A responsabilidade civil extracontratual do estado na prestação de serviços públicos de saúde

This study aims to examine the Brazilian legal model for the non-contractual liability of the state in providing public health services, from the perspective of threedimensional theory of law. Up based on bibliographical and documentary research, with emphasis on legislation, doctrine and Brazilian jurisprudence, the following conclusions were reached. The right to health is typified in the Constitution as a social fundamental right, and understands the pretension to obtain from the State, the supply of goods or the provision of services that reduce the risk of disease and other health problems; or promote, protect and recover the physical and mental well-being. Once violated the fundamental right to health, provides the managed, among other fundamental guarantees, the non-contractual liability of the state. The provision of public services by the state can be made directly through the Direct or Indirect Public Administration, or by recourse to private entities. In any case, the provision of public health services is entirely subordinate to the principles of administrative law and should be fully funded by tax revenues. As the provision of public health services is part of the administrative activity of the State, there is no way to exclude the application of the guarantee of non-contractual liability of the state in the face of the damage suffered by administered as users of these services. Therefore, it applies the theory of administrative risk, even in the event of harmful and illegal state failure.

Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

Proposta de um sistema de avaliação de desempenho para o Restaurante Universitário da UFRN

The aim of this study was to propose a Performance Evaluation System for outsourced employees of the University Restaurant of the Federal University of Rio Grande do Norte to supply the lack of evaluative instruments. According to Provision of Services Contract nº050/2010 and nº055/2011 of FURN with SAFE LOCAÇÃO DE MÃO DE OBRA LTDA ME, it is the hired company to promote periodic functional performance evaluation of the outsourced employees, but this is not done. The performance evaluation process serves to evaluate if the employees are making their tasks according to the organizations’ objectives and goals, besides that helps to find service failures and capacity of employees demands, thus contributing to improve work conditions and the global performance of the organizations. To elaborate the proposal of evaluation, it was chosen an action research with the participation of all stakeholders, employees and managers from UR. On data collect, first, outsourced employees and management servers were interviewed, in order to raise existing perceptions about performance evaluation aspects. From these data and the work routine observation, a proposal of performance evaluation was elaborated, that was appreciated, criticized and adjusted by the actors involved (employees and managers) to the final formulation of the instrument. This study also presents the necessary steps to the implementation of the Performance Evaluation System. The proposed Performance Evaluation System can be applied to the FURN assuming this process, after modification of contract terms and the approval by the ADCON. It also can serve as an example to others units that works with the provision of outsourced services, enabling so the performance evaluation to be part of the management policy of all people working in FURN.

De gata borralheira a Cinderela :nova espacialidade decorrente do desenvolvimento turístico, diferenciada pelo estilo de vida em Ponta Negra, Natal, RN

The transformations economical, social and politics in you finish them decades of the century XX brought changes that didn't just limit to the production system. The flexible accumulation took many workers lost her/it their workstations and they look for her/it new survival forms, migrating for administrative activities, of services rendered and for the tourist activity of small and medium load. The State has been investing in the implantation of plans of tourist development in order to create favorable conditions for the reproduction of the tourist activity in Brazil, mainly in the Northeast. A space when it starts to present a predominant economical activity suffers a restructuring in their social and economical relationships. The restructuring of these relationships takes to the construction of a new espacialidade. In the city of Christmas, in Rio Grande do Norte, the neighborhood of Black Tip is the most representative of the public investments for the tourist development. After intense process of tourist urbanization, Black Tip passed interfering in the global context consolidating as the tourist locus in the city. The tourist urbanization of the neighborhood took to the transformation of the space in merchandise that is sold and consumed as such. The recreation of fragments of other cultures brought by social actors, resulting from migratory processes stimulated by the tourist development, it has been presenting ruled social relationships in the informational technology, consumption of global goods and in the fragmentation of the urban space characterized by the internationalization and cosmopolitização. That process has been masking the inequalities partners and cultural as well as the territorial appropriation for an economical elite. The spaces are being appropriate for investors of the tourist section, private investors, agents and real estate producers, where the inequality is not just economical, but also cultural. The local population, mainly of the urban fraction of the Town of Black Tip, it doesn't participate of the productive process in function of the little or any professional qualification and he/she doesn't also have access to the consumption process. To the native ones it remains the fight for the preservation of his/her cultural identity and for the survival

Mercado de trabalho, ocupações e rendimentos: a Região Metropolitana de Natal na década de 1990

