Serviço de atendimento móvel de urgência (SAMU) e a assistência às urgências psiquiátricas

The objective of this work which is characterized as an applied research, with a qualitative exploratory approach and has case study character has been the analysis of the conceptions and dealings of health professionals of SAMU in Natal RN about the attendance of psychiatric urgencies. The information was collected between the months of March and April of 2010, by means of semi-structured interviews, performed with 24 health professionals integrating of SAMU-Natal as well as the usage of direct observation technique, performed in the institution's medical regulation room. Both the number of professionals involved in the interviews and the bringing about of the observations, were determined by saturation methods in qualitative research's information collecting. The interviews and observations were transcribed and submitted to contents analysis technique , more specifically, to thematic analysis, which made possible to reach the deepest levels, that go beyond what has simply been manifest in the speech of the interviewed, getting to the relations among the categories and social structures of the issue of the research. Keeping this in mind, three analysis categories have been built, namely: conceptions and concepts of psychiatric urgencies shared by health professionals in SAMU-Natal; attendances to psychiatric urgencies in SAMU-Natal; and the Brazilian Psychiatric Reformation under the view of the SAMU-Natal's health professionals. Reflection about the analyzed information revealed discussions pertaining to the stigma and prejudice on mental illness, and also, pointed out to some hindrances which impair the attendance to individuals in mental suffering in SAMU-Natal. The interviewed health professionals' conceptions on the individual in psychical crisis involve concepts of unpredictability, aggressiveness and risk, stigmatizing elements and historically associated to the social hazard ideology and need for mentally sicks' segregation. The predominance of these conceptions, seen in health professionals speech, had identifiable reflexes on assistance to psychiatric demands performed by SAMU-Natal, namely: indiscriminate request for military police's presence during psychic crisis intervention, neglect about occasions that involve mental health patients, as well as repetitive assisting practice directed on physical contention, and transportation to psychiatric hospital. Associated to it, the professionals have shown distorted and reductionist understanding about Brazilian Psychiatric Reformation, and, in the majority, haven't lent credibility to present model of attention to mental health, based on psycho-social treatment, pointing their speech to a need for psychiatric patient's internment. In this sense, we notice that the hospital-centered and excluding model conceived by classical psychiatry still remains alive in these health professionals' mentality as a reference to psychiatric urgency's assistance. Therefore, the research revealed a sequence of elements, that make us think about the challenges that health sector and society must face to realize Brazilian Psychiatric Reformation's principles and guidelines

Inclusão da criança com deficiência na estratégia de saúde da família

The objective of analyze the shift of the working process of the ESF team in care of children with disabilities, from awareness-raising actions. It is a qualitative study, with the action-research method. Thirteen health professionals were involved from two teams of ESF unit area of the Unidade de Saúde da Família Dr. Chico Porto (UBSFCP) in Mossoró, from March to August 2011. Data were analyzed following the direction of freirean s thematic analysis. In the situational diagnosis of the current reality of CwD assistance in that UBSFCP, through participant observation and application of semi-structured interviews with professionals, we realize that despite these actions carry some assistance to the CwD, in practice few are used for inclusion and accessibility. The monitoring of the CwD is done through individual consultations by each team professional, home visits when possible, both ruled on the complaints and problems, with little solving in the used actions. Since the need for a change in the treatment model and training requirements as pointed out by professionals in the interview, then we decided to build the proposed of training suggested by the multidisciplinary team and put together collectively the achievement of this moment in all its phases. In the step of implementation (action), aspects related to the current situation in Brazil and Mossoró (Laws, policies and health care) for the CwD and CwD Assistance and their family in the ESF in the first two moments of the first training (action) were contemplate. On the second day we discussed the specialized care to CwD, contribution of the Handicapped Parents and Friends Association of Mossoró and in a second moment a workshop was held in which awareness for inclusion of CwD and actions of ESF were discussed. All these moments were discussed and collectively constructed. In the evaluation, we found that implementation (action) allowed to the professional the comprehension of new understandings about people with disabilities, on ways to include, guiding, caring, watching, and mainly to have a new vision on health assistance of the CwD, expanding assistance beyond clinical aspects and recognizing the educational aspects of the rights and duties of citizens and the inclusion of these children in the social spaces area. As difficulties, we face the need for some professionals to be absent to attend another job, solve personal problems, and little or no participation. Thus, during this action-research, the subjects were able to realize the importance of carrying out their practice to the quality of life for him and to the one they care

