A redução de danos no atendimento especializado em álcool e outras drogas

The harm reduction HR is the official policy of Ministry of Public Health to deal with problem derived from alcohol consumption and other drugs AD. The HR refers to policies and support programs whose purpose is to reduce the risks related to the use of AD, without necessarily decrease individual consumption. This research aim was to analyze the HR conceptions and practices at two specialized institutions for AD users: 1) Psychosocial Care Center Alcohol and Drugs III (CAPSad III); 2) Therapeutic Community Fazenda da Esperança (FE) Dom Bosco. This is a qualitative research that used the following methodological tools: semi-structured interview with 21 professionals; socio demographic file and rounds of conversation with 63 participants users; participant observation and field journal. The interviews with professionals have characterized HR as a less complex and cheap treatment. At FE the HR proposal does not make part of their actions, being considered ―against the human being dignity‖. At CAPSad III is understood as an ―inevitable‖ guideline to service, once users do not remain abstinent. The users understand RD as an improvement in healthy conditions, social relations and work that occurs with the decreasing consumption of AD. They use the HR when they avoid situations that facilitate AD consumption, share relapse prevention strategies and, exclusively at CAPSad III, decrease psychotropic consumption. Stands out as an analyzer the HR comprehension as a less efficient treatment that opposes to the objective of both institutions, which is abstinence. The HR is not operationalize in daily routine by professionals and users as a healthy promotion strategy, however, the users are more affected to HR and produce strategies to face the difficulties arising from the AD consumption

Gênero, trabalho e saúde mental entre trabalhadoras rurais assentadas na região do Mato Grande Potiguar

The lack of studies aimed at the mental health of the rural population, the social, economic, familial and emotional impact that mental disorders produce and the vulnerability that women have in this context, lead us to believe in the need to investigate the mental health demands of female rural workers, in order to subsidize the development of more effective and culturally sensitive public health programs and policies that take into account the specificities of this population. The present study aims to investigate the prevalence of common mental disorders (CMD) and the possible factors associated with the emergence of such disorders among women living in a rural settlement in Rio Grande do Norte. This survey has a quantitative and qualitative character with an ethnographic approach. As methodological strategies, we made use of an adapted version of the socio-demographic and environmental questionnaire prepared by The Department of Geology/UFRN s Strategic Analysis Laboratory to evaluate the quality of life of the families from the rural settlement and the mental health screening test Self-Reporting Questionnaire (SRQ-20) to identify the prevalence of CMD in adult women from the community. Complementing the role of methodological tools, we use the participant observation and semi-structured interviews with women who presented positive hypothesis of CMD attempting to comprehend the crossings that build the subjective experience of being a woman in this context. The results point to the high prevalence of CMD (43.6%) and suggest the link between poverty, lack of social support, unequal gender relations and the occurrence of CMD. We also verified that the settled women do not access the health network to address issues relating to mental health and that the only recourse of care offered by primary health care is the prescription of anxiolytic medication. In this context, the religiosity and the work are the most important strategies for mental health support among women

Faz-de-conta que eu brinco : o comparecimento da brincadeira na educação infantil da rede pública de Vitória da Conquista-Bahia

This research aimed to understand the place that the child s play in the childish education of Vitoria da Conquista s public system. We understand the childish education institution like a space that should respect the child as a person in a peculiar condition of development. We adopted the social-historical approach understood from Vygotsky and Leontiev, with the social theory of construction of knowledge and its dialogue with authors like Piaget e Brougère. The child s play was seen like result of social relations with great influence in the childish development. The research was accomplished in 04 public day care centers, amongst 18 existent ones in the city. While subjects of investigation participated 09 educators that works with children with ages between 03 and 04 years old and the children of their respective class-room. The procedures used were the participative observation and the interview with the educators, as a procedure of composition of research corpus, focusing the child s play activity, particularly in the way that it is expressed in the childish education. From of corpus constitution we used the thematic content analysis. We clustered the appearance of child s play in the childish education in three thematic nucleuses to detailed analysis: 1. mediated by the educator; 2. proposed by the educator; and 3. started by the children. The results show that, despite of the limitations that configure the day care centers routine, the child s play appears in the childish education. We hope, through the comprehension of the place occupied by the child s play in the childish education, contributes to the execution of the public politics, above all in the educational scope, to children with ages between zero and six years old, fomenting the discussion of the educator practice, its limitations and possibilities

