Reinternações psiquiátricas no Rio Grande do Norte: implicações e impacto das novas estratégias de atenção à saúde mental

The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital João Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care.

Segredos da alma: a dádiva da assistência de Enfermagem

The present study is an analysis of interpersonal relationships between the nursing staff and the patients under their care. Its objectives are to analyze ties/links that may possibly exist in such relationships and to describe, based on the experience of the patients, how they are received by the nursing staff, and what is the extent of their reliability on the nursing staff within the hospital. This investigation is analytical in nature and qualitative in approach, having as its leading thought Marcel Mauss s gift-exchange theory. The study involved eighteen in-patients, eight of them from government institutions, at a large hospital school and ten others from a private specialty hospital; both in the city of Natal, state of Rio Grande do Norte, Brazil. Data were collected between January and March 2006. Results point to ties being created between the nursing staff and patients irrespective of their social status, involving especially the development of friendship and reliability. We have noticed that in both services the interpersonal relationship is associated with the circulation of the symbolic goods mentioned in the patients discourse, such as attention, loving care and concern, among others, marking the formation of ties during hospital stay. Likewise, reliability is also present in close relationship with the technical competence of the professional. Patient hospitality is associated with the manner in which the patients were treated on being admitted to the hospital, although they also refer to hospitality at later moments, during the course of their treatment. Finally, we are in a position to say that there are ties/links between in-patients and nursing staff, irrespective of the patient s social status and class divide. It is thus evident that the antiutilitarian symbolism of gift to give, receive, give back -, which shapes the setting of social ties also takes place in today s utilitarian, individualistic and competitive societies. Thus, human beings whose existence is dependent on mutual relationships try to save their humanity, especially those who are fragile and dependent as is the case of the hospital in-patient

Conquistas e desafios do processo de trabalho de enfermagem: o caso dos CAPS em Natal/RN

The Brazilian Psychiatric Reform proposes creating linkages / interactions of the mentally ill with civil society , through promoting citizenship and assistance to the mentally ill. The deinstitutionalization of mental health advocates from the guidelines decreased supply of hospital beds and consequently the creation of substitute services for psychosocial care, especially with regard to therapeutic practices emancipatory. From this scenario, the present study aims to investigate the relevance and challenges of the process of nursing work in CAPS III in Natal / RN. It is descriptive research with a qualitative and exploratory. The subjects are employees of the nursing team in CAPS III East of Natal / RN. This service has actions for the psychosocial care of the subjects treated with daily multidisciplinary care by behaving the length of treatment and follow-up activities, industrial and cultural activities. Employ the semi-structured interview as a tool for data collection. The data analysis was done by means of thematic analysis proposed by Bardin. Thus, this sought to bring to the discussion of how this process is consolidated in the daily service. Thus, purposed to contribute to the debate on deinstitutionalization in psychosocial care as a guideline in the process of mental health nursing work in a CAPSIII, Natal / RN

Avaliação da incorporação de cinzas de lodo de esgoto como adição mineral em concretos de cimento Portland

O desenvolvimento das grandes cidades tem gerado um dos maiores desafios ambientais enfrentados na atualidade, que é a gestão eficaz de resíduos sólidos. A grande variedade e quantidade dos resíduos produzidos diariamente, tem tornado a destinação ecologicamente correta e sustentável destes materiais cada vez mais difícil. Dentre os vários resíduos produzidos diariamente destacam-se os lodos oriundos de estações de tratamento de esgotos, denominados de lodos de esgoto, cuja destinação final segura tem sido discutida mundialmente em diversos estudos, tendo em vista que a tendência de geração deste tipo de resíduo tende a crescer com o aumento do saneamento das cidades. Uma forma amplamente difundida nos países desenvolvidos para destinação dos lodos de esgoto é a incineração destes materiais para posterior envio das cinzas geradas neste processo a aterros sanitários. Porém, tem-se estudado formas alternativas de disposição, destacando-se a utilização destas cinzas como adição mineral em concretos e argamassas de cimento Portland. Sabe-se que o desempenho de resíduos de incineração como adição mineral em matrizes cimentícias, depende em grande parte da capacidade de atuação destes materiais como elementos pozolânicos ou como fileres, podendo estas características serem influenciadas pela temperatura de queima ao qual estes resíduos foram submetidos. Neste sentido, verificou-se com esta pesquisa a influência da temperatura empregada na queima dos lodos sépticos no índice de atividade pozolânica (IAP) das cinzas geradas como resíduo deste processo, aqui denominadas de cinzas de lodo séptico (CLS), sendo em seguida, avaliadas as implicações técnicas e microestruturais da utilização deste resíduo em teores de 10%, 20% e 30% como adição mineral em concretos de cimento Portland. Os resultados obtidos demonstraram não haver alterações significativas no IAP das CLS em decorrência da temperatura utilizada durante o processo de queima dos lodos de esgoto. Além disso, verificou-se que embora a utilização das CLS tenham provocado diminuição da trabalhabilidade dos concretos para todos os teores de incorporação, estas melhoraram a resistência mecânica à compressão, o índice de vazios, a absorção de água e o comportamento microestrutural dos concretos contendo 10% e 20% de resíduo

