Avaliação da terapia comunitária na atenção primária à saúde

A busca por um modelo democrático de saúde despertou a atenção do governo brasileiro para o estabelecimento de prioridades e estratégias, que impulsionaram a implantação do Programa de Saúde da Família (PSF), atualmente denominada Estratégia Saúde da Família (ESF), a fim de aproximar a equipe de saúde da comunidade e, assim, implementar ações de promoção da saúde e de prevenção do adoecimento. Nessa perspectiva a Terapia Comunitária (TC) emerge como uma tecnologia de cuidado voltada à saúde mental na Atenção Básica de Saúde. Desde 2007, a TC vem sendo desenvolvida no município de João Pessoa/PB por profissionais da ESF: enfermeiras, agentes comunitários de saúde, médicos, odontólogos, fisioterapeutas, nutricionistas, psicólogos, entre outros. O estudo teve como objetivos: avaliar a satisfação dos usuários em relação à TC na Atenção Básica no município de João Pessoa/PB; medir o nível de satisfação dos participantes da TC em relação a essa ferramenta do cuidado; identificar elementos importantes para a satisfação em relação à TC por parte dos usuários. Trata-se de um estudo avaliativo, transversal e observacional, realizado no período de maio a agosto de 2009. Utilizou-se como instrumento de coleta de dados a Escala de Avaliação da Satisfação dos Usuários com os Serviços de Saúde Mental Satis-BR, bem como um instrumento de perguntas complementares utilizado pelos terapeutas comunitários. Os resultados revelaram que dos 198 (100%) entrevistados, 105 (53%) verbalizaram satisfação e 93 (47%) muita satisfação nos encontros de TC, o que evidencia que a totalidade da amostra está satisfeita com a terapia. Os elementos importantes que concorreram para a satisfação dos usuários da TC foram: respeito, dignidade, escuta, compreensão, acolhimento, apoio nas necessidades e boas instalações dos locais onde ocorre a terapia. A TC vem fortalecendo o cuidado à saúde mental, por se constituir como uma tecnologia de prevenção e fortalecendo a porta de entrada para a rede de saúde mental e de apoio psicossocial. Conclui-se, portanto, que a TC vem se destacando como instrumento de inclusão da saúde mental na Atenção Básica no atendimento aos usuários do Sistema Único de Saúde

A atenção à crise e o apoio matricial: analisadores da estratégia atenção psicossocial

The National Policy on Mental Health is characterized as a territorial - political community , and it has the Psychoso cial Care Strategy (Eaps) as guideline for the proposal and the development of their actions. In its design, CAPS is idealized to be a strategic equipment within the Psychoso cial Care Network/RAPS. Matricial support and at tention to the crisis constitute strategic areas of action of CAPS in its replacement mission , and as it is g uided by the scope of deinstitutionalization, those are essential to the success of these services. We argue that sustain crises in existential territories of life is a condition for the effectiveness of psychosocial care and, ultimately, to the sustainability of its Reform. In this direction, the matricial support tool reveals a territorial supporter, intercessory and powerful in building a psychosocial care to the crisis. Recognized as one of the major challenges by the Brazilian Ministry of Health, forward these fronts materializes for workers in their mi cropolitical crafts. Our research arises as an investment toward empower them , and aimed to understand the operationalization of attention to the crisis and matricial support in a CAPS II, in the view of its workers . Besides, it aims to examine such practi ces forward the principles and purposes of Psychosocial Care Strategy. Inspired by the research - intervention and by the political and social ideas of Institutiona l Analysis, we offer a space for reflection and exchange, by implicational interviews , enablin g workers to launch them in analysis of practices in the EAPs view. We have done a documentary consulting CAPS Technical Project, and a return stage to the institution, by organizing workshop and conversation groups with CAPS workers. The results have show n that there are institutional logics in competition on that service. When operating the logic risk, some difficulties in sustaining most intense crisis situations were identified, the psychiatric hospital internment is used as a facility, particularly in view of some cases, in which the aggressiveness of the person in crises becomes aggressive, and when the brackets SAMU, the CAPS III and Comprehensive Care Beds do not respond satisfactorily to their users requests. Order weaknesses were indicated in this thesis as macropolitical and micropolitical interfering in network support. The matricial actions were identified as a powerful intercessor resource in crisis care appeared weakened, and indicates little porosity in the relationship between the Service and the territory where it takes place. Noticed by the logic of home care, without operate primarily as a knowledge exchange device, we saw capture points in the logic of assistance with ambulatoriza tion production of CAPS, welfare practices and "ext empore " . T he E APs , although it emerge s as a guiding, it is not seen to workers as effective practice. On the one hand, the results signaled that the attention to the crisis and the matricial actions are developed without tenacious connection with the purposes of EA Ps, on the other hand, successful cases were indicated with the main leads to conducting wire of intersectoral actions to the powerful bonds and to the participation of user in their care process es , indicating insurgent forces tha t intend by traditional lo gic .

