Abstract This study aimed to describe potentially inappropriate medication (PIM) use according to the Beers criteria among older adults followed in a comprehensive medication management (CMM) service, the pharmacists´ interventions, and the clinical outcomes of PIM use. All older adults in a CMM service delivered in the Brazilian public primary care system were included in the study (n = 389). Two methodological approaches were developed: (I) cross-sectional - prevalence of PIM use and associated factors were identified (univariate analysis - Pearson’s chi-square; multivariate - logistic regression); (II) documental analysis of the negative clinical outcomes potentially associated with PIM use and pharmacists’ interventions. The prevalence of PIM use was 48.3%, and it was independently and positively associated with the use of ≥ 5 drugs. For 21.3% of PIMs, a potential negative clinical outcome was identified. The most common negative clinical outcome was hypotension (35.1% of the negative outcomes), fractures or diagnosis of osteoporosis (21.1%), and hypoglycemia (14.0%). For most of them (78.9%), an intervention was performed to mitigate harm or discontinue use. A high prevalence of PIM was detected and was associated with polypharmacy. A significant proportion of PIM showed potential negative clinical outcomes that were identified by clinical pharmacists, and the majority of pharmacists’ interventions aimed at its mitigation or deprescription. Overall, our findings reinforce the potential of CMM services for reducing PIM use and the occurrence of negative outcomes.

Abstract We evaluated the accuracy of radiomorphometric indices (RI) and fractal dimension (FD) for screening bone mineral density (BMD) in postmenopausal patients who had breast cancer and were using aromatase inhibitors (AI). The sample consisted of 40 participants. Digital panoramic radiography (DPR) and cone beam computed tomography (CBCT) were evaluated along with dual-energy X-ray absorptiometry (DXA), which is the gold standard for detecting low BMD. According to the T-scores of DXA, the subjects were assigned into two groups: with normal BMD and with low BMD (osteopenia and osteoporosis). The area under the curve (AUC), sensitivity, and specificity with their respective confidence intervals were determined for DPR and CBCT. For DPR indices, AUC ranged from 52.6 to 75.8%. The mandibular cortical width (MCW) had the highest AUC. For FD, the total trabecular index had the highest sensitivity, while the index anterior to the mental foramen (MF) had the highest specificity. In CBCT, the AUC ranged from 51.8 to 62.0%. The indices with the highest AUC were the molar (M) and anterior (A). The symphysis (S) index had the highest sensitivity and the posterior (P) index had the highest specificity. Sensitivity and specificity were adequate for the computed tomography index (Inferior; CTI [I]). Therefore, MCW, FD of the mandible angle, and total trabecular ROI in DPR and the CTI (I), M, P, and A indices in CBCT proved to be promising tools in distinguishing individuals with low BMD. Cutoff point for these indices could be a useful tool to investigate low BMD in postmenopausal women taking AI.

Abstract Pharmaceutical education should enable the development of competences for community pharmacy practice, which is an important field for the pharmacist workforce. The aim of this study was to evaluate the competences perceived by pharmacy interns from a Brazilian pharmacy school for community pharmacy practice. This study adopted a combined quantitative and qualitative approach. The study cohort included undergraduate students who undertook internships in community pharmacy in the final year of the pharmacy course. Students responded to an 11-item structured questionnaire according to a five-point Likert scale that included perceptions of their competences for community pharmacy practice. Among the 693 possible answers, 605 (87.3%) agreed that the course promoted the development of competences for professional practice in community pharmacy. Less than 70% of students perceived themselves as prepared to respond to symptoms and provide non-prescription medicines. Qualitative analysis of the comments revealed three themes: the need to improve patient information skills, improve practice as a member of a health care team, and improve dispensing according to legal requirements. These findings may support improvements in undergraduate pharmacy programs, such as the inclusion of experiential learning, active learning methods, interprofessional education, and development of clinical skills.

