Ajuda mútua nos CAPS: o papel dos serviços no empoderamento dos usuários

The research objective is explore practices to mutual help between CAPS users from the east and west regions of the city of Natal, RN, in Brazil. In the mental health field, we observe the care from substitutive services is based on technical knowledge where the person of the mental health professional is predominant. The Brazilian psychiatry reform invests in equipments and mental health care protocols, but it is necessary to invest more vigorously in new strategies and actors capable of obtaining resources to achieve this goal, such as the users. If one cornerstone of the psychiatric reform consists of changing the type of relationship established with the person with mental disorders, why this relationship, nowadays, is still dominated by technique and unevenness, where on one side we have a person who knows something and who needs take care of someone, and on other side we have another who knows nothing and thus needs to be cared for? Starting from this problematization of the traditional methods of health/mental health care, an attempt was made to investigate in what ways the mutual help practices between people with mental disorders can realize potential avenues not yet explored within the scope of psychiatric reform. The objective of this research was to map possible mutual help practices among the users, and the technical understanding of such practices. For that, we took part in the daily activities of the CAPS, mapping the experiences of mutual help among users. In addition, we accompanied the users in external activities (such as return home, trips, etc), and we had roundtables with the professionals. The research was guided by theoretical methodological references of the institutional analysis. The results pointed to a lack of behaviors of mutual help or support among users, something that can probably be explained by the service work dynamics, as well as the relationship between technicians and users, which has a tendency to create hurdles for meetings among users, as well as being non-conducive to theirempowerment

Moradores crônicos de hospital psiquiátrico: um desafio à desinstitucionalização

The existence of chronic inhabitants in the psychiatric hospitals imposes a challenge to the Psychiatric Reform, that proposes things such as the gradual and progressive way to extinct mental institutions, once the permanence of the hospital in the system is only necessary because there is not a net of well structured substitute services capable of receiving that demand. This work considered relevant to deepen the knowledge about those people who passes their lives jailed by the walls of psychiatric hospitals and compose significant part of the world population. It also aimed to investigate the problem relative to the condition of being an inhabitant of a psychiatric hospital the Dr. João Machado Hospital (HJM), in the city of Natal/RN. The paper used different points of view (patients , families and professionals ) to define the profile of the inhabitants, to identify the possibility of insertion in substituting social equipment, to know the expectations of the inhabitants and their relatives regarding to the exit of the life shelter, to investigate the demands related to the net of cares social support for making feasible the discharge and to identify the difficulties that are involved in the exit of the chronic inhabitant of the hospital. There were defined three methodological phases: delineation of the identification, socio-economic and clinical profile of the inhabitants of the HJM; semi-structured interviews with professionals; and open interviews with inhabitants and family. It concluded that the psychiatric institutionalization contributes to the generation of chronic inhabitants in the psychiatric hospitals. Among the professionals, it was detached the defense of desospitalization, but an existence of devices of the asylum model. The relatives showed a resistance to participate in the care and the inhabitants exposed their desire to leave the hospital, as well like the wish of permanence. It was considered important: the construction of an extra-hospital net that enables to desinstitutionalization; the qualification of the technical; orientation to the family, stimulating its participation in the process of caring; give freedom to the individuals in mental suffering, enabling them to be ahead of their lives and express their desires and opinions; the implementation of an extended clinic that is capable of building new possibilities; and a subjectivity guided by the social enclosure

A atuação do psicólogo no contexto das referências ambulatoriais em saúde mental de Aracaju - SE

Psychologists‟ insertion in mental healthcare ambulatory clinics occurred during the decade of 1980, in the context of the claims disseminated by sanitary and psychiatric reforms, of the formation of minimum mental healthcare teams and of the retraction of the private clinic. Historically, this migration had been accompanied by the importation of practices traditionally applied at the clinics. Furthermore, the lack of clear guidelines from the Health Ministery occasioned the opening of ambulatory clinics with diversified structures at each city. The objective of this dissertation was to study the practices of psychologists at mental healthcare ambulatory references at Aracaju-SE. Were interviewed psychologists of these services and managers of the municipal health secretary using a semi-structured interview guideline, in addition to the analysis of management reports. It was observed that the mental healthcare references had experienced substantial changes referred to its structures and operation, leading to a present framework of expansion and readjustment. It was realized that there is an effort by the psychologists to maintain individual and group assistance, using adjustments in the frequency of the sessions and in the focus of the activities. Besides the progresses, the relation with the psychiatrist still works basically through the medical record, blocking advances on joint discussions of the cases. Some advances toward the amplified clinic are notable, like the overcoming of the isolated usage of psychiatric diagnostic and the replacement of the line‟ criterion by the urgency one. Sheltering had become an interesting strategy on flux ordination, however the mismatch between offer and demand seems to be a matter which extrapolates the psychologists‟ sphere at the references. For this reason the narrow of the relation with family healthcare centers seems to be the major challenge to be faced by psychologists at mental healthcare ambulatory references

