Universalização do acesso à saúde e regulação dos planos privados de assistência à saúde: a atuação regulatória da ANS como instrumento de harmonia contratual e viabilização do papel suplementar da iniciativa privada na efetivação do direito social à saúde

While essential to human nature, health and life have been protected since ancient times by various areas of knowledge, particularly by the Law, given its dynamics within the regulation of social interactions. In Brazil, health has been granted major importance by the Federal Constitution of 1988, which, disrupting the dictatorial authoritarianism, inaugurating a Social State and focusing on the values of freedom and human dignity, raises health to the condition of a social right, marked predominantly by an obligational bias directed, primarily, to the State, through the enforcement of public policies. Although, given the limitation of the State action to the reserve for contingencies, it turns clear that an universalizing access to public health is impossible, seen that the high cost of medical provisions hinders the State to meet all the health needs of the rightholders. As a result of the inefficiency of the State, the effort of the Constituent Assembly of 1988 in creating a hybrid health system becomes nuclear, which, marked by the possibility of exploration of healthcare by the private initiative, assigns to the private enterprise a key role in supplementing the public health system, especially through the offer of health insurance plans. At this point, however, it becomes clear that health provisions rendered by the private agents are not unlimited, which involves discussions about services and procedures that should be excluded from the contractual coverage, for purposes of sectoral balance, situation which draws the indispensability of deliberations between Fundamental Rights on one hand, related to the protection of health and life, and contractual principles on the other hand, connected to the primacy of private autonomy. At this point, the importance of the regulation undertaken by the ANS, Brazilian National Health Agency, appears primordial, which, by means of its seized broad functions, considerable autonomy and technical discretion, has conditions to implement an effective control towards the harmonization of the regulatory triangle, the stability and development of the supplementary health system and, consequently, towards the universalization of the right to health, within constitutional contours. According to this, the present essay, resorting to a broad legislative, doctrinal and jurisprudential study, concludes that economic regulation over the private healthcare sector, when legitimately undertaken, provides progress and stability to the intervening segment and, besides, turns healthcare universalization feasible, in a way that it can not be replaced efficiently by any other State function.

A função social do contrato como concretização de direitos fundamentais nas relações privadas

This dissertation deals with the social function of the contract, based on constitutional principles, especially those relating to fundamental rights. The social function of the contract (general clause) is described in the Civil Code so intentionally generic, no precise criteria to define it. Because of the fluidity of this principle, it is justified its closer study, seeking to assess its various meanings and looking away from the legal uncertainty that an unlimited conceptual vagueness can cause. The social function of the contract arises from a transformation experienced in private law from the inflows received from the Constitutional Law, the result of an evolutionary process by which it became the state structure, leaving the foundations of the classical liberal state and moving toward a vision guided by existential human values that give the keynote of the Welfare State. Arose, then the concern about the effectiveness of fundamental rights in relations between individuals, which is studied from the inapplicability of fundamental rights in private relations (U.S. doctrine of State action), passing to the analysis of the Theory of indirect horizontal effect of fundamental rights (of German creation and majority acceptance), reaching the right horizontal efficacy Theory of fundamental rights, prevailing Brazilian doctrine and jurisprudence. It has also been investigated the foundations of the social contract, pointing out that, apart from the provisions of the constitutional legislation, that base the principle on screen, there have also been noticed foundations in the Federal Constitution, in devices like the art. 1, III, the dignity of the human person is the north of the relationship between contractors. Also art. 3rd, I CF/88 bases the vision of social covenants, equipping it for the implementation of social solidarity, as one of the fundamental objectives of the Republic. Still on art. 170 of the Constitution it is seen as a locus of reasoning in the social function of the contract, the maintenance of the economic order. It is also studied the internal and external aspects of the social function of the contract, being the first part the one that considers the requirement of respect for contractual loyalty, through the objective good faith, as a result of the dignity of the hirer may not be offended by the other through the contract. On the other hand, the external facet of the social function of the contract, in line with the constitutional mandate of solidarity, indicates the need for contractors to respect the rights of society, namely the diffuse, collective and individual third party. In this external appearance, it is also pointed the notion of external credit protection, addressing the duty of society to respect the contract. There has been shown some notions of the social contract in comparative law. Then, there has been investigated the content of principle study, through their interrelationships with other provisions of private and constitutional law, namely equality, objective good faith, private autonomy and dignity of the human person. We study the application of the social contract in contractual networks as well as the guidance of conservation of contracts, especially those denominated long-term captive contracts, considering the theory of substantive due performance, concluding with an analysis of the social contract in code of Consumer Protection

