Saúde mental: concepções e práticas profissionais de um campo em tensão

A Reforma Psiquiátrica, atual política de saúde mental, redireciona os recursos da assistência psiquiátrica para o modelo de base comunitária, substituindo o modelo asilar. A abordagem proposta pela Reforma Psiquiátrica procura conjugar o esforço teórico e prático para a construção da Rede de Atenção Psicossocial. O presente trabalho objetivou desvelar concepções e práticas de trabalhadores da saúde mental, construídas na práxis de suas trajetórias profissionais e contextos de vida, em relação à incorporação do modelo de atenção psicossocial ou manutenção de princípios asilares, caracterizadores da tradicional prática profissional em saúde mental. Objetivou também identificar pontos de tensão, que caracterizam interesses de diferentes naturezas, como obstáculos e desafios à implementação da Reforma Psiquiátrica. A pesquisa, de natureza qualitativa, contou com 10 entrevistas de profissionais atuando na área, baseada na técnica de depoimento oral e em roteiro do tipo temático, sendo 3 enfermeiros, 3 psicólogos, 3 psiquiatras e 1 terapeuta ocupacional. Os relatos dos profissionais foram organizados em categorias gerais e específicas tendo em vista a interpretação das narrativas à luz da literatura especializada. Através dos discursos dos profissionais do campo da saúde mental é possível observar que um tensionamento ideológico marca fortemente o espaço da saúde. Alguns profissionais relataram a busca por construir práticas em equipe interdisciplinar, pautadas pelo modelo psicossocial; porém, referem à resistência de outros profissionais da equipe. Praticamente todos os profissionais apresentam discursos de humanização no campo da saúde mental, mas alguns não enunciam visões críticas aos modelos asilares. Alguns trabalhadores revelam a crença na possibilidade de coexistência integrada entre o Modo Asilar e Modo Psicossocial. Para estes trabalhadores de CAPS, é desejável a permanência dos hospitais psiquiátricos e é possível a humanização dos mesmos. Essa questão indica, ao que parece, que as práticas em saúde mental ainda operam sobre premissas epistemológicas diferenciando sujeitos que podem ou não circular no meio social. A existência dos hospitais psiquiátricos, considerados como instituições totais, é problematizada e questionada pela Luta Antimanicomial, indica a permanência da lógica asilar que respalda a continuidade dos hospitais, exclusivamente psiquiátricos, entre os serviços de atendimento, com o apoio de parte dos profissionais da rede de saúde mental. Concordantes com a possibilidade de coexistência do modelo asilar e modelo psicossocial, estes profissionais permitem-nos demonstrar que mesmo uma visão clínica pretensamente humanizadora, que defenda em seu discurso um tratamento digno, pode operar no modelo teórico-metodológico positivista e não está necessariamente vinculada a uma postura política de sujeitos de direitos e de cidadania. Os profissionais que apresentaram em suas narrativas a não concordância com a permanência dos hospitais psiquiátricos, defendem que as transformações sejam clínicas e políticas nos saberes e nas práticas em Saúde Mental. Estes trabalhadores já fizeram ou fazem parte de movimentos sociais, apontados como lugares de reflexão crítica sobre ideias instituídas contribuindo, ao que parece, para o processo de desnaturalização de concepções construídas culturalmente e orientadoras de práticas profissionais. Diante de tais constatações podemos indagar e refletir se a desinstitucionalização, concreta e simbólica, encontra-se no horizonte de uma política pública de atenção em Saúde Mental que realmente tenha como projeto a sua real implementação e se a permanência dos hospitais psiquiátricos e das comunidades terapêuticas estaria descaracterizando as propostas iniciais da construção da Atenção Psicossocial, considerando os interesses privados e a manutenção da lógica asilar, contrários aos princípios do SUS.

