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

Adiamento da aposentadoria e o significado do trabalho para servidores de uma universidade federal

This study investigated the intention of the older workers to continue working after state pension age/time. On this way, it explores the relation between this intention and factors related with the meanings of the work and retirement. Specifically, it was examined that factors related to work and non-work are predictors of the intention to continue working, and it was explored if meanings of retirement are linked to this decision. It is a crosssectional mixed methods study, using a survey conducted with 283 federal civil servants of a federal Northeastern University which were near retirement. It envolved an on-line questionnaire, with open-ended questions and the likert-type scale "Older Worker's Intention to Continue Working" (OWICW) of Shacklock and Brunneto (2011), which was validated to the Brazilian version. The quantitative data were analyzed using descriptive and multivariate statistics, specifically procedures for comparing means and coefficients of multiple logistic regression. The qualitative data were analyzed using the lexicographical technique Descending Hierarchical Classification. The findings indicate that most participants want to continue in paid work, and that perception of personal autonomy at work, interpersonal relationships at work, interests outside of work, and flexible working arrangements are significant predictors of intention to continue working. Furthermore, the perception of personal autonomy at work, flexible working arrangements, and the financial incentives are predictors of decision to postpone retirement and remain in the organization. The analysis revealed five patterns of meanings of retirement: "worker's right", "resting", "idle time at home", "new stage in the life course", and "enjoy the use of time”. The decision to postpone retirement is linked to idleness and lack of substitutionary activities work, and the decision to stop working linked to retirement as a life with more quality. The study provides information that can contribute with management policies before the process of retirement decision.

Mulheres na Política e Autonomia

The proposal of this study was to work with women in the politics, focusing on their trajectories, biographies and speeches, to catch the meanings given by themselves to their insertion in the political field. The privileged instrument of research was the autobiographical narratives of fifteen women who, in Paraíba, had participated of the electoral processes and the life partisan politics in the period from 1998 to 2008, in the state and federal scopes. This permitted us to search the dimension of their lived expericence, to understand the trajectories and the processes of autonomation of the women, in the politics. Moreover, a quantitative mapping of the feminine presence in the processes was made electoral politicians in a wider context. In a similar way, two surveys had been carried throughout the research, among others aspects, to understand that image voters and politicians they construct concerning the feminine participation in this field. These instruments were important not to lose of all the social view where these lives were developed, the places from which these women speak and locate and the social meanings originated from this participation. The research aimed to establish dialogues between knowing and fields of discipline, beyond the dichotomy of actor/structure, preventing generalizations that ignore the plurality of the individuals, to reveal some aspects of the complex and contradictory processes that involve their participation in the political field. At last, it is tried to show that, although the frequent accusations of autonomy lack, when establishing relations in the public space, the women, as all subjects, can reflect about themselves, the motives of their thoughts and their actions escaping from the servitude of the repetition and avoid being only product of the institution that formed them (CASTORIADIS, 1992, p.140-141)

Desenvolvimento e autonomia das mulheres: uma avaliação do POPMR na região oeste potiguar - 2008/2012

The dissertation evaluates about Rural Women s Productive Organization Program effectiveness of Western Rio Grande do Norte(2008-2012). Specifically, it has aimed to: 1) Describe about Rural Women s Productive Organization Program characteristics in Western Potiguar Region; 2) Investigate which social economic changes the program has caused in Rural Women s lives from Western Potiguar Region; 3) Evaluate whether women s participation in the feminist social movement has contributed in order to facilitate access to the program; 4) evaluate whether rural women s participation from western Potiguar region in POPMR has provoked some questions in relation to labor sexual division in policy all female users or whether it has amplified their capacities for their economical autonomy conquest. The evaluation has been as reference the development concept as freedom according to Amartya Sen (2000) and labor sex division sustained by separation and hierarchy activities performed by men and women according to Kergoat (2009). The qualitative character investigation was made up by a bibliographical and documental research, semi-structured interviews and focal group. The interviews with female mediator agents and female public managers have demonstrated the paths how to create the program by explaining the difficulties and possibilities. The research was concluded with focal groups that had accessed POPMR in western region. With the methodological instruments used, it was possible to achieve the results: The research data show that POPMR has contributed for the region development specifically by expanding rural women s capacities. However, there are still some difficulties which could be overcome with a state actualization, as policies for home labor and home labor care socialization. In this way, the infrastructure construction for production and reproduction must be based on a kind of legislation for a small production which are indispensable elements for a bigger effective policy for women in a rural environment

