Desistência ao tratamento de usuários de crack no centro de atenção pssicosocial em Campina Grande/PB

This study aimed to analyze the phenomenon of abdication of monitoring/treatment of crack users in a CAPS AD in Campina Grande-PB. That s an exploratory , description approach ,whose theoretical focus was historical-dialect of public politics on alcohol and drugs. The information collected was realized by using the technique of semi-structured interviews, combined with the crack users registered in CAPS AD in Campina Grande between 2007 and 2011.The material collected was subjected to thematic analysis method, obtaining the extraction of the following categories and subcategories of analysis: CATEGORY 1: Factors of abdication of monitoring/treatment in CAPS AD in Campina Grande PB with subcategory 1.1. Abdication on their own , 1.2. To take work/employment, 1.3 . Search for more intensive treatment , 1.4. Due to relapse; CATEGORY 2 : Treatment/monitoring in CAPS AD to the subcategory, 2.1. The dependence of crack and family support as reasons that led to frequent CAPS AD. CATEGORY 3: Living with crack addiction without treatment/monitoring in CAPS AD with the subcategory, 3.1. Religiosity as a therapeutic tool .The results showed a distance between priority for community treatment and the reality where there is lack of information about this kind of treatment and the admission as a solution. The discourse about the abdication of treatment of crack users make reference to the importance of family support, to the influence for the phenomenon of relapse and the affection to religious conceptions. Although the subjects recognize the qualifications of CAPS AD treatment, they try by themselves or by family influence, another ways of hospitalization. This leads us to conclude that it is necessary reflection and assessment of the work of CAPS AD. Counting on the social changes and the need of answers that the phenomenon requires

Análise do modelo de gestão implantado no Centro de Atenção Psicossocial CAPS II OESTE de 1995 a 2005, situado no distrito sanitário Oeste do município de Natal/RN, à luz da Co-gestão

This dissertation has as aim the praxis of co-management of the health service of CAPS II OESTE of Natal-RN, where health workers, family members got to materialize guidelines and principles of psychiatric Brazilian reform in real possibilities of subjectivity construction, whereas they changed social relations in daily life. The path chosen to record was from testimonials and contributions of those who meant their done. Redeeming this story from social representations of the majority of their builders was an instigating, delicate and rewarding task, emphasizing the living memory, rebuilt in a line of time which could not be found in simple documentary collections. Mainly, by knowing that service routine was intense and had as characteristic the singular mobility itself from a creation process and therefore not always its dynamic allowed adequate records. At the same time, from this occurred the field and bibliographic research which allowed the detailed information from the prior milestones and motivated to the practice here reported. The rereading of concepts in an interface with the reports of the interviewees enabled the verification that the model of mental health advocated by psychiatric reform was understood. Once noticed the presence of the beliefs and values of people in motivating energy for the progress of reform, it has gone to fetch theoretical subsidies of administrative order to understand how they saw this building and that uniqueness has been printed. The theoretical way and praxis have tracked here has allowed to analyze how occurred such a process of production and subjectivity and collectives that when organize enabled themselves for analysis and intervention, including in crisis situations. Therefore, it was revealed that ethical and multi-disciplinarity, the humanitarian sense, the coresponsibility, co-production and horizontal management were the key factors for spread from a changing protagonist. One can thus conclude that co-management from that collective has been multi-disciplinary weaving a cross

Qualidade do serviço em organização do terceiro setor: um estudo na casa de apoio à criança com câncer

The research aimed identify how the quality of services provided by Casa de Apoio à Criança com Câncer Durval Paiva is perceived by its users, giving an opportunity of improve their performance in social services provision pointing out the failures experienced, the institution will have the user as a important partner in fails identification, serving as a subsidy to the actions of correction and improvement to such situations demands. With this work implementation will be observed contributions that will permeate to the fields of theory and practice, enabling progress and enrichment on the subject. The theoretical contribution is observed as this work execution will provide greater advance about the models developed for the third sector. The proposed work will raise awareness issues about the full potential of the social economy, with regard to the quality of services provided by organizations, allowing a better definition of priorities on their development. The study addressed three issues: identifying the people that receive support of the Casa Durval Paiva, identifying what is the level of satisfaction of families served and evaluate the services provided by Casa Durval Paiva that demand improvements in the perception of families assisted. Found a demand for services has been found that the institution has a multidisciplinary team with a high level of professionalism, and supervised with students of various educational institutions and many volunteers to complement the actions of individual professionals. Was measured a high satisfaction of users of the services provided by Casa Durval Paiva

