A mediação como instrumento concretizador do direito fundamental à saúde: uma alternativa à judicialização de conflitos Natal 2013

In Brazil, the 1946 Constitution enshrined the right to health, having it defined as the possession of the best state of health that the individual can achieve. Already the Federal Constitution of 1988 lifted that right to the status of fundamental social right, which transcends the effectiveness and cure of the disease is based on the joint liability of public entities for the provision of a quality service, efficient and prioritize human dignity and comprehensive evaluation of patients. According to the World Health Organization, the definition of health, first characterized as the mere absence of disease, has become recognized as the need to search for preventive mechanisms to ensure the welfare and dignity of the population. Garantista this context, the growing seem lawsuits that deal with the implementation of public policies, especially in the area of the right to health, the omission of which the Government can result in the risk of death. Hence the concern of law professionals about whether or not the intervention of the judiciary in cases that deal with providing material benefits of health care. It claims to break the principle of separation of powers, disobedience to the principle of equality and the impossibility of judicial intervention in the formulation of public policy to try and exclude the liability of public entities. In contrast, the judiciary has repeatedly guardianships granted injunctions or merit determining the supply of materials indicated by the medical benefits that accompany the treatment of patients who resort to a remedy. In this context, mediation, object of study and resolution presented in this work, is presented as an instrument conciliator between the reserve clause and the right to financially possible existential minimum, as it seeks to serve all through rationalization of health services , avoidance of negativistic influence of the pharmaceutical industry, with prioritizing the welfare of the individual and the quality of relationships. This is alternative way to judicialization that in addition to encouraging and developing active citizen participation in public policy formulation also allows the manager to public knowledge of community needs. It is in this sense that affirms and defends the right to health is no longer the mere provision of medical care and prescription drugs, but a dialogue conscious existential minimum to guarantee a dignified life

A intervenção do poder judiciário no acesso a medicamentos no Rio Grande do Norte: uma análise sob a ótica das políticas nacionais de medicamento e de assistência farmacêutica

The present study aimed to evaluate the inclusion of the principles of the National Medicines Policy - PNM and the Pharmaceutical assistance - PNAF in the prosecution of lawsuits involving medicines. To fulfill this necessity , data collection was performed on the website by the Tribunal Rio Grande do Norte - TJ RN ( Rio Grande do Norte Court) , in 2012 . It was obtained 115 judgments, which were analyzed in order to generate Monitoring Indicators from lawsuits and conduct content analysis proposed by Bardin (2006). The results showed that : a) 100 % of the decisions were favorable to the author , b) 76 % of decisions were requests by the trade name of the drug , c) only one drug (eculizumabe) had not granted by ANVISA , d) 36 % of drugs were present in the list of standard medicines in SUS , 16 % of primary care block and 20 % of specialized component , e) 76 % of the decisions presented the request of at least 01 non-standard medicine. With regard to decentralization of PNM and PNAF we observed a commitment to this principle at judicial decisions, to see that municipalities and states are often forced to buy medicines of responsibility from another federal entity or other tertiary units as CACONs and UNACONS. The content analysis revealed that the argument from the judges used when you utter their decisions was that the right to health is recognized by Brazilian law as a fundamental right and should be guaranteed by the State for all its citizens. So, health is more than budgetary constraints of federal entities, which are severally liable for lawsuits , regardless the medication requested belongs or not to a particular block of a pharmaceutical assistance funding. Given these data, it is observed that there are gaps in the judgment when it comes to the insertion of the words and principles of PNM and PNAF, creating then the need for greater dialogue between the executive and judicial, so that they may consider relevant the effectiveness and application of such principles to minimize the negative consequences of the phenomenon of health judicialisation. Keywords: Judicialisation, Medicines, Public Policy, Pharmaceutical Care

Práticas de letramento digital de professores em formação: demandas, saberes e impactos

