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Objetivo: conhecer as dificuldades elencadas pelos profissionais de saúde na assistência pré-natal às usuárias de substâncias psicoativas. Método: estudo qualitativo, exploratório-descritivo, realizado nas mídias sociais, com profissionais da área da saúde que realizam atendimento pré-natal. A coleta de dados ocorreu de novembro de 2022 a janeiro de 2023 por meio de questionário eletrônico. Os dados foram analisados por meio da análise temática. Protocolo aprovado pelo Comitê de Ética em Pesquisa. Resultados: os profissionais destacam o déficit de conhecimento para abordar este público em específico. A abordagem superficial e condenatória do uso de substâncias pelas políticas públicas corrobora para que os profissionais se sintam preparados em parte para atender essas gestantes. Considerações finais: a capacitação dos profissionais é necessária para superar práticas condenatórias e retrógradas de cuidado que focam unicamente a abstinência; como também, o investimento na capacitação acerca da rede de atenção à saúde, buscando ampliar sua visibilidade e utilização.

Objective: understanding the difficulties listed by health professionals in prenatal care for users of psychoactive substances. Method: this is a qualitative, exploratory-descriptive study carried out on social media with health professionals who provide prenatal care. Data was collected from November 2022 to January 2023 using an electronic questionnaire. The data was analyzed using thematic analysis. Protocol approved by the Research Ethics Committee. Results: the professionals highlight the lack of knowledge to deal with this specific public. The superficial and condemnatory approach to substance use by public policies contributes to making professionals feel partly prepared to deal with these pregnant women. Final considerations: the training of professionals is necessary to overcome condemnatory and retrograde care practices that focus solely on abstinence; and investment in training about the health care network, seeking to increase its visibility and use.

Objetivo: conocer las dificultades mencionadas por los profesionales de la salud en la atención prenatal de las consumidoras de sustancias psicoactivas. Método: estudio cualitativo, exploratorio-descriptivo, realizado en redes sociales, con profesionales de la salud que brindan atención prenatal. La recolección de datos se llevó a cabo de noviembre de 2022 a enero de 2023 a través de un cuestionario electrónico. Los datos se analizaron mediante análisis temático. El protocolo fue aprobado por el Comité de Ética en Investigación. Resultados: los profesionales destacan que les falta el conocimiento para atender a este público específico. El abordaje superficial y condenatorio del consumo de sustancias por parte de las políticas públicas contribuye a que los profesionales se sientan parcialmente preparados para atender a esas gestantes. Consideraciones finales: es necesario capacitar a los profesionales para superar las prácticas asistenciales condenatorias y retrógradas que se centran únicamente en evitar el consumo; e invertir en capacitación sobre la red de atención de salud, para ampliar su visibilidad y uso.

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Evaluating the access to and quality of healthcare services from the users' perspective is an important assessment process to identify priorities. This study assessed the profile of health service usage and the views of the Unified Health System (SUS) users about the access to and quality of SUS public health services. A cross-sectional study was conducted with participants from the Coastal Lowlands Region of the Rio de Janeiro State/Brazil, between August and November 2023. The association between categorical variables was analyzed using the Pearson Chi-Square test, using R software 4.3. A total of 200 individuals were interviewed using a 66-question survey instrument. Participants who reported using SUS services more frequently rated this system as essential (p-value = 0.031). However, overall, 64% of participants rated the quality of care to be very bad/bad and 34.9% rated access as very bad/bad. Access was considered poor by respondents who used public services rarely or sometimes (p-value = 0.002). In terms of accessing SUS services consultations provided by specialists (e.g., neurologists), these were available only in another municipality (p-value = 0.001). Many participants were SUS dependent for health services, and gaps and weaknesses were observed regarding users' perspectives of the access to and quality of SUS health care. Policymakers should prioritize evaluations and dialogue with the community to make SUS services responsive and to optimize value-for-money in health service planning.

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INTRODUCTION: Heated tobacco products (HTPs) are promoted as less harmful than cigarettes; nonetheless, whether HTPs help smokers quit is uncertain. METHODS: Data from 4067 Mexican adult smokers surveyed longitudinally every four months (November 2019-March 2021) were analyzed. Mixed-effects multinomial models regressed HTP use frequency (no use=reference; monthly; weekly; and daily use) on sociodemographics and tobacco/nicotine-related variables. Among participants who completed at least two surveys (n=2900) over four months, the duration of their longest smoking quit attempt (SQA) between surveys (SQAs: <30 days; ≥30 days; no SQA=reference) was regressed on HTP use frequency, and changes in the number of cigarettes smoked per day were regressed on HTP initiation between surveys, adjusting for covariates. RESULTS: Consistent predictors of all HTP use frequencies (monthly, weekly, or daily vs no use) were daily smoking >5 cigarettes (ARRR=1.69 [95% CI: 1.12-2.55], 1.88 [95% CI: 1.26-2.81] and 6.46 [95% CI: 3.33-12.52], respectively); e-cigarette use (ARRR =5.68 [95% CI: 3.38-9.53], 6.54 [95% CI: 4.06-10.55] and 2.59 [95% CI: 1.26-5.30]); lower HTP risk perceptions (ARRR=2.12 [95% CI: 1.50-30.00], 2.25 [95% CI: 1.63-3.10] and 2.00 [95% CI: 1.25-3.22]); exposure to HTP information inside (ARRR=2.13 [95% CI: 1.44-3.15], 2.13 [95% CI: 1.49-3.05] and 3.72 [95% CI: 2.28-6.09]) and outside stores (ARRR=2.36 [95% CI: 1.56-3.57], 2.32 [95% CI: 1.65-3.25] and 2.44 [95% CI: 1.41-4.24]) where tobacco is sold; having family (ARRR=2.46 [95% CI: 1.54-3.91], 2.90 [95% CI: 1.93-4.37] and 2.96 [95% CI: 1.52-5.77]) and friends (ARRR=5.78 [95% CI: 3.60-9.30], 4.98 [95% CI: 3.22-7.72] and 6.61 [95% CI: 2.91-15.01]) who use HTPs. HTP use frequency was not associated with quit attempts, except for monthly HTP use predicting SQAs lasting ≥30 days (ARRR=2.12 [95% CI: 1.17-3.85]). Initiation of HTP use was not associated with changes in smoking frequency. Limiting analysis to those who intend to quit smoking also yielded null results. CONCLUSIONS: Among Mexican adult smokers, frequency of HTP use was mostly not associated with either cessation behaviors or changes in cigarette consumption, suggesting that HTPs have limited to no effectiveness for smoking cessation.