Estratégias de avaliação de desempenho dos propagandistas de medicamentos utilizados pela indústria farmacêutica no nordeste do Brasil

A Indústria Farmacêutica é uma das mais competitivas indústrias do mundo contemporâneo, e um dos seus principais desafios está na comercialização de seus medicamentos, que na sua maioria depende da prescrição médica. O objetivo deste estudo é identificar as estratégias de avaliação de desempenho utilizadas pela Indústria Farmacêutica de origem multinacional que atua no nordeste Brasileiro e o papel dos seus gerentes, para avaliar os propagandistas vendedores de medicamentos. Para tanto, buscouse reunir elementos para uma abordagem satisfatória que contemple a complexidade da temática pesquisada: Avaliação de Desempenho, Estratégias da Indústria Farmacêutica, Propaganda Médica e Competências dos Propagandistas de Medicamentos. A temática justifica-se em razão da importância estratégica dos propagandistas de medicamentos para a indústria farmacêutica, que é uma das indústrias que mais investe em pesquisa na atualidade, e contribui para melhorar a qualidade de vida e a saúde humana. A metodologia é caracterizada como um survey, de natureza quali-quantitativa. O objeto de estudo é composto pelas empresas farmacêuticas multinacionais de origem Americanas, Europeias e Asiáticas, associadas à INTERFARMA que atuam no Nordeste do Brasil. A coleta de dados foi realizada através de um questionário fechado (instrumento de pesquisa), composto por 5 perguntas fechadas que abordam a temática central dessa dissertação, 27 afirmativas para medir a concordância(escala likert) e 1 tabela contendo 46 competências, aplicado junto a gerentes da indústria farmacêutica. A análise dos dados foi feita por meio das técnicas de estatística descritiva e uma análise quantitativa para estabelecer o Ranking Médio (RM) para a parte do questionário que utilizou escala tipo Likert de 5 pontos para mensurar o grau de concordância dos respondestes. Através dos resultados desta pesquisa foi possível identificar as estratégias de avaliação de desempenho, utilizadas pelas empresas farmacêuticas, que atuam no Nordeste do Brasil, na gestão dos propagandistas vendedores de medicamentos, e identificar as competências essenciais dos propagandistas de medicamentos, na percepção dos gestores. Os resultados demonstraram que a Indústria Farmacêutica desenvolve e utiliza várias estratégias para medir e avaliar o desempenho dos propagandistas de medicamentos no Brasil, assim como em outros países, e que na percepção dos gerentes da Indústria Farmacêutica existem competências consideradas essenciais ao bom desempenho profissional dos propagandistas de medicamentos da indústria farmacêutica, contribuindo de para avanço do conhecimento deste tema

Infra-estrutura para avaliação e testes de protocolos sociais de comunicação em ambientes tridimencionais compartilhados

The advent of the Internet stimulated the appearance of several services. An example is the communication ones present in the users day-by-day. Services as chat and e-mail reach an increasing number of users. This fact is turning the Net a powerful communication medium. The following work explores the use of communication conventional services into the Net infrastructure. We introduce the concept of communication social protocols applied to a shared virtual environment. We argue that communication tools have to be adapted to the Internet potentialities. To do that, we approach some theories of the Communication area and its applicability in a virtual environment context. We define multi-agent architecture to support the offer of these services, as well as, a software and hardware platform to support the accomplishment of experiments using Mixed Reality. Finally, we present the obtained results, experiments and products

