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

Avaliação da educação física na escola: análise de uma proposta de intervenção

El presente estudio tiene como tema principal el debate sobre la evaluación de la escuela, específicamente la evaluación de la enseñanza y el aprendizaje de la educación física en la escuela. Presenta las tendencias pedagógicas que influyeron en los modelos de valoración de la educación en general y específicamente determinados que el proceso de evaluación en la escuela de educación física. Analiza la evaluación en educación física de una experiencia de enseñanza en la escuela pública. Para ello, hemos desarrollado la siguiente pregunta: ¿cuáles son las posibilidades de evaluación en Educación Física, teniendo en cuenta su significado y sus implicaciones en el proceso de enseñanza-aprendizaje que experimentan los estudiantes? Ya que era un problema se guían la reflexión sobre nuestra práctica docente, hablamos de la evaluación en Educación Física de cinco cuestiones esenciales para nuestra consideración, a saber: ¿para qué evaluar (razones) para evaluar la (las dimensiones del contenido ), al evaluar (momentos) se evalúa (estrategias metodológicas), que evalúa (responsable de la evaluación)? En este sentido, este estudio tuvo como objetivo discutir el proceso de evaluación en Educación Física, al reflexionar sobre su significado y sus implicaciones pedagógicas en la enseñanza y el aprendizaje de la educación física, y guiado por el informe de una experiencia de aprendizaje experiencia en una clase de 6 º y 7 º grado de la escuela primaria Escuela Fernandes Arcelina Estado, ubicado en la ciudad de Macaíba / RN. Hemos encontrado en este estudio que es la evaluación de la escuela es un proceso complejo determinado por muchos factores sociales,. Jurídica, cultural, estructural, y que sea útil para repensar el proceso de enseñanza-aprendizaje y su propia práctica docente También creemos que nuestro estudio se revela como una evaluación metodológica de las posibilidades. En ella, que se encuentra es posible evaluar en Educación Física que estudia no sólo los resultados de aprendizaje de los contenidos técnicos, habilidades y destrezas motrices, sino que nos permite analizar el rendimiento de los estudiantes en otras dimensiones de la integridad humana, como la las actitudes (valores), los conceptos, los aspectos afectivos y sociales

O trabalho do gestor escolar: intensificação e implicações administrativas e pedagógicas na gestão da escola

Analyze the work of the school manager who now faces the changes experienced in school management for the last two decades. We propose that there have been changes in school management that have generated a larger number of activities to be developed by managers, causing both the intensification of work and a greater involvement of professionals in the financial-administrative dimension of their work in opposition to the political and pedagogical dimension. This study has a historic-critic approach. That is why we performed semi-structured interviews with school managers of the city schools in Natal RN, BR as a methodological procedure. We also analyzed the literature as well as the documentation relevant to this subject. From the study it was possible to conclude that changes in the field of school management and also teaching have led to an intensification of work of school managers and that such changes have not been followed by corresponding improvement in working conditions and teaching career of these professionals. They, as a rule, are considered by controlling agencies and by the school community as the primarily responsible for the school condition and for creating actions or projects that may improve the institutional objectives and results, including even the maintenance of the institution. Moreover, the growing number of administrative activities represents for obvious reasons extra work for these managers, who, when trying to cope with the growing bureaucratic situations, end up misplacing other political and educational aspects of school work, which may undermine the final purpose of school itself. We stress that we must broaden the discussions on the functions of the school manager, so that this worker can actualize a pedagogical project more committed to an emancipatory nature, despite all the challenge in keeping the school running in often-precarious conditions