Implicações das síndromes da tensão pré-menstrual e do transtorno disfórico pré-menstrual na qualidade de vida

Enquadramento: Embora o ciclo menstrual seja um fenômeno normal na vida de mulheres em idade fértil, a ele podem se associar síndromes de intensidade variável. Objectivo: Determinar o impacto da síndrome pré-menstrual e da síndrome disfórica pré-menstrual na qualidade de vida de mulheres em idade fértil, comparadas a mulheres sem essas síndromes. Material e Métodos: Procedeu-se a estudo quantitativo, descritivo, correlacional, transversal, com 60 participantes do sexo feminino (16 com síndrome pré-menstrual, 28 com sintomatologia compatível com SDPM e 16 não apresentavam sintomas compatíveis com diagnóstico), A colheita de dados foi no Ambulatório de Ginecologia do Hospital Militar de nível terciário no período de janeiro a fevereiro de 2015, apresentando idade entre 18 e 56 anos, menarca há mais de um ano; ciclos menstruais em ausência de uso de terapia de reposição hormonal, com queixas associadas ao período menstrual. Três instrumentos de recolha de dados foram empregados: um questionário de identificação da paciente e caracterização de vida reprodutiva; o Questionário de Triagem de Sintomas Pré-menstruais e o Short Form Health-Survey com 36 itens. Para organização e análise dos dados, foi empregado o programa Statistical Package for Social Sciences, na versão 21.0. As variáveis foram dicotomizadas, para análise de contingência com o teste exato de Fisher. Para comparação de médias, foram utilizados o teste de diferença de médias de amostras independentes e o teste Kruskal Wallis, todos em nível de significância de 0,05. Resultados: A prevalência de síndrome menstrual igualou-se a 76,3%, sendo 46,6% compatível com síndrome disfórica e 29,7% com síndrome pré-menstrual. Esses grupos diferiram significantemente nos sintomas de ansiedade/tensão, fadiga/perda de energia, dificuldade de concentração, fome excessiva ou anorexia e sentimento de opressão. A síndrome disfórica pré-menstrual associou-se a maior comprometimento de relações sociais, familiares e domésticas, bem como à perda de saúde geral e de saúde mental, nos domínios de vitalidade, funções sociais, limitações devidas a problemas emocionais e saúde mental. Essas alterações não interferiram na percepção da libido e de orgasmo, mas alguns domínios da qualidade de vida estiveram associados a características reprodutivas. Conclusão: As síndromes pré-menstruais comprometem a qualidade de vida das utentes e requerem assistência voltada à melhoria do conhecimento das mulheres sobre seu problema de saúde. Palavras-chave: Síndrome pré-menstrual, Síndrome disfórica pré-menstrual, Qualidade de vida.

Mudanças na relação entre estado e mercado na produção de habitação de interesse social em Parnamirim-RN

The formulation of public policies, particularly those relating to social housing – SH -, follow a dialectical process of construction, which are involved in the figures of the State and tha Market.The combination of the State and Market remains in constant tension and struggle for power, which provides beyond products (policies, programs and projects), periods of crises and disruptions that can give rise to new institutional arrangements. It is possible to verify a change in the relationship between the State and the Market in the formulation of public policies of SH financing, justified by the context of the Brazilian economy growth, especially after 2003, year that began the first Lula Federal Government , and through the international financial crisis (in 2008). Thus, the State and the Real Estate Market has been undergoing a process of redefinition of their interrelations, articulating new arrangements, new scales of action and new logics of financial valorization of urban space. This peculiarity demanded the rapid thinning of speech and the proposals in the reformulation of housing policies, with the primary result within the pre-existing Growth Acceleration Program – PAC -, the release of My House , My Life – PMCMV -, established by Law 1.977 of the year 2009. Given the above, this research has as study object the relationship between financing public policies of SH, promoted by the State, and behavior of Formal Housing Market. It is believed that the established roles for each agent in the new housing finance model introduced with the PMCMV, have been adapted according to the needs of each location to make this a workable policy. It remains to identify the nature of these adaptations, in other words, what has changed in the performance of each agent involved in this process. Knowing that private capital remains where there is more chance of profit, we tend to believe that most of the adjustments were made on scale of State action. The recommendation of easing urban legislation taken by PMCMV points to how the State has been making these changes in activity to implement the production of social housing by this program. We conclude that in the change for PMCMV, the direct relationship for construction and housing projects financing began to be made between the Caixa Econômica Federal bank and the builders. The city was liberated from the direct interlocutor role between all actors involved in the production of SH and could concentrate on negotiating with the parties, focused on the effectiveness of SH public policies proposed by PMCMV. This ability and willingness for dialogue and negotiation of municipal government (represented by their managers), undoubtedly, represents a key factor for rapprochement between State and Real Estate Market in the City of Parnamirim.

