Saúde Mental e enfermagem: em busca da integralidade na ESF

The present work shows an inquiry about the conceptions and practical work of the nursing professionals on the accompaniment of mental sick patients in the Family s Health Strategy, under the approach of the completeness in health. The justification of this research is given by bringing an special attention concerning the subjet to these professionals of health: the gradual abandonment of the traditional manicomial model leads to the insertion of mental patients in the community . The nursing professionals must be prepared to receive these patients in the basic net of health and contribute to help their adaptation and insertion in the social environment as citizen. In this context, considering the entire attention to the mental health, it is important to detach that the assistance to the patient must search his reinsertion in the community by providing programs that develops his sociability. This analytical study was developed using a qualitative approach and a thematic verbal history. Ten nurses of Nova Natal s Health of the Family Unit, of Felipe Camarão Mista s Unit and of Cidade da Esperança s Health Unit contributed for its development . The information was acquired through an instrument research that made possible the accomplishment of the interviews. These ones were set previously and counted on the assent of the participants. The interviews were recorded and analyzed in accordance with the pertinent literature concerning the subject. The aggregation of the information was then discussed. At this moment three thematic axles were defined dividing the categories of analysis. According to the results of the interviews, the practical procedure given to the patients with mental upheaval is resumed by the prescription of psicotroprics medicaments. It doesn t provide an accompaniment by the professionals of health, specifically, nurses, to the patients and their families. The lack of qualification and a multi-professional team emerged as one of the challenges for the implementation of practical procedures towards the patients with mental upheaval. Therefore, the results of this research show the necessity of transformations in the current scene of the mental health in the Family s Health Strategy. These changes can be reached by politics investments on the mental health area, not only financially but by providing human resources that should allow the professionals to exert the completeness procedures

Trânsito de saberes e campo representacional na visão dos profissionais da saúde da família e do programa de educação pelo trabalho e para a saúde

The Family Health Strategy (ESF) is emerging as a possible restructuring of services and new practices of intervention in health care; it requires skilled professionals to work with that framework. Within this purpose, we established the Education Programme for Work and Health (PET-Saúde), in order to integrate teaching and service activities, focusing on primary care. On this basis, the aim of this work is to apprehend the social representation of nurse, doctor and dentist (Project PET-Natal Health RN preceptors) on the ESF, while practice field of them. It is a descriptive and exploratory study, with a qualitative approach, carried out in 07 Family Health Units (USF) included in the PET-Saúde Natal (RN). The population was composed of 35 professional components of the primary care team with bachelor's degree of the USF linked to this project. The sample was composed of 05 nurses, 05 physicians and 05 dentists, for a total of 15 subjects. Data were collected through three instruments: the drawing-themed story, a semi-structured individual interviews and field diary. The data relating to the identification of the subjects were entered and tabulated by the Microsoft Excel software 2007 version. The drawing analysis and interpretation is given by the significance attributed to the resource chart from title and keywords assigned by the subjects, considering the ESF as an inductive term. The stories and interviews were transcribed and typed and then subjected to read/listen the material and a lexical analysis through Alceste. After this process, the discursive material was analyzed and discussed by theoretical and methodological feature of the Social Representations theory. The majority of health professionals were female, aged between 46 and 52 years old, married, income less than six minimum wage, time since graduation ranged from 22 to 29 years and working time in the ESF range from 02 to 11 years. From the classification system ALCESTE were selected categories identified by: Category 1 - ESF: relations and territory; Category 2 - Training and bond profile; Category 3 - Working process in the ESF; Category 4 - Articulation between teaching and service; Category 5 - Health care and disease prevention. The representational field construction, while a process, followed the logic of structural cores in existing categories. In this sense, it is clear that the ESF is an environment rich in diversity, experience and relationships with potential such as the relationship "very subject-subject" and the link established between professional-community, but also has some weaknesses such as poor working conditions, lack of popular participation and management support, thus difficulties in the achievement of teamwork. Being essential to that end, the teaching-service aimed at the formation of a new health professional able to work in the ESF. In this research, the training of the representational field encountered a diversity of structural cores, or thoughts on training, about the ESF because of the greater emphasis on the here and now of the interaction between health professionals, the ESF, the community, PET Health-UFRN and students, emphasizing that such proposals are still considered as concepts in the context of recent health and that, therefore, are not fully realized in the social imaginary

