Morte como desafio afetivo para o profissional da saúde: ansiedade e sentimentos de quem lida com o paciente terminal com câncer

It is a Cross-sectional and multi-disciplinary study whose population selection was made by department of human resources (composed by a Manager, an Oncologist and a Psychologist) from the hospital where this research was realized. They also collaborated with important information about the work of that professionals in the hospital. We also counted on a Statistic who made study design calculating the sample and analyzing data. This research issued Evaluating health professionals anxiety levels who care for cancer terminally ill and their feelings about that work as well as identifying the factors which have influence on it. 100 health professionals from the Hospital which is a reference on cancer caring in Brazil situated in the city of Natal, state of Rio Grande do Norte, participated of this research. There was a sample loss of 21%. Data were collected through a questionnaire and State-Trait Anxiety Inventory (STAI). Results showed that 15% of the professionals have low State Anxiety levels, 70% Medium State Anxiety levels and 15% high State anxiety levels. The Number of Patients and Working in another Institution have interfered in the anxiety levels. Doctors and Nursing Assistants and Technicians have got the highest high State Anxiety percentage (25%). 73% of them declare to feel some sort of different behavior and/or feelings in caring for terminally ill. The most remarkable professionals feelings were Suffering and Sadness, and Terminally ill Children was the most difficult age group to care for. We conclude that work overload and having more than one job can interfere in professional stress levels and anxiety. Dealing with terminally ill, specially children one, can cause on the professionals psychological suffering. It s recommended the development of supporting and training strategies to reduce and/or to prevent Stress and Anxiety high levels

Os dias são maus : o ensino religioso cristão em dias pós-modernos o desafio de fazer crer perante a cultura da incredulidade

This paper adopts the assumption that religion continues to be a major highlight in the dimension of the contemporary world - characterized by pluralism, the ideas of tolerance and freedom. But for certain streams of Christianity, the postmodern culture seems to be characterized as a highly damaging to their doctrines and principles, since this religious matrix carries a truth claim that would support all its significance, its definition values and their dissemination effort ( evangelism ). This is not to say that Christianity is the only religion that claims to the truth, which would be a gross mistake. Now, religion has been reputed as a phenomenon doomed to disappear, according to the " ideology " of Modernity, given the idea that scientific development would lead us inevitably to the statement that religion was merely a social institution based in the superstition, in fantasy, the imaginary and therefore had nothing "real " unless its existence as an institution capable of aggregating society (give it cohesion), provide values and meaning to different ontological anxieties and doubts of humankind. In the contemporary scenario - seeded by modernity - as Christian ideas, doctrines and principles are in harmony or conflict with postmodernity? These are our starting questions and issues that we intend to stop and reflect. From the assumption that the religious phenomenon has great force in the present day, this research aims to perform central analysis of how religious education, a Protestant denomination specific, harmonizes or clashes with the ideology or ideas more general and emphatic that we can observe in the western world is presented to us from the diagnoses made by the contemporary authors who debate about postmodernism and postmodernity, notably David Harvey, Jean - François Lyotard, Bauman Zygmunt and Fredric Jameson

O desafio constitucional da distribuição dos royalties de petróleo da bacia pré-sal para promoção de políticas públicas

The administrative model of the Brazilian State, based on regulation, strives, with the application of the efficiency principle and assessment of economical costs, to give a greater effectiveness to fundamental rights by implementing public policies.The objective of this work is to analyze the role of Oil royalties in the context of the Brazilian State, considering that, being an income gap, they might work as a device that promotes intra/intergenerational justice. By means of a correct and efficient distribution and application in the national region, the royalties constitute financial resources available for implementing public policies that intend to guarantee the fundamental rights; above all, with the discovery of the Pre-salt basin and the indisputable rise in the tax revenues arising from Oil exploration. In the making of this work, the theoretical-descriptive methodology is observed, grounded in a critical-reflexive analysis about Constitutional Law and Oil Law. This work analyzes the administrative model of the Brazilian State, the theory of costs of fundamental rights and the theoretical aspects about royalties, such as: the ethical and economical fundamentals, the distribution and destination of revenues, considering the oil exploration scenario before and after the discovery of the pre-salt basin. it is verified, with the present work, the importance of the creation of a new regulatory framework, and consequently the creation of a sovereign wealth fund, which arises to re-evaluate the application of the current norms of Oil revenue distribution. Still, it is imperative that the mechanisms for controlling the application of royalties are defined in detail, so that those can fully admit the objectives of intra/intergenerational justice. Furthermore, it is emphasized that this process should develop from the efficiency principle viewpoint, as well as the principle of reducing social and regional differences, given that the Oil revenues might be used to ensure fundamental social rights, by implementing public policies that are aligned with the development recommended by the Federal Constitution

