Promoção da saúde: estratégias para a autonomia e qualidade de vida do sujeito com diabetes

O diabetes é uma doença crônico-degenerativa de grande prevalência na população mundial configurando-se enquanto sério problema de saúde pública. Por ser crônico exige dos sujeitos autocuidado e autogoverno longitudinal. A autonomia, por sua vez, é um direito fundamental e também um dos princípios da bioética mais discutidos na atualidade. Seu conceito é complexo e leva em conta a vida experimentada ao longo dos anos. Quando a discussão sobre autonomia se trata de diabetes, a dependência do outro e os conflitos no controle da doença, diante de novas regras e estilos de vida, nem sempre condizentes com os valores dos pacientes, torna-a fragilizada. Embora a autonomia seja claramente parte integrante do tratamento e alicerce para uma vida digna e de qualidade, observamos que os sujeitos se tornam ainda mais dependentes dos serviços de saúde, quando se deparam com o diagnóstico e não têm confiança para tomar suas próprias decisões diante da patologia limitadora. Por isso, há a necessidade dos serviços de atenção primária à saúde traçarem estratégias para promover a saúde desses sujeitos. Os Grupos de Promoção da Saúde são estratégias recentemente utilizadas para influenciar no nível de autonomia dos sujeitos, pois possibilitam, respeitando os limites éticos, a garantia de participação decisória no grupo, através de estratégias e treinamentos de habilidades com competências claramente definidas, que favorecem o empowerment e o protagonismo dos sujeitos. Desse modo, este trabalho objetiva identificar estratégias no âmbito da promoção da saúde na ESF, que contribuam para melhor autonomia e qualidade de vida dos sujeitos com diabetes mellitus, a partir de sua percepção. E, mais especificamente, analisar o perfil clínico e socioeconômico dos portadores de diabetes da ESF; identificar as experiências, necessidades e expectativas dos sujeitos com diabetes sobre autonomia, autocuidado e qualidade de vida; e realizar um levantamento em conjunto com os sujeitos com diabetes, sobre aspectos que sirvam de evidências para construção de propostas para implantação de um Grupo Estratégico de Promoção da Saúde GEPS, com foco na autonomia. Para isto, foi realizada uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, com 65 sujeitos com diabetes acompanhados por uma Unidade de Saúde da Família do Município de Santa Cruz/RN. A pesquisa foi realizada em três etapas interdependentes: 1) coleta de dados clínicos e socioeconômicos, para o qual foi utilizado entrevista estruturada e análise retrospectiva dos registros feitos em seu prontuário; 2) a análise das experiências, necessidades e expectativas dos sujeitos sobre autonomia, autocuidado e qualidade de vida, que se utilizou de entrevista semiestruturada com 6 sujeitos, sendo 3 com mais e 3 com menos complicações autorreferidas e verificadas no prontuário; e 3) a construção coletiva de propostas para melhor autonomia e qualidade de vida dos próprios participantes do estudo, por meio de roda de conversa. Para a análise dos dados utilizamos software de estatísticas simples para os dados das questões fechadas de cunho quantitativo e os dados qualitativos foram analisados através da análise de conteúdo. Observamos que o perfil clínico e socioeconômicos dos sujeitos com diabetes aproximam-se das estatísticas nacionais, embora existam variáveis, como cor da pele, com variação significativa. A autopercepção dos sujeitos diante de algumas complicações divergem de registros encontrados em seu prontuário o que aponta uma possível desvalorização de queixas como hipoglicemia e disfunção sexual, como também baixa adesão ao tratamento por, muitas vezes, não terem suas opiniões valorizadas. As categorias encontradas: vida, qualidade de vida, diagnostico e enfrentamento do problema, autonomia, limites e dependência assim como as práticas coletivas de promoção da saúde, apontam para a necessidade de estratégias por meio de grupos que considerem as crenças e valores dos sujeitos, favoreçam sua emancipação e torne-os protagonistas de sua própria história e de seu processo saúde doença. A autonomia é fundamental para o exercício da cidadania efetiva. É por meio dela que os sujeitos transformam sua realidade e a si mesmo. A contribuição desta pesquisa consiste em identificar estratégicas que se propõe a potencializar a autonomia dos sujeitos, através dos GEPS, norteando a atuação dos profissionais na atenção primária à saúde, que deve sustentarse em ações de prevenção e promoção da saúde e também no incentivo à participação popular e protagonismo dos sujeitos

