Protagonismo silencioso: a presença da OPAS na formação de recursos humanos em saúde no Brasil

The aim of this study is to assess the contribution of the Pan American Health Organization (PAHO) to the field of human resources for health in Brazil. The assumption is that this organization not only influenced the development of this field, but but that it was also influenced by Brazilian institutions and by national political movements, through the interaction of its consultants with these movements. Four projects were selected, through which the contribution of PAHO was evaluated: the Program for the Strategic Preparation of Health Personnel (PPREPS), the Project for the Large Scale Formation of Middle and Low Level Personnel (Large Scale Project), the Project for Qualification in the Development of Human Resources in Health (CADRHU) and the Project for the Managerial Development of Basic Units of the National Health System (GERUS). To operacionalize the study, we used three basic complementary procedures: a bibliographic research, documental research and an interview. The time frame considered was from 1975, the year an agreement was signed between PAHO, the Ministry of Health and the Ministry of Education and Culture, establishing PPREPS. It was through this program that the first PAHO team of national human resource consultants was contracted. The period between 1975 and 1999 was marked by political and social movements that changed the course of health in the country; among these was the Movement of Sanitary Reform in Brazil, which culminated in the implementation of the National Health System (SUS). This paper shows the connections of the PAHO consultants with this movement and the implications that this had for the Program of Cooperation in the Development of Human Resources of PAHO/Brazil. It also demonstrates that as the program became contaminated by national movements of health system reorganization and of democratization of Brazilian society, it proposed, in cooperation with national institutions, an organization of determinate areas of operation of these same institutions. The manuscript further reveals that, with the Large Scale Project, the human resources program determined the pedagogical and methodological option that would be the model for various other educational projects undertaken by a number of Brazilian institutions with the technical cooperation of PAHO. And finally, the repercussions and contributions of these projects, which strengthened the the field of human resources in the public health services of the country, are identified. Data analysis was based mainly on the theories of Bourdieu, Gramsci and Freire

Jardim do Seridó: A construção dos espaços públicos na Veneza Seridoense nas primeiras décadas do século XX

As the space and the city are objects of desires, interests, seduction, sedition, appropriations, battles, victories, defeats, require to be analyzed historically. This research investigates and discusses the construction of public spaces in Jardim do Seridó City, backwoods of Rio Rio Grande do Norte, in the first decades of twentieth century, when the municipality was chaired by Heráclio Pires Fernandes, who ruled from 1917 to 1930 and was graduated from the University of Pharmacy of Recife, where he contacted the architectural, political and artistic influences circulating in the capital of Pernambuco. In the first decades of the twentieth century, the space of Jardim earns statements and practices, against the discourse of modernity, which sought to justify the title of Veneza Seridoense . At the time, the city had undergone several transformations in its public spaces through the construction of the Butchery, the Market, the Public Roads connecting the city to other urban centers, the building of the Bridge of the Pedra Lavrada Farm, the Elementary School Antônio de Azevedo , the creation of the Music Band Euterpe Jardinense , the Literary and Recreative Guild, the pavilion, the paving, tree planting, lighting, streets naming and listing of the annual painting of households, the arrival of automobiles, mail and telegraph. The construction of these new sceneries and the arrival of equipments generated impacts in the daily life of the population and were received differentiated ways by individuals involved in the process, which shows the tension between old and new, the relationship between history and space

Impactos sócio-econômicos e ambientais da introdução da Tilápia do Nilo, Oreochromis niloticus, em açudes públicos do semi-árido nordestino, Brasi

