Reforma previdenciária: em busca de incentivos para atrair o trabalhador autônomo

Este artigo busca modelar que incentivos são capazes de influenciar a decisão do trabalhador autônomo de participar ou não do sistema público de Previdência (INSS) utilizando um arcabouço de Teoria de Contratos (modelo de Principal e Agente). Por conta de alterações nas regras referentes à cessão de benefícios previdenciários presentes na Constituição Federal de 1988, supunha-se que os trabalhadores de renda mais baixa teriam incentivo para saírem do sistema. A análise empírica, entretanto, contradiz as previsões do modelo. Há um movimento generalizado de saída do sistema público de previdência e esse movimento É mais acentuado exatamente no grupo dos autônomos mais ricos. Em termos teóricos isto é explicado como uma violação das restrições de compatibilidade de incentivos. Em termos práticos pode-se pensar na maior oferta de fundos de pensão privados existente no mercado, concorrendo com o INSS.

Estoque domiciliar de medicamentos na comunidade ibiaense acompanhada pelo Programa Saúde da Família

É grande o uso e a disponibilidade de medicamentos no meio doméstico. Um estoque domiciliar de medicamentos pode influenciar nos hábitos de consumo dos moradores, favorecendo a automedicação e a reutilização de prescrições. Este estudo objetivou estudar o estoque de medicamentos na comunidade Ibiaense acompanhada pelo Programa Saúde da Família (PSF). Buscou-se descrever as características dos usuários, as condições de armazenamento, as classes terapêuticas e formas farmacêuticas, a procedência dos medicamentos e o custo dos medicamentos provenientes do Sistema Público de Saúde. Foram visitados 285 domicílios, no período de julho a setembro de 2004. Verificou-se que a média de medicamentos por domicílio foi de 8,4 e que 93,5% das famílias entrevistadas apresentaram pelo menos um medicamento em estoque. Os medicamentos estocados em maior número foram: analgésicos (11,15%), seguidos dos diuréticos (6,42%), antibacterianos para uso sistêmico (5,82%), antiinflamatórios (5,08%) e os antiácidos (4,10%). Embora seja considerável o número de medicamentos estocados nos domicílios, foi pequeno o número de medicamentos sem prescrição médica procedentes do Sistema Público de Saúde , sendo este um reflexo favorável dos serviços de Assistência Farmacêutica do Município. Por outro lado, foi verificado um elevado percentual de medicamentos adquiridos em farmácias sem a devida prescrição médica, 41,6%. Este percentual sugere uma inserção de medicamentos adquiridos por automedicação. Foi encontrado um percentual de 18,5% de medicamentos vencidos. O estoque domiciliar resulta de prescrições com quantidades superiores ao necessário para o tratamento (20%) , não cumprimento do tratamento prescrito (17%), aquisição por conta própria (9%) no Sistema Público de Saúde. O estudo sugere a necessidade de orientação dos usuários em relação a utilização e armazenamento dos medicamentos, de sistematização dos registros de dados com perspectiva de auxílio na gestão dos recursos, além de oferecer subsídios para adoção de decisões vinculadas ao processo de planejamento e execução das ações na Assistência Farmacêutica.

Fluxos e acesso dos usuários a serviços de saúde de média complexidade no município de Camaquã, RS

Trata-se de um estudo sobre acesso e fluxos de utilização dos serviços de saúde em Municípios da “Metade Sul” do Rio Grande do Sul, que se insere no programa interdisciplinar “Evolução e diferenciação da agricultura, transformação do meio natural e desenvolvimento sustentável em espaços rurais do Sul do Brasil”. Tem como objetivo caracterizar a rede de serviços de saúde existente em Camaquã e a utilização da mesma, pela identificação dos fluxos de utilização, do acesso dos usuários aos serviços de saúde de média complexidade, e o motivo que os levam ao uso desses serviços. Possui abordagem quanti-qualitativa, sendo transversal e do tipo exploratório e descritivo. A análise das trajetórias, acesso, fluxos e motivos de utilização dos serviços de saúde de média complexidade demonstra fragilidades do Sistema Público de Saúde em nosso País, representado no microespaço (o Município). A análise é enriquecida quando se tem oportunidade de conhecer a trajetória terapêutica dos usuários e o fluxo de utilização desses serviços, em função de um problema de saúde atual. Observa-se que a dificuldade está, por um lado, na falta de resolutividade dos problemas de saúde dos usuários, o que os leva a procurarem vários serviços de saúde, com trajetórias diversas, nos diferentes Municípios da área de estudo e, por outro lado, nas diferentes concepções das necessidades de saúde. Evidencia-se, portanto, a urgência de um inevitável engajamento político em prol da regionalização.

