RESUMO Este artigo visou analisar os fatores protetores e estressores da pandemia na saúde mental... more RESUMO Este artigo visou analisar os fatores protetores e estressores da pandemia na saúde mental no Brasil e internacionalmente. Foi realizada uma revisão integrativa da literatura a partir da busca por publicações científicas indexadas nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Medical Literature Analysis and Retrieval Sistem on-line (Medline) no período de janeiro a dezembro de 2020. Foram analisados 29 artigos por autor, ano, país de estudo, metodologia; fatores estressores e protetores relacionados com a saúde mental. Conclui-se que pessoas que são submetidas às medidas restritivas impostas pelo período de pandemia da Covid-19 se mostram vulneráveis a problemas de saúde mental. Porém, apresar do impacto global, ainda são poucos os estudos que avaliaram os fatores psicossociais relacionados.
This paper aimed to analyze the mental health protective factors and stressors of the pandemic in... more This paper aimed to analyze the mental health protective factors and stressors of the pandemic in Brazil and internationally. We conducted an integrative literature review by searching for scientific publications indexed in the LILACS and MEDLINE databases from January to December 2020. Twentynine papers have been analyzed by author, year, country of study, methodology; mental health stressors and protective factors related. We concluded that people subjected to restrictive measures imposed by the COVID-19 pandemic are vulnerable to mental health problems. However, very few studies have evaluated the related psychosocial factors despite the global impact.
The Health Promotion practices of the basic attention teams in Brazil and macro-regions were anal... more The Health Promotion practices of the basic attention teams in Brazil and macro-regions were analyzed from the PMAQ-AB (2012). The variable frequency axes were studied: Services Reorientation; Community Actions; Healthy Environments; Personal Skills (n = 17,202 teams). The territorial approach is restricted to geographic aspects; the vulnerability of the "Bolsa Familia Program" beneficiaries; there is a predominance of clinical actions at school (buccal health); sexuality/reproduction education; environmental information were restricted. It is concluded that the practices are still fragmented and focused; an even integration of clinical care, prevention and health promotion shall be urged.
This article investigates how the approaches towards the harmful use of crack cocaine and other d... more This article investigates how the approaches towards the harmful use of crack cocaine and other drugs are conformed in Brazil and worldwide. A critical revision of the literature has been made regarding the pattern of consumption of crack cocaine and its related factors through a systematic search in scientific publications electronic data bases between 2010 and 2016. 37 articles have been analyzed by author, year, country of the study, and methodology; crack cocaine consumption pattern, individual and contextual factors related to this consumption. The conclusion was that the approach towards the use of drugs should be focused on damage reduction perspective, promotion of autonomy and human rights, and not on the utopia of eliminating consumption and drugs production.
Plano de disseminacao dos resultados de pesquisa . Plano de disseminacao pensado e adaptado pelo ... more Plano de disseminacao dos resultados de pesquisa . Plano de disseminacao pensado e adaptado pelo PMA para ajudar a equipe de pesquisa a pensar em maneiras de selecionar a informacao estrategica e refletir sobre as formas, conteudos e atividades pensando em processo de disseminacao dos resultados da pesquisa para diferentes publicos.
Rede de Pesquisa em Politicas Publicas, Modelos de Atencao e Gestao em Saude/Fiocruz. Vice-presid... more Rede de Pesquisa em Politicas Publicas, Modelos de Atencao e Gestao em Saude/Fiocruz. Vice-presidencia de Pesquisa e Colecoes Biologicas da Fiocruz
RESUMO O estudo objetivou analisar a produção de cuidados primários à saúde à população em situaç... more RESUMO O estudo objetivou analisar a produção de cuidados primários à saúde à população em situação de rua, prestados por equipes de Consultório na Rua (eCR) no contexto de uma metrópole brasileira, identificando potencialidades e dificuldades. Estudo de caso, de abordagem qualitativa, considerando o universo das sete equipes no ano 2016/2017, com observação direta do trabalho e realização de entrevistas semiestruturadas com profissionais de várias categorias (n=34), com análise temática de conteúdo. Observou-se que as eCR atuavam com escopo ampliado e integral de ações, cuidados clínicos e intersetoriais, nos espaços das ruas e nos serviços, em trabalho de equipe integrado. Organizavam-se com flexibilidade, baixa exigência, busca ativa nos territórios, de forma itinerante, no tempo oportuno, imediato, construção de planos terapêuticos compartilhados, que promoviam autonomia, baseados na redução de danos. Dificuldades eram inerentes às vulnerabilidades e complexidades dos casos, à f...