Regime constitucional do direito privado das organizações religiosas

In Brazil, constitutional clauses regarding religious freedom have concrete applications in Private Law. Church-State Law, or "Ecclesiastical Law of the State," studies the legal principles which may be applicable to religious activity, exercised individually and collectively. The study of Church-State Law in Brazil lacks a thorough introduction to the constitutional and civil aspects of religious organizations: such an introduction is the main end of this work. Following a brief introduction, the main aspects of religious freedom and the principle of private autonomy as it concerns religious organizations are explained. A careful introductory analysis of Church-State Law in Brazil is thus developed: (1) the historical aspects, including a detailed account of the relations between Catholicism, the established religion up to 1889, and the government; (2) the current constitutional principles, as presented in the text of the federal Constitution of 1988, regarding the rights and claims of religious organizations; (3) how the same constitutional principles are to be used in the interpretation of Private Law (especially the Civil Code of 2002), fostering and preserving the uniqueness of religious organizations in the Brazilian legal system. A brief complementary chapter presents some aspects of the legal position of religious institutions in three other nations whose constitutional documents have influenced the current Brazilian federal Constitution (France, Spain, and the United States)

Mediação como instrumento de desjudicialização das questões familiares: constitucionalização do Direito de Família

The Liberal Constitutionalism emerged from the late eighteenth century, a period of major revolutions (French and American), fruit of the struggle for libertarian rights. Although the time of the first written constitutions, these were linked to mere political letters, did not provide for fundamental human rights, as it is, so only on the state organization, structure of powers, division of powers of the state and some relations between state and individuals. There was a clear division between the civil codes and constitutions, those governing private relations and acted as barriers to non-state intervention. After the Second World War, the constitutions are no longer Letters political order to establish how the human person, in order to enshrine the fundamental rights, the primacy of constitutional principles and take their normative function against ordinary legislator. Constitutional evolution gave the name of contemporary constitutionalism, based on repersonalization or despatrimonialização of Private Law, ceasing the separation of legislative civil codes and constitutions, in favor of the protection of fundamental rights of the human person. And this tendency to the Brazilian Federal Constitution of 1988 brought higher ground the dignity of the human person, the epicenter axiological legal to govern private relations, including family law. The constitutionalization of family law motivates the adoption of desjudicialização family issues, so as to respect the direio intimacy, privacy, private autonomy and access to justice. Conflictual family relationships require special treatment, given the diversity and dynamism of their new compositions. The break in the family relationship is guided in varied feelings among its members in order to hinder an end harmonic. Thus, the judiciary, through performances impositive, not to honor the power of decision of the parties, as also on the structural problems faced to operate on these cases, the environment is not the most appropriate to offer answers to the end of family quarrels. Situation that causes future demands on the dissatisfaction of the parties with the result. Before the development of the Family Law comes the need to adopt legal institutions, which monitor the socio-cultural, and that promote an effective assistance to people involved in this kind of conflict. In obedience to the private autonomy, before manifestations of volunteers involved in family mediation, among autocompositivos instruments of conflict resolution, is indicated as the most shaped the treatment of family quarrels. Remaining, then the state a minimal intervention to prevent excessive intrusion into private life and personal privacy

A negociação coletiva como instrumento de efetividade do direito fundamental à igualdade