Atenção à saúde mental na Estratégia Saúde da Família no Município de Parnamirim/RN: opinião dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population´s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user´s care and the promotion of family health

Conquistas e desafios do processo de trabalho de enfermagem: o caso dos CAPS em Natal/RN

The Brazilian Psychiatric Reform proposes creating linkages / interactions of the mentally ill with civil society , through promoting citizenship and assistance to the mentally ill. The deinstitutionalization of mental health advocates from the guidelines decreased supply of hospital beds and consequently the creation of substitute services for psychosocial care, especially with regard to therapeutic practices emancipatory. From this scenario, the present study aims to investigate the relevance and challenges of the process of nursing work in CAPS III in Natal / RN. It is descriptive research with a qualitative and exploratory. The subjects are employees of the nursing team in CAPS III East of Natal / RN. This service has actions for the psychosocial care of the subjects treated with daily multidisciplinary care by behaving the length of treatment and follow-up activities, industrial and cultural activities. Employ the semi-structured interview as a tool for data collection. The data analysis was done by means of thematic analysis proposed by Bardin. Thus, this sought to bring to the discussion of how this process is consolidated in the daily service. Thus, purposed to contribute to the debate on deinstitutionalization in psychosocial care as a guideline in the process of mental health nursing work in a CAPSIII, Natal / RN

A tabela periódica: um recurso para a inclusão de alunos deficientes visuais nas aulas de química

Nowadays there are many reasons that aim to include people with special necessities, like those with visual deficiency, in the world of work, education, and in the society as a whole. However it is observed that when we talk about schooling inclusion, especially in High School, there is a huge gap between the theory and the practice. The lack of didactic resources, the inadequate installations, unprepared teachers, the families´ lack of information, are some of the factors that hinder the process of inclusion. Furthermore, the educators also have to deal with the roughness of the disciplinary contents and, refering to the study of Chemistry, with the use of signals related to this subject´s language. So, the objective of our research is to reflect about the apprehension of this language by the visually handicapped people, and try to contribute with their process of inclusion in the school life. On this perspective we work with the Periodic Table, which constitutes one of the indispensable tools necessary to the Chemistry learning. In order to acomplish it, the way followed by us happened in three passages. Initially, by means of a semistructured interview, we tried to get acquainted with the blind students opinion, who were participating in the research about the Periodic Table used by them throughout High School, as well as the dificulties felt when using it. After getting the answers, the Table was reelaborated to fill those students´necessities. Here, two new Tables were designed, one in Braille which shape is more compacted, and another made with high printed dots, built with sand and glue. On the third moment, the new designed Tables were tested by the students and, by means of a semi-structured interview, we tried to identify if this new resource would solve the problems concerned to the old Table. The students showed that the compacted Tables would facilitate the touch reading of the chemical elements simbols, making it clear and fast. We hope that, with the elaboration of this learning tools we can contribute with one of the elements to favor the effective participation of blind students in Chemistry classes, when studying the Periodic Table

Trajetória do ifrn em inclusão escolar

Discussions over the topic of inclusion of handicapped people at school are considered recent, but they have become more and more frequent within the national and international scenario. Such discussion has also being inserted in the speeches and actions of the school institution and with the formation of educators. This investigation is made necessary as a way to collect elements to reconsider the actions for the inclusion of the special education need youth. In special the visually handicapped ones, at Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Norte (IFRN). The creation of a support unit functions as main vehicle for the actions of the institution. It is intended to know what young people with limitations have to say regarding their experiences as a way to signal paths to be and not to be followed by the support unit. Therefore, the experience which these young boys and girls have is of crucial importance. In order to accomplish the task, it was decided to use methodological elements based upon elements supported by the life reports of two deficient students here called Borges and Stéfano. Their reports are from childhood to their arrival at IFRN. From their reports, categories appeared: childhood and the role of family; school life and, finally, related to the actions of the support unit of IFRN, being divided in inclusive actions and obstacles. The first one takes a second look at the actions of the family within the learning-teaching process of these students. The second category presents the moment in which students started to receive formal education per se. The last category constitutes the cornerstone of the investigation, for it analyses the process of inclusion in the institution, according to the perception of the students with visual limitations. The results signaled the need for shared intervention between students with Special Education Needs and school professionals in the elaboration of the Educational Planning, which guarantees the defense of the rights to an efficient teaching practice and effective in the process of inclusion of these students

