Compreendendo a experiência de pessoas portadoras de transtorno mental: histórias de vidas severinas repletas de possibilidades

This study aims to understand the experience of people suffering from mental disorder. The patients are enrolled in a mental health ambulatory clinic in the city of Natal (RN). Mental disorders are growing rapidly in the contemporary world and are a source of intense mental suffering. Besides patients being strongly marked by a history of isolation and prejudice, they have been the target of real atrocities committed in the name of preservation of a supposed normality. The understanding and treatment of this disorder is influenced by cultural and historical inferences, depending on the period in which it is experienced. Semi-directed Interviews were conducted with a group of users, with the emphasis on giving voice to their uniqueness and individuality, highlighting how each one perceives his or her own experience. These were recorded and later transcribed by identifying the core of meanings. The results were analyzed under the gaze of the Humanist Phenomenology Existential perspective, which aims to unravel the phenomenon, without truths from volatility, highlighting the existence of the mental disorder as a way of living, being permeated by suffering mental and influenced by social problems, assuming contours very particular to each individual. Some progress has been perceived, even by users, with respect to the change of paradigm in the way of care, but still there is a consistent emphasis on medical and drug use. The changes point to the need for offering services to replace the asylum hospital model, and in addition to accept the bearer of mental disorder as a citizen, a bearer of rights who should be accepted and respected by society. Despite the pain expressed and its close liaison with suicide, their reports are full of perspectives and attitudes of confrontation facing life, pointing to new possibilities to be, recreating itself

Moradores crônicos de hospital psiquiátrico: um desafio à desinstitucionalização

The existence of chronic inhabitants in the psychiatric hospitals imposes a challenge to the Psychiatric Reform, that proposes things such as the gradual and progressive way to extinct mental institutions, once the permanence of the hospital in the system is only necessary because there is not a net of well structured substitute services capable of receiving that demand. This work considered relevant to deepen the knowledge about those people who passes their lives jailed by the walls of psychiatric hospitals and compose significant part of the world population. It also aimed to investigate the problem relative to the condition of being an inhabitant of a psychiatric hospital the Dr. João Machado Hospital (HJM), in the city of Natal/RN. The paper used different points of view (patients , families and professionals ) to define the profile of the inhabitants, to identify the possibility of insertion in substituting social equipment, to know the expectations of the inhabitants and their relatives regarding to the exit of the life shelter, to investigate the demands related to the net of cares social support for making feasible the discharge and to identify the difficulties that are involved in the exit of the chronic inhabitant of the hospital. There were defined three methodological phases: delineation of the identification, socio-economic and clinical profile of the inhabitants of the HJM; semi-structured interviews with professionals; and open interviews with inhabitants and family. It concluded that the psychiatric institutionalization contributes to the generation of chronic inhabitants in the psychiatric hospitals. Among the professionals, it was detached the defense of desospitalization, but an existence of devices of the asylum model. The relatives showed a resistance to participate in the care and the inhabitants exposed their desire to leave the hospital, as well like the wish of permanence. It was considered important: the construction of an extra-hospital net that enables to desinstitutionalization; the qualification of the technical; orientation to the family, stimulating its participation in the process of caring; give freedom to the individuals in mental suffering, enabling them to be ahead of their lives and express their desires and opinions; the implementation of an extended clinic that is capable of building new possibilities; and a subjectivity guided by the social enclosure

