Hospital humano: etnografia da humanização hospitalar na perspectiva de usuários

This ethnographic work studies the experiences of patients admitted in public (PUH) and private (PRH) hospitals in the Brazilian northeastern region. 28 adult patients of different clinics participated in the study. Data were analyzed by the patient path method, consisting in a combination of complemented and articulated techniques free observation, participating observation, ethnographic interview and patient testimonials collected prospectively during the patients admissions, from their arrival and until their discharge. The analysis was carried out according to the Thematic Categories Analysis Technique and the data were interpreted pursuant to medical anthropology, healthcare humanization and healthcare promotion theoretical references. The ethical principles of Resolution 196/96 were followed. The human hospital, as revealed by the patient, highlights the significance of subjectivity. 225 (54.7%) out of 411 mentioned concepts were collected in a public hospital (PUH) and 186 (45.3%) in a private institution (PRH). The results show that the patient at the PUH and PRH ethnoevaluates different aspects of the healthcare professionals´ human and technical competence, the hospital´s functioning structure, the access to and the ethics in the financial management, and develops overcoming strategies for his stay at the hospital. This ethnoevaluation is mediated by different factors, namely: social and economic status, personality, religiosity, ironic speech, somber diagnosis and satisfied needs, prior hospital experiences and the conditions under which the interview was carried out. A pedagogic proposal for the hospital humanization must include structural, managerial and organizational changes of the offered services and use active methodologies aimed to the political resolution of problematic situations at work and the inclusion of affective and subjective factors, and become as well a tool for the collective learning. This study shows the importance for the user´s ethnoevaluation to be incorporated into the hospital management and care as a guideline in the decision making and clinical action, thus promoting practices that shall lead to a decent and humanized care. The multidisciplinary nature of this study allowed a wide understanding of the user´s perspective as a socially critical ethnoevaluator

Determinantes envolvidos na resposta imune celular humana à infecção por Leishmania infantum chagasi

Visceral leishmaniasis (VL) is a disease caused by protozoa of the Leishmania donovani complex, whose infection has clinical spectrum ranging from asymptomatic infection to active disease characterized by fever, cachexia, hepatosplenomegaly, and immunosuppression. The healing or protective immunity require an antigen-specific type 1. The Montenegro skin test (DTH) has been interpreted as a marker of protective immunity. However, there is no known correlation between the DTH response to type 1 and DTH and immunity of type 1 are maintained in the long term. Thus, a longitudinal study of 8 years, nested in a cohort family held in Brazil, documented the status of DTH and cytokine production by peripheral blood mononuclear cells in response to antigen-specific stimulation. This study was the interdisciplinary approach of physicians, biochemists, nutritionists, veterinary medicine, biology and statistics. The results show that 46.2% of subjects were analyzed DTH positive at baseline. The prevalence of positive and DTH induration size increased with age (p = 0.0021). 15.7% of individuals positive DTH "retro-converted" the negative and 50.4% (64) of individuals negative DTH became positive. The size of DTH induration was correlated significantly with the antigen-induced production of IFN-γ (r = 0.6186, p = 0.0001). IL-6 was secreted at higher levels in peripheral blood mononuclear cells of individuals who "retro-converted" DTH positive to negative than individuals who remained stable DTH status (p = 0.005). Thus, IFN-γ produced by peripheral blood mononuclear cells, may be a surrogate marker for protective immunity instead of the DTH response. In addition, differences in innate immune response may determine whether individuals maintain or eliminate the infection by Leishmania infantum chagasi in asymptomatic patients

