Resumo Introdução Colocar a prática em palavras é tarefa árdua para terapeutas ocupacionais, considerando os aspectos narrativos da prática nas relações complexas e multifacetadas entre seres humanos e sociedade. A linguagem favorece a nomeação e a conceituação daquilo que se faz e abre esse espaço de compreensão e aprofundamento do conhecimento. Objetivo Discutir a necessidade de conceituação de termos para melhor delinear a prática profissional. Método Uma pesquisa-ação participativa, organizada como comunidade de prática para o desenvolvimento do raciocínio clínico, com participação de terapeutas ocupacionais iniciantes e experientes, teve seus dados analisados tematicamente, explicitando a construção de sentidos sobre a assistência em terapia ocupacional em saúde mental (especificidades práticas, teóricas e conceituais), à luz do Método Terapia Ocupacional Dinâmica. Resultados A reflexão sobre a prática compartilhada favoreceu a identificação de dilemas em torno de narrativas sobre a atividade terapêutica e, na medida em que foi ganhando clareza conceitual, favoreceu a valorização do contexto e das ações em terapia ocupacional. Conclusão Quando a prática é colocada como objeto de estudo, identificando-se enunciados capazes de representá-la, nosso campo profissional e de saber ganham clareza e possibilitam visibilidade a comunidades epistêmicas e de práticas mais críticas, delimitadas, coerentes, significativas e complexas.

Abstract Introduction Placing practice in words is an arduous task for occupational therapists by considering the narrative aspects of practice in the complex and multifaceted relationships between human beings and society. Language favors the naming and conceptualization of what is done and opens up space of understanding and deepening of knowledge. Objective To discuss the need to conceptualize terms to better delineate professional practice. Method A participatory action research, organized as a community of practice for the development of clinical reasoning, with the participation of novice and experienced occupational therapists, had its data analyzed thematically, highlighting the construction of meanings about care in occupational therapy in mental health (practical, theoretical and conceptual specificities), in the light of the Dynamic Occupational Therapy Method. Results The reflection on the shared practice favored the identification of dilemmas around the therapeutic activity and, as it gained conceptual clarity, favored the valuation of the context and the actions in occupational therapy. Conclusion When practice is placed as an object of study, identifying statements capable of representing it, our professional field of knowledge and practice gain clarity and provide visibility to practice and epistemic communities more critical, situated, coherent, meaningful and complex.

We conducted a cross-sectional, hospital-based study between January 2006-March 2008 to estimate the resistance of Mycobacterium tuberculosis to first-line drugs in patients with tuberculosis at a Brazilian hospital. We evaluated the performance of the [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide] (MTT) microplate assay compared with the Bactec-MGIT 960™ system for mycobacteria testing. The prevalence of resistance in M. tuberculosis was 6.7%. Multidrug-resistance [resistance to rifampicin (RMP) and isoniazid (INH)], INH-resistance and streptomycin (SM)-resistance accounted for 1%, 3.8% and 3.8% of all resistance, respectively, and all isolates were susceptible to ethambutol (EM). The resistance was primary in four cases and acquired in three cases and previous treatment was associated with resistance (p = 0.0129). Among the 119 M. tuberculosis isolates, complete concordance of the results for INH and EM was observed between the MTT microplate and Bactec-MGIT 960TM methods. The observed agreement for RMP was 99% (sensitivity: 90%) and 95.8% for SM (sensitivity 90.9%), lower than those for other drugs. The MTT colourimetric method is an accurate, simple and low-cost alternative in settings with limited resources.

Tuberculosis (TB) is a major concern in developing countries. In Brazil, few genotyping studies have been conducted to verify the number of IS6110 copies present in local prevalent strains of Mycobacterium tuberculosis, the distribution and clustering of strains. IS6110 DNA fingerprinting was performed on a sample of M. tuberculosis isolates from patients with AFB smear-positive pulmonary TB, at a hospital in Brazil. The IS6110 profiles were analyzed and compared to a M. tuberculosis database of the Houston Tuberculosis Initiative, Houston, US. Seventy-six fingerprints were obtained from 98 patients. All M. tuberculosis strains had an IS6110 copy number between 5-21 allowing for differentiation of the isolates. Human immunodeficiency virus infection was confirmed in nearly half the patients of whom data was available. Fifty-eight strains had unique patterns, while 17 strains were grouped in 7 clusters (2 to 6 strains). When compared to the HTI database, 6 strains matched isolates from El Paso, Ciudad de Juarez, Houston, and New York. Recently acquired infections were documented in 19% of cases. The community transmission of infection is intense, since some clustered strains were recovered during the four-year study period. The intercontinental dissemination of M. tuberculosis strains is suspected by demonstration of identical fingerprints in a distant country.