Abstract Introduction: Psoriatic arthritis (PsA) is a multifaceted inflammatory disease that can cause joint destruction and impair quality of life. The Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL) was the first disease-specific tool for determining the impact of the disease on the quality of life of people with PsA. Objectives: The primary objective was to develop and validate a Brazilian Portuguese version of the PsAQoL. Methods: The UK PsAQoL was translated into Brazilian Portuguese using two translation panels. This translation then checked for face validity and construct validity with new samples of patients. Finally, a test-retest validation study was conducted with 52 patients with PsA. The survey included the Nottingham Health Profile (NHP) as a comparator instrument. Results: Internal consistency and reproducibility were both excellent for the new adaptation (0.91 and 0.90 respectively Scores on the PsAQoL were found to correlate as expected with the comparator measure and the instrument was able to detect differences in score related to perceived severity of PsA, general health status and presence of a flare. Conclusions: The Brazilian PsAQoL was found easy to understand and complete and has excellent reliability and construct validity. The new measure will be a valuable new tool for use in routine PsA practice and clinical trials.

Resumo O objetivo deste artigo foi identificar o perfil dos usuários e a prescrição de medicamentos nos Centros de Atenção Psicossocial (CAPS) em uma região de Minas Gerais, Brasil. Foi realizado um estudo transversal em 11 CAPS de 5 diferentes modalidades. Dados sociodemográficos e informações sobre o uso de medicamentos foram obtidas por meio de entrevistas com os usuários, análise de prescrições e prontuários utilizando um formulário semiestruturado. O número médio de medicamentos prescritos por usuário dos CAPS foi de 3,38 (±1,76) e os valores foram 4,08 (±1,56), 3,54 (±1,64) e 2,00 (±1,66) para as modalidades de CAPS álcool e Drogas (CAPS ad), CAPS II e III e CAPS infantil, respectivamente. A classe terapêutica mais prescrita foi de antipsicóticos. Usuários que estavam na faixa etária economicamente ativa, frequentavam serviços de maior porte (24h) ou modalidade CAPS ad e relataram que já utilizaram os medicamentos de maneira inadequada, apresentaram maior prevalência de prescrições com 5 ou mais medicamentos. O uso de medicamentos nos CAPS diferiu segundo a modalidade do serviço, tendo sido observado um maior grau de utilização nos CAPS ad. As diferenças encontradas podem subsidiar a discussão de estratégias para a promoção do uso racional de medicamentos.

Abstract The scope of this article was to identify the profile of users and the prescription of drugs in the Psychosocial Care Centers (CAPS) in a region of Minas Gerais, Brazil. A cross-sectional study was conducted in 11 CAPS of 5 different modalities. Sociodemographic data and information about drug use were obtained through interviews with users and analysis of prescriptions and medical records, using a semi-structured questionnaire. The mean number of drugs prescribed per user in CAPS was 3.38 (± 1.76) and the amounts were 4.08 (± 1.56), 3.54 (± 1.64) and 2.00 (± 1.66) for CAPS Alcohol and Drugs (CAPS ad), CAPS II and III and CAPS for children (CAPSi), respectively. The most prescribed therapeutic class was antipsychotics, with emphasis on haloperidol. Users in the economically active age group attended larger units (24h) or the CAPS ad modality and reported that in the past they had used drugs inappropriately and had a higher prevalence of prescriptions containing 5 drugs or more. The profile of drug use in the CAPS differed according to the modality of the service, and a greater degree of utilization was observed in the CAPS ad units. The differences revealed may subsidize discussion of the strategies for promoting the rational use of drugs.

Resumo O objetivo deste artigo foi identificar o perfil dos usuários e a prescrição de medicamentos nos Centros de Atenção Psicossocial (CAPS) em uma região de Minas Gerais, Brasil. Foi realizado um estudo transversal em 11 CAPS de 5 diferentes modalidades. Dados sociodemográficos e informações sobre o uso de medicamentos foram obtidas por meio de entrevistas com os usuários, análise de prescrições e prontuários utilizando um formulário semiestruturado. O número médio de medicamentos prescritos por usuário dos CAPS foi de 3,38 (±1,76) e os valores foram 4,08 (±1,56), 3,54 (±1,64) e 2,00 (±1,66) para as modalidades de CAPS álcool e Drogas (CAPS ad), CAPS II e III e CAPS infantil, respectivamente. A classe terapêutica mais prescrita foi de antipsicóticos. Usuários que estavam na faixa etária economicamente ativa, frequentavam serviços de maior porte (24h) ou modalidade CAPS ad e relataram que já utilizaram os medicamentos de maneira inadequada, apresentaram maior prevalência de prescrições com 5 ou mais medicamentos. O uso de medicamentos nos CAPS diferiu segundo a modalidade do serviço, tendo sido observado um maior grau de utilização nos CAPS ad. As diferenças encontradas podem subsidiar a discussão de estratégias para a promoção do uso racional de medicamentos.

