Cuidado psicossocial em saúde mental: estudo em assentamentos rurais do Rio Grande do Norte

Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people’s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

"Ombro a ombro com os mais fracos": a inserção de João Café Filho nos espaços do trabalhador na cidade do Natal 1922 - 1937

The purpose of this thesis is to analyze how João Café Filho constituted a discourse of advocate of the labor movement and workers in different sociability spaces. It is intended to understand, on one hand, how political relations were established between different categories of workers and the ‘middle classes’ and, on the other hand, how places were instituted to house the meeting of these relations. It a ims to understand the insertion of Café Filho in union activities in the urban world. It demonstrates specificities of the political culture in Natal emphasizing the dispute between a city politically ruled by a still reigning rural paternalistic mentality and the rise of a new way to experience the urban conflicts which appeared. Temporally, the work is delimited between 1922 (proclaimed by Café Filho himself as the initial period of his political action) and 1937 (when he broke up with Vargas and went into exile in Argentina). The research was constituted by three main document types: several published newspapers between the decades of 1920 and 1930 in the cities of Natal, Recife, São Paulo, Porto Alegre and Rio de Janeiro; the autobiographical memoirs written by Café Filho himself and memoirs of other people who lived in his time. The main pillars that have supported the work were: the concepts of society and individuals (ELIAS, 1994; 1995), political cultures (BERSTEIN, 1998) and theater of the memory (GOMES, 2004); the sociability spaces category (CERTEAU, 1994; MALATIAN, 2001; RIOX, 1996); the biography notion (DOSSE, 2009; LORIGA, 2011). We demonstrated that Café Filho acted in some sociability spaces as: the Jornal do Norte, the Federação Regional do Trabalho and the Partido Democrático Nacional. In such spaces, Café Filho, gradually, become an important leader of workers and, at the same time, linked to national entities led to the opposition that fight against the power established in the Brazilian First Republic. In Café Filho’s interpretation, workers were individuals who needed to fight against the political structures prevailing at that time because the poor living conditions and the low representativeness of this group were caused by the way the political system in the First Republic was structured. After the 1930 Movement, the 3 de Outubro Club, the Jornal and the Labor Federation of Natal were constituted in spaces where the cafeista critical discourse about the government was changed: workers should follow the official syndicalism and defend the 1930 Movement which put Vargas in the presidency of the Republic.

Análise da organização da rede de saúde da Paraíba a partir do modelo de regionalização

Este artigo analisa a organização da rede de saúde da Paraíba a partir do modelo de regionalização proposto pelo estado da Paraíba. Material e Métodos: Trata-se de um estudo documental que tomou por base, prioritariamente, o Plano Diretor de Regionalização da Paraíba e os documentos oficiais do Ministério da Saúde que orientam a construção dos mesmos pelos Estados. Resultados: A análise dos dados revelou alguns limites no processo de implantação do PDR/ PB, tais como a ausência de análise das características sociais, econômicas e culturais durante a escolha das sedes das regiões de saúde e a inexistente descrição da organização da assistência à saúde do território estadual. Conclusão: O processo de regionalização e a formulação do PDR da Paraíba não seguiram a Instrução Normativa do Ministério da Saúde em alguns aspectos, desconsiderando as especificidades de cada região de saúde, o que pode resultar em problemas no acesso e na articulação da rede de serviços com vistas à legitimação das regiões de saúde desse Estado