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Background Hepatitis B virus (HBV) testing in oral fluid samples may provide advantages in diagnosis, screening or prevalence studies, especially among individuals with venous access difficulties. This study aims to optimize one commercially available assay for detecting total anti-HBc marker in oral fluid samples and to evaluate its utility under real life conditions in different settings for the purposes of prevalence and diagnostic studies. Methods Oral fluid was collected using a Salivette device and some parameters were initially evaluated: type of elution buffer and sample volume. Thereafter, the utility of oral fluid samples for detection of anti-HBc was evaluated in real life conditions in which, 1296 individuals gave serum and oral fluid samples. All serum samples were submitted to commercial EIAs to detect total anti-HBc, according to the manufacturer’s instructions and oral fluid samples according to previous optimization. Results In optimization evaluation, PBS/BSA 0.5% and 100 μL of oral fluid (volume was two-fold increased compared to serum in EIA) were chosen as transport buffer and sample volume. In the field study, anti-HBc was detected in 211 out of 1296 serum samples giving overall oral fluid sensitivity of 52.6% and specificity of 96%. Concordance was higher in ambulatory setting (67.7) compared to general population (31.8). Mean ± standard deviation values of optical density/cutoff (OD/CO) in serum samples were higher in false-negative oral fluid samples than those seen in true positive samples. Sensitivity was higher in those presenting active infection compared to anti-HBc isolate and past infection. Sensitivity also increased in the ambulatory group when HCV individuals were excluded. Conclusions It was possible to optimize a commercial EIA for detecting anti-HBc in oral fluid samples and where the highest concordance was found in ambulatory settings and among individuals with active infection.

Introduction: This paper presents a narrative review of the literature on the everyday life of people diagnosed with the schizophrenia spectrum, from their narratives about the illness experience, published as articles in indexed journals. The narrative reviews start from broad issues with data sources and selection of articles that may contain some bias, seeking to develop a contextual and theoretical theme. Objective: The main objective is to indicate how narrative studies on the everyday life and experience of schizophrenia are presented in the national and international scenario; the most relevant authors; how the everyday life concept is described; type of studies performed and the possible contributions to the health/disease/care in mental health care process. Method: We sought the breadth of the researched material, appropriation, and organization of it. We reported the findings in quantitative terms on the subject to then present an overview of the selected papers. We aimed to know those who present the everyday life experienced by people diagnosed with schizophrenia. Results: Considering the seven databases used during this review, we selected 281 papers, 90% of them were international and just under one-third (82 papers) report/describe and value their narrative in the first person about the illness experience. Conclusão: We discuss the relevance and responsibility of mental health research centered on the experience, the current sciences scenario, and the dialogues with singularities, and regarding the different experiences of illness in the Brazilian sociocultural context

Estudo da prevalência de sofrimento psíquico entre pessoas em tratamento em um serviço de atenção diário público e dois centros de internação privados, sendo um prestador de serviços ao Sistema Único de Saúde, da cidade de Macaé, Rio de Janeiro, Brasil. Estudo transversal. Foi aplicado questionário para caracterização dos participantes, adaptado do formulário EULAC-CICAD. A escala de Kessler-10 foi utilizada para rastreamento do sofrimento psíquico. Participaram 60 pessoas, sendo 88,3% homens. Do total, 51,5% estavam na faixa de 24 a 39 anos de idade. Depressão foi o principal diagnóstico prévio referido em 35%, seguido por ansiedade em 33,33%. Durante o tratamento atual, a ansiedade foi o principal diagnóstico referido em 8,3%, seguido de depressão em 28,3%. Dos entrevistados, 34% apresentaram níveis severos e 27,2% muito severos de sofrimento psiquico. Conclui-se que os níveis de sofrimento psíquico severo e muito severo em 61,2% encontrados com a escala K-10, especialmente sensível para ansiedade e depressão, são semelhantes para esta população nos estudos internacionais. Study of prevalence and psychological distress among people attending a public day care service and two private in patients services in the city of Macaé, Rio de Janeiro, Brazil. Cross-sectional study. A questionnaire adapted by the form EULAC-CICAD was applied to characterize the participants. The scale of Kessler-10 was used as a screening tool for psychological distress. The sample was 60 people: 88.3% men and 51.5% between 24-39 years old. Depression was referred as the most important previous diagnosis in 35%, followed by anxiety in 33.33%. During the current treatment this relationship changed: anxiety was the main diagnosis in 38.3%, followed by depression in 28.3%. The 34% of the sample had severe psychological distress and 27.2% very severe psychological distress. The levels of psychological distress severe and very severe in 61.2% screened by K-10, a scale especially sensitive to anxiety and depression, are similar to international studies on this population. Estudio de prevalencia de distrés psicológicos entre personas que acuden a los servicios públicos de atención de día y dos centros de hospitalización privada en la ciudad de Macaé, Rio de Janeiro, Brasil. Estudio transversal. Se aplicó un cuestionario adaptado de lo formulario de la EULAC-CICAD para caracterizar a los participantes. Para la detección de los distrés psicológicos se utilizó la escala de Kessler-10. Participaron 60 personas, y los hombres eran 88.3%. De la muestra total, el 51.5% tenían entre 24 a 39 años de edad. La depresión fue el principal diagnóstico relatado en 35%, seguido de la ansiedad en 33.33%. Durante el tratamiento actual la ansiedad fue el diagnóstico principal en 38.3%, seguido de depresión en 28.3%. De los encuestados el 34% tenían niveles graves de distrés psicológicos y el 27.2% niveles muy graves. Las conclusiones de que los niveles de distrés psicológico grave y muy grave en 61.2% identificados pela escala K-10, especialmente sensibles a la ansiedad y la depresión, son similares a los estudios internacionales de esta población.

