Saúde mental e os novos paradigmas de cidadania e inclusão social na sociedade contemporânea

Este estudo tem por objetivo analisar as categorias de cidadania e inclusão social na política de desinstitucionalização nos sujeitos em sofrimento psíquico diante do processo de individualização na teoria social contemporânea. Assume como hipótese que a saída do hospital psiquiátrico por si só não garante a inclusão social e nem o livre exercício da cidadania. Considerado o objetivo desta pesquisa, optou-se por fazer uma pesquisa bibliográfica como procedimento metodológico. O material de estudo foi dividido em três conjuntos: (1) 56 artigos científicos, visando a compreender a visão da academia; (2) um conjunto de legislação, composto de 10 leis que implementaram a política de desinstitucionalização no Brasil e a reforma dos serviços de saúde psiquiátrica, visando a compreender as ações do Estado; (3) quatro Relatórios Finais das quatro Conferências Nacionais de Saúde Mental, para também compreender a participação da sociedade civil. Para a análise do material, utilizou-se uma combinação de duas técnicas complementares: leitura bibliográfica com a análise de conteúdo. Dentre os vários processos que caracterizam a sociedade contemporânea, optou-se por analisar a individualização que impacta nas formas de exercício da cidadania e na inclusão social. Na análise dos resultados da categoria de cidadania foram identificadas associações em relação à interdição civil, liberdade, moradia, saúde, trabalho, educação e participação política. Relacionadas à categoria de inclusão social foram identificadas as referências à família, estigma, laços sociais, autonomia, contratualidade e trabalho. Os resultados obtidos indicam que o campo da saúde mental não está em completa consonância com as transformações da sociedade contemporânea, o que provoca um descolamento da realidade social da própria politica de desinstitucionalização e, portanto, maior dificuldade para a efetiva inclusão social e o exercício da cidadania desses indivíduos.

Discursos e produção de sentidos: experiência da transferência da política do tratamento diretamente observado de curta duração para o controle da tuberculose em Moçambique - África

A estratégia do Tratamento Diretamente Observado de Curta Duração para o controle da tuberculose (DOTS) tem sido usada por vários países do mundo especificamente pelos 22 mais afetados pela doença, que contribuem com cerca de 80% de casos, porém, apesar da estratégia demonstrar a redução de casos e aumentar a adesão dos pacientes ao tratamento, e ter sido implementada em Moçambique desde a década de 1980, a doença continua a ser um problema grave de saúde pública no país. Este estudo tem como objetivo central: analisar a transferência da política do DOTS a partir da visão dos gestores centrais, provinciais e distritais, e profissionais de saúde da província de Nampula. Trata-se de um estudo qualitativo que usa a Análise de Discurso de matriz francesa como seu referencial teórico metodológico que busca a compreensão dos sentidos a partir das condições da produção. Participaram deste estudo 15 profissionais de saúde que ocupavam as posições de gestores, médicos e profissionais de enfermagem e/ou técnicos, e atuavam no Programa nacional de controle de Tuberculose em Moçambique com o mínimo de um ano de experiência, nos meses de maio a agosto de 2014, nos níveis central, provincial (Nampula), e distrital (em oito distritos da província de Nampula). Para a coleta de dados usou-se um roteiro de entrevista semi-estruturado que permitiu explorar os sentidos produzidos. O corpus em análise foi constituído a partir das entrevistas transcritas. Para o auxílio da organização dos dados usou-se o sofware Atlis.ti versão 6. Este estudo teve a aprovação da Comissão Nacional de Bioética e da autorização do Ministro da Saúde de Moçambique. Para a análise dos dados foram identificados quatro blocos discursivos: experiências adotadas na implementação e manutenção do DOTS; estratégias adotadas na implementação e manutenção de DOTS; potencialidades, fragilidades de DOTS no controle da tuberculose e; discursos não buscados pelo roteiro: possíveis soluções. Os sentidos produzidos enfatizam dizeres inscritos em formações discursivas que desconsideram a subjetividade do enfermo; de fragilidades do sistema de saúde, falta de recursos humanos, falta de transporte, baixos salários, insuficiência de laboratórios, distâncias longas entre a moradia do paciente e a unidade sanitária. Ainda os entrevistados entendem como potencialidade a participação dos agentes comunitários e da família no tratamento da doença. Conclui-se que para o controle da tuberculose usando a estratégia DOTS o compromisso do governo deve ser pragmático traduzindo-se em ações concretas como o aumento do financiamento das ações de controle de tuberculose, incluindo as pesquisas, formação dos recursos humanos e, sobretudo, atuar sobre os determinantes socias da saúde

Restoration Efforts and Prairie Dog Management at the Rocky Mountain Arsenal National Wildlife Refuge

The Rocky Mountain Arsenal National Wildlife Refuge is being re-seeded to native shortgrass prairie, but the effects of prairie dog colonization on some sites may be limiting successful native plant establishment. This Capstone Project compares vegetation monitoring data and prairie dog distributions in four refuge sites to evaluate the effects of prairie dog colonization on restoration. In general, native plant abundance has increased on study plots since initiation of restoration. Localized changes in plant abundance have occurred among transects, but prairie dog densities could not be correlated with the changes. Future prairie dog expansion is cause for concern due to intensified burrowing and grazing effects. Seven recommendations are presented to aid future restoration efforts.