Comunicação dos enfermeiros com usuários do gênero masculino: um estudo representacional

Communication is seen as vital function. Through it, individuals and organizations relate to each other, the environment and the shares of their own group, influencing each other to turn facts into information. The user of the male part of a group of patients whose health policy is still in development. This fact can create insecurity in the nurse to establish a process that promotes disease prevention, promotion and / or recovery of health for that user. Aiming to elucidate this, the present study aimed to: apprehend the social representations of nurses communication with the users were male, looking for disease prevention, promotion and recovery of his health; identify the factors that influenced, positively or negatively on the effectiveness of nurses communication with the users were male and investigate the strategies used by nurses to clarify communication with the users were male. In order to achieve the goal raised, this study was a descriptive, exploratory and qualitative approach. Was based on theoretical and methodological framework social representations of Denise Jodelet and Serge Moscovici. The project has, through no Parecer nº 649/10, approval of the Ethics and Research HULW. During data collection, we used a semi-structured script and a diary interviews with 24 nurses in basic health units of district-Mangabeira Health District III, the city of João Pessoa (PB). The results were analyzed using the technique of content analysis according to Bardin (2007). Classifying the research subjects and identified three categories and five nuclei of the central ideas. The categories identified: the grasp of the RS communication of nurses with male users, identifying factors that influence the effectiveness of nurses' communication with users and male research on the strategies used by nurses to the elucidation of the communication with male users. The nuclei of the central ideas found: social representations of nurses' communication with the users of the male is externalized as difficult, different, difficult, not technical (knowledge) specific, with a dubious sense in relation to its therapeutic action, the factors examined as positive in this communication were based on the connection between professional and user look in detail and not mechanistic, in preventive actions, the dynamics of care, accessibility, participatory care, humanization, and qualification service. Whereas served as negative factors for the communication, signed on the behavioral differences of men, the feminization of nurses, lack of training for professionals in relation to the subject, prescriptive conduct and prejudice (concerns) sociocultural. Another related consolidated core strategies employed for the occurrence of such communication. Given these results, it was realized the importance of social representations for the consecration of a single language, the common understanding of reality on the nurse's communication with the user in male and determination of changes in the behavior of nurses and the user to the establishment of more effective strategies for obtaining a therapeutic communication between them

Enfermeiros pós-graduados: continuidades e rupturas no cotidiano profissional de hospitais universitários

A presente pesquisa teve como objetivo analisar as transformações do cotidiano profissional do enfermeiro do hospital universitário após a realização do curso de mestrado. Trata-se de um estudo com abordagem qualitativa, realizado no Complexo Hospitalar Universitário da UFRN, composto pelo Hospital Universitário Onofre Lopes (HUOL), Maternidade Escola Januário Cicco (MEJEC), e Hospital de Pediatria Professor Heriberto Ferreira Bezerra (HOSPED) localizados em Natal-RN; e pelo Hospital Universitário Ana Bezerra (HUAB) situado em Santa Cruz-RN. A população foi composta por vinte e dois enfermeiros, com título de mestre em enfermagem, que trabalham nessas instituições. Após encaminhamento e aprovação pelo Comitê de ética em pesquisa, conforme Parecer nº 268.498 e CAAE: 13922713.1.0000.5537, as entrevistas foram iniciadas, utilizando-se um roteiro semiestruturado, organizado em questões orientadas em conformidade com os objetivos do estudo. Do material empírico, emergiram as categorias que foram trabalhadas com base na análise de conteúdo temática, tendo como aporte teórico os estudos de Agnes Heller acerca do cotidiano e os de Paulo Freire sobre educação e mudanças, buscando a possível interlocução entre esses autores. Os resultados demonstram que o cotidiano dos enfermeiros nos hospitais universitários, após cursarem o mestrado, modifica-se a partir da própria motivação em cursálo e do apoio institucional recebido. As continuidades e rupturas apontadas estão distribuídas nas categorias: a inércia da cotidianidade, na qual os enfermeiros relatam a dificuldade em mudar seu cotidiano devido à rotina exaustiva e à falta de apoio; reconhecem mudanças particulares, compreendendo a formação de um olhar crítico/reflexivo/analítico, e a qualificação para o ensino e pesquisa; e as rupturas do cotidiano, que se referem às mudanças ocorridas no serviço, como a melhoria da assistência, pela implantação de resultados; e uma prática diferenciada por ter um profissional qualificado. Portanto, considera-se que a realização do mestrado contribuiu para o crescimento do intelectual e profissional do enfermeiro e, consequentemente, para o serviço, no cotidiano do Complexo Hospitalar Universitário, sendo reconhecido pelos enfermeiros o compromisso com uma maior responsabilidade social. Porém, ainda são necessárias reflexões sobre maneiras de minimizar as dificuldades apontadas, como forma de incentivar essa qualificação