Serviço Social Profissão com Risco

A intranquilidade sentida ao nível do contexto de trabalho ou do bem-estar emocional dos assistentes sociais traduz o facto destes profissionais se terem tornado no rosto mais próximo das políticas de controlo das desigualdades e da exclusão, resultantes de todo um conjunto de factores que leva ao aumento da insegurança nos quotidianos de vida da população socialmente mais vulnerável. Com este estudo, de natureza exploratória, pretendeu demonstrar-se que o crescimento das incertezas e da violência, que singularizam a sociedade do risco, está a produzir alterações na relação do assistente social com o seu exercício profissional. A relação circular que tradicionalmente suportava o relacionamento instituído entre o indivíduo, instituição e assistente social deu origem à sua triangulação, assumindo o profissional, uma função quer de mediador, quer de gestor de interesses. Esta mesma transformação na qualidade da relação criada entre o assistente social e o utente, gera um exercício profissional praticado em tensão face ao medo controlado, ou não, das reacções menos esperadas de quem manifesta descontentamento em relação às medidas apresentadas pelos assistentes sociais, por via das instituições onde trabalham. Tendo o Serviço Social, desde o seu passado histórico, desenvolvido uma relação de trabalho muito próxima com grupos de risco e/ou perigo, nunca foi considerada uma profissão de risco. Contudo, face aos níveis de insegurança que actualmente cromatizam o habitat do exercício profissional dos assistentes sociais, a sua actividade profissional começa a manifestar sintomas de transformação numa profissão com riscos.

O marketing e a atuação social das empresas: uma relação possível?

The present work is about a study of multiple cases with exploratory and descriptiveperspective and qualitative emphasis. Its field of study is constituted by three local companieswith description of social performance, with emphasis in the personal interview with thecontrollers. Its main objective consists of understanding as it has occurred the marketingrelation with the enterprise social performance in the context of these companies located inthe State of the Rio Grande do Norte who carry out social investments. For this, it hassearched to analyze the types and characteristics of the developed social actions, to evaluatethe motivations and objectives of the accomplishment of social actions, to verify theimportance and influence of the social performance in the dynamics of the companies, toverify the level of specific knowledge and information in the areas of marketing and socialperformance in the companies and to evaluate the process of communication (promotion andspreading) of the social performance carried out by the companies. It has been verified thatthe company A directly associates it its social and ambient activities with differentiationbenefits, competitiveness, creation of value, loyalty, relationships, image, prestige,positioning of the company, sale and financial return, beyond benefits in the internal level asbigger motivation of its employees and retention of talents, not existing rejection to theinterlacement of the concepts related to the marketing and the social one. Already in companyB rejection in relating its practical social to the marketing, being observed after posteriorquestionings, that the relation of direct and indirect form exists and those divulgations of theseactions are carried out, contradicting the arguments of the controllers of that the actions wouldnot be carried out to generate media. In company C, it been verified rejection andcontradiction with relation to the concepts related to the marketing, alleging itself that theimage of the harnessed company to its social performance is not used in proper benefit,evidencing itself that this company divulges its action and is marketable benefited, even so isnot this the main objective of its social programs. It has concluded that the association ofthese two concepts is positive and favorable to the development of the businesses and thesocial actions of the companies, legitimizing them and benefiting the involved company,groups in the actions and the society that profits socially from the private social involvement in the social matters

O marketing e a atuação social das empresas: uma relação possível?

