O Serviço Ambulatorial Móvel de Urgência (SAMU) no contexto da reforma psiquiátrica: em análise a experiência de Aracaju/SE

This research investigated professional practices from Mobile Urgency Care Service (Serviço Ambulatorial Móvel de Urgência - SAMU) at psychiatric cases of the city of Aracaju/SE, Brazil and its possible articulations to psychosocial services network. The regulation no. 2048 of 11/05/2002 from Ministry Health establishes National Urgency Policy and designates that psychiatric cases are SAMU's responsibility. Then, it is necessary to propose an analyze of psychiatric urgency service under anti-asylums social movements standpoint, mainly because this service is responsive in assisting a person in crises. Fieldwork was developed in two phases. First one was made with SAMU workers and the information were produced by recorded semi-structured interviews. Results of this first phase indicate that urgency psychiatric conception from SAMU workers is based on aggressiveness concept; delays at psychiatric cases support and low training in mental health care which means several difficulties to emergency service. Although, we noticed that SAMU use asylum procedures at psychiatric cases like ropes and odder instruments to contain people. The second step of our research was to attend meetings to build a new psychiatric urgencies protocol for SAMU to define practices to auxiliaries, vehicular conductors and medical support regulation. Therefore, open interviews were accomplished with some participators and follows-up to psychiatric case on board of SAMU's cars. Afterwards we discussed how the urgency paradigm, that influence the protocol draw and as consequence distort what we believe is the essentially function of this device, that is to give care support to persons in crises and produce articulation to psychosocial services network

A loucura interrompida nas malhas da subjetividade manicomial

Psychiatric reform occurring in Brazil has progressed significantly during the last two decades, both in the transformation of the help structure and in the treatment of madness. At the same time a paralell movement is observed marked by the maintenance of the hospital centered or psychiatric ward ideology present not only in the psychiatric institutions but also in the substitute services in the cities and , above all, in the ways of contemporary subjectivation. We affirm that the idea of deinstitutionalization is intertwined with capitalistic agent both from the epistomological, assistance, and legal aspect as from the cultural one. This work aims mainly to discuss madness and subjectivity from the ethic esthetic-political perspective, specially the wishes of the psychiatric hospital, which we inhabit and who inhibits our interactions and our desired and creative productivity. We do also want to access the invisible threads that capture and modify madness, which make our cities a means for the production of pathologies, and those that, on the contrary, insinuate a process of resistance, facilitating life and health

As especificidades da clínica psicanalítica com crianças na neurose e na psicose: conseqüências para a direção do tratamento

This dissertation aims to answer the question: What are the specifics of psychoanalytical clinic with children in neurosis and psychosis and its consequences for the treatment direction? It constitutes a theoretical study based on Freud, Lacan and the current productions of Lacanian psychoanalysts about the clinic with children. It presents some clinical vignettes. To answer this question, were constructed four chapters. The chapter The subject constitution treats the psychoanalysis subjectivity, based on a structure from the relationship with the Other. Key concepts of Lacanian psychoanalysis are shown, necessary to understand what becomes present in clinic with children. The second chapter, The clinic of neurosis, reveals the structure of the subject in its oedipal mooring held by the Name-of the-Father, that separates the mother-child dual relationship. The child neurosis is the effect of psyche constitution and the symptoms are an interpretation of what child picks up from parents and helps him/her on the passage through the Oedipus. The analyst is there to help him/her through this path. The next chapter is entitled The clinic of psychosis. In psychosis the non-occurrence of the Name-of-the-Father is concerned. The subject is stuck in duality with the mother, and becomes what fills the Other s gap. To protect themselves, they have to be in incessant work. The analyst will be a child s partner in daily work already carried out by him/her. The last chapter, The consequences for the treatment direction, shows that the standard analytic treatment works well to the clinic of neurosis. To psychosis it s not true. Psychoanalysts thought about a different way of psychotic children treatment: the practice held in a multiprofessional team work. The practice shared by many has been a team strategy applied to the institutional practice that aims to attenuate the invasive character of the Other, facilitating the partnership between the analyst and the child in treatment and the Other contention

