Promoção da saúde: estratégias para a autonomia e qualidade de vida do sujeito com diabetes

O diabetes é uma doença crônico-degenerativa de grande prevalência na população mundial configurando-se enquanto sério problema de saúde pública. Por ser crônico exige dos sujeitos autocuidado e autogoverno longitudinal. A autonomia, por sua vez, é um direito fundamental e também um dos princípios da bioética mais discutidos na atualidade. Seu conceito é complexo e leva em conta a vida experimentada ao longo dos anos. Quando a discussão sobre autonomia se trata de diabetes, a dependência do outro e os conflitos no controle da doença, diante de novas regras e estilos de vida, nem sempre condizentes com os valores dos pacientes, torna-a fragilizada. Embora a autonomia seja claramente parte integrante do tratamento e alicerce para uma vida digna e de qualidade, observamos que os sujeitos se tornam ainda mais dependentes dos serviços de saúde, quando se deparam com o diagnóstico e não têm confiança para tomar suas próprias decisões diante da patologia limitadora. Por isso, há a necessidade dos serviços de atenção primária à saúde traçarem estratégias para promover a saúde desses sujeitos. Os Grupos de Promoção da Saúde são estratégias recentemente utilizadas para influenciar no nível de autonomia dos sujeitos, pois possibilitam, respeitando os limites éticos, a garantia de participação decisória no grupo, através de estratégias e treinamentos de habilidades com competências claramente definidas, que favorecem o empowerment e o protagonismo dos sujeitos. Desse modo, este trabalho objetiva identificar estratégias no âmbito da promoção da saúde na ESF, que contribuam para melhor autonomia e qualidade de vida dos sujeitos com diabetes mellitus, a partir de sua percepção. E, mais especificamente, analisar o perfil clínico e socioeconômico dos portadores de diabetes da ESF; identificar as experiências, necessidades e expectativas dos sujeitos com diabetes sobre autonomia, autocuidado e qualidade de vida; e realizar um levantamento em conjunto com os sujeitos com diabetes, sobre aspectos que sirvam de evidências para construção de propostas para implantação de um Grupo Estratégico de Promoção da Saúde GEPS, com foco na autonomia. Para isto, foi realizada uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, com 65 sujeitos com diabetes acompanhados por uma Unidade de Saúde da Família do Município de Santa Cruz/RN. A pesquisa foi realizada em três etapas interdependentes: 1) coleta de dados clínicos e socioeconômicos, para o qual foi utilizado entrevista estruturada e análise retrospectiva dos registros feitos em seu prontuário; 2) a análise das experiências, necessidades e expectativas dos sujeitos sobre autonomia, autocuidado e qualidade de vida, que se utilizou de entrevista semiestruturada com 6 sujeitos, sendo 3 com mais e 3 com menos complicações autorreferidas e verificadas no prontuário; e 3) a construção coletiva de propostas para melhor autonomia e qualidade de vida dos próprios participantes do estudo, por meio de roda de conversa. Para a análise dos dados utilizamos software de estatísticas simples para os dados das questões fechadas de cunho quantitativo e os dados qualitativos foram analisados através da análise de conteúdo. Observamos que o perfil clínico e socioeconômicos dos sujeitos com diabetes aproximam-se das estatísticas nacionais, embora existam variáveis, como cor da pele, com variação significativa. A autopercepção dos sujeitos diante de algumas complicações divergem de registros encontrados em seu prontuário o que aponta uma possível desvalorização de queixas como hipoglicemia e disfunção sexual, como também baixa adesão ao tratamento por, muitas vezes, não terem suas opiniões valorizadas. As categorias encontradas: vida, qualidade de vida, diagnostico e enfrentamento do problema, autonomia, limites e dependência assim como as práticas coletivas de promoção da saúde, apontam para a necessidade de estratégias por meio de grupos que considerem as crenças e valores dos sujeitos, favoreçam sua emancipação e torne-os protagonistas de sua própria história e de seu processo saúde doença. A autonomia é fundamental para o exercício da cidadania efetiva. É por meio dela que os sujeitos transformam sua realidade e a si mesmo. A contribuição desta pesquisa consiste em identificar estratégicas que se propõe a potencializar a autonomia dos sujeitos, através dos GEPS, norteando a atuação dos profissionais na atenção primária à saúde, que deve sustentarse em ações de prevenção e promoção da saúde e também no incentivo à participação popular e protagonismo dos sujeitos