Over the last decades, the digital inclusion public policies have significantly invested in the purchase of hardwares and softwares in order to offer technology to the Brazilian public teaching institutions, specifically computers and broadband Internet. However, the teachers education to handle these artefacts is put away, even though there is some demand from the information society. With that, this dissertation chooses as an object of study the digital literacy practices performed by 38 (thirty-eight) teachers in initial and continuous education by means of the extension course Literacies and technologies: portuguese language teaching and cyberculture demands. In this direction, we aim at investigating the digital literacy practices of developing teachers in three specific moments: before, while and after this extension action with the intent to (i) delineate the digital literacy practices performed by the collaborators before the formative action; (ii) to narrate the literacy events made possible by the extension course; (iii) to investigate the contributions of the education course to the collaborators teaching practice. We sought theoretical contributions in the literacy studies (BAYNHAM, 1995; KLEIMAN, 1995; HAMILTON; BARTON; IVANIC, 2000), specifically when it comes to digital literacy (COPE, KALANTZIS, 2000; BUZATO, 2001, 2007, 2009; SNYDER, 2002, 2008; LANKSHEAR & KNOBEL, 2002, 2008) and teacher education (PERRENOUD, 2000; SILVA, 2001). Methodologically, this virtual ethnography study (KOZINETS, 1997; HINE, 2000) is inserted into the field of Applied Linguistics and adopts a quali-quantitative research approach (NUNAN, 1992; DÖRNYEI, 2006). The data analysis permitted to evidentiate that (i) before the course, the digital literacy practices focused on the personal and academic dimensions of their realities at the expense of the professional dimension; (ii) during the extension action, the teachers collaboratively took part in the hybrid study sessions, which had a pedagogical focus on the use of ICTs, accomplishing the use of digital literacy practices - unknown before that; (iii) after the course, the attitude of the collaborator teachers concerning the use of ICTs on their regular professional basis had changed, once those teachers started to effectively make use of them, promoting social visibility to what was produced in the school. We also observed that teachers in initial education acted as more experienced peers in collaborative learning process, offering support scaffolding (VYGOTSKY, 1978; BRUNER, 1985) to teachers in continuous education. This occurred because of the undergraduates actualize digital literacy practices were more sophisticated, besides the fact being integrate generation Y (PRENSKY, 2001)

O direito à saúde e a política nacional de atenção oncológica: uma análise a partir da crescente judicialização dos medicamentos antineoplásicos

The 1988 Federal Constitution of Brazil by presenting the catalog of fundamental rights and guarantees (Title II) provides expressly that such rights reach the social, economic and cultural rights (art. 6 of CF/88) as a means not only to ratify the civil and political rights, but also to make them effective and practical in the life of the Brazilian people, particularly in the prediction of immediate application of those rights and guarantees. In this sense, health goes through condition of universal right and duty of the State, which should be guaranteed by social and economic policies aimed at reducing the risk of disease and other hazards, in addition to ensuring universal and equal access to actions and services for its promotion, protection and recovery (Article 196 by CF/88). Achieving the purposes aimed by the constituent to the area of health is the great challenge that requires the Health System and its managers. To this end, several policies have been structured in an attempt to establish actions and services for the promotion, protection and rehabilitation of diseases and disorders to health. In the mid-90s, in order to meet the guidelines and principles established by the SUS, it was established the Política Nacional de Atenção Oncológica PNAO, in an attempt to sketch out a public policy that sought to achieve maximum efficiency and to be able to give answers integral to effective care for patients with cancer, with emphasis on prevention, early detection, diagnosis, treatment, rehabilitation and palliative care. However, many lawsuits have been proposed with applications for anticancer drugs. These actions have become very complex, both in the procedural aspects and in all material ones, especially due to the highcost drugs more requested these demands, as well as need to be buoyed by the scientific evidence of these drugs in relation to proposed treatments. The jurisprudence in this area, although the orientations as outlined by the Parliament of Supreme Court is still in the process of construction, this study is thus placed in the perspective of contributing to the effective and efficient adjudication in these actions, with focus on achieving the fundamental social rights. Given this scenario and using research explanatory literature and documents were examined 108 lawsuits pending in the Federal Court in Rio Grande do Norte, trying to identify the organs of the Judiciary behave in the face of lawsuits that seeking oncology drugs (or antineoplastic), seeking to reconcile the principles and constitutional laws and infra constitutional involving the theme in an attempt to contribute to a rationalization of this judicial practice. Finally, considering the Rational Use of health demands and the idea of belonging to the Brazilian people SUS, it is concluded that the judicial power requires ballast parameters of their decisions on evidence-based medicine, aligning these decisions housing constitutional principles that the right to health and the scientific conclusions of efficacy, effectiveness and efficiency in oncology drugs, when compared to the treatments offered by SUS