A Constituição Federal de 1988 e a integração regional : o desafio da harmonização tributária

As an effect of the growing interdependence in international relations, regional integration was conceived to face globalization, with a remarkable influence in politics and law, since the first steps of the European experience. In Latin America, regional integration ideas have blossomed in the 60 s. Among its experiences, MERCOSUL is the one with the most advanced objectives. However, MERCOSUL has not managed to achieve the objectives planned nor moved forward the integration process. Differently of what happened in Europe, in MERCOSUL the common market projected is concluded. It faced many disappointments throughout its brief history. As it matters to law, those were caused by the absence of supranationality, a mechanism that would allow MERCOSUL s decisions to be directly binding in the States with no need of bureaucratic proceedings to incorporate them to national legal systems. Among Latin American States, Brazil is probably the most resistant to integration process, due to Federal Constitution 1988 rigidity and legal professionals conservadorism towards opening legal system to international law. In Brazil hermeneutical standards are always based on national sovereignty and international law is referred as less important. The problems become more visible relating to taxation, a subject that plays an enormous role in integration process for its economic impact, demanding the execution of tax harmonization policies compatible to the integration levels aspired. However, because of the large number of tax rules in the Federal Constitution, structural changes initiatives face difficulties in order to be implemented. Actually, after two Constitutional Reforms on taxation, Brazil has not yet succeeded on promoting the necessary adaptations to regional integration. The research has confirmed the hypothesis that supranationality has indispensably to be adopted if Brazil really desires to move forward the integration process. But it has also been demonstrated that there are hermeneutical paths suitable to the constitutional profile which allow the adoption of supranationality, through the revision of the sovereignty traditional concept

Políticas públicas de atendimento à criança: desafio da ação articulada no Projeto Belém Criança (2001-2004)

Public politics of Service to the Child: The Challenge of the Action Articulated in the Project Belém Criança (2001-2004) if it constitutes in a study on the politics directed toward the children of 0 the 6 years. It has as objective to analyze the configuration of the politics of integral attention to the child, evidencing the form as the same ones they had been redimensioned by the neoliberal ideas and by the lines of direction of the international organisms. The work has like empiric reference the project Belém Criança, developed by county of Belém from a partnership with the Deep of United Nations for Infancy (UNICEF), in the period of 2001 and 2004. The project intends to develop an articulated action among the several county departments which offer assistance to the children looking for to rationalize the resources and to optimize the services. Amongst the methodological procedures that materialized the research distinguished: The bibliographical review and documental allowed to analyze the contextualization of the public politics and, between them, the social politics of attendance to the child; the historical revolution this attendance; the paper of the UNICEF how articulator of the politics in municipal scope; and the paper of county how executer these politics. Still it was utilized, the half-structuralized interview, Having like subjects: the representative of the UNICEF in Belém, the municipal co-managers and actors of community in which the project was implemented. The result of the analyzes review that, historically, the politics destined to the child they had been being dimensioned having like support the fight of social movements vindictive for publics politic which guarantee the fundamentals rights these citizen. Although legal dimension of current politics of attendance to the child, to assume a vision of completeness and the guarantee of the rights, it still has a great exaggeration between the speech and the practical one. Actually, the same one are elaborate inside the neoliberal optics, with ruled actions by the beginning in combat to the poverty, implanted with low costs and with practice which to lead to the excessive fragmentation, generating inadequate actions and punctual programs which don t guarantee the social quality of the attendance. This perspective was evidenced to the most of the actors which the Project Belém Criança don t constitute itself a real public politic toward the child of 0 the 6 years, although present innovating aspects, how the mobilization and participation. It was demonstrated yet, in the participant s depositions of the research, that the bureau had numberless of difficulty to develop the action preview in the project, it has seen the great complexity of articulation between the several organism responsible by politics of attendance

O desafio da parceria na implementação do PRONERA: o caso do projeto alfabetização cidadã no nordeste Paraense.