The aim of this study is the labour market at Natal Metropolitan Region with emphasis in occupations and incomes that took place at the nineties. The definition of its chronological boundaries passed by verification of existence of evident socio-spatial impacts for output, occupation and income in national economy, with rebounds in all national territory, conditioned by institutional and socio-economical transformations which marked Brazilian insertion to capital flows and commodities globalization movement that took place at the cited decade. It has been shown that such impacts did not distributed themselves equally between diverse spatial levels (great regions, federate unities, municipalities) because of historical specificities in each place in terms of output structures and organization of distinct social agents. Having as its basis the Marxist perspective, it tackled theoretically occupations and incomes, transformations in labour universe occurred at world level, mainly in most urbanized areas, and following that to focus changes occurred in Brazilian society related to the search for competitive insertion in global economy during the period regarded. Special attention was gave to Natal Metropolitan Region, because it was historically a concentration area for investments, productive structure, people, occupations and incomes generated/appropriated in Rio Grande do Norte State. The basic data sources for research were the demographic Census (micro data) made by the Instituto Brasileiro de Geografia e Estatística (IBGE) intending to present the structure and the labour market dynamics, having as basis: 1) traditional indicators about labour market; 2) sectors of economic activities and 3) social positions and classes segments. One of the purposes is the demonstration that occupations and incomes keep relation with the restructuring which occurred in each specific sector during the period. Other purpose is to make explicit the factors which bear the participation of distinct segments in production or service execution that make possible the different participation in income distribution. Results are revealing the increasin precariousness in labour market, enlargement of occupations in tertiary sector and greater concentration of average incomes in the social segments which were owners of the greatest capital allowances between residents in Natal Metropolitan Region during the nineties

O direito social fundamental de acesso à energia elétrica e a atuação estatal

Electrical energy today is an essential element in the life of any human being. Through the access to electrical energy it is possible to enjoy dignified conditions of life, having in mind the possibility of making use of minimal material conditions of life. The lack of access to electricity is directly linked to poverty and degrading conditions of life, in which are some communities in Brazil, especially the more isolated from urban centers. Access to the electric service is a determining factor for the preservation of human dignity, constitutional principle inscribe in the art.1 of the Federal Constitution, and the promotion of development, being a right of everyone and a duty of the State to promote universal access. For that reason, focuses mainly on the analysis of their setting as a fundamental social right and its importance for national development. For this, the theoretical and descriptive method was used, with normative and literary analysis, in particular the Constitution of 1988. This study also discusses the form of action of the State in the energy sector, to give effect to the fundamental social right of access to electricity, the characteristics of public service and the principles that guide it, in addition to the role of public policies in universalization of access, in particular the analysis of the Program Luz para Todos, and the function of regulation in the implementation of these policies and the provision of adequate public services.

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

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

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Fatores condicionantes da utilização da Internet na compra de serviços de viagens e turismo: estudo com turistas brasileiros em visita à Natal-RN

In today s global society, companies have become even more competitive with the abundance of information that prospective clients have available to them. This way the tourist services has appropriate the distribution using electronics ways as information for doing acquirement services. This work, shows the adopted provision of on-line tourist services does have suited apportionment for factors and buy decisions. The method used is a survey applied to the tourists, at international airport Augusto Severo, no matter why the visit reason to Natal city, at all, they were 210 people, being the chief variables evaluated the tourist perception of facility, utility, benefits, amenity and pleasure from the Internet s use, under the terms at the tourists experiences from the WEB about to acquisitions and researches. The results acquaint that the younger tourists or less experts tourists, in visit to Natal, demonstrated greater bias to the Internet s use than the other people. By the way women have a larger representation as a consumer from the WEB and finally, people along greater study tends to adopt. The work s contribution provides greater knowledge for the tourism executives about how might use the Internet, as well as bring forward a scene propitious for the on-line diffuseness service

Cargos comissionados da administração pública direta do Rio Grande do Norte: análise comparativa entre o perfil profissional dos cargos comissionados com vínculo funcional e sem vínculo funcional

