https://tede.unisantos.br/handle/tede/39 2026-04-09T17:06:21Z https://tede.unisantos.br/handle/tede/8108 Title: O matriciamento em saúde mental como forma de dispersão de saber Abstract: Introduction: Matrix support in mental health, as a technical-political device of the Brazilian Unified Health System, is grounded in the perspective of the horizontal dispersion of knowledge, articulating Primary Health Care and Psychosocial Care Centers within a logic of shared responsibility. In light of the Brazilian Health Reform and Psychiatric Reform, matrix support seeks to overcome the physician-centered and fragmented model, fostering comprehensive care, territorialization of practices, and strengthening local resolvability. However, the normative institutionalization of matrix support does not ensure its concrete implementation within territories, making critical analysis of its occurrence, organization, and professionals’ understanding within Primary Health Care necessary. Objectives: To evaluate the occurrence of the matrix support process in mental health within Primary Health Care in the Baixada Santista region, its organizational forms, and the understanding of the professionals involved regarding the theme. Method: This is a cross-sectional study with a mixed analytical approach, conducted with Primary Care professionals from the municipalities of Cubatão, Santos, and São Vicente. The estimated sample comprised 240 participants, based on probabilistic calculation with a 5% significance level and 80% statistical power. A self-administered questionnaire developed by the researcher was used, consisting of structured questions to construct the variables 'level of knowledge about matrix support' and 'perceived effectiveness of matrix support,' as well as semi-structured questions subjected to thematic analysis. Association tests between variables were performed, alongside qualitative analysis of narratives concerning participation in care, barriers, and perceptions related to mental health. Results: Heterogeneity was observed in the occurrence and organization of matrix support across units, with distinctions related to the organizational model. An association was identified between greater knowledge about matrix support and higher perceived effectiveness, suggesting a dynamic feedback relationship between knowledge and practice. Qualitative narratives indicated that participation in mental health care does not automatically derive from the formal existence of matrix support, but rather from the internalization of the comprehensive care model. Discourses marked by technical insecurity, persistence of biomedical references, and the presence of stigma emerged, in addition to reports of structural limitations and weaknesses in network articulation. Conclusion: Matrix support proved to be more than an organizational strategy, configuring itself as an ethical-political device capable of challenging traditional models of care. Its consolidation requires continuous investment in professional training, organizational regularity, and integration with Permanent Health Education policies. The interrelationship between knowledge and perceived effectiveness indicates that strengthening knowledge enhances practice, while effective experiences expand collective learning. Despite methodological limitations, the findings contribute to Public Health by reaffirming matrix support as a concrete expression of SUS principles and as an instrument for qualifying mental health care within Primary Health Care. Type: Tese 2026-03-23T00:00:00Z https://tede.unisantos.br/handle/tede/8107 Title: Avaliação da contaminação por metais tóxicos na água potável fornecida à população de cidades da Baixada Santista Abstract: The contamination of drinking water by toxic metals constitutes a significant public health issue, especially in the Metropolitan Region of Baixada Santista (RMBS), characterized by intense industrialization, unplanned urbanization, and a history of environmental degradation, which raises concerns about the population's exposure to toxic metals such as aluminum, chromium, manganese, lead, and other chemical elements. This study aimed to evaluate the presence of these toxic metals in the water supplied by the recently privatized utility to the populations of the municipalities of Cubatão, Santos, and São Vicente, through quantitative determination of drinking water distributed by the Cubatão Integrated System. The study contributes data for independent environmental monitoring for the Exposure and Environmental Risk Assessment Group at the Universidade Católica de Santos, as well as aims to protect public health in the region. Water samples were collected at 30 georeferenced points, strategically distributed in consumption areas, during two distinct periods (summer and winter). The samples were analyzed by inductively coupled plasma mass spectrometry (ICP-MS), a highly sensitive technique recognized as the gold standard by the World Health Organization, using certified reference materials and automated accessories to minimize potential contamination during sample handling. The results indicated the presence of some metals above the limits established by legislation, such as aluminum, in the neighborhoods of Santa Maria, Vila Nova, Japuí, and Parque das Bandeiras in the summer collection, and Jockey Club and Jardim Rio Branco in the winter collection. The remaining metals investigated were found below quantification limits or within legal parameters, highlighting the need for continuous monitoring to ensure the safety of the water consumed by the population of Baixada Santista, especially considering seasonal variations and changes in water management. Type: Dissertação 2026-02-23T00:00:00Z https://tede.unisantos.br/handle/tede/8106 Title: Direito comparado: sentença canônica de nulidade matrimonial e sua incorporação no ordenamento brasileiro Abstract: In this