Planejamento em saúde no Brasil: convergências e divergências entre instâncias de gestão

Trata-se de uma investigação que busca revelar convergências e divergências no processo de planificação da Política Pública de Saúde, com foco primordial na participação dos organismos de representação social na consolidação do Sistema Único (SUS), destacando a Conferência Nacional de Saúde CNS, instância que deve ter participação obrigatória na formulação de recomendações para essa política estatal. Considera que a planificação reúne elementos de concepção jurídica, técnica e política para a elaboração dos documentos intitulados Planos Nacionais de Saúde PNS. A partir de pesquisa qualitativa de base documental e argumentação com apoio de Cartografia Simbólica, põe em exame o processo de elaboração e o teor presente nos relatórios da 12ª (2003), 13ª (2007) e 14ª CNS (2011), alinhando seus eixos, diretrizes e prioridades nos correspondentes PNS nos quadriênios 2004-2007, 2008-2011 e 2012-2015. A escolha desses instrumentos, na temporalidade sugerida, tem por esteio o período em que a implantação do sistema de Planejamento do SUS PlanejaSUS, orienta normativa e tecnicamente a elaboração do PNS, tendo como uma de suas referências o que foi emanado das conferências. Propõe-se verificar as tensões existentes entre momentos distintos da definição das prioridades elencadas nas políticas públicas de saúde à luz das contribuições teóricas sobre a concepção do Estado, numa visão contemporânea associada à sua dinâmica de atuação vinculada ao modo de produção e acumulação capitalista; sobre a metodologia do Planejamento Estratégico com base na participação de atores diversos; e ainda, na análise sobre a expressão desse participacionismo na ótica dos processos democráticos representativos no SUS. Na confecção dos mapas cartográficos foi proposta a correlação entre os conteúdos dos Relatórios das 12ª a 14ª conferências de saúde com o que está expresso nas prioridades constantes nos Planos Nacionais de Saúde (2004 a 2007, 2008 a 2011 e 2012 a 2015), verificando-se aproximações e distanciamentos existentes entre o que expressa a sociedade e a política governamental. Conclui-se que, do exame crítico entre as diretrizes e prioridades contidas no acervo documental existente e sua metodologia de construção, com fundamento na argumentação do aporte teórico trabalhado, são verificadas tensões e harmonizações que revelam pontos convergentes e dissonantes das pactuações e consensos entre os atores sociais representantes dos segmentos, no qual critério da representatividade condiciona a defesa de opiniões, interesses e prioridades, de modo diverso para os que estão implicados nesse processo de planificação

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

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

A implementação de ações de integração na segurança pública: o caso das polícias civil e militar do Rio Grande do Norte

The research aimed to understand the challenges for the implementation of the proposed integration between the Civil Police and the Military Police in Rio Grande do Norte to the proposals of the SUSP. This study aimed to explore the gap with regard to the deepening of the possible causes that may hinder the implementation of integrated working between the police in public security, through a specific analysis on the state of Rio Grande do Norte. Was based on a theoretical framework that includes policies: general concepts, the steps of a public policy, the implementation stage , public security : conceptual definitions, policies on security in Brazil, the structure of public security in Brazil and systems police, Military Police x Civil Police: Roles and conflicts , integrating public security: the challenges to be overcome, the Unified public Safety (SUSP) and the main difficulties in the integration of the police. Being classified as to the purposes as an exploratory research on how to approach ranks as qualitative. The research unit was the Center for Integrated Operations Public Safety (CIOSP) through three subjects who were the chief CIOSP, the representative of the military police acting with the CIOSP, and representative civil police also active with the CIOSP. These subjects were chosen because of the understanding that individuals occupying senior positions would have more ability to respond to questions that guide the research problem. Data were collected through a set of interviews, qualitative data analysis was performed based content analysis, based on the definition of categories of analysis, gated time cross. With the results, it was revealed that the main problems of integration between the state police are treatment protocols, lack of political will and lack of infrastructure. The relationship between the Military Police and Civil Police in Rio Grande do Norte has differing cultural aspect, but can be considered as good value, professionalism and integrated operations. The implementation of CIOSP-RN followed the characteristics of the top-down model, the main difficulties in implementing the proposals of the SUSP, lack of own resources, the lack of standardization in public safety and the lack of professional training of public safety. It was concluded that with respect to the challenges to the implementation of the proposed integration between the Civil Police and the Military Police in Rio Grande do Norte to the proposals of the SUSP, the actions follow the characteristics of the top-down model, with no autonomy of administrators public to say in decisions, which restricts the view of the public safety of the state

