O trabalho em equipe na atenção primária à saúde: situação de Portugal e do Brasil

Introdução: Na Atenção Primária à Saúde, nos contextos internacional e nacional, o trabalho em equipe tem sido reconhecido como estratégia decisiva para a organização de processos que visam à integralidade do cuidado, além de possibilitar melhorias na satisfação dos usuários com os serviços de saúde. Neste sentido, o objetivo, deste estudo, é analisar o trabalho em equipe na Atenção Primária à Saúde. Método: Trata-se de uma pesquisa em banco de dados secundários. Realizou-se três estudos: a) O trabalho em equipe na Atenção Primária à Saúde, em Portugal, pesquisa avaliativa, de natureza qualitativa, tipo estudo de caso descritivo, que representou um recorte dos resultados derivados da pesquisa integrada ao projeto “Implantação das Unidades de Saúde Familiar em Portugal”, que teve como procedimentos entrevistas semiestruturadas, roteiro de coleta de informações (check list) e análise documental. Foi realizada a estratégia de triangulação dos dados com análise de conteúdo; b) trabalho em equipe, acesso e qualidade na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 17202 profissionais e 65391 usuários. Utilizou-se entrevista estruturada, com análise estatística realizada pelas frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. c) satisfação dos usuários com o trabalho em equipe na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 65391 usuários. Realizou-se análise estatística das frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. Utilizou-se, ainda, o Teste X2 , com nível de significância de 5%; análise de regressão logística múltipla. O modelo final foi ajustado pelo teste de Hosmer/Lemeshow, o qual indicou um ajuste de 66%. Resultados: Sobre o trabalho em equipe na Atenção Primária à Saúde, em Portugal, destacou-se a formação das equipes de forma voluntária, por meio de afinidades pessoais, a existência de “carteira básica de serviços”, juntamente com x intervenções de vigilância, promoção da saúde e prevenção de doença, cuidados em situação de doença aguda, acompanhamento clínico de doença crônica e de patologia múltipla, cuidados domiciliares, interligação e colaboração em rede com outros serviços (cuidados hospitalares), sistemas informatizados nas unidades de saúde. Os dados revelaram dificuldades quanto ao atendimento domiciliar. No Brasil, foi destaque o processo de trabalho, com avanços relacionados a realização de planejamento e programação das ações e o apoio da gestão. Existência de território definido e de prontuários familiares. É destaque a agenda compartilhada e pactuada entre os profissionais. As equipes realizam acolhimento e reuniões, cujos temas, discutidos, giram em torno do processo de trabalho e planejamento. Os desafios, enfrentados, estão relacionados ao agendamento dos usuários; ao número de pessoas sob a responsabilidade das equipes; à existência de população descoberta nas áreas adscritas à Unidade de Saúde; à incipiência na ação intersetorial e ao pouco envolvimento da comunidade pelas equipes. Quanto aos fatores associados à satisfação do usuário foi marcante: a faixa etária; a escolaridade; a raça; se a falta de material prejudica o atendimento e se a equipe consegue marcar consulta para outros profissionais. Conclusões: Constatou-se o trabalho em equipe como elemento central no processo de mudança na Atenção Primária à Saúde, tanto no contexto de Portugal quanto no do Brasil, o qual ampliou o acesso e a qualidade na oferta de serviços de saúde e obteve, ainda, o reconhecimento social, mesmo que, em ambas as realidades, não tenha avançado na coordenação do cuidado e no estímulo à participação social. Os fatores, associados com a satisfação do usuário, estão relacionados diretamente ao cuidado prestado e refletem a expectativa, por parte do usuário, de resolução concreta de suas necessidades.