A política como projeto de autonomia em Cornelius Castoriadis

La investigación presenta los conceptos y argumentos más importantes para Cornelius Castoriadis que permitan elucidar el papel de la acción política en la búsqueda de la autonomía individual y colectiva. A partir de la delimitación histórica y conceptual de la reflexión filosófica sobre la autonomía, se muestra las principales críticas de Castoriadis dirigida al determinismo histórico, las tendencias totalitarias en la historia de la filosofía y la alienación promovida por la ideología capitalista. Por lo tanto, es esencial para comprender las categorías utilizadas por él durante toda su camino filosófico: sociedad, imaginación radical, imaginario social, lenguaje y social-histórico. Castoriadis opone a cualquier concepción de la historia que apela a un plan predeterminado, ya sea natural, racional o divino. Continúa la idea de que cada sociedad es el resultado de una tensión permanente entre la sociedad establecida y la sociedad instituyente porque cada sociedad es el resultado de la diferencia entre la sociedad en particular y el imaginario social que promueve su modificación. La historia es creada por la actividad teórica y práctica de los hombres, en la dimensión llamada social-histórico que impone un límite que no se puede superar incluso objeto de cuestionamiento y del constante cambio de la acción humana. Para aclarar el concepto de la democracia presentado por Castoriadis se analizan en profundidad como la imaginación radical se inserta en la formación de la persona y la institución de la sociedad, así como elucidar la forma en que se relacionan los conceptos de autonomía, heteronomia, libertad, igualdad y justicia, explicando el contexto que aparecen en la obra de Castoriadis.

Círculos ao invés de linhas: em busca de valores e princípios estruturantes da gestão social. Projeto juventude, participação e autonomia (Instituto Universidade Popular - UNIPOP)

The organizations are characterized as dynamic spaces, they are being revisited and redefined, because they constitute structural human spaces and new vain outlines won expression. As it begins, of the non consensus in its conception, it is explicit the complexity degree that is identified in the plurality and diversity, brought by the people that compose them, characterizing it as accomplishment space, of happiness and also of conflict, of relationships of power and organizational limits and from birth and burial of faiths, values, norms, symbols, knowledge and rituals, therefore, deeply human. In that way, to know the administration of the organization is preponderant condition for the format of the human relationships to be delineated in its living. Like this the work makes an option in knowing the social administration, this work tries to know and analyze the values and beginnings of the social administration; revealling characteristics and specificities of the organizational performance of UNIPOP that contribute to the formation of the conception of Social Administration, it tends as source of the information the managers of the institution; to identify the formative values of UNIPOP that contribute to the youths' partner-political action in the community, tends for reference the current students of the organization and last to evaluate values structurates and supporting that interconnection between the organizational Administration, formation youth's program, participation and autonomy and attendance, starting from the existences gained by the exits, of that program. This way, the research will be qualitative, looking for understanding starting from their documents, the existence of those values

A arte de conduzir-se pelo ensino de teatro: realidades e ficções de alunos-diretores em Camarão

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Modificações introduzidas pelos treinamentos cardiopulmonar e neuromuscular nos níveis séricos basais de fatores de crescimento insulina símile i (igf-1), cortisol, autonomia funcional e qualidade de vida de mulheres idosas

Changes introduced by cardiopulmonar and neuromuscular training on basal serum insulin-like grow factor-1 (IGF-1) and cortisol levels, functional autonomy and quality of life in elderly women The aim of this study was to compare the effects of strength and aerobic training on basal serum IGF-1 and Cortisol levels, functional autonomy (FA) and quality of life (QoL) in elderly women after 12 weeks of training. The subjects were submitted the strength training (75-85% 1-RM) with weight exercises (SG; n=12; age=66.08 ± 3,37 years; BMI=26,77 ± 3,72 kg/m2), aerobic training with aquatic exercises (AG; n=13; age=68,69 ± 4,70 years; BMI=29,19 ± 2,96 kg/m2) and control group (CG; n=10; age=68,80 ± 5,41 years; BMI=29,70 ± 2,82 kg/m2). Fasting blood was analyzed to measure basal IGF-1 and cortisol levels by chemiluminescence method. The t-Student test showed increased IGF-1 in the SG (p<0.05) for intragroup comparison. The Repeated-measure ANOVA presented increased IGF-1 (p<0.05) in the SG compared to the other two groups. There were no differences in cortisol levels. All the FA tests (GDLAM autonomy protocol) presented decreased significant in the time marked in seconds to the SG. The same results were found in the AG, except in the rise from a sitting position test. The autonomy index presented significant improvements (p<0.05) in the SG related to the AG and CG and in the AG to the CG. The SG showed increased QoL (p<0.05) (by WHOQOL-Old questionnaire) in the facet 1 (sensorial functioning) and facet 5 (death and dying). Thus, the SG obtained positive changes on IGF-1 and FA levels when compared to the AG. This suggests that strength training can indicated to decrease the effects of ageing.

