Percepções ambientais de comunidades rurais e indicadores de sustentabilidade como subsídios à conservação de áreas de caatinga no Rio Grande do Norte

Environmental degradation is a global problem that particularly affects areas subject to seasonal climatic variations, such as the brazilian semiarid region, namely the Caatinga Domain. Combined with other negative factors, such as natural resource misuse and disorderly land occupation, the consequences of Environmental Degradation have challenged science in the quest for addressing the resulting social and environmental problems. Accordingly, Environmental Perception methodology, by analyzing the concepts, attitudes and values, (especially those pertaining to environmental conservation) represent an important tool in studies that address the relationship between the environment and human actions. Sustainability Indicators are also relevant tools to assess the possible causes and consequences of environmental problems. Among several Sustainability Indicators available, the PressuresState-Impact-Response (PSIR) method is an analytical tool that permits the grouping of factors affecting sustainability as well as their consequences for nature and human health, and thus indicate mitigating actions for society and the public authorities. From this perspective, three areas of Caatinga were studied in Rio Grande do Norte state: Seridó Ecological Station (ESEC), Municipality of Serra Negra do Norte; Private Natural Reserve Stoessel de Brito (PNRSB), Municipality of Jucurutu; and part of the Serra de Santana, Municipality of Tenente Laurentino Cruz. The areas are both legally protected and unprotected and subject to diferent management protocols, though their share the common characteristic of human misuse of natural resources. In this scenario, this thesis´ main goal was to introduce the rural communities into the conservation process, using the results of Environmental Perception of such communities, combined with the analysis of the sustainability of municipalities through PSIR. Information on Environmental Perception was obtained from primary and secondary data from previous studies carried out in the ESEC Seridó and PRNP Stoessel de Brito. Additional data was obtained through direct observation and interview forms applied to rural communities in the Municipality of Tenente Laurentino Cruz. The results showed that respondents possessed a broad knowledge regarding environmental degradation, its causes and consequences for the caatinga biome. PEIR analysis showed that environmental degradation was smaller in countries with protected areas, as compared to those without. The population´s knowledge about environmental degradation and their acceptance of conservation units, as showed by Environmental Perception Analysis, coupled with the results of PEIR, suggest that those attitudes may foster actions aimed at reduction of environmental degradation in the Caatinga domain

Espécies arbóreas nativas ornamentais do Rio Grande do Norte

The Caatinga and Atlantic Forest exhibit great species richness, which can attend requirements for various uses. Considering the current level of degradation of vegetation in Rio Grande do Norte, and the increasing use of exotic species, it is urgent to perform actions for the conservation of these biomes. From this perspective, using native plant species in the urban forestry becomes an instrument for the conservation and enhancement of local biodiversity. In this context, the general objective of this study is to gather and provide information about the ornamental native tree species in the state in order to promote and disseminate their use in urban areas. Specific aims of this work are: (1) evaluate and verify the demand and maintenance costs of native and exotic urban forestry, comparatively, with data obtained in the state (Cap. 1); (2) Provide a ornamental native tree species list in the state, including species already widespread use and suggesting new elements with ornamental potential (Cap. 2); and (3) produce a guide of native tree species as a means of disseminating the results obtained in a way accessible to the society. Analysis of maintenance of urban trees was performed at the UFRN's Central Campus, and the ornamental native tree species survey was carried out through literature survey combined with expeditions to forest fragments in the state. As a result, it was obvious that the maintenance of native vegetation resulted in lower costs and least demand for services highlighting the visible advantage in using a afforestation with regionalized floristic composition. The survey of ornamental native tree species led to the selection of 95 species belonging to 30 families, 17 species (17.35%) occurring exclusively in the Caatinga, 27 species (25.55%) in the Atlantic Forest and more than half (55.10%) occurring in both biomes, which provides a good selection available for the composition of urban forestry, both for cities located in the area of Atlantic Forest (81 spp.) or for those located in the Caatinga (71 spp.). From these results, a guide for the recognition and cultivation of native ornamental trees was prepared, consisting in the initial step in the enhancement of existing floristic potential value with the aim to assist in the development of a regionalized perspective of urban environmental management in the state

O papel da violência interpessoal compreendida como a manifestação de uma endemia social: uma análise geográfica sobre o fenômeno no Brasil e Rio Grande do Norte