Os agentes funerários e a morte: o cuidado presente diante da vida ausente

The present time is marked by the art of escape from death, which has become synonymous with failure, its exposure has become intolerable and the care of the dead body were assigned to third parties who market this practice through services and products that shape the market undertaker. In this context, in which death is an object of study, has arisen funeral officers, as professionals dealing with a dead body, with the pain of relatives and their reactions, often being the first to have contact with the death scene. As professionals in the health area, the morticians also deal with death. The first attempt to prevent the arrival of death, funeral officers already has begun their work routine from there. Death and its surrounding part of their profession. What about those professionals whose work demands as a feared and denied by society? This study aims to understand the intents, meanings and implications for the mortician to deal with death in their daily work in order to focus renewed attention to the care of these professionals. To this end, it was carried out a qualitative research grounded in the theoretical framework of Gadamerian hermeneutics for production and interpretation of narratives. It was used two methodological strategies for data collection: in-depth interview with script and workshop with the use of "scenes". Research participants were nine morticians funeral of two funeral agencies of the city of Natal. It was possible to detect the presence of the social imaginary of interdiction on the theme of death from living with feelings of his presence daily, from the need of respondents to naturalize their contacts with death, a requirement of their office to deal with the difficulties of manipulating body fluids and odors, sometimes in a state of decomposition; allied to wishes to achieve the goal of delivering to family-customers a "embellished" body for the final farewell. Being a mortician, in addition to not being a professional motivation, involves facing difficulties related to heavy routine work, low salaries, unprofitable work materials and equipments, besides having to deal with the social gaze that devalues the profession. In turn, they also deal with the pain coming especially from contact with family members, either when they are targets of these feelings of anger, whether they identify with the pain of the bereaved ones. On the other hand, when the recognition and gratitude of the families occur, they find meaning and beauty in their profession of caring for the dead body. The present study by giving voice to morticians has become possible to understand better their profession, the pain that surrounds and care needs of these workers. Finally, it has argued that the mortician may be recognized as a care professional for the way exercising caution with the dead body and their families.

Percepção de estigma e qualidade de vida em crianças com neoplasia

The increase in survival time and cure requires more extensive care about the quality of life of cancer patients, which begins soon after diagnosis. Thus, it seems reasonable to the emphasis on development of studies covering the psychosocial variables, such as stigma, treatment of childhood cancer aiming thereby to the attention of the overall needs of the child. Thus, this research aims to investigate the perception of stigma and quality of life in children with cancer. This is a cross-sectional research and understanding of the descriptive type, the type specimen being adopted for convenience. This consisted of thirty children with cancer and thirty children without chronic disease. The instruments used were the Quality of Life Questionnaire, the Perceived Stigma Scale and Technical Drawing Story with a Theme. The results indicate that the chronic condition, no interfered significantly in satisfaction with the quality of life in children with cancer and identified that the quality of life is not related to the stigma. Comparison with children with no chronic disease with infants with cancer, no significant differences were observed. However, the group mean contrast was lower, suggesting a greater impairment in quality of life of children with cancer compared to those without chronic disease. It is worth noting that the psychosocial effects and the limitations imposed by disease and treatment are presented as important factors in the design mode of subjective manifestations of children with cancer. Therefore, it is expected that knowledge elucidated by this study will assist, greatly to the promotion of improved emotional, biological and social development itself and the involvement of children with cancer treatment

Mulheres em situação de violência e atenção em saúde mental: um estudo no município de Natal (RN)

The present study aims to meet the attention given to women with mental health needs in specialized services for the fight against violence against women, as well as psychosocial care network in the municipality of NatalRN. It is a qualitative research characterized as research-intervention that took place in the year 2011. The study started in the Centre of Reference in which individual semi-structured interviews were carried out directed to the coaching staff and manager, in order to know the care offered in relation to the aforementioned clientele. From the Reference Centre were identified through analysis of registration records, the routes traversed by users through the network of psychosocial care and hospital network. After the identification of the same were visited two day-care Centers, two psychiatric hospitals, a basic health Unit and the local shelter. In these organizations was investigated the reception and procedures offered to users in situations of violence, the knowledge of policies for women and the coordination with the attention to women, through interviews with semi-structured individual scripts directed to professionals. The interviews were analyzed taking as starting point the theoretical framework of French Institutional Analysis, which includes the assumption of events analysers for the critical reading of dimensions introduced in the practices of care of the teams that took part in the study. The survey results revealed difficulties on the part of the same host of users with this profile, both in the face of violence as services in mental health services. This fact led to the lack of support under the guarantee of their rights, ceasing the possibilities of confronting the situations of violence, as well as in the context of mental health care