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This database consists of the Peruvian media diet in a post-pandemic context. Specifically, it examines how Peruvians define and utilise media to create environments for information, learning, and entertainment. Since the pandemic, the relationship that users have developed with the media has intensified and changed, fostering new uses and interactions. However, our data demonstrates that the Peruvian public maintains a critical role towards mass media (broadcasting model) [1], which motivates them to seek out media and platforms that cater to their interests and expectations. In this regard, we compare three axes of analysis (information, education, and entertainment), taking socio demographic variables, to produce a baseline that is useful for specific research projects. Through a quantitative approach we explored the expectations, decisions, forms of interaction, and satisfactions that users obtain in their relationship with the media, offering new theoretical insights based on emerging data, such as the level of planning in content consumption or the role that traditional media play in different age and socioeconomic groups.

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Introdução: A utilização de cocaína é bastante associada ao surgimento de algumas manifestações sistêmicas e também de algumas alterações orais. Objetivo: Identificaras alterações sistêmicas e bucais mais comuns a pacientes usuários de cocaína. Metodologia: Trata-se de uma revisão sistemática da literatura, considerando artigos com texto completo, com restrição de idioma em Português ou Inglês e que tenham sido publicados entre os anos de 2017 a 2022. Usou-se as bases de dados LiLaCS, MedLine e BBO, por via portal Biblioteca Virtual de Saúde, e SciELO. Os artigos excluídosf oram aqueles que não apresentaram relação explícita do uso de cocaína com alguma manifestação sistêmica e/ou bucal. Resultados: Após o processo de triagem,10 artigos foram salvos para serem analisados e 111 foram descartados por não atenderem aos critérios de inclusão. Dos 10 artigosselecionados,40% deles (n=4) trouxeram informações identificando possíveis riscos de desenvolvimento de doenças cardiovasculares sofridas pelos usuários de cocaína, 10%(n=1) identificou problemas cognitivos associados ao uso da cocaína,30% dos artigos (n=3) mostrou as alterações bucais associadas à utilização abusiva de cocaína. Conclusões: Houve a predominância de algumas manifestações sistêmicas e bucais nos indivíduos usuários de cocaína, como doenças cardiovasculares, xerostomia, perfurações no palato, etc. A partir disso, há algumas alterações sistêmicas e bucais provocadas por esse uso. Mediante o risco considerável, faz-se necessário que o Cirurgião-Dentista se atualize sobre essas alterações em pacientes usuários de cocaína visando promover um trabalho transdisciplinare multiprofissional para atender adequadamente às suas necessidades (AU).

Introduction: The use of cocaine is closely associated with the appearance of some systemic manifestations and also some oral alterations.Objective: To identify the most common systemic and oral alterations in cocaine-using patients.Methodology:This is a systematic review of the literature, considering full-text articles, with a language restriction of "Portuguese" or "English" and published between 2017 and 2022. We used the LiLaCS, MedLine and BBO databases, via the Virtual Health Library (VHL) portal, and SciELO.The articles excluded were those that did not explicitly relate cocaine use to some systemic and/or oral manifestation.Results: After the screening process, 10 articles were saved for analysis and 111 were discarded because they did not meet the inclusion criteria. Of the 10 articles selected, 40% (n=4) provided information identifying possible risks of developing cardiovascular diseases suffered by cocaine users, 10% (n=1)identified cognitive problems associated with cocaine use, 30% of the articles (n=3) showed oral alterations associated with cocaine abuse.Conclusions: There has been a predominance of some systemic and oral manifestations in cocaine users, such as cardiovascular diseases, xerostomia, perforations in the palate, etc. Based on this, there are some systemic and oral alterations caused by this use. Given the considerable risk, it is necessary for dentists to be up-to-date on these alterations in cocaine-using patients in order to promote transdisciplinary and multi-professional work to adequately meet their needs (AU).

Introducción: El consumo de cocaína está estrechamente asociado a la aparición de algunas manifestaciones sistémicas y también de algunas alteraciones orales. Objetivo:Identificar las alteraciones sistémicas y bucales más frecuentes en los consumidores de cocaína. Metodología: Se trata de una revisión sistemática de la literatura, considerando artículos a texto completo, con restricción de idioma en "portugués" o "inglés" y publicados entre 2017 y 2022. Se utilizaron las bases de datos LiLaCS, MedLine y BBO, a través del portal Biblioteca Virtual en Salud (BVS) y SciELO. Los artículos excluidos fueron aquellos que no mostraban una relación explícita entre el consumo de cocaína y alguna manifestación sistémica y/o oral. Resultados: Tras el proceso de cribado, se guardaron10 artículos para el análisis y se descartaron 111 por no cumplir los criterios de inclusión. De los 10 artículos seleccionados, el 40% (n=4) proporcionaba información que identificaba posibles riesgos de desarrollar enfermedades cardiovasculares sufridaspor consumidores de cocaína, el 10% (n=1) identificaba problemas cognitivos asociados al consumo de cocaína, el 30% de los artículos (n=3) mostraban alteraciones orales asociadas al abuso de cocaína.Conclusiones:Ha habido un predominio de algunas manifestaciones sistémicas y orales en los consumidores de cocaína, como enfermedades cardiovasculares, xerostomía, perforaciones en el paladar, etc. De acuerdo con esto, existen algunas alteraciones sistémicas y orales causadas por este uso. Dado el considerable riesgo, es necesario que los odontólogos estén al día sobre estas alteraciones en los pacientes consumidores de cocaína, con el fin de promover el trabajo transdisciplinar y multiprofesional para atender adecuadamente sus necesidades (AU).