The professional profile of public administrators in Brazil is changing very rapidly in recent years, seeking to meet the principle of efficiency by public agencies at all levels. The admission of the permanent government employee under the Public Administration is by competition, however, commissioned positions are free appointment of managers, which allows effective participation of external experts according to their respective standards and norms. In this context, this dissertation seeks to understand the main characteristics of the profile of the occupants of commissioned positions in Direct Public Administration of the State of Rio Grande do Norte, noting the differences between those with functional link with the have nots. For this study, by data collection and content analysis, a mapping of the administrative structure of the Government of the State of Rio Grande do Norte was done, i.e., the organization of the Executive Branch, which is regulated by the Complementary Law no. 163/1999 and its amendments, which consists of 53 (fifty three) entities, these 29 (twenty nine) are agencies of the direct administration and the remaining 24 (twenty four) comprises the indirect administration. With the collected data, analysis on the number of commissioned positions of each organ of the State of Rio Grande do Norte and information on education, age, length of service, gender and functional link with the direct administration was carried out. Data were available from SEARH in June/2013, when they totaled 58,733 (fifty-eight thousand seven hundred thirty-three) servers, these 2.15% (two point fifteen percent) occupy commissioned positions, corresponding to 1,262 commissioned positions under the Direct Administration, below the national average of 4% (four percent). Of total commissioned positions 64.7% (sixty-four point seven percent) have no functional link with the direct administration, while only 35.3% (thirty -five point three percent) have functional link. It was noticed that there are no clear and specific criteria for the appointments of commissioned positions in the State. They occur freely, as provided in the State Constitution. Another conclusion is the importance of Public Administration define and improve their capacity, competence and efficiency in the delivery of public services. For that it is necessary to invest in their workforce composed of permanent employees and commissioned positions to define the appropriate professional profile

Diagnóstico do usuário no aprimoramento dos serviços de tecnologia da informação: um projeto de intervenção para o Ministério Público do Estado do Rio Grande do Norte

The information tecnology (IT) has, over the years, gaining prominence as a strategic element and competitive edge in organizations, public or private. In the judiciary, with the implementation of actions related to Judiciário Eletrônico, information technology (IT), definitely earns its status as a strategic element and significantly raises the level of dependence of the organs of their services and products. Increasingly, the quality of services provided by IT has direct impact on the quality of services provided by the agency as a whole. The Ministério Público do Estado do Rio Grande do Norte (MPRN) deployments shares of Electronic Government, along with an administrative reform, beyond these issues raised, caused a large increase in institutional demand for products and services provided by the Diretoria de Tecnologia da Informação (DTI), a sector responsible for the provision of IT services. Taking as starting point strategic goal set by MPRN to reach a 85% level of user satisfaction in four years, we seek to propose a method that assists in meeting the goal, respecting the capacity constraints of the IT sector. To achieve the proposed objective, we conducted a work in two distinct and complementary stages. In the first step we conducted a case study in MPRN, in which, through an internal and external diagnosis of DTI, accomplished by an action of internal consulting and one research of the user satisfaction, we seek to identify opportunities of change seeking to raise the quality perceived of the services provided by the DTI , from the viewpoint of their customers. The situational report, drawn from the data collected, fostered changes in DTI, which were then evaluated with the managers. In the second stage, with the results obtained in the initial process, empirical observation, evaluation of side projects of quality improvement in the sector, and validation with the managers, of the initial model, we developed an improved process, gazing beyond the identification of gaps in service a strategy for the selection of best management practices and deployment of these, in a incremental and adaptive way, allowing the application of the process in organs with little staff allocated to the provision of information technology services

Os Centros de Especialidades Odontológicas como suporte da atenção básica: uma avaliação na perspectiva da integralidade

The public dental services in Brazil were limited, practically, to the basic care, so that the specialized services acted, up to 2002, no more than 3,5% of the total of clinical procedures. That lower offer reveals the difficulty of continuity of the attention, that is, the comprehensiveness in the assistance, particulary, the reference and counter-reference system. Brasil Sorridente search to supply those needs when proposing Speciality Dental's Centers(CEOs Centros de Especialidades Odontológicas, Brazil) to compose the services of average complexity. In 2005, Ministry of Health enabled the three CEOs of Natal, located in the North II, East and West Sanitary Districts. This investigation evaluated the implantation of these CEOs, as support of the family health care teams, in the perspective of organization of the services in assistencial nets in Natal/RN. It was a study of evaluation, with qualitative approach and some quantitative data as contribution. Dentists, users and managers were interviewed to identify and to understand their perceptions, relationships and experiences in the daily of the services. The conceptual base that orientated the investigation was the principle of comprehensiveness, in its operational sense of the hierarchization in health attention levels. The collection of data was done with documental research, direct observation and semi-structured interview. The analysis was accomplished by triangulation of the extracted content from the used techniques and sources of interviewed groups depositions, looking for theoretical-conceptual support in specific bibliography. The results pointed aspects that go away from the comprehensiveness like: low resolution of problems in the basic net; little valorization of the space in the health units; traditional models of access to health services, insufficient offer for some specialties, compromising the reference and counter-reference system; practices centered in procedures in the CEO; bureaucratic directions from basic care to the specialized service; disintegrated and disjointed system among levels of attention; disrespect to the municipal protocol. On the other hand, there is an approach of compreensiveness in situations like: increase of the access and covering in the Family Health Strategy (ESF Estratégia Saúde da Família, Brazil); larger approach between professional and user; tendency to the quantitative and qualitative growth of specialized actions; punctual initiatives of relationships among levels; existence of protocol to guide professionals

As organizações não-governamentais (ONGs) de atenção à criança e ao adolescente em Natal/RN: contribuição na garantia de direitos?

