Atenção à saúde mental na Estratégia Saúde da Família no Município de Parnamirim/RN: opinião dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population´s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user´s care and the promotion of family health

Fatores associados à efetividade da doação de órgãos e tecidos para transplantes

The transplantation of organs and tissues presents itself as an important therapeutic option, both from a medical standpoint, the social or economic. Thus, the identification of variables that can interfere in the effectiveness of organs and tissues donation for transplantation needs to be investigated adequately, because it stands before increasing index of chronic and degenerative diseases in the population, what makes the waiting list for transplantation grow disproportionately and patients come to death without the opportunity of realization the treatment due to a lack of donors. In this context, has defined as objective of this study evaluate the factors associated with the effectiveness of organs and tissues donation for transplantation. It is a evaluative research, quantitative, prospective, with longitudinal design, developed at Central of Catchment, Notification and organ donation for transplant, Organ Procurement Organization and in six accredited hospitals to collect and transplantation of organs and tissues, in Natal/RN, between august 2010 and february 2011, after the approval of the Research Ethics Committee, under No. 414/10 and CAAE 007.0.294.000-10. The probabilistic sample without replacement was composed of 65 potential donors. It was used as an instrument of data collection a structured script non-participant observation of checklist type. Data were analyzed using descriptive statistics and presented in tables, charts, graphs and figures. For this, was used Microsoft Excel 2007 and statistical program SPSS version 20.0. To check the level of significance was chosen by applying the chi-square test (χ2) and Mann Whitney and caselas for less than five, it is considered the Fisher exact test. It was adopted as the significance level p-value <0.05. Among the surveyed it was observed that most of the individuals were male (50,8%), in the age group 45 years (53,8%), mean age of 42,3 years, minimum 5 and maximum 73 years (± 17,32 years). Single / widowers / divorced (56,9%), with up to completed elementary school (60,0%) in the exercise of professional activity (86,2%), catholic (83,1%) and residents in metropolitan region of Natal (52,3%). Was obtained donation effectiveness of 27,7%. There was no statistical significance between structure and effectiveness of the donation, but were observed inadequacies in physical resources (36,9%), materials (30,8%), organizational structure (29,2%) and human resources (18,5%). In the process, the maintenance phase (p= 0.004), diagnosis of brain death (p= 0.032), family interview (p≤ 0.001) and documentation (p= 0.001) presented statistical significance with effectiveness. Thus, it is accepts the alternative hypothesis of the study, in which is evidenced that the adequacy of the factors related to structure and process is associated to effectiveness of organs and tissues donation for transplantation. In this way, the effectiveness of organ and tissue donation ends in an essential way the rapidity and accuracy with which the donation process is conducted, requiring appropriate structure, with appropriate physical and material resources and skilled human resources to optimize the reduction of time and the suffering of those waiting for an organ or tissue transplant queued in Brazil

A pessoa com tuberculose e o cuidado de si

Tuberculosis is a serious disease with high incidence and prevalence, and in many countries a priority public health problem, with persisting high epidemiological significance. Seeing the person with tuberculosis it is important to observe his/her self care, as well as the difficulties intertwined in this process, since it can be directly impacting the health/disease process. The aim of this study was to analyze the self care of people with tuberculosis. Descriptive study with qualitative approach, conducted in West Sanitary District of the city of Natal, RN. Data collection occurred through a semi-structured interview guided by questions concerning sociodemographic and about the disease, treatment, and self care, between the months of July to September 2012 and met the ethical precepts of research with human beings. To analyze the results we used the technique of thematic content analysis of Laurence Bardin, through the prism of the theoretical-philosophical self care discussed by Michel Foucault. From the analysis emerged two categories, the first being, Meaning of tuberculosis, with subcategories: tuberculosis as sadness and unhappiness and tuberculosis as a normal issue, and the second, Beware yourself to tuberculosis, which had subcategories: self care as attention to the health care of oneself as satisfaction of basic needs and difficulties to self care. Tuberculosis represents for some people, something really sad, causing psychological suffering, however the other presents as normal. Self care of persons with tuberculosis in this study are related in great part to seek health care and the satisfaction of basic needs. About the difficulties related to the practice of self-care, it is observed that these are tied to food, time for rest, slowness of health services for scheduling appointments and tests, as well as related habits and dependencies in the lives of these people. This study contributed to a reflection of the users with tuberculosis and self care, revealing aspects that healthcare professionals should pay attention to watch these people, being able to see everyday on the run, the need for a space and time for oneself

Cuidado de enfermagem ao potencial doador de órgãos em morte encefálica: uma reflexão sobre a prática