Experienciando a ausência do companheiro nas consultas de pré-natal

This research aimed to understand pregnant general meaning about consort absence in prenatal care. It s an exploratory and descriptive qualitative approach, developed at Centro de Saúde de Jardim Lola, São Gonçalo do Amarante / RN. Participated in investigation 20 pregnant enrolled in prenatal program, their aged over 18 years, guidance of mental faculties and who survive together her partner. Data were collected from March to May 2009, through semi-structured interview. The analysis was processed according to grounded theory and symbolic interactionism as theoretical and methodological references. To support discussions were used literature findings involving political aspects of women humanization in health care and gender relations within family. Following footsteps of points it were adopted derived following sub categories: ¨Realizing involvement of consort during prenatal¨, ¨Expressing feelings during prenatal¨ and ¨Manifesting attitudes during prenatal period¨. These, when they had their properties and dimensions analyzed, resulted in the main category ¨ Experiencing absence of compeer in clinical prenatal¨. The construction of this theory leads to conclusion that women understand absence of her partner, attributing this to even work at the moment prenatal care or does not like to attend health institutions. However, this does not mean that his presence is dismissed, because desire to be with him in prenatal care was mentioned by most interviewees. So, partner absent at time, leads women to experience desires, feelings, attitudes, perceptions and expectations about studied phenomenon. This reality, induce that absence of them partner in prenatal care predisposes women to strengthening of discomforts arising from pregnancy and therefore goes against wellbeing of pregnant, and ensure the possibility of marital discord. This requires professional nursing measures to get in inclusion of partner in daily pre-natal care in humanization perspective.

O cuidar de enfermagem e da família à pessoa idosa no domicílio: uma abordagem etnográfica

O envelhecimento é um processo multidimensional que envolve entre outros os aspectos físico-biológicos, sociais, econômicos e psicológicos. Ao avaliar essa fase da vida dentro de uma visão social e cultural, percebe-se que ser idoso ou não varia com as concepções culturais, sendo necessário investigar as variações que atuam no processo e rege o fenômeno sociocultural da realidade em que se está inserido. Com o aumento da população idosa mundial, esse processo tende a se intensificar. Estima-se que até em 2050 existam cerca de dois bilhões de pessoas com mais de 60 anos no mundo, e a maioria delas vivendo em países em desenvolvimento. No Brasil, acredita-se que existam, atualmente, cerca de 20 milhões de idosos. A normatização e legislação brasileira de amparo ao idoso em relação à saúde iniciaram-se a partir da Constituição Federal de 1988 e da Lei 8080 que regulamenta o Sistema Único de Saúde em 1990, em seus níveis de complexidade: atenção básica, média e alta complexidade. Para auxiliar nessa prestação dos serviços na atenção básica de saúde é importante observar as condições sociais, culturais, econômicas e de saúde dos idosos e seus familiares. Nesse sentido, a visita ao domicílio e a avaliação deste idoso em seu ambiente doméstico torna-se fundamental para acompanhar o cuidar prestado e o quanto esse processo irá interferir no sistema de saúde, na família e na qualidade de vida dos idosos. Neste contexto, o enfermeiro como integrante da Equipe de Saúde da Família, presta assistência à saúde do idoso no domicílio. Nesse sentido, o objetivo do estudo é analisar o cuidado de enfermagem e da família à pessoa idosa no domicílio com vistas à identificação das influências socioculturais. Trata-se de um estudo do tipo descritivo e de abordagem qualitativa, norteados por princípios teórico-metodológicos da etnografia com vistas ao estudo da influência dos aspectos culturais e sociais na assistência da família e do enfermeiro à idosos em domicílio. Foi realizado no município de Santana do Matos, RN, tendo como participantes, idosos, familiares e enfermeiros da equipe da ESF, definidos a partir da população do município e obtendo-se uma amostra intencional de 25 participantes: 6 enfermeiras, 10 idosos e 9 grupos familiares. Para a coleta de informações, utilizou-se observação, entrevista, diário de campo e grupo focal. Os resultados foram apresentados em forma de narrativa descritiva, na perspectiva dos conceitos de Boris Cyrulnik, com análise interpretativa cultural de Geertz, na busca dos significados e símbolos próprios da cultura da velhice de idosos e dos seus familiares, sobre cuidados que são realizados, tanto pela família, como pelos enfermeiros em domicílio. Observou-se que a família e o cuidador, dentro de sua realidade social e cultural, precisam ser mais compreendidos pela equipe de saúde para ser melhor orientados e capacitados na realização do cuidar de forma adequada. Por sua vez, os profissionais de saúde, em especial o enfermeiro, enfrentam dificuldades para realizar o cuidado ao idoso no domicílio como a grande demanda de atribuições na unidade de saúde como consultas e atendimentos; falta de transporte até os domicílios; extensão territorial do município e das áreas assistidas; número de pessoas atendidas por cada equipe; falta de compreensão dos profissionais de saúde quanto à importância da visita domiciliária na atenção básica. Entendem a necessidade de realizar ações de promoção em saúde, prevenção de agravos e de educação em saúde, além de reconhecerem a importância de uma melhor formação acadêmica para atuar nessa perspectiva e contribuírem para as mudanças necessárias na prática dos cuidados ao idoso em domicílio