Entre a hegemonia e a polissemia: a Política de Educação e Desenvolvimento para o SUS no contexto do Brasil contemporâneo

The proposal of the Unified Health System Policy (SUS) has been considered one of the most democratic public policies in Brazil. In spite of this, its implementation in a context of social inequalities has demanded significant efforts. From a socio-constructionist perspective on social psychology, the study focused on the National Policy for Permanent Education in Health for the Unified Health System (SUS), launched by the Brazilian government in 2004, as an additional effort to improve practices and accomplish the effective implementation of the principles and guidelines of the Policy. Considering the process of permanent interdependencies between these propositions and the socio-political and cultural context, the study aimed to identify the discursive constructions articulated in the National Policy for Permanent Education in Health for the Unified Health System (SUS) and how they fit into the existing power relations of ongoing Brazilian socio-political context. Subject positionings and action orientation offered to different social actors by these discursive constructions and the kind of practices allowed were also explored, as well as the implementation of the proposal in Rio Grande do Norte state and how this process was perceived by the people involved. The information produced by documental analyses, participant observation and interviews was analyzed as proposed by Institutional Ethnography. It evidenced the inter-relations between the practices of different social actors, the conditions available for those practices and the interests and power relations involved. Discontinuities on public policies in Brazil and the tendency to prioritize institutional and personal interests, in detriment of collective processes of social transformation, were some of obstacles highlighted by participants. The hegemony of the medical model and the individualistic and curative intervention practices that the model elicits were also emphasized as one of the drawbacks of the ongoing system. Facing these challenges, reflexivity and dialogism appear as strategies for a transformative action, making possible the denaturalization of ongoing practices, as well as the values and tenets supporting them

A humanização no parto e no nascimento: os saberes e as práticas no contexto de uma maternidade pública brasileira

The practice of medicine related to the gestational processes tend to be organized according to the context and the place of work, being thus dependent of the conditions both social and economical, and of the physical structure and the functionality of the services. The high mortality rate in this process has diminished, since 1986, the study made by the World Health Organization (WHO) as to the technical aspects and the social inequalities that influence this situation in different geographical contexts. This culminated recommendations that proposed the reorientation of the dynamical practice of medicine, with a focus on the safety of maternities. Brazil adopted, in the year 2000, the suggestions of the OMS, emphasizing the humanization as the main reason for these actions. However, this discussion tends to not consider the problems caused by the social inequalities and the epidemiological and social conditionings that define the actions of the Unified Health System (Sistema Único de Saúde SUS). In this area, this research seeks to analyze the practices, cares taken, and the universal symbol that promotes and rewards the assistance to the birth of children by the SUS. Besides the analysis of the public documents that deal with this subject, an ethnographic study was developed in a maternity in Natal/RN, considered a model of humanization after receiving the Galba de Araújo prize in 2002. In this stage, the methodological strategies were observed, and the focus of the individual interviews with workers and users of this service. In the analysis of the data, it became evident that the different professional workers and women who gave birth, tend to show concern of the standards the delimit production and reproduction of the practice of medicine, as they favor the absence of a critical posture of the actions destined to the population. Besides this, if became evident that the institutional difficulties associated to the economical, cultural, and political problems also difficult the involvement and the reflection of the workers in favor of assisting changes of the process. There is also a utilization of a perspective prescriptive of humanization in the everyday life of the social workers, without reflection of its meaning. Some workers present, in their statements, a preoccupation with the social and economical aspects that affect the practice of medicine, and with the limitations of the humanization discourse that disarticulates the necessities of those involved in the process of formation, and soon tend to return to the discussion of humanization while a kind practice characterized by the minimization of the interventionist actions. Now the users of the system show themselves before the dynamic of the services, submitting themselves to what is offered while assistance, without questioning and/or reflecting about their usual shortages. Therefore, to think of changes in the know and do of the practice of medicine destined to the birth of children implies reflection on the quotidian production of these practices and of the social contexts that influence the process of assistance in the practice of medicine. Herein it would be possible to predict the appropriation, by different workers concerning their exasperations and necessities, making them active in the pursuit of their rights as citizens