Despite of the technological advances that favor the transplant process, there are issues of effectiveness of care necessary for the maintenance of potential organ donors with brain death, which contribute to the no realization of transplants of organs and tissues of these patients. It is presupposed that the problems could be related to perceptions and understandings that the professionals of the units of internment have about the care required by the diagnosis of brain death. The aim of this study was to understand the meaning of the nursing care of the potential organ donor with brain death to the nursing staff. Descriptive study with qualitative approach guided by Action Science Theory and the critic-reflexive research methodology accomplished with five nurses and 19 nursing technicians from Operative Rehabilitation Center in a public hospital at Natal / RN, Brazil, between March and May 2013. Data were collected through semi-structured interviews with individual reflection about the care and through group interview, after approval by the Ethics and Research Committee, CAAE No.: 04255612.7.0000.5537. The analysis was performed in a thematic way according to Bardin. During the group meeting the participants were driven in a discussion about the need for change and how to perform them. The results indicate that the professionals actions are consistent with those required for maintenance of potential organ donors, although the material and human resources are not adequate. That situation leads the professionals to develop a meaning of care as one labor more, demanding more than they can give. They express beliefs and feelings concerning the hope that their care brings a greater good that is to save lives. The reflection for a possible change of action was difficult to accomplish due to professionals not to be able to self evaluate, what lead to direct your changes suggestions for other team members. It is concluded that the care provided to these patients is a difficult care, evidenced by suffering both death situation of the person cared and pain of their families, as the dehumanizing conditions of work, helping themselves to keep distance from patients to not suffer so much. The knowledge impregnated in their act, are scientific, ethical, aesthetic and personal kind with a predominance of the scientific followed by the personal. The study was also relevant to the practice of nursing in maintaining the potential donor, in that it allowed the identification of the knowledge used by nurses in their care practice and the meaning understanding of the professionals on the care provided, as a good action that brings satisfaction when the transplanting is executed. Other experiences are suggested with the critic-reflexive research methodology, both in research as in teaching nursing

Nascimento de um filho :o significado para o pai

Qualitative study on the meaning of a child s birth to the father. Its general purpose was to comprehend the significance the man attaches to his child s birth and its specific objectives were to identify the man s feelings with regard to his child s birth as well as to verify his attitude toward a child s birth. The study was founded on the theoretical reference system about the man in the gravid-puerperal cycle and the humanization of the assistance. The data were obtained through semistructured interview performed with men accompanying their children s birth whose wives were in the immediate puerperium. This stage occurred in two maternity hospitals in Natal-RN, both of which adopt the principle of safe notherhood in the attendance of women in the process of parturition. The material apprehended from the statements was treated in conformity with the content analysis method in the mode of thematic analysis according to Bardin. Three thematic categories emerged from this process: the father s attitude toward his child s birth, the father s feelings in respect of his child s birth, and the informations received by the father in the course of his child s birth. The speech content was analyzed in accordance with the principles of symbolic interactionism according to Blumer. The results showed that the husbands interact with their respective wives and respond with attitudes of care, help, support, and encouragement within the principles of humanization intermingled with feelings of happiness, restlessness, and suffering leading them to appraise and exalt their consorts. Besides, we verified that the father s attitudes and feelings in the delivery room in the light of symbolic interactionism tend to be influenced by the interaction between him and the attending professionals

Aceitabilidade da carne caprina no hábito alimentar e percepção sobre o impacto ambiental na produção de caprinos no nordeste entre estudantes universitários

The present work has an objective of investigate the acceptability of consumption of the goat meat and studies the perception of university students on the productive sector of goats in the Northeast. The habit to eat goat meat has strong regional traditions and has been suffering the demographic, cultural, economic and personal influences. Currently, a new habit in the food consumers is observed and has been configuring itself a trend that concern with the health and welfare in general, in countries mainly developed. This fact comes directly contributing for the modernization of the production models, including the ambient conscience. The methodology applied includes bibliographical research, data-collecting through questionnaires applied in the UFRN (Federal University of Rio Grande do Norte ) and analysis of the data using statistic techniques assisted for software Statistica V6. It is concluded that the rate of consumption of goat meat is low in the population studied. The frequency of consumption is higher in times of leisure or to visit relatives. The descriptive analysis of the responses of interviewees shows ignorance of the production of goat meat and its importance to the state of Rio Grande do Norte.

Análise pelo Supply Chain Management da cadeia produtiva da castanha de caju no Rio Grande do Norte

This work presents the cashew nuts chain in the State of Rio Grande do Norte between 1960 and 2009. The main purpose of this research was to find the reason of the low productivity of the cashew nut in this state, identifying in the cashew's chain production the struggling points which were limiting the commerce of this product through the distribution network. Therefore, the Supply Chain Management was used as a logistic analysis methodology, focusing on relationships management between the nodes of this chain, from the producer until the final customer. Many problems were found: first, the precarious production conditions of the small producer don't lead to reach the demanded productivity by the market. The distance, the lack of communication of the small producers among themselves and an archaic way of dealing with their businesses, may be an explanatory reason for this problem, considering that those factors are the main elements which contribute for the weakening of the small producer placed in the productive chain. Another spotted point was that the business-oriented relationship between the producer and the local trader does not allow the small producer's economical development, which interferes in any technological investment to reach a good quality production that fulfills the market demand. And also, the fact that there is a tendency of the final costumer to require lower prices day-byday, forcing a pressure on the nodes transferring to the other and successively until arriving at the producer who inevitably is suffering the biggest impacts from this mentioned pressure.