Impacto do trabalho em profissionais de Saúde Mental de serviços de saúde do município de Mossoró-RN, 2012

The Psychiatric Reform has brought profound changes in assistance to people affected by mental disorders and behavior. In this context, mental health workers have played decisive roles of great impact, acting driving the process. Objective: To evaluate the impact felt by working professionals, because of the daily work with people who have psychiatric disorders. Methodology: This is a search field, a quantitative approach, sectional, descriptive and applied. Data collection occurred through the Assessment Scale Impact of Working in Mental Health Services (IMPACT-BR) applied to mental health researchers city Mossoró - RN. Results: Participants in this study 87 professionals, mostly female married, which took charge of higher education, working on a single service, working in the area for more than six years, aged between 25 and 64 years. There were a low effect of overloading the professionals surveyed. Discussion: Our results corroborate findings in other surveys conducted previously, not identifying large impact load at work among professionals of mental health teams studied. Subscales studied the highest score was observed in measuring the impact of work on team functioning. It was observed that the greater age and duration of action, reduced the emotional impact at work, suggesting that the experience enhances safety in decisions made and the possibility of greater control over the demands of work. Final Thoughts: The work presented showed that the interactive relationships between professionals and users are not the causes of greatest impact in the workplace, although it revealed overload in relation to specific aspects such as: fear of being assaulted by a patient and the feeling of physical exhaustion the end of the workday. Further investigations should be conducted on this topic in order to contribute to the implementation of psychiatric reform proposed by advances both in terms of assistance to individuals and the quality of life in the work of the professionals involved

Tratamento do Centro de Atenção Psicossocial para usuários de álcool e outras drogas CAPSad II Leste Natal/RN : uma avaliação da efetividade

The treatment for abusive users of alcohol and other drugs suffered significant modifications until arriving to the psychosocial model that is used by Centro de Atenção Psicossocial CAPSad II Eastern Natal/RN (Psychosocial Support Center). That model appears starting from Brazilian sanitary and psychiatric reforms which are expressed in the principles and propositions of Sistema Único de Saúde SUS (Unique System of Health). The Psychiatric Reform meant a rupture with the mental hospital and hospital centered treatment pattern which was destined to the abusive users of alcohol and other drugs. The new proposal offers the universalization, democratization, regionalization and completeness of the actions in the field of mental health. It gathers a strictly interdisciplinary health staff. The purpose of this study is to evaluate the effectiveness of the treatment for abusive users of alcohol and other drugs offered by CAPSad II Eastern Natal/RN. The evaluation used, as priority, the qualitative social research through an evaluating study starting from the non-experimental model. The methodological process used different instruments of data collection: bibliographical and documental researches, systematic observations at CAPSad II Eastern Natal/RN and, mainly, the semistructured interviews (21) that were accomplished with the professionals, users and relatives of CAPSad II Eastern Natal/RN. The investigation showed the effectiveness of the service and, therefore, CAPSad II Eastern Natal/RN constitute itself as the main confronting strategy to the mental hospital and hospital centered treatment pattern of caring the abusive users of alcohol and other drugs

A CRONIFICAÇÃO NOS SERVIÇOS SUBSTITUTIVOS NA REDE DE SAÚDE MENTAL DE NATAL/RN

Brazilian Psychiatry Reform, through Psychosocial Care Strategy, has intended to build insane people care practices from community care services which contemplates the subjects complete lives. However, to change the traditional care ways demands the facing of a series of epistemological, political and cultural obstacles. One of the current challenges deals with patients aggravation processes, with management ways, with devices and with professionals, as well as with the assistance network. The purpose of this thesis was to investigate how these aggravation processes has been constituted in Natal mental healthcare network, understanding its effects in the work teams and patients. Theoretical and methodological perspective used was Institutional analysis was, subsidizing the usage of concept-tools as the implication analysis, selfmanagement and self-analysis, and restitution. The research was carried out at the Natal East Sanitary District Mental Healthcare Clinic, with the participation of technicians and patients. The research procedures were: literature and document research on the attendance and the analyzed theme; attendance registers analysis; participating observation of the institutional routine for three months and field log entries; talking groups, one with the team and one with the patients. Two main discussion points are shown: 1. The mental healthcare clinic organization logic and the intersector politics; 2. The work and management processes developed at the mental healthcare clinic. The analysis show diversity in the attended demands in the service, which has favored the patients aggravation, this device and the substitute network processes. The work processes are apart from the political sphere and from the managements processes. In this sense, we show the need to reevaluate the clinic device as well as the management models adopted in the Brazilian Psychiatry Reform context

Ajuste estrutural e educação superior no Brasil: princípios negados

SILVA, Hiran Francisco Oliveira Lopes da. A juste estruturale educação superior no Brasil: princípios negados. 206 f., 2007. Tese (Doutorado em Educação) - Universidade Federal da Paraiba, João Pessoa, 2007.