Avaliação neuropsicológica de crianças com hemiparesia congênita e adquirida

A hemiparesia consiste no déficit da força muscular, com consequente debilidade na mão e no pé, afetando um dos lados do corpo. A literatura mostra poucos estudos enfocando detalhadamente as funções cognitivas e emocionais de crianças afetadas por essa condição neurológica. Este estudo teve como objetivo realizar avaliação neuropsicológica de 23 crianças e adolescentes, de ambos os gêneros, com idades entre 5 anos e 4 meses e 16 anos e 6 meses, com hemiparesia congênita e adquirida. Aplicou-se uma bateria de testes específica para avaliação de funções cognitivas superiores incluindo processos intelectuais, atenção, função perceptiva, função motora, praxias, gnosias, linguagem, memória e função visuomotora. Em relação aos aspectos emocionais, foi usado o teste do desenho da figura humana, visando-se a avaliação da percepção da imagem corporal dos pacientes. Os resultados mostraram que a hemiparesia da criança conduz a déficits em funções neuropsicológicas importantes, além de déficit motor e alterações na esfera emocional, mais precisamente aquelas relacionadas com a representação da imagem corporal. A abrangência multidisciplinar, envolvendo a neurologia pediátrica e a psicologia, engrandeceu o trabalho, referendando os resultados obtidos em todos os seus aspectos

A (bio)ética e a Odontologia: os (des)caminhos de uma formação humana

The present research carried out from three national dentistry magazines published in the period between 1990 and 2004, has as a goal to analyze how bioethics has been approached in this area, not only identifying the main concerns and tendencies, but also aiming to learn how this knowledge is produced and divulged in the dentistry circuit. We have articulated a quantitative-qualitative approach, studying 2995 articles. The articles were selected and assorted in twenty thematic categories, through their titles and key words. The analysis of the empiric material shows that, although there is a growth tendency of this discussion, little has been published about this theme (1,9%). Besides, it seems that there is an arrhythmia between the present bioethic approach in dentistry and the present life demands, where the deontology and legalist focuses are predominant, seeming to correspond to the inner aspects of the profession alone. In spite of this, through the qualitative approach it was possible to identify ways to build a more complex and integral odontological formation and practice. Within the conclusions, we still point out, that, this investigation, even face to its limitations, seems to offer subsidies for reflection and further studies about the theme, working as a parameter to keep up with the evolution of the bioethic thinking in the Odontology

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

Estrutura econômica, mercado de trabalho e evolução sócio-ocupacional no Rio Grande do Norte 2001 a 2008: reflexo de uma condição mercantil e estruturalmente periférica

The aim of this thesis was to investigate the evolution of the socio-occupational status in Rio Grande do Norte from 2001 to 2008, based on the characterization of the socio-economic status of this State from the analysis of labor market norte-rio-grandense . The study, specifically, drew a comparison between the dynamics of the labor market in Rio Grande do Norte and the capital city, Natal. From this perspective, the purpose was to make a relationship between the social division of labor and its effects on the socio-spatial division, represented in the "macro scale" by the federal unit and the "micro level" for the capital; locus of economic and population concentration. The collection of data on the labor market had as a major source PNAD/IBGE, characterizing the labor market in many ways: people of working age, economically active population and employed and unemployed people, classified by age, sex, color, education, income and social protection condition. However, as for the socio-occupational division, we follow the methodology used by the research group on national television, based in IPPUR /UFRJ, called Monitoring of the Metropolis," which rallied twenty-four groups that aggregate the occupations found in the PNAD/IBGE, in eight groups of socio-occupational categories, according to the similarity between them. It was used in the socio-spatial cutting two relevant discussions, which are inter-related and were characterized as crucial points in developing the research problem: the former was related to the influence of the hegemony of merchant capital in the labor market in Rio Grande North and, the latter, it referred the socio-economic relations between the territory and the variable occupation. Lastly, the results all indicated that in Rio Grande do Norte, as a peripheral state, has suffered the devastating influence of the hegemony of capital purely commercial basis, where "wealth" of capitalism is generated through the sphere of mere movement of goods and services rather than a productive process due to the social relations of production more advanced. We have a little advanced economic structure, with a tertiary sector that has propagated under-employment or disguised unemployment. Similarly, the agricultural sector has been presented as an example of greater social degradation of working conditions in the state. The secondary sector, in turn, also was not behind this uncertainty; on the contrary, confirmed that condition, with poor levels of income, low education of the workforce and a high degree of social helplessness, even in the state capital, space full urban area, which although always appear with a favorable condition compared to Province, in practically most of the variables studied, was also reflected at the same time the author of a structurally underdeveloped condition