Análise da atividade de trabalho profissional de gerentes de hotel à luz da abordagem da ergonomia

This Masters degree dissertation presents a research that aims at analyzing the activities regarding within a hotel managers work in Natal/RN - Brazil, This Masters degree dissertation presents the research that aims at analyzing the activities regarding the hotel managers work in Natal / RN - Brazil, performing diagnosis of their activities and relating the aspects that impact the quality and productivity of hotel services and managers occupational health. This research is characterized as a case study with a qualitative approach, taking the method of Ergonomic Work Analysis which is the analysis of the managers work activity as a reference to the focus; and combining the use of observational and interactional methods. Ergonomics and macroergonomics are used in this study not only to understand the physical, cognitive and organizational constraints of the manager s duties, but also to characterize the work organizational architecture and design of that hotel. High workload, accumulation of tasks and diversion of functions performed by managers were noticed, increasing thereby the physical and psychological suffering for them. It was found that the activity of managers is characterized by the ambivalence of power, limited autonomy, cooperation, interdependence between managers and the fear of incompetence. It was also noticed that managers devote more time to the day job (37%), another time to sleep (30%), while only 33% of the rest of the day are meant for activities like taking care of health, family, social life and study. Although there are few studies addressing the health and safety of hotel managers, this research revealed that 84% of the surveyed hotel managers complain of musculoskeletal pain which 50% are obese and are 100% sedentary. It was also observed that managers adopt unsuitable postures for carrying out the work activities that contribute to becoming injured or work-related musculoskeletal disorders in the near future. Ergonomic measures were recommended as an investment in the skills and the training of managers, encouraging cooperative work, appropriateness of workload, limiting overtime, preserving the enjoyment of breaks during work and weekly holidays, changing the layout of the work sector , usage of communication technology to prevent displacement, compensatory physical activities, furniture adaptation, among others

Aplicação e análise de metodologia de deterioração ambiental em micro-bacia do seridó potiguar

In the contemporary world to the deterioration of semi-arid areas of the planet has been the focus of media attention and the scientific community. Brazil has a semiarid, considered the most problematic of the world, either by pressure from physical factors, whether as a result of misguided public policies, has over time been suffering from the consequences of a deterioration that expands over the years. Methodologies, that amidst the problems of semi-arid, come against the deteriorating local, have a good chance to be reapplied in other contexts around the world. This research, based on methodological model for analyzing environmental deterioration, introduced and examined the applicability of the methodology in the semi-arid region of Rio Grande do Norte - Brazil. Although the results provide guidelines for the introduction of underground dams, the application of the methodology was ineffective, given the high rates of forest cover that gave low values for the physical diagnosis conservationist

Helena de Machado de Assis; Imagens literárias e a retórica da morte da nação inconclusa

Helena is the romance of perishable and discontinuous title character denominator of a dialectic that does not consume and build the narrative by sequential fragmentation combined with episodic frame. The novel is a lightning stroke to the romantic literary project. Therefore, this study aims to find "objective" elements of the novel that would constitute a conception of literary nation proposed by Machado de Assis, as in classical writing, where women are engaged as a metaphor for the nation by a non-cultural heroism, as the example of the Greek myth of Helena, where the feminine represents a mythical image of the nation. The paper's theoretical conception of the history of Walter Benjamin, that is, that is constructed as an allegorical appeal, the conclusions about the disciplinary society of nineteenth century of Michel Foucault, the construction of the nation as a subtle game to remember and forget of Wander Miranda and the rhetoric of death and loss reflected in the speeches of the cultural heritage of José Reginaldo Santos Gonçalves, which allow you to analyze the work permeated by subjectivity and existential conflicts by Machado, who has it arranged in dialectic with the avant-garde literary romanticism and realism. In this relationship with the Greek myth of Helen, explained that characters with the nickname of Helena in Machado's work are not uncommon. As in classical Helena, Machado s Helena uses three rhetorical are the cause of the seizure of the nation. In this game of remembering and forgetting, in the daily plebiscite, Machado draw ideal images that forged our mythical past and commitment to the future. The suffering love of Helena is suffering from failure of the nation which would have led the author to the use of allegorical language, seeking a balance in the chaos generated by the opposition between cruelty and pity widespread view in an area where only left the character's confession guilt for the death. It is a simulacrum of unfinished nation, the space for the game of remembering and forgetting, while the rhetoric of negotiation of our Brazilianness

Nietzsche e Rosset: alegria, impulso à criação

Understood in a project of transvaluation of values, the joy is one of the central themes of the thought of Friedrich Nietzsche and Clément Rosset. Opposed to the dogmatic philosophy that moralize and robs your strength to think of it as "happiness", evaluated, in short, a target linked to virtue and rationality these thinkers propose a perspective that makes the joy of point to an instance extraterrestrial and back to the earth, to the body. In this vein, beyond the oppositions of values constitutive of metaphysics dogmatic, the joy and suffering are conceived as elements that are not mutually exclusive, they are complementary as foundations of a gaia(ta) science, based in laughter and friendship. Contents of a tragic wisdom that leads to an unconditional fidelity to the real (expressed in formulas of amor fati Nietzsche and unrestricted approval of existence Rosset), the joy is then interview as vital impulse, the force majeure, the strength plastic encourages artistic creation: the joy of children playing