Aparências da forma e forma do espaço: análise da configuração espacial de residências unifamiliares dos anos 1970 em João Pessoa PB

Assuming that the form of a building shell and its content the spatial form are distinct dimensions of architecture - however indivisible and interdependent -, this study focus, in the light of the Social Logic of Space (HILLIER; HANSON, 1984), on the intrinsic properties through which domestic space was structured in a sample of single-family dwellings built in João Pessoa (PB) during the 1970s - when the vocabulary of modern architecture still prevailed in Brazil though sharing the urban scene with other architectural trends -, in order to investigate regularities or divergences underlying their conception. These dwellings were originally classified (ARAÚJO, 2010a) in five categories defined according to the form of their building shells and to their prevailing construction techniques: (1) Brazilian modern legacy (considered as truly Brazilian modern style); (2) Paulista architecture (that refers to the modern production of São Paulo, Brazil, from the 1950s through the 1970s); (3) experiences of rationalization and prefabrication ; (4) experiences of adaptation to the climate (referring to a design strongly influenced by the hot and humid climate of North-eastern Brazil); and (5) hybrid (to account for a kind of stylistic hybridism that includes formal attributes, which evoke our colonial past). This study aims to determine, through the analyses of nineteen cases that represent each category, whether this taxonomy corresponds to distinct modes of spatial configuration. This research therefore proposes an approach to the classification of domestic architecture based on topological properties. The dwellings spatial organization was represented, quantified and analyzed, their spatial properties explored in consonance with one another and with the literature. Results pointed out that there is no evidence of a reciprocal relationship between the formal look of the built shells and their respective spatial structures

Análise comparativa entre simuladores de linha de fluxo e diferenças finitas para um reservatório de petróleo submetido a injeção de água

Water injection is the most widely used method for supplementary recovery in many oil fields due to various reasons, like the fact that water is an effective displacing agent of low viscosity oils, the water injection projects are relatively simple to establish and the water availability at a relatively low cost. For design of water injection projects is necessary to do reservoir studies in order to define the various parameters needed to increase the effectiveness of the method. For this kind of study can be used several mathematical models classified into two general categories: analytical or numerical. The present work aims to do a comparative analysis between the results presented by flow lines simulator and conventional finite differences simulator; both types of simulators are based on numerical methods designed to model light oil reservoirs subjected to water injection. Therefore, it was defined two reservoir models: the first one was a heterogeneous model whose petrophysical properties vary along the reservoir and the other one was created using average petrophysical properties obtained from the first model. Comparisons were done considering that the results of these two models were always in the same operational conditions. Then some rock and fluid parameters have been changed in both models and again the results were compared. From the factorial design, that was done to study the sensitivity analysis of reservoir parameters, a few cases were chosen to study the role of water injection rate and the vertical position of wells perforations in production forecast. It was observed that the results from the two simulators are quite similar in most of the cases; differences were found only in those cases where there was an increase in gas solubility ratio of the model. Thus, it was concluded that in flow simulation of reservoirs analogous of those now studied, mainly when the gas solubility ratio is low, the conventional finite differences simulator may be replaced by flow lines simulator the production forecast is compatible but the computational processing time is lower.