Equality as a principle and as a legal rule, integrates brazilian constitutional order since the Constitution of 1891, constituting the target always be sought, built and promoted by the state and society as a whole. Also e xs urgem for protection of equality and non - discrimination, declarations and international treaties, mostly ratified by Brazil. The international protection of human beings with intrinsic value began in the UN Declaration of 1948, which declared the equality of all men in rights and dignity, followed by more specific international documents, in a growing movement of ratification of international standards protection of human rights occurs after the atrocities during the Second World War. Within the Internation al Labour Organisation (ILO), the theme of equality and non - discrimination in employment relationships integrates one of its main conventions, to No. 111, ratified by Brazil since 1965, which aims to eliminate discrimination in respect of employment and oc cupation. In this context, lies the collective bargaining work, with her normative instruments arising from the collective agreement and the agreement recognized constitutionally and with full ability to create and establish standards and conditions for de tails of suitable work for each occupational category and economic having the unions the power and duty to use them as a means of effecting the postulates of equality and non - discrimination in employment relationships, filling gaps in state law and / or su pplementing it, molding them to existing events in the capital - job. Driven by greater freedom contained in the Constitution of 1988, trading, and with it, the private collective autonomy, in fact, have included the issue of equality and the right to differ ence between clauses created, scheduled to affirmative action and sealing exclusionary conduct, and reported some positive outcomes, such as greater diversity in work and training followed by admission of persons with disabilities environment. These attitu des of union entities and employers should be broadened because corroborate the fulfillment of constitutional requirements for compliance with the international declarations, adapting them to the reality of labor relations and contributing to the construct ion of equality in the pursuit of social justice with the recognition of the right to be different with respect to the inherent dignity of the human condition.

A envergadura constitucional da posse qualificada na desapropriação privada

The constitutionalisation of private relations is the central theme of this work. Approached him overcome the dichotomy between public and private, through functionalization to the constitutionalization of civil law. Research on the effectiveness of horizontal rights. Constitutional under the lens, we analyzed the tense relationship between possession and ownership desfuncionalizada functionalized. We realize that having qualified and gained autonomy, and mechanism of access to goods, in view of the status sheet minimum, and of accomplishment, materializing human dignity. Then, we investigated the expropriation of private ownership qualified as legislative intervention that ensures the enforcement of fundamental rights through the state-court. We face the legal, the constitutionality and the burden of this institute. Also operability that it gives the judge, the process of exercise, the object, issues related to the burden and assessment of damages, as well as the nature, timing and costs of transferring property. At the end, we point to the scarcity palace, as well as the need to repair lege ferenda. The methodological approach has been championed by legal dogmatics in its analytical aspect, as we explore concepts and correlate with our planning. In empirical connotation, we evaluated the normativity and applicability of our law courts. For the ultimate in normative vision, answers to the problems faced and perform the necessary propositions, based on the results from the conceptual and empirical analysis

Gestão pública em saúde mental: um estudo em CAPS com gerência pública e privada do Rio Grande Do Norte

Currently, several models of management services from the public administration are in operation in Brazil following a global trend. Besides the traditional public management operated in SUS, there are ongoing experiments of privately management in the public health services. Accordingly, we have developed an investigation into two Psychosocial Care Centers operating between these two forms of financial resources management: the first is the CAPS II - PAR situated in the municipality of Parnamirim whose form is private and the second is the CAPS II West Christmas is that the municipal government. We seek to know the workings of services, planning forms and criteria for use of financial resources, identify differences between departments on ways to run and see how technicians and users participate in the planning and management of these resources. Documentary Research was conducted by the municipal Christmas and the financial administration of the CAPS service in Parnamirim. Were conducted an interview with manager (mental health coordinator of Natal) and another interview with an employee of planning department in the Health Department of Natal, an interview with the coordinator and financial administrator of CAPS - PAR and two groups of discussion taped conversation with semi structured script interviews with six technicians in CAPS PAR and six professionals crowded in CAPS - West.Differences were observed in the management of resources funded from four blocks of discussion and analysis of results, where the privately-run service for the direct management and bureaucracy without being discussed and planned spending on staff, as well as through meetings with users, the use of the financial resources available in box; already in service with municipal public administration there is a hierarchy, this answering the coordination of mental health and the local health department that centralizes resources and defines their spending. There are meetings with patients and families, but the demands are limited as to what can be sued because of the manager s authorization. Such differentiation would be related to differences in the articulation of public management with the different types of possible management in public services, where from the implementation of new public administration in the Brazilian s State Management Reform initiated in the second half of the 1990s, benefit management services with private regime, with autonomy and direct transfer of resources