The stocking of exotic fish, especially the tilapia, has become a common practice in the public reservoirs of the Brazilian semi-arid region. The stocking of tilapias has had as its main aim the improvement of the fisheries in the reservoirs and consequently the improvement of the socio-economic conditions of the families that have fishing as the main source of income. However, the environmental risks associated with this practice are high and can lead to a loss in aquatic biodiversity and to changes in the quality of the water. The object of this work was to quantify the socio-economic and environmental effects of the introduction of the Nile tilapia in the public reservoirs of the semi-arid northeastern Brazil. The analysis of the fish yield of 100 public reservoirs from 1970 to 2000 demonstrated that the introduction of the Nile tilapia apparently contributed to an increase in the total fish yield from the late 1970 s until the mid-1980 s. Nevertheless, from that time onwards the fish yield in these reservoirs has fallen into decline to levels inferior to those observed prior to the introduction of the tilápia. The analysis of the fishing activity statistics of the Gargalheiras reservoir located in the city of Acari, Rio Grande do Norte, demonstrated that the introduction of the Nile tilapia in the reservoir has not significantly increased the fish yield, the gross overall income, the gross per capita income nor the number of fishermen actively fishing in the reservoir. On the other hand, the analysis of the fishing activity statistics of the Gargalheiras reservoir has revealed a significant reduction in the captures of other commercially important fish species after the introduction of the tilapia. This result suggests that the Nile tilapia could have negatively affected other species of fish in the reservoir, contributing to the decline in their stocks. In order to assess the perception of the fishermen concerning the effects of the Nile tilapia over other species of fish and the quality of the water, questionnaires containing open and multiple choice questions were applied with 30 fishermen from the colony of the Gargalheiras reservoir. The great majority of the local fishermen stated that the tilapia is currently the most important species of fish to those who depend on fishing as a source of income and that they have not caused damage to other species of fish nor to the quality of the water in the reservoir. However, the results of the present work indicate that the alleged socio-economic benefits, employed to justify the introduction of the Nile tilapia in the reservoirs, are overestimated while the environmental impacts of the introduction of this exotic species are underestimated

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

Adaptação sociocultural de gestores espanhóis expatriados no Brasil

This study aims at understanding how sociocultural adjustment occurs in the case of managers, and their spouses, expatriated to Brazil by private and public Spanish organizations. To do so, it adopts as main theoretical frame the expatriate adaptation model proponed by Parker & McEvoy (1993), based on Black, Mendenhall & Oddou s model (1991), which establishes three dimensions of adaptation: adjustment to work; adjustment to general environment and adjustment to interaction with host country nationals. This work, of exploratory and descriptive nature, used field research to gather primary data subsequently analyzed with a qualitative approach. Data collection came from individual in-depth interviews with three Spanish managers expatriated in Brazil and two of their spouses. Resulting data were analyzed through one of content analysis procedures, thematic analysis. This research shows that adjustment is obstructed by cultural distance or cultural novelty rather than by work role characteristics, being more successful in expatriates that carry previous solid sociocultural knowledge about host country. It also verifies that the degree of expatriate adjustment is enhanced by the comprehension of cultural differences that originate values and behaviors different from those of the expatriate. It points out that individual factors such as perception and relation skills, flexibility, empathy and self-efficacy are positively linked to the three dimensions of adjustment: work, general adjustment and interaction adjustment. It finds expatriate adjustment to be lowered by spouse unsuccessful adjustment and shows that location in an environment perceived as short in key infrastructures is negatively linked to adjustment in expatriates coming from strongly urban environments. It concludes that expatriate adjustment occurs through progressive understanding of host country environment and through comprehension of the sociocultural context that explains differences between host country behaviors and values and those from the country of origin, a process which is favored by expatriate individual characteristics not directly linked to his/her technical qualification, such as perception and relation skills, flexibility and empathy, together with solid sociocultural knowledge about the host country. This research propones, therefore, that organizations involved in expatriation processes should include in their selection criteria the degree to which candidates possess personal characteristics and sociocultural knowledge that may facilitate adaptation

