Reinternações psiquiátricas no Rio Grande do Norte: implicações e impacto das novas estratégias de atenção à saúde mental

The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital João Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care.

Análise de estabilidade de falésias na zona costeira de Baía Formosa - RN

The natural and anthropogenic changes that are occurring at the coastal zone around the world represent the greatest problem to society in this century. This problem becomes more evident due to high density of coastal cities, to growing tourist-estate speculation of those areas and to climate change that tend to trigger and accelerate the erosive processes that operating in the littoral. In this context, it‟s possible perceive ever more a significant increase of problems associated to the coastal erosion and retreat of cliffs in the state of Rio Grande do Norte, where this study area of this search is located. The area is located in the coastal zone of the city of Baía Formosa/RN, in south-eastern coast of Rio Grande do Norte, and has a extension of about 1200 meters along the Porto beach. The main objective of this study is to analyze the stability of these cliffs in this region. Through field investigations, testings and computational analysis using the Finite Element Method and Equilibrium Limit Methods. The area was divided into four sections, and were applied checklists, and also realized characterization tests and direct shear tests with materials obtained along these sections. In this manner, it was found that the segments of cliff in this coastal zone have heights around 4 meters to 14 meters and inclinations of approximately 40° to 90°.However the constituents soils of the cliffs were classified, in general terms in accordance to Unified Soil Classification System (USCS), as clayey sands or silty sands, clays of low plasticity, clayey gravels and poorly graduaded sands. The most variegated and clayey soils belong to base of the cliff. The stability analysis showed that the safety factors ranged in section 01, from 1.92 to 4.93, in the section 02, from 1.00 to 1.43, in the section 03, from 1.36 to 1.75 , and section 04, from 1.00 to 3.64. Thus, the sections 02 and 03 were considered more unstable. However, the section 03 can be considered as the most critical section due to the absence of coastal protection structures and the narrow strip of beach.