En Brasil, la violencia interpersonal (homicidios) se ha incrementado de forma significativa, convirtiéndose en una preocupación cada vez mayor en todos los ámbitos políticos de la sociedad. Hoy es uno de los más graves problemas sociales y de salud pública. Se refiere a los problemas sociales, ya que interfiere en la distribución de la oferta de bienes y servicios a los ciudadanos; sino también un problema de salud, porque la violencia es uno de los fenómenos que causan gran impacto en la morbilidad y mortalidad del país, y genera un alto costo para el Sistema Único de Saúde (SUS). Esta es una crisis social, que es el resultado de un mundo capitalista globalizado, que exige a todos sus instrumentos de dominación (dinero, poder y competitividad en estado puro), en virtud del cual la violencia y los conflictos interpersonales se materializan en el territorio. El Río Grande do Norte (RN) ha estado siguiendo esta realidad que es nacional, con el aumento de las tasas de mortalidad por homicidios. En este sentido, este estudio tuvo como objetivo analizar la violencia interpersonal (agresión / homicidio), en Brasil y en el estado del RN, para entender cómo esto afecta a su población, en la morbilidad y mortalidad durante los años 2001 a 2011. Para ambos hicimos uso de método descriptivo / cuantitativo para determinar la magnitud, el tamaño, el perfil de las víctimas y los costos del SUS generados por el problema. Como resultado, podemos diagnosticar que en Brasil, la violencia se ha presentado una nueva dinámica regional, promovida por un proceso de interiorización del fenómeno en todo el país, este proceso de internalización se ha reflejado en la última década, el crecimiento de la violencia en el estado del RN, que ha causado un gran impacto en las tasas de la mortalidad del estado. Acerca la victimización, se puede ver que hay un perfil vulnerable formado por, varón, baja instrucción joven, sola y negro. Con respecto a los datos de morbilidad hospitalaria, la demanda creciente del fenómeno genera costes para el sistema de salud, y las graves consecuencias humanas, como la escalada del miedo y la destrucción de una generación de jóvenes brasileños. Por lo tanto, la falta de una política pública para afrontamiento, prevención y mitigación del problema revela el fracaso de la gestión pública, con consecuencias sociales y de salud, tanto individual como colectivamente.

Produção do espaço e reestruturação produtiva do setor de laticínio no Rio Grande do Norte

Since the 1970s, Brazil has gone through several changes in its economic and productive structures, which have symbiotic relationship with the organization and dynamics of the Brazilian territory. This set of economic, social and technical-scientific transformations developed in the amid the productive capital restructuring, a process that occurs on a global scale, but that effective with particularities in different places. Adopting this presuposition the present research had as main objective analyze the productive restructuring of the dairy sector in Rio Grande do Norte, highlighting its relationship with production process / organization of space and its impact on the social relations of production. The adopted methodology to elaborate of this study was based on the achievement a bibliographic review with regard to proceedings of production of space and productive restructuring, document research about the dynamics of the dairy sector in Rio Grande do Norte, as well as on regulatory instructions governing the dairy production in Brazil, we achieve parallel secondary data collection, with official organs such as IBGE, EMATER and SINDLEITE. Another important methodological resource was the realization of the field research, which enabled us to empirically understand the distinct realities lived by agents acting on milk production system in Rio Grande do Norte. The analyzes performed nevertheless evidence that the restructuring process in the dairy sector is fomented, greatly by state,that finance, encourages and normatizes the production of milk in the country. In the specific case of Rio Grande do Norte, this process is boosted by the creation of "Programa do Leite," which by constituting of an institutional market, contributes to the strengthening and expansion of industries, the detriment of the artisanal processing sector. Nevertheless family farmers continue to act in the activity, be only producing and trading fresh milk, supplying milk to processing units, mediating the production of their peers or by the craft benefiting milk in traditional cheese factories presents in the entire state of Rio Grande do Norte. The results reveal that it is a complex web of social relations of production that are established at the heart of laticinista activity in the Rio Grande Norte, these are summarily marked by relations of competition and complementarity between industrial and artisanal processing of milk

Políticas públicas de economia solidária: uma avaliação do PCPR II na microrregião de Angicos do Rio Grande do Norte

