A satisfação e a intenção de continuidade de uso em servços de e-learning:validação empírica de um modelo aplicado no serviço público

The present study aims to investigate the constructs of Technological Readiness Index (TRI) and the Expectancy Disconfirmation Theory (EDT) as determinants of satisfaction and continuance intention use in e-learning services. Is proposed a theoretical model that seeks to measure the phenomenon suited to the needs of public organizations that offer distance learning course with the use of virtual platforms for employees. The research was conducted from a quantitative analytical approach, via online survey in a sample of 343 employees of 2 public organizations in RN who have had e-learning experience. The strategy of data analysis used multivariate analysis techniques, including structural equation modeling (SEM), operationalized by AMOS© software. The results showed that quality, quality disconfirmation, value and value disconfirmation positively impact on satisfaction, as well as disconfirmation usability, innovativeness and optimism. Likewise, satisfaction proved to be decisive for the purpose of continuance intention use. In addition, technological readiness and performance are strongly related. Based on the structural model found by the study, public organizations can implement e-learning services for employees focusing on improving learning and improving skills practiced in the organizational environment

O serviço público de fornecimento de água nas regiões metropolitanas: cooperação entre entes da federação e desenvolvimento

This work aims to study the material conflict of jurisdiction as to the ownership of public water supply, between the municipalities and the Member States, in metropolitan areas. One of the important points of analysis is the realization of the fundamental right of access to water, a right that is implicit in the Constitution of 1988, being prevented from having their achievement considering the lack of definition of the ownership of the service. Knowing discussed the essential public service, in all its stages, it will realize it is a complex activity that depends for its operation, joint activities of federal entities and the society. In its pursuit of development (understood as better conditions of life), that in view of the Federal Law nº 11.445 of 2007 is the universal access to service, require the adoption of popular participation and the positive benefits of the state, such as planning. Moreover, it will find cooperation between federal entities (after the study of Brazilian federalism) peaceful solution to the conflict through the adoption of joint management or shared, depending on the factual situation and legal

Assistência odontológica diferenciada para crianças de 0 a 3 anos: avaliação de impacto no Serviço Público Municipal em Natal-RN

In Brazil, 0-5 years old children just have an oral health care system since 1990 s. Innumerable experiences of implantation of the attendance to the babies in the cities had appeared throughout the years, but it hasn´t been evaluated the comparative effect between children displayed and not displayed to the program. In this regard, the main of this research was describe the Early Childhood Oral Health Care in public health service in Natal, Rio Grande do Norte, Brazil and evaluate the impact of this specific oral health care for babies by comparison of indicators between exposed and non-exposed children. It was created an experimental group, formed by children covered by program which was paired, based on sex, age and socioeconomic status, with a control group, formed by uncovered children. After filling ethical application, the parents of children were questioned about some risk factors to dental caries and, in sequence, it was accomplish an oral examination in the child. It was verified the Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), dmf-s and verification of caries activity. The sample was 40 children in each group. The results showed, for VPI, a difference of 7 percentile points for the experimental group, however this difference had no statistical significance, obtained by Student s t test (p=0.314). In relation to GBI, the control group showed a low mean (0.8%) comparing with experimental group (2.77%) and this difference was statistically significant (p=0.003). The results for dmf-s and evaluation of caries activity showed no statistical difference between groups. Among the probable reasons for absence of impact of intervention, could be included: (a) the practice model was the same in two groups, or the difference was very weak and (b) the oral health care has intrinsic limitations for to impact on oral health in low income populations

Dependência química em mulheres :um estudo sobre o consumo de medicamentos ansiolíticos no serviço público de saúde de Natal/RN