Os conflitos de competência normativa do estado regulador brasileiro no setor administrado pela ANP

The dissertation has by objective describe the administrative activity of regulation exercised by independent regulatory agencies, observing that this activity was already done before this structures creation, however, after a really deep administrative reform that had as objective built a Public Administration with more efficiency, it passed to be done with some own peculiarities of these new structures of regulation. The work gave especial attention to what concern the conflicts of normative competency that really often happen between ANP (Agência Nacional do Petróleo, Gás Natural e Biocombustíveis) and the legislatives organs of the Republic Federative of Brazil, because energetic area has unbelievable mater to any country, and the fact of some juridical norm be against the law and be accepted is very dangerous, it affronts the constitutional principle of the legality e may put in risk the democratic Estate of law, them, regulatory dogmatic must be scientifically knows, and developed, thought and especially there are so many doctrinaires divergences about regulation constitutionality. As a theorist point, the investigation got the Logical nocontradiction principle, according Hans Kelsen and Lourival Vilanova thought, doing a philosophical reflection about the system of positive law, in which there are many antinomies, or conflicts of norms, what include the conflicts of the administrative acts expedited by ANP and the legislation of the brazilian regulatory Estate. For a better understanding and exemplify some perplexities treated by the doctrinaire angle, this work did a lucubration about a possibility of a normative conflict between a ANP resolution and the municipal legislation in a specific case, also, brought several jurisprudences for the brazilians courts of justice, that confirm the empiric existence of normative conflicts among ANP s administrative norms and federal legislation. Finally, concludes observing that the regulation is not a legislative competency delegation to regulatory agencies, is just a new exercise of the administrative function, it is a technical specialization of the public administration, that using this know-how can acting with more efficiency, however the normative power of regulatory agencies must respect the empire of law, so in this terms, the dissertation suggests the ponderation of the constitutionals principles of efficiency and legality how form to harmonizing the democratic legitimate inherent to legal norm supremacy, with the perspective of an efficient economic and institutional development

O princípio constitucional da legalidade administrativa e os limites do controle das atividades-fim das agências reguladoras pelo Tribunal de Contas da União

Analysis of the role of the Union Accounts Court on the control of regulatory agencies, with the objective of identifying the limits of the Institution s acting on the aim activities of the agencies, particularly the control limits of the Court on the merits of discretionary administrative actions, taking into account the autonomy of these entities in the model of regulatory state. Analyzes the principle of administrative legality, the control of public administration, state s action in the economy and facing regulatory agencies, their emergence, evolution and characteristics. Includes the study of jurisprudence and doctrinal differences, as for the limits of the powers conferred by the constitutional legislator to Federal Court of Audit, regarding the control of agencies aim activities, or, in other terms, their regulatory and inspector missions of market, under the principle of administrative legality. Performs analysis, based on case studies involving Court s audits on regulatory agencies. Are appreciated differences within the Institution about the their decisions effects - imposed or not - as regards the arrangements to be adopted by regulatory agencies to correct the flaws and omissions found during Court s inspections, in which content of the act of public agent, despite their technical nature, can happen the criterion of convenience and opportunity

