As múltiplas dimensões da garantia dos direitos do paciente idoso internado: o caso de uma instituição hospitalar pública no município de Natal/RN

In the context of current capitalist society, marked by the logic that restricts the human person their status as workforce, in order to generate profits, old age is often treated as an underprivileged life stage. This reality becomes more intense considering the sharp aging process that affects brazilian society is accompanied by the country's entry into a globalized world and tensioned by the dictates of capital. Thus, despite the increasing development of policies to strengthen the guarantee of elderly rights, it is necessary to establish effective strategies of these measures to ensure a higher quality of life to these subjects. Therefore, it is necessary to develop studies that problematize the issue of the elderly, which represent a growing portion of the population, and hence have more visible demands, including in health. With the increase in the elderly population in Brazil it is possible to realize the country is going through a demographic transition and epidemiological changes that contribute to change the landscape of health care of the elderly, especially the hospitalization. Thus, this study aimed to analyze the multiple aspects of ensuring the rights of elderly patients admitted to the State Hospital Dr. Ruy Pereira dos Santos (HRPS), located in Natal / RN, whose most patients are elderly. Specifically sought to understand the aging process, its social consequences and the vulnerability to which it is exposed, especially during the disease situation; understand the process of construction of the Brazilian public health and their actions for older people; learn the expressions of citizenship formation in Brazil with regard to policies for older people; and investigate the design of health professionals about the guarantee of the right of hospitalized elderly. Starting from an integrated coordinated theoretical and practical possibilities, a qualitative research and literature character, documentary and field was held. For this, there were four semi-structured interviews with health research locus Hospital professionals - namely, two social workers, a doctor and a nurse - as well as life stories with the hospitalized elderly patients, one in each deck the said Hospital, totaling three. The results pointed to the difficulty of health policy become effective as law and stressed one historical scenario violation of the rights of elderly hospitalized patients, which persists due to the precarious situation and the difficulty of effective implementation of the Unified Health System (SUS ) and other public policies to that end.

Teleconsultoria Off-line: uma arquitetura distribuída e compartilhada para sistemas heterogêneos

The Telehealth Brazil Networks Program, created in 2007 with the aim of strengthening primary care and the unified health system (SUS - Sistema Único de Saúde), uses information and communication technologies for distance learning activities related to health. The use of technology enables the interaction between health professionals and / or their patients, furthering the ability of Family Health Teams (FHT). The program is grounded in law, which determines a number of technologies, protocols and processes which guide the work of Telehealth nucleus in the provision of services to the population. Among these services is teleconsulting, which is registered consultation and held between workers, professionals and managers of healthcare through bidirectional telecommunication instruments, in order to answer questions about clinical procedures, health actions and questions on the dossier of work. With the expansion of the program in 2011, was possible to detect problems and challenges that cover virtually all nucleus at different scales for each region. Among these problems can list the heterogeneity of platforms, especially teleconsulting, and low internet coverage in the municipalities, mainly in the interior cities of Brazil. From this perspective, the aim of this paper is to propose a distributed architecture, using mobile computing to enable the sending of teleconsultation. This architecture works offline, so that when internet connection data will be synchronized with the server. This data will travel on compressed to reduce the need for high transmission rates. Any Telehealth Nucleus can use this architecture, through an external service, which will be coupled through a communication interface.

A interação ensino-serviço no processo de formação dos graduandos em fisioterapia da UFPB: a percepção dos docentes