Ofensiva do Capital e Desmobilização das Forças do Trabalho: As Estratégias Gerenciais Burguesas para a Desarticulação das Classes Trabalhadoras

The problematic that gives shape to this research is the question of the historical process of demobilization of the movement of the working classes in your accented contemporary moment. Their object of study, however, and that it particularizes, it relates to a portion this problematic; it relates to set of determinations that comprise a broader set of determinations of this historical process: it is a set of determinations forged and mediated by bourgeois strategies of management for the conformation of the circumstances necessary for the domination and for the conduct of labor force on operations in work processes for the production of surplus value. What we investigated are, because, the strategies of disarticulation that the bourgeoisie utilizes, under the mantle of subsidies conceptual and interventive of its management of work processes and the sieve of class struggles, to obstruct the union of workers; hamper the movements proletarians. Managerial strategies that intentionally or unintentionally, instill in the social relations of production means to produce and reproduce, activate and reactivate conditions of incitement of individualism and competition between the workers themselves. We shall see, thus, by analyzing means, centrally, from some of the fundamentals of disarticulation in the managerial strategies bourgeois and some of the fundamental strategies of management bourgeois hegemonized with the restructuring productive of 1970, that the disarticulation, and also the demobilization, is a concrete condition, is an objective condition, that is beyond a question that can be "solved" only by enlightenment cognitive, only by formation criticism intellectual. In everyday of the work spaces permeated by managerial strategies bourgeois there elements, then, operating as a material force putting difficulties important for the articulation of the workers, the solidarity of the proletariat; elements that constitute obstacle significant to an awareness of class and belonging; elements act in favor of the atomization of the worker - even if engenders, in the same process, as a contradiction, potentiality of resistance and fight the forces of labor

Um método para desenvolvimento de abordagens generativas com composição de linguagens específicas de domínio

The software systems development with domain-specific languages has become increasingly common. Domain-specific languages (DSLs) provide increased of the domain expressiveness, raising the abstraction level by facilitating the generation of models or low-level source code, thus increasing the productivity of systems development. Consequently, methods for the development of software product lines and software system families have also proposed the adoption of domain-specific languages. Recent studies have investigated the limitations of feature model expressiveness and proposing the use of DSLs as a complement or substitute for feature model. However, in complex projects, a single DSL is often insufficient to represent the different views and perspectives of development, being necessary to work with multiple DSLs. In order to address new challenges in this context, such as the management of consistency between DSLs, and the need to methods and tools that support the development with multiple DSLs, over the past years, several approaches have been proposed for the development of generative approaches. However, none of them considers matters relating to the composition of DSLs. Thus, with the aim to address this problem, the main objectives of this dissertation are: (i) to investigate the adoption of the integrated use of feature models and DSLs during the domain and application engineering of the development of generative approaches; (ii) to propose a method for the development of generative approaches with composition DSLs; and (iii) to investigate and evaluate the usage of modern technology based on models driven engineering to implement strategies of integration between feature models and composition of DSLs

Genética e biologia reprodutiva de vriesea minarum (Bromeliaceae): em busca de estratégias de conservação no quadrilátero ferrífero, minas gerais

Vriesea minarum is a rupiculous bromeliad species, with naturally fragmented populations, restricted to the Iron Quadrangle, Minas Gerais, Brazil. It is a threatened species, which is suffering from habitat loss due to the growth of cities and mining activities. The knowledge of genetic variability in plant populations is one of the main branches of conservation genetics, linking genetic data to conservation strategies while the knowledge about plant reproductive biology can aid in understanding key aspects of their life story, as well as in the comprehension of their distribution and survival strategies. Thus, the study of diversity, richness, and genetic structure, as well as the reproductive biology of populations of V. minarum can contribute to the development of conservation actions. Chapter 1 presents the transferability of 14 microsatellite loci for V. minarum. Among the results of this chapter, we highlight the successful transferability of 10 microsatellite loci described for other species of Bromeliaceae, all of which are polymorphic. In Chapter 2, we present the genetic analyses of 12 populations of V. minarum that are distributed throughout the Iron Quadrangle. We used the 10 microsatellite loci tested in Chapter 1. The results show a low population structuring (Fst = 0.088), but with different values of genetic richness (mean = 2.566) and gene diversity (mean = 0.635) for all populations; and a high inbreeding coefficient (Gis = 0.376). These may be the result of pollinators action and/or efficient seed dispersal, thus allowing a high connectivity among populations of naturally fragmented outcrops. The reproductive biology and floral morphology of a population of V. minarum, located in the Parque Estadual da Serra do Rola-Moça, are studied in Chapter 3. This reserve is the only public environmental protection area where the species occurs. As a result of field experiments and observations, we found that the species has its flowering period from January to March, with flowers that last for two days and that it has a mixed pollination syndrome. It is primarily alogamous, but also has the capacity to be self-ferilized. It is expected that data obtained in chapters 1, 2 and 3 serve as basis for other studies with species from the ferruginous rocky fields, since until now, to our knowledge, there are no other survey of endemic species from the Iron Quadrangle, seeking to merge the genetic knowledge, with the data of the reproductive biology, with the ultimate aim of biodiversity conservation. Considering the great habitat loss for the species by mining, it becomes crucial to analyze the creation of new protected areas for its conservation