This work was concerned to investigate the meaning attributed to anxiolytic drugs by women, in public health service. It proposes a joint analysis through a link between three dimensions: the woman, the drug, and public health service itself, in an hegemonic medical assistance model. It is observed that the relation between these elements has a great influence over the use and construction of a particular meaning, by the user. The medication is analysed as a consumption merchandise and as an health symbol. In this way, it reflects a biologized vision, which believes the drug as a solution for all health problems. It tries to analyse the generalized medical prescription for anxiolythics and it s consequences. It focalizes also the production and utilization of public health services by patients, mainly women. The question related to the use of anxiolytics and the meaning construted by women is analysed focusing the way that relations of masculine/feminine gender are organized in our society. At this point of view, it tries to understand the dimension that these questions have in subjectivity production, and how it acts in the health/disease process. Finally, this work tries to understand, in a broad sense, the use of anxiolytics looking at the problem not only as a biological question, but also as a cultural matter. The research was done over seventeen women, all of them anxiolytic users. It was used, as research instrument, semi-structured interview associated with methodological analysis of user s speeches

Impacto do racionamento nos resultados das empresas concessionárias do serviço público de distribuição de energia elétrica: um estudo nas empresas privadas da Região Nordeste

This work verifies the impact caused by the Emergencial Program of Reduction of Consumption of Electric Energy (energy-rationing program) in the results of the concessionary private companies of the public service of electric energy distribution localized in the Northeast Area. As the rationing invigorated from June 2001 to February 2002, its effects are diluted in the results presented by these companies in the second semester of 2001 and first quarter of 2002, with prominence for the last quarter of 2001, when the revenue of extraordinary tariff restore was instituted by the National Agency of Electric Energy (ANEEL), consequence of the so-called General Agreement of the Electric Sector made between the federal government and the companies of the electric sector. The structure of a generic electric sector and a historical review of the Brazilian electric sector from the time it was controlled by the private enterprises, including the State control period, about 1960, and returning to the control of the private enterprises in 1990, under a new regulation structure are presented. An explanation of the models of economic regulation that Brazil used for the electric sector is made, with prominence for the price cap that is the actual effective model. The process of tariff revision foreseen in the concession contracts signed by the federal government and the concessionary companies is presented, highlighting its two stages: the tariff rebalancing that defines the new price cap and the calculation of the factor X that establishes the efficiency goals for the companies. There is made a presentation of the Emergencial Program of Reduction of Consumption of Electric Energy and of the consequent General Agreement of the Electric Sector, which created the revenue of extraordinary tariff restore. A conceptual revision on reviews is presented, regarding to concepts, accomplishment and recognition. A brief review of the six companies that made part of the worked sample is also presented. Analyzing the quarters historical review and of amount of sold energy, it was possible to conclude that the energy-rationing altered the results of the studied companies significantly and that alteration was masked by the accounting process of the revenue of extraordinary tariff restore

Reflexões fenomenológicas sobre o sofrimento em relação ao trabalho

The literature review reveals that the field of Work Organizational Psychology, as well as the Mental Health of Work has been developing relevant research about the suffering and the world of work. This research intended to approach the unique experience of suffering in relation of the work, from the clinical view, taking the Heidegger’s phenomenological hermeneutics perspective as a reference. Inspired by the thought of the philosopher, sought to understand the suffering in their ontic and existential dimensions, in its limiting aspects; as the one who restricts the possibilities of relationship that man with others, putting in danger significances networks woven for him to deal with things and to live with others. The world of work has been envisioned as a space of possibilities for realization of the existence. Thus, the objective of this study is to understand how the suffering is experienced in relation to work, from the experience of professionals inserted in a judicial organization. The research, with the qualitative approach, used semi-structured individual interviews, whose narratives were analyzed from the heideggerian hermeneutic perspective. Three employees collaborated into this research. The narratives showed that the suffering is related with excess and diversity of tasks carried out by the same employee, associated with lack of acknowledgment of the work executed, and also with working relationship. In general way, the suffering revealed itself as helplessness, loneliness and lack of sense to the existence. We hope that this study enables the opening towards new horizons of understanding about the meanings and sense of work and their relationship networks, as well as contributes to the field of psychology in general

Depreciação no serviço público: reconhecimento e evidenciação nas demonstrações contábeis dos estados e municípios brasileiros