Técnicas estendidas para saxofone em obras compostas por meio de colaboração compositor-intérprete

This dissertation deals with the use of extended techniques for the saxophone in the piece Minus (for solo saxophone in Bb), composed through a composer-performer collaboration between Agamenon de Morais and the saxophonist Kleber Dessoles. The text is organized in the following manner: the first part brings the historical background of the concert music written for the saxophone since the beginning of the 20th-century, exploring the use of extended tehcniques and the main characters and historical facts of this period, with data obtained through a literature review; the second part deals with the issue of the composer-performer collaboration, since cases documented in the 18th and 19th centuries until nowadays, exploring in which different ways collaborations may happen and the motivations behind them; the third and final part is about the specific work, followed by a detailed description of the collaboration between the composer and the interpreter, as well as detailed explanations about the extended techniques present in the work (multiphonics and flatterzunge), through bibliographic and documental research, as well as descriptions of the meetings between composer and interpreter. At the end of the collaborative process, one may say that the final result was created from a sum of the composer's knowledge with the interpreter's, almost as if the composition had double authorship. The document describing this process may help composers and interpreters in composing for the saxophone, as well as guide future collaborative experiences.

Papel da extensão e do trabalho junto à comunidade na formação médica

SILVA, Thiago Demétrio Nogueira Costa e; CORRÊA, Edison José; MARANHÃO, Técia Maria de Oliveira. O papel da extensão e do trabalho junto à comunidade na formação Médica. Revista Eletrônica Pesquisa Médica, v.1, n.3, p.9-13, jul./set. 2007

O estado como empregador de última instância: uma proposta de pleno emprego, estabilidade e condições dignas de trabalho para o Brasil

GOMES, Z. B. ; LOURENÇO, André Luís Cabral de . Atuação do Estado como empregador de última Instância: uma proposta para eliminar o desemprego estrutural do Brasil. In: Encontro Nacional de Economia Política, 13. 2008, João Pessoa/PB. Anais... João Pessoa: ENEP, 2008.

Atuação do estado como empregador de última instância: uma proposta para eliminar o desemprego estrutural do Brasil

GOMES, Z. B. ; LOURENÇO, André Luís Cabral de . Atuação do estado como empregador de última instância: uma proposta para eliminar o desemprego estrutural do Brasil. In: Encontro Nacional de Economia Política,13., 2008, João Pessoa/PB. Anais... João Pessoa, 2008.

A arte de montar equipes colaborativas

Bezerra, Gesiane Ferreira et. al. A arte de montar equipes colaborativas. In: SEMINÁRIO DE PESQUISA DO CENTRO DE CIÊNCIAS SOCIAIS APLICADAS,16,2010. Anais eletrônico... Natal: CCSA, 2010.Disponível em: . Acesso em: 25 nov. 2011.

Cooperação e competição entre políticas no Brasil: os cursos da governabilidade no presidencialismo da catalização

Public policies have been studied in the various fields of humanities and social sciences, from different theoretical and technical aspects. However, there is still a lack of studies that incorporate the dimension that encompasses the political action and its interference in such actions, also recognizing the importance of the institutional setting of the Brazilian presidential model in implementing these policies. This fragmented and multiparty system has led to power heterogeneous sets of political parties. Thus, the ministerial offices, more than assisting the President´s government project, manage particularized agendas, which are party biased and have the influence of interest groups in hegemonic themes addressed by government agencies. When these agendas operate in sectoral and specialized policies, the friction level is apparently low. However, when this occurs in intersectoral actions, such as in regional development, there is evidence of strong signs of competition among government agencies, which in theory, should operate in an integrated manner. Although this is not a specific feature of Luiz Inacio Lula da Silva´s government- the period to be studied- there was similar behavior in Fernando Henrique Cardoso´s presidency, one realizes that the expansion of coalition on behalf of governance is increasingly interfering in the outcome of intersectoral public policies, due to these multiple arguments in action. In order to understand these processes, this study focused on the Sustainable and Integrated Development Programme for Differentiated Meso-Regions (PROMESO), part of the National Policy for Regional Development (NPRD). The program provides interface with various government agencies and their public policies in a clear intersectoral design. The research sought to identify and analyze the relationships between government agencies and their programs with interest groups, whether political parties or other segments of civil society, highlighting the logic of favoritism, which poses in second place the integration of actions in the intersectoral policies. Therefore, besides the theoretical debate that incorporates several categories of political science, public administration, public policy, geography and economics, the study focused on secondary sources, using different government agencies databases in order to raise information. It was observed that the interference of partisan politics has been disastrous for some public policies. Thus, the research confirms that cooperative character is fragile within government agencies, often limited to official documents, and that there is indeed, a striking feature of competition, especially when it comes to transversalized policies