Práticas educativas e integralidade na saúde da família: um estudo etnográfico

Primary Health Care, especially in the family health strategy, it is expected that the joint assistance and actions of health promotion. The Ministry of health (BRAZIL, 2007) defines health education as an eyeshadow strategy of prevention and health promotion, based on reflective practices, which allow the user to their condition of historical, social and political subject, under the vision of an expanded clinic on the part of health professionals. In this sense, there are guidelines for it professionals to develop educational activities and that they can interfere in the health/disease process of the population, with a view to the development of autonomy of the subject. This research had as objective to understand in the light of the integrality of the care, as is the production of health education practices, within the framework of the family health strategy from ethnographic study in a family health unit (USF). The location of the research was the unit of USF Felipe Camarão II in West Health District, in the city of Natal, RN, Brazil, selected from preliminary mapping of educational practices deployed in units of health of the family of this municipality, based on criteria such as time-to-deployment of USF and sustainability of existing actions. Immersion in the field consisted of participant observation with journaling, held during the period of August 2012 to January 2013, in which she accompanied team work processes in clinical-welfare actions on the USF, in households and in educational activities of group character. The results presented in ethnographic description were analyzed based on the axes proposed by Ayres (2009) for identification of integrality in health practices:the axis of the needs; the axis of the purposes; the joint axis; and the axis of the interactionsThe evidence described from observation point the presence of each axle up health education practices developed by the teams, even incipient form, namely: articulation and appreciation of knowledge and practices of popular culture with local initiatives (Pastoril do Peixe Boi Encantado, Auto de Natal e Grupo Terapia e Arte); Clinical integration with health promotion actions and coordination of multidisciplinary knowledge, with professional-user link (course for pregnant women). However, a few challenges were identified to be faced in order to move forward in these practices in integral care: the need to break with the fragmentation of actions; strengthening teamwork; need for greater sustainability policy of collective actions; intersectoral work aimed at a better role of the State in the face of the health-disease process, adding to the action of individuals.The analysis produced from observation of the processes experienced indicates the need for a better recognition of local managers that actions similar to those that occur in the USF Felipe Camarão II enable advances in completeness as allows inclusion of actors involved in the processes of health work, and stimulate participation and shared responsibility in the fight for health-disease situations

Ações educativas com portadores de diabetes Mellitus através da educação popular em saúde

Popular Health Education in its emancipatory dimension refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions. Under this view, health workers and health users are subjects of the educative process. Thus, this study aims to identify the key clinical and socio sanitary attributes and promote educational activities with patients with Diabetes Mellitus (DM) in a Family Health Care Unit of the Western Sanitary District, in the city of Natal / RN. It is an action research which uses the references of the Theory of Liberating Education, which is based on a problem-solving pedagogy and that values dialogue in the process of understanding oneself and the world. Thirty-six diabetics, who are residents of the area covered by the health care unit, and thirty health workers participated in the survey. Each group had an average of twelve participants, and the meetings took place at the Unit´s hall, using conversation wheels, group dynamics, life narratives, experiences telling, movie exhibition and discussions, music, knowledge telling, desires, limitations, beliefs and values socially constructed. Data collection took place during the second half of two thousand and thirteen through Free Word Association Technique (FWAT), recordings of conversation wheels, participative observation, group dynamics, testimonies, questionnaires, life narratives and photographs. The empirical material was organized and subjected to three analyzes: thematic content (Bardin), textual statistics analysis by software IRAMUTEQ (Ratinaud), and photographic analysis (Edmund Feldman). The data analyses originated words, expressions, categories, themes and creative situations showing that popular health education is in process of construction, but still very incipient in primary care. The National Policy on Popular Health Education shows us the necessary ways for the transformation of health practices and the build of a more shared and solidary society. The meetings could be place to reverse that normative logic that has been happening over the years in primary care, but that by itself is not enough. It is possible to conclude that the use of active practices, increasing of listening and training on Popular Health Education will enable changes in the scenario where users and health workers deal with diabetes mellitus. Thus we see the popular health education is being timidly incorporated to the educational process of the subjects involved in this study, and far away from the principles of participation, organization of political work, increase opportunities for dialogue, respect, solidarity and tolerance among different actors involved in addressing the health problems that are fundamental to the improvement in building healthy practices of primary care