The health paradigm, consolidated in the last century, directed the training of health professionals, educated under the aegis of the Flexnerian training, fragmentary and hospital-centered model. However, it proved to be insufficient to meet the demands of the Unified Health System and the population. In this sense, the National Curriculum Guidelines for Undergraduate health courses emerge as a normative framework in proposing a new professional profile, as well as the recommendation of strategies for the restructuring of curricula and teaching practices, and one of them is the teaching-service integration. Therefore, the aim of this study was to investigate the process of training of Physiotherapy course students of the Federal University of Paraíba with the guiding principle of teaching-service integration, considering DCN. In this sense, the chosen method was a case study with qualitative approach. The sample was intentional, including all faculty members of the permanent staff of the Department of Physiotherapy at UFPB, linked to curriculum components whose practice scenarios occur in the SUS network and time longer than one year in that component. The data collection technique was the semi-structured interview. Data analysis was performed using the content analysis technique. The following categories were considered: professional training for SUS, integration of students to the SUS network services, the relationship between theory and practice in the training of physiotherapists, teaching and health professional partnership in the teaching-learning process and programs of training reorientation and their integration with the course. The results allowed identifying positive points in the teaching-service integration: recognition of the importance of integration activities between university and health services based on the insertion of students in the network, the combined actuation with health service professionals and the opportunity to work in a multidisciplinary team; the existence of structured and organized School Network; participation of students and teachers in government programs that offer the experience of insertion in the labor market. The following weaknesses stood out: difficulties in agreement, planning and evaluation of activities by the service; gap between theoretical and practical activities; lack of definition of roles of teacher and health service professionals in the training process and the fragile relationship of reorientation of vocational training programs with the curricular activities of the course. The teaching-service integration as a guiding principle in the analysis of the formation of physiotherapists reveals limits and possibilities for training that meets the health needs of the population. Thus, the choices of educational institutions regarding the care model have an influence on health practices, as well as the commitment by management and services and the permeability to social control instances decisively contribute to the improvement in the training of future professionals. Thus, the commitment of all involved for the effective change in the training process of health paradigm is indispensable.

A interação ensino-serviço no processo de formação dos graduandos em fisioterapia da UFPB: a percepção dos docentes

The health paradigm, consolidated in the last century, directed the training of health professionals, educated under the aegis of the Flexnerian training, fragmentary and hospital-centered model. However, it proved to be insufficient to meet the demands of the Unified Health System and the population. In this sense, the National Curriculum Guidelines for Undergraduate health courses emerge as a normative framework in proposing a new professional profile, as well as the recommendation of strategies for the restructuring of curricula and teaching practices, and one of them is the teaching-service integration. Therefore, the aim of this study was to investigate the process of training of Physiotherapy course students of the Federal University of Paraíba with the guiding principle of teaching-service integration, considering DCN. In this sense, the chosen method was a case study with qualitative approach. The sample was intentional, including all faculty members of the permanent staff of the Department of Physiotherapy at UFPB, linked to curriculum components whose practice scenarios occur in the SUS network and time longer than one year in that component. The data collection technique was the semi-structured interview. Data analysis was performed using the content analysis technique. The following categories were considered: professional training for SUS, integration of students to the SUS network services, the relationship between theory and practice in the training of physiotherapists, teaching and health professional partnership in the teaching-learning process and programs of training reorientation and their integration with the course. The results allowed identifying positive points in the teaching-service integration: recognition of the importance of integration activities between university and health services based on the insertion of students in the network, the combined actuation with health service professionals and the opportunity to work in a multidisciplinary team; the existence of structured and organized School Network; participation of students and teachers in government programs that offer the experience of insertion in the labor market. The following weaknesses stood out: difficulties in agreement, planning and evaluation of activities by the service; gap between theoretical and practical activities; lack of definition of roles of teacher and health service professionals in the training process and the fragile relationship of reorientation of vocational training programs with the curricular activities of the course. The teaching-service integration as a guiding principle in the analysis of the formation of physiotherapists reveals limits and possibilities for training that meets the health needs of the population. Thus, the choices of educational institutions regarding the care model have an influence on health practices, as well as the commitment by management and services and the permeability to social control instances decisively contribute to the improvement in the training of future professionals. Thus, the commitment of all involved for the effective change in the training process of health paradigm is indispensable.