A encruzilhada da vida política em assentamentos de reforma agrária no Rio Grande do Norte

The rural settlements represent a mark in the expensive historical process of fight by the land in Brazil. At first offer basic terms of survival, through the access the land and of the fundamental supports for exploration. At the same time, have stimulated organization forms politicizes of the families who manage to work with the new challenges of the everyday. The moment that follows the land conquest, and therefore, the settlements construction while life and work project, it is crossed for objective and subjective demands, with highlight for options of agricultural production and strategies of collective action. Originally formed as representation instance legitimates of the families - front to the government and social actors - the settlers associations are private spaces for political sociability, that guided by principles participative, can lead the settlers the new conquests through indeed democratic experiences. The goal of this work is to comprehend the participation forms in the scope of these associations and the way as that translates in life best terms for the group, from the settlements experiences located in the Territories of the Citizenship Mato Grande and Açu-Mossoró, in Rio Grande do Norte's State. The theoretical conceptions that guide this analysis are concentrate on discussions about democracy and participation (Patermam, Putnam, Bodernave) and in the reflections about the rural world (Medeiros, Martins, Woodman e Woodman and Bergamansco). About methodological, different point of view strategies were developed: The direct observation, the application in locate of questionnaires to the families settlers and interviews semi-structured with the internal leaderships. With that could verify that the participation forms in the associations operate in two heartfelt: Of a side, they promote assimilation opportunities of democratic abilities accompanied of notions of social rights and redefinition of political standards; Of another, it offers indeed the possibility of the settlers lead, with relative autonomy, the political organization and her changes in direction to a way of life that wish to have in the settling

Protagonismo silencioso: a presença da OPAS na formação de recursos humanos em saúde no Brasil

The aim of this study is to assess the contribution of the Pan American Health Organization (PAHO) to the field of human resources for health in Brazil. The assumption is that this organization not only influenced the development of this field, but but that it was also influenced by Brazilian institutions and by national political movements, through the interaction of its consultants with these movements. Four projects were selected, through which the contribution of PAHO was evaluated: the Program for the Strategic Preparation of Health Personnel (PPREPS), the Project for the Large Scale Formation of Middle and Low Level Personnel (Large Scale Project), the Project for Qualification in the Development of Human Resources in Health (CADRHU) and the Project for the Managerial Development of Basic Units of the National Health System (GERUS). To operacionalize the study, we used three basic complementary procedures: a bibliographic research, documental research and an interview. The time frame considered was from 1975, the year an agreement was signed between PAHO, the Ministry of Health and the Ministry of Education and Culture, establishing PPREPS. It was through this program that the first PAHO team of national human resource consultants was contracted. The period between 1975 and 1999 was marked by political and social movements that changed the course of health in the country; among these was the Movement of Sanitary Reform in Brazil, which culminated in the implementation of the National Health System (SUS). This paper shows the connections of the PAHO consultants with this movement and the implications that this had for the Program of Cooperation in the Development of Human Resources of PAHO/Brazil. It also demonstrates that as the program became contaminated by national movements of health system reorganization and of democratization of Brazilian society, it proposed, in cooperation with national institutions, an organization of determinate areas of operation of these same institutions. The manuscript further reveals that, with the Large Scale Project, the human resources program determined the pedagogical and methodological option that would be the model for various other educational projects undertaken by a number of Brazilian institutions with the technical cooperation of PAHO. And finally, the repercussions and contributions of these projects, which strengthened the the field of human resources in the public health services of the country, are identified. Data analysis was based mainly on the theories of Bourdieu, Gramsci and Freire

O ideário modernizador do governo graccho cardoso (1922-26) e a reforma da instrução pública de 1924 em Sergipe

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Política de formação docente na América Latina :Argentina, Brasil e Chile

