Desnudando as condições para materialização da reforma psquiátrica em Natal/RN: para além da implantação dos serviços substitutivos em saúde mental

Esta pesquisa objetivou analisar a concretização da reforma psiquiátrica em natal, partindo de um dos serviços substitutivos que compõe a rede psicossocial deste município. A política de saúde mental tem passado por mudanças paradigmáticas, definindo como objetivo maior o processo de desistitucionalização. Redirecionando sua ação para os serviços substitutivos e não, mas o hospital psiquiátrico tradicional. Nesse cenário os Centros de Atenção Psicossocial (CAPS) se mostram estratégicos para materialização dos objetivos pretendidos pela reforma psiquiátrica. O estudo transcorre dentro da perspectiva materialista dialética. A presente pesquisa teve como lócus de investigação empírica o primeiro Centros de Atenção Psicossocial implantado em Natal/RN. A escolha por um serviço extra-hospitalar vai ao encontro de uma postura defendida pelo movimento de Reforma Psiquiátrica. Considerando o CAPS um serviço substitutivo estratégico em saúde mental para a efetivação da Reforma Psiquiátrica, neste sentido objetivamos apreender as contradições que marcam o processo de concretização da Reforma Psiquiátrica através da vivência dos usuários e de suas famílias, no interior de uma unidade integrante do novo modelo de atenção em saúde mental. Partimos do pressuposto de que os usuários e seus familiares são sujeitoschave no processo de reforma psiquiátrica, por vivenciarem em seu cotidiano as mudanças concretas realizadas, que acenam para um processo de re-inserção social, mas também, contraditoriamente, os limites e entraves desse processo

Gestão por Competências em Organizações Públicas: O Processo de Transformação Organizacional e seus Impactos Junto aos Servidores na Secretaria Estadual de Administração e Recursos Humanos (SEARH/RN)

The state has changed over time in order to meet a society with increasingly stringent demands. Techniques of private means begin to be employed in an attempt to overcome the dysfunctions entrenched bureaucracy, making the machine faster. By federal law by the People Management Skills was established as a reference for the administration of Human Resources of the public sector in an attempt to develop professionally servers, based mainly on the three pillars of the model: the knowledge, skills and attitudes. This thesis aims at understanding, in the view of employees, the perceived impacts on the organizational changes occurring in the Department of Administration and Human Resources of the State of Rio Grande do Norte in order to implement a People Management Skills-based. It is a simple case study, characterized by the research during a certain period of time, collecting data in a real environment of an organization, in this case SEARH/RN. The procedures used in collecting data were the literature review, documental research and field research. We used a qualitative approach with exploratory and descriptive approach. Every reform was implemented in the institution and reported from there analyzed the impacts observed by the servers. As a result we observed a considerable advance in institutional activities, mainly relating to physical structure / organizational and human resource policies, with minor advances on labor policies, in much the result of the guiding focus of the reform on SEARH/RN. The impacts in total were more positive than negative and direct paths to improvement in public organizations. Making a general analysis of the modernization program implemented in SEARH/RN, we can conclude that there was a distinct change in all dimensions studied, mostly pointing out positive aspects, and contrary to the opinion of some authors, who claim to be very difficult to implement reforms in public organizations, since they are highly institutionalized environments. What was found was a big organization, with gaps and weaknesses, but with a much larger number of hits and recognition from institutional actors

Reforma agrária de mercado e territorialização: um estudo a partir do Programa Cédula da Terra em Canindé-CE

The research Reforma Agrária de Mercado e Territorialização: um estudo a partir do Programa Cédula da Terra em Canindé-Ce , has an objective to discuss until whas time denominated agrarium refom has capacity of territory the of families in Five from the seven settlements cmated by resourles from the prgramme cell of earth em Canindé-Ce. In this context, the present work analysis the relation sitip between power and kind of identity, in special in those settlements, trying to learn the dialetic relationship. That passes by the process and appropriation in these spaces by these families gave the beginning of buying the land. The procedure methologic used by us gave privilege to realize the interview included in this process, wita the leaders of rural associations (STR); commission clero of earth (CPT); rural workers movement without land (MST); wita agricolas tecnics, and so the local coordinators of cell of earth in Fortaleza. The analysis of agrarium reform in Canindé, infects that the families giving entrance in buying the land, they could creatieg a hope in quality of life for getting the land. Nevertheless, it did not happen, in the rost of the parts of the areas in study. The territories present in general focus, the worse process of poomest besides the amount of debiths of these families, putting in risk the territorialization of themselves

Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial

Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program “Validate Epi Info 3.5.4” , used along with the “SPSS 17.0” for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; “Fisher's” exact test to check the CAPS impact on hospital admissions and the “Bonferroni” adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.

