O artigo tem como objetivo identificar a produção normativa dos Legislativos Federal e do estado do Rio Grande do Sul sobre o processo de implementação da Atenção Primária à Saúde no sistema prisional. Trata-se de um estudo qualitativo do tipo exploratório e documental com dados secundários (leis, decretos, normas, resoluções, portarias), publicados entre 2003 a 2016. Evidencia-se que a partir da instituição da Política Nacional para Atenção Integral à Saúde das Pessoas Privadas de Liberdade no Sistema Prisional, inspirada na Política Estadual de Atenção Básica à Saúde no Sistema Prisional, passaram a vigorar os parâmetros e diretrizes que orientam o financiamento, gestão e fiscalização destes serviços, e as unidades de saúde prisionais passam a ser ponto de atenção da Rede de Atenção à Saúde, seguindo os princípios e diretrizes do Sistema Único de Saúde e da Política Nacional de Atenção Básica.
Resumo O trabalho analisa os limites e desafios para o acesso da população prisional feminina e egressa do sistema prisional nos serviços da Rede de Atenção à Saúde (RAS). Trata-se de estudo qualitativo, exploratório e descritivo realizado com dez trabalhadores de uma Equipe de Atenção Básica prisional de um presídio feminino na Região Sul do Brasil. Realizaram-se sessões de grupo focal e os dados foram analisados tematicamente, resultando em dois eixos: (a) Barreiras para inclusão das reclusas na RAS; e (b) Barreiras para inclusão das egressas na RAS. Apesar de a unidade básica de saúde prisional ser considerada a principal porta de entrada da população carcerária no sistema de saúde, ainda precisa ser organizada para tornar-se ordenadora do cuidado à saúde da mulher. As dificuldades para o acesso das egressas nos serviços de saúde extramuros contribuem para a descontinuidade do tratamento, haja vista a falta de acompanhamento desta população pelos componentes da RAS, especialmente pelos serviços de saúde mental. Faz-se necessário avançar na ampliação e otimização de serviços mais equitativas e integrais, estimulando a integração na gestão de fluxos entre a atenção básica prisional e os demais dispositivos da RAS.
Clerocidin (CL), a microbial diterpenoid, reacts with DNA via its epoxide group and stimulates DNA cleavage by type II DNA topoisomerases. The molecular basis of CL action is poorly understood. We establish by genetic means that CL targets DNA gyrase in the Gram-positive bacterium Streptococcus pneumoniae, and promotes gyrase-dependent single- and double-stranded DNA cleavage in vitro. CL-stimulated DNA breakage exhibited a strong preference for guanine preceding the scission site (−1 position). Mutagenesis of −1 guanines to A, C or T abrogated CL cleavage at a strong pBR322 site. Surprisingly, for double-strand breaks, scission on one strand consistently involved a modified (piperidine-labile) guanine and was not reversed by heat, salt or EDTA, whereas complementary strand scission occurred at a piperidine-stable −1 nt and was reversed by EDTA. CL did not induce cleavage by a mutant gyrase (GyrA G79A) identified here in CL-resistant pneumococci. Indeed, mutations at G79 and at the neighbouring S81 residue in the GyrA breakage-reunion domain discriminated poisoning by CL from that of antibacterial quinolones. The results suggest a novel mechanism of enzyme inhibition in which the −1 nt at the gyrase-DNA gate exhibit different CL reactivities to produce both irreversible and reversible DNA damage.
Pacientes de longa permanência em um hospital psiquiátrico no sul do Brasil ABSTRACT OBJECTIVE: To describe the demographic profile, social functioning, and quality of life of a population of long-stay care patients in a psychiatric hospital. METHODS:A study was carried out in Porto Alegre, Southern Brazil, in 2002. A total of 584 (96%) long-stay patients were assessed by means of the following instruments: the World Health Organization Quality of Life, the Social Behavior Schedule, the Independent Living Skills Survey, the Brief Psychiatric Rating Scale and another instrument for assessing disability (Questionnaire for Assessing Physical Disability). RESULTS:The average hospital stay was 26 years (SD: 15.8) and 46.6% of inpatients had no physical disability. Patients had their social functioning skills and autonomy largely impaired. Few of them (27.7%) answered the instrument for assessing quality of life, and showed significant impairments in all domains. The Brief Psychiatric Rating Scale evidenced a low prevalence of positive symptoms in this population. CONCLUSIONS:The institutionalized population studied presented significantly impaired social functioning, autonomy, and quality of life. These aspects need to be taken into consideration while planning for their deinstitutionalization. KEYWORDS
Autonomia de pacientes em internação prolongada em hospital psiquiátrico ABSTRACT OBJECTIVE:To assess personal autonomy of long-stay psychiatric inpatients, to identify those patients who could be discharged and to evaluate the impact of sociodemographic variables, social functioning, and physical disabilities on their autonomy was also assessed. METHODS:A total of 584 long-stay individuals of a psychiatric hospital (96% of the hospital population) in Southern Brazil was assessed between July and August 2002. The following instruments, adapted to the Brazilian reality, were used: independent living skills survey, social behavioral schedule, and questionnaire for assessing physical disability. RESULTS:Patients showed severe impairment of their personal autonomy, especially concerning money management, work-related skills and leisure, food preparation, and use of transportation. Autonomy deterioration was associated with length of stay (OR=1.02), greater physical disability (OR=1.54; p=0.01), and male gender (OR=3.11; p<0.001). The risk estimate of autonomy deterioration was 23 times greater among those individuals with severe impairment of social functioning (95% CI: 10.67-49.24). CONCLUSIONS:In-patients studied showed serious impairment of autonomy. While planning these patients' discharge their deficits should be taken into consideration. Assessment of patients' ability to function and to be autonomous helps in identifying their needs for care and to evaluate their actual possibilities of social reinsertion. KEYWORDS
RESUMO:Este artigo relata os resultados de pesquisa-ação pautada na Política de Saúde Integral da População Negra, realizada com o objetivo de instrumentalizar trabalhadores de um serviço de saúde de atenção básica da Secretaria Municipal de Saúde de Porto Alegre. Existem poucos estudos acerca dessa Política, que ainda é um importante meio de afirmação da inclusão social e enfrentamento à discriminação. Ao colaborar com a qualificação dos processos de trabalho de equipe de serviço de saúde, a pesquisa se propôs a auxiliar na operacionalização dos trabalhos do SUS e contribuir para uma sociedade mais igualitária e equânime, onde os sujeitos tenham seus direitos garantidos. PALAVRAS-CHAVE:SUS; Política de saúde da população negra; Etnia; Atenção básica em saúde; Pesquisa-ação. ABSTRACT: This article reports the results of an action research based on the Integral Health Policy of the Black Population conducted with the aim of providing knowledge to basic health
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