Matriciamento em saúde mental: atuação de núcleos de apoio à saúde da família

In the context of break with psychiatric hospitals, the Brazilian Psychiatric Reform is a historical process of reformulation of knowledge and mental health practices. In this way, the Centers of Support for Family Health (NASF) have been acting in the supply of matrix support in mental health. So, the present research aims to analyze the actions which the NASF is taking for the matrix support in mental health in the city of Natal/RN. This is a kind of research descriptive, exploratory and qualitative. The data collection, was made by a direct observation of the professional pratices and semi-structured interviews with health professionals NASF's. The Data were analyzed according to thematic analysis technique, with the support of the content analysis method, which is a way to investigate clusters of meanings which make up the communication of the investigated object. Three analytical categories were organized by this method, whose titles were inspired in two theories in the health field called “Health to Paidéia” and “Expanded Clinic”. The name of the categories are: 1. “Mental illness in brackets: working dimensions of the Centers of Support for Family Health interfaces with the concrete subject”, which is about the work process of NASF; 2. “Freedom and engagement in the arrangement of matrix support in mental health”, which explore the matrix support limitations in mental health in Natal/RN from the professionals interviewed at the NASF’s; 3. “Between the desire and interest: influence of expert orientation in mental health in Psychosocial Care Network” (RAPS), which is related to matrix support in mental health, as an organizational arrangement responsible to ensure intersectoral and comprehensive care, strategies inside of context of the constitution of RAPS. We can extract and say that the actions of NASF teams in the brazilian city called Natal/RN, still not part of a structured link with health care networks, as happens with the absence of discussions and lack of professionals in the matrix support. In addition, there is a difficulty to do an specialized orientation in mental health because of the lack of human resources in this area and of the insufficient number of the replacement services for psychiatric hospital pratices, bringing up the discussion about the consolidation and expansion of RAPS in fact investigated.

Síndrome de ovários policísticos: enfoque psicossocial

A síndrome dos ovários policísticos (SOP) é um distúrbio endócrino-ginecológico que se caracteriza, principalmente, por anovulação crónica e hiperandrogenismo, afetando entre 5 a 10% das mulheres em idade reprodutiva. As principais manifestações da SOP incluem os seguintes sintomas: irregularidade menstrual, hirsutismo, infertilidade, acne, alopecia androgenética, obesidade e acantose nigricans. Esses sintomas apresentam- se de forma bastante heterogênea, havendo diferenças marcantes na sua prevalência e intensidade entre diferentes grupos de mulheres que apresentam SOP. Apesar da condição biológica, a SOP não é apenas um problema físico, mas também psicossocial, interferindo e comprometendo a qualidade de vida das mulheres que a apresentam. A partir de uma revisão da literatura, este estudo discute os aspectos psicossociais de mulheres com SOP, destacando o impacto dos sintomas na qualidade de vida relacionada com a saúde. Considerando que cada mulher responde de forma singular aos sintomas que apresentam, destaca-se a importância de incorporar a perspectiva individual da mulher com SOP ao seu contexto social. Nesse sentido, são discutidos achados de pesquisas utilizando abordagens metodológicas quantitativas e qualitativas, numa tentativa de melhor compreender a experiência das mulheres diante da SOP. Os sintomas da SOP podem estar associados com a ocorrência de ansiedade, disfunções sexuais e sentimentos de inadequação ao papel feminino, como também podem desencadear sintomas depressivos e isolamento social, com comprometimento significativo da qualidade de vida. Os autores destacam a importância do atendimento multidisciplinar para as mulheres com SOP, considerando essa condição como importante problema psicossocial. A atenção aos aspectos psicossociais da SOP tem aumentado nos últimos anos, no entanto, a produção científica relacionada ainda é escassa

