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.

Modos projetuais de simulação: uso de ferramentas de simulação térmica no processo projetual de arquitetura

This thesis aims to describe and demonstrate the developed concept to facilitate the use of thermal simulation tools during the building design process. Despite the impact of architectural elements on the performance of buildings, some influential decisions are frequently based solely on qualitative information. Even though such design support is adequate for most decisions, the designer will eventually have doubts concerning the performance of some design decisions. These situations will require some kind of additional knowledge to be properly approached. The concept of designerly ways of simulating focuses on the formulation and solution of design dilemmas, which are doubts about the design that cannot be fully understood nor solved without using quantitative information. The concept intends to combine the power of analysis from computer simulation tools with the capacity of synthesis from architects. Three types of simulation tools are considered: solar analysis, thermal/energy simulation and CFD. Design dilemmas are formulated and framed according to the architect s reflection process about performance aspects. Throughout the thesis, the problem is investigated in three fields: professional, technical and theoretical fields. This approach on distinct parts of the problem aimed to i) characterize different professional categories with regards to their design practice and use of tools, ii) investigate preceding researchers on the use of simulation tools and iii) draw analogies between the proposed concept, and some concepts developed or described in previous works about design theory. The proposed concept was tested in eight design dilemmas extracted from three case studies in the Netherlands. The three investigated processes are houses designed by Dutch architectural firms. Relevant information and criteria from each case study were obtained through interviews and conversations with the involved architects. The practical application, despite its success in the research context, allowed the identification of some applicability limitations of the concept, concerning the architects need to have technical knowledge and the actual evolution stage of simulation tools

Atenção, consciência e prática pedagógica: um estudo de suas interconexões

This thesis entitled, Attention, Consciousness and Practice of Teaching: A Study of its Interconnects, argues about a relationship between development of attention and consciousness and its connection to the pedagogical practice developed in a public elementary school in Natal city, Rio Grande do Norte state. The research school is located in the south of the city. School activities are developed according with the political pedagogical project. The group investigated was 25 students aged between 8-12 years of the fourth grade. The students of the research are residents of Ponta Negra village, Pirangi and Neópolis districts. The research was effected by three teachers however, the purpose of this thesis was to investigate the relationship between the development of attention and awareness and the pedagogical practice of one of the teachers who participated in the research, and more specifically understand the psychic procedures involved in the development of attention and awareness; enabling conditions for the realization of an educational action that enables the development in terms of focused attention and states of consciousness of students, analyzing their interrelations. Therefore, it was used as methodology the collaborative research by providing elements for research as strategy of formation and development, the coproduction of knowledge, and the change of educational practice through reflective processes effected through the collaboration and critical reflection among participants. For empirical construction, it was used the following procedural elements: meeting, planning, diagnosis of attention and awareness, reflective period studies, collaborative observation and reflection sessions with the participant teachers and the students. The diagnosis of attention was effected through a game and its elaboration was based on the study proposed by Luria (1991). The purpose of the game was to apprehend the stage where students were in relation of a development attention. Concerning the diagnosis of consciousness, it was taken as reference studies by Burlatski (1987), Pinto (1960a, 1960b), Rubinstien (1973), Leontiev (1978) and others studies discussing this topic. As a method of analysis, it was resorted to the dialectical historical materialism, the ability to identify, analyze and explain those contradictions generated in the process. In the analysis procedures were prepared some categories as well as, were used categories by other authors with the purpose of understanding the critical reflective process collaborative evidencing the formation of concepts and pedagogical practice of the participants, and the analysis of a practical pedagogical of a teacher and her relationships with the development of the psychic process and functions of students, in other words, attention and awareness. Regarding the reflective process were used the categories: technical reflection, critical reflection and practical reflection (LIBERALI, 2008). Concerning the analysis of the concepts were used the categories: description, characterization, definition and conceptualization (FERREIRA, 2003). And for critical collaboration were the categories: critical collaboration, uncritical, technique and practice. In pedagogical practice, were used categories: repetitive practice teaching, heterogeneous and reflexive critical (SOUZA, 2010). During the collaborative observation was evident predominance of heterogeneous practice, because the main participant teacher searches for immediate solution to the situations problem, as well as reflection moments, is the technical arrangement, practice, critical, as well as concern in interacting with students, the qualitative changes, deep knowledge, renewal and transformation of the teaching activity. In this process, the collaborative reflection proved to be an effective strategy for developing awareness of students, because through reflection sessions, the students were able to understand that learning is a building process and that it necessary to be careful for their development

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

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

A Methodology for Building Service-Oriented Applications in the Presence of Non-Functional Properties