O Benefício da Prestação Continuada BCP: as condições de vida dos usuários no Município de Macau/RN

This rescearch comprises a study of the life condictions of the users of the Continuous Installment Allowance in the city of Macau, RN. This benefit has been predicted by the Federal 1988 Constitution and regulated by the Social Assistance Organic Law (LOAS), but it has been carried out only since january 1996. It consists of an amount of half a minimum salary given to old-age and handicapped peoplewhose families mathch the per capita income criterion of less than 0,25 minimum salary. It is a least-income policy relud by the principle of the smallest elegibility. The study focused on aged or handicapped people who were receiving the BPC from 1996 to 2004. Through a quatitative analysis, the life reality of these users has been critically examined. In order to achieve this, it has been necessary to trace their social and economical profile. The research revealed the precarious life conditions of the aged and handicapeed people after they were given the BPC, as well as their interpretation of this politcal directive, and also the need for revision of the eligibility criteria so that a public policy of integral service to the basic needs of the social being can be accomplished

Belmiro Borba, um homem de abismos: um personagem em conflito sob o prima da melancolia na obra O amanuense Belmiro, de Cyro dos Anjos

This master‘s thesis presents an analytical reading of Cyro dos Anjos (1906-1994)‘s novel O amanuense Belmiro (1937) and its main objective is to analyze the way some aspects of melancholy, together with the notion of memory, diary writing as well as time permeate all the narrative of this unique book in the Brazilian literary scenario. Anjos‘ novel is an atypical work in the fiction of the 1930s as it is considered a dissonant voice compared to the regional and social productions of the time it was published. Among other themes, the book depicts the relationship of man with life; the present and the past; love and frustrations and the hero in search of itself. Belmiro Borba, character-narrator, is a sentimental man, often handicapped by his inner life. For this matter, Borba decides to write a book in order to register his stories, memories, feelings, meditations and illusions. From this perspective, this research aims to deal with issues related to the aesthetics of melancholy, especially its relationship with the creative process, which belongs to Borba‘s attempt to write literature. Throughout our academic research, we used the work of Aristotle (1998), Lambotte (2000), Benjamin (2011) and Kristeva (1989) to articulate relevant issues of melancholy; Halbwachs (2006) on the concept of memory, among other theorists who were essential to the completion of this study.

Relação entre função sexual, sintomatologia depressiva e qualidade de vida em mulheres grávidas

INTRODUCTION: Human sexuality is recognized as one of the pillars of quality of life. In women, sexual function is influenced throughout life by many factors that can lead to the appearance of changes in the cycle of sexual response, and hence the quality of life (QOL). Pregnancy is a period of change, leaving them physically and mentally vulnerable, which may affect sexual function and quality of life during pregnancy. OBJECTIVE: To investigate the relationship between sexual function, presence of depressive symptoms and quality of life in pregnant women. METHODS: The study included 207 pregnant women attending prenatal examination of the Maternity Divine Love, Parnamirim / RN and the participants of the Course for Pregnant Women of the Department of Physical Therapy at UFRN (central campus). Initially it was applied, a questionnaire containing questions about sociodemographic, gynecological and obstetric data, as well as body and sexual self-knowledge. Sexual function was assessed using the Sexual Function Index Female (Female Sexual Function Index - FSFI). To assess the quality of life, we used the Quality Index Ferrans Life & Powers mom. The presence of depressive symptoms was verified by applying the Beck Depression Inventory. The Shapiro-Wilk test for normality was carried variables, Mann-Whitney test for carrying out the comparisons and the Wilcoxon test for comparing the monthly sexual frequency before and during pregnancy. Multiple linear regression was used to verify the relationship between sexual function, depressive symptoms and quality of life. We used the Spearman correlation to check correlation between the variables. Ap value <0.05 was adopted. RESULTS: Sexual function and depressive symptoms were related quality of life (R2 = 0.30, p <0.001). Depression had a moderate negative correlation with quality of life (0.53; p <0.001), whereas sexual function showed a positive correlation with low quality of life (0.22; p = 0.001). The planning of pregnancy, education and income shown to influence depression scores. With respect to sexual function, it was seen that during pregnancy, a reduction in the monthly frequency of sexual partner (Z = -10.56; p <0.001). Among the sexual domain, just the pain, showed a statistically significant difference compared between the second and third quarter (Z = -1.91, p <0.05). The score of the quality of life of women with sexual dysfunction was xvii significantly lower than that pregnant women without dysfunction (Z = -2.87, p = 0.004). Conclusion: Sexual function and the presence of depressive symptoms are related to the quality of life of pregnant women.