Instrumentalidade do serviço social na previdência social no Brasil contemporâneo

In the sociability of the capital, the challenges to the consolidation of social security as a public policy become expressive, which has implications for social security services, particularly for Social Works who works for the security and fulfillment of social rights. Therefore, in this context of denial of these rights becomes relevant the work of social worker, as a professional committed to the ethical-political project and the Matrix Theory and Methodology of Social work, which potentiate the action able to establish professional articulated strategies for the strengthening of collective struggles for equality in society. Thus, this study examines the instrumentality of social work in the contemporary world and its contribution to the realization of rights. For this, we conducted a literature review, using authors dealing with the issue, as Behring (2008), Boschetti (2003), Mota (1995), Guerra (2007) among others, as well as documentary research through laws, decrees, instructions Normative, Internal Guidelines, and especially the analysis of the Matrix itself of Social Work in welfare. We use also of paramount importance to our analysis - the field research, using techniques such as semi-structured interview and questionnaire. The research enables the identification of important aspects of the subject studied, as the understanding of professionals about the instrumentality of Social Works in its ethical-political aspects, both theoretical and methodological and technicaloperative. The demands made by the managers for the profession on the sociooccupational have extrapolated the powers and duties of the Law Regulating the Profession and the Matrix of Social Work in welfare. The subjects of this study emphasize the role of social category of the National Institute of Social Security and the Federal Council of Social Service in defense of Social Works. The knowledge of social and institutional framework is critical to building control strategies that strengthen social security and public policy, the guarantor of social rights for workers in Brazil

A inserção das mulheres na luta pela terra: movimento de participação e/ou submissão

The following dissertation studies the insertion of peasant women in the conflict for land since the occupation process, dispossession and construction of the settlement New Horizon II, in the municipal district of Maxaranguape. It analyses their participation in the conflict Valley of the Hope", that resulted in the settlements New Life II and New Horizon II in the municipal district of Maxaranguape. The analysis exposes the reasons which took the peasant women, after the land conquest, to go back into domestic space and/or to assume positions of lesser relevance in the political organizations of the settlement. In the conflict Valley of the Hope, the women had a fundamental role, facing the police violence, being front line of the conflicts against the repression forces, risking their lives and the life of their families. After the conquest of the land, transformed into the New Horizon II Settlement, there are a lot of changes in the participation of the women. We can observe that, despite the protagonism of the families, in special of the women in the Valley of the Hope conflict, these female workers still experiment unequal social, economic, political and cultural conditions in relation to the men, expressing the gender inequalities which are found in the daily life of the settlement: in the community, in the domestic and agricultural task. The conflict for the land in the Valley of the Hope and the conquest of the settlement did not necessarily mean the incorporation of the emancipation of the peasant women. However, the political participation in the development of the conflicts allowed to the women the self discovering and the beginning of an emancipation process as gender. There are signals of continuities and ruptures of the present culture, almost always stimulated by the organization of the agricultural female workers