O acolhimento como promoção da saúde entre pacientes com câncer

Cancer has been affecting people all around the world; disregard sex, ethnicity or social class. Despite the fact it is not always deadly, to be diagnosed and treated of cancer brings a lot of physical, emotional and social suffering, specially for those with less economic resources. Considering the complexity of the problem, there has been perceived that medical treatment is not enough to support cancer patients. There is an increasing understanding about their necessity of integral care, supposed to be given by a multidisciplinary health care equip that can consider all the different aspects involved in the illness process. Everyone has a particular way of been ill or healthy, and gives different meanings to the experienced events. The starting point of the research was the contact with a called work `group of shelter', developed with cancer patients by a multidisciplinary health care equip working on the LIGA Norte Riograndense Contra o Câncer. The research goal is to identify meanings people give to the shelter they receive in the group and to understand the way they experience the disease. Considering it singularity of this process, one worked with individually half-structuralized interviews, carried through with nine patients of the chemotherapy clinics and suck, that they had passed for the experience of the group of shelter, having approached getting ill, the treatment, the shelter and the recreation of the psychosocial processes (or not) after all this process. It was chosen as focus of analysis the creation of psychosocial processes and production of felt of these social actors through its discourse analysis perspective, boarded in accordance with the following thematic axles: the experience of the cancer, the shelter and recreation of the psychosocial processes the life. It was found that shelter has an extensive meaning going beyond the the group and involving others besides the multidisciplinary health care equip, and being important to give each patient the best possible benefit. It was also identified the importance of other social actors, such as relatives, friends and neighbors; added of religious faith, mentioned by all interviewees. It is to be considered the recovering capacity shown by eight interviewees, demonstrated by changing the way of interacting with others, getting new values and behaviors, and demonstrating more wisdom. We can consider the possibility of making this strategy to become part of the everyday practices of others health services working with cancer patients, what we think can help to minimize their suffering

Práticas institucionais/discursivas acerca dos cuidados com os bebês prematuros e/ou de baixo peso: o programa canguru

The Kangaroo Program was implemented in Brazil in 2000 through the Unified Health System (Sistema Único de Saúde SUS) sustained with a humanized rethoric of health care assistance. This program adopts the skin-to-skin contact contributing to the mother-infant bond, breastfeeding and promoting security in mother s care. The users of SUS are encouraged to live in the maternity ward to follow the baby health improvement. However, it was verified in previous observations that mothers participation in the Kangaroo Program has been done through an imposed practice. Therefore, this study intended to understand the texts that permeate the kangaroo practice. This research was developed through two studies: 1) an historic exploration of motherhood concept and an analysis of how the motherhood is presented in the official document that orients the program; 2) an analysis of institutional dynamic of Kangaroo Program, emphasizing the study about the health workers everyday practice, the mothers view about their life in the maternity wards, and the attendance practice. It is highlighted that the relation between this two studies allowed the comprehension abouthow the official discourses can influence the health workers behaviors and how their viewpoint and position can shape the everyday work in a public health program. This research, supported by Institutional Ethnography, considers that people s practices and experiences are socially organized and shaped by broad social forces. The discourse method was used in the documental analysis and in the analysis of qualitative data from empiric research. The research showed that the kangaroo program has been an excellent way to save resources and to improve some baby s biologic and psychological aspects. However, this program has failed to consider the social, economic and cultural complexity of mothers and the structural limitation of the health care system. The official document uses the economic and medical approach, following the hegemonic biomedical model and the life style of the people that don t use the public health system. Consequently, the program has not been successful because it is planned without people participation. On the other hand, it was verified that although some professionals are committed with their work, the mainly does not consider mothers participation as an active process, using the institutional power as a social control to keep mothers uninformed about the possibility to leave the maternity wards. As a result, the research also showed that mothers perceive the program as mandatory and not as option that can improve pleasure moments. It is, therefore, necessary to consider the complex social determinants of health that can increase mothers participation in the Kangaroo Program. Bringing these issues into debate can be a reflective exercise on citizenship and governance, allowing spaces for the improvement of public health programs

Fatores socioeconômicos contextuais associados à condição bucal de adolescentes no Brasil