Trata-se de pesquisa clínica acerca da experiência de ouvir vozes, centrada na análise do funcionamento de um grupo de ouvidores de vozes em um Centro de Atenção Psicossocial (CAPS). Verificamos que o exercício de construção de narrativas sobre o ouvir vozes aplicado em um dispositivo grupal produz como efeito um aumento do engajamento dos participantes nos desafios decorrentes de seu adoecimento, auxiliando na criação de alternativas que promovam a sustentação do cotidiano. O grupo se assevera, consequentemente, como um meio profícuo de avançar, coletivamente, na elaboração de soluções singulares e de criar uma comunidade de trabalho voltada para uma experiência que se caracteriza essencialmente por não ser passível de ser compartilhada.This is a qualitative clinical research on the hearing voices experience, based on the analysis of a hearing-voices group functioning in a Psychosocial Care Center (CAPS). We verified that the practice of patients narratives construction about their hearing voices experiences, in a group context, provides the raise of participants engagement in coping with the challenges of the mental illness process and helping them to create alternative ways that gives support to daily life. Consequently, the group assures a proficuous way of, collectively, developing singular solutions and creating a voice-hearing network dedicated to an experience essentially characterized as not passible for being shareable.

Introduction Studies have shown important gender differences among drug (including crack) users related to: drug use patterns; health risks and consequences; criminal involvement; and service needs/use. Crack use is prevalent in Brazil; however, few comparative data by sex exist. We examined and compared by sex key drug use, health, socio-economic indicators and service use in a bi-city sample of young (18–24 years), regular and marginalized crack users in Brazil. Methods Study participants (total n = 159; n = 124 males and n = 35 females) were recruited by community-based methods from impoverished neighborhoods in Rio de Janeiro and Salvador. Assessments occurred by an anonymous interviewer-administered questionnaire and serum collection for blood-borne virus testing between November 2010 and June 2011. Descriptive statistics and differences for key variables by sex were computed; in addition, a ‘chi-squared automatic interaction detector’ (‘CHAID’) analysis explored potential primary factors differentiating male and female participants. Results Most participants were non-white, and had low education and multiple income sources. More women had unstable housing and income from sex work and/or panhandling/begging, whereas more men were employed. Both groups indicated multi-year histories of and frequent daily crack use, but virtually no drug injection histories. Men reported more co-use of other drugs. More women were: involved in sex-for-drug exchanges; Blood-Borne Virus (BBV) tested and HIV+. Both groups reported similar physical and mental health patterns; however women more commonly utilized social or health services. The CHAID analysis identified sex work; paid work; begging/panhandling; as well as physical and mental health status (all at p&thinsp