Exercício aeróbico, resistência de artéria carótidae autonomia funcional em mulheres idosas

The aim of this study was to analyze the effects of an aerobic exercise program on the internal right carotid resistive index (IRCRI) and the functional autonomy levels of elderly women. The sample was composed of 25 elderly sedentary women, aged between 60 and 75 years, allocated into two groups: an experimental group consisting of 14 women submitted to aerobic treatment and a control group (n=11). Carotid artery resistance assessment was conducted using Doppler ultrasound and functional autonomy by the following tests: 10m walk (10mW), rising from a sitting position (RSP), rising from a chair and moving about the house (RCMH), rising from the ventral decubitus position (RVDP) and putting on and removing a t-shirt (PRTS). Aerobic training consisted of walking 30 minutes a day, 3 times a week, for 3 months. To control the intensity of the walk, the index of perceived exertion was used, with standardized Borg scale values corresponding to 13-15 points, characterized as slightly tiring exercise with training heart rate (TRH) between 50% and 80% of heart rate reserve (HRR). Repeated measures ANOVA was used for statistical analysis. Compared to the control, the experimental group obtained a statistically significant decrease in right internal carotid resistance (p = 0.021) and a significant increase in the following tests: 10mW (p=0.000), RSP (p=0.035) and RCMH (p=0.016). These results suggest that engaging in aerobic exercises was effective in decreasing IRCRI and improving functional autonomy inelderly women

Exercício aeróbico, resistência de artéria carótida e autonomia funcional em mulheres idosas

Este estudo teve como objetivo analisar os efeitos de um programa de exercício físico aeróbico sobre o índice de resistência da artéria carótida interna direita (IRCID) e os níveis de autonomia funcional de mulheres idosas. A amostra foi constituída por 25 idosas sedentárias, com idade entre 60 e 75 anos, divididas em dois grupos: grupo experimental com 14 idosas submetidas ao treinamento aeróbico e grupo controle (n=11). A avaliação da resistência da artéria carótida foi realizada pelo método de ultrasom Doppler e a autonomia funcional pelos testes: caminhar 10m (C10m), levantar da posição sentada (LPS), levantar-se da cadeira e locomover-se pela casa (LCLC), levantar-se da posição decúbito ventral (LPDV) e vestir e tirar a camisa (VTC). O treinamento aeróbico foi realizado na forma de caminhada, 30 minutos por dia, 3 vezes por semana, durante 3 meses. Para o controle da intensidade da caminhada foi utilizado o índice de esforço percebido, com valores padronizados pela escala de Borg onde a intensidade deveria corresponder a uma faixa entre os valores 13 a 15 pontos, correspondente a uma situação orgânica derivada de um exercício compreendido como ligeiramente cansativo e a frequência cardíaca de treino (FCT) entre 50% a 80% da frequência cardíaca de reserva. Para analise estatística foi utilizado a ANOVA de medidas repetidas. O grupo experimental quando comparados com o grupo controle obteve uma diminuição estatisticamente significativa na resistência da artéria carótida interna direita (p=0,021), e um aumento significativo nos testes: C10m (p=0,000), LPS (p=0,035) e no LCLC (p=0,016). Estes resultados sugerem que a prática de exercícios físicos aeróbicos foi eficaz em diminuir o IRCID e melhorar os níveis de autonomia funcional em mulheres idosa

A encruzilhada da vida política em assentamentos de reforma agrária no Rio Grande do Norte

The rural settlements represent a mark in the expensive historical process of fight by the land in Brazil. At first offer basic terms of survival, through the access the land and of the fundamental supports for exploration. At the same time, have stimulated organization forms politicizes of the families who manage to work with the new challenges of the everyday. The moment that follows the land conquest, and therefore, the settlements construction while life and work project, it is crossed for objective and subjective demands, with highlight for options of agricultural production and strategies of collective action. Originally formed as representation instance legitimates of the families - front to the government and social actors - the settlers associations are private spaces for political sociability, that guided by principles participative, can lead the settlers the new conquests through indeed democratic experiences. The goal of this work is to comprehend the participation forms in the scope of these associations and the way as that translates in life best terms for the group, from the settlements experiences located in the Territories of the Citizenship Mato Grande and Açu-Mossoró, in Rio Grande do Norte's State. The theoretical conceptions that guide this analysis are concentrate on discussions about democracy and participation (Patermam, Putnam, Bodernave) and in the reflections about the rural world (Medeiros, Martins, Woodman e Woodman and Bergamansco). About methodological, different point of view strategies were developed: The direct observation, the application in locate of questionnaires to the families settlers and interviews semi-structured with the internal leaderships. With that could verify that the participation forms in the associations operate in two heartfelt: Of a side, they promote assimilation opportunities of democratic abilities accompanied of notions of social rights and redefinition of political standards; Of another, it offers indeed the possibility of the settlers lead, with relative autonomy, the political organization and her changes in direction to a way of life that wish to have in the settling