Resumo O Programa “De Braços Abertos” (DBA) é uma política pública de São Paulo que tem por objet... more Resumo O Programa “De Braços Abertos” (DBA) é uma política pública de São Paulo que tem por objetivo promover a reabilitação psicossocial de usuários de drogas em situação de vulnerabilidade social por meio da oferta de um pacote de direitos e de ações assistenciais. O DBA tem o diferencial de trabalhar de forma intersetorial, sendo uma inovação no campo das políticas públicas sobre drogas. Este trabalho é fruto da pesquisa de campo do doutorado em saúde pública da ENSP/Fiocruz. Foram realizadas entrevistas com gestores e profissionais do programa de vários setores. Utilizou-se a metodologia qualitativa, apresentando a sistematização das principais “fortalezas, fragilidades, desafios e sustentabilidade” do DBA. Os resultados principais foram a redução do uso prejudicial do crack; a inserção em trabalho e a melhoria do acesso ao cuidado em saúde. Os principais desafios seriam o aprimoramento das moradias e o avanço no trabalho apoiado para a reinserção social. Conclui-se que o DBA se...
Brazilian public policy on drugs has been permeated by two diametrically opposing approaches: one... more Brazilian public policy on drugs has been permeated by two diametrically opposing approaches: one focusing on prohibition and the other on non- prohibition. Similarly, there have been two opposing approaches to mental healthcare, one centered on hospitalization and the other psychosocial care and development. In the context of these different paradigms, this article presents an analysis of twenty-two documents sourced by the legislative rules over the last sixteen years. After the year 2000, a renewed focus by healthcare community on drugs was noticeable as was the immersion of a harm reducing approach. Following international trends, although there are still considerable divergencies between (a) psychosocial care and(b) residential care in the therapeutic communities there seems to be an alignment to anti- prohibition approaches.
The crack issue is a complex one, as there are several approaches around its debate, attemptingto... more The crack issue is a complex one, as there are several approaches around its debate, attemptingto find a solution. This thesis advocates that the crack focused drugs public policies (PPD) shallbe designed and implemented intersectorally, based on the harm reduction (RD). It has beenelaborated in the form of three articles aiming to: assess the crack and other drugs academicproduction in a national and international perspective; assess the PPD and the sociallyvulnerable crack users care models and; assess the potentialities, weaknesses and challenges ofthe With Open Arms (DBA) program from the Sao Paulo municipality. A quality drivenempirical research was carried out on the DBA program, where 34 semi structured interviewswere performed by managers, professionals and crack users during 2016. The results from thescientific literature pointed towards a crack usage closer to the compulsive pattern linked to thesocial vulnerability, and showed the relevance of the social and contextual factors associated tothe usage. The 2000 to 2016 legislation analysis about the PPD in Brazil has not identified aprogressive linear tendency towards the RD and psychosocial care model, although this issuewas predominant in the legislation. One could observe an alternation of public security andjustice reaffirming the war on drugs paradigm, and the approach of drugs as a public healthissue; still with the presence of the dispute between the different visions regarding the meansof tending the crack users. The empirical research verified the DBA as an innovative experienceon socially vulnerable crack users care. It has been observed progressively that the offering ofa rights package allowed vulnerable persons could chose a less harmful crack consumption,investing in self-care and aiming the social reinsertion, thus the RD was evidenced as the mostappropriate mean of approaching such users. Among the challenges pointed out, the progressivesustainability of this type of program is paramount; such experiences are required to becomepublic policies, being no longer government programs, but an Estate Policy. The DBAmanagement and operation were designed after an intersectorial fashion, an innovation in thedrugs field. Therefore, the conclusion is the those peoples in the harmful crack use in the usagescenarios, as the cracolandias, shall be prioritized by the different public policies,intersectorial, through a sound network, promoting the deconstruction of the drugs users stigma.Investments in PPD shall be made taking into account the freedom and human rights assuranceaiming the promotion of health, and not the utopian drug consumption eradication, as it hasbeen understood that the harmful user requires care, not jail.