Desafios da gestão de pessoas nos processos de contratualização : o caso do Hospital Municipal Infantil Menino Jesus

A estratégia de contratualização vem sendo adotada pela Prefeitura de São Paulo (Lei Municipal 14.132/2006) como em outros governos pelo país afora, com o intuito de melhorar a eficiência e a qualidade dos serviços de Saúde. Neste modelo, o Estado, por meio de um “Contrato de Gestão” firmado com uma Organização Social, transfere para esta entidade o gerenciamento de uma unidade do sistema público. Desse modo, o Hospital Municipal Infantil Menino Jesus (HMIMJ) está sob administração do Instituto de Responsabilidade Social Sírio-Libanês desde novembro de 2008. Esta experiência paulistana tem como especificidade, sobretudo em comparação ao governo estadual, a realização de um contrato de gestão com uma unidade já em funcionamento, o que cria uma situação em que funcionários do antigo modelo estatal convivem lado a lado com outros contratados pela Organização Social (OS). O presente trabalho tem como objetivo analisar e propor melhorias na gestão de pessoas do HMIMJ, visando alcançar ao mesmo tempo maior eficiência e maior engajamento de todos os funcionários. Para avaliar esta situação, à luz da referência teórica sobre Organizações Sociais, foi feito um diagnóstico aprofundado da convivência dos diferentes vínculos dos trabalhadores desta instituição, por meio de entrevistas e visitas de campo. Ao final, são apresentadas sugestões para o aperfeiçoamento do gerenciamento de pessoas levando-se em conta a existência de um modelo institucional híbrido.

Fatores associados às internações de pacientes com transtornos mentais: um olhar para as questões de gestão na microrregião de Ituiutaba/MG

O tema deste estudo insere-se na área de Administração em Saúde, especificamente, Administração em Saúde Mental. A pesquisa destaca a importância e a relevância desse tema a partir de estudos científicos, em nível nacional e internacional. Delimitou-se a pesquisa para a microrregião de Ituiutaba/MG, que é composta por nove cidades (Cachoeira Dourada, Campina Verde, Canápolis, Centralina, Capinópolis, Gurinhatã, Ipiaçu, Santa Vitória e Ituiutaba), por apresentar características “quase experimentais”, o que a torna propícia e relevante. Diante disso, a pergunta de pesquisa é quais os principais fatores que, para a gestão do sistema público de atenção à saúde da Microrregião de Ituiutaba, podem ser associados às (re)internações de pacientes com transtornos mentais? A resposta pode levar a uma contribuição empírica, pois a identificação dos determinantes das (re)internações de transtornos mentais servirá de subsídio às ações e às políticas de saúde mental da microrregião e das cidades envolvidas e a uma contribuição teórica, visto que essa cria e valida uma ferramenta, a partir da coleta de dados primários, que leve em consideração as categorias e indicadores derivados de uma proposta de atenção psicossocial. Após a aprovação do projeto de pesquisa no Comitê de Ética da Universidade Federal de Uberlândia, iniciou-se as visitas aos municípios para entendimento das realidades locais; estabeleceu-se a definição da amostra; executou-se a coleta e análise de dados para posterior validação do instrumento de coleta de dados; apresentou-se a proposta de um modelo; e as diretrizes de análises de dados, segundo esse modelo. Para atender ao primeiro objetivo específico, que é elaborar e validar um instrumento de coleta de dados com constructos e indicadores associados às internações de pacientes com transtornos mentais, desenvolveu-se um modelo composto por cinco constructos e oito indicadores. Para atender ao segundo objetivo específico, que é avaliar a associação dos constructos e indicadores com as (re)internações de pacientes com transtornos mentais, testaram-se as doze hipóteses propostas, dentre as quais, cinco foram rejeitadas, e sete, aceitas. E, para atender ao terceiro e último objetivo específico, que é apontar elementos que possam contribuir para as políticas públicas em Saúde Mental para a Microrregião de Ituiutaba/MG, a presente tese propôs ações específicas do ponto de vista da gestão a partir do “olhar” do Gestor da Microrregião e do “olhar” do Gestor Municipal. Além do modelo proposto, o trabalho aponta para algumas opções e decisões políticas que podem contribuir para a diminuição das internações naquela microrregião. Dentro das possibilidades e prioridades, os gestores públicos devem: focar em ações relacionadas à diminuição do uso de álcool e drogas pelos pacientes; desenvolver ações que promovam o fortalecimento da responsabilidade do cuidador sobre o paciente; ampliar o atendimento e acompanhamento dos pacientes por psiquiatras; e promover a distribuição, acesso e uso de medicamentos pelos pacientes. Por fim, o trabalho apresenta suas limitações e indica algumas propostas de continuidade.