O direito coletivo prestacional à saúde e o poder judiciário: a concretização do art. 196 da Constituição de 1988 pela via jurisdicional

During the ninth century, owing to the process of industrialization, new social conflicts were showed, forcing the Government not to remain inert. The necessity of answer to these new demands requires from the State some actions that assure the new economic, cultural and social rights, able to exceed the formal equality, according to the principles of redistributive equality and well-being. Among the social rights, the right to health is showed up, which is placed at the Universal Declaration of Human Rights and the International Treaty for the Economic, Social and Cultural Rights, as a necessary term to promote the dignity and the free development of the human personality. Under the Constitutional Law, it is clear that the implementation of the right to health, placed at the 6th article of the Brazilian Constitution, demands a government activity, which usually requires a provision of material goods, depending on budgetary resources. The Legislative and Executive Branches have a very important role in compliance with the constitutional regulations about the satisfactory offer of health care services, besides the correct use of the resources at this area. The adoption of public policies is the way of Government action to the planning and realization of this right. Though, some public policies are usually made apart from the social compromises, to the detriment of the basic social rights. The government has a discretionary competence to manage the health services. That is the reason it is necessary the control of the political choices, through the popular control, the extrajudicial control by the Account Courts, or the judicial review. Owed to the constitutionalization of social rights, the constitutional justice has a very relevant role, concerning to the constitutional jurisdiction, in a way the Judiciary Branch assume your position as a player that transforms the society. On the control of the public health policies, there is a cast of official instruments, judicial or not, to the guarantee of the collective right to the public health services, and to allow the citizens to reach the real implementation of the right to health

Práticas de letramento digital de professores em formação: demandas, saberes e impactos

Over the last decades, the digital inclusion public policies have significantly invested in the purchase of hardwares and softwares in order to offer technology to the Brazilian public teaching institutions, specifically computers and broadband Internet. However, the teachers education to handle these artefacts is put away, even though there is some demand from the information society. With that, this dissertation chooses as an object of study the digital literacy practices performed by 38 (thirty-eight) teachers in initial and continuous education by means of the extension course Literacies and technologies: portuguese language teaching and cyberculture demands. In this direction, we aim at investigating the digital literacy practices of developing teachers in three specific moments: before, while and after this extension action with the intent to (i) delineate the digital literacy practices performed by the collaborators before the formative action; (ii) to narrate the literacy events made possible by the extension course; (iii) to investigate the contributions of the education course to the collaborators teaching practice. We sought theoretical contributions in the literacy studies (BAYNHAM, 1995; KLEIMAN, 1995; HAMILTON; BARTON; IVANIC, 2000), specifically when it comes to digital literacy (COPE, KALANTZIS, 2000; BUZATO, 2001, 2007, 2009; SNYDER, 2002, 2008; LANKSHEAR & KNOBEL, 2002, 2008) and teacher education (PERRENOUD, 2000; SILVA, 2001). Methodologically, this virtual ethnography study (KOZINETS, 1997; HINE, 2000) is inserted into the field of Applied Linguistics and adopts a quali-quantitative research approach (NUNAN, 1992; DÖRNYEI, 2006). The data analysis permitted to evidentiate that (i) before the course, the digital literacy practices focused on the personal and academic dimensions of their realities at the expense of the professional dimension; (ii) during the extension action, the teachers collaboratively took part in the hybrid study sessions, which had a pedagogical focus on the use of ICTs, accomplishing the use of digital literacy practices - unknown before that; (iii) after the course, the attitude of the collaborator teachers concerning the use of ICTs on their regular professional basis had changed, once those teachers started to effectively make use of them, promoting social visibility to what was produced in the school. We also observed that teachers in initial education acted as more experienced peers in collaborative learning process, offering support scaffolding (VYGOTSKY, 1978; BRUNER, 1985) to teachers in continuous education. This occurred because of the undergraduates actualize digital literacy practices were more sophisticated, besides the fact being integrate generation Y (PRENSKY, 2001)

O cotidiano do(a) Assistente Social frente as demandas apresentadas pela paciente portadora do câncer de mama em tratamento no Hospital Doutor Luiz Antônio em Natal/RN