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Objetivos: Descrever as principais manifestações bucais associadas ao uso das drogas lícitas e ilícitas mais utilizadas atualmente, bem como os cuidados que devem ser tomados durante o atendimento odontológico desses pacientes. Revisão de literatura: Na revisão foi abordada a classificação das substâncias químicas, as principais manifestações orais e os cuidados que o cirurgião-dentista deve ter durante o atendimento odontológico. As substâncias descritas foram álcool, tabaco, benzodiazepínicos, maconha, anfetaminas e cocaína/crack. As complicações de saúde bucal associadas ao abuso de drogas podem resultar da exposição direta dos tecidos orais às drogas durante o fumo ou ingestão, da interação biológica das drogas com a fisiologia normal da cavidade oral e dos efeitos das drogas na função cerebral que resultam em um espectro de comportamentos de dependência, como comportamento de risco, falta de higiene e descuido. Considerações finais: O consumo de substâncias psicoativas, seja a curto ou longo prazo, pode desencadear consequências, tanto na saúde geral como na saúde bucal do usuário. Sob essa perspectiva, o cirurgião-dentista deve estar ciente das manifestações orais e sistêmicas causadas pelas substâncias psicoativas e estar capacitado para diagnosticar, tratar ou também encaminhar o usuário, se necessário, visando um cuidado integral e multiprofissional.

Objective: to describe the main oral manifestations associated with the use of the most commonly used licit and illicit drugs today, as well as the care that should be taken during the dental care of these patients. Literature review: The review covered the classification of chemical substances, the main oral manifestations and the care that dentist should take during dental care. The substances described were alcohol, tobacco, benzodiazepines, marijuana, amphetamines and cocaine/crack. Oral health complications associated with drug abuse can result from direct exposure of oral tissues to drugs during smoking or ingestion, from the biological interaction of drugs with the normal physiology of the oral cavity, and from the effects of drugs on brain function that result in a spectrum of addictive behaviors, such as risk behavior, poor hygiene and carelessness. Final considerations: The consumption of psychoactive substances, whether in the short or long term, can have consequences for both the general health and the oral health of the user. From this perspective, the dentist must be aware of the oral and systemic manifestations caused by psychoactive substances and be able to diagnose, treat or also refer the user, if necessary, aiming for comprehensive, multi-professional care.

RESUMO

Resumo O estudo teve como objetivo conhecer as dificuldades para o cuidado em saúde de pessoas que fazem uso problemático de drogas, dentro do contexto dos serviços especializados em saúde mental nacionais e internacionais. Trata-se de uma revisão integrativa realizada nas bases de dados PubMed, LILACS, Web of Science, Scopus e Embase, com os descritores: usuários de drogas; serviços de saúde mental; cuidado em saúde. Foram selecionados 18 estudos, sendo os critérios de inclusão: estudos primários, disponíveis na íntegra, publicados nos idiomas inglês, espanhol e português, no período de janeiro de 2016 a janeiro de 2021. A partir da análise, identificou-se que as dificuldades para o cuidado de saúde de pessoas que fazem uso problemático de drogas estão ligadas às dimensões das políticas públicas em saúde, aos modelos de cuidados adotados e aos atores envolvidos, e que tais pontos se relacionam. Ressalta-se, ainda, a necessidade de formação específica, bem como a condução de novas pesquisas que abordem, com profundidade, a terapêutica do uso problemático de drogas e a produção de novas tecnologias de cuidado em saúde para essa população.

Abstract The scope of this study was to understand the difficulties involving healthcare for people with a drug use problem within the context of specialized mental health services, both nationally and internationally. It involves an integrative review conducted in the PubMed, LILACS, Web of Science, SCOPUS, and EMBASE databases, with the following key words: Drug Users; Mental Health Services; Health Care. Eighteen studies were selected, the inclusion criteria being primary studies, available in full, published in English, Spanish and Portuguese, between January 2016 and January 2021. The inclusion criteria were primary studies, available in full, published in English, Spanish and Portuguese, during the period from January 2016 through January 2021. The analysis identified that the difficulties in healthcare for people with a drug use problem are linked to the dimensions of public health policies, models of care adopted, and the stakeholders involved, and that these aspects are interrelated. It also emphasizes the need for specialized training, as well as further in-depth research that addresses the therapeutics of the drug use problem, and the development of new healthcare technologies for this population group.

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Resumo O artigo apresenta os resultados obtidos em uma pesquisa bibliográfica que objetivou compreender aspectos bioéticos envolvidos no uso de psicodélicos com fins terapêuticos presentes nas publicações nacionais e internacionais acerca do tema. Pelo Portal Periódicos CAPES, a partir de critérios de inclusão/exclusão, foram selecionados 28 artigos, que foram analisados tomando como base premissas de escolas de bioética latino-americanas. Os resultados foram apresentados em três eixos de discussão, organizados a partir dos temas e princípios bioéticos: liberdade de investigação científica, que discute os entraves e suas implicações para a ciência psicodélica; consentimento, autonomia e respeito à vulnerabilidade, que discute segurança; e igualdade, justiça e equidade, que discute o acesso. Constata-se que questões bioéticas precisam ser levadas em conta de modo central, para que o uso de psicodélicos com fins terapêuticos seja acessível, produza benefícios e proteja potenciais pacientes e demais pessoas de eventuais danos.