A tributação como instrumento de proteção ambiental no Brasil

The Federal Constitution of 1988 gave special treatment to the issue of the environment, raising this diffuse right to the status of a fundamental right. In order to preserve it, the constitutional order is provided with various means to this purpose, including the possibility of using taxation. Several principles both constitutional, as infraconstitucional, support the use of taxation as a legal instrument to protect the environment. There is an intense legal debate about the suitability, characteristics, purposes and principles which underlie and restrict the environmental taxation. Discussions and proposals for reform of the tax system in order to include the ecological aspect at its core have been developed. The use of taxation as a way to fund public expenditures related to environmental causes, promote the internalization of negative externalities and as a way to induce behavior to benefit the environment finds support in the Brazilian legal system. This paper seeks to demonstrate that the national tax system is fully able to act as a tool available to the state for the implementation of the fundamental right to an ecologically balanced environment, whether through the taxes fiscal role or due, mainly, through the phenomenon of extrafiscality. Also, it is intended, through doctrinal, jurisprudential analysis and concrete cases, to investigate whether the tax system can be effective in protecting the environment in the way it is currently constructed, or if there is need to proceed with changes in its structure in order to achieve this goal

Computação em nuvem no governo: caminhos para a formação de uma agenda governamental

This work aims to understand how cloud computing contextualizes the IT government and decision agenda, in the light of the multiple streams model, considering the current status of public IT policies, the dynamics of the agenda setting for the area, the interface between the various institutions, and existing initiatives on the use of cloud computing in government. Therefore, a qualitative study was conducted through interviews with a group of policy makers and the other group consists of IT managers. As analysis technique, this work made use of content analysis and analysis of documents, with some results by word cloud. As regards the main results to overregulation to the area, usually scattered in various agencies of the federal government, which hinders the performance of the managers. Identified a lack of knowledge of standards, government programs, regulations and guidelines. Among these he highlighted a lack of understanding of the TI Maior Program, the lack of effectiveness of the National Broadband Plan in view of the respondents, as well as the influence of Internet Landmark as an element that can jam the advances in the use of computing cloud in the Brazilian government. Also noteworthy is the bureaucratization of the acquisition of goods to IT services, limited, in many cases, technological advances. Regarding the influence of the actors, it was not possible to identify the presence of a political entrepreneur, and it was noticed a lack of political force. Political flow was affected only by changes within the government. Fragmentation was a major factor for the theme of weakening the agenda formation. Information security was questioned by the respondents pointed out that the main limitation coupled with the lack of training of public servants. In terms of benefits, resource economy is highlighted, followed by improving efficiency. Finally, the discussion about cloud computing needs to advance within the public sphere, whereas the international experience is already far advanced, framing cloud computing as a responsible element for the improvement of processes, services and economy of public resources

Desindustrialização no Brasil: teorias e evidências para o debate

This study aims to contribute with evidence to reinforce or not the thesis of a possible deindustrialization of the Brazilian economy, with emphasis on period after 1995. The debate began in the late 80s, however, recently the industry deceleration gained strength in discussions academic. Between the main theses in this debate is the new-development that believes in precocious deindustrialization caused primarily by overvaluation exchange rate. However, part of heterodoxy believes the industry downturn is more related to the rate of investment than the exchange rate. Nevertheless, according to the orthodox thesis the loss of competitiveness due to the high cost of production may have caused the de-industrialization in Brazil. On the other hand, part of Orthodoxy does not believe that the country is deindustrializing it, but is occurring convergence of Brazilian industry the world average. Thus, in an attempt to shed light on this debate, this study intends to identify the reasons for the deceleration of the Brazilian industry, emphasizing aspects underexplored in the literature and define whether or not the country suffers a process of deindustrialization. When analyzing various indicators, especially the quantum level we find strong indications that the deceleration of the Brazilian industry can be characterized as a deindustrialization, though still insufficient to qualify as precocious, given the loss of share in physical production in total output and the share of primary goods in the export basket

O papel da violência interpessoal compreendida como a manifestação de uma endemia social: uma análise geográfica sobre o fenômeno no Brasil e Rio Grande do Norte