Public institutions, as well as other entities, if use of various assets for development of its activities. These assets are tools that help with the generation of benefit present and future. For the assets that compound the Property, Plant and Equipament, this loss of generation of future benefits is called Depreciation and must be recognized as an expense in the period in which it occurs. This way, be considered as an expense, the depreciation has negative influence on the composition of the entity’s income, as this is the result of the confrontation between revenue and expenditure incurred in the same period. The Brazilian legislation regulates it is necessary to recognize and disclosure in the financial statements, all of the situations that interfere with the composition of economic and financial income of the public institution. The main objective of this work was to verify if the states and cities recognize and disclosure the depreciation on their Statements of Financial Position. The data were extracted from datas of the Brazilian public administration’s entities.. The sample analyzed is 100% of the States (including the Federal District) and 91% of the Brazilian cities. The research found the historical evolution of the expenditure with depreciation, evidenced in the balance sheets of the Brazilian cities, in the last 10 years, in the period 1999 to 2008. The results indicate that 10 Brazilian states (37 %) did not show the depreciation of fixed assets in the Statements of Financial Position of the year 2008. The situation is even more worrying in relation to cities, because 4,971 (98.4 %) of 5,050 municipalities not evidenced the depreciation. The evidence found in this study indicate that public entities do not recognize the expense with depreciation, which may indicate that the economic income and financial position presented in the financial statements of these public entities does not accurately reflect the actual situation of institutional performance.

A satisfação e a intenção de continuidade de uso em servços de e-learning:validação empírica de um modelo aplicado no serviço público

The present study aims to investigate the constructs of Technological Readiness Index (TRI) and the Expectancy Disconfirmation Theory (EDT) as determinants of satisfaction and continuance intention use in e-learning services. Is proposed a theoretical model that seeks to measure the phenomenon suited to the needs of public organizations that offer distance learning course with the use of virtual platforms for employees. The research was conducted from a quantitative analytical approach, via online survey in a sample of 343 employees of 2 public organizations in RN who have had e-learning experience. The strategy of data analysis used multivariate analysis techniques, including structural equation modeling (SEM), operationalized by AMOS© software. The results showed that quality, quality disconfirmation, value and value disconfirmation positively impact on satisfaction, as well as disconfirmation usability, innovativeness and optimism. Likewise, satisfaction proved to be decisive for the purpose of continuance intention use. In addition, technological readiness and performance are strongly related. Based on the structural model found by the study, public organizations can implement e-learning services for employees focusing on improving learning and improving skills practiced in the organizational environment

O médico diante da morte na urgência e emergência:reflexões sobre o ser médico

The literature pointed that the way which people deal with death have been changing along centuries, and nowadays what is realized it is that, each time more, the human being have difficulties to deal with death. Due to the fact that the main function of the physician is to save their patients lives; responsibility that is aggravated by the necessity of to take decisions quickly, once he need to deal with the unexpected situations of the urgency and emergency, many times these professional have to face of impotency and fail situations, when he lose a patient. The main goal of this study was to understand the experience of physicians that work in the urgency and emergency, in front of death. These questioning it justified by the fact of the physicians do not have, many times, a space to express their suffering and anguish about the issues related to death in their work routine, despite lifedeath question to be often present their everyday. It is still possible to verify in the literature, an appointment of the necessity of to include in the curriculum of Medicine courses, subjects that approach such questions. The method used was based on the existential-phenomenological perspective, using as instrument the participant observation, to the intent of understand the routine in the urgency and emergency context, and semi-structured interview. It was interviewed six physicians that work in the urgency and emergency of the most important hospital of public health system of Natal-RN. The results showed that the physicians reported pleasure in work in the urgency and emergency, despite of they presented stress and the difficulties that they deal with in the public system. Despite of the fact that the death to be considered as a phenomenon that make part of the physician s routine, sometimes, deals with these one is more difficult. Many times losses generate an impotency and guilty feeling, as well as questionings about their performance during the attempts to save lives. We verified, from this study, the importance of the existence of some kind of intervention in the emergency, in order to the physicians can elaborate the questions about death and die emerged in their work. We consider yet that this study corroborates and reiterates the discussions concerning the importance of this thematic to be approached in a more effective way, during the academic formation of these professionals, as well as, the importance of a larger investment from the part of Government in the urgency and emergency sector, in order to propitiate to these professionals a work that brings less harmful for their health

