A saúde ambiental e os resíduos de serviços de saúde nos três níveis de complexidade do Sistema Único de Saúde - SUS

The environmental management in the health establishments is a reality still little explored in the health sector in Brazil, especially concerning its wastes. The management of wastes of health services is established in the valid legislation through the National Council of Environment and Sanitary Vigilance Agency (358/2005 and 304/2004 respectively). The present work is about a descriptive work about the environmental health in the health services. The used criterion was to diagnose the environmental management in twelve establishments of health inserted in the three levels of complexity of the Unique Health System (Sistema Ùnico de Saúde SUS). Among the sub criteria used the waste management is the one of bigger concern. The one referring to the water quality is considered good. The analysis of data reveals that 66% of the establishments got a poor environmental ranking, 17% critical and 17% appropriate, showing that the health establishments in the three levels of complexity of the SUS need urgent structural, environmental and educational interventions

Qualidade de vida do servidor da Universidade Federal do Rio Grande do Norte em condição crônica de saúde

The study aimed to analyze the influence of chronic health conditions (CHC) on quality of life (QOL) of UFRN servers assaulted by CHC. It is a descriptive and cross-sectional study with prospective data and quantitative approach, accomplished in the ambulatory clinic of the Department of Server Assistance (DSA) of the Pro-Rectory of Human Resources, during three months. The sample was composed by accessibility, totaling 215 people, being 153 active and 62 inactive servers, in chronic health condition. The data were collected through the application of the sociodemographic characterization, health, environmental and laboral form, the Medical Outcome Study 36-Item Short Form (SF-36). The study was evaluated by the HUOL Ethics Committee (CAAE no. 0046.0.294.000.10), obtaining assent. The results were analyzed in the SPSS 15.0 program through the descriptive and inferential statistics. It was identified servants predominantly male (59,1%), under 60 years old, married or in stable union, Catholics, brown color, living in the capital and residents in own home. Regarding labor issues, there was a predominance of active servers technical-administrative with intermediate and medium level positions and small proportion of docents. Among the CHC, the non-communicable diseases - NCDs (95.8%) had a higher frequency, followed by persistent mental disorders - PMDs (18.6%) and, finally, the continuous and structural physical deficiency - CSPD (16.9 %). The QOL of servers was considered good, with a mean score of 72.5 points in the total score, with the most affected domains: physical (59.1), general health (66.2), bodily pain (66.3) and functional aspects (72.0). The mental health dimension (76.5) had a better average than the physical dimension (68.0 points). It was found that the decrease in QOL scores is significant statistically related to higher number of CHC (ρ <0.001), with no statistical significance regarding the functional situation (p = 0.259). The administrative technicians of elementary, primary, secondary levels and docents had the worst QOL scores. After the correlation analysis of CHC with the domains and dimensions of the SF-36, there was statistically significant, negative and weak correlation of the domains: functional aspect (ρ = 0.002, r = -0.207), physical aspects (ρ = 0.007; r = -0.183), vitality (ρ = 0.002, r = -0.213), social function (ρ = 0.000, r = -0.313), emotional aspects (ρ = 0.000, r = -0.293), mental health (ρ = 0.000 , r = -0.238), physical health dimension (ρ = 0.002, r = -0.210) and mental health dimension (ρ = 0.000, r = -0.298). The presence of PMD isolated or together, contributed to a lower SF-36 scores, being the domains variation of mean significant, except for bodily pain, general health and physical aspects. By correlating the categories of CHC and QOL, there was a weak correlation (r ≤ -0.376) and significant (ρ ≤ 0.011), mainly related to the NCD, PMDs and NCD + PMD, affecting the mental health, social function, emotional aspects, vitality and functional aspect domains. Front of the results, it was concludes that the servers quality of life is influenced by the CHC. Thus, it was inferred that the presence of CHC causes a negative effect on quality of life, leading the active and inactive servers to exposure their overall life activities and work over the years, due to the morbidity affected, mainly related to NCDs and PMDs. Descriptors: Quality of life. Chronic disease. Occupational Health. Nursing