En Brasil, la violencia interpersonal (homicidios) se ha incrementado de forma significativa, convirtiéndose en una preocupación cada vez mayor en todos los ámbitos políticos de la sociedad. Hoy es uno de los más graves problemas sociales y de salud pública. Se refiere a los problemas sociales, ya que interfiere en la distribución de la oferta de bienes y servicios a los ciudadanos; sino también un problema de salud, porque la violencia es uno de los fenómenos que causan gran impacto en la morbilidad y mortalidad del país, y genera un alto costo para el Sistema Único de Saúde (SUS). Esta es una crisis social, que es el resultado de un mundo capitalista globalizado, que exige a todos sus instrumentos de dominación (dinero, poder y competitividad en estado puro), en virtud del cual la violencia y los conflictos interpersonales se materializan en el territorio. El Río Grande do Norte (RN) ha estado siguiendo esta realidad que es nacional, con el aumento de las tasas de mortalidad por homicidios. En este sentido, este estudio tuvo como objetivo analizar la violencia interpersonal (agresión / homicidio), en Brasil y en el estado del RN, para entender cómo esto afecta a su población, en la morbilidad y mortalidad durante los años 2001 a 2011. Para ambos hicimos uso de método descriptivo / cuantitativo para determinar la magnitud, el tamaño, el perfil de las víctimas y los costos del SUS generados por el problema. Como resultado, podemos diagnosticar que en Brasil, la violencia se ha presentado una nueva dinámica regional, promovida por un proceso de interiorización del fenómeno en todo el país, este proceso de internalización se ha reflejado en la última década, el crecimiento de la violencia en el estado del RN, que ha causado un gran impacto en las tasas de la mortalidad del estado. Acerca la victimización, se puede ver que hay un perfil vulnerable formado por, varón, baja instrucción joven, sola y negro. Con respecto a los datos de morbilidad hospitalaria, la demanda creciente del fenómeno genera costes para el sistema de salud, y las graves consecuencias humanas, como la escalada del miedo y la destrucción de una generación de jóvenes brasileños. Por lo tanto, la falta de una política pública para afrontamiento, prevención y mitigación del problema revela el fracaso de la gestión pública, con consecuencias sociales y de salud, tanto individual como colectivamente.

Um percurso sobre o patrimônio e a morfologia urbana do centro de Fortaleza-CE

The incursion into the historical area from Fortaleza´s downtown presents reminiscences of a heritage collection that can be recognized as city built heritage, in architectural and urban aspects. The neighborhood has in its urban tracing a synthesis of the various phases from the Brazilian architecture materialized in its tracing and built goods. This composition mainly covers the eclectic production, passing the time of art déco, including the period of modern production. This paper aims to identify the existing heritage collection. This study aims to identify the existing net assets, the temporality and spatiality that allow to recreate the neighborhood´s form urbain history. Based on the theoretical and methodological support of the urban morphology urban of authors such as Aldo Rossi (1966), Gordon Cullen (1971), José Lamas (1990), Kevin Lynch (1960), and Philippe Panerai (1999) was allowed on a predefined route, to build part of urban memory of Fortaleza. The historical and morphological study runs through a sequenced analysis developed on the articulated subsets, formed by the network neighborhood squares: Praça José de Alencar, Praça Capistrano de Abreu (Lagoinha), Praça Clóvis Beviláquia, Praça do Carmo, Praça Murilo Borges (BNB), Praça Coração de Jesus, Parque das Crianças, Praça do Riacho Pajeú, Praça dos Voluntários (Polícia), Praça do Ferreira, Praça Waldemar Falcão (Correios), Praça General Tibúrcio (Leões), Praça Figueira de Melo, Bosque Dom Delgado (Pajeú), Praça Cristo Redentor, Praça Caio Prado (Sé), Praça dos Mártires (Passeio Público), e Praça Castro Carreira (Estação). Separated the neighborhood based on this square system because it is perceived that there is in these public spaces a path which includes a portion of the urban history of Fortaleza. In addition to this there is a higher concentration of goods in its area in relation to others sectors of the neighborhood, where the loss of the characterization is an imperative of the urban set. In order to find this network of public spaces contained in the study area were proposed two routes based on the city limits of 1875 established by Adolfo Herbster (Fortaleza´s city plan).The path starts by known boulevards (Imperador, Duque de Caxias and Dom Manuel avenues) and the seafront. The study is grounded in the literature review, document and empirical theme, consisting of an overlay of maps, drawings and photographic collection that ratify this net assets as both architectural urban nowadays. Among the results, it was observed that before a current context of loss of locus of the concept of historical-cultural agglomerated, the squares express the strongholds of equity ambience that perhaps stand in urban morphology of the capital from Ceará.