Avaliação do acesso aos serviços de reabilitação física para vítimas de acidentes de trânsito: caminhos para melhoria da qualidade do sistema de saúde

The Physical Rehabilitation services (PR) are of fundamental importance in combating the global epidemic of Traffic Accidents (TA). Considering the numerous physical and social consequences of the survivors, quality problems in access to PR are a hazard to recovery of victims. It is necessary to improve the management of quality of services, assessing priority dimensions and intervening in their causes, to ensure rehabilitation available in time and suitable conditions. This study aimed to identify barriers to access to rehabilitation considering the perception of TA victims and professionals. The aim is also to estimate the access to rehabilitation and their associated factors. This is a qualitative and quantitative study of exploratory nature developed in Natal / RN with semi-structured interviews with 19 health professionals and telephone survey to 155 victims of traffic accidents. To explore barriers to access the speeches were transcribed and analyzed using the Alceste software (version 4.9). During the interviews used the following guiding question: “What barriers hinder or prevent access to physical rehabilitation for victims of traffic accidents?”. The names of classes and axes resulting from Alceste was performed by ad hoc query to three external researchers with subsequent consensus of the most representative name of analysis. We conducted multivariate analysis of the influence of the variables of the accident, sociodemographic, clinical and assistance on access to rehabilitation. Associations with p <0.20 in the bivariate analysis were submitted to logistic regression, step by step, with p <0.05 and confidence interval (CI) of 95%. The main barriers identified were: “Bureaucratic regulation”, “Long time to start rehabilitation”, “No post-surgery referral” and “inefficiency of public services”. These barriers were divided into a theoretical model built from the cause-effect diagram, in which we observed that insufficient access to rehabilitation is the product of causes related to organizational structure, work processes, professional and patients. Was constructed two logistic regression models: “General access to rehabilitation” and “Access to rehabilitation to public service”. 51.6% of patients had access to rehabilitation, and 32.9% in public and 17.9% in the private sector. The regression model “General access to rehabilitation” included the variables Income (OR:3.7), Informal Employment (OR:0.11), Unemployment (OR:0.15), Perceived Need for PR (OR:10) and Referral (OR: 27.5). The model “Access to rehabilitation in the public service” was represented by the “Referral to Public Service” (OR: 23.0) and “Private Health Plan” (OR: 0.07). Despite the known influence of social determinants on access to health services, a situation difficult to control by the public administration, this study found that the organizational and bureaucratic procedures established in health care greatly determine access to rehabilitation. Access difficulties show the seriousness of the problem and the factors suggest the need for improvements in comprehensive care for TA survivors and avoid unnecessary prolongation of the suffering of the victims of this epidemic.

Condições de trabalho e saúde psíquica de servidores técnico-administrativos da UFRN