O significado da educação popular na formação dos trabalhadores de saúde: estudo com base em experiências de extensão universitária

A Saúde do Trabalhador (ST) refere-se a um campo do saber que compreende as relações entre o trabalho e o processo saúde/doença de modo articulado a um corpo de práticas teóricas interdisciplinares. No contexto das possibilidades para se efetivar a ST na amplitude que exige este conceito, diferentes iniciativas de Educação Popular em Saúde se articulam com demandas do Controle Social em Saúde, permitindo novas abordagens para configurar a formação crítica e ativa de trabalhadores de saúde e movimentos sociais no mosaico das políticas de ST. Nessa direção, os projetos de extensão universitária orientados pela Educação Popular têm desvelado caminhos metodológicos e novas possibilidades teóricas de pensar a Atenção à Saúde do Trabalhador, de forma articulada com a necessidade de re-significar o processo de formação dos profissionais da saúde, com ênfase no cuidado integral na atenção à saúde. O estudo promovido por ocasião do Doutoramento em Ciências da Saúde propiciou a avaliação do impacto e da potência das ações destes projetos na reorientação do cuidado guiado pela educação popular no campo da saúde do trabalhador. A sistematização foi utilizada como principal estratégia metodológica para a produção dos dados analisados, além de estratégias de pesquisa qualitativa como constituintes da fase exploratória do estudo, tendo como técnica central, nesse sentido, o grupo focal. Os resultados mostraram mudanças significativas no processo do cuidar em saúde guiado pela educação popular, A reorientação de práticas e saberes, coadunadas aos princípios fundamentais do Sistema Único de Saúde, foi observada nos sujeitos que participaram da experiência. A sistematização da experiência permitiu ainda concluir que estratégias de diálogo, organização político-social e troca de experiências de vida se apresentam como cenário significativo no compartilhamento de cultura e saúde do trabalhador, oportunizando crescimento coletivo e melhor qualidade de vida.

A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”

Trabalho em equipe de saúde: uma análise contextual

COSTA, Roberta Kaliny de Souza ; ENDERS, Bertha Cruz ; MENEZES, Rejane Maria Paiva de . Trabalho em equipe em saúde: uma análise contextual. Ciência, Cuidado e Saúde, v. 7, p. 530-536, 2008.

Análise da organização da rede de saúde da Paraíba a partir do modelo de regionalização

Este artigo analisa a organização da rede de saúde da Paraíba a partir do modelo de regionalização proposto pelo estado da Paraíba. Material e Métodos: Trata-se de um estudo documental que tomou por base, prioritariamente, o Plano Diretor de Regionalização da Paraíba e os documentos oficiais do Ministério da Saúde que orientam a construção dos mesmos pelos Estados. Resultados: A análise dos dados revelou alguns limites no processo de implantação do PDR/ PB, tais como a ausência de análise das características sociais, econômicas e culturais durante a escolha das sedes das regiões de saúde e a inexistente descrição da organização da assistência à saúde do território estadual. Conclusão: O processo de regionalização e a formulação do PDR da Paraíba não seguiram a Instrução Normativa do Ministério da Saúde em alguns aspectos, desconsiderando as especificidades de cada região de saúde, o que pode resultar em problemas no acesso e na articulação da rede de serviços com vistas à legitimação das regiões de saúde desse Estado

Avaliação da terapia comunitária na atenção primária à saúde

A busca por um modelo democrático de saúde despertou a atenção do governo brasileiro para o estabelecimento de prioridades e estratégias, que impulsionaram a implantação do Programa de Saúde da Família (PSF), atualmente denominada Estratégia Saúde da Família (ESF), a fim de aproximar a equipe de saúde da comunidade e, assim, implementar ações de promoção da saúde e de prevenção do adoecimento. Nessa perspectiva a Terapia Comunitária (TC) emerge como uma tecnologia de cuidado voltada à saúde mental na Atenção Básica de Saúde. Desde 2007, a TC vem sendo desenvolvida no município de João Pessoa/PB por profissionais da ESF: enfermeiras, agentes comunitários de saúde, médicos, odontólogos, fisioterapeutas, nutricionistas, psicólogos, entre outros. O estudo teve como objetivos: avaliar a satisfação dos usuários em relação à TC na Atenção Básica no município de João Pessoa/PB; medir o nível de satisfação dos participantes da TC em relação a essa ferramenta do cuidado; identificar elementos importantes para a satisfação em relação à TC por parte dos usuários. Trata-se de um estudo avaliativo, transversal e observacional, realizado no período de maio a agosto de 2009. Utilizou-se como instrumento de coleta de dados a Escala de Avaliação da Satisfação dos Usuários com os Serviços de Saúde Mental Satis-BR, bem como um instrumento de perguntas complementares utilizado pelos terapeutas comunitários. Os resultados revelaram que dos 198 (100%) entrevistados, 105 (53%) verbalizaram satisfação e 93 (47%) muita satisfação nos encontros de TC, o que evidencia que a totalidade da amostra está satisfeita com a terapia. Os elementos importantes que concorreram para a satisfação dos usuários da TC foram: respeito, dignidade, escuta, compreensão, acolhimento, apoio nas necessidades e boas instalações dos locais onde ocorre a terapia. A TC vem fortalecendo o cuidado à saúde mental, por se constituir como uma tecnologia de prevenção e fortalecendo a porta de entrada para a rede de saúde mental e de apoio psicossocial. Conclui-se, portanto, que a TC vem se destacando como instrumento de inclusão da saúde mental na Atenção Básica no atendimento aos usuários do Sistema Único de Saúde