O Probásica e a formação de professores no Pólo de Parnamirim: política de formação profissional no Rio Grande do Norte?

This work studies the thematic of the politics of formation of teachers in the Program of Professional Qualification for Basic Education (PROBÁSICA) developed in the City of Parnamirim, Rio Grande do Norte. It has as its main objective to identify and to analyze the contribution of this politics of initial formation for the professional formation of teachers. To install the work, we will use the procedures of bibliographical research, documentary analysis, comment, structuralized interview, questionnaire-script and virtual research. In the analysis of the data, we trace a general view on PROBÁSICA while initial formation along with the continued formation, pedagogical research, collaborative research and the exercise of the teaching profession, identifying the possibilities and limits of the Program in the direction to reach the objective considered in this work. From the inquiry, we construct the institutional land scope of the program in question, also focusing, the organizational aspects of its functioning. We have to take care about the results, we evidence that PROBÁSICA is making the possible to access of the teachers in the educational service to the University, what the main aspect that consists, trying to prove eminent weak points in its systematic due to give to the organizational structure of this educational politics that does not count with curricular, institutional and financial the necessary conditions for the success of the professional formation of the teachers. The research will try to understand that the operationalization of the politics of formation in Parnamirim will be belong with it the main idea of the Educational Reformation in years of 1990, articulated to the neoliberal interests, that the responsibility for the problems of the public system of education attributed to the teachers, and that are not answered completely through the purpose of the professional formation, and ti seems that it does not define one global national politics that deals with seriousness to the questions the initial formation, permanent formation, pedagogical research, , career and conditions of work for the teachers

O dia mais feliz da minha vida: a entrada na universidade segundo os alunos recém-ingressos no curso de Pedagogia da UFRN(2004.1)