Um ambiente integrado para manipulação de tráfego multicast

In the two last decades of the past century, following the consolidation of the Internet as the world-wide computer network, applications generating more robust data flows started to appear. The increasing use of videoconferencing stimulated the creation of a new form of point-to-multipoint transmission called IP Multicast. All companies working in the area of software and the hardware development for network videoconferencing have adjusted their products as well as developed new solutionsfor the use of multicast. However the configuration of such different solutions is not easy done, moreover when changes in the operational system are also requirede. Besides, the existing free tools have limited functions, and the current comercial solutions are heavily dependent on specific platforms. Along with the maturity of IP Multicast technology and with its inclusion in all the current operational systems, the object-oriented programming languages had developed classes able to handle multicast traflic. So, with the help of Java APIs for network, data bases and hipertext, it became possible to the develop an Integrated Environment able to handle multicast traffic, which is the major objective of this work. This document describes the implementation of the above mentioned environment, which provides many functions to use and manage multicast traffic, functions which existed only in a limited way and just in few tools, normally the comercial ones. This environment is useful to different kinds of users, so that it can be used by common users, who want to join multimedia Internet sessions, as well as more advenced users such engineers and network administrators who may need to monitor and handle multicast traffic

O masculino em revista: mídia, discurso e modos de subjetivação afetivos-sexuais

This dissertation has the thematic of the sexual affection of the masculine subjectivity within texts of Universo Masculino and Men‟s Health magazines as object of analysis. The central objective was to describe and interpret the theme on the masculine subjectivity in discourses about the affection of sexuality materialized in discourse practices in those magazines. The main point of the research matters how the discourse structures of texts in those magazines make it possible to comprehend the meanings produced about the masculinity nowadays. On the perspective of the thematic trajectory what consists the main aspect that concerns the leading of corpus in the research under the French discourse analysis, we have searched, in reports of those magazines, an arch-genealogy of masculinity, from a specific sexual-affection disposable of our mediate culture. The analytic trajectory enables us to conclude that the thematic trajectory about the sexual affection of the masculine subjectivity produces a semantic way that confirms hegemony and hetero-normative ideals, rather than what proposes new performances on the masculine subjectivity experiences. In its real effects, such mediate discourse practice pursues to link certain sexual affection knowledge to the male individual‟s lifestyle today, from the thematic choices, enunciation modalities and discourse strategies which are specific to the masculine media

Contribuições ao método de rastreamento de máxima potência para sistemas fotovoltaicos

The scarcity of natural resources and the search for alternative energy sources promote a rapid change in the energy world. Among the renewable energy sources, solar energy is the most promising, presenting technology of greatest growth rate nowadays. Researchers around the world are seeking ways to facilitate their progress, developing technologies with higher efficiency and lower cost. As a contribution to global progress, this master thesis proposes the development of a strategy of maximum power tracking based on perturbation and observation method for photovoltaic systems. The proposed control strategy is based on active power balance of the system, with a reduced number of sensors. It also allows the PV system to act as a regulator of the power quality at the point of commom coupling (PCC), compensating the harmonic distortion and power factor of the current netw

Desenvolvimento de nanocompósito (hidroxiapatita/ poliuretano) pela gelação (gelling) de poli ( álcool vinílico) (PVA) para remoção de metais pesados

Removing microcontaminants from effluents is a challenge today, because of its high cost and low efficiency, especially in the treatment of effluents containing heavy metals. An alternative that has emerged is the use of biodegradable nanocomposites, which exhibit good removal and recovery performances, in addition to its low cost. With this in mind, the present study aimed to develop and characterize a nanocomposite based on hydroxyapatite (HAP), polyurethane (PU) and polyvinyl alcohol (PVA) for removing heavy metals. Thus, the research was conducted in several steps: i)- Physico-chemical and microbiological hospital effluent characterization; ii)- Production of hydroxyapatite by aqueous precipitation technique, and their characterization; iii)- Production of the nanocomposite in which the hydroxyapatite was added to the polyurethane prepolymers and then the polyvinyl alcohol/hydroxyapatite film was produced; iv)- Polyvinyl composite without film PU/HAp was also produced in the proportions of 20 and 40% HAp; v)- The composites was characterized by the techniques of XRD, FTIR, SEM / EDS, BET, Zeta Potential and TGA; vi)- The sisal and coconut fibres were washed and dried for comparative tests of adsorption; vii)- Adsorption tests for evaluating the removal of heavy metals (nickel and cadmium). Initial screening adsorption capacity (HAp; PU/HAp - 20 and 40%; PU / HAp / PVA), kinetic studies of adsorption of Cd (II) by HAp; multifactorial design analysis (factorial design) for identifying the most important variables in the adsorption of Cd (II) by composite PU/HAp. Also comparative analysis of adsorption of Cd and Ni by composite PU/HAp were conducted, as well as comparative tests of adsorption of Cd (coconut fibre) and Ni (sisal fibre). It was possible to verify that the composite PU/HAp 40% showed better effectiveness for the removal of Cd (II) and Ni (II), above 80%, equivalent to the lignocellulosic fibre used and HAp produced. As main conclusion, it can be referred that the composite PU/HAp 40% is an effective adsorvent to wastewater treatment for heavy metal removal, with low cost and high efficiency