El desafío de la parcería en la implantación del PRONERA: el caso del Proyecto Alfabetización Ciudadana en Noreste de Pará se constituye en un estudio sobre las políticas públicas de educación del campo. El trabajo tiene como objeto de análisis la implantación del PRONERA, a partir del estudio de caso del Proyecto de Alfabetización Ciudadana en Noreste de Pará, con el objetivo de comprender como la parcería, principio operacional y metodológico propuesto por el PRONERA, se concretó en la implantación del Proyecto y cuales sus posibles implicaciones en las políticas públicas de educación del campo. Entre los procedimientos metodológicos, realizamos la investigación bibliográfica y documental que nos permitieron situar la educación del campo en términos históricos y políticos, sistematizar la constitución y la organización del PRONERA y reflexionar acerca de la parcería a partir de diferentes ópticas. Realizamos también la investigación de campo por medio de entrevistas semi-estructuradas, con el propósito de analizar la implantación del Proyecto da Alfabetización Ciudadana, a partir del dialogo con los actores sociales involucrados. Los resultados de las análisis indicaron que, históricamente, las políticas públicas de educación destinadas a las poblaciones de la zona rural fueron instituidas verticalmente, desvinculadas de la realidad del campo e incompatibles con las necesidades e intereses de los sujetos. Constatamos que, en período reciente, movimientos sociales del campo reivindican y proponen acciones que se establezcan como políticas públicas de educación del campo. Identificamos que el PRONERA resulta de ese movimiento y se presenta como anuncio de una política pública de educación del campo, teniendo como diferencial el hecho de ser un programa del gobierno federal idealizado fuera de la esfera gubernamental, construido por los movimientos sociales del campo y presentar, entre otras innovaciones, el modelo de parcería y la gestión compartida, participativa y democrática. En esta perspectiva, en este estudio de caso, se evidenció que la parcería, frente a los conflictos y las disputas entre sus miembros participantes, no es el problema de la implantación del PRONERA, sino su punto fuerte. De este modo, la parcería es uno de los elementos necesarios para la construcción de políticas públicas, en particular, de educación del campo, una vez que posibilita la interacción de instituciones públicas y movimientos sociales locales, atribuyendo legitimidad a la educación del campo. Al promover un proceso de aprendizaje democrático, la parcería se presenta como estrategia de democratización de la educación del campo.

A escola rural e o desafio da docência em salas multisseriadas: o caso do seridó norteriograndense

Uno de los principales desafíos colocados a la educación del medio rural está relacionado a la enseñanza de las escuelas rurales con salas multifacéticas. Estas comprehenden alumnos de diferentes comunidades, series, edades, aprendizaje y niveles de conocimientos. Son cursos heterogéneos, que tienen como característica central la diversidad. En muchas regiones rurales de Brasil, la educación escolar es organizada en cursos multifacéticos debido a las grandes distancias entre las comunidades y el bajo número de alumnos en cada serie/año. Es común encontrar a los que están en fase de alfabetización estudiando con quien ya sabe leer y escribir - y todos sobre la orientación de apenas una profesora, que necesita enseñar a partir del contexto y la cultura local. El punto principal a ser tratado en este estudio está relacionado a las prácticas ejercidas en la acción educativa de las profesoras que actúan en escuelas rurales con salas multifacéticas de la región del Seridó do Rio Grande do Norte, precisamente en los municipios de Caicó, Jardim do Seridó y Ouro Branco. Creemos que este es uno de los puntos centrales en la discusión sobre la organización de la educación en el medio rural con fuertes implicaciones para el atendimiento cualificado de la población en condiciones de escolaridad de ese medio. Las contribuciones de Werthein y Bordenave, Calazans, Paiva, Ramalho, Therrien y Damasceno, Leite, Passador, Molina, Arroyo, Nascimento, Hage, además de documentos oficiales del MEC, como cuadernos SECAD, Ley de Directrices y Bases de la Educación Nacional, Directrices Operacionales para la Implantación de la Enseñanza Básica de 9 (nove) años, Proyecto Base del Programa Escuela Activa, entre otros, fundamentaron el análisis sobre la escuela rural y el desafío de la docencia en salas multifacéticas en el contexto del Seridó norteriograndense. El estudio envolvió 24 (veinticuatro) profesoras y 06 (seis) profesionales de la educación que desempeñan sus funciones en los Centros Municipales de Enseñanza Rural (CMER). Los instrumentos de investigación empleados fueron cuestionarios y observaciones aplicados para responder a las siguientes preguntas: ¿cómo se estructura la escuela rural con salas multifacéticas? ¿Cómo las profesoras se posicionan sobre su trabajo en salas multifacéticas esto es, como las concibe en el contexto de la educación rural del Seridó? ¿Qué opinan sobre la formación recibida para actuar en salas multifacéticas? Las profesoras y los/las profesionales de los CMER poseen en general formación superior en pedagogía, sin embargo, presentan limitaciones delante de las situaciones surgidas en el día a día de la sala de clases. El estudio revela que son las deficiencias de las políticas sociales y educacionales de formación docente, el bajo apoyo didáctico-pedagógico, reforzadas por la ausencia de un plano de carrera que dignifique el trabajo docente en ese medio, que generan limitaciones en el desarrollo profesional del magisterio rural, claramente junto a los docentes que actúan en salas multifacéticas en los municipios investigados