Preceptoria em profissionais de saúde: viabilizando meios para uma formação pedagógica em hospitais públicos em Natal-RN

This study aimed to construct and carry out a distance course of pedagogical training for health professional performing preceptorship functions in public health institutions. The preceptorship in health is a pedagogical practice that occurs in workplace, led by assistance professionals with teaching position or not, where the vast majority of these acts intuitively, reproducing their own training, confusing transmitting information with education. These preceptors often do not dominate the pedagogical knowledge, necessary for the organization of training activities, such as the various teaching-learning processes and the different assessment types. Student supervision is essential in the training process of students in the health field, and on the occasion of supervised internships that the teaching-learning process is based on practical experience with participation in real life situations and professional work. It was realized an exploratory study, descriptive with qualitative approach, with the development of tutoring teaching course in health as final product. Applied semi structured research instrument from may to july 2014. It were evaluated 162 health professionals who perform the preceptorship, which made it possible define the preceptor's profile and identify the educational requirements related to the educational process, which justified the construction of the program content and the professionals’ perception analysis about preceptorship through identification of three categories: clinic knowledge valuation; valuation of professional orientation and valuation of professional future. The course was available on distance mode through Moodle platform with forty hours of work load from October to November 2014. With the aim of capacitate the health professionals to development of necessary abilities and skills to tutoring performance through thoughts about tutoring concepts, professional training within the curricular guidelines and SUS precepts, the role of health professionals as educators, application of active teaching methodologies, and evaluation methods. The applications were done online through the provided link; 300 vacancies offered, 243 professionals applied, chosen 134 that works on tutoring, where 49 represented professionals that works on the location of the study. The course lasted 45 days, and counted with tutors responsible to interact and evaluate the students. 28 professionals joined the course, 12 concluded. Opportunities were identified to stimulate the involvement, however the professionals’ satisfaction shows that, make an investment on tutors education, starting from the Permanent Education precepts, will provide a bigger appropriation of the knowledge to the education and therefore the awareness of their role as an educator on work ambit, proportioning essential tools to tutors act while enabler of integration between theory and practice and result better teaching-learning process.

Trabalho e saúde: análise da relação entre condições de trabalho e motivação no emprego e suas interfaces com a saúde dos profissionais nos hospitais públicos

Health results from the interaction of biological, social, economic, political and cultural factors. Under this perspective, we aim to analyze the relationship among working in public emergency hospitals and the health-sickness of the professionals who work there. We are based in a quantitative and qualitative research, in which 240 health professionals (doctors, nurses, social workers, psychologists, dentists, nutritionists, audiologists, physiotherapists and occupational therapists) answered a survey. All of them recognize the importance of work to guarantee favorable conditions to good health. However, they highlight its physical and mental wear effects on workers like stress, absence of a healthy life-style, high blood pressure, musculoskeletal, gastrointestinal and sleep disorders. It becomes urgent to face this reality, to enhance professionals' health and, consequently, the quality of user’s assistance, since the illness of health workers is strongly correlated with the existing health model in society.

Gastos públicos em educação municipal: uma análise da eficiência-custo na gestão dos recursos no ensino fundamental no estado do Rio Grande do Norte

This study evaluates the cost effectiveness of municipalities in the state of Rio Grande do Norte in the execution of spending in basic education carried out in 2011, as well as analyze the determinants of the inefficiency of the same. For this, we used two methodological approaches (i) stochastic frontier cost, and (ii) analyze data envelopment (DEA), which allows to identify the efficient frontier of the municipalities analyzed non-parametrically. Results show that municipalities under review achieved low efficiency rates in the stochastic frontier cost, while the DEA method they achieved higher rates where nineteen among them reached full efficiency. The results suggest that a significant portion of the Potiguar municipalities should review its administrative practices, especially the means of allocation of resources. In regard to determining the efficiency observed distinct results by the two methods.