The Solidarity Economy is considered in this work as a development option. Talk about it is to think in the workforce as a producer of material wealth and, above all , subjective , therefore it is necessary to take into account that these relations coexist different types of practices that encompass emotions , lifestyles , etc. This research has as an object of study evaluating the effectiveness of public policy for Solidarity Economy, microrregion Angicos / RN, demonstrating how the Solidarity Economy has encouraged the development not only as a driving force for economic growth, but as the expansion capabilities and freedoms. The Solidarity Economy has several definitions, and despite having its origin in the cooperative movement, is a concept under construction. Focused on the discussion of public policy, is now understood as a proposal for employability, either as a generator of employment and income, reflecting its polymorphism. Theories and concepts developed by Amartya Sen is an important analytical tool for understanding the Solidarity Economy as a development strategy. When speaking of instrumental freedoms, Senniana theory contributes to reflection on how participants socioeconomic actions are becoming active agents of change i n their own freedoms. The analysis was based on the discussion of development beyond economic bias, using the lines of the vari ous local stakeholders with PCPR II, p hase 2, for microrregion Angicos / RN, comprising: public managers, technical advisors and beneficiaries of the program rural poverty alleviation. Besides the discussion of the economic organization of the RN and its spatial distribution, the survey brings the result that the Solidarity Economy in microrregion Angicos / RN contributed to the dev elopment as freedom, proving the effectiveness of public policy by allowing an improvement in the quality of life, enabling efetivations, even without major proportions.

Avaliação da atenção humanizada ao abortamento em maternidade-escola, em Natal, Rio Grande do Norte

Unplanned pregnancy is experienced by millions of women worldwide. Such fact increases the risk of abortion-related morbimortality, which represents a serious public health problem. This study aims to evaluate the advances and challenges of the implementation of Humanized Abortion Care at the Maternity-School in Natal, state of Rio Grande do Norte. The research was evaluative, was preceded by an Evaluative Study, and resulted in a Case Study. The intentional sample totaled 102 subjects (60 users, 39 professionals and 3 managers). The collection techniques included documental analysis, semi-structured interview and observation with a field diary. The documental analysis was descriptive, while the Content Analysis by Bardin was used for semi-structured interviews and field diary. The Evaluative Study observed that Humanized Abortion Care is an evaluative program with preparation and pact of the logical model, of the matrix of indicators and evaluative questions. The Case Study showed that users were satisfied with the problem-solving capacity and access to the service; however, is also showed that they pointed out inadequacy in terms of environment, qualified hearing and reproductive planning. Professionals reported that the inefficiency of service consists of infrastructure and environment, which are considered inefficient and inadequate to humanized care, especially regarding patient accommodation, the lack of hospital beds, the reduced number of rooms in the surgical center and the lack of laboratory inside the maternity. Moreover, reproductive planning does not consist of an institutionalized practice in the service, and integrality with other services or partnership with the community is not in place. The Maternity Board emphasizes that the excessive demand of patients is one of the reasons that hinders the appropriate implementation of the technical standard. We then conclude that although satisfied regarding problem-solving capacity in terms of service and ease of access, there is room for improvement in qualified hearing systems, in the creation of a system to promote team work, implementation of ombudsman and satisfaction surveys. The right of shared choice did not prevail among users and health professionals with regard to the option of uterine evacuation procedure. Environment was the most mentioned category as that requiring more changes, seeing as a limited factor for the development of humanized and welcoming practices. Health professionals do not establish a periodic routine of planning practices, and such practices are not aligned with the Technical Standard. Incorporation of guidelines and availability of a plurality of methods and possibilities of choices for family planning are required. There is no institutionalization of reference and counter-reference, or partnerships with the community, which makes integrality of care not viable. The Standard needs to be included in the action plans of managers as one of the priorities in the construction of care strategies for women's health, in order to enable, allied to other initiatives, the real integration among safe conduct service, primary care network and social organizations. As a result, respect for human rights and adequate humanized care, as a way of attention and prevention of abortion, can be secured.