Este artigo discute a autonomia da pessoa que faz uso problemático de substâncias psicoativas (UPSP). Após o exame da ideia de autonomia de quem faz UPSP, a partir dos paradigmas médico, psicológico e moral, que oscilam entre as compreensões do uso como compulsão ou escolha, discute-se os aspectos psicopatológicos envolvidos no UPSP, em especial a experiência da temporalidade e suas implicações para o debate da autonomia dessas pessoas e para o seu processo de recuperação pessoal. This paper discusses the autonomy of subjects engaged in substance misuse (SM). After examining the concept of autonomy of subjects engaged in SM, based on medical, psychological and moral paradigms that range between understanding SM either as a compulsion or a choice, we discuss the psychopathological aspects involved in SM, i.e., the experience of temporality and its implications regarding the autonomy of these subjects and their recovery process. Cet article discute l’autonomie de personnes sujettes à l'utilisation problématique de substances psychoactives (UPSP). Après avoir élaboré la notion d’autonomie de ces sujets à partir de paradigmes médicaux, psychologiques et moraux qui comprennent l’UPSP soit comme une contrainte, soit comme un choix, on discute les aspects psychopathologiques liés à l’UPSP, en particulier l’expérience de la temporalité et ses implications pour le débat sur l’autonomie de ces personnes et leur processus de rétablissement. Este artículo discute la autonomía de la persona que sufre con el consumo problemático de sustancias psicoactivas (CPSP). Después examinar la idea de autonomía en quien tiene un CPSP, a partir de los paradigmas médico, psicológico y moral, que oscilan entre las comprensiones del uso como compulsión o elección, se discuten los aspectos psicopatológicos involucrados en el CPSP, en especial en la experiencia de la temporalidad, y sus implicaciones para el debate de la autonomía de esas personas y para su proceso de recuperación personal. Dieser Artikel ergründet die Autonomie von Personen, die einen problematischen Gebrauch von psychoaktiven Stoffen machen. Wir analysieren den Begriff der Autonomie dieser Subjekte basierend auf medizinischen, psychologischen und moralischen Paradigmen, die den Drogenkonsum entweder als Zwang oder Wahl verstehen. Nachfolgend diskutieren wir dann die psychopathologischen Aspekte des Drogenkonsums, vornehmlich die Erfahrung der Temporalität und ihren Einfluss auf die Debatte über die Autonomie dieser Subjekte während ihres Rehabilitationsprozesses.

Background Rapid tests (RTs) might have several advantages over standard laboratory procedures, increasing access to diagnosis, especially among vulnerable populations and/or those living in remote areas. The aim of this study was to evaluate the performance of RTs for the detection of hepatitis B virus surface antigen (HBsAg) in samples from different populations/settings. Methods Three RTs for HBsAg detection (Vikia® HBsAg, HBsAg Teste Rápido®, and Imuno-Rápido HBsAg®) and different biological specimens (serum, whole blood, and saliva) were evaluated. Analyses comprised a reference panel and samples from field studies targeting suspected cases of hepatitis B virus (HBV) (G I), individuals living in deprived areas (G II), and highly vulnerable individuals (G III). Enzyme immunoassay (EIA) was defined as the gold standard in this study. Reproducibility, repeatability, and cross-reactivity with other infectious agents such as dengue, immunodeficiency (HIV), and hepatitis C (HCV) viruses and T. pallidum were determined. Results For the reference panel, the sensitivity and specificity of all HBsAg RTs were higher than 93.00 %. G I presented the highest kappa values for all rapid assays using sera samples. When using serum, the sensitivity values were higher than 93.40 for G I, 60.00 % for G II and 66.77 % for G III, and the specificity values were higher than 99.50 for GI, 97.20 for G II and 99.10 % for G III for all tests. For whole blood samples & the Vikia® HBsAg assay, the best performance was achieved for GIII (k = 79.75 %). For saliva samples, the Imuno-Rápido HBsAg® assay showed the highest concordance values with EIA for G I (40.68 %) and G II (32.20 %). The reproducibility and repeatability of all RTs for serum and saliva were excellent, and the concordance between HBsAg EIAs and RTs using samples reactive with other infectious agents varied from 70.10 % to 100.00 %. Conclusions The overall performance of RTs for HBsAg in serum was high/moderately high for all groups, thereby promoting increased access to HBV diagnosis among vulnerable populations as well as samples from individuals in emergency settings or remote areas. Rapid tests for HBsAg using whole blood could be used in prevalence studies, though these assays should not be used for saliva samples. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1249-5) contains supplementary material, which is available to authorized users.