A gestão do conhecimento e a inovação tecnológica como fatores de sobrevivência e de competitividade na sociedade do conhecimento: uma análise exploratória das MPEs do Rio Grande do Norte

The study examines the process of Knowledge Management and Technological Innovation in Small and Micro Enterprises (SME) in Rio Grande do Norte, Brazil, and proposes actions that can contribute to regional development and competitiveness of SME. Presents as technological innovation can help to make the SME entrepreneurial activities with innovative and competitive. Defines the phases and activities of the construction of knowledge in small organizations. Examines the process of Innovation, Research and Development (R & D) in SME. Identifies the use of knowledge management and technological innovation in management practices and social interaction to influence the competitiveness of SME. Covers the communities of practice as a diffuser of knowledge and learning. To obtain the data were used questionnaires with closed questions with multiple choice, direct observations and interviews with companies. The questionnaires and interviews covered the topics of Innovation, Knowledge Management and Competitive Intelligence on SME. The sample consisted of a total of 13 Small and Micro Enterprises Award winning MPE Brazil Competitiveness, sponsored by SEBRAE in the State of Rio Grande do Norte. The assessment questionnaires dealing with the Knowledge Management (KM Diagnostics - Model Bukowitz and Williams, 2002) and the process of Technological Innovation (Adaptation of ANPEI - National Association for Research, Development and Engineering of Innovative Companies). With the analysis, we concluded that the SME perceive knowledge management, but not formalized management practices so as to facilitate the dissemination of information. Soon, these companies need additional supports to direct them to the innovative activities that generate added value and competitiveness in the market

Construção e implementação do Balanced Scorecard em uma organização educacional: o caso do Serviço Nacional de Aprendizagem Comercial do Rio Grande do Norte SENAC RN

The changes that have taken place in the organizational environment in recent decades have led to new performance measurement systems being proposed, given the inadequacy of traditional models. The Balanced Scorecard (BSC) emerged as an instrument to translate financial and non-financial assets into real values for all interested parties in the organization, allowing the introduction of strategies to achieve the desired goals. Research shows that most errors committed with the use of this method are related to the implementation process. Thus, the aim of this dissertation is to analyze the process of building and implementing the BSC in an organization. This empirical exploratory study is based on the classic case study method, which enables the researcher to work with a set of evidence, including direct observation, interviews and document analysis. The results show that the use of BSC in the company investigated posed problems during the process of building and implementing the method. These problems were caused mainly by the lack of involvement on the part of upper management and the team s scant knowledge of Balanced Scorecard. One of the gains obtained from adopting the system was the introduction and/or consolidation of a culture of strategic planning and participative management. The continuous implementation phase was highlighted in the monitoring program, created by the organization in an attempt to reverse existing problems, using the BSC as a third generation strategic management system, which led to significant gains, better use of the system and stronger management practices

Utilização do Balanced Scorecard na gestão pública : um estudo de caso na Polícia Militar do Estado do Rio Grande do Norte