Abstract The article presents the results obtained in a bibliographical research that aimed to understand bioethical aspects involved in the use of psychedelics for therapeutic purposes in national and international publications on the topic. Through the CAPES Periodicals Portal, based on inclusion/exclusion criteria, 28 articles were selected and analyzed based on premises from Latin American bioethics schools. The results were presented in three axes of discussion, organized in themes and bioethical principles: freedom of scientific investigation, which discusses the obstacles and their implications for psychedelic science; consent, autonomy and respect for vulnerability, which discusses security; and equality, justice and equity, which discusses access. It appears that bioethical issues need to be taken into account in a central way, so that the use of psychedelics for therapeutic purposes is accessible, produces benefits and protects potential patients and other individuals from possible harm.Resumo: O artigo apresenta os resultados obtidos em uma pesquisa bibliográfica que objetivou compreender aspectos bioéticos envolvidos no uso de psicodélicos com fins terapêuticos presentes nas publicações nacionais e internacionais acerca do tema. Pelo Portal Periódicos CAPES, a partir de critérios de inclusão/exclusão, foram selecionados 28 artigos, que foram analisados tomando como base premissas de escolas de bioética latino-americanas. Os resultados foram apresentados em três eixos de discussão, organizados a partir dos temas e princípios bioéticos: liberdade de investigação científica, que discute os entraves e suas implicações para a ciência psicodélica; consentimento, autonomia e respeito à vulnerabilidade, que discute segurança; e igualdade, justiça e equidade, que discute o acesso. Constata-se que questões bioéticas precisam ser levadas em conta de modo central, para que o uso de psicodélicos com fins terapêuticos seja acessível, produza benefícios e proteja potenciais pacientes e demais pessoas de eventuais danos.

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RESUMO Objetivo: Avaliar as potencialidades e desafios existentes no cuidado a usuários de substâncias psicoativas em uma Estratégia de Saúde da Família através da percepção dos profissionais. Método: Estudo de caso qualitativo, realizado por meio da Avaliação de Quarta Geração, desenvolvido em 2023, numa Estratégia de Saúde da Família de um município do Rio Grande do Sul, Brasil, com 19 profissionais. Foram utilizadas técnicas de etnografia prévia, entrevistas com aplicação do círculo hermenêutico-dialético, para análise dos dados utilizou-se o método comparativo constante. Resultados: ão potencialidades o comprometimento da equipe e matriciamento. Os desafios são as dificuldades dos vínculos com os usuários, os medos, os estigmas, os despreparos da equipe, a falta de estrutura física e profissionais. Conclusão: Este estudo contribuiu para o desvelamento dos desafios encontrados no cuidado à usuários de drogas e pretende fomentar um atendimento voltado para o acolhimento e integralidade do sujeito.

ABSTRACT Objective: To assess the potential and challenges in caring for users of psychoactive substances in a Family Health Strategy through the perception of professionals. Method: A qualitative case study was carried out using the Fourth Generation Evaluation, developed in 2023, in a Family Health Strategy in a municipality in Rio Grande do Sul, Brazil, with 19 professionals. Previous ethnographic techniques were used, interviews were conducted using the hermeneutic-dialectic circle, and the constant comparative method was used to analyze the data. Results: Team commitment and matrix support are potentialities. The challenges are difficulties establishing bonds with users, fears, and stigmas, the team's lack of preparation, and the lack of physical structure and professionals. Conclusion: This study has helped to uncover the challenges encountered in caring for drug users and aims to promote care that embraces and integrates the individual.

RESUMEN Objetivo: Evaluar las potencialidades y desafíos en la atención a usuarios de sustancias psicoactivas en una Estrategia de Salud Familiar a través de la percepción de los profesionales. Método: Estudio de caso cualitativo, realizado utilizando la Evaluación de Cuarta Generación, desarrollada en 2023, en una Estrategia de Salud Familiar en un municipio de Rio Grande do Sul, Brasil, con 19 profesionales. Se utilizaron técnicas etnográficas previas, así como entrevistas con la aplicación del círculo hermenéutico-dialéctico, y se empleó el método comparativo constante para analizar los datos. Resultados: El compromiso del equipo y el apoyo de la matriz son potencialidades. Los retos son las dificultades para establecer vínculos con los usuarios, los miedos, los estigmas, la falta de preparación por parte del equipo, la falta de estructura física y de profesionales. Conclusión: Este estudio ha contribuido a desvelar los retos a los que se enfrenta la atención a los consumidores de drogas y pretende promover una atención orientada a acoger e integrar al individuo.

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RESUMO: Objetivo: compreender o significado do fenômeno crise, as motivações e as expectativas dos trabalhadores no atendimento à pessoa em crise em um Centro de Atenção Psicossocial Álcool e Drogas (CAPSad). Método: pesquisa qualitativa, sob o referencial da fenomenologia social de Alfred Schutz, realizado com 14 trabalhadores no período de janeiro e fevereiro de 2022 no município de Porto Alegre, RS-BR. As entrevistas foram submetidas à análise fenomenológica. Resultados: a crise é relatada como um momento de sofrimento, com um potencial de transformação, que abrange aspectos subjetivos, sociais e familiares. O cuidado eficaz da pessoa em crise envolve o manejo verbal, o vínculo e o trabalho em equipe. As expectativas após o atendimento de uma pessoa em crise visam o bem-estar, a redução do sofrimento e a proteção do usuário. Conclusão: mostra-se essencial a ruptura do modelo biologicista na abordagem ao usuário com superação de estigmas e fortalecimento do cuidado integral.

ABSTRACT Objective: To understand the meaning of the crisis phenomenon and the motivations and expectations of workers in the care of people in crisis in a Psychosocial Care Center for Alcohol and Drugs (CAPSad). Method: qualitative research, based on Alfred Schutz's social phenomenology, was carried out with 14 workers in January and February 2022 in the municipality of Porto Alegre, RS, Brazil. The interviews were subjected to phenomenological analysis. Results: the crisis is reported as a time of suffering, with a potential for transformation, covering subjective, social, and family aspects. Effective crisis care involves verbal management, bonding, and teamwork. The expectations following the care of a person in crisis are aimed at the well-being, reduction of suffering, and protection of the user. Conclusion: It is essential to break away from the biological model in the approach to users, overcoming stigmas and strengthening comprehensive care.