Fundamentos dos cuidados com crianças e adolescentes: um olhar sobre o Rio Grande do Norte entre 1964 e 1988

Childhood and adolescence care has frequently caused theoretical and methodological discussions. At national level, the way of dealing with this public has always been on the agenda, either by maintaining a paternalistic treatment, or by coercive and repressive expression with which this public is treated. Given the above, this research presents a thorough study of social policies focused on children and adolescents in Brazil, with the overall purpose of investigating how this process of implementation of public policies for poor children and adolescents in the state of Rio Grande do Norte was. In previous studies, it was identified that there are no official records regarding the policy implementation process for this population in the state of Rio Grande do Norte. A retrospective study about the care towards children and adolescents in Brazil was held. It ranged from the XXVIII century, through the period of assistance, until the historical period in which the child started to be considered from the perspective of a policy. Thus, a certain period was framed, so that, through the historical research method, this study could focus on gathering data about the attention focused on childhood and adolescence in the state of Rio Grande do Norte, between the years 1964 and 1988. Data was listed from newspaper files that circulated in the state during period mentioned above. This time framing corresponds to the regency of the National Policy of Child Welfare. In the state of Rio Grande do Norte, the implementation of institutions such as FUNBERN and then FEBEM did not differ from the national standard, since many projects and care programs for poor children and teenagers were executed in this period. The implementation of these institutions revealed the concern of the state in solving the problem of “minors” regarding to situations of abandonment or "delinquency" which they were involved with. However, the kind of protection provided by the state toward this population was based on the current ideology that supported the political system at the time: the military dictatorship. Thus, the main way to provide care to this population was through its institutionalization, through taking children to daycare centres and adolescents to “reeducational” institutes for “minors”.

O atendimento às adolescentes autoras de atos infracionais no estado do Rio Grande do Norte

The objective of this study was to investigate the assistance for the female adolescents perpetrators of offences in the state of Rio Grande do Norte. Through the Thematic Oral History and Documentary Analysis methods, we sought to uncover historical aspects of the work provided in women’s units of the Fundação dos Direitos das Crianças e Adolescentes (FUNDAC) [Foundation for the Rights of Children and Adolescents], from the experiences of professionals who have worked in these units since the beginning of their activities. For this, we made visits to FUNDAC and the Centro Educacional Padre João Maria (CEDUC) [Educational Center Father João Maria], to identify professionals who could participate in the study, as well as institutional documents on routine of treatment. Eight professionals were found from three identified units: Granja Santana, Instituto Padre João Maria and CEDUC, who were interviewed according to a semi-structured script. The analysis of the collected material is supported in Marxian theory and feminist perspective on the sexual division of labor. The results are organized into five areas of analysis: (1) the creation of the service units; (2) the deviant “behavior”: reasons for institutionalization of female adolescents; (3) educational proposal: a female version; service strategies and; the rules and punishment: the domesticated teenage girl. The study indicates that the commission of the offense by the female adolescents in state of Rio Grande do Norte (RN) has been associated with the conduct of their families, particularly their mothers. Moreover, in general, service strategies, educational proposals, disciplinary measures were and have been developed based on the naturalization of what is female. Therefore, the assistance to adolescent girls in RN, those thirty-five years, left intact the existing hierarchy in social relations between the sexes, it reproduced the subordination of female adolescents in the juvenile justice system.

Avaliação da conformidade dos blocos cerâmicos produzidos em algumas cerâmicas no Rio Grande do Norte

The final quality of the works accomplished by the building construction industry depends directly on the quality of the materials supplied and used during all their phases of execution. The federal government participation and several state programs have established conditions to stimulate and require the increment of the quality level in the building construction industry´s product chain. These programs aim at the product conformity to the technical standards. Within this context, the evaluation program of the ceramic product conformity in Rio Grande do Norte state is assessing the conformity degree to Brazilian Technical Standards of ceramic bricks and tiles made in the ceramic production area in the state. In this work, is determine the degree of conformity of the sealing ceramic bricks made by some companies in different areas of the state, such as Assú, São Gonçalo do Amarante, Apodi, Parelhas, São José do Mipibu e Macaíba. Using the technical standards as a point of reference, we attempted to reproduce in the laboratory the experimental procedures to the analysis execution, according to the specifications. It was possible to determine that none of the evaluated samples are in strict conformity with the current technical standards, what reflects the real situation of the products available on the market.