O piso salarial nacional: a valorização do professor na Constituição de 1988

The paper investigates the legal mechanisms used by the Legislature and the Executive to implement the constitutional principle of the teacher s minimum wage, which is proclaimed in the Constitution as a strategy of professional appreciation for this category. The text demonstrates that the legal mechanisms used to value the teacher were: the 1988 Constitution, the constitutional amendments to this Charter updated and modified the original text in relation to the matter, and finally, the Minimum Wage Law . Article nº 206 of 1988 s Federal Constitution established that basic education teachers, who work in public schools, would be entitled to a national minimum wage. Law nº 11.738/2008 ( Minimum Wage Law ) regulated the matter and made other determinations on the relationship between the State and the teachers such as the establishment of parameters for the distribution of the workload of teachers. Based on this law, since 2009 the minimum wage has been set annually by the Federal Government. However, state governments and municipalities throughout Brazil protested prescriptions contained in the Minimum Wage Law . In this context, some governors and mayors led the Supreme Court regarding the constitutionality of this law. The complainants considered that there was unconstitutional by the following: definition of the teacher s workday, which in the complainants point of view was competence of local governments; ensuring that teachers receive salaries tied to the minimum wage with retroactive effect; transformation of the minimum wage in basic salary, lack of sufficient budget in the states and municipalities to honor with the new values to be paid to teachers and, finally, determining workload for the teacher to perform other activities besides classroom activities. At the trial held at the STF the majority of Ministers rejected the claim and considered that the Minimum Wage Law , taken together, was constitutional. However, this decision did not alter the position of the managers or the interpretation of the ministers who agreed with the unconstitutionality of some aspects of the law. This means that one law can present differences in interpretation between ordinary people and among members of the Judiciary. The search showed the following conclusions: the law is not a definitive parameter of justice, because it is deeply linked to various interests; the development, implementation, and judgment of laws dealing with minimum wage of teaching are linked to historical and cultural aspects of society; the demand for enhancement of teacher and setting a minimum wage has only emerged in the late twentieth century, a fact explained in this work based on data that indicate the recent concern of Brazilian State with schooling a phenomenon typically Republican and with the professionalization of teaching emerging concern from the knowledge society; the Legislative and Executive search mechanism to implement the minimum wage of the teachers because of the contemporary need for professionalization of teaching

O licenciamento ambiental pelos municípios: uma análise sobre o federalismo cooperativo adotado pela Constituição Federal

In complex federal systems as that found in Brazil, which provides simultaneous attributions to of the Union, States and Cities in many aspects, the definition of performance limits of each of these entities, in procedural or material aspect, generates many (positive and/or negative) competence conflicts, bringing insecurity to general administered. Environmental licensing is one of the most important instruments of environmental management, seeking the realization of the fundamental right to an ecologically balanced and sustainable development. Despite its importance, the environmental licensing has not been more effective due the conflict related to the authority to regulate regardind environmental law. This essay will analyze the structure of competence distribution for conducting the environmental licensing processes, the conflict between laws, the performance of the municipal environmental agencies, the cooperation between the licensing agencies and the future about the additional regulatory law of article 23 of Federal Constitution

Biologia populacional comparada de duas espécies de heliconius (Lepidoptera: Nymphalidae) em um ambiente sazonal de floresta atlântica do nordeste brasileiro

Tropical environments often face strong seasonal variations in climate, such as alternate periods of dry and rain, that may often be important influence in the annual X the organisms lives. Here we assess how population dynamics of two butterfly species (Heliconius erato and Heliconius mepomene) respond to environmental and seasonal variations. A mark-release-recapture study carried out in an Atlantic forest reserve, 15 Km from Natal, Rio Grande do Norte, Brazil, for 3 years, during the dry and rainy season, with three visits weekly done. Information such as species, wing lenght, site of capture, pollen load and phenotype (number of spots) (in H. erato only) were noted for each capture. Seasonal variation exists in capture rates of the two species, with great capture rates during the rainy season. Despite finding differences in the mean density of individuals of the two species among the different collection areas, this difference was only significant between floodplain and central areas, and no influence of seasonality was observed in the mean density between the areas. Seasonality in wing size was only observed for H. erato, with larger wings during the rainy season. Females carried larger pollen loads than males both species, but species were similar. Only males differed seasonally, with larger pollen loads during the rainy season. The distribution of the number of wing spots did not vary between the dry and rainy seasons, and the number of spots in males and females was similar. Therefore, we conclude that there was a strong influence of seasonal variation in the population dynamic of the two Heliconius species, as well as in several aspects of their biology

Ecologia trófica de anfíbios anuros: relações filogenéticas em diferentes escalas