RESUMEN: Objetivo: Comprender el significado del fenómeno de la crisis, las motivaciones y expectativas de los trabajadores en la atención a personas en crisis en un Centro de Atención Psicosocial de Alcohol y Drogas (CAPSad). Método: investigación cualitativa, basada en la fenomenología social de Alfred Schutz, realizada con 14 trabajadores en enero y febrero de 2022 en el municipio de Porto Alegre, RS-BR. Las entrevistas se sometieron a un análisis fenomenológico. Resultados: la crisis se describe como un momento de sufrimiento, con un potencial de transformación, que abarca aspectos subjetivos, sociales y familiares. Una atención eficaz en caso de crisis implica la gestión verbal, la vinculación y el trabajo en equipo. Las expectativas tras la atención a una persona en crisis tienen como objetivo el bienestar, la reducción del sufrimiento y la protección del usuario. Conclusión: es imprescindible romper con el modelo biologicista en el abordaje de los usuarios, superando estigmas y reforzando la atención integral.

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ABSTRACT Objective: to understand Singular Therapeutic Project actions, developed for users of psychoactive substances, in a Psychosocial Care Center, from professionals' and users' perspectives. Method: phenomenological qualitative research in light of Alfred Schütz's Social Phenomenology. It was carried out in a Psychosocial Care Center for Alcohol and Other Drugs in a municipality in the north of southern Brazil. Phenomenological interviews were used with 13 healthcare professionals and 13 service users between April and August 2023. A comprehensive analysis of information was based on the theoretical-methodological framework. Results: the Singular Therapeutic Project actions were identified from two perspectives (users and professionals) and the reciprocity of perspectives among participants, such as reception and return actions, individual care, collective therapeutic activities, pharmacological treatment and network and referral coordination. Conclusion: the actions are limited to Psychiatric Reform principles and medication care and are centered on professionals, pointing out the need to promote leading role, autonomy and co-responsibility for users.

RESUMEN Objetivo: comprender las acciones del Proyecto Terapéutico Singular, desarrollado para usuarios de sustancias psicoactivas, en un Centro de Atención Psicosocial, desde la perspectiva de profesionales y usuarios. Método: investigación cualitativa fenomenológica a la luz de la Fenomenología Social de Alfred Schütz. Se llevó a cabo en un Centro de Atención Psicosocial al Alcohol y Otras Drogas de un municipio de la región norte del sur de Brasil. Se utilizaron entrevistas fenomenológicas a 13 profesionales de la salud y 13 usuarios del servicio entre abril y agosto de 2023. El análisis integral de la información se basó en el marco teórico-metodológico. Resultados: las acciones del Proyecto Terapéutico Singular fueron identificadas desde dos perspectivas (usuarios y profesionales) y la reciprocidad de perspectivas entre los participantes, como acciones de acogida y retorno, atención individual, actividades terapéuticas colectivas, tratamiento farmacológico y coordinación de redes y derivaciones. Conclusión: las acciones se circunscriben a los principios de la Reforma Psiquiátrica y de la atención médica y se centran en los profesionales, señalando la necesidad de promover protagonismo, autonomía y corresponsabilidad del usuario.

RESUMO Objetivo: compreender as ações do Projeto Terapêutico Singular, desenvolvidas aos usuários de substâncias psicoativas, em um Centro de Atenção Psicossocial, nas perspectivas de profissionais e de usuários. Método: pesquisa qualitativa fenomenológica à luz da Fenomenologia Social de Alfred Schütz. Foi realizada em um Centro de Atenção Psicossocial Álcool e Outras Drogas em município da região norte do sul do Brasil. Utilizou-se entrevista fenomenológica com 13 profissionais de saúde e 13 usuários do serviço, entre abril e agosto de 2023. A análise compreensiva das informações foi pautada no referencial teórico-metodológico. Resultados: foram identificadas as ações do Projeto Terapêutico Singular em duas perspectivas (usuários e profissionais) e a reciprocidade de perspectivas entre os participantes, que foram: as ações de acolhimentos e retornos, atendimentos individuais, atividades terapêuticas coletivas, tratamento farmacológico e articulações de rede e de encaminhamentos. Conclusão: as ações se limitam nos princípios da Reforma Psiquiátrica e ao cuidado medicamentoso e estão centralizadas nos profissionais, apontando a necessidade de promover o protagonismo, a autonomia e a corresponsabilização ao usuário.

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Objetivo: Evaluar la efectividad de un programa para prevención de consumo de sustancias en estudiantes de una universidad pública en Cartagena, Colombia. Metodología: Diseño cuasiexperimental, sin grupo control. La muestra fue de 1098 estudiantes de primer semestre de los programas académicos la Universidad de Cartagena. Las edades variaron entre 16 y 27 años (la media es de 7,0; y la desviación estándar, 1,8), con un registro de 472 mujeres (56,9 %) y 358 hombres (43,1 %). El grupo, en su totalidad, recibió el programa psicoeducativo Construyendo Salud, que consta de diez sesiones, de dos horas semanales, que refuerza habilidades sociales, personales y afronta los efectos negativos de las diferentes sustancias, mitos y realidades. Las escalas mostraron adecuada consistencia interna: escala de actitud hacia el consumo, intención hacia el consumo, autoeficacia general, asertividad, enfado, funcionamiento familiar, ansiedad y autoestima. Se compararon puntuaciones antes y después de la intervención, se aplicó t de Student y se aceptaron valores de p 0,05), cocaína (5,1 vs. 7,1 %; p> 0,05) e inyectables (4,3 vs. 5,7 %; p> 0,05). Se mejoraron la autoestima (t= 2,29; gl = 824; p< 0,02), el control de emociones (t= 2,13; gl = 813; p< 0,03) y el manejo de ansiedad (t= 3,06; gl = 805; p< 0,01). Conclusión: El programa mostró efectividad en reducir el consumo de alcohol, contuvo el consumo de marihuana y cocaína, fortaleció la autoestima, el control emocional y la ansiedad. No presentó efectividad para prevenir el inicio o la intención del consumo de sustancias.