Diagnóstico sócio-produtivo-econômico da comunidade de catadores de resíduos sólidos do município de Codó-MA: um estudo de caso

The research was carried out in the urban area in Codó-MA, a small city the east part of Maranhão, which has 4,228.000 km2 (IBGE, 2000) and population of 113,768 hab. (IBGE, 2008). The city is also inside Codó-MA micro-region. The city is located in one of the lacking area in Brazil, where the Human Development Index (IDH) is approximately 0,558. It does not present an adequate model of management when talking about solid residue collecting. All of the solid residue produced and collected in the city is stored in an open area that they call lixão , which is located in a residence area in the suburbs. Because of that, a problem that involves public health and environmental areas, we understand it is necessary to investigate the way the local government treats and manages the solid residue collecting, as well as, the social, economical and productive reality of those who are directly involved in the collecting itself, its productive chain of the material, including the handling, transportation and its final destiny. It means a social, productive, economical diagnosis, that in a such way,the local society and the organs of inspection can act in a better way to control the problems that include solid urban residue and come from a bad administration. That way, this work proposes to carry out a study that has as result a diagnosis with feasible alternatives on management, taking as basis, social and economical aspects that compound this productive chain. This work can bring great contributions to a better local reality through the introduction of an integrated and supported system of management of solid residue that includes a selective collecting and the creation of a sanitary area. Taking that into consideration, we can contribute to minimize the environmental impacts in Codó Novo, caused by the garbage

Por uma "cidade nova": apropriação e uso do solo urbano no terceiro bairro de Natal (1901-1929)

This research aimed to analyze the forms of ownership and use of urban land in Cidade Nova, third official neighborhood of Natal (Rio Grande do Norte), between 1901 and 1929. During this period, the city and state authorities began an urban renewal, trying to transform the city, represent it as a new, modernized, able to track the progress and the new political condition of the capital of a republican state. It is observed in Cidade Nova construction of a new material and symbolic territory: the area that was once occupied by huts built by refugees of drought and some summer houses, was, from 1901, transformed, scanned through a urban plan. In Natal various municipal resolutions published between 1901-1929, showed the desires of the group leader to build on Cidade Nova neighborhood a delightful, modernized its structures to reflect the new political condition of the capital of a republican state. The analyzes of the edicts of the materials published in the newspapers A Republica and Diário do Natal, and especially the study of letters of aforamento, demonstrated how many laws were not enforced or resignified, highlighting the existing continuities. Thus, throughout the paper aims to examine how this territory was occupied and used by its inhabitants, such as the granting of land in aforamento may exemplify this practice and noncompliance and how the land was used to consolidate relations of influence and power. After all, the values given to a space, turning it into territory, resulting from the social dimension of this space, in other words, the social categories that use it. Cannot be, therefore, analyze the ways of appropriation and use of urban land in the third neighborhood of Natal without studying individuals who appropriated and used this territory. The study of the allocation of extant aforamentos of land located in this neighborhood process demonstrated the formation of a specific type of market that were at stake not only economic exchanges, but also, and above all symbolic exchanges involving political and social capital. The analysis of such personnel developed market with the lands of Cidade Nova may indicate the existing relations of power between state government, Stewardship and tenants, providing a significant example of this modernization Natal early twentieth century process, guided by a more wealthy group and influential and characterized by limited social changes