A gestão da informação sob a luz do Enterprise Content Management (ECM): um estudo de caso em uma universidade pública

This work involves the organization and content perspectives on Enterprise Content Management (ECM) framework. The case study at the Federal University of Rio Grande do Norte was based on ECM model to analyse the information management provided by the three main administrative systems: The Integrated Management of Academic Activities (SIGAA), Integrated System of Inheritance, and Contracts Administration (SIPAC) and the Integrated System for Administration and Human Resources (SIGRH). A case study protocol was designed to provide greater reliability to research process. Four propositions were examined in order to reach the specific objectives of identification and evaluation of ECM components from UFRN perspective. The preliminary phase provided the guidelines for the data collection. In total, 75 individuals were interviewed. Interviews with four managers directly involved on systems design were recorded (average duration of 90 minutes). The 70 remaining individuals were approached in random way in UFRN s units, including teachers, administrative-technical employees and students. The results showed the presence of many ECM elements in the management of UFRN administrative information. The technological component with higher presence was "management of web content / collaboration". But initiatives of other components (e.g. email and document management) were found and are in continuous improvement. The assessment made use of eQual 4.0 to examine the effectiveness of applications under three factors: usability, quality of information and offered service. In general, the quality offered by the systems was very good and walk side by side with the obtained benefits of ECM strategy adoption in the context of the whole institution

Parcerias municipais com o terceiro setor: o caso do conselho municipal dos direitos da criança e do adolescente de Natal

The relationship between the State and the non-governmental organizations (NGOs) needs to be analyzed and debated by the objective to extinguish or to reduce the existent failures in this partnership in order that the whole society may benefit from it. To understand how the partnership between the public and NGOs work is fundamental. The present study searches to contribute to a better understanding of this matter. With this aim, the research focused the partnership formed between Natal Child and Adolescent Council (COMDICA) and NGOs which were selected by public notice in 2007. Theoretical references were based on the Continuum of Collaboration proposed by Austin (2001) that serves to differentiate the degree and the mode of interaction between the two organizations. It was observed that in some points there is a lack in the interaction between COMDICA and the NGOs. The frequent change of the government counselors makes difficult a more intense involvement and partnership awareness with the NGOs. The NGOs members need to be more involved with the activities of COMDICA and search for a larger participation in the assemblies, on the discussions and on the intrinsic council actions. The relationship must also be rethought, since that the partnership must not be limited to financial resources support. The channels of communication must be improved and become more frequent. The evaluation and monitoring of social projects are poor and own methodologies need to be elaborated. Therefore, it is necessary to make some adjustments in this relationship involving not only the partnerships made by the selected ONGs, but also all those who assist the child and the adolescent. A closer relation makes possible a greater effectiveness of the public policies on one side and on the other side improves the performance of the COMDICA and the NGOs

O Ofício das Rezadeiras: um estudo antropológico sobre as práticas terapêuticas e a comunhão de crenças em Cruzeta/RN

