A fiscalização do exercício profissional no Conselho Regional de Enfermagem do Rio Grande do Norte: um debate ético

The present investigation had as its study subject the history of professional monitoring, at the Regional Nursing Council of Rio Grande do Norte (Coren-RN). It assumes that the fiscalization by the Council is an important tool for improving the quality of nursing care. This study aims to analyze the history of monitoring of the nursing profession in Rio Grande do Norte, in the period from 1993 to 2013. It was marked in the ethical-philosophical contribution of Fourez and Vázquez. This is a study of social history, descriptive and analytical, with a qualitative approach, using the methods of documentary research and the technique of oral history. It had the Coren-RN as locus of the empirical research, with its documents and the participation of inspectors and presidents. The history of monitoring was built based on documents and interviews with those who lived through this path. The project was approved by the Research Ethics Committee of UFRN as Opinion 562 400/2014 (CAAE: 25452113.7.0000.5537). The results indicate that the Coren-RN, during these twenty years faced many difficulties such as the shortage of inspectors, the precarious reality of most health services, lack of professional qualification, the illegality of professional practice and structural deficiency in the institution. Nevertheless, it must be recognized that the monitoring process exercised by the Council, has evolved over the years. This evolution is expressed in increasing the number of inspectors, in the acquisition of a new seat and three vehicles, the creation of the subsections in the cities of Natal, Caicó and Pau dos Ferros, the referral of ethical procedures, among other achievements. Similarly, it is registered an improvement in the credibility of nursing professionals and other regulatory agencies. In summary, the monitoring as core activity of the Council is going through a process of transformation, in order to make the dialogue between the disciplinary design and the pedagogical design, in defense of nursing care quality. Therefore, it is an unfinished process, in continuous construction.

Promoção da alimentação saudável na atenção primária à saúde: contribuição para construção coletiva do saber-fazer

The recognition of the food as determinant and health-disease process etching requires new explanations and interventions of the food and nutrition policy action and demand health care model based on the completeness of the actions and focused on health promotion. This study, characterized as research-action of interventionist character, sought to develop strategies to support the transverse insertion of healthy eating promotion in professionals practices a core of support for the health of the family and a family health strategy Unit in the city of Natal, capital of Rio Grande do Norte, from the analysis of perceptions and work processes of these teams. Several methodological strategies were adopted: Dialectical Hermeneutical Circle, direct observation, reflective and Thematic Meetings Workshop "Rethinking the educational practices for promoting healthy eating". For data logging, search diaries - SD were used and moments. The analysis of procedural form occurred in conjunction with research participants, in constant movement of reflection-action-reflection, based on hermeneutics-dialectic. About the results, in relation to the promotion of health, showed the following insights: health promotion and disease prevention-related harms; health promotion related to quality of life and well-being, in its various dimensions; health promotion as a responsibility of the State; health promotion related to the actions of health education; health promotion as an expression of efficaciousness and accessibility to health services. Regarding healthy nutrition, predominated the perceptions relating to nutritional aspects. With regard to food and nutritional education - FNE, it was observed a predominance of perception of FNE as information, guidance and knowledge transfer for changes of dietary practices. As regards the working process, it was observed that among the actions for health promotion, educational activities predominate, such as lectures, conversations, groups that mostly occur in fragmentary form, without joint planning teams, varying according to the professionals and the moment of work in which they are carried out. The results pointed to the need for reorganization of the work processes, in the context of intra-and intersectoral coordination and the construction of new technologies, such as: Health project of the territory – HPT, Unique Therapeutic Project- UPT, Expanded Clinic and educational practices, Shared with active teaching and learning methodologies. From the results we believe that it is necessary to "thought reform", from changes in vocational training and strengthening of the permanent education spaces, whereas the complexity that involves feeding, food and nutrition education and health promotion. The reformation of thought must be articulate and closely tied to the production of knowledge and practices that encourage intersectoral approach, the transversality, dialogue and democratic and supportive attitude, based on the collective construction of know-how. We hope that this study can contribute with reflections and initiatives that encourage building practices that promote healthy eating in primary health care, in terms of completeness of the care and the attainment of food security and nutrition.