Método Fuzzy para auxílio ao diagnóstico de câncer de mama em ambiente inteligente de telediagnóstico colaborativo para apoio à tomada de decisão

Breast cancer, despite being one of the leading causes of death among women worldwide is a disease that can be cured if diagnosed early. One of the main techniques used in the detection of breast cancer is the Fine Needle Aspirate FNA (aspiration puncture by thin needle) which, depending on the clinical case, requires the analysis of several medical specialists for the diagnosis development. However, such diagnosis and second opinions have been hampered by geographical dispersion of physicians and/or the difficulty in reconciling time to undertake work together. Within this reality, this PhD thesis uses computational intelligence in medical decision-making support for remote diagnosis. For that purpose, it presents a fuzzy method to assist the diagnosis of breast cancer, able to process and sort data extracted from breast tissue obtained by FNA. This method is integrated into a virtual environment for collaborative remote diagnosis, whose model was developed providing for the incorporation of prerequisite Modules for Pre Diagnosis to support medical decision. On the fuzzy Method Development, the process of knowledge acquisition was carried out by extraction and analysis of numerical data in gold standard data base and by interviews and discussions with medical experts. The method has been tested and validated with real cases and, according to the sensitivity and specificity achieved (correct diagnosis of tumors, malignant and benign respectively), the results obtained were satisfactory, considering the opinions of doctors and the quality standards for diagnosis of breast cancer and comparing them with other studies involving breast cancer diagnosis by FNA.

Mapeamento geoambiental do campo de dunas Pirangi-Potengi com ênfase a San Vale e Lagoinha Natal/RN: um instrumento de apoio ao planejamento ambiental

The city of Natal-RN is constructed on dune areas with wavy relives softly waved and green areas that help to keep a pleasant climate, amongst these is distinguished field Pirangi-Potengi the dune with the areas of San Vale and Lagoinha. These environments are being substituted gradual for property and other workmanships of engineering on behalf of the urban expansion. This study the elaboration of a geoambiental mapping of Field had as objective generality Pirangi-Potengi the Dune with emphasis the San Vale and Lagoinha in Natal-RN. The done mapping had as objective specific to elaborate a vegetation map, a map of registers in cadastre of ambient problems to dunes, a map of flooding susceptibility, a map of vulnerability to the underground water contamination and a map of use and occupation of the ground. Of the carried through analysis, the area in study reveals sufficiently degraded, remaining only few green areas and dunares, as well as, the vulnerable presence of areas of vulnerability in floods and areas the contamination of the water-bearing one. The gotten results allow to affirm that this type of mapping, is of great importance for analysis and evaluation of the environment of the city

Apoio social e síndrome da fragilidade em idosos residentes na comunidade

Introduction: The frailty in the elderly is the result of a complex interplay between many social and clinical factors involved in its genesis. Although there is an understanding of its association with increased risk of adverse clinical outcomes, still it is unclear whether this syndrome can be aggravated due to lack of social support. So, the objective of this study was to analyze the association between social support and frailty syndrome in elderly community residents. Materials and methods: Observational analytical cross-sectional study, with a sample of 300 elderly living in the city of Natal-RN. Were collected informations about socialdemographic, economics and physical health data. The Social support was assessed by the status of cohabitation; marital status; contact frequency and diversity rate; received and given attendance frequency rate; and Map Minimum Relations of the Elderly. The frailty was assessed using the following criteria: unintentional weight loss, weakness, low physical activity, exhaustion and Slowness. To observe any possible associations, we performed the Pearson chi-square test, the Student t test and multivariate analysis using binary logistic regression, adopting a significance level of 5%. Results: It was observed that there were no associations of frailty with the social support variables, except for housekeeping mode (p = 0.046) of the MMRI. For the sociodemographic, economic, physical health and social support data, only age (p <0.001), sedentary lifestyle (p = 0.002) and poor perceived health (p = 0.001) were the ones that remained in the logistic regression model, with strong association for the presence of frailty. Conclusion: Among the variables related to social support, only to help with housekeeping was significantly associated with frailty. However, more studies need to be developed to characterize the social vulnerability, as well as health services need to recognize the importance of social support as an integral part of care for the elderly

A percepção dos docentes da UFRN sobre o programa de apoio a planos de reestruturação e ampliação das universidades federais - REUNI

