Atenção à saúde mental na Estratégia Saúde da Família no Município de Parnamirim/RN: opinião dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population´s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user´s care and the promotion of family health

Atenção à saúde da pessoa idosa na estratégia saúde da família no município de Santo Antônio/RN: um estudo de caso

According to demographic estimates, by the year 2025 Brazil will be the sixth country in the world in number of elderly. For this reason, it is a purpose of public policies to help people to reach that age being healthier. The current health care model of health surveillance through the Family Health Strategy (EFS, in portuguese) is configured as a gateway into the care of the elderly in the Unified Health System (SUS, in portuguese). It is also an area of development of practices to promote health, prevention and control of chronic nondegenerative diseases. The aim of this study was to analyze the health care of the elderly provided by ESF professionals for the achievement of a full care. The study is descriptive case study with a quantitative approach, performed in the city of Santo Antônio/RN. The population included all health professionals, who are FHS members of the city that agreed to participate of the survey, a total of 80 professionals. Data were collected using a structured questionnaire, having mostly closed questions and divided into two parts: one containing sociodemographic information of health professionals and vocational training and the other, the activities carried on by the professionals in senior care, being analyzed from a database tabulated in a spreadsheet and discussed according to the descriptive statistics in tables, graphs and charts using frequencies, medians and values of central tendency. It was verified a predominance of professionals who finished highschool, mostly female, aged from 30 to 34 years old, with training completed in the last 10 years, without being graduated in the field of geriatrics or gerontology and mostly without training in gerontology. Family members and caregivers were the components of the social support network most identified by the professionals (66.3%).The elderly access to the Family Health Basic Unit was considered by83.8% of professionals as the most important factor that interferes in the activities of health care of the elderly. Considering the inclusion of the family in care: 98.8% of professionals consider the family as one of the goals of care, but 82.5% assist the family to know their role and participate in the care of the elderly, emphasizing that no professional makes use of tools for evaluating the functionality of the family. Regarding the actions taken to assist the elderly, 91.25% have home visits program to the elderly, 88.75% use the host program; 77.5% know the habits of life, cultural, ethical and religious values of the elderly, their families and their community ;51.25% complement the activities through intersectoral actions, 50%participate in groups of living with the elderly; 33.75% keeps track and maintain updated the health information of the elderly; 11.25% of the professionals perform the Single Therapy Planning (PTS, in portuguese) and few implement the actions to promote health according to PTS; there is a deficit in the number of professional categories in the identification and monitoring of the frail older people in their households. It is concluded that the health care of the elderly developed by ESF professionals differs among the professional categories. It was identified weaknesses in the promotion of an active and healthy aging and also in the establishment of an integrated and full care of the elderly. It is recommended the adoption of permanent educational activities by the City Management, initially for ESF professionals in the the perspective of the guidelines of the National Policy of Health Care for the Elderly and later to the other professionals that are part of the health care network of the elderly, at all levels of care in the city for the development of strategies and practices that promote the improvement of the quality of healthcare for the elderly, expecting concrete and effective results in terms of promoting health within Brazilian reality

e-Resíduos: A influência da norma européia WEEE na estratégia da indústria de celulares no Brasil e no mundo e o impacto ambiental do descarte inadequado

This present Thesis, is explorer work and presents an analysis of e-wastes of the industry of cellular mobile telephony, evaluating the evolution of the telecommunications nets and as if it holds the global and Brazilian market of cellular telephony. It approaches the elements gifts in the cellular devices that can badly cause to the environment and the health, the discarding of the devices in end of life cycle is made. It analyzes the new European regulation of electric equipment residues and electronic, the WEEE, as it influenced the strategy of the companies manufacturers of mobile phone cellular and of that she forms is possible to create a Brazilian national industry for recycling of devices of cellular, with conditions to globally competition. For this some possible models of being implanted in Brazil are presented. The project of law 203/91 on solid residues is argued and as it would be interesting if to persist some proposals presented to the project, to create a Brazilian market of recycling with capacity of global competition for use to advantage of the European regulation if to get a competitive advantage

Construção e implementação do Balanced Scorecard em uma organização educacional: o caso do Serviço Nacional de Aprendizagem Comercial do Rio Grande do Norte SENAC RN