O cotidiano do(a) Assistente Social frente as demandas apresentadas pela paciente portadora do câncer de mama em tratamento no Hospital Doutor Luiz Antônio em Natal/RN

This work deals with an analysis related to the social worker s practice in the oncology area. It aims to identify demands, work conditions as well as current challenges related to this profession. It considers the specificities of breast cancer and relates it to political decisions in the health sector considering the concept of contemporary capitalism. The study analyzes professional action and the demands presented by breast cancer patients who are currently in treatment in Hospital Dr. Luiz Antônio em Natal-Rio Grande do Norte-Brazil. The methodological procedures considered of documental analysis, semi-structured interviews (with two social workers that work with fifteen breast cancer patients) as well as participant observation; which was done counting with my own professional practice in the oncology area. Thus, the research also discusses the breast cancer issue in the life of the users considering their social-economical, cultural and political determinants. Factors such as age in which the diagnosis was known, the relation user/social workers, number of children, rights of the oncology patient, place where he/she lives, education, civil status, (re)insertion of the professional in the work field, perception of self-esteem and bio-psycho-social representation of breast cancer in the lives of these women, all of which were dealt with in this research

Turismo religioso na cidade da santa: a percepção da comunidade sobre a construção do Complexo Turístico e Religioso Alto de Santa Rita, Santa Cruz/RN

The general objective of this study was to analyze the city of Santa Cruz cope with the impacts of the changes caused by the insertion of religious tourism with the construction of the Tourist Complex Religious Alto de Santa Rita, and specific objectives: to identify the economic activities from building the Tourist Complex Religious Alto de Santa Rita with the monument of Santa Rita; describe the research scenario to respect the traditions, rituals and spatial organization of the city and to evaluate the impacts through construction of movement by Religious Tourism Complex human capital and economic development fostered by Religious Tourism. To this end, we used the methods of application of Questionnaires and interviews, as well as the method was conducted participant observation, individual and systematic, having exploratory held through a correlational analysis regarding the impacts by inserting Tourism religious elsewhere. Was performed also discourse analysis of speeches Stakeholder city of Santa Cruz / RN for understanding the local reality. Literature search was performed readings of books, articles, theses and dissertations dealing with the issue, it was necessary to use data from websites. As for the media research field was qualitative. At the end of the study, it was concluded that the city of Santa Cruz suffered socio-economic and cultural, as a result, especially the lack of a previously developed tourism planning

Descobrindo novas ofertas: recursos histórico-culturais e oportunidades de inovação em turismo para a região do Marco/RN

Having as reference the fundamentals of regional innovation systems (RIS) and the policy guidelines defined in the regionalization program implemented by the federal government, this study focus on the analysis of the so-called "Landmark Region", northern coast of Polo Costa das Dunas-RN, in order to indicate how the historical and cultural resources can support innovation in the tourism of the region, represented here by the cities of Pedra Grande and São Miguel do Gostoso. This is a descriptive research, using qualitative methods of data collection and analysis, configuring, still, as a case study. Data were gathered from literature, documents, semi-structured interviews and mainly by participant observation methods. The results show a great diversity of cultural resources in the region, both material and immaterial, which however are disarticulated, and need to be worked in order to be included in the tourism productive chain. The main opportunity for innovation regards the return of the Landmark to the region, an invaluable monument, with the construction of a memorial. Taking in account the relevance of the monument and the growth of the region, we conclude that the return of the Landmark to its place of origin, in conjunction with other cultural resources, could attract a flow of cultural tourists. This fact could be, as the theory suggests, characterized as market or niche innovation, as the region is dominated by the sun and sea and wind sports tourism