Abstract The scope of this article was to identify the profile of users and the prescription of drugs in the Psychosocial Care Centers (CAPS) in a region of Minas Gerais, Brazil. A cross-sectional study was conducted in 11 CAPS of 5 different modalities. Sociodemographic data and information about drug use were obtained through interviews with users and analysis of prescriptions and medical records, using a semi-structured questionnaire. The mean number of drugs prescribed per user in CAPS was 3.38 (± 1.76) and the amounts were 4.08 (± 1.56), 3.54 (± 1.64) and 2.00 (± 1.66) for CAPS Alcohol and Drugs (CAPS ad), CAPS II and III and CAPS for children (CAPSi), respectively. The most prescribed therapeutic class was antipsychotics, with emphasis on haloperidol. Users in the economically active age group attended larger units (24h) or the CAPS ad modality and reported that in the past they had used drugs inappropriately and had a higher prevalence of prescriptions containing 5 drugs or more. The profile of drug use in the CAPS differed according to the modality of the service, and a greater degree of utilization was observed in the CAPS ad units. The differences revealed may subsidize discussion of the strategies for promoting the rational use of drugs.

ABSTRACT BACKGROUND: Access to medicines is an important indicator of healthcare system quality and capacity to resolve problems. The healthcare system needs to ensure free access to medicines for elderly people, in order to provide greater effectiveness of disease control, thus reducing morbidity and mortality, and improving health and quality of life. OBJECTIVES: To analyze the frequency of free access to medication among older adults within primary care and determine the factors associated with free access. DESIGN AND SETTING: Cross-sectional study at two primary care units. METHODS: Free access was defined as provision of all medicines through pharmacies within the Brazilian National Health System and through the Brazilian program for free medicines in private pharmacies. We investigated the sociodemographic, clinical, functional and pharmacotherapeutic characteristics of older adults. Multivariate logistic regression was performed to identify factors associated with free access to medicines. RESULTS: This study included 227 older adults, among whom 91 (40.1%) had free full access to prescription drugs. A direct association with age ≤ 70 years and indirect associations with polypharmacy and multimorbidity (P < 0.05) were found. CONCLUSIONS: Age ≤ 70 years increases the likelihood of having free full access to medicines, and older adults with multimorbidity and polypharmacy use have a lower likelihood of access. Identification of factors associated with free access to medicines among elderly people provides elements to guide the Brazilian National Health System in implementing access improvement actions.

Resumo A satisfação dos usuários é um importante critério para avaliar a qualidade dos Centros de Atenção Psicossocial (CAPS). O objetivo foi avaliar a satisfação de usuários dos principais CAPS de uma região de Minas Gerais e seus fatores associados. Foi realizado um estudo transversal em 11 CAPS, os usuários foram entrevistados para aplicação da Escala de Avaliação da Satisfação dos Usuários com os Serviços de Saúde Mental e um formulário semi-estruturado com variáveis sociodemográficas e clínicas. Os usuários estavam satisfeitos com os CAPS, sobretudo quanto à competência dos profissionais, acolhida e ajuda recebida no serviço. Condições físicas e conforto do serviço obtiveram os menores escores na escala de avaliação de satisfação. Verificou-se que quase metade dos usuários não conhecia aspectos básicos de sua terapia medicamentosa, como o nome dos medicamentos em uso, e um terço relatou que já fez uso inadequado destes. Os usuários dos CAPS álcool e drogas ou de serviços de médio porte estavam mais satisfeitos que os dos CAPS saúde mental ou serviços com funcionamento 24h. Os usuários estão satisfeitos com o modelo de atenção praticado nos CAPS, embora detectada a necessidade de melhorias na estrutura física, mecanismos de participação e empoderamento dos usuários.