Avaliação de políticas públicas para arranjos produtivos locais: a eficácia da terceira edição do PROCOMPI no apoio ao APL de água mineral da grande Natal

This study has the objective examine the mechanisms of programs oriented fort cluster development, focusing on the analysis of the effectiveness of Procompi on support to APL of Mineral Water in Natal/RN. Search on the theory on public policy and support on apps for the theoretical and methodological reasons for the success of the program. In the document analysis was used reports from SEBRAE, IEL and SINCRAMIRN and was realized survey in the companies. The research indicates that not reaching the goals set. It is concluded that a poor definition of objectives and lack of orientation to the external economies are the causes of the failure

Apoio governamental à inovação Tecnológica: análise da indústria farmacêutica paraense

The transformations economical, cultural and social that happen in world ambit they are associated to the intense progress and expansion of new technologies, forcing governments, people, companies and nations to the introduction of new patterns of behavior, forcing, in that way, to the continuous renewal of products and technological processes to maintain the competitiveness, so much among nations, as in the managerial world. In that matter, the technological innovation is recognized as basic factor of maintainable economical competitiveness, being the responsible for the breaking and/or improvement of the techniques and production processes, what presupposes the systematization varied institutional arrangements that they involve firms, interaction nets among companies, government agencies, universities, research institutes, laboratories of companies and scientists and engineers activities. Those arrangements, to the if they articulate with the educational system, with the industrial and managerial section and, also, with the financial institutions, they take the form that Freeman (1987) it coined of national system of innovation, promoted through public politics of CT&I, which seek to induce and to support innovative initiatives in the companies, as well as to establish demands and to prioritize vocations and regional potentialities. In that context of government support to the technological innovation interferes this study, that it looked for to know the reasons of the fragility innovative in the pharmaceutical industry of State of Pará in Brazil, pointed for PINTEC (2005), starting from the point of view of the businessmen of that section. For such, the qualitative approach was used - with interviews directing semi and the technique of the content analysis. The results of the research pointed that the fragilities innovative of the section links to the ignorance of the government support to the technological innovation on the part of the businessmen of the pharmaceutical industry of State of Pará in Brazil

Fatores críticos de sucesso para sistemas de informação de apoio ao gerenciamento de projetos: o caso SEBRAE/RN

Universidade Federal do Rio Grande do Norte

Tecendo vivências e sentidos do câncer infantil : família, doença e redes de apoio social em Natal-RN

This paper discusses the experiences related to the treatment of children´s cancer which had children, their mothers and families as their main characters. They were mainly originated from areas in the countryside and urban poor areas in the State of Rio Grande do Norte. The non-governmental organization Grupo de Apoio à Criança com Câncer (GACC) was the privileged ethnographic location. In this setting, the mother, which was called acompanhante (companion), and the children, defined as pacientes (patients), were often sheltered in reason of therapeutic practices and the treatment undertaken by children in a nearby hospital. This study aims to focus on the therapeutic itinerary, beyond the children´s suffering, dealing with the family as a whole, since the moral values from these popular families imply the complete involvement of the family in relation to the illness and its treatment. Therefore, it is experienced as a family problem. We also intend to understand the construction of meanings to the illness, dealing with the ideological continuity in the relationships between the families and the GACC. These meanings were built in the intersection of these two spheres, which refer particularly to medical, religious and emotional explanations. Ethnographic methods were applied in this research at the entity and another social contexts, such as the family households. I also tried to retrieve the process of treatment outside the GACC, visiting the family context, when doing dense interviews or just having conversations with informants. It was found that the GACC, as a non-governmental organization, generates a negotiation of identities, which develops, then, through the family as a whole, but also through the child and especially the mother, affecting, in some way, their internal organization. Furthermore, the meanings of the experience of illness appeared to be shaped by the family sphere as well as by the logic of public health structures