This thesis presents ⇡SOD-M (Policy-based Service Oriented Development Methodology), a methodology for modeling reliable service-based applications using policies. It proposes a model driven method with: (i) a set of meta-models for representing non-functional constraints associated to service-based applications, starting from an use case model until a service composition model; (ii) a platform providing guidelines for expressing the composition and the policies; (iii) model-to-model and model-to-text transformation rules for semi-automatizing the implementation of reliable service-based applications; and (iv) an environment that implements these meta-models and rules, and enables the application of ⇡SOD-M. This thesis also presents a classification and nomenclature for non-functional requirements for developing service-oriented applications. Our approach is intended to add value to the development of service-oriented applications that have quality requirements needs. This work uses concepts from the service-oriented development, non-functional requirements design and model-driven delevopment areas to propose a solution that minimizes the problem of reliable service modeling. Some examples are developed as proof of concepts

Uma linguagem de modelagem da interação para auxiliar a comunicação designer-usuário

The development of interactive systems involves several professionals and the integration between them normally uses common artifacts, such as models, that drive the development process. In the model-driven development approach, the interaction model is an artifact that includes the most of the aspects related to what and how the user can do while he/she interacting with the system. Furthermore, the interactive model may be used to identify usability problems at design time. Therefore, the central problematic addressed by this thesis is twofold. In the first place, the interaction modeling, in a perspective that helps the designer to explicit to developer, who will implement the interface, the aspcts related to the interaction process. In the second place, the anticipated identification of usability problems, that aims to reduce the application final costs. To achieve these goals, this work presents (i) the ALaDIM language, that aims to help the designer on the conception, representation and validation of his interactive message models; (ii) the ALaDIM editor, which was built using the EMF (Eclipse Modeling Framework) and its standardized technologies by OMG (Object Management Group); and (iii) the ALaDIM inspection method, which allows the anticipated identification of usability problems using ALaDIM models. ALaDIM language and editor were respectively specified and implemented using the OMG standards and they can be used in MDA (Model Driven Architecture) activities. Beyond that, we evaluated both ALaDIM language and editor using a CDN (Cognitive Dimensions of Notations) analysis. Finally, this work reports an experiment that validated the ALaDIM inspection method

BRIDGE: uma ferramenta para o Design de Interfaces de Usuário baseada em especificações IMML

With hardware and software technologies advance, it s also happenning modifications in the development models of computational systems. New methodologies for user interface specification are being created with user interface description languages (UIDL). The UIDLs are a way to have a precise description in a language with more abstraction and independent of how will be implemented. A great problem is that even using these nowadays methodologies, we still have a big distance between the UIDLs and its design, what means, the distance between abstract and concrete. The tool BRIDGE (Interface Design Generator Environment) was created with the intention of being a linking bridge between a specification language (the Interactive Message Modeling Language IMML) and its implementation in Java, linking the abstract (specification) to the concrete (implementation). IMML is a language based on models, that allows the designer works in distinct abstraction levels, being each model a distinct abstraction level. IMML is a XML language, that uses the Semiotic Engineering concepts, that deals the computational system, with the user interface and its elements like a metacommunicative artifact, where these elements must to transmit a message to the user about what task must to be realized and the way to reach this goal. With BRIDGE, we intend to supply a lot of support to the design task, being the user interface prototipation the greater of them. BRIDGE allows the design becomes easier and more intuitive coming from an interface specification language

Visual IMML: um perfil UML para a modelagem de interfaces de usuário

The software development processes proposed by the most recent approaches in Software Engineering make use old models. UML was proposed as the standard language for modeling. The user interface is an important part of the software and has a fundamental importance to improve its usability. Unfortunately the standard UML does not offer appropriate resources to model user interfaces. Some proposals have already been proposed to solve this problem: some authors have been using models in the development of interfaces (Model Based Development) and some proposals to extend UML have been elaborated. But none of them considers the theoretical perspective presented by the semiotic engineering, that considers that, through the system, the designer should be able to communicate to the user what he can do, and how to use the system itself. This work presents Visual IMML, an UML Profile that emphasizes the aspects of the semiotic engineering. This Profile is based on IMML, that is a declarative textual language. The Visual IMML is a proposal that aims to improve the specification process by using a visual modeling (using diagrams) language. It proposes a new set of modeling elements (stereotypes) specifically designed to the specification and documentation of user interfaces, considering the aspects of communication, interaction and functionality in an integrated manner

Cloud Integrator: uma plataforma para composição de serviços em ambientes de computação em nuvem

With the advance of the Cloud Computing paradigm, a single service offered by a cloud platform may not be enough to meet all the application requirements. To fulfill such requirements, it may be necessary, instead of a single service, a composition of services that aggregates services provided by different cloud platforms. In order to generate aggregated value for the user, this composition of services provided by several Cloud Computing platforms requires a solution in terms of platforms integration, which encompasses the manipulation of a wide number of noninteroperable APIs and protocols from different platform vendors. In this scenario, this work presents Cloud Integrator, a middleware platform for composing services provided by different Cloud Computing platforms. Besides providing an environment that facilitates the development and execution of applications that use such services, Cloud Integrator works as a mediator by providing mechanisms for building applications through composition and selection of semantic Web services that take into account metadata about the services, such as QoS (Quality of Service), prices, etc. Moreover, the proposed middleware platform provides an adaptation mechanism that can be triggered in case of failure or quality degradation of one or more services used by the running application in order to ensure its quality and availability. In this work, through a case study that consists of an application that use services provided by different cloud platforms, Cloud Integrator is evaluated in terms of the efficiency of the performed service composition, selection and adaptation processes, as well as the potential of using this middleware in heterogeneous computational clouds scenarios