RESUMO Este artigo visou analisar os fatores protetores e estressores da pandemia na saúde mental... more RESUMO Este artigo visou analisar os fatores protetores e estressores da pandemia na saúde mental no Brasil e internacionalmente. Foi realizada uma revisão integrativa da literatura a partir da busca por publicações científicas indexadas nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Medical Literature Analysis and Retrieval Sistem on-line (Medline) no período de janeiro a dezembro de 2020. Foram analisados 29 artigos por autor, ano, país de estudo, metodologia; fatores estressores e protetores relacionados com a saúde mental. Conclui-se que pessoas que são submetidas às medidas restritivas impostas pelo período de pandemia da Covid-19 se mostram vulneráveis a problemas de saúde mental. Porém, apresar do impacto global, ainda são poucos os estudos que avaliaram os fatores psicossociais relacionados.
This paper aimed to analyze the mental health protective factors and stressors of the pandemic in... more This paper aimed to analyze the mental health protective factors and stressors of the pandemic in Brazil and internationally. We conducted an integrative literature review by searching for scientific publications indexed in the LILACS and MEDLINE databases from January to December 2020. Twentynine papers have been analyzed by author, year, country of study, methodology; mental health stressors and protective factors related. We concluded that people subjected to restrictive measures imposed by the COVID-19 pandemic are vulnerable to mental health problems. However, very few studies have evaluated the related psychosocial factors despite the global impact.
The Health Promotion practices of the basic attention teams in Brazil and macro-regions were anal... more The Health Promotion practices of the basic attention teams in Brazil and macro-regions were analyzed from the PMAQ-AB (2012). The variable frequency axes were studied: Services Reorientation; Community Actions; Healthy Environments; Personal Skills (n = 17,202 teams). The territorial approach is restricted to geographic aspects; the vulnerability of the "Bolsa Familia Program" beneficiaries; there is a predominance of clinical actions at school (buccal health); sexuality/reproduction education; environmental information were restricted. It is concluded that the practices are still fragmented and focused; an even integration of clinical care, prevention and health promotion shall be urged.
This article investigates how the approaches towards the harmful use of crack cocaine and other d... more This article investigates how the approaches towards the harmful use of crack cocaine and other drugs are conformed in Brazil and worldwide. A critical revision of the literature has been made regarding the pattern of consumption of crack cocaine and its related factors through a systematic search in scientific publications electronic data bases between 2010 and 2016. 37 articles have been analyzed by author, year, country of the study, and methodology; crack cocaine consumption pattern, individual and contextual factors related to this consumption. The conclusion was that the approach towards the use of drugs should be focused on damage reduction perspective, promotion of autonomy and human rights, and not on the utopia of eliminating consumption and drugs production.
Plano de disseminacao dos resultados de pesquisa . Plano de disseminacao pensado e adaptado pelo ... more Plano de disseminacao dos resultados de pesquisa . Plano de disseminacao pensado e adaptado pelo PMA para ajudar a equipe de pesquisa a pensar em maneiras de selecionar a informacao estrategica e refletir sobre as formas, conteudos e atividades pensando em processo de disseminacao dos resultados da pesquisa para diferentes publicos.