Travestis na atenção primária: o cuidado em saúde na cidade de Natal

Among the deviant a heteronormative ideal, transvestites are the ones that suffer abuse and discrimination. Have been found that health services often present themselves as places that maintains and reproduce such discrimination, which makes transvestites only sought medical care in the latter case. Based on the guidelines of the SUS and the National Humanization Policy as well as the inclusion and leadership of the users, we conducted a qualitative study seeking to understand the experience of transvestites in seeking health care within primary care in Natal-RN. We use as techno-methodological instruments in depth interview and workshop with use of "scenes". For interpretative analysis of the narratives we use to Hermeneutics-Dialectic. From the dialogue with the narrative we come to the following themes: 1) Understanding the meaning of being a transvestite; 2) The experience transvestite in search of health; 3) Transvestites and humanized health care. In the first point they reveal the daily struggle of transvestites between prejudice and the search for respect, as well as the meanings of being a transvestite, who appeared as: Being gay, being feminine, not transsexual and accept themselves as they are. In the second axis, expressed difficulties in access to and use of health services: the embarrassment by not using the social name; fear of going out during the day; the association of transvestites to HIV; and pain caused by discrimination from health professionals. It was also possible to identify simple demands such as illnesses from day to day, the demand for hormone therapy, which involves treatment needs as well as the vital need to have their rights XVII respected. The third axis, for the range of a humanized care identified that the respectful gaze guarantee their dignity and their right to health in a humane way, but it identified some necessary changes: Training of professionals, dialogue with the social movement, publicity campaigns and rapprochement with the transvestite. Finally, it is expected that the research will contribute to the field of knowledge know-how in health care transvestites, inside and outside of the university

Ícones urbanos na cidade de Natal: arquitetura e desenvolvimento urbano na cidade do sol e mar

Natal has come through major changes in the last 150 years, since the actions of city beautification, in the 19th century, until the present day, when such transformations start to have the objective of including the city in the competition for the attraction of the capital flows and consumption, domestically and in a foreign sense. It is thought that the first initiatives aimed at increasing tourism in Natal occurred in the 1960s, however, it became apparent that only from the 1980s was there a significant increase in tourist activities in Natal and the Metropolitan Region, especially on the east coast of the state of Rio Grande do Norte, leading to an expansion of the labour market, the significant increase of foreign investment, territorial changes of great impact and the production of buildings primarily intended for the hotel industry and second residence for European tourists. Since then, the incentives for tourist activity in the state have been maintained and even increased, based on tourism aimed at natural beauties, local cuisine and events, which transformed the tourist activity in one of the main sources of foreign exchange for the city of Natal. In the early 21st century, the construction of high-rise condominiums, monuments (including the designer ones), such as the Parque da Cidade, designed by Oscar Niemeyer, were already established. Also, shopping centers and, in order to host the World Cup, the new football stadium, the Arena das Dunas, among others, which were aimed at local and foreign consumers, especially European, stood out in the city. It is understood that these new buildings, monuments and also renovations and restorations that were deployed in the city of Natal aimed at constructing a new identity for the city, within the process of capitalist development and urban spectacle. It is considered that the monuments and the iconic buildings are attributes of the cities aimed at selling locations as goods, establishing a new urban environment, a new role as cities, which aimed at seeking greater autonomy from the nation-state. In this research, it was sought to analyze the architectural object, that is, buildings and monuments built or restored in Natal and its relevance to the city marketing promoted by the city itself. It was found that, indeed, such buildings and monuments are inserted in contemporary architectural production as a basis for increasing the competitive nature of Natal. In addition, they reveal a capitalist mode of production, supported by public resources, operating in the production of urban space with a view to repeating the hegemonic model of a competitive city

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.

Acompanhamento coletivo do crescimento e desenvolvimento infantil: participação de mães/cuidadores