Impactos do estresse salino e da cobertura morta nas características químicas do solo e no desenvolvimento do amaranto

Availability of good quality water has been reduced vertiginously, over the last decade, in the world. In some regions, the water resources have high concentration of the dissolved salts, these characteristics of the water make it s use impossible. Water quality can be a limitation for irrigated agriculture, principally in regions of arid or semiarid climate where the water resources are generally saline and are exposed at high evaporation ratio. For that reason, precipitation of the salts occurs near the soil surface and those salts themselves cumulate in the vegetal tissue, reducing the soil fertility and crop production. The adoption of tolerant crop to the water salinity and soil salinity, adaptable to the climatic conditions is other emergent necessity. This work had the goal of studying the effects of four salinity levels of the irrigation water salinity and use of mulch, dried leaves of Forest mangrove (Acacia mangiumWilld), in cultivated soil with amaranth (Amaranthus cruentus, BRS Alegria variety), in greenhouse. It was utilized the transplant of plants to PVC columns, containing 30 kg of silty loam soil, 10 days after emerging, with space of 50 x 50 cm between lines. Treatments were composed by combination of four levels of salinity (0.147; 1.500; 3.000 e 4.500 dS m-1), obtained by addition NaCl (commercial) to irrigation water and soil with and without protection, by mulch. A factorial system 4 x 2 was used with four repetitions, totalizing 32 parcels. The concentrations of nutrients in soil solution have been evaluated, in the dry matter of the vegetal tissue (roots, stem, leaves and raceme residue), at the end of the vegetative cycle. The use of soil protection reduced time for the beginning inflorescence of plants, at the same time, the increase of the salinity delayed this phase of amaranth development. The use of the mulch effectively increased the height, stem diameter, area of the larger leaf, humidity and dry matter content and amaranth grain production. The vegetal species showed salinity tolerance to experimented levels. The adopted treatments did not affect the pH values, exchangeable cation contents, electrical conductivity of soil solution (EC1:5) and saturated extract (ECSE), and Ca+2, Mg+, Fe+2 and Mn+2 contents, in the soil solution. The increase of the salinity concentration in the irrigation water inhibited the mineralization process of the organic matter (OM) and, consequently, the efficiency in the it´s utilization by plants, at the same time, produced increase in the values of the exchangeable sodium percentage (ESP), sodium adsorption ratio (SAR) and potassium adsorption ratio (PAR), in the soil solution. Therefore, the use of the mulch did not affect the first three parameters. The protein and nutrient contents: K+, Ca+2, P, Mg+2 e Cu+2, in amaranth grains, were improved by tillage condition. The raceme residues showed chemical/nutritional composition that makes advantageous its application in animal ration. In this context, it follows that amaranth tolerate the saline stress, of the irrigation water, until 4.500 dS m-1, temperature and relative humidity of the air predominant in the experimental environment

A tabela periódica: um recurso para a inclusão de alunos deficientes visuais nas aulas de química

Nowadays there are many reasons that aim to include people with special necessities, like those with visual deficiency, in the world of work, education, and in the society as a whole. However it is observed that when we talk about schooling inclusion, especially in High School, there is a huge gap between the theory and the practice. The lack of didactic resources, the inadequate installations, unprepared teachers, the families´ lack of information, are some of the factors that hinder the process of inclusion. Furthermore, the educators also have to deal with the roughness of the disciplinary contents and, refering to the study of Chemistry, with the use of signals related to this subject´s language. So, the objective of our research is to reflect about the apprehension of this language by the visually handicapped people, and try to contribute with their process of inclusion in the school life. On this perspective we work with the Periodic Table, which constitutes one of the indispensable tools necessary to the Chemistry learning. In order to acomplish it, the way followed by us happened in three passages. Initially, by means of a semistructured interview, we tried to get acquainted with the blind students opinion, who were participating in the research about the Periodic Table used by them throughout High School, as well as the dificulties felt when using it. After getting the answers, the Table was reelaborated to fill those students´necessities. Here, two new Tables were designed, one in Braille which shape is more compacted, and another made with high printed dots, built with sand and glue. On the third moment, the new designed Tables were tested by the students and, by means of a semi-structured interview, we tried to identify if this new resource would solve the problems concerned to the old Table. The students showed that the compacted Tables would facilitate the touch reading of the chemical elements simbols, making it clear and fast. We hope that, with the elaboration of this learning tools we can contribute with one of the elements to favor the effective participation of blind students in Chemistry classes, when studying the Periodic Table