O fazer do psicólogo no núcleo de apoio à saúde da família

The Brazilian Ministry of Health regulated in 2008 the Family Health Support Nucleus (FHSN) as a device for support and complementarity to the Family Health Strategy. The FHSN, through the matrix support, potentiates the Family Health teams on dealing with a great variety of demands and activities that are under their responsibilities. It is structured in teams of professionals from various health specialties, among which is the mental health. In preliminary studies we noticed that the psychologists have been the main representatives of mental health professionals at the FHSN from Rio Grande do Norte (RN-Brazil). On this scenario, this study intends to problematize the professional practice of the psychologists who work at the FHSN teams in RN, regarding how their work is done, discussing it under the perspective of collective health and the directions for the basic health care on Brazilian s health system. Still as a goal, in more specific ways: identify the forms of professional insertion of the psychologists in this field; characterize the work done by the psychologist at the FHSN (developed activities); and produce an analysis of the characteristics and limits of those actions, from theoretical and methodological references based on Marxian ontology. Were performed semistructured interviews with psychologists working in the oldest FHSN teams form RN. We conducted the analysis of the material following the blocks of information: determinants of the psychologist entry at the services, training for current practice; operation of FHSN; activities performed by FHSN team and the psychologist; joint actions; and limits of psychology practice in the FHSN. An important result, we observed the little articulation of practicing between the psychology and other professionals and teams, further indicating the prevalence of the traditional medical model (individual and outpatient) as guidance of their performance instead of the matrix logic that is the foundation of the proposed action for the FHSN. We also emphasize the potential of psychologists actions at the FHSN on contributing to the achievement of comprehensive care

O Serviço Residencial Terapêutico: cartografias de um híbrido no contexto da desinstitucionalização em saúde mental

This thesis seeks to uphold the idea that the therapeutic residential service, as hybrid device and recent process of deinstitutionalization in mental health, works as a problem producer while it also indicates challenges and potentialities in this process, the attention on mental health and on its own care production. To that end, we work with the prospect map with which we approach reality as the subjectivities production field which transformations and intensities are the major thought propellants. From this perspective, it was possible to produce three "purpose maps" from meetings with actors and groups involved with the TRS and the theoretical study carried out. On the first map we mapped the conditions of possibility of this device and its design in the midst of the process of institutionalization and health policies. We indicate on it the TRS configuration as a hybrid and we hassled its proposition as a means of "social rehabilitation" that can work as a social homogeneity mechanism. On a second map, we cartographied mental captures through images and ways historically built from madness presented in the biopolitical contemporary game and we indicated that the resistance to such catches should be built on a politic daily basis as important vectors of the institutionalization process in mental health. Finally, on a third map we mapped the carefulness produced in the TRS, by analyzing the transition psychiatric hospital - TRS and the caregivers´ team work. On this mapping, the care, for the weakness in the coresponsibility field, is reveled crossed by mental, disciplinary and normality elements, but it is also built in resistance born from links in the intersubjective field of the caring work. We conclude, then, that the TRS power and the deinstitutionalization process itself were in building and strengthening affective labor micro political networks of life and liberty producers

Desempenho auditivo ao longo do tempo e satisfação dos usuários de implante coclear com perda auditiva pós-lingual