Histórias de vidas de Usuários de psicofármacos: o desafio do cuidar para a enfermagem

Study of qualitative approach using the oral history methodology, in modality oral history of life, which aimed to: tell the stories of lives of users of psychotropic drugs for prolonged period of time, in Family Health Unit Santarém (FHU Santarém), Natal-RN-Brazil; identify possible causes which influence and trigger, respectively, use of psychotropic for prolonged period of time; search for greater knowledge about this problem of public health; contribute with the planning and development of nursing cares, to users of psychotropic drugs for prolonged period of time, as well as in Mental Health Care, integrally, in perspective of Family Health Strategy (FHS). It was used as a baseline survey, the coverage area of family health team, from FHU Santarém, which belongs to Health District North II, from Municipal Health Secretariat, in Natal-RN-BR. Eight employees who use psychotropic drugs for prolonged period of time were interviewed. They volunteered to narrate their life stories, which were analyzed by using the thematic modality, since the study is focused on the question of the use of psychotropic drugs for prolonged period of time. The thematic axis crisis, prejudice and care, defined by the categorization of common elements, found through successive and careful readings of narratives, were used to analyze these stories of lives. The study found that users of psychotropic drugs for prolonged period of time are affected by mental health crisis, feeling need to be heard, as well as the existence of social prejudice towards people with mental disorders, and non-completion of development of managed care, by the family health team, and particularly, the nursing care to people suffering from mental disorders and users of psychotropic drugs for prolonged period of time. It is proposed that, in the search of development and planning of nursing care to users of psychotropic drugs for prolonged period of time, and in mental health care, integrally, in FHS, the nurse can think and make a drawing about manners of performing nursing care to this clientele through the use of consultation of nursing, conducting home visits, collective construction of spaces for listening and socialization, which can be used as possible paths for the construction of such care

Moradores crônicos de hospital psiquiátrico: um desafio à desinstitucionalização

The existence of chronic inhabitants in the psychiatric hospitals imposes a challenge to the Psychiatric Reform, that proposes things such as the gradual and progressive way to extinct mental institutions, once the permanence of the hospital in the system is only necessary because there is not a net of well structured substitute services capable of receiving that demand. This work considered relevant to deepen the knowledge about those people who passes their lives jailed by the walls of psychiatric hospitals and compose significant part of the world population. It also aimed to investigate the problem relative to the condition of being an inhabitant of a psychiatric hospital the Dr. João Machado Hospital (HJM), in the city of Natal/RN. The paper used different points of view (patients , families and professionals ) to define the profile of the inhabitants, to identify the possibility of insertion in substituting social equipment, to know the expectations of the inhabitants and their relatives regarding to the exit of the life shelter, to investigate the demands related to the net of cares social support for making feasible the discharge and to identify the difficulties that are involved in the exit of the chronic inhabitant of the hospital. There were defined three methodological phases: delineation of the identification, socio-economic and clinical profile of the inhabitants of the HJM; semi-structured interviews with professionals; and open interviews with inhabitants and family. It concluded that the psychiatric institutionalization contributes to the generation of chronic inhabitants in the psychiatric hospitals. Among the professionals, it was detached the defense of desospitalization, but an existence of devices of the asylum model. The relatives showed a resistance to participate in the care and the inhabitants exposed their desire to leave the hospital, as well like the wish of permanence. It was considered important: the construction of an extra-hospital net that enables to desinstitutionalization; the qualification of the technical; orientation to the family, stimulating its participation in the process of caring; give freedom to the individuals in mental suffering, enabling them to be ahead of their lives and express their desires and opinions; the implementation of an extended clinic that is capable of building new possibilities; and a subjectivity guided by the social enclosure