Narratividade e estruturas cognitivas: o encontro entre a linguagem, a cognição e a experiência sociocultural

This work is within the framework of Cognitive Linguistics, which, as opposed to generative modular approach posits that language is not autonomous but part of human cognition manifest mental processing, socio-cultural and bodily experiences. Our goal is to describe and analyze cognitive mechanisms of understanding who work in the formal and meaningful organization of the narrative. In order to study and verification of this phenomenon, this project was based in the theoretical framework of Rapaport et al (1994) with the treatment of deictic center, Zwaan (1999) and Zwaan and Radvansky (1998) with situation models, Minsky (1974) with the concept frame, Johnson (1987) and Duke and Costa (2012) with pictorial schemes. To this end, we focused on the deictic perspective (WHERE, WHEN, WHO), social cognitive structures (frames) and body (pictorial diagrams) and the situation of models built by compreendedor from these cognitive structures. Methodologically, it is a qualitative research (BAUER and GASKELL, 2002), of interpretive base (MOITA LOPES, 1994), based on introspection (Talmy, 2005). The corpus selected is a sample of twelve texts written by 8th grade students, whose production consists of fictional narrative, the production of diary pages. The analyses were conducted by cognitive structures known as constructional blocks (BCs)(SANTOS, 2011), which guid the discussion about how we build understanding and creation of meanings in narratives. The result shows that the narrative events are mentally represented by the understander that conceives a deictic center and that, guided by it, has access to understanding and construction of meaning in narrative by means of cognitive domains established by bodily and socio-cultural experiences.

Estudo comparativo entre antipsicóticos atípicos no tratamento da esquizofrenia e sua influência na qualidade de vida dos pacientes

Schizophrenia is a severe and persistent mental illness; diagnosis occurs mainly during adolescence. The pharmacological treatment is done with typical and atypical antipsychotics. Atypical have the advantage of reduced extrapyramidal effects, which make them promising for the treatment of schizophrenia, furthermore, they have shown significant metabolic and hormonal changes. The objective of this study was to evaluate the influence of atypical antipsychotics, olanzapine and risperidone on the quality of life and on their adverse effects in schizophrenic patients. For this we analyzed the quality of life of patients with implementation of EuroQol-5D-3L instrument and performing biochemical and hormonal tests, blood pressure measurement, and measurement of anthropometric indices, besides the application of Ugvalg scales for Kliniske Undersgelser (UKU) and Simpson-Angus, who evaluated the side effects caused by drugs. Data were analyzed using the Student t test and chi-square test, with 5% significance level. The results showed that the EuroQol the antipsychotic olanzapine causes significant losses associated with personal care (p <0.001). Comparing the two groups of antipsychotics, the average years of quality-adjusted life, known per QALY was favorable for the risperidone group (p <0.032). The results of olanzapine and risperidone groups were compared. In terms of socioeconomic, it was observed that men used, the prevalent form, olanzapine (p <0.008); this same group showed the following results significantly unfavorable, related to anthropometric variables: waist circumference (p <0.01), hip circumference (p <0.02), weight (p <0.02) and blood pressure (p <0.04). The biochemical and hormonal analyzes showed that olanzapine resulted in losses related to the following variables: triglycerides (p <0.04), HDL cholesterol in men (p < 0.02) and cortisol (p < 0.01). In risperidone users, the only negative value was prolactin (p < 0.04). Regarding the analysis of the Simpson-Angus scale, the group treated with olanzapine was handicapped because the average total scores for olanzapine was 0.38, while for risperidone was 0.11 (p < 0.02). In the UKU scale, the following results were obtained also unfavorable for the olanzapine group: fatigue (P <0.02), dystonia (p <0.01) and tremor (p <0.03). According to the UKU scale, the side effects present in the risperidone group included: gynecomastia (p <0.01), ejaculatory dysfunction (p <0.02) and erectile dysfunction (p <0.02). It was concluded that olanzapine users had the worst score of quality of life, higher metabolic risks associated with overweight and inadequate lipid profile and greater tendency to extrapyramidal manifestations. However, risperidone users were more likely to adverse reactions due to hormonal changes.