Síntese de carreadores de oxigênio à base de Ni e Co para estudo do processo de Chemical Looping usando CH4 como combustível

Increasing energy demand is being met largely by fossil fuel reserves, which emit CO2, SOx gases and various other pollutants. So does the search for fuels that emit fewer pollutants and have the same energy efficiency. In this context, hydrogen (H2) has been increasingly recognized as a potential carrier of energy for the near future. This is because the H2 can be obtained by different routes and has a wide application area , in addition to having clean burning, generating only H2O as a product of combustion , and higher energy density per unit mass . The Chemical Looping Reforming process (CLR) has been extensively investigated in recent years, it is possible to regenerate the catalyst by applying cycles of reduction and oxidation. This work has as main objective to develop catalysts based on nickel and cobalt to study the reactivity of reform with chemical recycling process. The catalysts were prepared by three different methods: combustion assisted by microwave, wet impregnation and co-precipitation. All catalysts synthesized have the same amount by weight of the active phases (60% w / w). The other 40 % m/m consists in La2O3 (8% w / w), Al2O3 (30% w / w) and MgO (2%). Oxygen carriers have been named as follows: N or C, nickel or cobalt, followed by the number 3 or 6, meaning 30 to 60% of active phase in the oxide form and C, CI or CP, which means self-combustion assisted by microwave, self-combustion assisted by microwave followed by wet impregnation and co-precipitation. The oxygen carriers were then characterized by the techniques of X-ray diffraction (XRD), surface area (BET), temperature programmed reduction (TPR) and scanning electron microscopy (SEM). The characterization results showed that the different synthesis methods have led to obtaining different morphologies and structures. Redox tests using CH4 as reducing agent and sintetic air as oxidant agent was done with N6C and C6C, N6CI and C6CI and N6CP and C6CP oxygen carriers. The tests revealed different behaviors, depending on active phase and on synthesis procedure. N6C oxygen carrier produced high levels of H2. The C6CI oxygen carrier produced CO2 and H2O without carbon deposits.

A reforma psiquiátrica e a política de saúde mental do Rio Grande do Norte: papéis e funções de profissionais e gestores

This study arose from an interest in knowing the reality of mental health care in Rio Grande do Norte (RN) on the advances and challenges in the intersectoral agreements paths and consolidation of the Psychosocial Care Network (RAPS) from the state. Considering problematic and concerns were defined as objectives: Identify the knowledge of managers of Rio Grande do Norte on the National Mental Health Policy (PNSM) in the RN State; Describe the activities developed by health professionals in the individual service offered in the CAPS from RN; Understanding the relationship of managers’ knowledge on national mental health policy in professionals’ practice working in the the CAPS from the countryside. It is a descriptive study with a quantitative and qualitative approach, carried out in 30 CAPS from RN’s countryside, where 183 professionals answered a structured questionnaire with closed questions about the activities they do in individual care; and 19 mental health coordinators of municipalities and the state coordinator of RAPS were interviewed about their knowledge on the Mental Health Policy. Data were collected after approval by the Research Ethics Committee of the Federal University of Rio Grande do Norte, with the number 508.430 CAAE: 25851913.7.0000.5537 from August through October of 2014 in 26 municipalities with CAPS from the state. Quantitative data were tabulated and analyzed using a descriptive statistics aided by the software Statistical Package for the Social Scienses (SPSS) version 20.0. The qualitative data were prepared in a corpus and analyzed through software Analyse Lexicale par Contexte d’um Ensemble de Segments de Texte (ALCESTE) that allow to perform textual statistical analysis and categorization from their comments, submitted to Bardin content analysis. Five categories were generated approaching the managers’ knowledge, namely: Back to society: leadership and users’ role and autonomy; The gap between policy and practice; Barriers that affect the service; Structuring the Psychosocial Care Network; Multidisciplinary team: attribuitios and activities. The CAPS professionals’ ages ranged from 20 to 58 years, prevailing females, with 76.5% of the total, the majority were social workers (16.8%), psychologists (15.3%), nurses (14.8%) and nursing technicians (14.8%). The results showed precariousness in care associated with physical workload regard to high workload and low wages of the CAPS professionals' and, also, it was possible to observe a large involvement of professionals in care delivery, despite the difficulties encountered in services. It was found little knowledge in managers regarding the National Mental Health Policy having as causes of this reality the poor education and training of these professionals. The responses of professionals working in care reveals strong consistency with what is expected of a psychosocial care service. Points up as a thesis of this study that the psychiatric reform and mental health policy in Rio Grande do Norte is following a structural expansion process, but with precariousness of services from a still unprepared management to act in a psychosocial context.

Processo de construção do conhecimento a partir do diálogo ensino-serviço na ótica dos profissionais de saúde

INTRODUCTION: In Brazil, the health training policies have been going through deep changes, which are the fruits of the sanitary reform and of the breakage with the biomedical model, still hegemonic. Nevertheless, the paradigm of comprehensiveness is being introduced in health and, in order to consolidate this concept, the training has been gaining new methodological approaches. One can mention the teaching-service interaction (education-health system/citizenship health), whose proposal enables the expansion of the perception of the health-disease process, as well as the warranty of compromises of training in relation to SUS. OBJECTIVE: Understand, from health professionals, the relevance of teaching-service-community interaction, vocational training of students of the Faculty of Health Sciences / UFRN. METHODOLOGICAL PROCEDURES: This study is grounded on qualitative approach. The technique used to obtain research data was the focus group. Two focus groups (FG) were accomplished in two family basic health units of the municipality of Santa Cruz – RN, where there is participation of professionals of the Family Health Strategy. The discussions were performed from a previously elaborated script. The analysis of results was held from the categorical thematic content technique. RESULTS: The study had the participation of 18 health professionals, and 13 (72%) were females. For these professionals, the teaching-service interaction enables the student to understand the model of comprehensive health care, since the contact with the community enhances its perception about the health-disease process, but also enables recognizing the importance of teamwork to comprehensive health care. FINAL CONSIDERATIONS: The results highlight the importance of a policy of reorientation within the context of training so that students have an early contact with the service and therefore develop technical skills within the context in which they are inserted.