This work deals with an analysis related to the social worker s practice in the oncology area. It aims to identify demands, work conditions as well as current challenges related to this profession. It considers the specificities of breast cancer and relates it to political decisions in the health sector considering the concept of contemporary capitalism. The study analyzes professional action and the demands presented by breast cancer patients who are currently in treatment in Hospital Dr. Luiz Antônio em Natal-Rio Grande do Norte-Brazil. The methodological procedures considered of documental analysis, semi-structured interviews (with two social workers that work with fifteen breast cancer patients) as well as participant observation; which was done counting with my own professional practice in the oncology area. Thus, the research also discusses the breast cancer issue in the life of the users considering their social-economical, cultural and political determinants. Factors such as age in which the diagnosis was known, the relation user/social workers, number of children, rights of the oncology patient, place where he/she lives, education, civil status, (re)insertion of the professional in the work field, perception of self-esteem and bio-psycho-social representation of breast cancer in the lives of these women, all of which were dealt with in this research

O Serviço Social nas operadoras de planos privados de assistência à saúde: demandas, atribuições e respostas profissionais

The present study deals with the exercise of professional social workers in private health care plans registered with the Regional Council of Medicine/RN, in the city of Natal/RN, with regards to the demands/tasks, work conditions, and the professional response, given the climate of restructuring the capital. The set of socio-historical transformations, as a results of the dynamic capitalist, is a process of new configurations in relation to state and society that interfere directly in relation to working conditions, social rights historically won by workers. In this context, the operator of health plans arises as a possibilities to provide services in health, through the logic of the market, in which the subjects of law, become consumers contributing to the displacement of the responsibilities of the State. Obligating workers to lessen the burden with the reproduction of their workforce. This involves changing societal context for social service, since it is one of the professions that are active in terms of the immediate social issue, and come as part of the collective worker. From qualitative research based on a theoretical and methodological perspective and critical dialectics, it was possible to unveil some features and trends of the exercise of(a) social operators in private health care plans. The survey results indicated that : a) the demands and duties for certain social service, are associated with the redevelopment of the capital, whose requirements and responsibilities professionals have with their needs, particularly the guarantee of profit, services rendered; b) in the conditions of work there is a trend of insecurity uncertainty and dismantling of professionals; c) the answers professionals suffer the limits and contradictions present in the daily training, mainly depending one the characteristics of management and operation of the operators, which has professional relative autonomy

O elo entre o serviço social e o judiciário: demandas, desafios e contribuições na defesa de Direitos

Unveiling the link between the Social Services and the Judiciary is the object of this work, since the judiciary is constituted as one of the socio-occupational areas of the profession in the sphere of the state, seize the demands placed on professionals which work becomes relevant , considering that these are embody the multiple expressions of social issues, constituting a challenge to social work, while influencing the contributions that the profession has engendered in the defense and expansion rights. It constitutes an analysis from the standpoint of theoretical and methodological basis Qualiquantitative taking for granted the rights violations against children and adolescents in their social, legal and historical guide to the topic. For this we used a theoretical Marxist Behring (2009), Colman (2008), Faleiros (2205), Faria (1999, 2001), Fávaro (2007, 2008), Iamamoto (1985, 1992, 2002, 2006, 2007) Yazbek, Marx (1983), Netto (1994), Nicholas (1984), Pequeno (2009), Rizinni (1997, 2008), Santos (2009), Sales (2006), Telles (1999), Tonet (2009), among others. Besides literature, empirical research conducted through semi-structured interviews using a script and written records and systematic observation / free during interviews. The subjects were 06 social workers from the area of the judiciary to act on Justice for Children and Youth, Family Court and NOADE in Natal / RN. The research aims to analyze the demands and challenges of Social Services and their contribution in ensuring and enforcing rights in courts nowadays. The route established between knowledge and method involves conceptual analysis on the Judiciary, Social Services, and Child and Adolescent Rights. Seize-up in this study the existing contradictions in confronting the multiple expressions of social issues in the context of the judiciary. The research allowed us to identify relevant aspects regarding the challenges and demands placed Social Service; limits on defense and expansion of their rights and contradictions within sociojurídico. For being one of the judiciary institutions that comprise the system warranty rights, social workers also face difficulties in implementing the professional doing since the ills posed by current sociability capital focus in everyday spaces socio-occupational presented here. On the other hand, is commendable acting those protagonists who believe, defend and contribute to the defense and expansion rights