The present Master´s dissertation aims to study the practices of the rezadeiras, Brazilian women healers, through an anthropological perspective. Special attention will be given to the understanding of these practices as a dynamic process in relation to those women who heal in Cruzeta (Seridó, Rio Grande do Norte), where is located our ethnographic research. For this research, twenty four rezadeiras were contacted and colaborated with our work plan. Among them, two were pentecostal rezadeiras and another one was member of the Jurema cult, an afro-brazilian religious cult. Similarities among these women healers were perceived in the research process, mostly in terms of their learning process and the use of certain objects and ritual techniques. However, apparent differences among them gave us the chance for understanding and reflecting on the actual heterogeneity of this world of specialists. Furthermore, i tried to capture the relations between the rezadeiras and the therapeutic practices from health professionals or the religious practices of religious leaders (Catholic, pentecostal, etc). It is possible to ascertain about the complementarity between therapeutic practices from different cultural logics. This complementarity is also perceived through the religious interchanges and transits among different healers, including those who have different religious beliefs. In this work, rituals are also described and they are a crucial factor to the understanding of this particular religious and therapeutic practice conducted by women. Following these ideas, our basic aim is to understand how the rezadeiras make interpretations about health and illness, specially those ones which are particular associated with their practices, the so called "doenças de rezadeiras"

Da bancada ao Bureau: análise do desenvolvimento da biotecnologia no Nordeste Brasileiro sob o enfoque de Sistema Regional de Inovação

The starting point of the present work consisted of investigating the development of biotechnology in the Northeast region of Brazil from the perspective of a Regional Innovation System (RIS). The theoretical framework adopted relied on the approaches and concepts presented by the Neo-Schumpeterian perspective. This framework was chosen because, by means of the Innovation System concept, this literature allows us to analyze the relationships and configurations of actors, as well as the role of the state and of social, science and technology, and economic policies in the studied region. The analysis considered four selected dimensions: physical infrastructure, human capital, scientific production, and funding. These variables were chosen because they allow us to verify the possibilities and limitations of developing a biotechnology RIS in the Northeast of Brazil, and these elements would help in answering the question behind this dissertation. The location of the physical infrastructure was determined by means of bibliographic and documental research and interviews with heads of institutions that do biotechnology research. Regarding human capital, the analysis focused on resource training in biotechnology, highlighting graduate courses and research groups in the area. To measure knowledge production, we delimited scientific collaboration among researchers in the field of biotechnology as the focus of this category. For the funding dimension, information was gathered from reports available at the websites of national and state funding agencies. The data was analyzed through method triangulation, involving quantitative and qualitative research stages. To back the analyses, we revisited the integration policies in the area of Science, Technology and Innovation. Our analysis has shown that these policies play a crucial role in the development of biotechnology in the region being studied. The data revealed that the physical infrastructure is concentrated in only three states (Bahia, Ceará, and Pernambuco). In this regard, the Northeast Biotechnology Network (Renorbio) stands out as a strategic actor, enabling states with poor infrastructure to develop research through partnerships with institutions located in another state. We have also verified that the practices involving human resource training and knowledge production are factors that enable the emergence of a regional system for biotechnology in the studied region. As limitations, we have verified the low immersion level of regional actors, the heterogeneity of socioeconomic indicators, the lack of financial resources, and a low innovation culture in the business sector. Overall, we have concluded that the development of a Regional Innovation System in Biotechnology, based on the current regional dynamics, depends on an effective change in the behavior of the social agents involved, both in the national and regional dimensions as well as in the public and private spheres

Proposta de modelo de interação da Universidade Federal do Rio Grande do Norte e empresas do setor de petróleo