Objective: To assess the effectiveness of a program for the prevention of substance use among students at a public university in Cartagena, Colombia. Methodology: Quasi-experimental design, without a control group. The sample consisted of 1098 first-semester students of academic programs at Universidad de Cartagena. Their ages ranged from 16 to 27 years (mean 7.0, standard deviation 1.8), including 472 females (56.9%) and 358 males (43.1%). The entire group participated in the psychoeducational program Construyendo Salud [Building Health], which consists of ten two-hour sessions per week. This program strengthens social and personal skills, and discusses the negative effects of different substances, including myths and realities. The scales showed adequate internal consistency: attitude scale towards consumption, intention towards consumption, general self-efficacy, assertiveness, anger, family functioning, anxiety, and self-esteem. Scores before and after the intervention were compared; student's t-test was applied and p values 0.05), cocaine (5.1 vs. 7.1 %; p > 0.05) and injectables (4.3 vs. 5.7 %; p > 0.05). Self-esteem (t = 2.29; gl = 824; p < 0.02), emotional control (t = 2.13; gl = 813; p < 0.03) and anxiety management (t = 3.06; gl = 805; p < 0.01) improved. Conclusion: The program proved effective in reducing alcohol consumption, restraining marijuana and cocaine use, and strengthening self-esteem, emotional control, and anxiety. However, it was not effective in preventing the initiation or intention of substance use.

Objetivo: Avaliar a efetividade de um programa de prevenção do consumo de substâncias em estudantes de uma universidade pública em Cartagena, Colômbia. Metodologia: Design quase-experimental, sem grupo de controle. A amostra foi de 1098 estudantes de primeiro semestre dos programas acadêmicos da Universidade de Cartagena. As idades variaram entre 16 e 27 anos (a média é de 7,0 e o desvio-padrão de 1,8), com um registro de 472 mulheres (56,9%) e 358 homens (43,1%). O grupo em sua totalidade participou do programa psico-educativo Construyendo Salud, composto por dez sessões de duas horas semanais, que reforça habilidades sociais, pessoais e encara os efeitos negativos das diferentes substâncias, seus mitos e realidades. As escalas mostraram adequada consistência interna: escala de atitude perante o consumo, intenção perante o consumo, autoeficácia geral, assertividade, enfado, funcionamento familiar, ansiedade e autoestima. Foram comparadas as medições antes e depois da intervenção, aplicou-se t de Student e foram aceitos valores de p 0,05), cocaína (5,1 vs. 7,1%; p > 0,05) e injetáveis (4,3 vs. 5,7%; p > 0,05). Houve melhora na autoestima (t = 2,29; gl = 824; p < 0,02), o controle de emoções (t = 2,13; gl = 813; p < 0,03) e o manejo da ansiedade (t = 3,06; gl = 805; p < 0,01). Conclusão: O programa mostrou efetividade na redução do consumo de álcool, conteve o consumo de maconha e cocaína, fortaleceu a autoestima, o controle emocional e a ansiedade. Não apresentou efetividade na prevenção do início ou da intenção do consumo de substâncias.

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A acessibilidade das pessoas surdasno Sistema Único de Saúde ainda é precária devido às barreiras de comunicação. O objetivo do estudo foi analisar o acesso e o atendimento ofertado à comunidade surda nos serviços de saúde públicos, no município de Vitória da Conquista, Bahia, por meio de uma pesquisa qualitativa. Participaram oito profissionais de saúde e treze usuários surdos, cujos dados foram coletados com aplicação de um questionário e um roteiro de entrevista semiestruturada. Os resultados, com base na análise do conteúdo, apontaram que não há capacitação, as Unidades Básicas de Saúde não apresentam estratégias de acessibilidade nos atendimentos, têm rara comunicação em Libras e um número reduzido de intérpretes ­ o que dificulta a comunicação entre o profissional de saúde e o usuário surdo. A formação em Libras e a presença de um intérprete são apontadas como estratégias para um atendimento de qualidade às pessoas surdas

The accessibility of deaf people in the Unified Health System is still precarious due to communication barriers. The objective of the study was to analyze the access and care offered to the deaf community in public health services, in the city of Vitória da Conquista, Bahia, through qualitative research. Eight health professionals and thirteen deaf users took part in the research, whose data were collected using a questionnaire and a semi-structured interview script. Based on the content analysis, the results showed that there is no training, the Basic Health Units do not have accessibility strategies in care, rarely communicate in Libras and a have a small number of interpreters in their ranks ­ hindering the communication between health professional and deaf user. Training in Libras and the presence of an interpreter are identified as strategies for quality care for deaf people

La accesibilidad para los sordos en el Sistema Único de Salud todavía es precaria debido a las barreras de comunicación. El objetivo del estudio fue analizar el acceso y la atención ofrecida a este público en los servicios de salud públicos, en el municipio de Vitória da Conquista, Bahia, con una investigación cualitativa. Participaron ocho profesionales de la salud y trece usuarios sordos, cuyos datos fueron recolectados a través de cuestionario y guión de entrevista semiestructurada. Los resultados, basados en el análisis de contenido, mostraron que no hay capacitación, las Unidades Básicas de Salud no tienen estrategias de accesibilidad, y tienen poca comunicación en Libras y reducido número de intérpretes ­ lo que dificulta la comunicación entre el profesional de la salud y el usuario sordo. La formación en Libras y la presencia de un intérprete se identifican como estrategias para la atención de calidad a los sordos

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Introduction: There is sufficient evidence about the effectiveness of internet-based interventions; however, the users' level of adoption and utilization remains low, with this phenomenon requiring adequate explanation. Objective: The aim of this qualitative study was to explore the users' perceptions and experience of a web-based program (ASCENSO), designed to complement (usual) in-person depression treatment. Method: Twelve participants of the ASCENSO program, comprised of adult individuals (M = 44.3, SD = 13.4) of both genders (67% women) undergoing treatment for depression, were interviewed through semi-structured interviews. The data obtained from these interviews were analyzed utilizing a constructivist grounded theory approach. The interviews were transcribed and analyzed by trained coders. A constant comparative analysis of emergent themes was conducted. Results: These show that users employ and appreciate the program when their interaction with it emulates a "humanized relationship," that is, when the program is proactive in assisting users with their requests and when it responds in a pertinent and individualized manner to their emotional states and needs. Conclusions: Our findings highlight the challenges associated with the development of algorithms capable of attracting different potential users. These should be designed to generate a virtual relationship that emulates human interaction and targets the characteristics of each user, for example, considering the specific phenomenology of their health condition, their present emotional states, and perceived needs. Elements that will vary as mental symptomatology evolve.