This dissertation deals with the use of the Balanced Scorecard (BSC) in the Military Police of Rio Grande do Norte (PMRN), an organization of service delivery in the area of public safety. For this purpose we sought refuge in the company's own documents, which presented the mission, vision and strategic objectives, which are items essential to the development of the instrument and its prospects. With the general objective of developing the BSC to PMRN, fitting into the methodology in a single case study, that from the desk study and according to their development, we established the classification of goals to the generic models and the BSC then adjusted according to public understanding of the corporation presented by professionals in the process of collection and in-depth interviews. Thus emerged the strategy map PMRN, based on the presentation of the causes and effects between the strategic objectives of each perspective, the value proposition to customers, internal processes needed to meet this value proposition and intangible assets, which are the basis to execute these processes

Análise da situação de trabalho do motorista em uma empresa de ônibus urbano da idade de Natal (RN)

The problem dealt with in this study concerns the analysis of bus drivers' working situation. It stemmed from the need to identify the difficulties faced by these professionals in accomplishing the results expected by the company. A case study was carried out in a public transportation company in the city of Natal. Records and observations made in the workplace, alongside perfomance indicators, such as absenteeism tax, staff turnover and traffic accidents, revealed problems in their activity. It was made clear that, in the company being studied, absenteeism was related to health problems, particularly psychiatric and musculoskeletal disorders, and that although the indicators of traffic accidents and staff turnover have declined over the years, they are still elevated. The interviews involved 50 of the 124 drivers who worked directly in the service, and contained questions covering eleven factors related to the drivers' work. They indicated a gap between the prescribed work and the work actually done, in that there were a series of embarassing or stressful situations involving traffic, itinerary length, road conditions, vehicle maintenance, physical environment (bus terminus), job post and supervision policies. On the other hand, factors such as enjoying driving, the work itself and being with workmates positively influenced the drivers' working conditions. In the propositions of the administration and human resources subsystems, some alternatives were found in order to remodel this activity

A gestão de empreendimentos da agricultura familiar e os impactos para a sustentabilidade: um estudo de caso na rede xique xique

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Estratégias acadêmicas na avaliação de desempenho dos cursos de ciências contábeis no enade em NATAL - RN

O número de instituições de ensino superior no Brasil vem crescendo bastante nos últimos anos. Com isso a preocupação com a qualidade dos cursos ofertados também tem aumentado. Para avaliar essa qualidade do ensino o governo instituiu formas de avaliação e vem aperfeiçoando a cada ano. As instituições, por sua vez, buscam bons resultados nessas avaliações a fim de utilizar como item de vantagem competitiva, uma vez que as notas obtidas por elas chamam atenção de novos clientes. Dessa forma, o presente trabalho buscou analisar as principais estratégias acadêmicas utilizadas na avaliação de desempenho dos cursos de Ciências Contábeis, da região de Natal-RN, no ENADE. Trata-se de uma pesquisa de abordagem qualitativa e quantitativa, e foi aplicado um estudo de caso complementado por um survey. A parte qualitativa foi obtida através de entrevistas semiestruturadas realizadas com os coordenadores dos cursos e a quantitativa foi obtida através da aplicação de um questionário fechado aos alunos aptos a participarem do ENADE no ano de 2012. Foram estudadas todas as instituições em Natal que possuem o curso de Ciências Contábeis, modelo presencial, sendo ao todo 10 (dez) instituições identificadas. Os dados foram analisados por meio da análise de conteúdo (entrevistas) e do software SPSS® 18 (survey). Foram utilizados os métodos de análise fatorial, através da análise de componentes principais, com rotação Varimax e normalização Kaiser. Em relação à análise da importância do ENADE sob a perspectiva dos estudantes, foi utilizado o teste não paramétrico de Mann-Whitney. Como resultados da pesquisa, foi identificado que tanto os discentes como os coordenadores de curso entendem a importância do ENADE, também observou-se que a satisfação dos discentes com a instituição refletiu nos resultados obtidos por esta, bem como, o momento em que foi iniciada a preparação para o exame também refletiu nas notas recebidas pelas instituições

Estratégia de produção e competitividade :estudo de caso com enfoque de estratégia de foco em empresas de fibra de vidro