Turismo e pobreza: percepções dos guias de turismo, moradores e não moradores que trabalham na favela da Rocinha Rio de Janeiro

This project refers to a study somewhat controversial , as in focusing less recognized and valued hand, although the dynamics of tourism pass to take another view , you can not beforehand consider favorable or unfavorable . Analyzes the phenomenon related to conception or perception of poverty from tourism residents and non residents of the Favela of Rocinha in Rio de Janeiro tourist guides . It is a subject to an object of research somewhat controversial , but about which there is already an academic and scientific concern and deserves an investigator look. Fits as a qualitative study whose methodological procedure based on interviews and participant observation , and the geographic divisions chosen the Rocinha slum , for its expressiveness and for being a pioneer in this type of tourism , had to conducting fieldwork lasting six months, which was accompanied by at least four hours walking work of sixteen tour guides, eight residents and eight non- residents in the community, working for different travel agencies and tourism. End of each tour, all tour guides answered a semi-structured questionnaire, containing nineteen questions. Most respondents tour guides authorized record interview, which has made it possible to analyze the speech through spoken language. In tourism, foreign tourists are the main target, although rarely also count with the participation of domestic tourists. Notes that the relationship between poverty and slums, from the perceptions of tourist guides residents better reflects the reality of favela residents compared with non residents guides, since they fully know all the intricacies and better the difficulties they have endured and still go, when it comes to the issue of stigmatization respect, by which has suffered by Brazilian society, in relation to live in slums, and have your dwelling place as a tourist attraction. While presenting the social reality of Rocinha consistently during his work, the non residents guides worry about being as natural as possible with tourists as much as the locals show slum, in the same way they avoid authorize tourists to take compromising photos and that will expose the intimacy of community residents . Concludes that, while recognizing the importance of elevation to the rank of tourist attraction and its promising prospects, requires attention and priority, given the greater precariousness of the human condition in relation to the prime areas in which it operates tourism should be a vector of development, not a masking of reality

As múltiplas faces da evasão na educação superior a distância: a experiência do curso de tecnologia em gestão ambiental do IFRN em dois pólos de apoio presencial

This research presents a reflection on the dropout rates in higher education courses available through distance education in a context marked by deep changes in various spheres of society and by the uncontrolled growth of this educational method. For this, the object of analysis is related to the reality of students of Technology in Environmental Management offered by the Instituto Federal de Educação, Ciência e Tecnologia, Rio Grande do Norte (RN), Brazil, through the distance education in presence support poles located in Mossoró (RN) and Martins (RN). In this field research development several strategies of data collection are used, such as participant observation of reality; analysis of documents related to distance education and to the classes in Technology in Environmental Management; questionnaires answered by students who dropped the course. The results of such research enable us to say that the dropout rates in distance higher education is mainly referred to the consequences of a combination of aspects involved in the course development, personal difficulties faced by students during the period they attend the lessons and elements inherent in the context in which the course and students are inserted. Nevertheless there are specific situations in which the student may drop the program due to the influence of a single aspect, whether it is inherent in the development of the course, a personal situation, or even a factor determined by the context in which the course or the student belongs to