Rede de Pesquisa em Politicas Publicas, Modelos de Atencao e Gestao em Saude/Fiocruz. Vice-presid... more Rede de Pesquisa em Politicas Publicas, Modelos de Atencao e Gestao em Saude/Fiocruz. Vice-presidencia de Pesquisa e Colecoes Biologicas da Fiocruz
RESUMO O estudo objetivou analisar a produção de cuidados primários à saúde à população em situaç... more RESUMO O estudo objetivou analisar a produção de cuidados primários à saúde à população em situação de rua, prestados por equipes de Consultório na Rua (eCR) no contexto de uma metrópole brasileira, identificando potencialidades e dificuldades. Estudo de caso, de abordagem qualitativa, considerando o universo das sete equipes no ano 2016/2017, com observação direta do trabalho e realização de entrevistas semiestruturadas com profissionais de várias categorias (n=34), com análise temática de conteúdo. Observou-se que as eCR atuavam com escopo ampliado e integral de ações, cuidados clínicos e intersetoriais, nos espaços das ruas e nos serviços, em trabalho de equipe integrado. Organizavam-se com flexibilidade, baixa exigência, busca ativa nos territórios, de forma itinerante, no tempo oportuno, imediato, construção de planos terapêuticos compartilhados, que promoviam autonomia, baseados na redução de danos. Dificuldades eram inerentes às vulnerabilidades e complexidades dos casos, à f...
Resumo O Programa “De Braços Abertos” (DBA) é uma política pública de São Paulo que tem por objet... more Resumo O Programa “De Braços Abertos” (DBA) é uma política pública de São Paulo que tem por objetivo promover a reabilitação psicossocial de usuários de drogas em situação de vulnerabilidade social por meio da oferta de um pacote de direitos e de ações assistenciais. O DBA tem o diferencial de trabalhar de forma intersetorial, sendo uma inovação no campo das políticas públicas sobre drogas. Este trabalho é fruto da pesquisa de campo do doutorado em saúde pública da ENSP/Fiocruz. Foram realizadas entrevistas com gestores e profissionais do programa de vários setores. Utilizou-se a metodologia qualitativa, apresentando a sistematização das principais “fortalezas, fragilidades, desafios e sustentabilidade” do DBA. Os resultados principais foram a redução do uso prejudicial do crack; a inserção em trabalho e a melhoria do acesso ao cuidado em saúde. Os principais desafios seriam o aprimoramento das moradias e o avanço no trabalho apoiado para a reinserção social. Conclui-se que o DBA se...
Brazilian public policy on drugs has been permeated by two diametrically opposing approaches: one... more Brazilian public policy on drugs has been permeated by two diametrically opposing approaches: one focusing on prohibition and the other on non- prohibition. Similarly, there have been two opposing approaches to mental healthcare, one centered on hospitalization and the other psychosocial care and development. In the context of these different paradigms, this article presents an analysis of twenty-two documents sourced by the legislative rules over the last sixteen years. After the year 2000, a renewed focus by healthcare community on drugs was noticeable as was the immersion of a harm reducing approach. Following international trends, although there are still considerable divergencies between (a) psychosocial care and(b) residential care in the therapeutic communities there seems to be an alignment to anti- prohibition approaches.
The crack issue is a complex one, as there are several approaches around its debate, attemptingto... more The crack issue is a complex one, as there are several approaches around its debate, attemptingto find a solution. This thesis advocates that the crack focused drugs public policies (PPD) shallbe designed and implemented intersectorally, based on the harm reduction (RD). It has beenelaborated in the form of three articles aiming to: assess the crack and other drugs academicproduction in a national and international perspective; assess the PPD and the sociallyvulnerable crack users care models and; assess the potentialities, weaknesses and challenges ofthe With Open Arms (DBA) program from the Sao Paulo municipality. A quality drivenempirical research was carried out on the DBA program, where 34 semi structured interviewswere performed by managers, professionals and crack users during 2016. The results from thescientific literature pointed towards a crack usage closer to the compulsive pattern linked to thesocial vulnerability, and showed the relevance of the social and contextual factors associated tothe usage. The 2000 to 2016 legislation analysis about the PPD in Brazil has not identified aprogressive linear tendency towards the RD and psychosocial care model, although this issuewas predominant in the legislation. One could observe an alternation of public security andjustice reaffirming the war on drugs paradigm, and the approach of drugs as a public healthissue; still with the presence of the dispute between the different visions regarding the meansof tending the crack users. The empirical research verified the DBA as an innovative experienceon socially vulnerable crack users care. It has been observed progressively that the offering ofa rights package allowed vulnerable persons could chose a less harmful crack consumption,investing in self-care and aiming the social reinsertion, thus the RD was evidenced as the mostappropriate mean of approaching such users. Among the challenges pointed out, the progressivesustainability of this type of program is paramount; such experiences are required to becomepublic policies, being no longer government programs, but an Estate Policy. The DBAmanagement and operation were designed after an intersectorial fashion, an innovation in thedrugs field. Therefore, the conclusion is the those peoples in the harmful crack use in the usagescenarios, as the cracolandias, shall be prioritized by the different public policies,intersectorial, through a sound network, promoting the deconstruction of the drugs users stigma.Investments in PPD shall be made taking into account the freedom and human rights assuranceaiming the promotion of health, and not the utopian drug consumption eradication, as it hasbeen understood that the harmful user requires care, not jail.