Assistência a mulher com câncer de mama em um cenro de referência no Estado da Paraíba

The assistance to women who have breast cancer is studied in a Reference Center in Paraiba and also the way this assistance is performed in a School Hospital maintained by SUS (Single Health System) is questioned. Breast cancer demands institutional organization, provision of financial, material and human resources, requiring, from the health system, effective assistance with new technologies which make it possible for the population their access to specialized medical services although it not always is able to guarantee those services nor the rights which the legislation granted them, inhibiting a proper relationship between the health professional and the patient. The theme is discussed through a transdisciplinary knowledge view and has as its theoretical referential the contribution of classical and contemporary authors from the human and social sciences and, as an empirical research strategy, the structured interview. The objectives of the research were: identify how the assistance to women with breast cancer is carried on at a Reference Center on Oncology in Campina Grande, Paraiba, identifying their difficulties and their satisfaction with the received assistance; draw up a profile of the women with breast cancer who were assisted in this Reference Center; understand their gynecological and obstetric antecedents, life styles, age group and stage of the disease when the treatment started; check their knowledge about their rights and which benefits they had received. Most women ranged between 40 and 59 years old (63%), which corresponds to the risk range of developing breast cancer. As to their occupations, 38.3% were housewives and 30.1% retired, whose family income was among those who received between less than a minimum salary and one minimum salary (58.2%). This population was mainly constituted of married women (60.2%), whose most frequent schooling was an incomplete elementary school (27.6%) and complete elementary school (24.1%), which added up to 51.6%. It was observed that the majority of the women seemed to be satisfied with the assistance received, noting that a minimum care was enough to define this satisfaction, although it is perceived that the access to the health system does not ensure the ideal attention conditions they need; it was verified that the availability of the services and the assistance itself are seen (in the local culture) as a favor and not as a right. It is also observed that only 30% of the women mentioned that they knew about their rights and the most mentioned ones were the disease assistance (13%), the medicines (13%) and the treatment (12%), which represent the most important triad to face the disease and around which the oncologic assistance most focus on. It is concluded that the condition of the users´ minimum existential of a public health unit and the condition of belonging to a lower social stratum were variables that influenced the respondents´ satisfaction in relation to the assistance received but the importance of the Reference Center for the women with breast cancer´s assistance for the whole region cannot be denied as well as the need to broaden the way the policy of the oncologic assistance in Brazil in the local realm is seen

Avaliação de efetividade do centro de reabilitação de adultos - CRA/NATAL/RN

Public services with an emphasis on rehabilitation treatment of disabled people, as established law, have aimed to ensure quality and equity assistance in a rehabilitation way to the segment highlighted. As for people with physical disabilities, the Unified Health System (hereby SUS) through the directive GM/ MS No. 818 of 2001, requires the creation of hierarchical and regionalized services networks at different levels of complexity to ensure appropriate assistance. This study whose title is Evaluation of effectiveness of the Adult Rehabilitation Center in Rn: elements for a discussion aimed to evaluate the effectiveness of rehabilitation services that institution, reference in the State of Rio Grande do Norte, has directed its patients, more specifically those who have had a stroke and therefore are disabled ones. From the standpoint of methodological conduction, it was prioritized a qualitative and empirical theoretical research which was carried out from the following courses: literature references with authors who are the themes pertaining to rehabilitation, inclusion, public policy evaluation, health policy and disability; documentary research through Regulation of Technical Procedures, files, records, informative booklets that were of great importance to the knowledge of the institution, as well as its functioning and dynamics of field research that was materialized with the managers, rehabilitation staff and Center s users, through the application of semi-structured interviews as a tool for data collection. The information obtained was analyzed from the critical analysis of discourse. As a result, it was identified some technical, administrative and financial difficulties which have obliterated the effectiveness of services provided, such as: lack of many professionals to meet existing demand, poor quality of equipment and the physical structure, limits on autonomy management as a result of dependence along with the SESAP/RN; besides the excessive bureaucratization in the administrative processes compromising Center s problem-solving needs. However, in the narratives of managers, rehabilitation staff of patients, despite the difficulties, treatment made by Centre has effectiveness to the extent that has been contributing even in a limited way to improve their quality of life

