Avaliação do cuidado na estratégia saúde da família em metrópoles do nordeste brasileiro

Objective: To evaluate the implementation of the Family Health Strategy (FHS) in Brazilian cities of the Northeast, expanding coverage, analyzing the progress, challenges and innovations. Methods: Multicentric Evaluation Research, Studies Baselines in urban centers, using as a case study method. Selected cases of Aracaju, being capital, advanced coverage with extended team, and Fortaleza, capital coverage incipient and minimal staff. In Fortaleza, purposive sample of 11 Units Primary (APS), 03 managers, 53 professionals and 109 users. In Aracaju, 09 units of APS, 02 managers, 36 professionals, and 90 users. Structured interviews for managers, and structured to professionals and users. Descriptive analysis focusing on the political and institutional dimensions, organization and comprehensive care. Results: There was consensus that the ESF is the preferred port users and acts as inducing changes in care. In the case of Fortaleza, the specificities were: care protocols and community activities aimed at chronic conditions (100%) , with greater participation of doctors and nurses (93%) ; conjunction with more complex services, but the teams reported difficulties with the examination center and experts, the long waits and poor access to local services were the main difficulties reported by users., As innovative practice, the therapeutic group of elderly caregivers mentioned by respondents; There was intersectoral initiatives and teams 87 % of users have participated in meetings about health problems. In the case of Aracaju, care protocols were directed to the lines of care and formulated locally, 85 % coverage of the population with FHS counterpart local financing; employees hired by public tender; 70 % of teams with expertise in public health center for continuing education acting; democratization in management; access technologies, welcoming and computerization in different integrated networks, and evaluation matrix. Conclusions: The ESF has promoted access to health care and inclusion of disadvantaged populations. Different perceptions and practices in the organization of care, with distinct trajectories of reorganization. In the case of Fortaleza, predominance of model programs valuing older, with evidence of advances in care practices and teamwork, but restricted to primary care practices and incipient in public policy perspective. In Aracaju, had network integration with technologies related to the family, in which the ESF is consolidated as public policy. It can be argued that the XII APS expanding coverage, exhibited efficacy, despite the challenges inherent to the different degrees of implementation

A política pública de segurança em Mossoró-RN: uma avaliação de processo da implantação da guarda civil (2009-2013)

The subject of public safety is part of the academic and popular discussions, due to several factors that act in society culminating in an increasing criminality. The importance of the evaluation of public policies in this context consists in a possible control tool, monitoring and necessary adjustments to the government to make the necessary changes. Given this reality, it is thought the research problem: how Mossoró (RN) city has implemented his public security policy? In general guideline of the research, we work with the following hypothesis: the own formulation of the National Policy of Public Safety there are elements that hinder the implementation of a public policy of municipal security in Mossoró. The objective of this research is to evaluate the existing security public policy in the city of Mossoró, by the elements that facilitate and/or hamper its implementation, through the actions of municipal government in the activities of the Mossoro Civil Guard (GCM). For this, a review of the implementation process was conducted, specifically its subprocesses of selection, training, and logistical or operational. Was used bibliographical research, documental primary and secondary, and field research, with conducting of interviews. It was found that with a staff of 197 guards, and with five years of creation, the actions developed by this institution refer to an early implementation of the municipal security policy. The guard has the basic pattern selection, part of function relocation and part of public tender. The formation occurs in an introductory way, however, not complete and specific, for the function performance. Its operability is limited by the number of existing effective and by the physical structure that has not matching the demand yet, which touches on the municipal budgetary reality of direct resource intended to safety. It was found the absence of a municipal plan of public security with principles, guidelines and goals that could direct the actions of the guard. It is concluded that despite of the implementation of the GCM Mossoró have not achieved, within the parameters of efficiency, efficacy and effectiveness have played their actions, projects and programs, it could trigger a process of opening for construction of a municipal security policy. As well as break with the paradigm of municipal actions just meant for surveillance of public property, interaction affirmative for the prevention of violence and crime