This work aims at studying the policies of teaching training and their impact in the actors and in the education systems of the countries in which these policies were implemented into the context of neoliberal reforms. We particularly studied these policies in three Latin America countries: Argentina, Brazil and Chile. The policies studied here are the ones implemented from the 90 s. However, the horizon of this study is at the beginning of the 80 s, period that starts one of the four intervention initiatives of education here studied: The Main Project of Education For Latin America and Caribbean (PROMEDLAC), which in 2002 goes into a new stage and it is called Regional Project of Education for Latin America and Caribbean (PRELAC), worked out by UNESCO as a request of government representatives of countries of the region, based on the suggestions of Declaration of Mexico , signed by them in 1979. These suggestions will be in the base of the other three initiatives: The Education For All (EPT); Ibero-American Conferences of Education (CIE) and The Hemisphere Action Plan of Education (PAHE), whose documents are the base to the production of an abundant legislation and normatization on education that created the parameters on which the policies of education reforms were worked out and implemented and the dynamism of our education systems from the last two decades of the twentieth century on. All these initiatives intend to work with objectives, projects and programs that, in some cases, in isolation or in groups, are under influence of their actions in a way that frequently it is difficult to identify which of them is the main responsible for some advances. It is important to stand out that not all of the suggestions produced by these initiatives were implemented as policies, and many of them to be implemented were changed in such a way that they were distorted, even they were a result of a multilateral deal, each country gave to them its own interpretation. Moreover, in all these processes the teaching entities had and keep having a fundamental role. The evidences, result of the evaluations of each initiative, show that education policies implemented produced advances in several aspects. They are still not the ideal ones, in truth, but they do exist. In relation to the teaching questions, there were and are still being implemented multiples and varied actions that did not have the expected impact in the education systems of the countries, objects of this study, but, many of them that go on, are promising and start to have a positive impact into the education systems. Even so, the teaching subject matter, even playing a central role in the agenda of all countries of the region, still represents one of the big challenges to the advance and improvement of our education systems

Guiando almas femininas: a educação protestante da mulher em impressos confessionais no Brasil e em Portugal (1890-1930)

This paper treats confessional printings as a non formal space for the female education. It reflects on the importance of the woman s role to the diffusion of Protestantism in general, and its Presbyterian trend in particular, besides commenting on the proliferation of printings at the First Republic and its relation with education. In this study, Brazilian Northeastern is seen as a relevant space to the diffusion of Protestantism in Brazil; especially on what concerns the relations between Rio Grande do Norte and Pernambuco. Thereby some fountains were fundamental, as the confessional printings, that is, newspapers, magazines, prospects and other materials recollected in archives located in Natal/RN and Recife/PE, and São Paulo. It was also provided a brief incursion on Portuguese confessional printings kept in Oporto, PT. New Cultural History was chosen as theoretic-methodological guide, franchising ways inside the history of book and reading with the help of concepts like Interdependence, Social Configuration (ELIAS, 1993, 1994) and Representation (CHARTIER, 1990), considering that the survey worked out culture-manufactured products that is, intentional materials. It is well known that publishing, or better, the dissemination of printed material used to be associated to Protestants missionary practices since Reform began and, as what concerns the investigated period, in Portuguese and Brazilian lands indistinctly. Printing material in general books, booklets, fragments, as well as the press itself played a central role in divulging reformed ideas, their social options and the means of being and intervening in the world. In this regard, the confessional printings established themselves as an educative, although non schooled, informal space, but, all considered, relevant, seen that they dialogue with another important demand of that social group: formal, literate education. Because it dealt with the diffusion of a printed culture supported by the written word, it required of that group a different modus operandi: formal education. The first letters schools at first, then the high schools later represented spaces established for the circulation of printing material in order that they should be read, divulged and comprehended. This survey intends at last to take a look at Protestantism which, in this context of self-affirmation, reserved a specific place to woman by working out a non formal educational proposal disseminated by printing material. Three models were highlighted in the reformed proposal: Christian education in itself, household education, whose references of motherhood and care towards the neighbor were present and, at last, education to the public space, with emphasis on the practice of teaching. This study also offers a brief dialogue between Brazil and Portugal because, when some periodic printing, book or something like that got to be published in one margin of the Atlantic Ocean, the other margin surely was affected by that feat, received it, divulged it, corroborating the argument in support of the circulation of these printings. It was not only the same language that survived in both maritime coasts; some protestant specificities also crossed out along that sea

Serviço Social Audit Saúde no SUS/RN: projeto ético político profissional e de reforma sanitária

