases históricas, políticas e pedagógicas.

This work is about street social education as a pedagogical system that started in Latin America in the late 1970s, as the street population formed mostly by children and adolescents called for attention. The first street social educators were 'pastoral' agents working at the praça da Sé a place with large numbers of street children in São Paulo. Based on the Liberation Theology and on the pedagogies developed by Paulo Freire, Celestine Freinet, Anton Makarenko, and Emília Ferreiro, the street educators developed a conceptual field and participated in the promulgation of the 1988 Federal Constitution, particularly by writing and introducing the 'Estatuto da Criança e do Adolescente' (the 'Child and Adolescent Statute'). Street social education is currently latent and suffering the consequences of program discontinuity caused by successive changes of government. It is, therefore important to know the conceptual proposals.

Stages of moral development among Brazilian dental students.

This research study aimed to evaluate the level of moral and ethical development of first-year students in a dental school. The students were presented with a dilemma that touched on personal and conflicting values. In responding to the questions posed, they had to present their criteria for judgments and norms that directly influence their behavior. Answers were then analyzed, leading to the categorization of interviewees into five stages of moral development according to Kohlberg's moral development system. The first, lowest stage in Kohlberg's system was reached by 11 percent of students. Most interviewees (47 percent) were in stage two, where individuals are conscious of their own conflicting interests, but an individualistic and instrumental set of morals tends to regulate those interests. Thirty percent of interviewees were identified with stage three, and 8.3 percent were found in stage four, whose main characteristic is the perception of self as a member of society, thus integrating interpersonal perspectives. Only one student reached stage five, in which the person recognizes universal rights and establishes a hierarchy of priorities. No individuals were found in stage six of moral development. The level of moral development found was low for students at this level, which may compromise the optimal moral development of the future dentist. The low level of moral development found may jeopardize the work of the future professionals, their treatment of patients, and society as a whole.