Abstract Patient satisfaction is an important criterion for assessing the quality of Brazilian mental health services at Psychosocial Care Centers (CAPS – from the Portuguese ‘Centro de Atenção Psicossocial’). The aim of this study was to evaluate the satisfaction of users at the main CAPS in a region of Minas Gerais state, Brazil, as well as associated factors. This was a cross-sectional study with 11 CAPS. Patients were interviewed using the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and a semi-structured questionnaire containing sociodemographic and clinical variables. The users were satisfied with the CAPS, particularly in terms of staff competence and the welcome received and care provided. The physical facilities and comfort at the centers obtained the lowest satisfaction scores on the scale. Almost half of the users were unfamiliar with basic aspects of their drug therapy, such as the name of medicines, and one-third reported inappropriate use of medications. Users of midsize CAPS and those providing treatment for alcohol and drug addiction were more satisfied than patients at mental health or 24-hour CAPS. Although this study identified a need for improvement in physical facilities, mechanisms of participation and patient empowerment, the users were satisfied with the CAPS care model.

Resumo A satisfação dos usuários é um importante critério para avaliar a qualidade dos Centros de Atenção Psicossocial (CAPS). O objetivo foi avaliar a satisfação de usuários dos principais CAPS de uma região de Minas Gerais e seus fatores associados. Foi realizado um estudo transversal em 11 CAPS, os usuários foram entrevistados para aplicação da Escala de Avaliação da Satisfação dos Usuários com os Serviços de Saúde Mental e um formulário semi-estruturado com variáveis sociodemográficas e clínicas. Os usuários estavam satisfeitos com os CAPS, sobretudo quanto à competência dos profissionais, acolhida e ajuda recebida no serviço. Condições físicas e conforto do serviço obtiveram os menores escores na escala de avaliação de satisfação. Verificou-se que quase metade dos usuários não conhecia aspectos básicos de sua terapia medicamentosa, como o nome dos medicamentos em uso, e um terço relatou que já fez uso inadequado destes. Os usuários dos CAPS álcool e drogas ou de serviços de médio porte estavam mais satisfeitos que os dos CAPS saúde mental ou serviços com funcionamento 24h. Os usuários estão satisfeitos com o modelo de atenção praticado nos CAPS, embora detectada a necessidade de melhorias na estrutura física, mecanismos de participação e empoderamento dos usuários.

Abstract Patient satisfaction is an important criterion for assessing the quality of Brazilian mental health services at Psychosocial Care Centers (CAPS – from the Portuguese ‘Centro de Atenção Psicossocial’). The aim of this study was to evaluate the satisfaction of users at the main CAPS in a region of Minas Gerais state, Brazil, as well as associated factors. This was a cross-sectional study with 11 CAPS. Patients were interviewed using the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and a semi-structured questionnaire containing sociodemographic and clinical variables. The users were satisfied with the CAPS, particularly in terms of staff competence and the welcome received and care provided. The physical facilities and comfort at the centers obtained the lowest satisfaction scores on the scale. Almost half of the users were unfamiliar with basic aspects of their drug therapy, such as the name of medicines, and one-third reported inappropriate use of medications. Users of midsize CAPS and those providing treatment for alcohol and drug addiction were more satisfied than patients at mental health or 24-hour CAPS. Although this study identified a need for improvement in physical facilities, mechanisms of participation and patient empowerment, the users were satisfied with the CAPS care model.

Resumo O estudo avaliou as condições da Assistência Farmacêutica (AF) nos Centros de Atenção Psicossocial (CAPS) por meio de um estudo transversal em 15 CAPS na região do Médio Paraopeba, Minas Gerais. A coleta de dados foi realizada por meio de observação direta dos CAPS e entrevistas com farmacêuticos e gestores da AF. Os instrumentos foram baseados em indicadores propostos pela OMS, documentos técnicos para organização da AF, na legislação e recomendações que visam as Boas Práticas Farmacêuticas. Foram identificadas 13 unidades de dispensação, sendo nove delas internas aos CAPS. Os serviços apresentaram listas de medicamentos essenciais atualizadas e alta disponibilidade dos principais utilizados nos tratamentos da saúde mental. Todas as cidades participavam de um consórcio intermunicipal para aquisição de medicamentos. A identificação completa dos medicamentos estava presente em apenas sete serviços e todos apresentaram falhas na rastreabilidade dos que foram dispensados. Nos CAPS há apenas um profissional farmacêutico em parte do período de funcionamento e foi identificada apenas uma atividade direcionada aos usuários relacionada ao uso de medicamentos em um dos CAPS. Verificou-se a necessidade de maior participação do farmacêutico no controle e padronização das atividades dos CAPS e principalmente nas atividades assistenciais compondo a equipe de referência em Saúde Mental.