Many surveys are conducted comparing oral health conditions with individual variables, such as socioeconomic and demographic factors. However, in the same way that individuals differ among themselves, the groups also have their own characteristics and the effects of this differentiation must be researched. Brazil, despite being one of the major economic powers of the world and shows an improvement in the average value of its health indicators, is also one of the most unequal and remains among the countries with the greatest health inequities. The purpose of this study was to investigate the importance of social determinants on the contextual level oral health among Brazilian adolescents, population not much researched by the literature. The research was made using an ecological approach in order to identify possible inequalities between cities and capitals. Using data from SBBrasil 2010 it was evaluated less common outcomes (loss of first molar, dental care index and T-Health) which provide information on the degree of morbidity of caries and health level of dental tissues, in addition to analyze the related services. The association of these oral health indicators with socioeconomic factors such as income, employment, education and inequality, collected from Census 2010, was analyzed by simple and multiple linear regressions. The study included the 27 state capitals and four clusters representing the municipalities of the country. It was possible to see better access to services in locations with better income distribution. However, the strong association of contextual factors related to poverty, low levels of education and poor housing and jobs with poorer levels of oral health in adolescents seems to overshadow the effects of income inequalities on dental caries in the country. In some locations, particularly within the North and Northeast, whichever one keeps dentistry mutilating, whose effects are already noticeable in its adolescent population. Access to restorative services in Brazil remains limited and unequal. The results of this study highlight the inequities in oral health in the country and show the need of the inclusion of new perspectives on the traditional approach of Preventive Dentistry and education models in Dentistry. Tackling health inequalities in oral health in the country requires the cooperation of various actors involved in the process and the inclusion of oral health in the context of overall health. The social determinants approach, as well as evaluating the distribution of oral diseases in the country and its inclusion in the context of overall health, should guide the implementation of programs and oral health practices in order to contribute to the reduction of inequalities

Projeto de Sistemas Integrados de Propósito Geral Baseados em Redes em Chip Expandindo as Funcionalidades dos Roteadores para Execução de Operações: A plataforma IPNoSys

It bet on the next generation of computers as architecture with multiple processors and/or multicore processors. In this sense there are challenges related to features interconnection, operating frequency, the area on chip, power dissipation, performance and programmability. The mechanism of interconnection and communication it was considered ideal for this type of architecture are the networks-on-chip, due its scalability, reusability and intrinsic parallelism. The networks-on-chip communication is accomplished by transmitting packets that carry data and instructions that represent requests and responses between the processing elements interconnected by the network. The transmission of packets is accomplished as in a pipeline between the routers in the network, from source to destination of the communication, even allowing simultaneous communications between pairs of different sources and destinations. From this fact, it is proposed to transform the entire infrastructure communication of network-on-chip, using the routing mechanisms, arbitration and storage, in a parallel processing system for high performance. In this proposal, the packages are formed by instructions and data that represent the applications, which are executed on routers as well as they are transmitted, using the pipeline and parallel communication transmissions. In contrast, traditional processors are not used, but only single cores that control the access to memory. An implementation of this idea is called IPNoSys (Integrated Processing NoC System), which has an own programming model and a routing algorithm that guarantees the execution of all instructions in the packets, preventing situations of deadlock, livelock and starvation. This architecture provides mechanisms for input and output, interruption and operating system support. As proof of concept was developed a programming environment and a simulator for this architecture in SystemC, which allows configuration of various parameters and to obtain several results to evaluate it

Simulação de reservatórios de petróleo em ambiente MPSoC

The constant increase of complexity in computer applications demands the development of more powerful hardware support for them. With processor's operational frequency reaching its limit, the most viable solution is the use of parallelism. Based on parallelism techniques and the progressive growth in the capacity of transistors integration in a single chip is the concept of MPSoCs (Multi-Processor System-on-Chip). MPSoCs will eventually become a cheaper and faster alternative to supercomputers and clusters, and applications developed for these high performance systems will migrate to computers equipped with MP-SoCs containing dozens to hundreds of computation cores. In particular, applications in the area of oil and natural gas exploration are also characterized by the high processing capacity required and would benefit greatly from these high performance systems. This work intends to evaluate a traditional and complex application of the oil and gas industry known as reservoir simulation, developing a solution with integrated computational systems in a single chip, with hundreds of functional unities. For this, as the STORM (MPSoC Directory-Based Platform) platform already has a shared memory model, a new distributed memory model were developed. Also a message passing library has been developed folowing MPI standard

Sistema operacional e biblioteca de funções para plataformas MPSOC: um estudo de caso para simuladores de reservatórios