Understand the origin, maintenance and the mechanisms that operate in the current biodiversity is the major goal of ecology. Species ecology can be influenced by different factors at different scales. There are three approaches about the ecological differences between species: the first brings that differences result from current processes on niche characteristics (e.g. diet, time, space); the second that species differences are explained by random patterns of speciation, extinction and dispersion, the third that historical events explain the formation and composition of species in communities. This study aims to evaluate the influence of phylogenetic relationships in determining ecological characteristics in amphibians (globally) and test with that, if ecological differences between species of frogs are the result of ancient pre-existing differences or as result of current interactions. Another objective of this study is to verify if ecological, historical or current characteristics determine the size of species geographical distribution. The diet data for analysis of trophic ecology were collected from published literature. We performed a non-parametric MANOVA to test the existence of phylogenetic effects in diet shifts on frogs history. Thus, it is expected to know the main factors that allow the coexistence of anuran species. We performed a phylogenetic regression to analyze if niche breadth, body size and evolutionary age variables determine the size of the geographical distribution of amphibians in the Amazon. In the present study, new contributions to knowledge of major ecological patterns of anurans are discussed under a phylogenetic perspective

Concepões e práticas pedagógicas de professoras da educação infantil na inclusão de alunos com deficiência

This research focuses on inclusive in childhood education. Its purpose was to investigate and analyze the conceptions and expectations of teachers of childhood education, childhood education center form Natal/RN, on the inclusion students with disabilities, school and pedagogical practices developed and implications for students learning. Theoric base of the cultural historic perspective, the search took by qualitative analysis of numbers form the case study method. It was used methodological procedures: documentary analysis, participant observation, field journal and semi structures interview.Three teachers participated in the survey of that school had student with disabilities in their classrooms. These teachers were called: Rapunzel, Snow white e Pretty. The teacher s nouns involved the refered kind of education. The data obtained from the observation indicated the regular school of childhood education provides educational practices that promote the participation and participation and development of students with disabilities, live situation that may create barriers to learning and to the development of these children. The analysing data of interview from Bardin content analysis (1994) was based in Cunha s studies (2001) Brun (2006, 2008), Mantoam (2006, 2008), Palacios, Paniagua (2007), among others. The dada showed that correlation and divergence of perceptions and expectations about the issues surrounding inclusion in childhood education. The results shaved that teaching strategies, affective ties, sensitivity and own routine of childhood education are factors that can promote inclusive proposal, but also needs a greater fulfillment individual differences of each child in order to their potentiality. The study also shaved that the negative of pedagogic support to teacher, the ignorance of them as guidelines and strategies that include the student s diversity, the importance having positive conceptions about the learning and development of student with severe learning disabilities and the need for a pedagogic training and of a collective work at school which everybody collaborates : parents, direction, coordination getting inclusive school. Believe that this study pointed relevant issues to be focus new research, since the theme is still lacking in study, therefore emphasize, the importance of conducting research that continuous this job

Envelhecer entre pássaros e anjos: um estudo etnográfico sobre o processo saúde doença do idoso no contexto familiar

Study, a descriptive-like one, is guided by ethnographic principles which have analyzed the elderly within the familiar context in his/her process of health and aging, in the neighborhood called Felipe Camarão, located in the western administrative region of Natal, RN, a Northeastern city of Brazil. The participants are elders aging 61 to 84 years old, living in this referring neighborhood, whose majority is constituted of migrants from the rural region of the state of the RN, retired, including widows, widowers and married couples, with low school-educational degree. For the information gathering it was utilized a semi-structured interview, the participant observation and the field diary, being put into effect, in majority, in the houses and in the Family Health Unit, in a period between March and October of 2006. For the results discussion it was utilized an analysis of thematic content and the program ALCESTE (In Portuguese, Análise Léxica por Contexto de um Conjunto de Segmentos de Texto or Lexical Analysis by Context of a Set of Text Segments), which through have emerged two corpus: the corpus I, Family and the elderly, and corpus II, The elderly and the aging within society. The analysis of the results has permitted to conclude that the family, also used by the public policies as a strategy of their practices in health, it is a necessary base support for the elderly citizen in his/her process of aging and of health. The elders familiar contexts have allowed this study to identify the existence of minimal social conditions of life, of new rearrangements of the current families by means of the plurigenerational acquaintanceship and the active presence of the elderly woman as a maintainer of this family; also by means of conflicted relationships among one another but in a bearable level of acquaintanceship. Different conceptions about the aging and the elderly generate disagreement and divergency however the family support and help for the solving of these problems and the attention to health are proceeding from the family components. However, it is noticed that loneliness is something present in these elder s everyday lives. About the attention to health, in a basic level of it, it was noticed that there are still a lot of gaps, mainly concerning promotional and preventing actions, deserving a higher sensitization and effort by the local health institutions