Análise da toxicidade no açude Riacho da Cachoeira, Lajes Pintadas (RN): um desafio interdisciplinar

Contamination by complex mixtures of various origins has been explored and studied for decades. Radon is a naturally occurring environmental contaminant that causes carcinogenic effects. These emissions can cause mutations in the lung tissue, which can initiate a carcinogenic process. Thus the dam Creek Falls, located in the municipality of Lajes Pintadas, was chosen for the development of this study, since cancer rates in the region reach 9% of the population annually, with this, the main objective of this study was evaluate the mutagenicity and toxicity of Riacho da Cachoeira damunder the influence of radon. The methodology ecotoxicological tests were performed with Ceriodaphinia dubia, as well as tests with Tradescantia pallida genotoxicologicos and Oreochromis niloticus. To understand how the population of Pintadas Slabs realizes the environment, we performed a study of environmental perception. The test results indicated that the reservoir water is toxic to test organimos exposed, found heavy metals, chloride, total and fecal coliforms as well as radon levels above the maximum allowed under Brazilian law. These results can be justified because it is so complex samples composed of different compounds that interact only with each other or causing synergistic effects. It was concluded that the dam Creek Waterfall, is contaminated with radon, as well as heavy metals, coliforms and chloride, causing toxic effects to the natural community. Thus, further studies should be performed with the human population of the region, to verify that the high rates of cancer in the population of the municipality may be linked to the presence of natural radiation. Thus, it is expected that the competent bodies that administer the municipality of Lajes Pintadas take reasonable steps to minimize risks and ensure the health of the community that still makes use of the weir

Politícas públicas no Brasil: o desafio de garantir os direitos da infância

The article talks about the challenge of the construction of public policies for the child in the age group from 0 to 6 years old in Brazil, in the perspective of the right guarantees. One can presuppose that to comprehend the development of these policies, it is necessary to analyze the historical route of its assistance, possibilities and limits. It is also important to consider the contradictory relationships of power present in society, and its influence in the building of the conception of child and childhood that are very far to be neutral words, so they are policies. In this point of view, this work analyzes the arrangement of the current policies of assistance to children, making clear the shape as they were reorganized by the neo liberal policies and set of instructions of international organizations. The studies show that, instead of public and universal policies, programs and actions are introduced based on the focus in the fight against poverty, made with low costs and questionable quality.

Da voz que cala ao corpo que fala: o assédio moral no ambiente de trabalho como desafio para o serviço social

The changes ocurred in the world of capitalist labor, especially from the last decades of the 20th century, accentuated the process of manipulation and domination of the working class, materialized mainly through naturalization and / or trivialization of violence, conducted in the work environment. From this process, emerge the elements of bullying, that is, the embarrassing and humiliating practices which extend through time, degrading human race, and becoming fruitful object for study, debate and the intervention of the professionals of the Social Service area. Thus, we assume the perspective of analyzing the concepts and the work of social workers, whom work at people management area before the bullying in the workplace. We propose the following objectives: apprehend the settings of bullying, in the contemporary context of competitiveness and flexibility of work, as well as its implications for workers' health; characterize the background of this expression of violence at work in the municipality of Natal- RN; and analyze the powers and duties of the social worker in the process of prevention, identification and addressing of bullying in the context of work. This study consisted of a qualitative approach, based on the dialectical-critical method as soon as we adopt methodological procedures such as: theoretical knowledge, documental and field research, and performed using semi-structured interviews. The subjects of this research were nine (09) the Social Service professionals working in personnel management area, in five (5) institutions with legal and branches of different activities, located in Natal-RN. Even interviewed one (01) representative of the Public Ministry of Rio Grande do Norte Office (MPT-RN). The findings of this analysis indicate that bullying is a contemporary expression of "social question", which is presented as a demand for the Social-assistants – covered up and / or camuflage – under the guise of problems related to workers' health or mere conflicts of interpersonal relationships, that is, without any causal connection with the organization of work. The fear of losing job, not to be inserted in the labor market, and / or suffering reprisals, deepens the subject levels of the victims of bullying. Hence the importance of Social Workers are capable to understand the social reality, by preventing and combating the elements of bullying.