Abstract The study evaluated the conditions of Pharmaceutical Assistance (PA) in Psychosocial Care Centers (CAPS) through a cross-sectional study in 15 CAPS located in the Médio Paraopeba region of the State of Minas Gerais. Data collection was conducted through direct observation of CAPS and interviews with pharmacists and managers of PA. The instruments were based on indicators proposed by the WHO, technical documents for the organization of PA, from legislation and recommendations seeking pharmaceutical Best Practices. There were 13 dispensing units, nine of them within the CAPS. The services presented updated lists of essential medicines with high availability of the main drugs used in mental health treatment. All of the cities participated in an inter-municipal consortium for the purchase of medicines. The complete identification of drugs was present in only seven services and all had failings in traceability of medicines dispensed. In the CAPS there is only one pharmacist during part of the operating period. The need for greater participation of the pharmacist was observed in the control and standardization of the activities of CAPS and especially in care activities comprising the benchmark team in Mental Health.

Resumo O estudo avaliou as condições da Assistência Farmacêutica (AF) nos Centros de Atenção Psicossocial (CAPS) por meio de um estudo transversal em 15 CAPS na região do Médio Paraopeba, Minas Gerais. A coleta de dados foi realizada por meio de observação direta dos CAPS e entrevistas com farmacêuticos e gestores da AF. Os instrumentos foram baseados em indicadores propostos pela OMS, documentos técnicos para organização da AF, na legislação e recomendações que visam as Boas Práticas Farmacêuticas. Foram identificadas 13 unidades de dispensação, sendo nove delas internas aos CAPS. Os serviços apresentaram listas de medicamentos essenciais atualizadas e alta disponibilidade dos principais utilizados nos tratamentos da saúde mental. Todas as cidades participavam de um consórcio intermunicipal para aquisição de medicamentos. A identificação completa dos medicamentos estava presente em apenas sete serviços e todos apresentaram falhas na rastreabilidade dos que foram dispensados. Nos CAPS há apenas um profissional farmacêutico em parte do período de funcionamento e foi identificada apenas uma atividade direcionada aos usuários relacionada ao uso de medicamentos em um dos CAPS. Verificou-se a necessidade de maior participação do farmacêutico no controle e padronização das atividades dos CAPS e principalmente nas atividades assistenciais compondo a equipe de referência em Saúde Mental.

Abstract The study evaluated the conditions of Pharmaceutical Assistance (PA) in Psychosocial Care Centers (CAPS) through a cross-sectional study in 15 CAPS located in the Médio Paraopeba region of the State of Minas Gerais. Data collection was conducted through direct observation of CAPS and interviews with pharmacists and managers of PA. The instruments were based on indicators proposed by the WHO, technical documents for the organization of PA, from legislation and recommendations seeking pharmaceutical Best Practices. There were 13 dispensing units, nine of them within the CAPS. The services presented updated lists of essential medicines with high availability of the main drugs used in mental health treatment. All of the cities participated in an inter-municipal consortium for the purchase of medicines. The complete identification of drugs was present in only seven services and all had failings in traceability of medicines dispensed. In the CAPS there is only one pharmacist during part of the operating period. The need for greater participation of the pharmacist was observed in the control and standardization of the activities of CAPS and especially in care activities comprising the benchmark team in Mental Health.

Resumo O objetivo deste estudo foi identificar as características associadas à qualidade de vida (QV) em usuários de quatro Unidades Básicas de Saúde (UBS) de Belo Horizonte, Minas Gerais. Delineou-se um estudo transversal com 930 usuários adultos e cadastrados nas UBS selecionadas. Utilizou-se o um questionário contendo o instrumento WHOQOL-bref e perguntas sobre características sociodemográficas, estilo de vida e condições de saúde. Após análise descritiva, realizou-se regressão linear simples e múltipla para avaliar a associação entre as variáveis de exposição e os domínios da QV. As maiores médias de QV foram observadas no domínio relações sociais. No domínio ambiente foram observadas as menores médias, com diferença estatisticamente significante entre algumas das UBS. As piores percepções de QV relacionaram-se com piores condições de saúde, habitação, educação e renda, além de problemas nas relações sociais e condições psicológicas. São necessários esforços para a melhoria da QV em usuários da Atenção Primária, por meio de ações promovidas tanto por profissionais de saúde quanto por gestores públicos.