The present work is about a study of multiple cases with exploratory and descriptiveperspective and qualitative emphasis. Its field of study is constituted by three local companieswith description of social performance, with emphasis in the personal interview with thecontrollers. Its main objective consists of understanding as it has occurred the marketingrelation with the enterprise social performance in the context of these companies located inthe State of the Rio Grande do Norte who carry out social investments. For this, it hassearched to analyze the types and characteristics of the developed social actions, to evaluatethe motivations and objectives of the accomplishment of social actions, to verify theimportance and influence of the social performance in the dynamics of the companies, toverify the level of specific knowledge and information in the areas of marketing and socialperformance in the companies and to evaluate the process of communication (promotion andspreading) of the social performance carried out by the companies. It has been verified thatthe company A directly associates it its social and ambient activities with differentiationbenefits, competitiveness, creation of value, loyalty, relationships, image, prestige,positioning of the company, sale and financial return, beyond benefits in the internal level asbigger motivation of its employees and retention of talents, not existing rejection to theinterlacement of the concepts related to the marketing and the social one. Already in companyB rejection in relating its practical social to the marketing, being observed after posteriorquestionings, that the relation of direct and indirect form exists and those divulgations of theseactions are carried out, contradicting the arguments of the controllers of that the actions wouldnot be carried out to generate media. In company C, it been verified rejection andcontradiction with relation to the concepts related to the marketing, alleging itself that theimage of the harnessed company to its social performance is not used in proper benefit,evidencing itself that this company divulges its action and is marketable benefited, even so isnot this the main objective of its social programs. It has concluded that the association ofthese two concepts is positive and favorable to the development of the businesses and thesocial actions of the companies, legitimizing them and benefiting the involved company,groups in the actions and the society that profits socially from the private social involvement in the social matters

Entre a teoria social e a teoria da justiça : intersubjetividade, normatividade e vulnerabilidade

Este artigo pretende apresentar os motivos por trás de algumas propostas intersubjetivistas na teoria social e na teoria da justiça. Primeiramente, tentarei desenvolver alguns temas da filosofia de Hegel no sentido de formular a tese de que se estabelece aí uma relação fundamental entre teoria social e teoria da justiça (1). Em seguida, pretendo especificar o conteúdo desta relação num argumento duplo: mostrando (a) que ela consiste, do ponto de vista da teoria social, em uma dialética entre socialização e individualização; e (b) que esta dialética se vincula ao problema da normatividade, tornando-se relevante para a teoria da justiça (2). Em terceiro lugar, desejo mostrar que a ética do discurso projetou uma ampliação filosófico-jurídica não apenas para estabilizar a tensão entre validade e facticidade, mas que também, não sendo apenas especializada em questões de justiça, assume a tarefa de pensar a vulnerabilidade daquela dialética (3). Finalmente, procuro mostrar como uma teoria da justiça fundada no conceito intersubjetivo de liberdade é capaz de preencher mais adequadamente esta lacuna, criando condições para uma crítica terapêutica da modernidade (4). ______________________________________________________________________________ ABSTRACT

[the Teaching Of Social Sciences In Health: Between Practice And Theory].

The models of teaching social sciences and clinical practice are insufficient for the needs of practical-reflective teaching of social sciences applied to health. The scope of this article is to reflect on the challenges and perspectives of social science education for health professionals. In the 1950s the important movement bringing together social sciences and the field of health began, however weak credentials still prevail. This is due to the low professional status of social scientists in health and the ill-defined position of the social sciences professionals in the health field. It is also due to the scant importance attributed by students to the social sciences, the small number of professionals and the colonization of the social sciences by the biomedical culture in the health field. Thus, the professionals of social sciences applied to health are also faced with the need to build an identity, even after six decades of their presence in the field of health. This is because their ambivalent status has established them as a partial, incomplete and virtual presence, requiring a complex survival strategy in the nebulous area between social sciences and health.

[almost An Autobiography: A Study Of Social Scientists In Health Based On The Lattes Curriculum].

Among the various ways of adopting the biographical approach, we used the curriculum vitaes (CVs) of Brazilian researchers who work as social scientists in health as our research material. These CVs are part of the Lattes Platform of CNPq - the National Council for Scientific and Technological Development, which includes Research and Institutional Directories. We analyzed 238 CVs for this study. The CVs contain, among other things, the following information: professional qualifications, activities and projects, academic production, participation in panels for the evaluation of theses and dissertations, research centers and laboratories and a summarized autobiography. In this work there is a brief review of the importance of autobiography for the social sciences, emphasizing the CV as a form of autobiographical practice. We highlight some results, such as it being a group consisting predominantly of women, graduates in social sciences, anthropology, sociology or political science, with postgraduate degrees. The highest concentration of social scientists is located in Brazil's southern and southeastern regions. In some institutions the main activities of social scientists are as teachers and researchers with great thematic diversity in research.