Um estudo de práticas matemáticas históricas e sugestões de uso na matemática escolar

This dissertation aims to contribute on teaching of mathematics for enabling learning connected to the relationship among science, society, culture and cognition. To this end, we propose the involvement of our students with social practices found in history, since. Our intention is to create opportunities for school practices that these mathematical arising from professional practice historical, provide strategies for mathematical thinking and reasoning in the search for solutions to problematizations found today. We believe that the propose of producing Basic Problematization Units, or simply UBPs, in math teacher formation, points to an alternative that allows better utilization of the teaching and learning process of mathematics. The proposal has the aim of primary education to be, really forming the citizen, making it critical and society transformative agent. In this sense, we present some recommendations for exploration and use of these units for teachers to use the material investigated by us, in order to complement their teaching work in mathematics lessons. Our teaching recommendations materialized as a product of exploration on the book, Instrumentos nuevos de geometria muy necessários para medir distancia y alturas sem que interuengan numeros como se demuestra em la practica , written by Andrés de Cespedes, published in Madrid, Spain, in 1606. From these problematizations and the mathematics involved in their solutions, some guidelines for didactic use of the book are presented, so that the teacher can rework such problematizations supported on current issues, and thus use them in the classroom

A argumentação na petição inicial

This research investigates current sense effects at the use of linguistic resources of the argument in a corpus constituted by juridical pieces (Initial Petitions), that gave opportunity to actions originated from the Civil Special Court of the District of Currais Novos-RN. For this purpose it was established a relation between the Law and the Linguistics, mediated by the focus of the Argumentative Semantics, emphasizing, in a special way, the use of argumentative operators, which inserted in the own language, in its grammar, assume the orientation of the speech and the modalizers use, important mechanisms in the construction of the sense of the text and in the signalling in the way as that that one say is said,. This way, we began the investigation of that gender choosing as study object the section of the facts , that comprehends a part of Initial Petition where is explanted the narration of events that gave margin to the proposal for the Action. In face of the study object and the aim to be reached it was appealed, methodologically, to the notion of Rhetoric since from the classic antiquity to the emergence of the New present Rhetoric in Perelman and Olbrechts-Tyteca (2005) that, at the present time, is inserted in the studies of the Pragmatic connected to the central theses of the Ducrot s thinking (1977, 1980, 1987). Such referential allowed us to a better understanding about the production of the juridical speech on the part of the operators of the Law, as well as, to analyze in way wide the current sense effects from the use of argument linguistic marks the juridical speech. The data showed that such marks are indispensable elements to the construction of the textual web, particularly when in the range of the juridical argumentation, since they direct the speech for certain conclusions. However, we have observed that in the texts produced by the lawyers the use of those linguistic resources not always takes place in an appropriate way. The texts analyzed have also showed that it is possible to unmask, through the linguistic resources, the argumentative strategy employed by the authors for convincing of the magistrate, making evident that language is more than a system of signs, which it makes possible to see beyond the limit of the words and statements. Finally, we have verified that the categories analyzed, when used appropriately, are elements that engender argumentative maneuvers of effectiveness in the juridical text, being fundamental pieces which give argumentative strength the text, making the speech to move forward, not only the juridical, but the speech produced in any domain of the knowledge

O Barroco Hispano-americano: primero sueño ou Sor Juana Inés de La Cuz

The current dissertation is linked to the research line Poéticas da modernidade e da pós-modernidade (modern and post modern poetics), which is being developed for the Programa de Pós-graduação em Estudos da Linguagem (Program of post graduation in language studies), in the area of Literatura Comparada (comparative literature) CCHLA/UFRN. The main aim of the research is to show the reading of Primero sueño by sor Juana Inés de la Cruz, in the middle of the contemporary age, through an eclectic analysis which elucidates the baroque in its most recent concept; the social context and the life as a nun of sor Juana and the analysis of the poetry starting from the glance to the literary text. The perception of the baroque eon universal as a constant artistic movement from its appearance to the present time thus highlighted based on the most modern studies by the baroque specialists: Eugênio d Ors, O barroco (s/d), Severo Sarduy, Barroco (s/d) and Gilles Deleuze, A dobra: Leibniz e o barroco (1991). In that research, it will be presented the translation/transcreation of the study object corpus still guided by the translatological theories of Haroldo de Campos (2004), Da tradução como criação e como crítica, Walter Benjamin (1971), A tarefa do tradutor and Jacques Derrida (2006), Torres de Babel