Information literacy: uma análise nas bibliotecas escolares da rede privada em Natal / RN

GUEDES, Clediane de Araújo; FARIAS, Gabriela Belmont de. Information literacy: uma análise nas bibliotecas escolares da rede privada em Natal / RN. Revista Digital de Biblioteconomia e Ciência da Informação, Campinas, v. 4, n. 2, p. 110-133, jan./jun. 2007

Diagnóstico da cultura organizacional em hospitais da rede privada de Natal/RN

As peculiaridades presentes no ser humano são observadas a partir da manifestação de sua cultura. Estas manifestações podem ser influenciadas pelo contexto social do indivíduo. A cultura nacional é uma destas influências. A brasileira, por exemplo, possui alguns traços nacionais peculiares ao seu povo que amenizam a sua complexidade e pluralidade. Estes traços podem se tornar influentes na cultura organizacional, através da manifestação das práticas e dos valores utilizados pela organização. Diante disso, o presente trabalho teve como objetivo diagnosticar a cultura organizacional dos hospitais, enfatizando as práticas e os valores organizacionais e a percepção dos colaboradores sobre a cultura organizacional. A metodologia utilizada na pesquisa foi de caráter descritivo e explicativo. A pesquisa ocorreu através da aplicação do Instrumento Brasileiro para a Avaliação da Cultura Organizacional IBACO, com 283 sujeitos distribuídos em três hospitais da rede privada de Natal/RN. As evidências encontradas pelo estudo foram analisadas através do software estatístico SPSS, com as técnicas multivariadas de análise fatorial, análise de aglomerados e análise discriminante. A partir dessas análises, foram obtidos cinco fatores distribuídos entre práticas e valores apresentados pelo IBACO, que foram: as práticas de recompensa e treinamento; integração externa e promoção do relacionamento interpessoal; e, os valores de satisfação, bem-estar e cooperação dos empregados e profissionalismo competitivo. Os grupos encontrados na análise apresentaram divergências de opinião quanto às práticas e os valores utilizados nos hospitais. Concluiu-se, portanto, que o Hospital A apresentou uma cultura mais proativa e voltada mais para a satisfação e bem-estar dos funcionários. Já os outros dois hospitais apresentaram culturas semelhantes, com limitações quanto à valorização do bem-estar e da cooperação entre os colaboradores, porém com uma boa prática do relacionamento interpessoal

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

Excesso de peso em região do nordeste brasileiro: contraste entre escolares de rede pública e privada de ensino

The prevalence of obesity has been increased in the last three decades. It is already considered as epidemic by the World Health Organization and reaches around 300 million people worldwide. The weight gain in all ages is related to a sedentary way of life and hyper caloric food ingestion at the modern society. Obesity is a chronic disease and leads to high blood pressure, diabetes, cardiovascular diseases and cancer. The aim of this study was to evaluate the prevalence of weight excess among student in Natal schools and to analyze its association with age, gender, school category and geographic localization in city zones. This was a transversal study which enrolled 1927 children. 1084 of these were between 6 and 8 years-old (group 1) and 843 were 9 to 10 years-old (group 2). 895 of the total children studied in private schools and 1032 studied in public schools. 33,6% of the students had body mass index equal or above the 85th percentile and were considered as having weight excess. There was no statistical difference in this prevalence considering neither gender nor age. The weight excess prevalence in private schools was 54,5% and in public ones was 15,6% (p<0,01; OR=6,49). Weight excess was also more prevalent in the south and east city zones (41,3%) which have better quality of life index than in the north and west zones (28,4%) (p<0,01). In conclusion, the weight excess prevalence among students is found to be high in Natal and programs of intervention and prevention of obesity are necessary. The higher prevalence in private schools as in the wealthier city zones reflects the link between obesity and high socioeconomic level found in countries in developing. This was an interdisciplinary work with participation of epidemiology, child nutrition and pediatric endocrinology following the recommendations and principles of the Post graduation Program in Health Sciences of the Federal University of Rio Grande do Norte

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

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)