Trabalhadores por conta própria: O trabalho dos vendedores ambulantes da passarela do Natal shopping e do Via Direta

This study aid to understand the work conditions of street vendors located on the sidewalks of two malls in Brazil Northeast Natal / RN - Both malls Natal Shopping and Via Direta, to analyze their inclusion in the informal economy and to study the supposed autonomy provided by work as self-employment in its both aspects economic and social analyzing the importance on the condition of "masters of their own business" has for the street vendors, as an alternative to not submission to the figure of the boss, that represents the exploitation of one class over another. The theoretical and methodological aspects that support this study was aimed in discussion on the restructuring of production, considering its effects on the world of work, pointing to unemployment as one of the potencies element of excluded processes that exciting workers to engage in the informal market. Informality is presented as a survival strategy and as integrating part of the reproduction of capital. This research was conducted under a critical perspective, whish has been utilized quantitative and qualitative analyses. The results of this study format questions that provided during the research process the socio-economic characterization of workers, main cause of this study, and how street vendors expres their status of workers as self-employed for their work, and the perception that they have on their form of inclusion in the informal market.

Similitudes na gestão dos resíduos sólidos urbanos em países centrais e periféricos

A emergência na necessidade de se manejar os resíduos sólidos urbanos leva as administrações públicas em países centrais e periféricos a utilizarem modelos de gestão de resíduos bastante similares. A gestão dos resíduos nos países centrais é caracterizada pela eficiência na execução dos serviços (limpeza, coleta, transporte e destino final), uso de aparatos tecnológicos na execução de ditos serviços e forte tradição na separação dos materiais recicláveis a ser destinados para a reciclagem. Nos países periféricos, a gestão tradicional (coletar e descartar resíduos em lixões à céu aberto) vem sendo substituída pela gestão moderna, sobressaindo-se o controle dos resíduos em detrimento das estratégias de prevenção. Também, destaca-se a presença de trabalhadores informais que coletam e separam materiais, destinando-os à reciclagem. A partir do levantamento à referência bibliográfica especializada e na consulta a documentos oficiais e produzidos por entidades diversas, o presente artigo analisa as similitudes na gestão dos resíduos sólidos em países centrais e periféricos. A busca pela modernização nos serviços dos resíduos sem levar em conta as recomendações de documentos como a Agenda 21 caracteriza a gestão dos resíduos em países centrais e periféricos pelo ambientalismo econômico, no qual as ações de controle dos resíduos são justificadas pelos aspectos ambientais e sociais dessa gestão

A influência do conforto luminoso na satisfação dos profissionais que atuam no ginásio do Centro de Reabilitação Infantil, Natal-RN

This study addresses the environmental quality in therapeutic spaces for children's rehabilitation. The assumption that space is active and interfere in interpersonal relationships, highlights the importance of natural light to the hospital architecture, to foster the creation of environments that encourage and assist in the recovery of patients in the rehabilitation process. Therefore, interferes with health humanization through positive actions in the physiological and emotional effects of natural light, as facilitators of the health recovery process. In Brazil hospital openings systems projects are built exclusively to follow requirements of the local construction code which do not consider the landscape, but only ventilation and heat stroke; and the luminance levels are treated just as recommendations for artificial lighting. The National Policy for Healthcare Humanization presents the environmental comfort as a priority. However, it does not guidelines for achieving it. In this context this research aims to evaluate the lighting comfort in infant therapeutic areas from the professional satisfaction, in order to identify human preferences on the variables: technical and constructive aspects, relationship with the exterior, internal visual interface and quality elements. With this purpose it was adopted as research strategy the Post-Occupancy Evaluation (Technical Functional) through a multi method approach, which included a case study in the rehabilitation gym of Children Rehabilitation Center, at Natal, Rio Grande do Norte, and a reference study at SARAH Rehabilitation Center, Fortaleza Unit at Ceará, both in Brazil northeast. The results indicate that the definition of openings systems should consider external and internal factors to the building, as the natural landscape, the immediate surroundings and activities to be performed. The POE found out the preference of the professional visual privacy in detriment to other analyzed aspects. Thus, it is expected that this study can contribute to the discussion of luminous quality and generate inputs for future projects or renovations in the Children's Rehabilitation Centers, which should not be projected as hospitals