In contemporaneousness watches in Brazil the emergence of a "new" relationship between State and society based on partnership, which will allow the growing playacting organizations "non-profit" and "public interest" in the management of social public policies. In that sense, as part of a logic of global restructuring of the Capital, under the aegis of the neoliberal project, starting from the years of 1990, an administration model is had in favor of the market that looks for to minimize the actions of the State, reinforcing the outsourcing of the social public politics, and consequently, debilitating rights legally conquered. In that way, with this study it was pursued as general objective to apprehend the actions developed by Non-governmental Organizations NGOs in the child's area and of the adolescent in Natal / RN, verifying in that measured, these contribute to the warranty of rights or they reproduce practices of welfare work, and as specific objectives: to identify the group of the actions developed by NGOs in the child's area and of the adolescent in Natal / RN; to analyze the practice of NGOs of the point of view of the human resources, of the administration, of the financing, of the user's participation in the decision processes, as well as the quality of the services and the continuity of the actions of these organizations; and to apprehend the relationship between the researched organizations and users in the process of implantation of the actions, in order to identify the perspective that guide the practice of NGOs is going in the direction of contributing in the warranty of rights or in the reinforcement to the welfare work. In summary the results showed two trends in the actions of the NGOs, in the direction of the provision of services, which still unfurls in two perspectives of handouts. The other trend will give priority to the defense of rights of children and adolescents, with actions of political impact strengthen the promotion of public policies state, thus contributing to guarantee rights

A Construção/reconstrução das competências profissionais do assistente social diante da gestão do serviço social da indústria SESI a partir dos anos 90

L´étude du processus de construction / reconstruction des compétences de l´assistant social sous la gestion du SESI (Service Social de l´ Industrie), Natal/RN, dès la moitié des années 90 a réaffirmer la perspective que ce processus est le résultat de déterminations macrosociétaires qui sont présents, particulièrement au Brésil, aussi que, la façon par laquelle l´assistant social, le professionnel inscrit dans la division sociale et technique du travail, fait développer son perfectionement technique et intelectuel dans un milieu de nouvelles structures productives qui éxigent un nouveau profil du professionnel face à la crise du capital et de l´État. Cette recherche, de nature qualitative et quantitative, a eu lieu par de combinaisons de recherche bibliographique et empirique. Les sujets ont été huit assistants sociaux et six travailleurs administratifs du SESI, Natal/RN. Les donnés ont été obtenus par des interviews semi-structrées. On a analisé les changements qui sont arrivés dans les gestions du SESI et les compétences qui sont éxigées de l´assistant social ; l´influence du milieu socio-occupationel sur l´action professionnelle et sur le processus de construction/reconstruction de compétences; l´agrandissement de demandes institutionnelles pour l´assistant social par rapport à la prestation de services ; aussi que la constatation de l´importance de ce professionnel, sa hardiesse, mais aussi quelques limites et défis affrontés face à la qualification stimulé par le SESI, en amenant le professionnel dans un processus contradictoire de qualification et disqualification professionelle

Câncer de mama: vivência das usuárias dos serviços prestados pela Liga Norte Riograndense Contra o Câncer

This study is about the users' experiences of the services offered by League Against Câncer that are in treatment of breast cancer, focusing on how the health/illness process develops. It is distinguished, in this context, the National Politics of Health, approaching the sprouting, implantation and consolidation process of the Unified Health System and its shocks on the installment of health services to the low-income population as a legit right from Citizen Constitution. It has as an objective to analyze how the social-economic extract of these women intervenes with such process, the aspects who involve the cancer while a pathology, approaching the signals, symptoms, forms of prevention, diagnosis, among other aspects that configure themselves as important points to the understanding of these experiences, since the diagnosis, treatment and control phases. The research was carried out with 25 women, between the months of January and February of year of 2005. The used technique was the scriptstructured interview, whose universe was defined through intentional sample. The following distinguishes as a result of the research: The majority of the women has its origins on the interior of the state, possesses a familiar income from one to three minimum wages and didn't make any kind of prevention before diagnosis, currently make treatment, beyond other aspects. It becomes necessary posterior studies on this social problematic, with respect to the personal, professional, familiar and social daily behavior of these women. It is worth mentioning that the role of the social assistant in the developed work with these women, understanding all the impediments associated with such experiences, as well as giving information about the rights of the patients with cancer, conquered through the years