Sistema inteligente para apoio à decisão na operação de uma malha de escoamento de petróleo

The petroleum production pipeline networks are inherently complex, usually decentralized systems. Strict operational constraints are applied in order to prevent serious problems like environmental disasters or production losses. This paper describes an intelligent system to support decisions in the operation of these networks, proposing a staggering for the pumps of transfer stations that compose them. The intelligent system is formed by blocks which interconnect to process the information and generate the suggestions to the operator. The main block of the system uses fuzzy logic to provide a control based on rules, which incorporate knowledge from experts. Tests performed in the simulation environment provided good results, indicating the applicability of the system in a real oil production environment. The use of the stagger proposed by the system allows a prioritization of the transfer in the network and a flow programming

Estudo psicossocial das perdas dentárias na terceira idade

The present study seeks to understand tooth loss by investigating the social representations in the daily life of elderly individuals, thus characterizing itself as a comparative and analytic research. It is known that tooth loss is a common occurrence in elderly individuals, interfering at the psychosocial and biological levels, through its functional, esthetical and social implications. The area of oral health in Brazil is lacking studies on this topic, especially with respect to the psychosocial aspects of the elderly. The Theory of Social Representations and the Central Nucleus Theory were selected for theoretical-methodological support. The Free Association of Words Test was used, whose inducing stimulus were the words tooth loss , in which each subject was asked to associate 3 words, to respond to a questionnaire related to socio-economic conditions and containing an investigation of tooth loss, access to odontological services and the need for dental treatment, and to undergo a focus group interview. The study sample consisted of 120 individuals 60 years of age or over, resident in Natal, RN, Brazil and participants of the Live Together to Live Better group of the Basic Health Unit of Felipe Camarão Residential District and Unati (Open University of the Elderly); an interview was performed with 36 subjects. Data analysis was performed by Evoc 2000, SPSS/99, Graph Pad and Alceste softwares. The results demonstrate that the central nucleus of the social representations of tooth loss for the Live Together group emerged from the difficulty in eating categories, showing a relation between physiologic necessity, desire and pleasure from eating, not to mention the pain that resulted from justifying the tooth loss. Besides the central discourses, the following peripheral elements were gathered: difficulty in adapting to the prosthesis, treatment and difficulty in speaking. All of these categories, except the last, also comprised the class themes of the group interview. For the Unati group the central nucleus emerged from the socio-economic difficulties categories, demonstrating a narrow relation between poverty, access to health and education and esthetics, confirming in the discourse of common sense, the association between tooth loss and aging. At the margin of the central discourses was collected the peripheral element difficulty in adapting to the prosthesis, found both in the Live Together and Unati groups, which expresses the resistance of the subject to this new situation and the failure of the rehabilitation treatment in the sense of reviving the memory of their natural teeth. All of these categories also constitute the class themes of the of the group interview. Thus, through the study of the social representations, we can reveal a reality in the perspective of the social subjects, contemplating the multiple facets of the social-cultural reality experienced by these individuals

A informática como uma ferramenta de apoio a inclusão do deficiente visual

An inclusive environment has its foundations in the belief that all people are entitled to participate, to live as normal a life as possible, without discrimination, especially in education. This is to ensure equal opportunities. For individuals with special needs, the use of computers and digital materials is not an alternative, but one of the only forms of access to information. For the visually impaired, they start from the beginning to enter the university, through the selection processes, not always accessible. For those who can, other difficulties arise, undermining the initial enthusiasm and generating a large rate of dropouts. In most cases, these students will depend on the goodwill of colleagues and volunteers for the reading of texts in the basic literature of the disciplines studied. The high cost of technology assisted allied to a lack of resources and knowledge of curricular adaptations, prevents many teachers help these students in an appropriate manner. This thesis seeks to contribute to the inclusion of the visually impaired student pointing alternatives that can help in caring education. The research was conducted specifically for the doctorate during the period 2001 to 2006, the cities of Natal, Salvador and Curitiba, and is based mainly on the methodology of action research. The objective was the construction of Virtual Teaching Support Center , structured in a Web portal that can serve as a resource to help support teachers, staff and other users concerned with the process of inclusion of people with needs special education, with the goal of assimilation of educational opportunities, with the support of resources and methods. The inclusion is for everyone because we are all different