História oral de vida de pessoas com úlcera venosa nos serviços de atenção primária à saúde

The Chronic Venous insufficiency is characterized as a set of physical changes including how most serious complication of venous ulcers, characterized by irregular and progressive loss of continuity of the skin. The occurrence of venous ulcers in people with chronic venous insufficiency generates dependence on them with health services, with long-term treatments that cause limitations and high-impact changes, affecting their quality of life, affecting the physical, psychological, social, cultural and spiritual as an important public health problem. This study aimed to describe the experience of having a venous ulcer, in the scenario of primary health care services to Health, which includes Primary Care Units and Family Health Strategy in the city of Natal / RN, based on the life histories of users. This is a qualitative study, exploratory and descriptive, with the Oral History of Life as a methodological framework. From the ponto zero was the recruitment of participants who formed the network, totaling six employees, of both sexes and aged between 57 and 79 years. After approval by the Research Ethics Committee - UFRN under the Protocol 653 788/2014 and CAAE 30408014.0.0000.5537 was held data collection, between the months of July and August, through interviews, using identification and characterization of the instrument employees and open questions. Interviews were recorded, transcribed, transcriadas and returned to employees for a conference. The narratives were subjected to Content thematic analysis technique, according to Bardin, allowing the construction of three themes that encompass categories, namely: Axis I - Perspectives on the changes: the impact wound in social relations (changes with ulcer venous, venous ulcer and social and family relationships); Axis II - Brands in body and soul: the story of being hurt (conceptions of the body injured; therapeutic itinerary in primary care services); and Axis III - Reconstruction of being hurt: coping mechanisms (redefinition of the wounded body, resilience to chronic wound). The impact of having a chronic venous ulcer generates impact of physical, psychological and social order. As aspects related to changes after the appearance of venous ulcers, survey participants reported the presence of pain, physical limitations, psychological distress, social and emotional isolation, incapacity, aesthetic discomfort and dependency on health services; the family was the aspect thatshowed no significant change after the occurrence of wound for most participants, an ally in the therapeutic process as a support network. The redefinition of the body and the wound are the main coping mechanism of chronic condition. The services in the Primary Care Network play a fundamental role in the rehabilitation of patients with venous ulcers, although there are difficulties in accessing appropriate treatment and need for expanded services, with permanent professional training of health teams and providing the resources managers to strengthen the comprehensive care of people with venous ulcers in Health Primary Care.

Sanitarismo e planejamento urbano: a trajetória das propostas urbanísticas para Natal entre 1935 e 1969

The Escritório Saturnino de Brito (Saturnino de Brito Office), created in 1920 under the sanitaristic guidance of the engineer Saturnino de Brito, has a vast record of works throughout the whole national territory, even after the death of its founder, in 1929 at which point his son, and also engineer, Saturnino de Brito Filho, assumed the head of the company , with a compromise to continue his father s work and assure his administrative, technical and urbanistic principles up until the early 1980s, when that institution came to an end. The scarcity of theorical studies about this Office, alongside the importance of the contributions it made in countless cities, oriented the focus of this study on its performance in Natal, where it remained from 1935 to 1969, designing, executing and managing sanitationist works and the services associated with them and going through several political, economical, social, cultural and urbanistic contexts periodicized in this work into three moments. Thus, it is intended to analyze how the Saturnino de Brito Office behaved and adapted itself to the conjunctural changes that unfolded into each of these moments, and more specifically, to observe the forms of intervention adopted the principles, the instruments and the scope aiming to verify the transition of the sanitaristic set of urbanistic ideas into the urban planning as a development strategy on a local level