Da voz que cala ao corpo que fala: o assédio moral no ambiente de trabalho como desafio para o serviço social

The changes ocurred in the world of capitalist labor, especially from the last decades of the 20th century, accentuated the process of manipulation and domination of the working class, materialized mainly through naturalization and / or trivialization of violence, conducted in the work environment. From this process, emerge the elements of bullying, that is, the embarrassing and humiliating practices which extend through time, degrading human race, and becoming fruitful object for study, debate and the intervention of the professionals of the Social Service area. Thus, we assume the perspective of analyzing the concepts and the work of social workers, whom work at people management area before the bullying in the workplace. We propose the following objectives: apprehend the settings of bullying, in the contemporary context of competitiveness and flexibility of work, as well as its implications for workers' health; characterize the background of this expression of violence at work in the municipality of Natal- RN; and analyze the powers and duties of the social worker in the process of prevention, identification and addressing of bullying in the context of work. This study consisted of a qualitative approach, based on the dialectical-critical method as soon as we adopt methodological procedures such as: theoretical knowledge, documental and field research, and performed using semi-structured interviews. The subjects of this research were nine (09) the Social Service professionals working in personnel management area, in five (5) institutions with legal and branches of different activities, located in Natal-RN. Even interviewed one (01) representative of the Public Ministry of Rio Grande do Norte Office (MPT-RN). The findings of this analysis indicate that bullying is a contemporary expression of "social question", which is presented as a demand for the Social-assistants – covered up and / or camuflage – under the guise of problems related to workers' health or mere conflicts of interpersonal relationships, that is, without any causal connection with the organization of work. The fear of losing job, not to be inserted in the labor market, and / or suffering reprisals, deepens the subject levels of the victims of bullying. Hence the importance of Social Workers are capable to understand the social reality, by preventing and combating the elements of bullying.

Efeito de diferentes divisões territoriais na flutuação aleatória de indicadores socioeconômicos relacionados à determinação social da saúde

This research aimed to analyse the effect of different territorial divisions in the random fluctuation of socio-economic indicators related to social determinants of health. This is an ecological study resulting from a combination of statistical methods including individuated and aggregate data analysis, using five databases derived from the database of the Brazilian demographic census 2010: overall results of the sample by weighting area. These data were grouped into the following levels: households; weighting areas; cities; Immediate Urban Associated Regions and Intermediate Urban Associated Regions. A theoretical model related to social determinants of health was used, with the dependent variable Household with death and as independent variables: Black race; Income; Childcare and school no attendance; Illiteracy; and Low schooling. The data was analysed in a model related to social determinants of health, using Poisson regression in individual basis, multilevel Poisson regression and multiple linear regression in light of the theoretical framework of the area. It was identified a greater proportion of households with deaths among those with at least one black resident, lower-income, illiterate, who do not attend or attended school or day-care and less educated. The analysis of the adjusted model showed that most adjusted prevalence ratio was related to Income, where there is a risk value of 1.33 for households with at least one resident with lower average personal income to R$ 655,00 (Brazilian current). The multilevel analysis demonstrated that there was a context effect when the variables were subjected to the effects of areas, insofar as the random effects were significant for all models and with different prevalence rates being higher in the areas with smaller dimensions - Weighting areas with coefficient of 0.035 and Cities with coefficient of 0.024. The ecological analyses have shown that the variable Income and Low schooling presented explanatory potential for the outcome on all models, having income greater power to determine the household deaths, especially in models related to Immediate Urban Associated Regions with a standardized coefficient of -0.616 and regions intermediate urban associated regions with a standardized coefficient of -0.618. It was concluded that there was a context effect on the random fluctuation of the socioeconomic indicators related to social determinants of health. This effect was explained by the characteristics of territorial divisions and individuals who live or work there. Context effects were better identified in the areas with smaller dimensions, which are more favourable to explain phenomena related to social determinants of health, especially in studies of societies marked by social inequalities. The composition effects were better identified in the Regions of Urban Articulation, shaped through mechanisms similar to the phenomenon under study.

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

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

A Ouvidoria Pública como instrumento de controle das ações da Secretaria de Saúde do Pará

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