Federalismo cooperativo e o exercício da competência administrativa ambiental

This paper aims to discuss the conflicts of competence in environmental matters, as well as the legitimacy of the normative acts in the exercise of jurisdiction effected environmental management. For this work, addresses the issue of federalism, North American (dual) and German (cooperative), deepening its historical and theoretical fundamentals, as well as the influences on the evolution of the ideological matrix of Brazilian federalism. Distinguishes itself around the problem the theoretical and abstract discussion involving the constitutional division of powers, and the issue of his relationship with the vicissitudes in the embracement of environmental matters that invariably leads to mistakes in the exercise of jurisdiction environmental management. Its highlight the existence of a framework environmental law, embodying the principles themselves as well as a specific object of authority, which qualifies a different interpretation of the rules of constitutional powers as well as influencing the acting agent of government in managing the public good environment. The study represents an exploratory research as it investigates the depths of the institutes are in evidence not only with satisfying its practical outcome. For this to happen, explores bibliographical sources and identified by the science of law as more important, as the search for social-political boundary which takes the issue studied in their historical and contextual materiality, whose study is essential for a complete understanding of the topic . The dialectic that arguments have been constructed throughout the monograph, attempts to pass a critical way to expose the author's ideas, which considers as essential in the arrival of new questions

UBS RN-7: proposta arquitetônica para um padrão flexível de unidade básica de saúde para a zona bioclimática 7 do RN, com ênfase na sustentabilidade ambiental

Standardization and sustainability: these two apparently antagonistic words find the challenge of uniting in a flexible architectonic proposal. This was the idea that motivated the proposal of this assignment, whose appearing is bound up with the necessity of thinking about standardized spaces that attend on functional criterias and environmental sustainability, in reply to an existing real demand. The assignment consists of an architectonic proposal for a flexible standard of a Basic Unit of Health for the bioclimatic zone 7 of RN (UBS RN-7), with emphasis in the environmental sustainability. The project contemplates innumerable involved variables, such as: obedience to the current law of the Health Ministry for the UBSs; formal/aesthetic aspects; criterias of expansiveness of the UBS I for the UBS II; relative aspects to the constructive rationality and, mainly, sustainability aspects. With the intention to unite the variables and, also, glimpsing a proposal that could reach a good functional performance, aesthetic, of environment comfort and energetic efficiency, it was also necessary to consider concepts about the flexibility of the envelopment. The elaboration of the architecture first draft was based on bibliographical research, conceptual studies and references, elaboration of the architectonic program and the draft development for the UBS port I and the UBS port II. To the end, an implantation data sheet for the project is proposed for the UBS standard project, where strategies of thermal isolation, shadowing and thermal inertia are adopted and combined to three possible types of lot, resulting in 24 possibilities of implantation

Gestão ambiental na saúde pública: um estudo sobre a percepção ambiental de gerenciamento de resíduos sólidos de serviços de saúde, dos servidores do Hospital Universitário Onofre Lopes do Rio Grande do Norte

This research has aimed at studying the perception of University Hospital Onofre Lopes (HUOL) s workers on the environmental management plan of RSSS. They have been interviewed 250 workers: doctors, nurses, nursing assistants, and cleaners. It was used an exploratory and descriptive research of the type Survey, which aims at obtaining of data or information on characteristics, actions or opinions of any group of people. The questions of the questionnaire were of the kind objective", formulated in a model "scale", analyzed in according to the positioning of the interviewee. The wastes of health service have high potential for environmental impact in the activities from HUOL. Actions or environmental protective policy can improve the image of HUOL. They have been detected divergences on the rigor in application of law of ANVISA. The HUOL s workers unaware of the law of ANVISA and they have little or no knowledge about the practices of environmental control, public health and, they do not know the Environmental Management System ISO 14001. They have divergent views on the degree of importance of ISO 14001. There is not a Waste Management Plan for Health Service and / or is not disclosed for most of HUOL workers. It has not carried out audits or defined the goals and objectives. Besides, it has not been identified legal requirements, and there has not been communication about the service is performed or has been made a critical analysis and no control of documents the environmental management plan. The HUOL have not had a committee of environmental management. The direction of HUOL has not been organized courses, training and recycling of waste on environmental control of the health service. On a scale from 01 to 05, the level of aware level concerning to the waste management from health services of the workers, so is at the threshold between 01 and 02. For the reversal of this situation, the first and urgent step is the creation and institutionalization the environmental management committee of the University Hospital Onofre Lopes

Gestão ambiental na saúde pública: um estudo sobre a percepção ambiental em laboratórios de análises clínicas