The objective of this thesis is to study the theory of production as it relates to and focuses on the strategy of production and competitiveness. The theory utilized was based on Terry Hill s Strategies through the utilization of Matrix of Manufacturing Strategy Issues and supported by the studies of others in this area. The methodology used for the development of this study was based on observing the engagement between two companies over a long period of time. Through interviews and discussions it was possible to collect the necessary information to guide this study; and by constant involvement in each of these companies, their ways of thinking, performing and administrating were observed and understood. In conclusion, this work created an understanding of the importance of the strategy of production, not as the only important element but as an important factor to direct attitudes and decisions in the company under the concept of strategy and competitiveness

A influência da adição de caulim, quartzo e feldspato potássico na formulação de massas cerâmicas para telhas: Modelo estatístico

The production of roof tiles in the state of Rio Grande do Norte accounts for around 60% of the total of ceramic pieces produced. There is a need for investment to improve quality and productivity, thereby promoting technological innovations. Accordingly, the aim of this study is to determine the effect of kaolin, potassium feldspar and quartz in two standard formulations, as well as the effect of sintering temperature on the technological properties of linear firing shrinkage, water absorption and bending rupture stress, by fitting the statistical model and using multiple linear regression to assess the relationship between technological properties and independent variables. The raw materials were characterized using the following techniques: X-ray fluorescence (XRF), X-ray diffraction (XRF), rational analysis (RA), differential thermal analysis (DTA) and granulometric analysis (GA). The test specimens were compacted by uniaxial pressure (25 MPa), dried in a stove at 110 ºC for 24 hours and sinterized at 850 ºC, 950 ºC and 1050 ºC and held isothermal for 30 minutes. The results obtained indicate that the addition of kaolin to two standard formulations (M and R) promoted a reduction in water absorption values and an increase in bending rupture stress values. The sintering temperatures for group M that resulted in the lowest linear firing shrinkage and water absorption values were 850 ºC and 950 ºC, respectively, and the highest bending rupture stress values were reached at a temperature of 950 ºC. In the case of group R, the sintering temperature that obtained the lowest water absorption and linear firing shrinkage values was 850 ºC, and the highest bending rupture stress values were attained at a temperature of 1050 ºC. This work explains the statistical approach used to fit the model that describes the relationship between the technological properties and percentage of kaolin, quartz and feldspar, as well as the models that enable predictions, provided that the lower and upper limits of the percentage of clay minerals, flux and quartz used in this study are respected. Statistica 6 software was used and results were obtained by stepwise forward regression

Desenvolvimento de um reator fotoquímico aplicável no tratamento de efluentes fenólicos presentes na indústria do petróleo

With water pollution increment at the last years, so many progresses in researches about treatment of contaminated waters have been developed. In wastewaters containing highly toxic organic compounds, which the biological treatment cannot be applied, the Advanced Oxidation Processes (AOP) is an alternative for degradation of nonbiodegradable and toxic organic substances, because theses processes are generation of hydroxyl radical based on, a highly reactivate substance, with ability to degradate practically all classes of organic compounds. In general, the AOP request use of special ultraviolet (UV) lamps into the reactors. These lamps present a high electric power demand, consisting one of the largest problems for the application of these processes in industrial scale. This work involves the development of a new photochemistry reactor composed of 12 low cost black light fluorescent lamps (SYLVANIA, black light, 40 W) as UV radiation source. The studied process was the photo-Fenton system, a combination of ferrous ions, hydrogen peroxide, and UV radiation, it has been employed for the degradation of a synthetic wastewater containing phenol as pollutant model, one of the main pollutants in the petroleum industry. Preliminary experiments were carrier on to estimate operational conditions of the reactor, besides the effects of the intensity of radiation source and lamp distribution into the reactor. Samples were collected during the experiments and analyzed for determining to dissolved organic carbon (DOC) content, using a TOC analyzer Shimadzu 5000A. The High Performance Liquid Chromatography (HPLC) was also used for identification of the cathecol and hydroquinone formed during the degradation process of the phenol. The actinometry indicated 9,06⋅1018 foton⋅s-1 of photons flow, for 12 actived lamps. A factorial experimental design was elaborated which it was possible to evaluate the influence of the reactants concentration (Fe2+ and H2O2) and to determine the most favorable experimental conditions ([Fe2+] = 1,6 mM and [H2O2] = 150,5 mM). It was verified the increase of ferrous ions concentration is favorable to process until reaching a limit when the increase of ferrous ions presents a negative effect. The H2O2 exhibited a positive effect, however, in high concentrations, reaching a maximum ratio degradation. The mathematical modeling of the process was accomplished using the artificial neural network technique

