A dimensão sociocultural da reforma psiquiátrica: articulando redes para a consolidação da estratégia de atenção psicossocial

This thesis aims to discuss on articulations that have been produced on the socio-cultural field in the Psychiatric Reform process and its pertinence to the streghtening of Psychosocial Care Strategy (EAPS) in Fortaleza/CE. Such interest has been justified by the need to promote not only the production of these networks, but also interfaces to enable strategies of support and sociability from the perspective of deinstitutionalization of madness. We were inspired by the cartography perspective of Deleuze e Guattari, and determined as objectives: 1) to discuss the complexity of Psychiatric Reform process and analyze the EAPS as a model for the current Mental Health policy in the country; 2) to map socio-cultural strategies connected to the CAPS network in the city, investigating experiences that already exist or may be constituted as everyday social support networks; 3) from that mapping to start, define and discuss some aspects that converge to the accomplishment for this new mental health paradigm, drawing a cartography of the issues and movements in progress. The mapping was carried out in 2009 and consisted of semi-structured interviews with the coordinators of the 14 existent CAPS and with some people connected to the Coordination of Mental Health. Besides, during the whole development of the study, we have taken part in public events that brought us clues on the connection between mental health and culture. From the survey produced, we defined three vectors for discussion (Art, Labour and Partnership with Social Movements) which have been highlighted as effective possibilities of intervention in the socio-cultural field of Psychiatric Reform in Fortaleza and reveal important paths on the fulfillment process of a new pattern of care. For each of these axes, we chose a field of empirical research (Projeto Arte e Saúde, COOPCAPS e MSMCBJ) in which we could better understand their strengths and difficulties, starting from open interviews with some of their actors and the production of a diary of sensations in 2010. We have seen that they are articulated with the proposal of EAPS, being part of the concerns to the National Mental Health Policy and also the municipal administration. However, we have noticed to be necessary to promote those dimensions further, focusing on its complexity at the macro and micro policies, with the purpose of leading the Psychiatric Reform process

O Serviço Ambulatorial Móvel de Urgência (SAMU) no contexto da reforma psiquiátrica: em análise a experiência de Aracaju/SE

This research investigated professional practices from Mobile Urgency Care Service (Serviço Ambulatorial Móvel de Urgência - SAMU) at psychiatric cases of the city of Aracaju/SE, Brazil and its possible articulations to psychosocial services network. The regulation no. 2048 of 11/05/2002 from Ministry Health establishes National Urgency Policy and designates that psychiatric cases are SAMU's responsibility. Then, it is necessary to propose an analyze of psychiatric urgency service under anti-asylums social movements standpoint, mainly because this service is responsive in assisting a person in crises. Fieldwork was developed in two phases. First one was made with SAMU workers and the information were produced by recorded semi-structured interviews. Results of this first phase indicate that urgency psychiatric conception from SAMU workers is based on aggressiveness concept; delays at psychiatric cases support and low training in mental health care which means several difficulties to emergency service. Although, we noticed that SAMU use asylum procedures at psychiatric cases like ropes and odder instruments to contain people. The second step of our research was to attend meetings to build a new psychiatric urgencies protocol for SAMU to define practices to auxiliaries, vehicular conductors and medical support regulation. Therefore, open interviews were accomplished with some participators and follows-up to psychiatric case on board of SAMU's cars. Afterwards we discussed how the urgency paradigm, that influence the protocol draw and as consequence distort what we believe is the essentially function of this device, that is to give care support to persons in crises and produce articulation to psychosocial services network

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

As pessoas com deficiência no mercado de trabalho: expressão das desigualdades sociais