Abstract This study aimed to identify the characteristics associated to quality of life (QOL) in users of four Basic Health Units (Unidades Básicas de Saúde, UBS) in Belo Horizonte, Minas Gerais. We conducted a cross-sectional study with 930 adult users enrolled in the selected UBS, using a questionnaire containing the WHOQOL-bref instrument and questions about sociodemographic characteristics, lifestyle and health conditions. Following descriptive analysis, we performed simple and multiple linear regression to evaluate the association between the exposure variables and the QOL domains. The highest mean values of QOL were observed in the social relationships domain. The lowest means were observed in the environment domain, with a statistically significant difference between some of the UBS. The worst perceptions of QOL were related to worse health, housing, education and income conditions, as well as problems in social relationships and psychological conditions. Actions are needed to improve QOL in Primary Health Care users through actions promoted by both health professionals and public managers.

Resumo O objetivo deste estudo foi identificar as características associadas à qualidade de vida (QV) em usuários de quatro Unidades Básicas de Saúde (UBS) de Belo Horizonte, Minas Gerais. Delineou-se um estudo transversal com 930 usuários adultos e cadastrados nas UBS selecionadas. Utilizou-se o um questionário contendo o instrumento WHOQOL-bref e perguntas sobre características sociodemográficas, estilo de vida e condições de saúde. Após análise descritiva, realizou-se regressão linear simples e múltipla para avaliar a associação entre as variáveis de exposição e os domínios da QV. As maiores médias de QV foram observadas no domínio relações sociais. No domínio ambiente foram observadas as menores médias, com diferença estatisticamente significante entre algumas das UBS. As piores percepções de QV relacionaram-se com piores condições de saúde, habitação, educação e renda, além de problemas nas relações sociais e condições psicológicas. São necessários esforços para a melhoria da QV em usuários da Atenção Primária, por meio de ações promovidas tanto por profissionais de saúde quanto por gestores públicos.

Abstract This study aimed to identify the characteristics associated to quality of life (QOL) in users of four Basic Health Units (Unidades Básicas de Saúde, UBS) in Belo Horizonte, Minas Gerais. We conducted a cross-sectional study with 930 adult users enrolled in the selected UBS, using a questionnaire containing the WHOQOL-bref instrument and questions about sociodemographic characteristics, lifestyle and health conditions. Following descriptive analysis, we performed simple and multiple linear regression to evaluate the association between the exposure variables and the QOL domains. The highest mean values of QOL were observed in the social relationships domain. The lowest means were observed in the environment domain, with a statistically significant difference between some of the UBS. The worst perceptions of QOL were related to worse health, housing, education and income conditions, as well as problems in social relationships and psychological conditions. Actions are needed to improve QOL in Primary Health Care users through actions promoted by both health professionals and public managers.

Resumo O objetivo deste estudo foi avaliar a estabilidade da cor de dois sistemas cerâmicos em função de dois cimentos resinosos, avaliando a diferença de cor (ΔE00) pela mensuração de L*, a*, b*, c* e h* de transmitância. Formou-se 4 grupos (n=5) de acordo com as duas cerâmicas (reforçada com dissilicato de lítio e feldspática) e dois cimentos resinosos - cor A3 (RelyX ARC e Variolink II). Dez discos foram confeccionados para cada sistema cerâmico (10 x 1,5 mm), tratados com ácido fluorídrico (10%) e silanizados antes da cimentação. A análise de cor foi feita 24 h após a cimentação das amostras e após 6 meses de armazenamento em umidade relativa por meio de espectrofotometria. ANOVA a dois fatores foi utilizada para análise dos dados de ΔE00 seguido pelo teste de Tukey (p<0,05). ANOVA a um fator foi realizada para avaliação das coordenadas individuais de cor (L*, a*, b*, c* e h*). Apenas o fator cerâmica foi significativo (p=0,003),mas não houve diferença para o fator imento (p=0,275) nem para a interação entre cerâmica e cimento (p=0,161). A cerâmica feldspática apresentou os maiores valores de ΔE00. Variações de L*, a*, b*, c* e h* foram mais significativas para cerâmica feldspática. Concluiu-se que o armazenamento alterou as propriedades ópticas dos cimentos resinosos de forma semelhante e a porcelana feldspática foi mais susceptível à mudança de cor do cimento após o envelhecimento.