In recent decades higher education in Brazil has gone through several changes. The Programa de Reestruturação e Expansão das Universidades Federais REUNI has been the greatest overhaul performed by the government in public universities in the last years. REUNI is presented as the biggest reform in tertiary education in contemporary times, having as the main goal a gradual increase in the average rate of conclusion in live learning graduation courses up to 90%, as well as a rate expansion of graduating students in face to face classes per professor. This research aims at studying the perception of professors from UFRN concerning the REUNI program in execution from 2008 until 2012. The study seeks to understand how professors evaluate the program and what the dimensions that most influence in this evaluation are. The study made use of a research tool (survey) which was sent through the internal system of the university, SIGAdmin, to all professors of superior teaching from UFRN. The answers generated by the survey were processed using SPSS statistical software (Statistical Package for Social Science). Factorial Analysis and Multiple Linear Regression were used as an analysis technique. 180 answers were obtained, reaching all UFRN Centers and some academic units, as well as some campuses in the countryside of the state. Through the research was possible to analyze how professors from UFRN perceive the REUNI program implemented in the institution. The results point to the program approval by the professors. Statistical tests showed that the average values obtained in the Centers and academic units are basically the same. It was demonstrated that the extent that most influenced in the answers is linked to practical outcomes of the program, whereas the knowledge of REUNI goals was the least that impacted on the marks given to the program. Another dimension which influenced the perception of professors relates to the influence of REUNI in their activities. It was observed that professors from UFRN don t see REUNI as an impediment to them

A dimensão sociocultural da reforma psiquiátrica: articulando redes para a consolidação da estratégia de atenção psicossocial

This thesis aims to discuss on articulations that have been produced on the socio-cultural field in the Psychiatric Reform process and its pertinence to the streghtening of Psychosocial Care Strategy (EAPS) in Fortaleza/CE. Such interest has been justified by the need to promote not only the production of these networks, but also interfaces to enable strategies of support and sociability from the perspective of deinstitutionalization of madness. We were inspired by the cartography perspective of Deleuze e Guattari, and determined as objectives: 1) to discuss the complexity of Psychiatric Reform process and analyze the EAPS as a model for the current Mental Health policy in the country; 2) to map socio-cultural strategies connected to the CAPS network in the city, investigating experiences that already exist or may be constituted as everyday social support networks; 3) from that mapping to start, define and discuss some aspects that converge to the accomplishment for this new mental health paradigm, drawing a cartography of the issues and movements in progress. The mapping was carried out in 2009 and consisted of semi-structured interviews with the coordinators of the 14 existent CAPS and with some people connected to the Coordination of Mental Health. Besides, during the whole development of the study, we have taken part in public events that brought us clues on the connection between mental health and culture. From the survey produced, we defined three vectors for discussion (Art, Labour and Partnership with Social Movements) which have been highlighted as effective possibilities of intervention in the socio-cultural field of Psychiatric Reform in Fortaleza and reveal important paths on the fulfillment process of a new pattern of care. For each of these axes, we chose a field of empirical research (Projeto Arte e Saúde, COOPCAPS e MSMCBJ) in which we could better understand their strengths and difficulties, starting from open interviews with some of their actors and the production of a diary of sensations in 2010. We have seen that they are articulated with the proposal of EAPS, being part of the concerns to the National Mental Health Policy and also the municipal administration. However, we have noticed to be necessary to promote those dimensions further, focusing on its complexity at the macro and micro policies, with the purpose of leading the Psychiatric Reform process

Estratégias de cuidado integral à saúde: os CAPS no processo de implementação do apoio matricial em Natal/RN

This study aims to analyzing the implementation of the Matrix Support proposal with professionals of Substitutive Services in Mental Health in the city of Natal/RN. The Matrix Support (MS) is an institutional arrangement which has been recently adopted by the Health Ministry, as an administrative strategy, for the construction of a wide care net in Mental Health, deviating the logic of indiscriminate follow-through changed by one of co-responsibility. In addition to this, its goal is to promote a major resolution as regards health assistance. Integral attention, as it is intended by the unique health system, may be reached by means of knowledge and practices interchange, establishing an interdisciplinary work logic, through an interconnected net of health services. For the accomplishment of this study, individual interviews of semi-structured character were used as instrument, with the coordinators and technical staff of the CAPs. The data collection was done in the following services: CAPS II ( East and West) and CAPS ad ( North and East), in the city of Natal/RN. The results point out that the CAPs to initiate of the discussion the process in the implementation of the MS aiming, to promote the reorganization and redefinition of the flow in the net, thus not acting in a fragmented way. Nevertheless, there is no effective articulation concerning the basic attention services, there is a major focus of the attention in mental health on the specialized services, little insertion in the territory and in the everyday life of the community