O planejamento turístico e o comércio ambulante : uma análise à luz da teoria das representações sociais

The Social Representation Theory provides subsidies to scientifically analyze what is called common sense, suggesting that thought be given credibility to the individual, from the assignment of logic to it. The Representations allow us to interpret, understand, explain and thus classify information, events and people. In this sense, this study aimed to analyze how social representations of the actors of the intinerant traders who operate in Ponta Negra/RN can be used as an element for tourism planning. To achieve the desired goals, we conducted a qualitative study, from a descriptive study, using methods of data collection the research literature, the technique of free association of words and the questionnaire, applied with 90 intinerant traders who work in Ponta Negra/RN beach. As tools of data analysis were used to analyze literature, and software EVOC and SPHINX. This research has revealed the predominance of people in itinerant male, between 18 and 28 years, with incomplete primary education, no contributors of Previdência Social and working seven days a week. The core elements of representations brings that explain that their knowledge is guided by collectively shared knowledge in the culture of tourism, which is seen as something that brings economics benefits (money) to the society, from the travel and entertainment. The plan represents the forward thinking, based on development plans that seek improvements and organization. The structure and operation of tourism planning in Natal/RN, there were no representation of intinerant traders. It is concluded that understanding the needs of itinerant traders provides grants to developing strategies for the development of tourism. This is achieved from its inclusion in tourism planning, since it enables tourism managers to understand how they are capturing, interpreting and acting on their next reality, since these representations are fundamental in forming opinions and the establishment of individual attitudes and collective. Thus, it is an important theory to be used to subsidize social research with individuals living reality and local needs, but which is the margin of decision-making processes of economic in the Brazil

Desenvolvimento local e responsabilidade social empresarial: estratégias de cidadania ou marketing social?

As transformações em curso no sistema mundial evidenciaram, dentre outros aspectos, a necessidade de (re) significação da noção de desenvolvimento e a compreensão das modificações significativas na relação Estado, mercado e sociedade. Nesse cenário, redefinemse papéis de atores sociais, que passam a fazer parte da efetivação de propostas de desenvolvimento que se materializam nos espaços locais. Em meio a essa reconceituação, pode-se incorporar a dimensão da responsabilidade social empresarial. Assim, desmistifica-se a globalização como geradora de um modo homogêneo de vida, permitindo visualizar outra sociabilidade possível, induzida pelo agir multifacetado dos participantes da dinâmica local

Estudo comparativo de estratégias de controle aplicadas a um gerador síncrono

The robustness and performance of the Variable Structure Adaptive Pole Placement Controller are evaluated in this work, where this controller is applied to control a synchronous generator connected to an infinite bus. The evaluation of the robustness of this controller will be accomplished through simulations, where the control algorithm was subjected to adverse conditions, such as: disturbances, parametric variations and unmodeled dynamic. It was also made a comparison of this control strategy with another one, using classic controllers. In the simulations, it is used a coupled model of the synchronous generator which variables have a high degree of coupling, in other words, if there is a change in the input variables of the generator, it will change all outputs simultaneously. The simulation results show which control strategy performs better and is more robust to disturbances, parametric variations and unmodeled dynamics for the control of Synchronous Generator