Developing an Interdependent Relationship between Preservation and Recreation: Managing Mountain Bicycling in National Parks

Increasing demand from mountain bikers for greater access to riding in National Park Service (NPS) units is driving the need for park managers to seriously look at the impacts from and feasibility of permitting this recreational use. Currently, NPS units that permit mountain bicycling do not have formal mountain bicycling management plans. An analysis of recreational policies and existing research was conducted to identify criteria for effective mountain bicycling management strategies. Criteria were developed for trail selection, establishment, use, closures and rehabilitation. Criteria were also developed for user education, participatory planning and monitoring. This study shows that the NPS needs formal mountain bicycling management plans that focus on the preservation of natural and cultural resources and consider the appropriateness of proposed recreational uses.

A Physical and Social Study of Mountain Bike Use on Five Segments of the Continental Divide National Scenic Trail in Colorado

This capstone reviews uses of the Continental Divide National Scenic Trail. Policies governing use of the trail appear to be ambiguous, especially regarding mountain bicycles. Mountain biking has grown since the trail was created, but is not fully addressed in existing or proposed policy. 382 people on five segments of the trail in Colorado were interviewed for this capstone. Mountain bikes, hiking, and motorized recreation were observed uses. User conflict, overcrowding, degraded recreation experiences, or user displacement was not reported. User satisfaction was high and most would return. Interviewees requested increased public involvement and recognition of user needs in setting policy. Trail degradation occurs, but is unassociated with any particular use. Recommendations for trail improvement and maintenance are presented.

The Impacts of National Culture on Safety Culture in the Global Oil and Gas Industry

Safety culture is one of the most-studied subjects in the safety literature today, although no agreement exists on exactly what it means. Most safety culture research has been conducted in high-hazard industries such as nuclear power, aviation, and offshore oil and gas production. Only limited research has investigated links between safety culture and the prevailing national culture. This paper proposes that efforts to build safety culture and improve safety performance in the global oil and gas industry will be enhanced if the safety culture maturity and the prevailing national culture are assessed and a location-specific plan is developed based on these factors. A model plan to improve safety performance for one multinational oil and gas company is presented.

Integration of Building into Nature for the Valles Caldera National Preserve Visitor Center

Valles Caldera National Preserve, located in northern New Mexico, has an opportunity to implement sustainable design concepts while demonstrating long-term financial sustainability in the design of its new visitor center. This building can be designed to use natural systems to provide energy and water, and to blend in with the setting‰Ûªs unique historical and natural landscape. Structures can be integrated into nature by incorporating common techniques, features, and materials of a particular period, area, or people. This analysis identified capital costs for both traditional and sustainable construction techniques, as well as long-term operational costs. The results demonstrate that capital costs of sustainable design that is integrated into the landscape can be comparable to conventional costs and provide long-term operational costs savings.

Policy Changes to the Federal and State Management of Subsistence Hunting and Fishing in Alaska

Subsistence in Alaska is currently being impacted by naturally occurring factors such as global warming, species migration shifts, and the declination of fishery and wildlife populations. Not only are external factors pressuring the debate, management strategies from the dual management operation appear to have failed. The current national focus has been centered on federal policy changes regarding subsistence. This project extends the federal subsistence review process into the state management of subsistence and provides practical solutions for enhancing both policy programs.

Rural Development Trends and Land Use Policy in Colorado: Contributors to Habitat Fragmentation?

Fragmentation of wildlife habitat is a primary driver of global species decline. A major contributor to habitat fragmentation in the United States is rural residential development. Rural development in Colorado is occurring at rates far greater than the national average. Additionally, the lack of state-level planning control coupled with a lack of comprehensive, effective planning tools at the local level creates conditions that contribute to habitat fragmentation in many rural counties. Greater oversight and involvement in land use planning is needed by the state level to assist county governments. This study provides five recommendations to strengthen Colorado state land use policy in order to reduce habitat fragmentation.

Gender sensitivity in national health plans in Latin America and the European Union

Objectives: To evaluate the situation regarding gender sensitivity in national health plans in Latin America and the European Union for the decade 2000–2010. Methods: A systematic search and content analysis of national health plans were carried out within 37 countries. Gender sensitivity, defined as the extent to which a health plan considers gender as a central category and develops measures to reduce any gender-related inequalities, was analysed through an ad hoc checklist. Results: The description of health problems by sex was more frequent than intervention proposals aimed at reducing gender health disparities. The greatest number of specific intervention proposals targeted at overcoming gender-based health inequalities were associated with sexual and/or reproductive health, gender based violence, the working environment and human resources training. Compared to the European Union member states, Latin American health plans were found to be generally more gender sensitive. Conclusions: National health plans are still generally lacking in gender sensitivity. Disparities exist in health policy formulation in favour of men, whilst women's health continues to be identified mainly with reproductive health. If gender sensitivity is not taken into account, efforts to improve the quality of clinical care will be insufficient as gender inequalities will persist.