dissertation, the autor aims to contribute in the improvement of national legal knowledge, especially in the field of comparative matrimonial law, in order to promote and encourage the correct implementation of Canon Law within national territory, displaying that the Ecclesiastical Law has a strong influence on the origins of Brazilian legislation, in order to avoid the production of undesirable effects due to the internalization of canonical judgements. Thus, it discusses primarily the internalization within the Brazilian legal system – in the extrajudicial sphere and throught action before the Superior Court of Justice – of judgement of canonical matrimonial nullity, handed down by the Ecclesiastical Courts, pervading, so, by a study about comparative law; the Brazil-Holy See Agreement; the institutions of marriage in the Brazilian Civil Code and in the Canonical Code; the grounds for nullity and voidability, as well as their implications; the jurisdiction for the recognition of foreign judgments in Brazilian territory, and the requirements for this procedure. The study's relevance is evident in light of the growing number of canonical marriage nullity cases before the Ecclesiastical Court of the Diocese of Santos – which can trigger actions before the domestic judiciary to homologate a foreign judgement, and even attempts to internalize it directly in the extrajudicial registry – as well as in view of the originality of the research in the academic field. In the social field, the failure to correctly apply legal concepts can result in undesirable effects, affecting the patrimonial and personal rights of the parties. Thus, the initial guiding question is whether or not it is necessary to homologate all canonical judgements of matrimonial nullity, given the legislative change that waives the homologation before the Superior Court of Justice of foreign rulings of consensual divorce (CPC, art. 961, §5). Concluding that the institute of canonical matrimonial nullity and consensual divorce are incompatible, and therefore, the need for homologation prevails, the paradigm judgments handed down by the Superior Court of Justice on the matter and the existence of technical errors that compromise the correct application of the law are analyzed, unfolding in the effects resulting from homologation in spite of the notorious incompatibility of the institutes. Type: Dissertação 2025-10-20T00:00:00Z https://tede.unisantos.br/handle/tede/8105 Title: Irmandade ou (in)tolerância: o repensar da luso-brasilidade para uma cooperação Brasil-Portugal contra a xenofobia e o racismo Abstract: Over the last two hundred years, Brazil and Portugal have experienced adverse moments in their political and social relations, facing structural dilemmas that date back to the colonization period and have characterized the basis of bilateral dialogues in the social, economic, migratory, legal, and political spheres, resulting in secular distancing and rapprochement. In the contemporary era, the two countries have stabilized their political exchanges through joint government efforts to promote a Luso-Brazilian community, based on the ideal of brotherhood between peoples and emphasized in political summits, multilateral forums, and media discourse. However, despite this emphasis, recent decades have seen an escalation of hostility in social relations between Brazilians and Portuguese, with Brazilian immigrants increasingly reporting physical, moral, verbal, and psychological abuse in Portugal. The current degradation of the human rights of Brazilian immigrants in the country finds space in the propagation of contemporary extremist and nationalist discourses, of a xenophobic and racist nature, which seem to be linked to the old stereotypes attributed to Brazilians since colonization and the reworking of old imperial hierarchies between peoples. The hypothesis proposed in this study is that, even with the evolution of exchanges between the states, the actions of the public authorities of both countries have historically been inefficient in enacting legal and political measures aimed at a complete decolonization and a break with colonialist impressions. Instead, more utilitarian exchanges were conducted, which, in the somewhat vague discourse of fraternal Luso-Brazilianism, provided political and capital gains for the ruling elites to the detriment of the most vulnerable population. The result of this process would be the non-elimination of social tensions that generate the discourses currently observed, from the popular sphere to the center of the State, jeopardizing the fundamental rights of the victims. This study is divided into three chapters, carried out using a hypothetical-deductive method and documentary and bibliographic research methodology, using an interdisciplinary approach mainly between History, International Relations, and International Human Rights Law. The main objectives of the text are to understand the possible correlation between the political use of Luso-Brazilian identity and the current scenario of violence; to ascertain which legal loopholes and political movements foster the proliferation of hatred in Portugal and to understand the patterns of violence; to outline prospects for Brazil-Portugal cooperation capable of mitigating the advance of discrimination between peoples through interculturality. At the end of the study, elements of the established hypothesis are proven and a new effort is advocated for a transnational cooperation that addresses both the shared history and the political and cultural meaning of Luso-Brazilian identity, in addition to the internal legal systems of the States regarding discrimination. It is understood that this process requires bilateral and multilateral efforts and the appreciation of the contributions of various non-state actors involved in the debate, within a logic of strengthened governance. Type: Dissertação 2025-10-20T00:00:00Z