This objective of this work was to investigate the enviromental perception of technician of clinical laboratories, in the city of the Natal/RN, focusing the generated environmental aspects and impacts in the activities, the strategical importance of the environmental management for the activity, as well as the knowledge about environmental norms and resolutions applied to the sector. A type survey exploratory and descriptive was carried through, using a questionnaire applied in 82 clinical laboratory, getting a return tax of 53,65%, or either, 44 laboratories. The results of the descriptive analyses point with respect to environmental conscience of the interviewed, therefore the majority (75%) described the activities of clinical analyses as great imapact on the environment. Although the interviewed present certain knowledge on the advantages of practical of envivonmental protection and the risks that the activities of clinical analyses offer, some important practical of environmental protection arer not develped by the majority of the iterviewed. The carried through statistical analyses had allowed to investigate the level of environmental knowledge of the professionals of the sector, being consisted themselves that they present little knowledge on practical ISO 14001 and of environmental protection in the health public sector. It can be conclude that, a program of environmental qualification for the sector becomes necessary, in order to improve the knowledge of the professionals of the area, and that the majority of the professionals would have a good recptivity therefore recognize the benefits of the practicadl of environmental protection for the competitiveness of the clinical analyses laboratories

UBS RN-7: proposta arquitetônica para um padrão flexível de unidade básica de saúde para a zona bioclimática 7 do RN, com ênfase na sustentabilidade ambiental

Standardization and sustainability: these two apparently antagonistic words find the challenge of uniting in a flexible architectonic proposal. This was the idea that motivated the proposal of this assignment, whose appearing is bound up with the necessity of thinking about standardized spaces that attend on functional criterias and environmental sustainability, in reply to an existing real demand. The assignment consists of an architectonic proposal for a flexible standard of a Basic Unit of Health for the bioclimatic zone 7 of RN (UBS RN-7), with emphasis in the environmental sustainability. The project contemplates innumerable involved variables, such as: obedience to the current law of the Health Ministry for the UBSs; formal/aesthetic aspects; criterias of expansiveness of the UBS I for the UBS II; relative aspects to the constructive rationality and, mainly, sustainability aspects. With the intention to unite the variables and, also, glimpsing a proposal that could reach a good functional performance, aesthetic, of environment comfort and energetic efficiency, it was also necessary to consider concepts about the flexibility of the envelopment. The elaboration of the architecture first draft was based on bibliographical research, conceptual studies and references, elaboration of the architectonic program and the draft development for the UBS port I and the UBS port II. To the end, an implantation data sheet for the project is proposed for the UBS standard project, where strategies of thermal isolation, shadowing and thermal inertia are adopted and combined to three possible types of lot, resulting in 24 possibilities of implantation

Lixo hospitalar: na estrutura curricular de cursos superiores de saude na cidade de Imperatriz – MA

SILVA, Dany Geraldo Kramer Cavalcanti e et al. Lixo hospitalar: na estrutura curricular de cursos superiores de saude na cidade de Imperatriz-MA. Educação Ambiental em Ação, v. 27, p. 00-10, 2009.

Ética na pesquisa em Administração

Ethics on scientific research is approached and often discussed in several areas of knowledge connected to health. In the Administration area there are very few studies which approach the topic of ethics on research. The present paper tried to fill in this gap in the production of knowledge about the topic, investigating how the ethical principles found in the literature and in the codes of conduct are noticed and taken into account in Administration research activities developed by acting researchers in Administration Post Graduation Programs. Theoretically speaking, the study was based mainly on the approaches by Creswell (2007) and Bell and Bryman (2007), which discuss the research ethical principles. Methodologically speaking it was all about an exploratory kind of study, with qualitative research approach. Upon data collection, personal interviews were made aiming at its depth and focus groups were formed. The first stage had interviews with four experienced researchers who took part on a teaching and researching event and on the second stage we used the focus group technique. The focus groups were done in four college institutions along with the post graduation programs in Administration in the states of Rio Grande do Norte, Paraíba and Pernambuco, in Brazil. The results suggest the existence of general principles and parameters for the scientific research recommended in the literature and on official resolution. However, in the Administration area, there are only a few recommendations of good practices when it comes to submitting articles for scientific publications but we found no guidance with ethical principles and parameters which cover all the activities in the scientific research and which specifically meet the research particularities in Administration. The main ethical dilemma pointed by the researchers refers to ethical questions which arise at the time of data collection and on disclosing the results. Most researchers do not know the guidelines and the ethical norms on ethics about research that we have in our country neither do they send in their projects to the research ethics committee. When dilemma arises, they decide the ethical question based on their values and common sense. These elements confirm the thesis that the researcher s procedure in the research activities in Administration is predominantly signed by personal values or by common sense and less by ethical principles, whether by not knowing the normative instruments related to ethics or by disagreeing with any disciplining rules on ethical behavior in the research