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INTRODUCTION: The global motorcycle market has grown significantly, with over 770 million vehicles estimated to be in use worldwide. Motorcycle-related road traffic deaths in low and middle-income countries (LMICs) like Colombia are concerning, comprising 30% of all reported fatalities. Cartagena has an average of 70 motorcycle-related deaths annually between 2019 and 2022, making it a high-risk area for motorcyclists. OBJECTIVE: The study aimed to identify factors associated with motorcyclist safety at unsignalized three-legged and four-legged intersections in Cartagena by observing the behavior of the motorcyclists and the analysis of the potential traffic conflicts. The observational analysis focused on the access of motorcyclists from a secondary road to a main road since it is the behavior offered by the most significant road interaction and the potential risk of traffic conflicts due to crossing. METHODS: The observational process was consolidated at ten three-legged intersections and seven four-legged intersections. Thirty-six hours of videos were collected considering different time slots and weekdays randomly distributed during September 2019 and March 2020. The selection of the intersections included different vehicular flows and road safety conditions. The variables considered in the study were: interaction with other road users, motorcyclist behavior, vehicle handling, potential distractors, and safety elements. The study used the Swedish Traffic Conflict Technique to analyze conflict analysis, incorporating the Post Encroachment Time (PET) measurement. The analysis was developed with descriptive and inferential statistical techniques. The collected variables were analyzed individually (frequency analysis), and contrasts were conducted with the PET values. The study evaluated associations between motorcycles and other motorized road actors at intersections about behaviors and crossroads. RESULTS: In the Records, 10,281 motorcycle accesses at three and four-Legged Intersections were interactions with other road users, where 2417 and 1903 resulted in potential traffic conflicts, respectively. Average potential conflicts per hour were 115 and 127 at three and four-legged intersections. At the two intersections, the average PET values in motorcycles were between 2.09 and 2.10 s, while in the other motorized road users, it averaged around 2.67 to 2.71 s. In the road conditions, it was identified that intersections with a traffic flow of<10,000 vehicles/day and poor visibility to the left of the intersection lead to more unsafe conditions for motorcyclists. Motorcycle taxi drivers were the user group most frequently involved in traffic conflicts. Actions on the part of motorcyclists, such as risky behaviors, not using helmets, not using turn signals, and not waiting patiently for access, showed a relationship with the potential for traffic conflicts. Finally, turns to the left, particularly the indirect turn to the left on the opposite road, showed a greater risk of traffic conflicts. CONCLUSIONS: The study found that motorcycles exhibit more severe traffic conflicts than motorized vehicles at intersections. Infrastructure conditions significantly impact the risk of intersection conflicts. Individual behaviors such as not stopping at intersections and driving recklessly increased the risk of traffic conflicts. The study recommends improving infrastructure such as visibility and signaling and implementing separators to reduce travel speed and traffic conflicts for motorcycles.

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Objetivos. Comprender las experiencias de usuarios nuevos y continuadores de los Centros de Salud Mental Comunitaria (CSMC) de Lima y Callao, y de sus familiares, en relación a la atención en salud mental que recibieron durante la pandemia de la COVID-19. Materiales y métodos. Estudio cualitativo realizado entre septiembre del 2021 y febrero del 2022, en el que se entrevistó a 24 usuarios y familiares que interactuaron con los servicios brindados por tres CSMC de Lima y uno del Callao, durante la pandemia de la COVID-19. Se realizó un análisis temático de las entrevistas transcritas. Resultados. Los informantes percibieron que la pandemia exacerbó los síntomas de las personas con problemas de salud mental. Durante la pandemia, las atenciones de salud mental se apoyaron en el uso de tecnología, principalmente de llamadas telefónicas, las que sirvieron para monitorear el estado emocional y el tratamiento farmacológico de los usuarios, así como para programar y recordar citas. Los usuarios destacan que las llamadas telefónicas frecuentes les hicieron sentirse acompañados y resaltan el compromiso de los trabajadores de los CSMC. Como dificultades, reportan el incremento en la demanda de atención, problemas para acceder a videollamadas, y menor calidad en las atenciones virtuales. Conclusiones. La COVID-19 impactó emocionalmente a las personas con problemas de salud mental, a su vez, los servicios de los CSMC vieron afectada la modalidad (presencial o virtual), recursos, frecuencia, tiempo y calidad de la atención, encontrando limitaciones y beneficios en el uso de la tecnología.

Objective. To understand the experiences of new and continuing users of Community Mental Health Centers (CMHC) of Lima and Callao, and their relatives, regarding the mental health care they received during the COVID-19 pandemic. Materials and methods. Qualitative study conducted between September 2021 and February 2022, in which we interviewed 24 users and family members who interacted with the services provided by three CMHCs in Lima and one in Callao during the COVID-19 pandemic. We carried out a thematic analysis of the transcribed interviews. Results. Participants perceived that the pandemic exacerbated the symptoms of people with mental health problems. During the pandemic, mental health care relied on the use of technology, mainly telephone calls, which were used to monitor the emotional state and pharmacological treatment of users, as well as to schedule and remember appointments. The users emphasized that frequent telephone calls made them feel accompanied and highlighted the commitment of the CMHC workers. Among the difficulties, they reported an increase in the demand for care, problems in accessing video calls, and low quality in virtual care. Conclusions. COVID-19 had an emotional impact on people with mental health problems; in turn, CMHC services were affected by the type of care (face-to-face or virtual), resources, frequency, time and quality of care, finding limitations and benefits in the use of technology.