Most cochlear implant (CI) users, who suffer from post lingual hearing loss, are able to perceive sounds and comprehend speech after the implant. The prediction of maximal benefit over time, with the use of CI, can be useful for counseling patients about their expectations in using the new device. The measurement of satisfaction should be of primary interest in medical intervention, as the results may be used for intervention feedback. The purpose of this study is to analyze auditory performance of CI over time, as well as to evaluate users‟ satisfaction. Therefore two types of study designs were employed: a) retrospective cohort study with the analysis of medical records from 59 subjects about auditory performance before and after surgery. Results were submitted to the Kaplan -Meier estimator of cumulative probability and compared to prognostic factors of auditory performance using the logrank test. b) A sectional study design was conducted to evaluate the satisfaction of 51 subjects. The instrument consists of two specific questionnaires: Satisfaction with Amplification in Daily Life SADL and International Outcome Inventory Cochlear Implant IOI- CI. Results show statistical significant differences (p<0,001) in auditory performance before and after CI. The majority obtained satisfactory results of CI use during the first six months. Logrank tests does not indicate significant correlation between the analyzed covariates and the time in which adequate speech perception occurs. SADL e IOI-CI questionnaires indicate that most of the CI users are satisfied with their devices. The SADL detected a 27, 5% insatisfaction amongst CI users in relation to services and costs involved with the CI. The results of the IOI show 4% of insatisfaction with the use of CI and the social environment. In conclusion CI is capable to rehabilitate social auditory function in a short period of time and CI users demonstrate satisfaction with auditory, social and psychological gain offered through CI device

Uma arquitetura de referência para o desenvolvimento de sistemas interativos multiplataformas

It is increasingly common use of a single computer system using different devices - personal computers, telephones cellular and others - and software platforms - systems graphical user interfaces, Web and other systems. Depending on the technologies involved, different software architectures may be employed. For example, in Web systems, it utilizes architecture client-server - usually extended in three layers. In systems with graphical interfaces, it is common architecture with the style MVC. The use of architectures with different styles hinders the interoperability of systems with multiple platforms. Another aggravating is that often the user interface in each of the devices have structure, appearance and behaviour different on each device, which leads to a low usability. Finally, the user interfaces specific to each of the devices involved, with distinct features and technologies is a job that needs to be done individually and not allow scalability. This study sought to address some of these problems by presenting a reference architecture platform-independent and that allows the user interface can be built from an abstract specification described in the language in the specification of the user interface, the MML. This solution is designed to offer greater interoperability between different platforms, greater consistency between the user interfaces and greater flexibility and scalability for the incorporation of new devices

Uma abordagem baseada em aspectos e composição dinâmica para a construção de aplicações adaptativas cientes ao contexto

Ubiquitous computing systems operate in environments where the available resources significantly change during the system operation, thus requiring adaptive and context aware mechanisms to sense changes in the environment and adapt to new execution contexts. Motivated by this requirement, a framework for developing and executing adaptive context aware applications is proposed. The PACCA framework employs aspect-oriented techniques to modularize the adaptive behavior and to keep apart the application logic from this behavior. PACCA uses abstract aspect concept to provide flexibility by addition of new adaptive concerns that extend the abstract aspect. Furthermore, PACCA has a default aspect model that considers habitual adaptive concerns in ubiquitous applications. It exploits the synergy between aspect-orientation and dynamic composition to achieve context-aware adaptation, guided by predefined policies and aim to allow software modules on demand load making possible better use of mobile devices and yours limited resources. A Development Process for the ubiquitous applications conception is also proposed and presents a set of activities that guide adaptive context-aware developer. Finally, a quantitative study evaluates the approach based on aspects and dynamic composition for the construction of ubiquitous applications based in metrics

Avaliação do Uso de Smartphones na Interação com as Aplicações da Televisão Digital Brasileira

Brazil is going through the process from analogical transmission to digital transmission. This new technology, in addition to providing a high quality audio and video, also allows applications to execute on television. Equipment called Set-Top Box are needed to allow the reception of this new signal and create the appropriate environment necessary to execute applications. At first, the only way to interact with these applications is given by remote control. However, the remote control has serious usability problems when used to interact with some types of applications. This research suggests a software resources implementation capable to create a environment that allows a smartphone to interact with applications. Besides this implementation, is performed a comparative study between use remote controle and smartphones to interact with applications of digital television, taking into account parameters related to usability. After analysis of data collected by the comparative study is possible to identify which device provides an interactive experience more interesting for users

Ambientes residenciais controlados por dispositivos móveis: estudo, concepção e desenvolvimento de um aplicativo considerando a diversidade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Comércio internacional e meio ambiente: estímulo à produção sustentável ou mero protecionismo comercial a posição do Brasil em dois casos de litígio