This work was developed in the extent of the Post Graduation Program in Social Service of the Federal University of Rio Grande do Norte. It talks about the process of inclusion of the disabled people in the Job market in Mossoró-RN, bringing for the academic debate relevant thematic for the Brazilian society, for the profession of Social Service and similar areas and for the people with deficiency. It has the objective to apprehend the determiners that make possible the process of the disabled people's inclusion in the Job market in Mossoró, having as parameter the National Politics for the Integration of People Bearers of Deficiency. The critical theoretical perspective is backed in Marx's ideas for the understanding concerning the work, as well as in Pochamann, concerning the job market, regarding the exclusion/inclusion category is based in Martins, Yasbek and Sposati and on deficiency in the National Politics for the Integration of the Disabled People. The research is of qualitative nature and it took as subjects 26 (twenty-six) people, being 09 (nine) people with deficiency, inserted in the formal job and regulated market, and 17 (seventeen) managers of private companies and public institutions of the city of Mossoró-RN. For the collection of data we used techniques of nonsystemic observation, semi-structured interview and documental analysis. The results of the research mark that any modality of the human workforce used in the current context, they are functional to the capitalism and they move forward towards exploration, alienation and subordination of the work to the capital; the National Politics for the Integration of the People with Deficiency expresses and reproduces the contradictory dynamics of the class society, it reflects the neo liberal shades through the selectivity and of the articulation among the federated beings and organizations of the civil society for its operational system; there is a misproportion between the percentages of the quotas and the amount of people with deficiency inserted in the job market, just corresponding to a tiny numeric magnitude; the developed activities are of low social status and it is expressive the amount of workers that receives between one and two minimum wages. These data drive us to infer that the mentioned politics make possible, partly, the inclusion of the disabled people in the job market, though, such inclusion is executed in the selective or focused dimensions, marginal, precarious and unstable

Desafios e limites da prática do sindicalismo rural :um estudo de caso em São Paulo do Potengi/RN

The dissertation analyzes how the syndical practice of the workers rural Brazilians works your aspects of mobilization and claim in front of the execution of attendance services and providences, instituted in the marks of the military dictatorship, in the decade of 1970. We try to apprehend how these services have been interfering in the development of base works. Considering base works, as an enduring political formation of the rural workers, formation of new syndical leaderships and an effect participation of the workers in the political spaces. We trace the path of the rural workers' organization, starting from the previous period to the military stroke of 1964, while protagonists inserted in the national political conjuncture, organizing fight fronts and conquering rights. The research reveals that the rural workers' syndical movement, when it develops the activities coming from Funrural, established in 1971, they confront a dilemma that go through the political nature of your practice, which such activities can reduce the syndical rural workers, to a antity of assistance, and so interfere in the accomplishment of base works with the rural working class. The rural workers' syndical movement, inserted in the several conjunctures, since of your emersion in ante-64, when they have passed by growth and retrocession, they built along this period a structure to the national level, which makes possible the recognition of the rural workers' organization, as a class, and human being politicians of your own structure. It is in this context that the syndical practice is analyzed, emphasizing your limits and your possibilities while policy strenght nationally constituted

A incorporação de preceitos ambientais no sistema de gestão de resíduos sólidos do município de João Câmara - RN Brasil

The reality points to the global environmental sustainability as the only viable option for addressing the crisis at hand. The move towards sustainability calls for the generation / evaluation systems in their direction, through the incorporation of environmental requirements and in line with the National Policy on Solid Waste. Therefore, the proposed research supports the importance of social and environmental vision, complementing the technical view, the system for management of solid waste from East London, which is a municipality that has a system whose inadequacies are configured in environmental risk and health. Therefore, by observing, applying the model of sustainability indicators and content analysis of interviews, this research proposes to investigate the principles of sustainability and social participation are presented and what is the perception of risk about the inadequacies in the system. The results confirmed the hypotheses of the study and draw a picture of worrying data, such as very unfavorable indicators of sustainability, lack of channels of participation, uncommitted investments with the management system, devaluation of the collector of waste and differing perceptions about the risk by making actors act in isolation. This worrying situation is eased by the appearance of a series of elements are configured as opportunities for the integration of environmental principles in the system. And despite the inability of managers to participate in the research system, yet it behaves as an opportunity to implement public policies in the area of solid waste such as: the preparation of the municipal waste, the institutionalization of selective collection and organization of cooperative with the support of companies present in the city and educational institutions as the Federal Institute. The research is an opportunity for the implementation of policies in the area of solid waste and will collaborate with the building instruments for the quality of life of residents, for the socioeconomic conditions of collectors and the move towards a sustainable society