Brincar, atividade humana e ferramenta pedagógica no contexto escolar da região metropolitana de natal

This thesis talks about the use of guided educational tools in play and playful in public schools in the Metropolitan Region of Natal (MRN), contributing to the teaching and students learning of basic education in the contents of portuguese and mathematics. We assume that the play is an activity / human need and therefore implies the proper development of children in physical, psychological, biological, cultural, social and historical aspects. We consider the mediation exercised by the teacher in the classroom, and the affection existing between teacher and student, sine qua non terms, so that the truth and fact of the process of teaching and learning occur. Thus, theoretically collaborated Paulo Freire, with his dialogical vision; Lev S. Vygotsky says that we learn and why we develop; Lev S. Vygotsky that states that we learn and for that we develop ourselves; Pierre Bourdieu and the concept of habitus, as something embedded and therefore procedural, and the cultural capital that needs to be fed and (re)meaning at school; Luiz Pereira, Bernard Lahire, Gilles Brougère and others brought their theoretical contributions. The empirical field of research was composed by the Municipal School Professor Ulysses de Góis, located in the neighborhood of Nova Descoberta in Natal, and the Municipal School José Horacio de Góis, located in the community of Guanduba, in São Gonçalo do Amarante, municipalities of the Metropolitan Region of Natal (MRN). We used as methodology the collaborative-action-research as a possible of effective participation of the research subjects, imputing them a voice and performance in the process, and not considering them just observers. The results indicate the effectiveness of the pedagogical tools in play and playful to the learning of students, but that alone is not able to solve all the problems of the school, other referrals need to be secured, as the planning of the actions to be developed in the school and in the classroom, systematized pedagogical orienttion for faculty, family participation/involvement in the school life of students, among other actions that need to be weighted so that education fulfills its role and promote the emancipation of the subject, because in the freireana liberating perspective, "the reading of the world preced the lecture of the word"

A moralidade e a vida pregressa do candidato como condição autônoma de elegibilidade

The objective of this work was about fixing the free will paradigm as negative evaluation of political rights which presents a new classification dde such rights, producing species: a) conditions of eligibility autonomous (free will), b) eligibility requirements heteronomous (will third party) and c) ineligibility (court decisions / administrative). This morality and life history as a condition of eligibility unattended, making a hermeneutic analysis of art. 14, § 9 of the Constitution, considering the justification of the views of the voting Minister Carlos Ayres Brito Appeal in Ordinary No 1069/2006 of the Supreme Electoral Tribunal (where Eurico Miranda). Are fixed concepts of morality and life history from the perspective of the moral act freely and consciously. Has resulted in the identification of the moral virtues of honesty and integrity, which are voluntary acts as a reference to morality and integrity respectively. Justifies the morality and life history as a condition of eligibility unattended. who depend exclusively on the willingness of the candidate. It is noteworthy that the conditions for eligibility as a factual finding does not violate the law and does not allow punitive sanctions or setting a deadline in case of refusal to register the application. Attributed to political parties to take responsibility in their statutes moral criteria for the nomination convention in pre candidates, giving an ethical dimension. Analyzes the law under the Clean Record of morality and life history of the candidate and the possible impact on the electoral context.

Proteção da relação de emprego sob o prisma da dignidade da pessoa humana

This work aims to show that the protection of the employment relation is one of the determining factors to respect the principle of the human dignity. The goal is initially to show the devaluation of work from antiquity to the early twentieth century, when the constitutions began to standardize protective devices. This way, the consecration of the social labor rights in the Constitution of 1988 represents the culmination of the historical achievements. This work demonstrates that such rights can not be reduced or suppressed by political conveniences, once these rights are included in the list of immutable clauses. It is displayed that to achieve the fundamental right to work is not well advised to encourage the creation of jobs that maculates the worker s dignity. The outsourced work is, therefore, a classic example of the advancement of precarious forms of contemporary labor. It is inferred that the presence of various forms of harassment results in a degradation of working environment, bringing about dire consequences on professional and personal life of the worker. Thus, decent work must be the appropriate benchmark for the creation of new jobs. It is also shown that the flexibilization of the propaganda rights by certain pressure groups has as main goal to reduce or eliminate rights, based on fallacious data depicting an increase of competitiveness and jobs. In addition, the flexibility implies a growth of the precarization of the work - a reality felt by many workers subjected to such a situation due to the unemployment phenomenon whose origin is not in the protectionism of the norms. It is necessary to expand and structure the constitutionally legitimate institutions to monitor and curb the precarized work, as well as all practices that go against the dignity of the worker. It is also shown the loss of power of the sindicates in the last few years as a consequence of the pulverization workes and the capital attacks through the productive restructure whose outsourcings and privatizations are notorious examples