The increasingly request for processing power during last years has pushed integrated circuit industry to look for ways of providing even more processing power with less heat dissipation, power consumption, and chip area. This goal has been achieved increasing the circuit clock, but since there are physical limits of this approach a new solution emerged as the multiprocessor system on chip (MPSoC). This approach demands new tools and basic software infrastructure to take advantage of the inherent parallelism of these architectures. The oil exploration industry has one of its firsts activities the project decision on exploring oil fields, those decisions are aided by reservoir simulations demanding high processing power, the MPSoC may offer greater performance if its parallelism can be well used. This work presents a proposal of a micro-kernel operating system and auxiliary libraries aimed to the STORM MPSoC platform analyzing its influence on the problem of reservoir simulation

Avaliação da execução de aplicações orientadas à dados na arquitetura de redes em chip IPNoSys

The increasing complexity of integrated circuits has boosted the development of communications architectures like Networks-on-Chip (NoCs), as an architecture; alternative for interconnection of Systems-on-Chip (SoC). Networks-on-Chip complain for component reuse, parallelism and scalability, enhancing reusability in projects of dedicated applications. In the literature, lots of proposals have been made, suggesting different configurations for networks-on-chip architectures. Among all networks-on-chip considered, the architecture of IPNoSys is a non conventional one, since it allows the execution of operations, while the communication process is performed. This study aims to evaluate the execution of data-flow based applications on IPNoSys, focusing on their adaptation against the design constraints. Data-flow based applications are characterized by the flowing of continuous stream of data, on which operations are executed. We expect that these type of applications can be improved when running on IPNoSys, because they have a programming model similar to the execution model of this network. By observing the behavior of these applications when running on IPNoSys, were performed changes in the execution model of the network IPNoSys, allowing the implementation of an instruction level parallelism. For these purposes, analysis of the implementations of dataflow applications were performed and compared

Detecção e recuperação de falhas para a máquina de redução de grafos PEWS-AM

Web services are software units that allow access to one or more resources, supporting the deployment of business processes in the Web. They use well-defined interfaces, using web standard protocols, making possible the communication between entities implemented on different platforms. Due to these features, Web services can be integrated as services compositions to form more robust loose coupling applications. Web services are subject to failures, unwanted situations that may compromise the business process partially or completely. Failures can occur both in the design of compositions as in the execution of compositions. As a result, it is essential to create mechanisms to make the implementation of service compositions more robust and to treat failures. Specifically, we propose the support for fault recovery in service compositions described in PEWS language and executed on PEWS-AM, an graph reduction machine. To support recovery failure on PEWS-AM, we extend the PEWS language specification and adapted the rules of translation and reduction of graphs for this machine. These contributions were made both in the model of abstract machine as at the implementation level

Uma nova proposta de antena planar multibanda para comunicações móveis

The great interest observed in wireless communication systems has required the development of new configurations of microstrip antennas, because they are easily built and integrated to other microwave circuit components, which is suitable for the construction and development of planar antenna arrays and microwave integrated circuits. This work presents a new configuration of tapered microstrip antenna, which is obtained by impressing U-slots on the conducting patch combined with a transmission line matching circuit that uses an inset length. It is shown that the use of U-slots in the microstrip antenna conducting patch excites new resonating modes, that gives a multiband characteristic for the slotted microstrip antenna, that is suitable for applications in communication systems that operates several frequencies simultaneously. Up to this date, the works reported in the literature deals with the use of Uslotted microstrip rectangular antennas fed by a coaxial probe. The properties of a linear array of microstrip patch tapered antennas are also investigated. The main parameters of the U slotted tapered microstrip antennas are investigated for different sizes and locations of the slots impressed on the conducting patch. The analysis of the proposed antenna is performed by using the resonant cavity and equivalent transmission line methods, in combination with a parametric study, that is conducted by the use of the Ansoft Designer, a commercial computer aided microwave software well known by its accuracy and efficiency. The mentioned methods are used to evaluate the effect in the antennas parameters, like resonant frequency and return loss, produced by variations of the antenna structural parameters, accomplished separately or simultaneously. An experimental investigation is also developed, that consists of the design, construction and measurement of several U slotted microstrip antenna prototypes. Finally, theoretical and simulated results are presented that are in agreement with the measured ones. These results are related to the resonating modes identification and to the determination of the main characteristics of the investigated antennas, such as resonant frequency, return loss, and radiation pattern

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