O Serviço Social e a exclusão/inclusão social dos portadores de HIV/AIDS :demandas e desafios nos hospitais públicos

This research presents the labors developed by the Social Service unto socially excluded HIV/Aids positives at public hospitals in Rio Grande do Norte (RN). It purposes to identify and to analyze the demands brought by the holder onto the Social Service professional as well as the challenges the latter face to minister to the former. It privileges, from the methodological viewpoint, the qualitative and quantitative analysis with the application of questionnaires, direct observation, semi-structured interviews and bibliographic references. Data were collected from 12 (twelve) social assistants who work at Giselda Trigueiro Hospital in Natal (7) and Rafael Fernandes Hospital in Mossoró (5). The central hypothesis that guided this study is that the social inclusion/exclusion process experienced by the HIV/Aids positive on society implies a demand for the Social Service that is inserted in the public health context (specially in HIV-referred public hospitals), whose agents, however, when attempting to answer those demands, meet obstacles due to both the precariousness of public health services and the social complexity that concerns the HIV/Aids epidemic. Results point out that, de facto, the HIV/Aids epidemic, because of the social exclusion/inclusion process to which the holder is subject results a demand for the social agents at hospitals. Demands rise principally from the patient s life condition, considering the increasing pauperization in the epidemic context. As to what it is concerned, social assistants, responding to the needs, come across concrete twofold challenges: the illness in itself, for all social, negative aspects that make part of quotidian life of holders; and the precarious state of the public health service in RN State, since that working conditions are unsatisfactory

Assistência social ao idoso no município de Natal na proteção social básica: identificando demandas e desafios

Over the past decades, starting mainly in the 1960s, the number of elderly has grown in the country and an aging population is considered a remarkable global phenomenon. Given the speed of this process, this growth has produced different implications for the structure of the social, economic and cultural societies and, as such, constitutes new challenges for public policy, and particularly for the Brazilian social assistance policy. Considering the significant increase aging population in Natal and the challenges of social welfare policy, this research aims to identify and analyze the demands and challenges of Social Assistance Policy in the city of Natal / RN, in particular the access of the elderly to social protection basic in the Reference Centers of Social Assistance. This research uses a critical dialectical method, and the methodological procedures that guided the study: the bibliographical research, documentary and field as well as systematic observation. Some initial questions were important to guide this work: What are the demands that come to CRAS the elderly population? What are the answers to these demands by the Basic Social Protection? How this CRAS has implemented social protection responses to these demands as rights guarantee the elderly population? The services offered by CRAS meets user needs? To get the results of this research, bibliographic sources were used, documentary and observation for four (4) CRAS of different district areas of the city of Natal. The results of this research show that basic social protection is quite fragile, leaving part of the population at risk and social vulnerability still without attention due to several factors, including the reduced technical team and the impossibility of service to all neighborhoods referenced by CRAS in the respective zones, and 50% of elderly assisted arising from spontaneous demands.

Assistência social ao idoso no município de Natal na proteção social básica: identificando demandas e desafios

Over the past decades, starting mainly in the 1960s, the number of elderly has grown in the country and an aging population is considered a remarkable global phenomenon. Given the speed of this process, this growth has produced different implications for the structure of the social, economic and cultural societies and, as such, constitutes new challenges for public policy, and particularly for the Brazilian social assistance policy. Considering the significant increase aging population in Natal and the challenges of social welfare policy, this research aims to identify and analyze the demands and challenges of Social Assistance Policy in the city of Natal / RN, in particular the access of the elderly to social protection basic in the Reference Centers of Social Assistance. This research uses a critical dialectical method, and the methodological procedures that guided the study: the bibliographical research, documentary and field as well as systematic observation. Some initial questions were important to guide this work: What are the demands that come to CRAS the elderly population? What are the answers to these demands by the Basic Social Protection? How this CRAS has implemented social protection responses to these demands as rights guarantee the elderly population? The services offered by CRAS meets user needs? To get the results of this research, bibliographic sources were used, documentary and observation for four (4) CRAS of different district areas of the city of Natal. The results of this research show that basic social protection is quite fragile, leaving part of the population at risk and social vulnerability still without attention due to several factors, including the reduced technical team and the impossibility of service to all neighborhoods referenced by CRAS in the respective zones, and 50% of elderly assisted arising from spontaneous demands.