A materialização da dignidade da pessoa humana e o cumprimento das penas privativas de liberdade

The current research come from need to analyze possibilities to materialize human dignity principle during freedom curtail penalties fullfilment, abreast finding that internal and international regulations dictate this is the way to be tread by Brazilian penitentiary system, however, verily, indignity, assistance missing, overcrownding, crime, in the end, barbarie reigns. The work will analyze two strands in order to effective the mentioned principle: the state responsability optics, such in internal scope, as internationally, abreast historical omission in satisfy Constitution, international treaties and laws; and also indicating penal execution alternative methods adoption as a way, bringing to fore a case study - called "apaqueano" method. With such desideratum will bring, first of all, considerations about consolidation process of human dignity principle, its concept and essential content. Furthermore, will address historical and philosophical evolution of freedom curtail penalties. As it follows, will be done an approach about constitutional and underconstitutional legislation that disciplines penalties fullfiling in Brazil, analyzing their main aspects, emphasizing the possibility to charge Brazilian state for disregarding mentioned standards. Next, will also be started a critical analyzis about international regulations, which forbids diminishing or cruel penalties or treatments, approaching human rights international treaties and conventions ratified by Braziland their incorporation and effectiveness in local Law, emphasizing monitoring forms and country international charging possibility for disregarding international regulations. Lastly, will advance to the real possibility to materialize human dignity principle in penalties fullfiling, based in a case study verification - the APAC (Associação de Proteção e Assistência aos Condenados) called method, analyzing the various theories about penalties grounding, with emphasis in their ressocializing function, as well as traditional penitentiary systems, and the theory adopted by vernacular order, in desideratum to contribute to improve national penitentiary system chaotic situation

O quinto momento do homem: ética e dignidade

This work has as objective to rise stages of the human beings dignity evolution and its superposing with the entirety and the men s activities development, until its elevation as a constitutional principle and its evolution as a judicial decisions vector, being important to register that conviction ethics or convenience ethics imposes the existence of the constitutional principle. Human beings dignity principle deals about a historic and cultural, politic and social and economical construction, whose sloping is violently imposed to the production resources, which drives the present work through a trial of clarifying and aggregating all those nuances of the men s stages until they find out, welcome and construct the human beings dignity in all its subjective and objective aspects. The adopted research method was based in historic enrolment of the appearance among people since the bases of the word dignity until the acceptation of this value in the Brazilian society. This research searched dignity s doctrinaire valuation at the juridical point of view and the way of appreciation of this value, in its condition of constitutional principle, by the Brazilian Judicial Power. The work concludes that man and Law s evolution, in this moment, exposes, necessarily, an ethical posture in favor of dignity

Animais não humanos: a construção da titularidade jurídica como novos sujeitos de direito