The changes that have taken place in the organizational environment in recent decades have led to new performance measurement systems being proposed, given the inadequacy of traditional models. The Balanced Scorecard (BSC) emerged as an instrument to translate financial and non-financial assets into real values for all interested parties in the organization, allowing the introduction of strategies to achieve the desired goals. Research shows that most errors committed with the use of this method are related to the implementation process. Thus, the aim of this dissertation is to analyze the process of building and implementing the BSC in an organization. This empirical exploratory study is based on the classic case study method, which enables the researcher to work with a set of evidence, including direct observation, interviews and document analysis. The results show that the use of BSC in the company investigated posed problems during the process of building and implementing the method. These problems were caused mainly by the lack of involvement on the part of upper management and the team s scant knowledge of Balanced Scorecard. One of the gains obtained from adopting the system was the introduction and/or consolidation of a culture of strategic planning and participative management. The continuous implementation phase was highlighted in the monitoring program, created by the organization in an attempt to reverse existing problems, using the BSC as a third generation strategic management system, which led to significant gains, better use of the system and stronger management practices

O Prêmio Nacional de Qualidade e as políticas e práticas de recursos humanos :um estudo em empresas do setor de transporte público por ônibus da região metropolitana de Natal/RN

This work has goal of analyzing the practices of Human Resources in the per missionary enterprises of urban transportation, by bus, in the metropolitan region of de Natal, based on the standard person of the National Program of Quality 2004 and points if they are able to take part as prize-winning in this standard. Also this work aims, through a theoretical evolution of people management and its current practices, the history of the National prize Quality and its main standards, the importance of the urban transportation, its characteristics and the system itself in the metropolitan region of Natal. The research was carried out in 11 enterprises that operated in the area, with several dimensions and forms of management. The research variations were based on the standard person of the 2004 NPQ that deals with the system of work, preparation and development and life quality. In the statistical treatment, discriminated and exploiting analyses were applied. The main obtained results through the research, we can verify an administrative centralization in managers and owners hands; that 45% of the enterprises don t have a Human Resources Department, however, on the other hand, they practice some human Resources politics, indicated by the variations; as to the items system of work, 55% of the enterprises are able; preparing and development, 43%

Indicadores bibliométricos em sistemas de informação: uma análise a partir de artigos publicados no Encontro Nacional de Engenharia de Produção

This research aims at to contribute to show the consolidation of the area of Information Systems (IS) as area of knowledge in Production Engineering. For this, it according to presents a scenery of the publication in IS in the field of the Production Engineering in Brazil amount of articles, the authorship profile, the methodologies, the citations, the research thematic and the continuity of the research thematic. The base for this study was the works published in the National Meeting of Production Engineering - ENEGEP of years 2000, 2001, 2002, 2003 and 2004, inside of the area of Information Systems. Classified as bibliographical research, of applied nature, quantitative boarding, of the point of view of the objectives description-exploration was called and for the collection of data its comment was systematic with bibliographical survey. As field research, the method of collection of data if constituted of the elaboration of an analysis protocol and, to arrive itself at the final diagnosis, it operation the data through the statistical method, with the accomplishment of descriptive analyses. It approached concepts of IS and the seek areas and, it studied research correlate in Production Engineering, in Information Systems, in Information Science and other areas of the knowledge. How much to the results one concluded that the national and international contents are compatible and that the area of IS is in constant evolution. For the continuity of research lines it was observed that the majority of the authors was faithful to the area of Systems of Information. Amongst other found results, some institutions must try to increase its volume of publications and research, while others must look for to keep its reached mark already in the last years

Estratégia de controle robusto para filtro ativo paralelo sem detecção de harmônicos de correntes

Conventional control strategies used in shunt active power filters (SAPF) employs real-time instantaneous harmonic detection schemes which is usually implements with digital filters. This increase the number of current sensors on the filter structure which results in high costs. Furthermore, these detection schemes introduce time delays which can deteriorate the harmonic compensation performance. Differently from the conventional control schemes, this paper proposes a non-standard control strategy which indirectly regulates the phase currents of the power mains. The reference currents of system are generated by the dc-link voltage controller and is based on the active power balance of SAPF system. The reference currents are aligned to the phase angle of the power mains voltage vector which is obtained by using a dq phase locked loop (PLL) system. The current control strategy is implemented by an adaptive pole placement control strategy integrated to a variable structure control scheme (VS¡APPC). In the VS¡APPC, the internal model principle (IMP) of reference currents is used for achieving the zero steady state tracking error of the power system currents. This forces the phase current of the system mains to be sinusoidal with low harmonics content. Moreover, the current controllers are implemented on the stationary reference frame to avoid transformations to the mains voltage vector reference coordinates. This proposed current control strategy enhance the performance of SAPF with fast transient response and robustness to parametric uncertainties. Experimental results are showing for determining the effectiveness of SAPF proposed control system

Estratégia de conversor para interligação de sistemas de geração eólica à rede elétrica