A educação popular para todos de uma cidade educadora (Natal, Rio Grande do Norte, 1957-1964)

This work has as a research subject of popular education policies of the city of Natal, Rio Grande do Norte, in the years 1957 to 1964. It aims to identify and analyze popular education policies developed and implemented by the Municipality of Natal in these years. To get the historical data, we establish as a guiding reserch question the following: Which elaborated educational policies were implemented by the Municipality of Natal in the years 1957-1964? and took over as the method Evidential Paradigm as proposition in Pinheiro (2009). This is anchored in documentary sources of Educational Legislation at National, State and Municipal levels as well as in the newspapers Folha de Tarde and Jornal de Natal; in existing documents from the archives of the Historical and Geographical Institute of Rio Grande do Norte (IHGRN), the Municipal Public Archives of Natal; iconographic sources; interviews and academic publications. In addition to these sources, we were inspired by the works of Aristotles (2011), Hobbes (2009), Freire (2011), Góes (1980), Germano (1989), Cortez (2005) and Galvão (2004). This research allowed us to understand that policies of popular education of Natal (RN) were based on a democratic educational practice, supported on three pillars, namely: participation and involvement of Natal population; construction and reconstruction of teaching practices in prioritizing their action programs to mass literacy and the training of lay teachers; and the democratization of culture. This historical process made Natal on educating city.

Epidemiologia e caracterização molecular dos vírus Dengue circulantes no Rio Grande do Norte, 2013-2014

Dengue is an acute infectious disease, usually transmitted by Aedes aegypti mosquitoes. The etiologic agents belong to the family Flaviviridae, genus Flavivirus, and occur as four antigenically related but distinct serotypes designated DENV-1, 2, 3, and 4. In Brazil, the disease represents a national public health problem. The purpose of the present study was to describe epidemiological aspects of dengue in the State of Rio Grande do Norte, from 2013 to 2014. A total of 483 blood or serum samples, collected from January 2013 to December 2014, were studied by RT-PCR for viral detection and typing. The infection was confirmed in 36.44% (176/483) of the cases studied. This study detected the circulation of three serotypes of dengue virus in Rio Grande do Norte, DENV-1, 2, and 4. The predominant serotype in 2013-2014 was the DENV-4, representing 83.51% (81/97) and 68.35% (54/79) of the positive cases, respectively. Regarding the spatial distribution, most of the cases occurred in Natal and Caicó, with 9.28% (9/97) and 18.99% (15/79), respectively. The months with the biggest viral circulation in RN were March 2013 and May 2014. The female gender was the most affected, representing 69.07% (67/97) in 2013 and 54.43% (43/79) in 2014. The most affected age groups were 21-30 years (2013) and 11-20 years (2014) with 25.77% (25/97) and 20.25% (16/79) positive cases, respectively. Phylogenetic analysis indicated that genotype V (DENV-1) and genotype II (DENV-4) circulated in the State. Our results provide information about the dynamics of DENV in the Rio Grande do Norte, important for the development of disease control strategies.

Descrição de novas espécies de Entomobryoidea, Womersley, 1934 (Collembola, Hexapoda) em remanescentes urbanos de mata atlântica no Estado do Rio Grande do Norte

Springtails are commonly recognized microarthropods edaphic environments. Among the most common (and most visible) forms of these animals are the Entomobryoidea, one of the most diverse groups of springtails. Although more than 8,300 species of Collembola are registered on the globe, in Brazil a little over 310 species are recorded, mostly in the Southeast. In the Northeast, particularly in Rio Grande do Norte, these records are still reduced, even in the Atlantic Forest domain for this admittedly diverse fauna and specifically, for Entomobryoidea. This study aimed to describe new species of Entomobryoidea in urban remnants of Atlantic Forest in Rio Grande do Norte, specifically in Parque das Dunas, Natal in the Environmental Protection Area Genipabu, Extremoz. The collections were made in the months July and August 2012 and January and February 2013, using entomological vacuums and plastic trays. The specimens were identified in the laboratory and described in detail by looking at the literature. In this paper four new species were described Entomobryidae family: Entomobrya sp. nov. 1, Seira sp. nov. 1, Seira sp. nov. 2 and Trogolaphysa sp. nov. 1. Seira sp. nov. 1 has clear similarities to S. paraibensis, however the chaetotaxy of the mesothorax and abdomen IV distinguishes both species. The number of phylogenetic proximity suggests similarities between species. Seira sp. nov. 2 is characterized by its chaetotaxy, mainly in the 'M' head and his mesothorax. There is possibility of a phylogenetic relationship with S. praiana and S. Potiguara due to some similarities. Entomobrya sp. nov. 1 has little resemblance to Brazilian species, from the point of view of color, however there is for the latter detailing the dorsal chaetotaxy, which might obscure evolutionary relationships of proximity. Even so, the main diagnostic feature Entomobrya sp. nov. 1 compared to other species of the genus is the complexity of the chaetotaxy of the fifth abdominal segment. Descriptions of new species of Collembola, potentially endemic to their habitats of occurrence may help to understand the morphological and evolutionary patterns in the sampled taxa, as well as the preservation of the environments in which they were found.