Operational procedures may negatively interfere in negotiation and execution regarding universities and business companies. In some cases it may even derail business interaction. Thus, aiming to overcome this and other barriers a university-industry interaction model was structured. The model enhances the appropriation of technological solutions on behalf of enterprises, as well as aim to improve the quality of teaching and research done at the university. In order to conduct a case study, sampling considering the Federal University of Rio Grande do Norte (UFRN) was made as well as the Oil and Gas sector. For data collection questionnaires, classroom observation, document analysis, semi-structured interviews were used. The study describes the companies as well as the internal organization of UFRN in their interaction context. The diagnosis related to past interactions as well as the expectations of the companies and the university s internal subjects regarding the university-industry relationship were also studied. Thus, specific questionnaires were applied for the three types of groups: researchers, managers and business companies. These subjects pointed out that the great deal of barriers they identified were related to issues regarding the university internal management. Given these barriers, the critical factors were then identified in order to overcome this reality. Among the nine critical factors only one belongs to the macro environment, while the remaining factors are related to organizational issues present in the university context. It was possible to formulate a university-business interaction model one the researched focused on the case study results and contribution from a theoretical framework that was enabled trough literature review. The model considers all business collaboration mechanisms; it focuses on a particular strategic productive sector and provides a co-evolution vision over time, according to the sector´s development strategy. The need for institutionalizing the relationship with the companies involved is pointed out. The proposed model considers all the critical factors identified by the research; it aims long-term relationship with the company and integrates teaching, research and extension actions. The model implementation was also considered. It was seen that it must be done in three phases. The phases will be defined by the level of maturity in the relationship between the university and the companies. Thus, a framework was developed in order to assess the interaction level regarding company institutionalization. Whilst structuring the model was a concern with replication came up. It was pointed out that this model should not only serve to this specific case study situation. So the final result is a model of university-industry relationship appropriate in the first instance, for UFRN, but has applicability, in general, to any Brazilian university

Avaliação de efeitos de um extrato aquoso de cinnamomum zeylanicum L. na marcação de constituintes sanguíneos com tecnécio-99m e na morfologia das hemácias de ratos wistar

Radiobiocomplexes are used to obtain images in nuclear medicine and employed in basic research. Blood constituents labeled with technetium-99m (99mTc) have also been employed as radiobiocomplexes and used also experimental model for evaluation of the biological effects of natural or synthetic drugs. The analysis of the morphology and the morphometrics parameters (perimeter/área ratio) can be used to evaluate the effects of drugs upon the structure of the membrane of red blood cells. Cinnamomum zeylanicum (cinnamon) is a spice used as herbal medicine to treat diseases. The aim of this study was to evaluate the effect of in vitro and in vivo treatment with an aqueous cinnamon extract on the labeling of blood constituents with 99mTc and on the morphology of red blood cells from Wistar rats. In the in vitro treatment, isolated blood sample from animals were incubated with cinnamon extract. In the in vivo treatment, blood samples were also withdrawn from animals treated with cinnamon extract. In both cases, the radiolabeling of blood constituents was done. The morphological analysis of red blood cells was also done. As control, blood or animals treated with NaCl 0.9%. The data obtained on the labeling of blood constituents with 99mTc experiments indicated that the in vitro treatment with cinnamon extract was capable to decrease signiicantly (p<0.05) the percentage of radioactivity in cellular compartments and on the fixation of cellular and plasma proteins. These effects were not observed on the in vivo treatment. The results obtained for the morphology of red blood cells suggest that the in vitro and in vivo treatments did not alter the morphology and the perimeter/area ratio. The in vitro treatment with aqueous cinnamon extract could affect the membrane structures related with the oxidation status of the stannous ion pertechnetate ion, altering the labeling of blood constituentes with 99mTc. This study was a multidisciplinary experimental research. It was developed with the contribution of the different Departments and Services of the Hospital Universitário Pedro Ernesto of the Universidade do Estado do Rio de Janeiro

Avaliação de efeitos DW extratos de sambucus australis E sambucus nigra na marcação de constituintes sanguineos com tecnécio-99M, na morfologia de Hemácias de ratos wistar, na topologia plasmidial e na ação do cloreto estanoso no DNA Plasmidial