Alguns aspectos sobre o processo da democratização dos sistemas políticos no mundo árabe :Egito e Líbano como modelos de estudo

The World has tried diverse democratic waves at distinct moments. Some nations have adopted the idea of the democracy for years; others have not yet and other ones are still in a slow process of transition. The field of studies on the Arabian political systems has testified since the last quarter of 20th century a notorious development. This advance disclosed in the existence of a set of trends that has turned around a number of concepts and main theoretical frames such as the political pluralism and the democratic transition and the civil society and its relation with the State. The speech on the process of democratic transition consists in part in the capture and the analysis of the role of the forces and the organizations of the civil society in this process. The peculiarities of the Arab World excite questions concerning the establishment of one governmental system in this universe in the mold of that one that develops with hegemony in the Occident, which has become an interesting field of inquiries for the Political Science. This study comprises the analysis of some aspects of the political situation in the Arab World towards the process of democratization in which Egypt and Lebanon are models of study. Thus the theoretical basis of the term democracy is introduced, presenting different considerations about this expression, since the sprouting of the term until its current conception; later the civil society is analyzed as well as the systems of the political parties and the electoral systems of both countries in attempt to identify the level of democratization existing there and also to find the possible ways to magnify the democratic horizons

Aspectos sociais e de saúde de portadores da coinfecção hiv/tuberculose

Objetivou-se avaliar os aspectos sociais e de saúde e a percepção diante do diagnóstico de indivíduos com a coinfecção HIV/tuberculose. Estudo descritivo, com abordagem quantiqualitativa, realizado em hospital de referência em Fortaleza, Ceará, de janeiro a abril de 2009, utilizando-se entrevista semiestruturada em ambiente privativo. Os dados foram analisados de modo descritivo e por análise de conteúdo. Participaram 16 pacientes com coinfecção HIV/tuberculose, 56,25% do sexo masculino, com faixa etária predominante entre 31 a 39 anos (43,75%), com pouca escolaridade e renda familiar mensal de aproximadamente um salário mínimo. A forma predominante da apresentação da tuberculose foi a pulmonar (62,50%). A percepção sobre a descoberta da coinfecção foi demonstrada por duas categorias: Medo e angústia face ao diagnóstico e Mudanças nos hábitos de saúde e no estilo de vida. Urge, diante dos achados, a promoção do bem-estar psicológico e físico desses pacientes, por meio de ações políticas e de saúde

Calçadas invisíveis: aspectos do passeio público, em Natal-RN, como projeção de uma cidadania ausente

This study has as a goal to establish a relationship between public sidewalk characteristics of Lagoa Nova District (neighborhood), in Natal and the kind of citizens whose constructions and maintenance layouts reflects. It‟s understood here as public sidewalk, specifically, the place reserved for passers-by traffic, located between public lots and vehicles pavements. It‟s a concern to make a brief survey about the occupation of this particular region and a detailed description over physical characteristic of its sidewalks that shows several obstacles for passers-by accessibility, trying to find possible factors that explain the problematic format , once, at the first sight, most of accessibility of passers-by is compromised. It‟ also, searched, local population thoughts regarding occupation notions about this environment, just like as cultural, political and economical aspects that might influence upon snatching these hybrid places located between private and public border line. It‟s confirmed that the nowadays sidewalks‟ shapes is not only citizenship reflection or a lack of it but shows it as an active agent related with the construction of this set of fundamental rights and duties vital for harmonical co-living local citizens