Arquitetura, cidade e território no Brasil colonial: a contribuição dos carmelitas calçados da Bahia e Pernambuco (1580-1800)

This study investigates the religious group named 'shoe wearing carmelites' (or Calced Carmelites) from Brazil´s Order of Carmo, from 1580 until 1800, in the Capitaincy of Bahia de Todos os Santos (Recôncavo, city of Salvador and Sergipe) and in the Capitaincy of Pernambuco (Alagoas, Pernambuco and Itamaracá). The study does not include the religious group known as the 'Reformed' Carmelites from Goiana, Recife and Paraíba convents. The Order of Carmo is a religious order from the Roman Catholic Church, founded in the 12th century. By the 16th century they were split into 'Calced' and 'Discalced'. In 1580 the Calced ones came from Portugal to Brazil, built convents in urban areas and were able to acquire slaves, farms and other assets. As any other religious order, the Carmelites had their modus operandi. This work emphasizes the way they operated or acted in the city, either individually or in association with other Carmelite religious foundations elsewhere (networking). Their action affected, although indirectly, the building of some specific aspects of the architecture, the city and the territory in colonial Brazil. The main objective of this study is to demonstrate the impact of the Calced Carmelites from Bahia and Pernambuco upon the territory of colonial Brazil, which is analyzed according to three scales: 1) the region or interurban; 2) the city or intraurban; 3) the building or the architecture. The research employs the comparative method of analysis, especially for the architectural scale. The work demonstrates that although not acting as architects or urbanists, the Carmelites contributed to the formation of the colonial territory of Brazil, behaving as a well-articulated and hierarchized religious network, from an economic and social perspective. Moreover, they influenced the emergence and growth of several colonial urban nuclei, from Bahia to Pernambuco, mainly in the surroundings of their religious buildings. Finally, it is very clear this religious order’s contribution to colonial architecture, as it can be seen by the architectural characteristics of the convents and churches which have been analyzed, many of which still stand in a good state of conservation nowadays.

A produção do cuidado no período gravídico-puerperal: experiência de mulheres usuárias de serviços públicos de saúde

Despite numerous government projects aimed at reorganizing and qualifying obstetric and neonatal care in Brazil, it remains problematic, with repercussions for maternal and newborn mortality and humanized care of both the mother and child. The objective of this study was to analyze the care provided to women during the pregnancy-puerperium cycle, based on reports of public health service users regarding their pregnancy and delivery experiences, using comprehensiveness and humanization as reference. The study applied a qualitative approach and the methodological strategy consisted of listening to the women, in order to identify, based on the meanings of their discourse concerning their experiences with health services, continuities and discontinuities of care during the pregnancy-puerperium cycle. Study participants were women who gave birth at a municipal public maternity, residents of Natal, Brazil, who at the time of the interviews, were between 10 and 42 days postpartum. Seven women reported their pregnancy and delivery experiences at public services. As interviews and observation took place, the material produced was also analyzed, in order to achieve simultaneous production and data analysis. Using systematization, a dialogue was established between the women’s discourses and production in the field of Collective Health, with respect to concepts and discussion about obstetric and neonatal care as well as the Comprehensiveness and Humanization of such care. Participant discourses underscored aspects related to prenatal care starting at pregnancy and its repercussions as well as prenatal monitoring by health services; aspects associated with care during labor and delivery, as well as those involved in postpartum in the maternity, both with respect to newborn and maternal careç and lastly, puerperium care after discharge from the maternity. Analysis of results sought to identify lines of continuity and discontinuity in the comprehensiveness and humanization of care. Based on these lines and as final contributions of the study, the following paths were proposed to achieve comprehensive and humanized production of health care for women during the pregnancy-puerperium cycle: Path 1- Reassess care in the maternal and newborn health network, aimed at comprehensiveness in terms of guaranteeing access to the various services and technological resources available to enhance health and life. Path 2- Reorganize work processes in order to attain comprehensive and humanized care for women in the pregnancy-puerperium cycle. Path 3 – Qualify the professional-user relationship in care management during the pregnancy-puerperium cycle. Path 4 – Invest in the qualification of communication processes in the different dimensions of care during the pregnancy-puerperium cycle.