Abstract The purpose of this study was to evaluate color stability of two dental ceramics cemented with two resin cements, assessing the color difference (ΔE00) by the measurement of L*, a*, b*, c* and h* of transmittance. The combination of two ceramic system (feldspathic and lithium disilicate) and two resin cements - color A3 (RelyX ARC and Variolink II) resulted in 4 groups (n=5). Ten disks-shaped specimens were fabricated for each ceramic system (10x1.5 mm), etched with hydrofluoric acid (10%) and silanized prior to cementation. The color analysis was performed 24 h after cementation of the samples and after 6 months of storage in relative humidity by means of spectrophotometry. The ΔE00 values were analyzed statistically by two-way ANOVA followed by the Tukey test (p<0.05). One-way ANOVA were calculated for the means of individual color coordinates (L*, a*, b*, c* and h*). Two-way ANOVA showed that only the ceramic factor was significant (p=0.003), but there was no difference for the cement factor (p=0.275) nor for the ceramic/cement interaction (p=0.161). The feldspathic ceramic showed the highest values of ΔE00. Variations in L*, a*, b*, c* and h* were more significant for feldspathic ceramic. In conclusion, storage alters similarly the optical properties of the resin cements and feldspathic porcelain was more susceptible to cement color change after aging.

Resumo OBJETIVO: avaliar as instalações físicas, recursos humanos e atividades desenvolvidas nos Centros de Atenção Psicossocial (CAPS) da região do Médio Paraopeba, Minas Gerais, Brasil, em 2014. MÉTODOS: estudo de avaliação sobre aspectos das dimensões de estrutura e processo propostos por Donabedian, baseado nas recomendações do Ministério da Saúde e legislação vigente, por meio de formulários semiestruturados para entrevista com gestores e observação direta nos CAPS. RESULTADOS: em 12 dos 14 CAPS estudados, foram encontradas todas as estruturas físicas mínimas recomendadas, equipe de profissionais completa e em número superior ao estipulado pela legislação; a utilização de espaços comunitários, comunicação e troca de informações com os demais pontos da rede de atenção era deficiente em grande parte dos serviços. CONCLUSÃO: embora houvesse adequação na maioria dos aspectos, observaram-se deficiências; a definição de critérios e a atualização de legislações são necessárias para melhoria dos serviços e atendimento da proposta de trabalho em rede.

Abstract OBJECTIVE: to evaluate the physical facilities, human resources and activities developed in the Psychosocial Care Centers (CAPS) in the region of Médio Paraopeba, Minas Gerais, Brazil, in 2014. METHODS: this is an evaluation study of the dimensions of structure and processes proposed by Donabedian, based on recommendations of the Ministry of Health and current laws; semi-structured forms were used to interview health managers; direct observation of mental health services was performed. RESULTS: in 12 of the 14 CAPS studied, it was found the minimum recommended of physical facilities and full professional staff and in greater number than established by law; the use of community spaces, communication and exchange of information with other units of health care network was deficient in most of the centers. CONCLUSION: although most of the aspects were suitable, some deficiencies were observed; criteria definition and legislation updates are necessary to improve health services and to accomplish the proposal of network service.

Resumen OBJETIVOS: evaluar las instalaciones físicas, los recursos humanos y las actividades desarrolladas en los Centros de Atención Psicosocial (CAPS) en la región Médio Paraopeba, Minas Gerais, Brasil, en 2014. MÉTODOS: estudio descriptivo que evaluó aspectos de las dimensiones de estructura y procesos propuestas por Donabedian, basadas en recomendaciones del Ministerio de Salud y las leyes existentes a través de un cuestionario semi-estructurado para entrevistar los gerentes y la observación directa de CAPS. RESULTADOS: en 12 de los 14 CAPS incluidos en el estudio se encontraron todas las estructuras físicas mínimas recomendadas, y personal profesional completo en mayor número de lo que la ley estipula; el uso de los espacios comunitarios, la comunicación y el intercambio de información con otros puntos de la red de atención es deficiente en la mayoría de los servicios. CONCLUSIÓN: aun cuando existía una adecuación en la mayoría de los aspectos evaluados, observamos deficiencias; la definición de criterios y actualización de legislaciones son necesarias para mejorar los servicios y atención de la propuesta de trabajo en la red.