Unfavorable working conditions constitute one of the factors that may contribute to cause psychic suffering and behavioral disorders in workers. This research aimed to characterize the working conditions public servant technical- administrative , specifically the auxiliaries and assistants in administration of the Federal University of Rio Grande do Norte – UFRN, Natal, Brasil, as well to identify the incidence of psychic suffering in this group of public servants. As a strategy, we chose a case study of multi-method type, descriptive with quantitative and qualitative sequential steps. For this, it initially performed desk research by surveying epidemiological data for these public servants working in central campus, to identify the major diseases presented in the period from January 2011 to June 2014. Then, we proceeded to diagnostic step of the aspects related to work, by applying online and in loco of Working Conditions Survey (already validated by Borges et al., 2013a) in 11 sectors selected according to the following criteria: high number of workers public servants and major and minor percentage of absences for health care for ICD-F (according to records of Sector of Workers Health Care - DAS). In the treatment of the data the spreadsheet editor software Microsoft Office Excel and statistical SPSS Statistical Package for Social Sciences were used and made qualifying type of content analysis of open questions. Applied to this study 174 public servants and the results show a predominance of absenteeism due to mental or behavioral disorders (ICD F), musculoskeletal diseases (ICD M) and respiratory system (ICD J). Among the factors that were significant are the working hours (contractual and legal); Physical Effort (M = 2.59) and workspace (M = 2.58) - physical and material conditions; encouraging collaboration (M = 3.5) - processes and characteristics of the work; and participation (M = 1.78) - social-management environment. Therefore, it infers the existence of a relationship between these factors and some of the reasons for absenteeism reported by participants. It is suggested the expansion of this research with studies involving other professionals (including scholarship workers and contractors) and specific sectors.

Fatores de longevidade do programa Central do Cidadão no Rio Grande do Norte

The public management reform in Brazil, since 1995, provoked new experiences in public administration. Among the new models of public service the one-stop shopping has distinguished and was adopted at Rio Grande do Norte with the Citizens Center Program. The one-stop shopping assembles in the same place many public services with appropriate structure, enabled human resources and citizens focus processes. The goal of this research was understand how citizens focus processes help to explain Citizens Center Program s longevity. It was made a case study and the research tools were applied with Citizen Center Programs workers and citizen-users at South Unit of Citizen Center Program placed at Via Direta Mall, Natal. The major contributions for Citizen Center Program s longevity were imputed to Basic Operation Processes. The most spoken features in Citizen Center Program mentioned were quality, efficiency, celerity e personal appearance, what demonstrate concern and care with citizen-users. Worker s personal appearance, accommodation, celerity, politeness and attending capacity planning were high evaluated by citizen-users revealing the wisely choice of use a large quality concept and citizenship concept in public administration. Citizen-users also pointed the necessity of refine and enlarge the communication ways that form an essential mechanism to public citizen focus administration. Not ignoring the policy aspect citizen focus processes were noticed like especial management actions that make easier citizen s activities and public service access, what generate satisfaction to citizen-users. It s possible to conclude that the high level approving evaluation of Citizen Center Program consolidates it an especial public policy that serves citizen s necessities e create appropriate legitimacy conditions of the public policy making harder the choice of ending the policy even in more fragile moments strongly contributing for its longevity

Conselho Municipal de Saúde de Pedras de Fogo - PB: um estudo sobre participação

The present study aims to understand the process of Participation of the Health Council- CMS in the formularization, implementation and control of the Municipal health plan of Pedras de Fogo, through four criteria of quality of participation considered by Demo (1993): representation, legitimacy, base participation, and self-responsibility. The criteria of representation is related to the quality of politics of the representative over the representings. Legitimacy is related to the politics` quality of the process of participation based on norms and rules that stipulate the participation, the base participation is a necessary political support so that the power authorization directed to the representings can be effective and the self-responsibility refers to the capacity of being responsible when it concerns to the public service or property. Through the descriptive and exploratory study a qualitative method was adopted to consider the conditions of the participation of the twelve council members of the City council of Health of Pedras de Fogo, through a formulated Instrument based on the criteria of DEMO (1993). It was concluded that the quality of the participation of the council members of the CMS of Pedras de Fogo understands essential aspects of the criteria of quality considered by Demo (1993) but it shows fragilities as unfamiliarity with the norms that legitimize the performance of the council; unfamiliarity of its condition of being an agent and the importance of the participation of the base for the reinforcement of its participation, as well as inertia related to the check and rendering of accounts on its performance. This way it makes sense that the participation of the council in the four criteria of quality of politics considered in this paper needs to improve