Currently, there are several power converter topologies applied to wind power generation. The converters allow the use of wind turbines operating at variable speed, enabling better use of wind forces. The high performance of the converters is being increasingly demanded, mainly because of the increase in the power generation capacity by wind turbines, which gave rise to various converter topologies, such as parallel or multilevel converters. The use of converters allow effective control of the power injected into the grid, either partially, for the case using partial converter, or total control for the case of using full converter. The back-to-back converter is one of the most used topologies in the market today, due to its simple structure, with few components, contributing to robust and reliable performance. In this work, is presented the implementation of a wind cogeneration system using a permanent magnet synchronous generator (PMSG) associated with a back-to-back power converter is proposed, in order to inject active power in an electric power system. The control strategy of the active power delivered to the grid by cogeneration is based on the philosophy of indirect control

Estratégia de gestão ambiental baseada nos princípios da produção mais limpa : um estudo de caso focado no segmento da carcinicultura

The objective of this scientific article is to introduce the opportunities of implementation of cleaner production (CP) in a shrimp culture farm. The methodology used for this was exploratory research implemented in a production unit located in the Northeast Brazil. The scientific article approaches since generic aspects of the technique about the management to use water, energy and the effluent characterization of this productive activity. It discusses quantitative aspects, environmental questions and chances of P+L during the productive process phases. The results points to input economy in the form of feed, soil correctives, medicines, and energy applied to the process, which range from 4% to 27%, emphasizing the small profit should be viewed as a source of considerable environment return. The authors conclude for the adoption property of this technique in this agribusiness segment, point out to the management importance of the input dosage in the quality of the final effluent, besides the adoption of a physical-chemistry remediation mechanism to the residual of Sodium metabissulphite used in the process of shrimp caught

Variáveis relacionadas ao processo de adesão a um programa de prevenção de quedas em idosos cadastrados na Estratégia de Saúde da Família

Introduction: Falls among older adults is a public health problem, therefore it is necessary preventive actions, however the adherence is the major problem faced by practitioners and researchers working on falls prevention programs. Objective: To evaluate the variables related to the adherence to falls prevention programs among the elderly enrolled in a Basic Health Unit (BHU). Methods: Was performed an observational cross-sectional analytical study. All elderly registered in a BHU and able to ambulate independently were invited to participate in a falls prevent program. The Elderly who Adhered to the Program (EAP) were evaluated at BHU; and the Elderly Not Adhered to the Program (ENAP) were identified and assessed at home. The assessment for both groups was performed using an evaluation form containing personal data, measures and clinical scales to assess cognitive status, balance, mobility, fear of falling, handgrip strength. Data were analyzed with SPSS 20.0. In addition to this assessment, the ENAP underwent a semi structured interview, in which we used the qualitative approach based on the figure of the Collective Subject Discourse. Results: The study included 222 elderly, 111 EAP and 111ENAP, most aged between 70 and 79 years (48.2%), female (68.5%), married (52.3%) and illiterate (47.7%). Consolidated as protective factors for adherence, worst rates of physical activity (p = 0.001), balance (p = 0.010) and cognition (p = 0.007). The interview of ENAP identified two themes: "Local implementation of programs for the prevention of falls" and "Relationship between BHU and the elderly health care," and found that the elderly who did not adhere were unable to displace and did not mention that primary care programs are related to health care in elderly. Conclusions: Elderly who do not adhere to the program differ from elderly who adhere as worst indices of cognition, balance and physical activity which implies greater risk of falling; and they were unable to participate in falls prevention program and by to be caregiver and showed displacement difficult

Estratégia de vida do peixe anual Hypsolebias antenori (Cyprinodontiformes: Rivulidae) do semiárido brasileiro

This work deals with the life strategy of an endangered annual fish, Hypsolebias antenori (Cyprinodontiformes: Rivulidae), of the Brazilian semiarid region. The eggs of these fish hatch at the onset of the rainy season, grows rapidly and they reproduce during the rainy season. When the water puddles dry out, the entire population dies. The resistant eggs which are buried in the bottom of the dried pools go through diapause stages, during which time the embryonic development becomes temporarily arrested. With the onset of the next rainy season, the eggs hatch and a new generation is formed. Specimens of H. antenori were captured during 2011 and 2013, in temporary water pools located in the hydrographic basin of river Jaguaribe in Ceará, Brazil. Sex ratio, the length-weight relationship, the growth type, first sexual maturity, anatomy and histology of the digestive tract, development of gonads, reproductive strategy, karyotypic pattern of the species, and the conservation status of H. antenori were investigated. The results of this study are presented in the form of eight articles. The first article is about the fish faunal composition of the hydrographic basins of Rio Grande do Norte, Brazil, wherein the record of H. antenori is included. The second article deals with the sex ratio, secondary sexual characteristics of males, the length-weight relationship and the type of growth. Males show a pattern of intense coloration with well developed fins. The sex ratio showed a significant predominance of females (1M:1.7 F). Males were larger in length and weight. The equation of weight and total length relationship was Wt=0.0271Lt3,8937, showing a positively allometric growth, indicating greater increase in weight than in length. The third article discusses the anatomy and histology of the digestive tract of H. antenori. It is considered as a generalist feeder with characteristics of omnivore, which utilizes different food sources. The fourth article discusses the stages and phases of gonad development and type of spawning of H. antenori. The fifth article is about the r reproductive strategy adopted by H. antenori which helps in successful reproduction over a short period of life. The sixth article deals karyotypic pattern of the species, constituting the first cytogenetic contribution to the genus. The seventh article discusses about the risk of extinction of this species which suffers a series of threats, such as, habitat loss through land use, deforestation, construction of reservoirs, pollution due to domestic and industrial sewage, besides pesticides and agrochemicals. Furthermore, decreasing rainfall and intensification of aridity due to global climate changes, interferes with the reproductive cycle. The eighth article deals with aggressive behavior adopted between males and among females during reproduction. All temporary water pools sampled during this study were in high degree of degradation, mainly due to human action. There is a great need for conservation measures to protect the populations of annual fish, including the creation of protected areas in the semiarid ephemeral aquatic environments of Brazil