Representações sociais de discentes sobre universidade: um estudo psicossocial entre ingressantes do vestibular e da seleção ProUni

Demand for access to higher education to put in test the education Brazilian system in view of the surplus of selective processes of public universities, people without option to pay their studies at this education level. In this context, it has arisen the University for All(Universidade para Todos)Program, the ProUni, from Ministry of Education - MEC, created by the Federal Government in 2004, and that it aims the granting of full and partial scholarships in private higher education institutions, graduate courses in sequential specific training, low-income Brazilians students who do not have higher-level degree. Created by the Provisional Measure No 213/2004 and institutionalized by Law No. 11096 of January 13, 2005, the ProUni offers, however, the exemption of some taxes to those institutions that join the program. This is one of the privileged time for the study of Social Representations by offering the researcher, a living laboratory, natural environment, the confrontation between the established and new. In time like this people are challenged to incorporate the new system to the pre-existing one, aiming it through a strangeness of what was so familiar. It is through this game of social forces that we developed the present study with 196 entering higher education, of these are 116 of selective vestibular system and 80 of the ProUni selective system. We opt by the procedures for data collection in order to have access to the circulating senses, in addition to the streamlined responses. With foundation in Abric, we perform the test the Free Association of Words, then analysed by the software and by EVOC Content of the type theme as Bardin. Besides, we require of the subjects, a writing on the study object university later analysed by the software ALCESTE. The results point out to a representation strongly rooted in social factors such as more traditional socio-cultural elements: the beliefs, values, the symbols. It is unique in both groups of subjects: among those entering by the selective ProUni system, there was a stronger anchor in that it does not make inquiries about the program. At the same time, there is a stronger presence of objectivation, entering the selective vestibular system in order that they explained with a value judgement on the programme. It is suggested further studies considering the embryonic state of social representation, as recent as the social purpose that triggered. It would be relevant even the replication of the same research with other people in order to strengthen the power of the theorising of empiria available

Apoio pedagógico, ação coletiva e diálogo: tramas da formação continuada em educação inclusiva

This work detaches the importance of the continued formation of the educators in terms of the inclusive educational process, pointing as basic elements the continued formation of the educational professionals. In this direction, it points and it defends the dialogue in the perspective of David Bohm, with interfaces of the freireanas ideas, as a methodological resource of action that allows the organization of strategies of collective and effective pedagogical support in inclusive schools, in the same time articulates the continued formation of the professionals in education. Characterized as research in a dialogical action with collective participation and collaboration, it counted with the participation of 87 educators, between professors, pedagogical, managing coordinators and specialists of special education in two schools of the state and municipal public system of Natal/RN. The results had pointed with respect to the viability of the dialogue as articulated methodological tool of the continued formation in service, when providing the establishment of personal and professional relationship between the educators, favoring the discursive enjoyment of the lived experiences, allows the organization of strategies of collective and effective pedagogical support in the scholar environment. On the basis of these results, this work also points to some items to reflections as the reorganization of the Secretariats and the schools, in the direction to brighten up the fragmentation and the discontinuity of the pedagogical actions evidenced and to instigate a process of changes that has glimpsed the professional development of the educators through its continued formation in service and the improvement of the school in the way of the concretization of an education directed toward the acceptance, respect and attendance the diversity of its pupils, as detaches the official documents and the studies on the inclusive education

Programa de apoio a planos de reestruturação e expansão das Universidades Públicas Federais (REUNI): repercussões na UFRN