A integração do tutorial interativo TryLogic via IMS Learning Tools Interoperability: construindo uma infraestrutura para o ensino de Lógica através de estratégias de demonstração e refutação

Logic courses represent a pedagogical challenge and the recorded number of cases of failures and of discontinuity in them is often high. Amont other difficulties, students face a cognitive overload to understand logical concepts in a relevant way. On that track, computational tools for learning are resources that help both in alleviating the cognitive overload scenarios and in allowing for the practical experimenting with theoretical concepts. The present study proposes an interactive tutorial, namely the TryLogic, aimed at teaching to solve logical conjectures either by proofs or refutations. The tool was developed from the architecture of the tool TryOcaml, through support of the communication of the web interface ProofWeb in accessing the proof assistant Coq. The goals of TryLogic are: (1) presenting a set of lessons for applying heuristic strategies in solving problems set in Propositional Logic; (2) stepwise organizing the exposition of concepts related to Natural Deduction and to Propositional Semantics in sequential steps; (3) providing interactive tasks to the students. The present study also aims at: presenting our implementation of a formal system for refutation; describing the integration of our infrastructure with the Virtual Learning Environment Moodle through the IMS Learning Tools Interoperability specification; presenting the Conjecture Generator that works for the tasks involving proving and refuting; and, finally to evaluate the learning experience of Logic students through the application of the conjecture solving task associated to the use of the TryLogic

As estratégias de negação variantes no inglês falado: uma comparação com o português

The general aim of this work is to verify the occurence of variant forms of negation in spoken English with the purpose of making a comparative study between the English and the Portuguese languages. As for Portuguese, we used as a matter of reference a study already made on negation. As for English, we analized a corpus of the North American English variant organized by a university in the United States. This study is based on the North American Functional Linguistics theoretical perspective, which considers relevant the study of language used in real situations of communicative interaction. The data analisys proved that there is at least one form of negative variant in spoken English which is not allowed by prescriptive grammar. This phenomenon turns out to be similar to Portuguese, which includes three variant strategies. According to the data obtained, it was possible to verify that the variant strategy used in English, from a contrastive point of view, corresponds to a negative strategy ruled by Portuguese prescriptive grammar. Finally, we discussed about the different conceptions of language, grammar and teaching, giving suggestions to colaborate to a productive and reflexive teaching of first or second language

Os farofeiros em excursão nas lagoas de Arituba, Boágua e Carcará (Nísia Floresta/RN): análise de uma outra face do turismo potiguar

This thesis analyzes another side of Potiguar tourism , the unplanned side, neglected and kept out of touristic activities: excursionism, a leisure practice enjoyed by tourists with low consumer power, and who are commonly referred by the pejorative term farofeiros (picnic lovers). The geographic research sites considered for this study include Arituba, Boágua and Carcará lakes in Nísia Florest, Rio Grande do Norte, where on Sundays and holidays the arrival of hundreds of excursionists, from around the metropolitan region of Natal, from surrounding municipalities, and neighboring States, such as Paraíba and Pernambuco, can be observed. The objective of this study is to analyze the appropriation of the physical site by the practice of excursionism, focusing on its relation to other social agents that also appropriate a designated touristic area. The theoretical discussion considers the use of the space by the touristic leisure practice and the appropriation by distinct social agents, using categories of analysis, such as, production of the space, territory and leisure. The field work was completed with interviews and questionnaires administered to excursionists, excursion organizers, local merchants, representatives of the public setor from the municipalities, and professional dune buggy drivers; besides this, photos, informal dialogue and field observations were important methodological instruments used. From the data, statistical analysis and the development of thematic maps demonstrating the established flux between excursionists and the segregated activity were done. With this research, one can affirm that the practice of excursionism is neglected by the public sector, contrary to the intention of the hegemonic agent‟s intentionality present in this touristic territory which aim at the development of a lucrative activity, geared toward tourists with greater spending power. This ignored and neglected faction of Potiguar tourism is considered poor or dirty , and generate conflicts among the distinct social agents: tourists, the market and the public sector, simultaneously peaking interest, which is then appropriated by the informal sector and formal economy. Excursionism is an expressive phenomenon, a socially relevant practice, enjoyed by citizens of the working class who, in order to have a day of leisure, use alternative consumer practices and subvert various strategies of segregation that are imposed within these tourist areas, behavior that, in part, justifies the nickname, picnic lovers , given to these tourists