Fatores determinantes da decisão sobre a prática da cesariana em Natal-RN

O objetivo deste estudo é analisar os fatores que contribuíram para as diferentes decisões para o parto cesáreo e a ligadura de trompas entre as mulheres de 18 a 45 anos de idade no Município de Natal, no Nordeste do Brasil, no ano de 2000. Tratou-se de um estudo longitudinal, originado da base de dados de um Estudo Multicêntrico, envolvendo outras localidades do Brasil, composta de mulheres em idade fértil que procuraram o serviço público ou privado. Foram realizadas três entrevistas: no início da gestação, no mês anterior à data provável do parto e até um mês após o parto, perfazendo um total de 433 entrevistas, sendo finalizada com uma amostra de 269 mulheres. O estudo satisfez a um critério de elegibilidade, abrangendo uma amostra das mulheres de 18 a 40 anos de idade, que residiam em Natal e que estavam grávidas no máximo, na 22a semana de gestação, e procuraram o serviço público ou privado para a realização do pré-natal. Não entraram no estudo, aquelas mulheres que faziam um acompanhamento em ambulatórios especiais (hipertensão ou diabetes gestacional, HIV/AIDS). A análise consistiu, primeiramente, num estudo descritivo, seguido de uma discussão sobre a trajetória do desejo à realização do parto e testou-se a significância estatística dos partos com variáveis socioeconômicas. Sequencialmente adotou-se uma análise bivariada centrada nos testes de associação, onde foi considerada a variável tipo de parto como sendo a variável resposta e as demais variáveis, relacionadas à condição sóciodemográfica e a saúde reprodutiva da mulher, como sendo as variáveis de risco ou independentes. Para o cálculo da razão de chance (OR), foi utilizado o modelo de regressão logística múltipla. Das 269 mulheres entrevistadas, 56,0% foram submetidas ao parto normal. Este tipo de parto foi desejado independente da categoria, por 71% das entrevistadas. Os resultados mostraram como fatores determinantes para cesárea, o serviço ser privado (OR = 5,6), a mulher ter idade acima de 20 anos (OR=2,87), ser primípara (OR=4,56) e a realização de ligadura de trompas (OR=12,94). Independente da parturição, 84% das mulheres do serviço público foram submetidas a um parto normal, enquanto que, 74% das primíparas do serviço privado, fizeram uma cesárea. Os resultados sinalizam um distanciamento efetivo entre o desejo por um tipo de parto e a sua realização, quando os fatores considerados, não foram somente técnicos, podendo, também, refletir a falta de prática do parto normal, pelo obstetra e a necessidade de uma maior consciência ética nos procedimentos obstétricos, de modo a favorecer uma maior abertura na participação da gestante na escolha pelo tipo de parto

Formação em odontologia: um estudo sobre as clínicas integradas em cursos do Brasil

Dental education is going through important changes in preparing workers to meet the needs of the society and the labor market. For that reason, we studied the offering of comprehensive dental care clinics in Brazil with the aim of encouraging future curriculum changes focused on the training of general dental practitioners. An email questionnaire on educational organization and comprehensive care clinics of undergraduate programs was sent to each academic dental affairs dean. Sixty-seven (41.6%) dental schools agreed to participate. We observed that curriculum changes have contributed to modify the format of comprehensive care clinics. This was felt mainly (88,1%) with regards to workload and course offerings in different levels of the dental curriculum, thereby creating a favorable environment for generalist training. Most schools shared the following characteristics: clinical procedures were being prioritized according to level of complexity (95,5%), students were having the chance to attend courses in other programs (37,3%), and attempt to diversify teaching methods was being challenged (58,2%). Although progress in combining teaching and clinical services was reported by 83,6% of schools, most clinical procedures were still being performed intramurally (50,7%) in partnership with public service. There was also improvement in clinical mentorship due to the hiring of instructors qualified to work in comprehensive care clinics and with aptitude to supervise a wider range of dental procedures (58,2%). Further changes to Brazilian comprehensive care clinics should hence be encouraged and intensified to ensure appropriate generalist training for dental practitioners