Crescimento econômico e restrição externa da economia brasileira: uma análise do padrão das exportações em relação ao BRIC e do Sistema de Inovação do Brasil (1980-2012)

This Master s Thesis aims to use the theoretical models of growth with restricted balance of payments, specifically Kaldor (1970) and Thirlwall (1979) models, to analyze the behavior and the pattern of specialization of Brazilian exports and imports in the last years. It is observed that, in some periods, the pattern of specialization has contributed in restricting long-term growth of the Brazilian economy. It has been hypothesized that overall this is due to lack of structural transformation policies. To achieve this goal, it analyzed the performance of Brazilian exports and imports disaggregating them according to their technological content. The basis for comparison was a group of countries to which Brazil is inserted in, the BRIC. In this regard, the work is a comparative analysis by using descriptive statistics. It is concluded that the low rate of GDP growth experienced by Brazil since the 1980s can be explained in part by the decoupling of the Brazilian National Innovation System (NIS) and the Brazilian productive structure. This would be reducing the income elasticity of exports and raising imports, causing a pattern of specialization intensive primary commodities and labor and low-skill labor

Universo encantado do cuidado na autopoiese docente: uma viagem epistemológica transdisciplinar

The health transition experienced in Brazilian health care model requires a metamorphosis in human and society, placing new demands on health and education. The Faculty of Science, Culture and Extension of Rio Grande do Norte (Facex), aware of their responsibilities to the Health System, which brings the principle of comprehensiveness as its structural axis, dared to implement a course of nursing in complex thinking and Experiential Pedagogy Humanescente with curriculum inter / transdisciplinary. For deployment of proprosta was not enough to reform thinking of educators, there was a need corporalizar new teaching practices that are aimed at the integral formation of human beings. In this context, emerged the workshop on Human Education autopoietic, self-forming area of the educator, where he developed an Action Research Existential (PA-E) which enabled experience, describe and analyze how the human autopoietic educators could contribute to the practice educational humanescente transdisciplinary curriculum project. Were worked out in meetings, knowledge necessary to practice the transdisciplinary 1st Meeting - learn to create; 2nd Meeting - learn to recognize the laws of nature with emphasis on complexity theory, 3rd Meeting - learn to organize, 4th meeting - namely autoestruturar themselves; 5th Meeting - know how to choose, 6th Meeting - knowing innovate 7th Meeting - namely exchange. Next an autobiographical perspective, we chose the metaphorical possibility to narrate the ways and strategies covered by the author and apprentice in the company of the Little Prince de Saint-Exupery, in search of a sensible pedagogical practice complex, which promotes re-enchant transdisicplinar education. The route involved five methodological connections: a literature review which relate to training for care in undergraduate nursing: the study of learning processes that drive the formation humanopoiética, emphasizing the relationship that involves the complexity and embodiment in the educational process transdisciplinary, highlighting the analysis of what is to learn from the findings of biosciences and recent cognitive theories of Maturana and Varela, the description of the interdisciplinary curriculum of the nursing course of Facex and Training Workshop, Human autopoietic, with emphasis on Experiential Education Humanescente; the report of seven meetings of the Workshops (cocoon), recording the experiences and listening to educators (luminescent butterflies), the final reflections with learning opportunized. Experientiality lived through, the expressions and words, educators say the influence of workshops for their teaching practices, highlighting it as a space for selforganizing, creating, learning and enchantment, and can identify the workshop as a place of transformation necessary for deployment an interdisciplinary curriculum. The knowledge emerging from the study indicate the need for permanent spaces of self, in which the educator learns from its body, between cognitive processes and vital, and in the experiences of their formative process the opportunity to act on the dimensions of knowing and being