Radiobiocomplexes are used in nuclear medicine to obtain images and to treat diseases. Blood constituents have been used as radiobiocomplexes. Natural or synthetic products can influence on the labeling of blood constituents with technetium-99m (99mTc), the morphology of red blood cells and on the stannous chloride (SnCl2) action on plasmid DNA. Sambucus australis and Sambucus nigra are used in popular culture for treating diseases. The aim of this work was to evaluate the effects of the extracts of Sambucus australis and Sambucus nigra on the labeling of blood constituents with 99mTc, on morphology of red blood cells of Wistar rats, on the topology of plasmids DNA and the action against the SnCl2 effects on the DNA of plasmids pBSK. On the labeling of blood constituents with 99mTc it was verified that both extracts were capable to decrease significantly the radioactivity in the cellular compartment and in the insoluble fraction of plasma. Sambucus australis also decreased the labeling of insoluble fraction of blood cells with 99mTc. Both extracts did not alter the morphology of red blood cells. Moreover, it was verified that Sambucus nigra did not alter the electrophoretic profile of plasmid DNA, but decreased the effect of SnCl2 on plasmid DNA. These last results sugest a genotoxic effect and a protective action of Sambucus nigra extract against the SnCl2 action on plasmid DNA. This work was developed with the contribution of several Departments of biomedical area of the Hospital Universitário Pedro Ernesto, of the UERJ, characterizing a multidisciplinary experimental research

Dípteros (Culicidae) transmissores de arbovírus em área de proteção ambiental urbana (Parque das Dunas Natal-RN,) 2004-2006

Desenvolvido no Parque das Dunas, segunda reserva ambiental urbana do Brasil, ocupando uma área de 1.172,80 hectares, com característica de mata atlântica de dunas, situada numa faixa litorânea na região urbana do município de Natal (05° 46 S, 35º 12 W), o presente estudo, realizado durante os anos de 2004 a 2006, teve como objetivo identificar as espécies de culicídeos existentes no Parque das Dunas, capazes de transmitir arbovírus, tendo em vista que em 2004 houve uma epizootia de saguis (Callitrix jacchus), que causou grande mortandade, sem definição do agente etiológico. No ano de 2004, foram pesquisados sete pontos no interior da mata, com instalação de 20 armadilhas de ovitrampas e 20 de bambu para coleta dos imaturos. Para os adultos, durante quatro vezes por semana, foram usadas as armadilhas de Sannhon. Foram coletados 5.691 imaturos, sendo 839 Ae. aegypti, 3.184 Ae. albopictus e 1.668 Hg. leucocelaenus. A coleta dos adultos foi realizada de 2004 a 2006, etapa em que se recolheu 17.506 culicídeos adultos, sendo 17.244 Wy. bourrouli, 255 Ae. aegypti, 593 Ae. albopictus, 1.275 Hg. leucocelaenus, 294 Oc. scapularis, 05 Oc. taeniorynchus, 02 Oc. serratus e 3 Li. durhami. Para os imaturos houve correlação significativa entre Ae. aegypti e umidade relativa do ar p = 0, 049 e pluviometria p = 0,00, Ae. albopictus apresentou correlação significativa positiva com a pluviometria, enquanto Hg. leucocelaenus não apresentou nenhuma das variáveis climáticas. Para os adultos, a análise de série temporal aponta flutuação sazonal significativa para Ae. aegypti (p = 0,003); Ae. albopictus (p = 0,04); Oc. scapularis (p = 0,008 ) e Hg. leucocelaenus (p = 0,003). Uma correlação significativa negativa foi observada entre o número de Ae. albopictus coletado e a temperatura (Corr= - 0,50, p = 0,01); isto é, para cada 1°C a mais há diminuição de 7 espécimes. Este estudo teve a participação de uma equipe multidisciplinar: biólogos, entomologistas, para confirmação das espécies; técnicos de laboratório, para acompanhamento diário das larvas eclodidas das armadilhas de ovitrampas. Teve a importante colaboração de profissionais da Fundação Oswaldo Cruz FIOCRUZ/Rio de Janeiro, da Universidade de São Paulo USP para identificação do grupo Wyeomyia.