Health policies in Brazil, the decentralization of SUS management responsibilities for the three spheres of government has driven the creation and regulation of the audits of health services in the National Audit Office, this is a trend of neoliberal policies imposed by international bodies like the World Bank and IMF to peripheral countries characterized by productive restructuring and reforming the state focuses on the presence of two competing projects in the area of health: Health Sector Reform Project which is based on the democratic rule of law with the assumption of health as social right and duty of the State in defending the extension of the conquest of rights and democratization of access to health care guaranteed through the public financing strategies and the effective decentralization of decisions pervaded by social control and privatized Health Project which is based on the state minimum, with a reduction in social spending or in partnerships and privatization, stronger nonprofit sector, subject to capitalist interests, is made effective through strategies targeting health policy and refilantropização actions. In this context, the present study is an analysis on the work of social audits of public health in infants from a qualitative and quantitative approach, embodied by the critical method of dialectical Marxist social theory that enabled us to unveil the characterization, the demands, challenges and outline the profile of Social Work in teams inserted audits of SUS in RN, but also provided evidence to demonstrate the prospects and possibilities of this area of activity of social workers. It was also found that through the audit work that the state fulfill its role as bureaucratic and regulator of health services with efficiency, effectiveness and economy. Yet, paradoxically, the audits of SUS may provide a vehicle for enforcing rights and ensuring the fundamental principles contained in the project of health reform, because it can be configured in a space of political struggle as representing a new field of knowledge production that needs to be appropriate for a theoretical critic able to redirect the social interests in favor of the user. From this perspective, it is concluded that the work of social audits of public health in infants despite the social relevance that prints, as they constitute an activity study of reality and its transformation proposition requires a transformative political action guided the discussion Marxist theory holds that the ethical project professional politician of Social Work

Reformas administrativas no Brasil: o caso do governo do estado do Piauí

From the 1980s, with technological development, globalization, and in a context of increasingly urgent demands, there is an international movement to modernize the state structures. Being driven by the victory of conservative governments in Britain and the U.S., this speech reform comes only to Brazil in the 1990s, the government of Fernando Henrique Cardoso. Thus, in view of the recent movement of states to implement this reform agenda in their structures this research was to identify the elements that made it possible to attempt to modernize the administrative structure of the state of Piauí in 2003, in view of the political and administrative career in which the state was entered. Seeking to clarify the problem studied here, through a case study carried out a descriptive and exploratory, using a technique of gathering data to document research and interviews semi-structured. As the lens of analysis for this study used the neo-historical and sociological institutionalism, through which it sought to identify the critical moment in which they gave the Administrative Reform of Piaui, the process of breaking with the political and administrative career that previously had being followed, and the isomorphic mechanisms that enabled this speech reform comes up to this state, mechanisms that allow the homogenization of the organizational field. In general it appears that the search for new patterns and new technologies for management by the states in Brazil is due to the context of fiscal crisis in which the states were entered, forcing them to seek alternative models of management . The process of diffusion of New Public Management agenda for the states became possible, among other factors, due to the new scenario in which was inserted into the Brazilian federal system in the second half of the 1990s, characterized by a greater articulation between the horizontalstates, where through the mechanisms of isomorphic institutional change was made possible by the absorption of the speech states reformer of the 1990s. However, due to the specificities of each region is given the experiences state unevenly. In the case of Piauí Administrative Reform only became possible due to the rearrangement of political forces in the state and the mechanisms of isomorphic institutional change, which allowed, in 2003, the state government to absorb the speech reformer

A constituição desmilitarizada: democratização e reforma do sistema constitucional de segurança pública

The normative construction of the public security system in the Constituent Assembly of 1987-1988 preserved paradoxical normative space, the military police linked to the Army with a restrictive legal statute of the police offices citizenship through a hierarchical and disciplinary model that is anachronistic. This research originates from the following problem: How is it possible to tailor the constitutional system of public safety, specifically the Military Police, according to the democratic paradigms constructed by the Constituent from 1988 and carry the right to public safety under these molds? The militarists limitations of the Constitution allowed the growing militarization of police departments, organizational culture and authoritarian institutional practices. Underlying this, the problems related to difficulties in realization of Right to Public Safety, the strikes of the military police, the incomplete policy cycle started demanding from the constitutional-legal system appropriate responses. Utilizing the dialogical method and an interdisciplinary approach to the subject, and theoretically grounded in overcoming of the constitutional normativist juspositivism.It was found that the constructed infraconstitutional legislation was insufficient to supply the systemic shortcomings of constitutional law, when looking to create a single system of public security without giving due scope to the federal principle and expand the autonomy the Federated States, and even grant democratic legal status to the military police. Formal legal limits imposed by the Constitution constructed a legal anachronism, the military police. Thus, a democratic reading of military police institutions becomes inconceivable its existence in the constitutional regulatory environment. Thus, reform the Constitution in order to demilitarize the police and conduct a normative redesign of the public security system is fundamental to Brazilian constitutional democracy