This work has the main goal on the recognition of the inherent value of nonhuman animals, under the constitutional framework. It is presented the main philosophical formulations of the current pattern of behavior that rules the relationship between man and animals: first those that have excluded animals from moral consideration and then the thinkers which do have included, in some way, in order to elucidate the origin of the anthropocentric thought over the natural world. In this way, the analysis these thinkers that have included animals in moral consideration will contribute to a paradigm change from the anthropocentric view, initiating legal debates. It will be made a simplified analysis of different philosophical and legal points of view that have been demonstrating the posture in which the human beings have been dealing with the environment, with the replacement of the anthropocentric thinking for the biocentric view, in which life becomes the center of existence. Life is life, no matter whether it is human or not, has a value in itself, and must be protected and respected by the legal system. Then, it will be analized the constitutionalization of the nonhuman animal dignity in comparative law; the infraconstitutional legislation which concerning the intrinsic value of all life forms and, finally, the 1988 Constitution. It will be advocated for non-human animals the condition of subjects, presenting some cases that the Habeas Corpus was used in animal defense. In this new Brazilian Habeas Corpus theory of for apes the argument of genetic proximity was used in order to overcome the literal meaning of natural person to achieve hominids in order to assure the fundamental right of physical freedom. It is realized that the fact that the great apes being recognized as a person does not preclude the possibility of other living beings be recognized as subjects of law. In this way, animals can be considered non-human subjects of law, according to the theory of depersonalized entities and may enjoy a legal category that allows a respect for existential minimum, and can hold constitutional fundamental rights

Direito fundamental à saúde: parâmetros e alternativas para sua concretização no Brasil

If, on one hand, only with the 1988 Federal Constitution the right to health began to receive the treatment of authentic fundamental social right; on the other, it is certain since then, the level of concretization reached as to such right depicts a mismatch between the constitutional will and the will of the rulers. That is because, despite the inherent gradualness of the process of concretization of the fundamental social rights, the Brazilian reality, marked by a picture of true chaos on public health routinely reported on the evening news, denatures the priority status constitutionally drew for the right to health, demonstrating, thus, that there is a clear deficit in this process, which must be corrected. This concern regarding the problem of the concretization of the social rights, in turn, is underlined when one speaks of the right to health, since such right, due to its intimate connection with the right to life and human dignity, ends up assuming a position of primacy among the social rights, presenting itself as an imperative right, since its perfect fruition becomes an essential condition for the potential enjoyment of the remaining social rights. From such premises, this paper aims to provide a proposal for the correction of this problem based upon the defense of an active role of the Judiciary in the concretization of the right to health as long as grounded to objective and solid parameters that come to correct, with legal certainty, the named deficit and to avoid the side effects and distortions that are currently beheld when the Judiciary intends to intervene in the matter. For that effect, emerges as flagship of this measure a proposition of an existential minimum specific to the right to health that, taking into account both the constitutionally priority points relating to this relevant right, as well as the very logic of the structuring of the Sistema Único de Saúde - SUS inserted within the core of the public health policies developed in the country, comes to contribute to a judicialization of the subject more in alignment with the ideals outlined in the 1988 Constitution. Furthermore, in the same intent to seek a concretization of the right to health in harmony with the constitutional priority inherent to this material right, the research alerts to the need to undertake a restructuring in the form of organization of the Boards of Health in order to enforce the constitutional guideline of SUS community participation, as well as the importance of establishing a new culture budget in the country, with the Constitution as a compass, pass accurately portray a special prioritization directed constitutional social rights, especially the right to health

Dignidade da pessoa humana e medidas sócio-educativas do Estatuto da Criança e do Adolescente

The main goal of this work is to verify the presence of the principle of human dignity, determined by the Constitution of 1988, when Socio Educational Acts from the Statute of Children and adolescent were put in practice, focusing on the treatment designated to the youth whose acts were against the law in the city of Natal, as well as the difficulties to match the legal texts and its reality. It is common knowledge that the law for children and adolescent was based in the principle of human dignity, for its institutes say so. But would the Law match the practice of Socio Educational Acts? Or this law would be an example of good intentions that never left the paper and became reality? First there is an approach on the human dignity principle, with its definition and limitation, according to a theory about the theme. Afterwards it is made a connection between human rights and the principle of human dignity considering historical and social features, for the law is also a reflect of these transformations, we try to show the different laws the country had until today, concerning the children inflicted by poverty and those whose acts were against the law, since the rodas dos expostos, the phase of irregular situation, in which the children were arrested simply because they were beggars, until present time. The theory aspects are shown beside a field research made with the adolescent and staff from CEDUC/Natal, producing a critical view about the subject and showing some solutions for the problems found. At last, it is made a critical analyses of the problems detected on the field research, and, in some cases, a suggestion is given to change the reality