Saúde bucal no programa de saude da família: o caso do distrito sanitário norte em Natal - RN

The inclusion of the dentist in the Family Health Program (FHP) teams designates a reorganization of the mouth health care in your country and establishes a new scenario in Brazilian odontology, through of a new way to organize the basic health care, creating conditions to consolidate in mouth health practice actions, in the level of the basic attention, the validation of Unique Health System (UHS) constitutional principles. The purpose of this research is to verify if the actuation of mouth health teams (MHT) dentists, in Natal city north sanitary district, is tuned with FHP goals.The target research population was composed by all dentists working in Basic Health Units (BHU) of Natal north sanitary district. Fifth-eight questionnaires were applied and using open and closed questions we look for identify the functional characteristics of each BHU, the dentists professional attributions on each BHU, as well as the clinical procedures that they execute. This research also searched to identify the factors that facilitate and/or difficult the inclusion process and the dentists activities performance on these BHUs, as well as the necessary actions to north sanitary district MHTs to fulfill the objectives proposed by FHP. The results point that the inclusion of mouth health actions in north sanitary district FHPs brought the incorporation of new values to the used practices. Whoever, its necessary a more frequent evaluation of the carried actions, in a way they can be adapted to the real community necessities, and, is fundamental the data accompaniment, for that these serve of base for planning and redirecting activities, in a way that we do not have only a reproduction of traditional practices, fragmented and isolated, but a truly substitution of the traditional practices and a new way of promoting health

Conselho Municipal de Saúde de Pedras de Fogo - PB: um estudo sobre participação

The present study aims to understand the process of Participation of the Health Council- CMS in the formularization, implementation and control of the Municipal health plan of Pedras de Fogo, through four criteria of quality of participation considered by Demo (1993): representation, legitimacy, base participation, and self-responsibility. The criteria of representation is related to the quality of politics of the representative over the representings. Legitimacy is related to the politics` quality of the process of participation based on norms and rules that stipulate the participation, the base participation is a necessary political support so that the power authorization directed to the representings can be effective and the self-responsibility refers to the capacity of being responsible when it concerns to the public service or property. Through the descriptive and exploratory study a qualitative method was adopted to consider the conditions of the participation of the twelve council members of the City council of Health of Pedras de Fogo, through a formulated Instrument based on the criteria of DEMO (1993). It was concluded that the quality of the participation of the council members of the CMS of Pedras de Fogo understands essential aspects of the criteria of quality considered by Demo (1993) but it shows fragilities as unfamiliarity with the norms that legitimize the performance of the council; unfamiliarity of its condition of being an agent and the importance of the participation of the base for the reinforcement of its participation, as well as inertia related to the check and rendering of accounts on its performance. This way it makes sense that the participation of the council in the four criteria of quality of politics considered in this paper needs to improve

O idoso e as ações sociais em prol desse grupo etário: um estudo sobre a qualidade de vida na Terceira Idade e o Projeto Saúde e Cidadania na Melhor Idade

The present study regards an applied qualitative social research (descriptive) which approaches the matter between old age and Brazilian social actions performed in social projects, aiming a qualified life and citizenship for this group of age. The objective of the study is to evaluate the contribution of Project Health and Citizenship in Old Age regarding social actions from the government directed to old age individual treatment for life quality improvement. The theoretical fundamentals of this work is, in a first moment, about old age and certain existing theories about aging process, as well as the differences and perspectives that come up throughout this process. In a second moment, some reflections are developed about the relation between life quality and leisure regarding old age, with the conception and historical rescue about these questions, as well as the evidence of leisure as an instrument of well-being feasibility and a better life quality in old age. Then the study contextualizes Brazilian government treatment to old age individuals, cutting off the Constitution of Republic from 1988 and some social attitudes taken by the government in a try to reach this specific group. Finally, the study presents the Project Health and Citizenship in Old Age , as a social program which belongs to extension activities from Federal Center of Technological Education of Rio Grande do Norte (CEFET-RN), which aims old age treatment and their citizenship and life quality. After the application of a semi-structured interview using the technique of Analysis of content for the Analysis and Discussion of Results, it is possible to conclude that the Project Health and Citizenship in Old Age fulfils its objective regarding contribution, through offered leisure activities, for old age well-being and life quality improvement. Hence, on this regard, it is possible to observe the importance and value of government actions, social projects and programs assisting old age individuals, for they are able to provide this group the opportunity to live out activities that allow their citizenship and socialization, regarding well-being and life quality improvement.