Trabalho e formação docente na rede municipal de ensino de natal

The study Teacher work and education in the municipal schools of Natal objectifies the analysis of the education and work conditions of the teachers in the municipal schools of Natal, placing them within the scenario of the public policies outlined for Basic Education (2005-2010). The thesis is based on the perspective that the educational reforms implemented by the Brazilian government in an attempt to answer to the new contextual demands originated from the world of work and globalization, demanding increasingly higher levels of qualification and constant extension of the teaching functions in school from the teachers, have been configured withal as a strategy for intensifying the teacher s work. The empirical field of study was constituded by thirteen municipal schools that offer basic education. Four hundred and seventeen teacher subjects that work in the municipal school system of Natal, two representatives of the Secretaria Municipal de Educação de Natal (SME)1 that work in the pedagogical team and one representative of the Sindicato dos Trabalhadores em Educação do Rio Grande do Norte2 took part in the study. The procedures/instruments used in the research were: bibliographic review, document research, questionnaires and recording of information in a field journal. The study confirmed that the majority of the teachers that work in the municipal school system were admitted by means of public entry exams, therefore meeting the requirements set by Law 9.394/96. Most of the teachers have the initial education demanded to work in basic education, although with some limitations due to the fact that they do not correspond to the needs of the educational system. The SME has a plan for continued training of the teachers in accordance to the current ideas defended by researchers of this field. There is, although, a disconnection between the purpose of the plan and the training strategies, because, in truth, predominate repetitive and specific actions that do not contemplate the training needs of the teachers, nor the demands of the system. Although the work conditions are evaluated, by the teachers, as relatively good, limits in relation to the physical structure of the schools are observed (dirty walls with holes in them, broken ceiling fans, old chairs and desks, old and stained black boards, inadequate restroom installations, poor maintenance of the computers, amongst other items). It was also verified the an increase in the functions of the teachers and an intensification of their work, materialized through an overburden of activities undertaken daily at school (and outside of it) and through the demand in taking part in activities that go beyond those inherent to the teaching process, such as the elaboration of political-pedagogical projects, participation in collegiate, registration of student information solicited by the SME and the participation in commissions, has been happening

A Tessitura de sentidos: representação social de licenciados do curso deletras da UFRN sobre o ensinar

En esta investigación, se busca comprender los procesos de formación de pregrado del Curso de Cartas da UFRN, de estas representaciones sociales acerca de los estudiantes de enseñanza. Por lo tanto, el objetivo fue conocer y analizar las representaciones sociales de curso de pregrado UFRN Cartas sobre la enseñanza. Por lo tanto, se aplica la Técnica de Libre de Palabras Asociación (TALP) con 20 participantes, después de haber sido probados individualmente, utilizando como estímulo palabra "enseñar" y limitar el número de invocaciones a 03 palabras por participante. Esta técnica fue elegida porque es una técnica proyectiva que permite la reducción y racionalización permite acceder al campo semántico de las representaciones sociales, en nuestro caso, en la enseñanza del de pregrado do Curso de Cartas da UFRN. Por lo tanto, llegamos a total de 60 llamadas, análisis de frecuencia después de 41 y 24 después de un análisis del significado que se utilizaron en otro procedimiento aplicado en esta investigación, las calificaciones de Procedimiento de Múltiples Calificaciones (PCM). Estas palabras, sobre la base de las justificaciones de las evocaciones y significados que atribuyen participantes en la investigación, se dividieron en 4 campos semánticos: Campo 1: Aspectos técnicos de la enseñanza, Campo 2: aspectos volitivos, Campo 3: aspectos relacionales de la enseñanza y de Campo 4: Elementos del campo. El PCM se aplicó de forma individual, con 50 estudiantes. Para el análisis de los datos generados, utilizamos Análisis Multidimensional (MDS) para la Escala Multidimensional de Evaluación Análisis gratuito (MSA: Multidimensional Scalogram Analysis) y el análisis de clasificación selectiva de los espacios menores (SSA: Smallest Space Analysis). El mapa generado por el análisis de MSA fue dividido en tres regiones: Aspectos de los aspectos de enseñanza, capacitación y asistencia técnica de los promotores de la profesionalización, la primera región que tiene una sub-regionalización llamada dimensión negativa. El mapa de la SSA análisis se dividió en dos partes y un subfaceta, llamado el aspecto faceta técnica de la enseñanza y la formación, la segunda faceta llamado Vínculo entre el campo y la enseñanza específica y su nombre subfaceta aspecto relacional. Del análisis del contenido de las justificaciones de la PCM, llegó a 5 categorías, a saber: Hacer la enseñanza, la faceta negativa, Escuela, Formación y faceta afectiva del profesor. El TALP aporta pruebas de que algunos de estos estudiantes ve la oportunidad de adquirir unos conocimientos en esta área, la formación en un nivel superior, como quieran, simplemente tienen un título universitario para realizar licitación abierta. El PCM nos ha hecho comprender que el contenido representacional en cuestión se configura desde el universo consensual conectado a la profesión y la formación. Por lo tanto, podemos decir que los titulares de licencias con respecto al tema estudiado anclar la representación social de "enseñar" a la imagen de ser un maestro y objetivar la imagen de la profesión