Adolescentes e jovens e suas bases de apoio :relações de amizade como suporte social no enfrentamento à violência

The purpose of this work is to map the family and community social supports for adolescents and young students from Bom Pastor Distric, West Zone of Natal/RN, as well as to describe how such resources are used by these individuaIs in that community. Social support refers not only to formal activities or organizations, but also to spontaneous or informal forms of support - friendship and solidarity nets available in the community, affective relations that are meaningful in the lives of children and young people. Our discussion is based on a research performed with 382 adolescents and young students from Jean Mermoz Public School (students from 5th to 11th grades, aged 13 to 14). We emphasized the situations of violence derived from family or community spheres faced by these students. In relation to this specific aspect, we observed the participants more frequently look for help from the informal social supports, mostly from their friends, which indicates that the formal ones are not considered to be effective instruments for social assistance. The search for informal social supports shows the relations informally established in the streets (for instance when they look for help from friends, rei atives or neighbors) have more effect and play an important role in which there are values and affections exchange. Thinking the strengthening of these social links is of extreme importance and leads to the weakening of the hegemonic logics focused on the production of subjects as private identities, and to the amplification of an ethics committed to the disassembly of a sociability anchored to fear, impotence, intolerance, discrimination, and reduction of spaces for circulating and confronting mechanisms of social exclusion. It is crucial that we concentrate our attention to building friendship as a system of reciprocity and affective exchanges, as a space for political actions and production of forms of lives that are potent against social anesthesia

Desvelando as teias de Pinóquio :concepções de família em jovens moradores de bairros periféricos

This thesis discusses family as a social and historical construction and concerns to the perceptions developed by the peripheral youth living in suburbs. It investigates the speeches of young boys and girls who take part in Engenho de sonhos a forum composed by a pool of eleven non-governmental organizations and UFRN which aim is the elaboration and execution of projects focusing local development of poor communities in violence and social exclusion context. Throughout interactive diagnosis seminars in five communities in West Side of Natal with six hundred teenagers, it was detected the need to work with family relationships. In order to build the methodological corpus a range variety of procedures were done such as: interviews, focal groups and psychosocial questionnaires with nine local young leaders. The purpose to understand data guided the research through the theory of social imagery and pointed out the following themes: conceptions, relationship, roles, family projects. Live stories of these young population reveals conflicts when it comes to the configuration of family ties, far from the family model stated by society. Family is also, in their perception, an important space to the development of affection, in experiences of all sorts, affecting personality development and determining behaviors in local contexts. The research concludes stating the urge to comprehend this academic work as a way to fight against symbolic and emotional poverty in family context producing discussions and critical reflection in a permanent relation between juvenile social vulnerability (characterized by lacks of all orders) and potential

Mães de neonatos pré-termo hospitalizados: avaliação do apoio social e da sintomatologia ansiogênica

Social support is an important factor throughout one s life, especially in times of crisis. Premature delivery can be considered a crisis, followed by neonatal hospitalization. This type of birth is associated with elevated anxiety, representing risks to maternal mental health and mother-infant relationship. This research aims to investigate whether a relationship exists between perceived social support and the expression of anxiety in mothers of premature, hospitalized newborns. This is a cross-sectional, correlational study, conducted during the period of April to October 2011, using a convenience sample. The sample consisted of seventy mothers with preterm, hospitalized newborns and seventy mothers of full-term newborns. The instruments used were the State-Trait Anxiety Inventory and the Social Support Scale. The results demonstrated a weak negative relationship between intensity-State Anxiety and emotional support as well as a negative relationship in intensity between low to moderate-Trait Anxiety, social support and its dimensions (material support, emotional, information, interaction positive social and emotional). These suggest that the better the perception of social support, the less severe anxiogenic symptoms will be, and the converse is also true. It is noteworthy, therefore, the importance of social support, as well as the importance of health professionals to be aware not only of the physical health of the newborn, but also the psychosocial aspects that pervade the context of preterm birth followed by hospitalization