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Substance use disorders have significant consequences for patients and those around them. A qualitative systematic review was conducted to examine the effectiveness of religiosity and spirituality (R/S) interventions based on Judeo-Christian principles during the multidisciplinary treatment of patients with substance dependence disorder. Studies of patients of both sexes, at any age, of any nationality, and from any geographic location who were participating in treatment programs with religious elements explicitly tied to Christianity or Judaism were eligible for inclusion. Other religious interventions were excluded. Seven electronic databases were searched to identify eligible intervention studies published in English until August 2021. Two reviewers independently screened studies and extracted data. JBI tools were used to assess risk of bias. Of 146 articles retrieved for full text reading, five were ultimately included in this review published from July 2008 to August 2021. The R/S interventions used in the included studies were music therapy in a religious context, reading of the Bible or Torah, reflexive readings, personal prayer and reflection, and religiously integrated cognitive behavioral psychotherapy with or without a comparison group. Despite the broad search, there were found only a small number of studies and little homogeneity in the data of patients that reported positive impacts of treatments. Well-designed controlled studies are needed to truly investigate the efficacy of Judeo-Christian religious interventions for helping people with substance use problems, so as to strengthen the evidence of the benefits of these type of approaches in the treatment of drug addicts.

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Trauma disproportionately affects vulnerable road users, especially the elderly. We analyzed the spatial distribution of elderly pedestrians struck by vehicles in the urban area of Maringa city, from 2014 to 2018. Hotspots were obtained by kernel density estimation and wavelet analysis. The relationship between spatial relative risks (RR) of elderly run-overs and the built environment was assessed through Qualitative Comparative Analysis (QCA). Incidents were more frequent in the central and southeast regions of the city, where the RR was up to 2.58 times higher. The QCA test found a significant association between elderly pedestrian victims and the presence of traffic lights, medical centers/hospitals, roundabouts and schools. There is an association between higher risk of elderly pedestrians collisions and specific elements of built environments in Maringa, providing fundamental data to help guide public policies to improve urban mobility aimed at protecting vulnerable road users and planning an age-friendly city.

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Algunas situaciones ponen en riesgo a Cuba en cuanto al uso de drogas, entre ellas el aumento del turismo, las relaciones con países que poseen altas tasas de consumo, la ubicación geográfica en corredores de narcotraficantes y la alta prevalencia de drogas porteras. Al respecto, el Sistema Nacional de Salud debe estar preparado para la prevención del problema y la atención a los afectados, de manera que resulta necesario mantener una información actualizada sobre los factores de riesgo y los principales productos utilizados por los consumidores. En la presente revisión bibliográfica sobre el tema se busca llamar la atención de los trabajadores de la salud en tal sentido, se ofrecen datos sobre la magnitud del problema y se abordan elementos de sus antecedentes, así como de la clasificación de las drogas, los factores de riesgo asociados a su consumo y las bases jurídicas para su control en Cuba.

Some situations put Cuba at risk for drug use, such as an increase in tourism, relations with countries that have high rates of substance abuse, the geographic location in drug trafficking corridors, and the high prevalence of "opening doors" drugs. In this regard, the National Health System must be prepared to prevent the problem and care for those affected, so it is necessary to maintain updated information on risk factors and main products used by consumers. In the present literature review on the subject, it is sought to draw the attention of health workers to this point, data on the magnitude of the problem and elements of its background are offered, as well as drug classification, the risk factors associated with its use and the legal bases for its control in Cuba.

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Na história da humanidade, a loucura foi concebida de diversas formas. Atualmente a Reforma Psiquiátrica propõe a construção de um novo lugar social para a loucura, concebendo-a como sofrimento psíquico. Para compreender como os usuários de saúde mental a concebem, fizemos uma pesquisa com o objetivo de analisar como essas pessoas produzem sentidos sobre o sofrimento psíquico em vídeos de domínio público. Para desenvolver esta pesquisa, adotamos a perspectiva teórico-metodológica da proposta de estudo da produção de sentidos a partir da análise das práticas discursivas. Trata-se de uma investigação de natureza qualitativa, com caráter exploratório, para cujo desenvolvimento foi feito uma pesquisa documental. Foram utilizados os videodocumentários 'A loucura entre nós' e 'Estamira' e a Conferência 'I am not a monster: schizophrenia'. Nos relatos analisados, os usuários referenciaram o sofrimento psíquico recorrendo ao discurso da Psiquiatria e à utilização de medicamentos, no entanto, alguns se posicionaram contrariamente a esse saber.

In the history of humanity, madness has been conceived in different ways. Currently, the Psychiatric Reform proposes the construction of a new social place for madness, conceiving it as psychic suffering. In order to understand how mental health users conceive it, we carried out a research with the aim of analyzing how these people produce meanings about psychic suffering in videos in the public domain. In order to carry out this researchwe dopted the theoretical-methodological perspective of the study proposal of the production of meanings from the analysis of discursive practices. This is a qualitative investigation with an exploratory approach for which a research of documents was carried out. The video documentaries "Madness among us", "Estamira" and the Conference "I am a monster: schizophrenia" were used, however, some of the subjects referred to psychic suffering using the internment Psychiatry jargon, mentioning the use of medicines. However, some of them took a position against this practice. (AU)

En la historia de la humanidad, la locura se ha concebido de diferentes maneras. Actualmente, la Reforma Psiquiátrica propone la construcción de un nuevo lugar social para la locura, concibiéndola como sufrimiento psíquico. Realizamos una investigación con el objetivo de analizar cómo los usuarios de salud mental producen sentidos sobre el sufrimiento psíquico en videos de dominio público. Para ello, adoptamos laperspectiva teórico-metodológica de la propuesta deestudio dela producción de sentidos a partir del análisis de las prácticas discursivas. Se trata de una investigación cualitativo, con carácter exploratorio, para cuyo desarrollo se realizó una pesquisa documental. Se utilizaron los video documentales: "A loucura entre nós", "Estamira"y la Conferencia "I am not a monster: schizophrenia". En los relatos analizados, los usuarios se refirieron al sufrimiento psíquico recurriendo al discurso de la Psiquiatría y a la utilización de medicamentos. No obstante, algunos tomaron posición contraria a ese conocimiento. (AU)

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