Festa na escola e a autopoiese do lazer

This study shows the problem of school party and its relations with the perspective of leisure autopoiesis in the lives of students living in student housing. It has aimed to describe and interpret the most meaningful leisure experiences in daily life of a student housing and the ludopoietic processes for the humanescent self-education. From the theoretical assumptions supporting the development of this research have highlighted: Education by Freire (1996); Embodiment by Pierrakos (1990); Leisure by Dumazedier (1999); Party by Duvignaud (1983), Playful by Schiller (2002), Working by Freinet (1998), Autopoiesis by Maturana and Varela (2001), belonging to each day by Certeau (1994). A qualitative study adopts the principles of existential action research, in an ethnofenomenological perspective. As a methodology, we use the metaphor of sowing covering the planting, flowering, harvest and new planting. The scenario was to sow the Escola Agrícola de Jundiaí - RN. Twenty-five students residing in the school participated in research from 2007 to 2008, which involved more actively in the development of an extension project for the implementation of recreational and leisure experiences in that institution. The main instruments used for the construction of data collection were: participant observation, questionnaire, interview, game sand and photographs. The process of data analysis with the ethnofenomenological principles emphasized the following points: experientiality, indexicality, reflexivity, self-organizability, adoptability, archetypal and humanescenciality. New meanings of ludopoietic flowering of seed "party school" were revealed, and you can see the emergence of autopoietic leisure as a big green tree, able to sprout in soil properly fertilized to produce wonderful fruit of joie de vivre

Tessituras poéticas da corporeidade na formação humana do educador infantil

Cette étude a comme sujet principal la formation humaine de l instituteur. L objectif général est d analyser et décrire les conditions créées par les vécus d un atelier corps biographique pour la resignification de la corporéité de l instituteur, fixant les questions suivantes pour l investigation : Quelles sont les implications du vécu de l atelier corps biographique dans la vie des instituteurs ? La recherche a été exposée sur l approche qualitative, suivant les principes de la recherche-action reliée à la méthode des histoires de vie. Pour révéler la beauté et la complexité du processus poïétique de la formation humaine, nous nous sommes servi de la métaphore du "dessus de lit en patchwork" comme opérateur cognitif en attachant les principes de la corporéité fondés sur la Théorie de la complexité (MORIN, 2005), la Théorie autopoïétique (MATURANA ; VARELA, 2001), la Théorie du flux (CSIKSZENTMIHALYI, 1999), les approches de transdisciplinarité (LA TORRE; MORAES, 2008), et d autobiographie (JOSSO, 2004; PINEAU, 2003; PASSEGGI, 2000;), joignant la conception de l éducation comme pratique d autonomie, de liberté, d espoir et de l enchantement (FREIRE, 1996, 1992; ASSMANN, 1995). Nous avons eu comme scène du développement de la recherche, l Unidade Educacional Infantil (UEI), la garderie qui accueille les enfants des fonctionnaires de l Université Fédérale du Rio Grande do Norte. Treise élèves (enfants), des institutrices titulaires, vacataires, boursières ont participé de l'investigation. En conptant sur eux, nous avons développé un atelier corps biographique, dans lequel nous avons réalisé 10 vécus dans la période qui a couvert le deuxième semestre de 2007 jusqu au deuxième semestre de 2008, en manifestant la réflexivité autobiographique, le ludique, la créativité, la sensibilité et la réflexivité du vécu. Nous avons utilisé comme instruments pour la construction des donnés, l observation participante, les propres vécus, le port folio, la technique du jeu de sable et l'enregistrement photographique. L analyse a montré que le vécu de la formation humaine à partir des principes de la corporéité, implique dans un parcours vers soi-même dans lequel émergent les expériences qui nous ont constitués en tant qu êtres existentiels. Pour finaliser, nous avons aperçu les répercussions dans la vie professionnelle et personnelle de ces institutrices, qui comme moi pensaient avoir besoin d exposer leur luminosité intérieure pour que l on la redécouvre. Lors des vécus des tissages, les institutrices se sont montrées impliquées aux moments de jeux, de création, de réalisation, d afection et d action réflexive, dans lesquelles la teneur humaine cachée, a été révélée, en ouvrant les possibilités pour le sentiment du mouvement de naissance de l humanisation intérieure. Pour conclure, le corps joyeux de savoir et de beauté a été révélé, et dans sa rencontre avec soi-même et avec l autre, a pu être auto- recréé

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