A precarização do trabalho do enfermeiro na estratégia saúde da família: contribuição ao debate

This study makes an analysis of the work of nurse of the, uncovering the meaning of work and of precarious work for the nurse. aims to analyze the forms of precariousness of work of the nurse of Family Health Strategy the municipality of Pau dos Ferros-RN, Brazil. This is a qualitative study with analysis of the categories that emerged from search through dialog with the authors studied in theoretical framework of the sense of human work, the world of work actual and the precariousness of work in health. Used if the methodology of thematic oral history and semi-structured interview as an instrument for data collection and information. Participated 07 nurses of. There was predominance of females, with civil state married, with age between 29 and 47 years, inserted as nurses in Family Health Strategy 1 to 9 years. All referred satisfaction with work. Emerged 02 main meanings of work, whichever the design of work as a source of human and practical transforming of reality, with the sense of perform an action by the individual facilitator and suffers change. Include the precarious work not only as the absence of links labor and social protection, unlike the thought of the Ministry of Health, similar to the design of the study, the precariousness understood yet as the absence of participation of workers in the spaces work management and running of the work and the absence of structural conditions and infra-structural where the work process takes place. evidenced the totality of nurses inserted in Family Health Strategy by public tender. Refer have labor rights guaranteed. Don´t include under which legal arrangements are governed. The researched reality does not have a policy desprecarização nursing work of Family Health Strategy. Concluded the municipality presents progress and setbacks for the precariousness of work of the nurse of Family Health Strategy. The collective work in health is a challenge in researched reality and the policy of desprecarização of the work of the management of education and work was not evidenced. Despite the implementation of the public tender these professionals have a degree of precariousness of work, with the accumulation gradient of responsibilities, some lack of working conditions in structural aspects, infra-structural and means and instruments