This study aimed to analyze the participation of mothers/caregivers from the perspective of the health care model that directs the collective monitoring of child growth and development. This is an exploratory and descriptive research with qualitative approach, carried out in two Family Health Units located in the city of Natal/RN. Data were collected between August and September 2014, through participant observation and semi-structured interview technique, with mothers of infants seen at follow-up visits collective child growth and development. A total of 13 mothers were included who met the following inclusion criteria: being a mother/caregiver responsible for the care of children who have attended one or more meeting of collective monitoring of child growth and development. Exclusion criteria was established: users outside the area covered by the Health Unit Family and who did not use the National Health System as the primary health care service. For the treatment of the collected material, the content analysis was used, thematic Bardin. The study followed the ethical and legal principles governing the scientific research on human subjects recommended by Resolution nº. 466/2012 of the National Health Council and its realization occurred with the approval of the project in the Research Ethics Committee of the Federal University of Rio Grande do North, which was approved by Opinion Embodied nº. 719 949, of June 27, 2014, and Certificate Presentation of Findings Ethics No 32510514.7.0000.5537. Although not conceptualize theoretically mothers demonstrated that collective consultations of child growth and development are actions aimed at health surveillance model, since most pointed monitoring your child to actions that can be measured. Even with that, it was established the existence of health promotion actions by reporting the exchange of experience and leadership of the subjects in collective action, factor facilitated by the link established between users and professionals and users. In this action there is the induction of permanent horizontal relationship where we seek to combine popular knowledge to scientific knowledge in order to promote the integral care for the child. However, it is still possible to find professionals who directs its assistance only to pathological processes and fail to create comprehensive care alternatives. In addition, there is still embezzlement in multi that should provide care to the child population. This factor may be related to their professional training, and thus an issue that can last for a few years. We conclude that it is necessary to incorporate alternatives and models of care that support overcoming limitations and enhancing the health of the population, involving it in the prospect of a better quality of life and therefore health.

A economia solidária sob a perspectiva do desenvolvimento endógeno: o caso da cooperativa de coleta seletiva e reciclagem amigos do planeta - Lauro de Freitas/BA (2004/2013)

In recent decades, the collective leadership of the Solidary Economical Enterprises (ESS) that are active in providing collection and recycling services, has been presented as a proposal for the organization of urban space with the creation of new enterprises and solidarity production chains. Are activities that have gained a new stimulus to the creation of the National Secretariat of Solidarity Economy and the National Policy on Solid Waste that assigned a leading role in these social actors. These experiences contribute to building a participatory development path, resembling with the pluralistic perspective of development of the Indian economist Amartya Sen, that goes beyond the simplistic design of the increased income, focusing on the process of expanding freedoms that people enjoy. The aim of this work is to situate the perspective of endogenous development with the Collection Services segment and Material Recycling in the field of Solidarity Economy, through the analysis of the experience of the Cooperative of Selective Collection and Recycling Friends of the planet, located in the municipality of Lauro to Freitas - BA, from 2004 to 2013. for this the following procedures were adopted: analysis of the main contributions of the international literature on the phenomenon of pluriactivity; review of national literature that analyzes the emergence and evolution of the projects of solidarity economy in Brazil; bibliographical and documentary research; and socio-economic evaluation of the EES. The guiding problem of this work, understandably, is: what is the meaning of endogenous perspective with the Materials Collection and Recycling Services segment in the field of Solidarity Economy? It starts with the hypothesis that the development of these practices requires an environment that removes the main sources of deprivation involving the conditions of existence of these enterprises. The results show that not enough development to be built with the participation of social actors, but there are minimally necessary conditions for such experiences can take hold in order to achieve their goals. Thus, not only is it a strictly economic issue, but requires political actions for a process of social transformation.

Música em projetos socioassistenciais governamentais: práticas e concepções culturais no Serviço de Convivência e Fortalecimento de Vínculos em Natal/RN

This present research focus at the teaching of music in social programs, it discuss about the teaching concepts that permeates the educational-musical practice presents in Serviço de Convivência e Fortalecimento de Vínculos (SCFV), of Complexo Dom Bosco, in Natal-RN. The Objective is to reflect upon the music teaching concepts and the relations between musical knowledge and culture. For this, it was problematized the concepts of music teaching and learning in governmental social projects through theoretical and empirical research. After this step, it was studied the cultural aspects involving the routine in the institutions the influenced the music learning at Serviço de Convivência e Fortalecimento de Vínculos, furthermore, and how these aspects are present in the constitution of the paradigms that involve music teaching. For this, it was used a qualitative approach and a case study as type of research. As data capture tool it was used the ethnographic write, photography, interviews as a Facilitator of music with the students of the program, and video recordings of musical learning situations. Theoretical support it was used authors who study the complexity, culture and music teaching in social projects. Finally, the conclusion is that musical learning, in the SCFV context, is involved of cultural conceptions steeped to the Oratório Dom Bosco space and the same time the Brazilian Social Assistance Policy. Sometimes these concepts are contradictory: discipline, leadership and combat social exclusion refer to dialogical cultural hologram of the institutions involved in the music education process.