Tratamento de materiais contaminados com bifenilas policloradas (PCBS) via extração convencional e fluído supercrítico

The decontamination of the materials has been subject of some studies. One of the factors that it increases the pollution is the lack of responsibility in the discarding of toxic trash, as for example the presence of PCB (Polychlorinated Biphenyls) in the environment. In the Brazilian regulations, the material contaminated with PCB in concentrations higher than 50 ppm must be stored in special places or destroyed, usually by incineration in plasma furnace with dual steps. Due to high cost of the procedure, new methodologies of PCBs removal has been studied. The objective of this study was to develop an experimental methodology and analytical methodology for quantification of removal of PCBs through out the processes of extractions using supercritical fluid and Soxhlet method, also technical efficiency of the two processes of extraction, in the treatment of contaminated materials with PCBs. The materials studied were soils and wood, both were simulated contamination with concentration of 6.000, 33.000 and 60.000 mg of PCB/ kg of materials. Soxhlet extractions were performed using 100 ml of hexane, and temperature of 180 ºC. Extractions by fluid supercritical were performed at conditions of 200 bar, 70°C, and supercritical CO2 flow-rate of 3 g/min for 1-3 hours. The extracts obtained were quantified using Gas chromatography-mass spectrometry (GC/MS). The conventional extractions were made according to factorial experimental planning technique 22, with aim of study the influence of two variables of process extraction for the Soxhlet method: contaminant concentration and extraction time for obtain a maximum removal of PCB in the materials. The extractions for Soxhlet method were efficient for extraction of PCBs in soil and wood in both solvent studied (hexane and ethanol). In the experimental extraction in soils, the better efficient of removal of PCBs using ethanol as solvent was 81.3% than 95% for the extraction using hexane as solvent, for equal time of extraction. The results of the extraction with wood showed statistically it that there is not difference between the extractions in both solvent studied. The supercritical fluid extraction in the conditions studied showed better efficiency in the extraction of PCBs in the wood matrix than in soil, for two hours extractions the obtain percentual of 43.9 ± 0.5 % for the total of PCBs extracted in the soils against 95.1 ± 0,5% for the total of PCBs extracted in the wood. The results demonstrated that the extractions were satisfactory for both technical studied

Estudo da oxidação do metabissulfito de sódio contido no efluente da carcinicultura

The shrimp farming is a process of creation of shrimp that has been growing rapidly in the country, occupying a meaningful space in the Brazilian exporting. In 2003, this activity presented a volume of 60 millions of tons and 220 millions of dollars, being the main generator of employment and income of the primary sector of the northeast economy. However, it is a new activity with c.a. five years in the Rio Grande do Norte State and therefore needs investment in the technological area. Among the wastewaters of this activity, the sulphite solution is being usually applied in the process of fishing, i.e. retrieval of the shrimps from the farming. The aim of this work is to present the oxidation experimental results of the sulphite that may be and to determine what it s the most efficient method, trough laboratory experiments. The measurements were carried out in a mixing reactor inserting air and with hydrogen peroxide addition with and without UV light. The solutions were prepared synthetically with concentrations found in the wastewater of fishing and also collected in locu. The oxidation process using air was monitorated by iodometric analysis for the sulphite and the oxidation using hydrogen peroxide was evaluated with turbidimetric analysis for sulphate, by spectrophotometer. The sulphite was totally oxidized in both processes. The experimental results permit to conclude that the oxidation by hydrogen peroxide is more efficient and allowed to determine the optimum operational conditions in terms of concentration and time of treatment