The World Trade Organization (WTO) was established in 1994 as a result of the Uruguay Round, and has as its principal aim advocate for the maintenance of free trade between nations. The preamble of its Constitutive Agreement specifically cites as an institution the goal of achieving sustainable development and the pursuit of protecting and preserving the environment, bringing into the sphere of world trade the idea that concern for the environmental cause is not restricted only the group of environmentalists, but rather has entered the economic landscape in a way not only ideological, but also pragmatic. The General Agreement on Tariffs and Trade (GATT) 1947, part of the GATT 1994, contains a device that allows the adoption of trade restrictive measures, provided that such measures aimed at protecting the environment - Article XX. The Settlement Body (DSB) is part of the WTO and acts in dissolving disputes between the countries motivated by trade. It examines two cases where countries have imposed restrictive trade measures with environmental justification. The first case was closed in 1996, with award of damages given to Brazil, on the breakdown of U.S. environmental legislation imposed on imported gasoline from Brazil - and the second, begun in 2005 and closed in 2007, coming out victorious again Brazil is on the import ban on retreaded tires to Brazil. The objective is to answer the question: how the environment is treated in the midst of trade discussions - which is aimed at its protection or its use with economic objectives in disguise? For the preparation of this work, extensive documentary research was undertaken with the virtual site of the WTO to review the entire production of legal cases and subsequent analysis of the key issue for the work, and literature of authors who have studied the tense relationship between trade international environment. The first case, it could be seen that the political movement performed by the U.S. with the aim of achieving acceptable standards of air quality was an institutional effort to ensure the quality of air, and thus would be inappropriate to say that the regulation of gasoline was merely a disguised trade barrier.However, a careful analysis of the implementation and operation of gasoline regulation may reveal intentions disguised trade and U.S. environmental argument did not hold. The weight of this environment was relegated, since there were clearly outside interests to the environmental cause. The second case, it was realized that, despite clear attempts by the EC to promote ecological dumping, send when brought to Brazil, supposedly a country with weaker environmental structure on surveillance, a residue that, pursuant to internal policies, as could not be sent to their own landfills, the Brazilian discourse remained focused on the environmental cause, and this sort there was the existence of disguised trade barriers, but of importance, at least a priori, the discussion of foreign forces on the environment environment because there is no way to legally justify the reversal of the total understanding of the first judging body, the sight of all the arguments presented by Brazil and the nonsubmission of new facts upon appeal. Still, quite heartening to reflect on the role of trade liberalization on the environment in general, because, while they do not reach a definitive conclusion will reveal positions in both directions, both for and against, the that only adds to the discussions and makes this a very fertile topic for future research

O efeito da autocorrelação no desempenho do gráfico T2 de hotelling: caso bivariado

The chart of control of Hotelling T2 has been the main statistical device used in monitoring multivariate processes. Currently the technological development of control systems and automation enabled a high rate of collection of information of the production systems in very short time intervals, causing a dependency between the results of observations. This phenomenon known as auto correlation causes in the statistical control of the multivariate processes a high rate of false alarms, prejudicing in the chart performance. This entails the violation of the assumption of independence and normality of the distribution. In this thesis we considered not only the correlation between two variables, but also the dependence between observations of the same variable, that is, auto correlation. It was studied by simulation, the bi variate case and the effect of auto correlation on the performance of the T2 chart of Hotelling.

Contribuições para a detecção e identificação de faltas em inversores Multiníveis

This work presents contributions in the detection and identication of faults in multilevel inverters through the study of the converters behavior under these operation conditions. Basically, the approached fault consists of an open-circuit in any switch of a three-level clamped diode inverter. The converter operation is characterized in the pre and post-fault states. A wave form behavior analysis of the pole voltage, phase current and dc-bus current is also done, which highlights characteristics that allow the detection of failure and, even, under favorable conditions, the identication of the faulty device. A compensation strategy of the approached fault (open-switch) is also investigated with the purpose of maintaining the driving system operational when a failure occurs. The proposed topology uses SCRs in parallel with the internal switches of the inverter, which allows, in some occasions, the full utilization of the dc-bus

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