Diálogos da Alma: uma outra história da loucura

The tesis intends to awake a new way of looking at madness. It presents as reference the Psychiatric Hospital Doctor João Machado (Natal/RN) and histories of life and narratives of four intern residents. The research in an ethical horizon, intends to give back to the subjects the voices long silented behind the institutions walls by their families and society in general. As well as to open the interpretations of science to receive and to dialogue with other itineraries of thought that, if on one hand does not restitute the explanation of the Real, on the other hand expresses other forms to see the world. Dislocated of the bigger social environment, the people identified as insane, construct their histories endowed with autonomy and displacements in relation to the social rules and structures that characterize our society, as much as in relation to the logical principles of thought that assume an objective and rational reality. As well as a remnants bedspread configured in a complex and unfinished object, the break up of histories of life of the interns, interviews with medical on psychiatrists to the Doctor João Machado Hospital, documents of the institution and depositions of that house, were the raw material to construct, with this tesis, another chapter of the 'history of madness'. In elapsing of the work innumerable voices have been heard. Some that study the phenomenon of madness, others that live this 'state of the being' in the world. We opt to detaching the first of an open conception on the theme through intellectuals as: João da Costa Machado, Ulysses Pernambucano, Nise da Silveira and Boris Cyrulnik. They express ethics compromised to the humanity of the being

Desenvolvimento e políticas públicas: uma avaliação do PRONAF nos assentamentos de reforma agrária do Rio Grande do Norte

The research DEVELOPMENT AND PUBLIC POLICY: AN EVALUATION OF PRONAF IN THE SETTLEMENTS AGRARIAN REFORM OF RIO GRANDE DO NORTE aimed to evaluate the effectiveness of the National Program for Strengthening Family enhancerelement od development in rural settlements od Rio Grande do Norte. The methodological approach consisted of the completion of desk research and literature on development issues, policies, and rural credit and field research through semi- structured interviews with managers and technicians who work with the program and conducting focus with farmers settles who accessed the PRONAF the period from 2000 to 2006. The survey results confirm the central hypothesis of this work, that acces to PRONAF A is not causing efetivations relevant in the lives of farm workers settlers in Rio Grande do Norte. In the setllements where efetivations these occur, they are short of what the program intends to carry out and rely on a set of conditionalities that are beyond the operational frameworks of the same. Such questions point to the need to revise the program in order to estabilish adjustments that in practice the approach of the proposed objectives. For this purpose it is necessary to invest in factor that contribute to the program has a positive effect not only to increase income, but to contribute to the autonomy of the resettled farmers, expanding its capabilities and increased the power of choise with respect to life who wish to take

PSEUDO: uma análise sociocognitiva sobre insinceridades, mentiras e crimes de fraude

The objective of this work is to analyze the phenomenon of lying, highlighting some uses and social consequences. Lies are a ubiquitous phenomenon, and in many cases they even promote social harmony. Furthermore, telling lies is an expression of individuality: it is the expression of relative autonomy that the subject has towards their social environment allowing them to defend their most personal interests. The work also aims to examine the concept of habitus applied to the social production of lies. Thus, the liars produce their lies aiming to obtain certain effects on their audiences. There are certain social cognitive principles that structure the kind of lie that is usually told to the public. Finally, the perpetrators of crimes of fraud and other deceptive practices may suffer a criminal prosecution because the damage they cause affects important social values recognized by the state, and are not restricted to the victim‟s chagrin. In the most common forms of fraud, the crooks make tempting offers to victims exploiting some of their standardized behaviors and reactions. To understand the fragility of the victims to scams is an attempt to understand how a social phenomenon as usual as is the lie can still surprise and cause perplexity

Ambiente institucional no crédito rural :avanços e retrocessos

This work aims to study the institucional environment for the implementation of financing policies directed to familiar agriculture. The central hypothesis is that, although all changes occured in the credit norms, in order to reduce the existing obstacles for the access of outsiders, the same institucional arrangement remains which gave support to the modernization - crystallizer of strengthening structures of this exclusion. The most relevant pressuposition is that the poor agriculturists are the most displayed to the institucional limitations. The concepts of institucional arrangements and environments used in this work had been constructed with support of the institucional school, contemplating itself the economic dimension, the organizational sociology and political science. In the relation of the institucional changes with the state performance, the theorist reading was important that reflect on the relative autonomy of the State and studious of the Brazilian State. The empirical part consisted of a research which had been applied questionnaires with benefited and non-benefited agriculturists with PRONAF B, in thirteen cities of Rio Grande do Norte. In each city, interviews with four of its main mediators had been carried out. The research results had ratified the hypothesis of the work of that the conception of the public policies does not take in account the institution role in the behavior and the choices of the individual and collective agents, inferring itself that this policy, as others, lacks of mediation that exceed the rationality of legal landmarks