Gestão dos resíduos sólidos no Brasil e seus rebatimentos em Natal, Brasil

O artigo apresenta a gestão dos resíduos sólidos no Brasil e seus rebatimentos na cidade de Natal/RN, verificando seus aspectos ambientais, econômicos e sociais. O fracasso da coleta seletiva revelado nos baixos índices de recuperação dos materiais; a baixa relevância da inclusão socioeconômica dos catadores que participam do programa assistencialista oficial; a inexistência de estratégias oficiais para que se minimize a quantidade de resíduos que se gera cada dia e o aumento exagerado dos gastos públicos, sobretudo com o tratamento dos resíduos no aterro sanitário, demonstram que a gestão de resíduos em Natal, conforme parâmentros da Política Nacional de Residuos Sólidos, objetiva o controle destes na cidade e a consolida- ção do tratamento finalista através do envio da quase totalidade dos resíduos coletados ao aterro sanitário

Políticas públicas de educação ambiental: a gestão do programa municipal de educação ambiental de Mossoró/RN

Study about environment education public policies, emphasizing the directress since the 1970 . It analyses the environment education administration of Mossoró city, indentifying its articulation with the international directresses and the Environment Education National Policy (PNEA), established according the law number 9.795/99. The text takes as empiric reference the Environment Education National Policy (PNEA) of Mossoró city, realized since 2006. In order to make the research, we employed as methodologic proceedings a bibliographical and documental revision from wich we developed a contextualization of the propolsals toward a environment Education policy and administration, the institution of the environment Education in Brazil, in the neoliberal context on the State reform ambit. We also employed a semi-structured interview, having as individuals two Environment Education Municipal Program Administration of Mossoró city / RN state administrators and nine Municipal Education System educators. The analysis was done from the historic and dialetic perspective, trying to understand the facts in its totallity. The results revealed that the environment Education has become to be emphasize as an environment crises superation strategy since the 1970 s. In this context, the environment Education administration directress, in the United Nations (UN) initiative ambit, emphasizes the participation and the partnership as a way to share responsabilities between the State and society. In the neoliberalism affirmation context, in the 1990 s, these directresses were fortified, once, since the State reform, their functions were redimensioned and the State turns into a stronger planner an controller, inducing the society to act as a public polcies executor. Therewith, a deconcentration action process is consolidated, rather than an administrative and pedagocgic decentralization, historically revendicated on Education by the progressist sectors. Even though the administrators interviewed have revealed the wish that the schools become autonomous on the PMEA execution, through the NEAs, we notice that the methods employed do not contribute to that, because of the decisions concentration on the associated managership ambit and the few human and financial resources. In spite of the difficulties, the research showed that the Mossoró municipality innovated on the environment Education field, by the institution of the NEAs, even though they demonstrate fragilities regarding their performance, revealed on the educators and adiminstration talk on the interviews. We verify that the main difficulties come from the politc culture installed on the municipality, ruled by a technocracy and power concentration wich brings difficulties to the implementation of a democratic and participative administration, even though it would not be totally impossible, even on the circumstances described

Integração de critérios técnicos, ambientais e sociais em estudos de alternativas locacionais para implantação de aterro sanitário

A Política Nacional do Meio Ambiente tem como objetivo a conciliação do desenvolvimento econômico e social com a qualidade ambiental, e dispõe de vários instrumentos que procuram contemplara capacidade de suporte do meio. Assim, a discussão sobre a localização das atividades é uma etapa importante para a avaliação da viabilidade ambiental de um determinado empreendimento, notadamente em processos de licenciamento ambiental. O trabalho apresenta uma abordagem metodológica para integração de critérios técnicos, ambientais e sociais em estudos de alternativas de localização de aterros sanitários, com especial atenção à interação entre os aspectos ambientais e os elementos fundamentais de um projeto (a saber, requisitos locacionais e concepção tecnológica), aplicado em um estudo de caso em São Carlos (SP). Como resultados principais, destacam-se o maior foco nos impactos significativos e a possibilidade de envolvimento de segmentos importantes da sociedade previamente à elaboração dos estudos ambientais.