Estratégia reprodutiva do peixe-voador, Hirundichthys affinis e do peixe agulha preta, Hemiramphus brasiliensis no litoral de Caiçara do Norte, Rio Grande do Norte, Brasil

The flyingfish, Hirundichthys affinis (Günther, 1866) (Exocoetidae) and ballyhoo half beak, Hemiramphus brasiliensis (Linnaeus, 1758) (Hemiramphidae) are marine fish species of commercial value, which contribute to artisanal fishery production of Rio Grande do Norte, Brazil. Besides the economic importance, these fish are important from an ecological point of view, being components in pelagic food chain, where they are the preferred prey of larger predators of high commercial value. This study aimed to determine the reproductive strategies of H. affinis and H. brasiliensis and the fishery production of H. affinis in the northern coast of Rio Grande do Norte. The results are presented in the form of six cientific articles and a review paper. The first article presents the morphometric measurements and meristic counts which confirmed the taxonomic status, population structure in length-weight and the gonad development of H. affinis through macroscopic observations of the ovaries and testes. Females of this species were bigger and heavier than males. The second article describes the reproductive tactics, such as, sex ratio, length at first sexual maturity, histological aspects of gonads, fecundity and spawning season, that indicate the reproductive strategy of H. affinis. The third article shows annual changes in the fishery production of H. affinis in Caiçara do Norte, during the period of 1993 to 2010, emphasizing the relevance of this fish in total fishery production of Rio Grande do Norte, besides registering the fall in production in the years 2008 to 2010. The fourth article describes the population structure, with respect to the length and weight, the length-weight relationship, growth type and sex ratio of Hemiramphus brasiliensis. The fifth article describes the reproductive biology of H. brasiliensis, with details about sex ratio, length at first sexual maturity, fecundity, type of breeding and spawning season. The sixth article deals with the reproductive strategy of H. brasiliensis. The review paper presents the topic of age determination of tropical fish using analysis of otoliths. Both species use the coastal waters of Caiçara do Norte for reproductive purposes. The flying fish, H. affinis migrates from the oceanic waters to the coastal waters to reproduce, coinciding with the rainy season. H. affinis presents total spawning and a seasonal reproductive strategy. However, H. brasiliensis lives and reproduces in the coastal waters displaying partial spawning and an equilibrium reproductive strategy

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

Fluxo de carga continuado utilizando estratégia de parametrização geométrica baseada em parâmetros físicos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Dos requisitos à arquitetura em linhas de produtos de software: uma estratégia de transformações entre modelos

The tracking between models of the requirements and architecture activities is a strategy that aims to prevent loss of information, reducing the gap between these two initial activities of the software life cycle. In the context of Software Product Lines (SPL), it is important to have this support, which allows the correspondence between this two activities, with management of variability. In order to address this issue, this paper presents a process of bidirectional mapping, defining transformation rules between elements of a goaloriented requirements model (described in PL-AOVgraph) and elements of an architectural description (defined in PL-AspectualACME). These mapping rules are evaluated using a case study: the GingaForAll LPS. To automate this transformation, we developed the MaRiPLA tool (Mapping Requirements to Product Line Architecture), through MDD techniques (Modeldriven Development), including Atlas Transformation Language (ATL) with specification of Ecore metamodels jointly with Xtext , a DSL definition framework, and Acceleo, a code generation tool, in Eclipse environment. Finally, the generated models are evaluated based on quality attributes such as variability, derivability, reusability, correctness, traceability, completeness, evolvability and maintainability, extracted from the CAFÉ Quality Model