The present work, based on the methodological principles of the Comprehensive Discourse Analysis, aimed, through the speech of twelve newly arrived students at the Pedagogy course of the Federal University of Rio Grande do Norte, to understand the moment students start university. It also aimed to analyze the relationship between the schools they were coming from and university entrance as well as the relationship between university and their new students. In the first part of the work, which focused on school knowledge, a comprehensive listening of the speeches of the students led primarily to a distinction, established by the students, between public and private schools, a distinction especially based on the view of superiority of private schools against public ones. The abovementioned interpretation is found in the discussion of the structural duality of Brazilian education which, historically, offers different pedagogical appliances among students of more priviledged social classes and those who come from lower levels of society. The overcome of this duality, aspired by the Brazilian Constitution of 1988, was stopped by the advent of a new economic model neoliberalism, which reinforced the differences between public and private when it prioritized the market on the economic, political and social relations, including educational projects. Impoverishment of public institutions and pauperization of the work of professors affected also the relationship between teachers and studens at the current institution. This is how the teacher becomes the greatest villain at the public management system. All of these references concerning differences in the quality of teaching at public and private schools, expressed by the students interviewed, however, were centered in the preparation for the entrance exam, called vestibular, thus showing a view that the relationship between the student and the school he came from is of a propedeutic kind and even so, reduced to a preparation for an entrance exam. In the second part of the work, which analyzed the relationship between newly arrived students and their university, it was noticed that the latter represents a whole new world. This world is seen as the change at the student´s social statute for now he is grown, takes more responsibilities and is socially respected. This change of attitude established by society and the discovery of a new world which requires more independence from the students, creates in them feelings of pride and fear and they feel insecure when it comes to making decision in the campus because now their decisions deliver a greater load of responsibility. This is when students understand they need to develop autonomy, which is seen, in this work, as the capacity to make conscious decisions. Nevertheless students expressed an understanding of autonomy as something that comes as a gift for those who enter university and not as a process that is constructed from social experiences. For these students, the need to be autonomous refers to the relationships with their teachers and the search for information. This search, however, is also related, according to interviews, to public school financial cuts, which penalize university, and to the lack of employers

A aproximação entre educação escolar e trabalho: a experiência da Casa do Menor Trabalhador

It aims to consider the possible relationship between formal school education and work, from the experience of the State School House of the Minor Worker CMT of Natal-RN in this first decade of the 21st century. In this institution, children and adolescents are enrolled in the Fundamental Teaching sponsored by the State Public System studying the regular curriculum contents defined for this level of teaching, and in the opposite shift they take part in career workshops which are kept by members of a religious congregation. CMT has had as its object, since its foundation, to take children and adolescents from the streets and to provide them with a full time education associating basic education and training/qualification for the job market. In our research, we tried to learn a little bit of the expectations, concerns and knowledge of the young participants of two workshops: carpentry and bakery, so that we could gain sufficient understanding of the learning process of these youths, while still keeping an approximation with the reality of the aforementioned subjects. It was possible for us to conduct a description of the contexts and of characteristics of the subjects which make up CMT, capturing concrete aspects and aspects of the thoughts of students, teachers, instructors and coordinators. The main point of our research was: how does the approximation between formal school education and work take place in the House of the Minor Worker? To search for possible answers we have made use of basic techniques for the data construction - questionnaire, observation, conversation groups, assessment drills which allowed an approximation and a good dialogue with the participants. We also discussed the job world in the context of the capitalist exploration, from the contributions of Mèszáros (2005), Frigotto (1989); (1993); (1999); (2002); Ferretti (1994); (2004); Kuenzer (1989); (1997), in order to understand the skills demanded of the worker and the necessity of an education which allows the professional qualification of youths eager to enter the job market, through the first job. In this perspective, the study that we have systematized here aims to show the relevance of an education which manages to take a firm and conscientious stand in connection with the hegemonic capitalist project and to provide for a humane, ethical, responsible, critical and civic background

A autonomia da escola pública :um complexo movimento entre a outorga e a construção

The present research to explorer the configurations that come being given to the autonomy of the school, since the decade of 1990. We investigate the implementation of the principle of the autonomy in the public system of education of the State of Pernambuco and, specifically, in four school units and this schools its in the quarters of Stubborn Brasilia Teimosa and Casa Amarela, both located in Recife. We try to know if the implementation of the autonomy of the school is circumscribed in the process of productive reorganization, it was evidenced that the inclusion of this principle in the educational politics - in the scopes national and state - obeyed the dynamics of retraction that, in the neoliberal context, the performance of the State in relation to the public education and the school characterizes, with consequence impact in the investigated schools. From the empirical inquiry it was identified to the occurrence of a movement realized for the social actors of the schools research in direction to the construction of the pertaining to school autonomy; this movement presenting some limits and fragilities. It was evidenced despite this movement varied of intensity in the measure where the social actors of the schools had developed levels of dinamics processes (in greater or minor degree) related with the diverse expressions of democratic management that can occur into the school, such as: elaboration of the Politician-Pedagogical Project, institution and functioning of the Pertaining to school Advice, etc. The set of the carried through analyses made possible that it concluded that, in the context neoliberal and delimited to the investigated time and space, the implementation of the autonomy of the school comes if giving in way to a complex movement of construction