A formação do nutricionista para atuação no SUS: um olhar sobre a produção científica obrigatória dos cursos do Rio Grande do Norte

The National Curricular Guidelines for nutrition course predict training directed to the work in the Unified Health System (SUS) and the mandatory completion of course work. The aim of this study was to analyze the formation of dieticians in Rio Grande do Norte state/Brazil to work in the SUS, from the compulsory scientific production provided for training. This is a bibliometric study, quantitative approach, performed with completion of course works of five nutrition undergraduate courses in Rio Grande do Norte state in the years 2013/2013. From the reading of the works, the following variables were collected: nature of the institution, institution administrative category, location, work title, number of authors, work format, titration of the teacher advisor, study type, area of interest, scenery of accomplishment, submission to the ethics committee, suitability of descriptors and, as pertaining to the field of public health, the subfield of public health and the theme. The pedagogical projects of the courses were read and were identified opportunities to develop research in the graduation. For detection of significant categories we applied the Pearson chisquare test. We analyzed 195 works, coming mostly belonging to universities courses (79.0%) and private institutions (56.4%). A higher frequency of articles (68.2%), developed by one student (65.6%), guided by master teachers (57.9%), with cross-sectional study design (49.2%), conducted in laboratory (25%) and without submission to the ethics committee in research (49.2%) was find. The median adequacy of descriptors was 50%. As for the interest of the study, there was a higher frequency of work in the field of public health (p <0.001), within this subfield highlighting the nutritional epidemiology (63.0%) (p <0.001) and the subject nutrition assessment (57, 4%) (p <0.001). In cut on three major areas of dietician performance, was significant performing work in the field of public health in public institutions (p <0.05). The presence of complementary activities was unanimous in the pedagogical projects of the courses. The results of the study showed some methodological weaknesses in the research approaches, as well as a hegemonic positivist training. Despite the emphasis on public health, it was noticed little approximation of policies and nutrition programs in the context of the mandatory recearch of Rio Grande do Norte state nutrition courses.

A fiscalização do exercício profissional no Conselho Regional de Enfermagem do Rio Grande do Norte: um debate ético

The present investigation had as its study subject the history of professional monitoring, at the Regional Nursing Council of Rio Grande do Norte (Coren-RN). It assumes that the fiscalization by the Council is an important tool for improving the quality of nursing care. This study aims to analyze the history of monitoring of the nursing profession in Rio Grande do Norte, in the period from 1993 to 2013. It was marked in the ethical-philosophical contribution of Fourez and Vázquez. This is a study of social history, descriptive and analytical, with a qualitative approach, using the methods of documentary research and the technique of oral history. It had the Coren-RN as locus of the empirical research, with its documents and the participation of inspectors and presidents. The history of monitoring was built based on documents and interviews with those who lived through this path. The project was approved by the Research Ethics Committee of UFRN as Opinion 562 400/2014 (CAAE: 25452113.7.0000.5537). The results indicate that the Coren-RN, during these twenty years faced many difficulties such as the shortage of inspectors, the precarious reality of most health services, lack of professional qualification, the illegality of professional practice and structural deficiency in the institution. Nevertheless, it must be recognized that the monitoring process exercised by the Council, has evolved over the years. This evolution is expressed in increasing the number of inspectors, in the acquisition of a new seat and three vehicles, the creation of the subsections in the cities of Natal, Caicó and Pau dos Ferros, the referral of ethical procedures, among other achievements. Similarly, it is registered an improvement in the credibility of nursing professionals and other regulatory agencies. In summary, the monitoring as core activity of the Council is going through a process of transformation, in order to make the dialogue between the disciplinary design and the pedagogical design, in defense of nursing care quality. Therefore, it is an unfinished process, in continuous construction.

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.