O trabalho em saúde como espaço pedagógico: desafios e possibilidades

The ongoing transformations in brazilian society, arising from technical and organizational changes in the working world, are making, with much emphasis, heated debates resurge related to themes and issues that refer to the relationship between work, skills and education. Thus, this study is inserted in the link between education and work, pointing to the work as an educational principle according to Antonio Gramsci. This paper aims to discuss the interfaces between education and work in the everyday health care teams and learn about the activities developed by health teams related to the learning processes in and with the work to analyze the opportunities and challenges of transforming spaces of health work in an environment of lifelong learning. This is a descriptive, exploratory with a qualitative approach case study developed from semi-structured interviews with the health staff professionals of the Unidade de Terapia Intensiva da Casa de Saúde Dix-Sept Rosado in Mossoró / RN , who answered open questions about the relationship between education and work. The interviews were conducted during the month of January 2010, the same being recorded, transcribed and analyzed, culminating in the production of new knowledge on the subject. It is understood that work and education activities are eminently human, therefore only the human being works and educates. Given the statements of participants, it is noticed that all work processes in health are learning moments. This happens through new demands imposed by the everyday of the services, by interaction with a multidisciplinary team, participation in educational activities and individual study. It was noticed that the institution in this case does not promote study courses related to Intensive Care and that there are obstacles to the realization of educational activities on and with the work, such as: excessive workload, inability to release staff to participate in events, low pay, which leads the worker to have more than one employment, rejection of new knowledge by some workers and lack of physical infrastructure and incentives for the activities. The daily situations must be transformed in learning, selfanalyzing the problems of practice and valuing the work process itself in its intrinsic context. We conclude that dealing with the web of relationships between educational processes and production processes of health services, unraveling the intricacies of the world of work and education requirements in this sector are increasingly on the agenda of Sistema Único de Saúde workers and managers. The continuing consideration of this issue becomes an essential condition for the proper discharge of their responsibilities. We consider that bringing the education to everyday life is the result of recognition of the educational potential of the work situation

Ações dos agentes comunitários de saúde diante do usuário da estratégia saúde da família com estados depressivos no Município de Abaiara-CE-BR

Brazilian health public assistance is going through two Reforms, Sanitary and Psychiatric, and through these the assistance is guaranteed in the three levels: primary, secondary and tertiary. Thus, mental health assistance should be offered since preventive cares until the ones that demand larger technological apparatus. Programs like Health Community Agent's Program (HCAP) and Family Health Strategy (FHS), besides increasing the services coverage, have been making possible the system reorientation in the meaning of integrality, universalization and equity. Thus, united intervention of mental health team and FHS can offer several benefits to the population, providing assistance and follow-up to patients with mental disorder. It was aimed to assess health community agents facing the user of Family Health Strategy in depressive state. This quanti-qualitative study took place in the municipal district of Abaiara-CE. Semi-structured interview was applied with health community agents and Beck Depression Inventory with the users registered in Family Health Strategy. It was verified that among the 64 users interviewed, 12.5% didn't present symptoms of depression, 10.9% presented symptoms of light depression, 14.1% symptoms of moderate depression and 62.5% symptoms of serious depression. For the 22 health community agents interviewed, they all reported the existence of people with symptoms of depression in their personal micro-areas, being difficult to work with them, once the FHS team is not qualified to work with mental health problems. It was verified that the Municipal district doesn't have specialized professionals, making difficult the routing and treatment. Based on these results, it was concluded that in spite of the articulation of mental health with FHS is necessary and benefactor to the population, it still doesn't exist, worsening the situation, mainly in small Municipal districts, once they don't have mental health services. Thus, the population is exposed and without follow-up, which allows the identification of installed diseases and with gravity, like depression, because there are no prevention and control activities. It is recommended, due the extreme need, the elaboration and implantation of a mental health program in these municipal districts, articulated with FHS