A escrita dos professores de língua portuguesa: desvelando dizeres e saberes

This documental research in a qualitative and interpretative nature is inserted in the field of Applied Linguistics and its object of study is teachers‟ writing in a literacy event (public exam) held for teachers of Portuguese Language by municipality in Natal city - RN in 2008. Overall, we have aimed to investigate the textual production of these teachers, considering their knowledge about writing, their sayings in relation to themselves and their views on new technologies and teaching. Specifically, we have chosen the following objectives: a) identifying what knowledge about writing have emerged from teachers' written text; b) analyzing the written text production of teachers, considering the knowledge they have revealed about themselves; c) mapping the sayings of the teachers about the teaching profession and new technologies. Our discussion is grounded theoretically by Bakhtin studies of language (BAKHTIN [1934], 1990; [1952-1953], 2000; BAKHTIN; VOLOSHINOV [1929], 1999); in studies of critical literacy as formulated by STREET (1984, 1995, 2006, 2010, 2014); KLEIMAN (1995, 2005, 2006, 2008); (BARTON, HAMILTON, 1998; BARTON; Ivanic, 1991); studies on teacher training in critical educational perspective (GIROUX, 1986; 1987; 1997; 1999) FREIRE, 1999; 2001). The corpus of this study is consisted of written texts by participants of this examination about the Writing Test, in which they were asked to produce an opinion paper. The research has allowed us to realize that, in relation to the writing, despite the recurring negative discourse on literacy teachers, especially the Portuguese ones, these, in the fabric of their texts, both have revealed to have dominion over the formal structure, particularly in respect to prototypical schema of argumentative sequence, as proposed by Adam (1992, 2008) and the mechanisms of textualization postulated by Bronckart (2007), and on those enunciation-discursive strategies relating to opinion genre. The relevance of this research is justified by seeking to understand the teacher‟s writing beyond the language system, i.e, writing as speech, assuming it as a contrapalavra (BAKHTIN, [1934], 1990) to those voices that insist on underestimating literacy teachers and they do so much harm to society, to the extent that foster a sense of disbelief in the qualification of teachers' work and distrust of the social role of these professionals in the preparation of future generations

Perfis e práticas dos profissionais de saúde mental em dois hospitais psiquiátricos de grande porte

In the Brazilian network of psychosocial care, health professionals are important actors in the process of transformation of mental health public policies among various services. In the reality of psychiatric hospitals, one should understand the need to expand the debate about the current context of practices developed. This study aimed at analyzing the process of psychiatric reform and the mental health policy in the State of Rio Grande do Norte (RN) from the profiles and practices of higher-level professionals in two psychiatric hospitals. This is a cross-sectional and descriptive research, with quantitative and qualitative data, conducted in two psychiatric hospitals of RN. The universe of the target population was 95 professionals, taking into account the margin of error of 8%, non-response rate and the inclusion criteria: holding effective link with the institution by means of approval in public examination for, at least, six months, being state or municipal servant; having a minimum weekly workload of 20 hours in service; participating in care and/or activities with patients and families in a direct way. The final sample consisted of 60 professionals. The tool for data collection was a questionnaire with closed and semi-open questions about socioeconomic profile, and mental health policies, practices and training. Quantitative data were tabulated in the statistical software SPSS, and simple and bivariate statistics, chi-square type, was used for analysis by adopting the significance level with the value p<0,05. In order to analyze data, the content analysis of Bardin was used. The qualitative findings obtained with the semi-open questions in Analyse Lexicale par Context d'un Ensemble de Segments de Texte (ALCESTE) were grouped into four thematic axes: Professional action in mental health; Mental health training; Scenarios of psychiatric reform and psychiatric hospitals; Mental health policies and practices: challenges for professionals in hospitals. The profile of professionals has revealed the majority of women (89,7%), nurses (36,7%), aged 50-59 years (42,9%), weekly workload of 40 hours (52,4% ), time of completion of graduation from six to 15 years (57%), and 21,4% reported to have specialization in mental health. Regarding the practices developed in individual care, it was found an association between those who do not build or partially conducts the therapeutic project and those who conduct care related to observation and annotation. In family care, it was obtained care consultation during crisis; and, in group care, recreational activities. In the analysis of thematic axes, it was noted that, despite changes identified in the profiles and practices of higher-level professionals in care services for mental health, with the implementation of new public policies for this field, the findings indicate the confluence of asymmetries and divergences in the actions of the teams in psychiatric hospitals, difficulties in managing services, frequent readmissions, reduced quantitative of available services and equipment, high demand of users, disarticulation of the network of psychosocial care, and the very shortage of skilled human resources to compose these services. Accordingly, the evidenced scenarios partially outline the current political and ideological mismatch of the national process of psychiatric reform that denies the role of care actions conducted within hospitals, although it has not gone far enough with the creation of new services that justify the total extinction of this institution