O problema do Hiker Dice em tabuleiro compacto: um estudo algorítmico

The Hiker Dice was a game recently proposed in a software designed by Mara Kuzmich and Leonardo Goldbarg. In the game a dice is responsible for building a trail on an n x m board. As the dice waits upon a cell on the board, it prints the side that touches the surface. The game shows the Hamiltonian Path Problem Simple Maximum Hiker Dice (Hidi-CHS) in trays Compact Nth , this problem is then characterized by looking for a Hamiltonian Path that maximize the sum of marked sides on the board. The research now related, models the problem through Graphs, and proposes two classes of solution algorithms. The first class, belonging to the exact algorithms, is formed by a backtracking algorithm planed with a return through logical rules and limiting the best found solution. The second class of algorithms is composed by metaheuristics type Evolutionary Computing, Local Ramdomized search and GRASP (Greed Randomized Adaptative Search). Three specific operators for the algorithms were created as follows: restructuring, recombination with two solutions and random greedy constructive.The exact algorithm was teste on 4x4 to 8x8 boards exhausting the possibility of higher computational treatment of cases due to the explosion in processing time. The heuristics algorithms were tested on 5x5 to 14x14 boards. According to the applied methodology for evaluation, the results acheived by the heuristics algorithms suggests a better performance for the GRASP algorithm

Integração da simulação termoenergética com o processo de projeto: a análise de 6 casos

This work consists of the integrated design process analyses with thermal energetic simulation during the early design stages, based on six practical cases. It aims to schematize the integration process, identifying the thermal energetic analyses contributions at each design phase and identifying the highest impact parameters on building performance. The simulations were run in the DesignBuilder energy tool, which has the same EnergyPlus engine, validated. This tool was chosen due to the flexible and user friendly graphic interface for modeling and output assessment, including the parametric simulation to compare design alternatives. The six case studies energy tools are three architectural and three retrofit projects, and the author the simulations as a consultant or as a designer. The case studies were selected based on the commitment of the designers in order to achieve performance goals, and their availability to share the process since the early pre-design analyses, allowing schematizing the whole process, and supporting the design decisions with quantifications, including energy targets. The thermoenergetic performance analyses integration is feasible since the early stages, except when only a short time is available to run the simulations. The simulation contributions are more important during the sketch and detail phases. The predesign phase can be assisted by means of reliable bioclimatic guidelines. It was verified that every case study had two dominant design variables on the general performance. These variables differ according the building characteristics and always coincide with the local bioclimatic strategies. The adaptation of alternatives to the design increases as earlier it occurs. The use of simulation is very useful: to prove and convince the architects; to quantify the cost benefits and payback period to the retrofit designer; and to the simulator confirm the desirable result and report the performance to the client

Modos projetuais de simulação: uso de ferramentas de simulação térmica no processo projetual de arquitetura

This thesis aims to describe and demonstrate the developed concept to facilitate the use of thermal simulation tools during the building design process. Despite the impact of architectural elements on the performance of buildings, some influential decisions are frequently based solely on qualitative information. Even though such design support is adequate for most decisions, the designer will eventually have doubts concerning the performance of some design decisions. These situations will require some kind of additional knowledge to be properly approached. The concept of designerly ways of simulating focuses on the formulation and solution of design dilemmas, which are doubts about the design that cannot be fully understood nor solved without using quantitative information. The concept intends to combine the power of analysis from computer simulation tools with the capacity of synthesis from architects. Three types of simulation tools are considered: solar analysis, thermal/energy simulation and CFD. Design dilemmas are formulated and framed according to the architect s reflection process about performance aspects. Throughout the thesis, the problem is investigated in three fields: professional, technical and theoretical fields. This approach on distinct parts of the problem aimed to i) characterize different professional categories with regards to their design practice and use of tools, ii) investigate preceding researchers on the use of simulation tools and iii) draw analogies between the proposed concept, and some concepts developed or described in previous works about design theory. The proposed concept was tested in eight design dilemmas extracted from three case studies in the Netherlands. The three investigated processes are houses designed by Dutch architectural firms. Relevant information and criteria from each case study were obtained through interviews and conversations with the involved architects. The practical application, despite its success in the research context, allowed the identification of some applicability limitations of the concept, concerning the architects need to have technical knowledge and the actual evolution stage of simulation tools