O fazer do psicólogo no núcleo de apoio à saúde da família

The Brazilian Ministry of Health regulated in 2008 the Family Health Support Nucleus (FHSN) as a device for support and complementarity to the Family Health Strategy. The FHSN, through the matrix support, potentiates the Family Health teams on dealing with a great variety of demands and activities that are under their responsibilities. It is structured in teams of professionals from various health specialties, among which is the mental health. In preliminary studies we noticed that the psychologists have been the main representatives of mental health professionals at the FHSN from Rio Grande do Norte (RN-Brazil). On this scenario, this study intends to problematize the professional practice of the psychologists who work at the FHSN teams in RN, regarding how their work is done, discussing it under the perspective of collective health and the directions for the basic health care on Brazilian s health system. Still as a goal, in more specific ways: identify the forms of professional insertion of the psychologists in this field; characterize the work done by the psychologist at the FHSN (developed activities); and produce an analysis of the characteristics and limits of those actions, from theoretical and methodological references based on Marxian ontology. Were performed semistructured interviews with psychologists working in the oldest FHSN teams form RN. We conducted the analysis of the material following the blocks of information: determinants of the psychologist entry at the services, training for current practice; operation of FHSN; activities performed by FHSN team and the psychologist; joint actions; and limits of psychology practice in the FHSN. An important result, we observed the little articulation of practicing between the psychology and other professionals and teams, further indicating the prevalence of the traditional medical model (individual and outpatient) as guidance of their performance instead of the matrix logic that is the foundation of the proposed action for the FHSN. We also emphasize the potential of psychologists actions at the FHSN on contributing to the achievement of comprehensive care

O dispositivo alta nos Centros de Atenção Psicossocial/CAPS : loucura, vida cotidiana e organização social

The present paper proposes an analysis about the Brazilian Psychiatric Reform as a public policy and deriving from a research developed with the workers of a Psychosocial Attention Centre III (CAPS III) and the managers of the Psychosocial Attention Web (REAP) in Aracaju. This analysis is developed as an investigation of the discharge at those services, understood not as a procedure, but as a dispositive from which different elements can be articulated: users, knowledge, technical procedures, police measures, juridical decisions, laws, services edifying. This, form the background of the articulation between mental alienation and the subject of right alienation, in the ways through which this articulation develops to the relations between madness,citizenship, internment and substitutive practices. Our investigation about the discharge as a dispositive was built with some narrative constructions, as a discourse analysis inspired by Michel Foucault s method, from the perspective of some of the main dispositive operators: workers and managers. The main aspect observed were: the articulations built by the discharge as a dispositive based on two discursive grate, the Reform as a new treatment substituting internship, and the Reform as juridical insertion and users rights practice; the exercise of these discursive grades based on the workers and managers perspective; the transference of limitations and contradictions of these grades to the competence of the dispositive operators, emerged in an outstanding way, as sometimes those operators are liable for the emergent limitations and difficulties, and some other times they are restrained by their institutional role, which is to maintain the domination relations articulated by the dispositive; finally, some aspects extracted which the dispositive operators - when they were expected to act in a way to maintain certain power relations - were capable to resist, managing other power relations from the dispositive, that we call, as Agamben, dispositive profanity

Avaliação das ações do Núcleo de Apoio à Saúde da Família (NASF) em Macaíba/RN

This research evaluated the contribution of the Support Center for Family Health (SCFH) in relation to its effect on the Family Health Units through perception of the Family Health Strategy (FHS) and SCFH professionals, in addition to the satisfaction of users in relation to that role. Data were collected in the public health services of the city of Macaíba-RN in 2012, through semi-structured questionnaire and non participant systematic observation and it counted as investigated subjects 272 individuals (60 FHS professionals, 12 SCFH professionals and 200 users representatives of 20 units). For analysis of the responses of the opened questions was used categorization process and, in relation to the observational method, that was based on checking the space organization, the characteristics of the participating subjects and the specific set of activities performed by SCFH teams through an observation guide. The results point to a good acceptance of the SCFH teams role by most FHS professionals who reported active participation in the health units routine, its integration activities to the FHS teams with resolving based health promotion actions. Regarding the SCFH professionals, they also reported positive contribution by participating actively in the units routine with integrated activities to the ESF teams and developing resolute actions. For users, the SCFH brought assurance services with better access to specialized, resolving and welcoming care. Systematic observation ratified data obtained by questionnaire. It was perceived the need to implement actions related to man`s health, to invest in expanding the number of the SCFH teams, the greater supply of medications, improving the regulatory process and planning together as a key strategy to promote a more effective integration between teams SCFH / FHS