El presente trabajo tiene como objetivo analizar la implantación del Programa de Apoyo a Planes de Reestructuración y Expansión de las Universidades Federales (REUNI) así como su papel en la reconfiguración de la Universidade Federal do Rio Grande do Norte, resaltando sus repercusiones en la gestión y organización de la universidad. Para la realización del trabajo, entre los procedimientos técnicos, utilizamos la revisión de literatura, el análisis de documentos y las entrevistas semiestructuradas. La revisión bibliográfica ha permitido profundizar en conceptos importantes sobre la temática, priorizando los contenidos referentes a los conceptos de globalización y neoliberalismo; La reforma del Estado y sus repercusiones sobre las políticas de educación superior brasileña; directrices de documentos internacionales y nacionales que definieron la organización de este nivel de enseñanza. Los estudios indican, en relación a la expansión de la UFRN, que las metas pactadas del REUNI fueron atendidas casi en su totalidad. Sin embargo, cualitativamente, no se puede afirmar que el REUNI haya tenido un impacto positivo, pues además del incremento de plazas y de la creación de cursos nuevos, que en su mayoría fueron cursos nocturnos, ha habido un aumento sustancial en relación a la cantidad de alumnos por profesor, lo que demuestra que dicho incremento también se da por la racionalización de los recursos humanos y de la estructura físca existentes. Desde esta perspectiva, el REUNI originó varias modificaciones en la forma de gestionar los servicios en la UFRN, mereciendo especial atención la intensificación del proceso de transformaciones en la concepción de una gestión burocrática a una gestión desde la gerencia, resaltando la cultura instituída con el contrato de gestión. En ese sentido, la utilización de las metas y de los indicadores de desempeño pasa a adquirir cada vez más importancia como forma de acompañar y evaluar el cumplimiento de las acciones pactadas, pues de este cumplimiento depende la concesión de recursos financieros. Dentro de este contexto, el Programa se ha caracterizado por dar continuidad a las políticas de privatización para la expansión de la educación superior brasileña, provocando la inserción en las universidades públicas federales, de un modelo de organización fundamentado en el paradigma de la gerencia y la administración, que conlleva así, a la mercantilización de los bienes y servicios académicos

Estudo representacional da participação familiar nas atividades dos centros de atenção psicossocial no município de Natal-RN

Comprehending social representations of users relatives of Psychosocial Care Centers (CAPS) from Natal-RN, about their participation in the activities of these services, was the purpose of this study. The research instrument used was a semi-structured interview, led to 28 relatives of users of East and West CAPS II, East and North CAPS-ad, involved in the Relative Therapeutic Group, in Relative Meeting, in the Assembly of Users, Technicians and Relatives, according to the therapeutic schedule of each health services, between August to November 2007. Data obtained in family and users identification were characterized with the aid of charts and boards in absolute and/or percentage values. The discursive material from the guide from interviews was submitted to the informational resource ALCESTE (Analyse Lexicale par Contexte d'un Ensemble of Segments of Texte), and analyzed on the basis of the Theory of Social Representations and Central Nucleus Theory. Most of the relatives were women, married, aged over 50 years, who participated for more than two years in CAPS activities, and a coexistence of more than 11 years with the user. From the classification system of ALCESTE were selected categories, identified by: Category 1, Treatment Improvements and Expectations; Category 2, Living User Before and After; Category 3, Activities Relevance, Contradictions and Suggestions; Category 4, Guidelines -- Psychopharmacology and Medicalization; Category 5, Family Participation and Activities; and Category 6, Therapeutic Conditions Thanks, Tips and Vulnerability. The social representation of the family exists in the desire for change, identifying that we need to promote change by the continuity of therapeutic activities and overcome the detected inconsistencies, targeted by strengthening and by the stability of improvements in living and health conditions of users, experienced in CAPS treatment. The central nucleus had corresponded to positive changes in health and living conditions of users, and the peripheral elements were constituted by family conducts before and during treatment, and the expectations of changes in activities, especially in workshops. Despite this family participation be considered important, it still does not meet conditions to promote the inclusion of family, under an emancipating point of view, capable of causing in subject the hope for autonomy, initiative, individual and collective growths, a closer and active involvement in therapeutic activities, in workshops and discussions