As representações sociais da morte e do processo de morrer para profissionais que trabalham em unidade de terapia intensiva uti

This study aimed to seize the general social representations of doctors and nurses who work in ICUs on the process of death and dying. We also aimed to know the social representations of these professionals in relation to death and the process of dying of people who are under their care, identify factors that influence the construction of these representations and identify similarities and differences between the two professions. The study was conducted from the perspective of the Theory of Social Representations of Serge Moscovici and the Central Nucleus of Jean-Claude Abric. The study was conducted in the Intensive Care Unit of Natal Hospital Center, a private hospital of the city of Natal - Rio Grande do Norte. This is descriptive and exploratory research. Twenty-four (24) professionals were interviewed, twelve (12) nurses and twelve (12) doctors. Data were collected through two instruments: Test of Free Association of Words, semi-structured interview. Later, they were coded, categorized and analyzed according to Content Analysis of Bardin (1977). The words evoked after the use of inducing words - death and dying - and the interviews, led to three thematic categories: Death and dying as a biological event, death and dying as a psychosocial event, death and dying as a transcendental event. As final considerations, we believe that the social representations of the group are translated in death and dying as biological and psychosocial events and anchored in the transcendental aspects, we do not see obvious differences in the testimonies of doctors and nurses , and the factors that interfere the construction of these offices is the culture, including religion

Gestão ambiental na saúde pública: um estudo sobre a percepção ambiental de gerenciamento de resíduos sólidos de serviços de saúde, dos servidores do Hospital Universitário Onofre Lopes do Rio Grande do Norte

This research has aimed at studying the perception of University Hospital Onofre Lopes (HUOL) s workers on the environmental management plan of RSSS. They have been interviewed 250 workers: doctors, nurses, nursing assistants, and cleaners. It was used an exploratory and descriptive research of the type Survey, which aims at obtaining of data or information on characteristics, actions or opinions of any group of people. The questions of the questionnaire were of the kind objective", formulated in a model "scale", analyzed in according to the positioning of the interviewee. The wastes of health service have high potential for environmental impact in the activities from HUOL. Actions or environmental protective policy can improve the image of HUOL. They have been detected divergences on the rigor in application of law of ANVISA. The HUOL s workers unaware of the law of ANVISA and they have little or no knowledge about the practices of environmental control, public health and, they do not know the Environmental Management System ISO 14001. They have divergent views on the degree of importance of ISO 14001. There is not a Waste Management Plan for Health Service and / or is not disclosed for most of HUOL workers. It has not carried out audits or defined the goals and objectives. Besides, it has not been identified legal requirements, and there has not been communication about the service is performed or has been made a critical analysis and no control of documents the environmental management plan. The HUOL have not had a committee of environmental management. The direction of HUOL has not been organized courses, training and recycling of waste on environmental control of the health service. On a scale from 01 to 05, the level of aware level concerning to the waste management from health services of the workers, so is at the threshold between 01 and 02. For the reversal of this situation, the first and urgent step is the creation and institutionalization the environmental management committee of the University Hospital Onofre Lopes