Atuação de psicólogos em Centros de Referência de Assistência Social na região amazônica do Marajó

This study investigated the role of psychologists in Social Assistance Reference Centres in the Amazon region of Marajó, considering its specificities: extensive territory, spread population and presence of native communities. Eleven interviews were conducted in 10 out of the total 16 cities. There’s a context of fragile economies and poor housing; incomplete or disarticulated public services; bad working conditions. The activities are ad hoc or asystematic. Promising experiences bet on decentralized and intersectoral services. Experiences from other groups point to the importance of long-term work. We conclude that a powerful way of action is to strengthen the sociability that is characteristic of the native peoples, valuing their knowledge and developing their social protagonism.

"Do alto da colina" - a província do Rio Grande do Norte, o comércio, os rios Potengi e Jundiaí e o complexo comercial do Guarapes 1850 - 1900

The commercial complex Guarapes was during the second half of the nineteenth century most commercial street of Rio Grande do Norte province. In that time frame, you can see its flourishing as one of the central places of trade in the province in 1850, and its subsequent abandonment in 1900. This thesis aims to investigate, in its first part, the paths that help to understand, as the context of the expansion of global markets in the second half of the nineteenth century enabled the conditions for the emergence of the commercial complex. However, trade relations established in this province through the commercial complex, even participating in this global environment, reserved particular characteristics in their social and trade relations, as if dealing with a peripheral province, we look at the uniqueness of the relationship occurred in this space. In the second part, we seek to understand the importance that the rivers Potengi and Jundiaí had to install the commercial complex Guarapes in the second half of the nineteenth century. As the geographical position in relation to rivers, enabled this space became flow zone and confluence of goods distributed to the various parts of the interior of the province. We also monitor the process that made these rivers leave the role of mobility and transport relations in this space, giving way the railways and roads shooting. In the third part, we seek to understand the commercial complex Guarapes in focus. Analyzing their spatial distribution on the landscape, and how the spatial organization held at the same time traces of the Brazilian patriarchy exposed by Gilberto Freyre, but also "modern" features, due to the increase of a new culture inserted material in the province. We also seek to understand elements of material culture that was the environment of the complex, and how these materials are important sources for understanding this society under study. We treat from the biggest to the smallest fragments without hierarchize them. Understanding that, the study associated the written sources and materials provide a gain in understanding of everyday these people who lived in that area of the complex in the second half of the nineteenth century.

A arte de conduzir-se pelo ensino de teatro: realidades e ficções de alunos-diretores em Camarão

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Entre ecos e narcisos: estudo de caso sobre a prática teatral com adolescentes como atividade extracurricular numa escola de nível médio

This masters thesis discusses the studying and the teaching of drama and its implications among teenagers of the contemporary world. This paper also analyses an extracurricular project entitled Drama in the development of citizenship , which was carried out in the public state school Berilo Wanderley in Natal/RN, between 1999 and 2005 with high school students. It comprises a case study that aimed at understanding how and why they chose to take drama classes outside of the school curriculum and even after they graduated, some of them never left the school project and even started participating in the cultural and artistic context of the city of Natal quite actively, both as part of an audience as well as on artistic, political, social and pedagogical performance. The project was high significant for its participants, for the school and for the community, by creating a sense of recognition of the relevance of the pedagogical and artistic production in the public school, as it managed to yield knowledge that helped students to understand the values of group work, sharing information, collaborative assessment and, most of all, to engender actions of protagonism by the teenagers themselves within their social environments. The empirical process developed is placed in a contemporary historical context where educational paradigms shifts occur, and where categories of youth empowerment and protagonism are fundamental to the educational process in the 21st century. The objective of this study is to reflect upon the pedagogical dimension of drama classes for teenagers, aiming at providing further discussions on the role of acting classes in the construction of the personality among youngsters, thus hoping to contribute to other teaching practices, including drama and other subjects of general education