Juan César García: Social Medicine As Project And Endeavor.

This paper analyses some aspects of the trajectory of the Argentinian physician and sociologist Juan César García (1932-1984) in the field of Latin American Social Medicine. Three dimensions constituting his basic orientations are highlighted: the elaboration of systematic and reflective social thought; a critical attitude in questioning teaching and professional practices; a commitment to the institutionalization and dissemination of health knowledge.

Diretrizes curriculares nacionais para o ensino médio: avaliação de documento

This text offers some contributions to the debate on the changes proposed to the National Curricular Directives to reform secondary education in Brazil. In the first part, the political and economic scene is evaluated as the context which generated the last stage of reforms in the educational field in the 90s. It questions the option for a model of structural reform (in the Brazilian case more restricted to the Program for Reform of Professional Education - PROEP) and of the curriculum, whose themes find their justification in the contemporary economic, social cultural and political context. It discusses the use of a model that bases itself on experiences developed in other countries and takes the international orientation of the multilateral organizations as its theoretical methodological reference, leaving out the peculiarities and injunctions of the Brazilian political administrative system. Such a policy measure can increase the tension and distance normally existing between government programs and the possibility of their real implementation in the school network. In the second part, it discusses the Resolution of the National Education Council, the Congress on Basic Education, no.3, of 16.698 that instituted the National Curricular Directives for secondary education, as well as the Legal Bases - Part I - of the National Curricular Parameters for secondary education. The analysis of official discourse takes Bardin's (1977, p. 209) proposals as its methodological reference for the models of structural analysis, seeking to make the implicit values and the connotations of the legal texts explicit

Utilização de um monitor de vídeo como fonte de alta tensão para eletroforese capilar

This article describes the use of a conventional CRT monitor as a high voltage power supply for capillary electrophoresis. With this monitor, a 23-kV high voltage with a ripple of 1.32% was observed. The reproducibility of the applied high voltage was evaluated by measuring the standard deviations of peak area and migration time for five consecutive injections of a test mixture containing potassium, sodium, and lithium cations at 50 mmol L-1. The errors were about 2.5% and 0.6% for peak area and migration time, respectively. The maximum current tested was about 180 mA, which covers most capillary electrophoresis applications. This system has been successfully used for several months, maintaining the desired level of performance.

Brazilian multicentre study of common mental disorders in primary care: rates and related social and demographic factors

Mental health problems are common in primary health care, particularly anxiety and depression. This study aims to estimate the prevalence of common mental disorders and their associations with socio-demographic characteristics in primary care in Brazil (Family Health Strategy). It involved a multicenter cross-sectional study with patients from Rio de Janeiro, São Paulo, Fortaleza (Ceará State) and Porto Alegre (Rio Grande do Sul State), assessed using the General Health Questionnaire (GHQ-12) and the Hospital Anxiety and Depression Scale (HAD). The rate of mental disorders in patients from Rio de Janeiro, São Paulo, Fortaleza and Porto Alegre were found to be, respectively, 51.9%, 53.3%, 64.3% and 57.7% with significant differences between Porto Alegre and Fortaleza compared to Rio de Janeiro after adjusting for confounders. Prevalence proportions of mental problems were especially common for females, the unemployed, those with less education and those with lower incomes. In the context of the Brazilian government's moves towards developing primary health care and reorganizing mental health policies it is relevant to consider common mental disorders as a priority alongside other chronic health conditions.

As vozes da sociedade: letramento, consciência e poder

The dialectic tension between the phenomenon of illiteracy and the remedial efforts of the literate to provide a voice for those who don t have one, reflects at the same time the difficulties that the emerging discourses have to struggle with, and highlights the importance of this struggle as one that belongs to the opressed, not the well-meaning educators and political activists. It also informs the latter s efforts on behalf of the uneducated. Naturally these issues have attracted a good deal of attention of some specialists in South America. There is now a movement afoot there that aims at placing illiterate discourse inside the societal discourse proper without letting the latter manipulate the former for its own ends. I will address the typical exigencies and limitations inherent in such efforts, but at the same time point to new ways of understanding and handling the problem of literacy in a developing country.

Identidade social e auto conceito do dançarino em cadeira de rodas

Universidade Estadual de Campinas . Faculdade de Educação Física