Globalization and Health Inequities in Latin America, 2018
his chapter systematizes and analyzes a model for working with primary healthcare (PHC) teams spe... more his chapter systematizes and analyzes a model for working with primary healthcare (PHC) teams specifically for homeless people in the municipality of Rio de Janeiro, a major metropolis in southeast Brazil. The chapter is organized as follows. The introduction reflects on the main theoretical references that underpin the workings of such teams, in Brazilian law called Consultório na Rua (CnaR) (literally “street clinic teams” or “homeless care teams,” although most of the care is provided at PHC facilities) and, in this chapter, the intervention under study. The specific context where these teams work in the municipal region is then outlined so as to frame the problem that justifies such an intervention as well as its expected outcomes. Next, the section “The case of the CnaR Teams in Rio de Janeiro” presents unpublished primary data from an evaluation study by health personnel with the Rio CnaR teams in 2016. This mode of service forms a strategy directed at the homeless population based on the principle of guaranteeing access to basic services, especially health services, and promoting comprehensive care. The importance of this study is indicated by how recently these teams have been introduced in Brazil and in Rio de Janeiro (about 5 years ago), the complexity and relevance of their work, directed as it is at such vulnerable groups, and the lack of evaluation studies of how the CnaR teams work in practice. The methodology used, strategic analysis, is directed at mapping problems, modeling interventions, and identifying key outcomes and the partnerships established.
A discussão da rede e apoio social é importante no campo da saúde pública e da gerontologia socia... more A discussão da rede e apoio social é importante no campo da saúde pública e da gerontologia social, tendo em vista que no processo de envelhecimento os vínculos sociais tendem a se fragilizar o que, por sua vez, impacta de modo negativo nas condições de vida e saúde dos idosos. Partindo da premissa de que o apoio social beneficia a saúde, esse artigo tem como principal objetivo aprofundar a discussão dos grupos de apoio social dos idosos como espaços promotores de saúde e que podem propiciar o empoderamento desses sujeitos. Esses grupos são espaços de convivência que fortalecem a auto-estima e permitem aos sujeitos obter um novo sentido e significado de vida, com conseqüente benefício à saúde física e mental. Dentro dessa abordagem, os grupos de apoio social apontam para outras formas de pensar o processo de saúde-doença e, podem ser entendidos como estratégia de empoderamento no campo do envelhecimento.
a coletânea desse Livro busca refletir sobre o acesso ao cuidado das pessoas em situação de rua e... more a coletânea desse Livro busca refletir sobre o acesso ao cuidado das pessoas em situação de rua e em uso prejudicial de crack. Traz diversas experiencias sobre Consultório na Rua em diferentes estados brasileiros.
Cartilha "Produzindo saúde nas ruas: o trabalho das equipes de Consultorio na Rua do municipio do... more Cartilha "Produzindo saúde nas ruas: o trabalho das equipes de Consultorio na Rua do municipio do Rio de Janeiro. Material produzido pelo nosso grupo de pesquisa da ENSP/Fiocruz. Disponivel online no Repositorio da Fiocruz: https://www.arca.fiocruz.br/handle/icict/26704
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Papers by Mirna Barros Teixeira
Material produzido pelo nosso grupo de pesquisa da ENSP/Fiocruz.
Disponivel online no Repositorio da Fiocruz: https://www.arca.fiocruz.br/handle/icict/26704