A ouvidoria pública como instrumento de controle das ações da Secretaria de Saúde do Pará

The State and Public Administration have gone through several reforms in search of a quick operation and the provision of services with quality. With the democratization of the country and the issue of the Constitution in 1988, further reform of the State and Public Administration, joined the government agenda in 1995 and included among its objectives, the principles of participation and social control. In view of this, it raises the Public Ombudsman in order to be a channel for the participation of users in the management of public affairs, social control, transparency of administrative actions, improving the quality of service and meeting the needs of the community. The aim of this study is to assess whether the Ombudsman of the State Department of Public Health to contribute to the period 2006-2008, for the improvement of specialized consulting services. The research is characterized as descriptive, qualitative approach. The collection technique used was the interview, conducted with 37 service users and two servants of the Ombudsman. The analysis was developed based on the perception of users and servers in the opinion of the Ombudsman. The most relevant results of the research showed that 41% of users search the Ombudsman because they believed that solve the problem presented. However, even with this level of public acceptance, the Ombudsman reached average index of resolvability of 53% in the period. In his role has not developed mechanisms for quality control of services, which is mentioned by 67% of users. It turned out the same fact in relation to popular participation, which is confirmed by 84% of users. For 24% of users, the problems raised were resolved, and of these, 56% believe that the Ombudsman has contributed to the positive outcome. As a result of the search results, it appears that the Ombudsman's SESPA / PA, is not fulfilling its role to ensuring the democratization of articipation in management, social control and has limited contribution to solving the problems of users and to improve the quality of services

Condições de trabalho e saúde na perspectiva de bem-estar um estudo realizado entre os profissionais de saúde da policlínica

This study had like general objective analyzed the relation observed between working conditions and healthy, in the welfare perspective, by the Policilínica Zona Oeste´s healthy professionals. Were used like theoretical bases the categories of working conditions of Borges et al. (2013): working conditions and contractual legal; physical working conditions and materials; working conditions and characteristics of the work processes and working conditions and social management. For the analise of personal wellness in the job, were used the categories of Dessen and Paz (2010): friendship relations, relationship with the organization, growth opportunity, relations with customers , valuation and realization. For this, this research use the descriptive statistic and Bardin (1977) ´s content analysis besides the help of Manyeyes software, using the word clouds and trees words. Was possible identify that the working conditions have strong relations with the health of the health professionals of Policlínica, mainly about the physical and materials conditions that are precarious and influences the other dimensions of working conditions and conditions health. The welfare professionals is spoiled in the dimensions of realization and growth opportunity and influences the professional´s health

Interação competitiva do zinco e ferro após administração oral e venosa de zinco em crianças eutróficas

The aim of this study was to assess the acute and chronic effects of zinc in serum iron profile of children aged 6-9 years in relation to nutritional status and dietary intake. The study participants were 11 children regardless of sex, aged 6-9 years. They were selected from three public schools of the city of Natal, Brazil. Body mass index was used to assess nutritional status. In order to determine the patterns of childhood growth and ideal weight we used the standards of the World Health Organization. The dietary intake assessment was based on information from a three-day prospective food survey. The variables were energy intake, protein, lipids, carbohydrates, fiber, calcium, iron and zinc. All children underwent an intravenous administration of zinc (IVAZn) before and after oral administration of zinc (OAZn) (5 mg Zn / day) for three months. We measured serum iron, hematocrit, hemoglobin and total protein, before and after the use of oral zinc. The analysis of hematocrit, hemoglobin and total protein was performed using standard methods of clinical laboratory. Zinc levels and serum iron were measured by atomic absorption spectrophotometry. The project was evaluated and approved by the Ethics in Research Committee of Federal University of Rio Grande do Norte. Results: All children had normal weight. The consumption of energy, fat, fiber, calcium and iron were below recommended levels. However, the levels of protein and carbohydrates were high. Protein and zinc increased significantly after OAZn. Carbohydrate and protein were elevated in the blood. After OAZn, both protein and zinc increased, being statistically significant. Conclusion: The potential inhibitory effect of physiological or pharmacological doses of zinc on the profile of serum iron was observed in children with healthy weight and aged between 6 and 9 years. This negative effect of zinc did not affect the levels of hematocrit or hemoglobin, and therefore did not cause anemia. This was a multidisciplinary study, involving researchers from medicine, nutrition and pharmacy. This met the requirements of multidisciplinarity of the Post Graduate Program in Health Sciences of Federal University of Rio Grande do Norte.