Espaços educativos impulsionadores da educação ambiental

A educação ambiental (EA) vem-se expandindo no Brasil em diversos espaços educativos formais e não-formais. Este texto considera a EA provocadora de mudanças políticas, estimuladora de uma racionalidade ética e ecológica e promovedora de atitudes e valores pessoais e de práticas sociais compatíveis com a sustentabilidade da vida na Terra. Sob esta visão, o artigo tem como objetivo refletir sobre a expansão da educação ambiental nas universidades brasileiras, nos últimos vinte anos; discutir as possíveis mudanças educacionais das políticas públicas da área, a partir da Constituição de 1988; considerar a possível influência das forças dos movimentos sociais da sociedade organizada e das redes de EA locais, regionais e nacionais formadas com a generalização do uso da informática, como impulsionadora da sua expansão. A EA se constitui e se formaliza com o respaldo de uma política nacional que propicia sua permanência e aprofundamento nos espaços já conquistados e promove sua inserção nos demais contextos da sociedade organizada.

Grupos de Conversa: saúde da pessoa idosa na estratégia saúde da família

A Política Nacional de Saúde da Pessoa Idosa aponta a importância de: divulgação dos direitos da pessoa idosa; promoção do envelhecimento ativo e saudável; formação permanente dos profissionais de saúde e apoio ao desenvolvimento de estudos e pesquisas. São relatados resultados parciais do desenvolvimento de uma experiência de extensão universitária realizada em parceria e com a colaboração da rede de atenção básica. Dentre as atividades realizadas, objetivou-se desenvolver um processo grupal de promoção à saúde com pessoas idosas, tendo em vista o envelhecimento ativo e a qualidade de vida dessa população. Observou-se que as atividades em grupo consistiram em um espaço privilegiado para a constituição de redes de apoio, estabelecimento e ampliação de vínculos afetivos; reflexão e conscientização das determinações do processo saúde-doença; organização e mobilização para o efetivo controle social; além de ser um espaço de ensino-aprendizagem, orientação, intervenção e educação em saúde.

Educação em saúde como estratégia de promoção de saúde bucal em gestantes

O objetivo desta revisão da literatura é discutir a importância da educação em saúde como estratégia de promoção de saúde bucal no período gestacional. Foram estudadas as manifestações bucais mais comuns na gestação, concluindo-se que, embora a gestação por si só não seja responsável por tais manifestações como, por exemplo, a cárie dentária e a doença periodontal, faz-se necessário o acompanhamento odontológico no pré-natal, considerando-se que as alterações hormonais da gravidez poderão agravar as afecções já instaladas. Destacou-se na promoção de saúde bucal na gestante a educação em saúde bucal, considerando-a parte importante do Programa de Atenção à Saúde da Mulher, conforme recomendado pelas atuais Diretrizes da Política Nacional de Saúde Bucal. Considera-se que, por meio de ações de educação em saúde bucal, desenvolvidas no pré-natal por uma equipe multiprofissional, orientada por um cirurgião-dentista, a mulher poderá se conscientizar da importância de seu papel na aquisição e manutenção de hábitos positivos de saúde bucal no meio familiar e atuar como agente multiplicador de informações preventivas e de promoção de saúde bucal.

Experiencias emblemáticas en la superación de la precariedad y pobreza urbanas en América Latina y el Caribe: acceso al suelo urbano para los pobres

Incluye Bibliografía

Los pueblos indígenas de Bolivia: diagnóstico sociodemográfico a partir del censo del 2001

Incluye Bibliografía

Situación y perspectivas de la eficiencia energética en América Latina y el Caribe = Situation and perspectives on energy efficiency in Latin America and the Caribbean

Incluye Bibliografía