Impacto urbano ocasionado por empreendimentos da construção civil no entorno da zona de proteção ambiental (zpa-6), Vila de Ponta Negra, Natal/RN

The process of urbanization in recent decades has generated considerable seriousness of problems relating to the use and occupation physical environment of cities. The concentration of population, economic activities and technological standards have reinforced an existing urban environment highly degraded as a consequence of the development style that leads to the predatory use of natural resources. In this context, cities as centers of production and consumption, have the most serious problems of environmental degradation. This study investigated the impacts of the municipal building projects to large-scale vertical in the town of Vila de Ponta Negra, Natal-RN, given the proximity to the Environmental Protection Area (ZPA-6) and considering its environmental importance , scenic, landscape and tourism for the city of Natal-RN. The fragility of the licensing process and the failure of the assumptions in the analysis, objective and subjective, for the granting of environmental permits for the building construction projects, specifically those set out in the surroundings of the Environmental Protection Area (ZPA-6) and fundamental importance of landscape and tourism for the city of Natal, has aroused the concern of local people in and of itself the Government, faced with the probable impacts that will affect greatly the Vila de Ponta Negra. The methodology used to achieve the intended objectives will be the literature review, questionnaire to the surrounding population and the Government, as well as findings on the spot, through the photographic record. The beneficiaries of the license, if the entrepreneurs, have been affected because of the granting of licensing act of investing large amount of capital in the works. Additionally, with distrust of the population, since they are to discredit the public system of environmental management have guessed by the probability of imbalance to the environment and structural damage to the Vila de Ponta Negra, where such failure to support energy, lack of regular supply of water , lack of sanitation and access roads sufficient for the flow of motor vehicles in these areas, among other factors. Thus, this work will contribute to the diagnosis and solutions to the problem in question, so that the Government will effectively fulfill its social management of ecologically balanced environment of continuing urban development in Natal, Brazil

Educação superior no período noturno no Brasil: políticas, intenções e omissões

Neste artigo analisa-se a oferta de vagas para o período noturno nos cursos de graduação da educação superior no país, com foco nas universidades públicas estaduais paulistas, a fim de se verificar como estas têm atendido à exigência da Constituição Paulista no sentido de se ofertar pelo menos um terço do total de suas vagas a este período. Avalia-se o impacto dessa exigência no contexto maior da oferta de vagas para a educação superior no país, considerando que a Reforma Universitária em trâmite propõe este mesmo índice para as universidades federais. Uma retrospectiva histórica apresenta a origem da educação superior no país, a presença exclusiva das instituições públicas até meados do século XX, a entrada das instituições religiosas no setor privado em 1946, e os desdobramentos da Reforma Universitária de 1968, marco da expansão do setor privado, que contempla atualmente 71,7% das 4,1 milhões de matrículas em cursos de graduação no país. As reflexões indicam que a expansão da educação superior deve priorizar o crescimento da oferta de vagas no sistema público, buscando uma melhor relação de vagas entre o sistema público e o privado, com ênfase nas demandas crescentes do período noturno, visando a um projeto maior de desenvolvimento do país, ordenado pelo Estado e alicerçado na valorização da Educação.

Desfechos clínicos e mortalidade de sujeitos submetidos à cirurgia bariátrica no Rio Grande do Norte

Introduction: Actually the obesity is a public health problem throughout the world. Bariatric surgery has been an efficient method of weight reduction body in severe obesity, reducing its associated effects and presenting low levels of immediate and late postoperative complications. In Brazil, bariatric surgery asa recent therapeutic that has been growing recently. Being Brazil a country with continental dimensions and with a huge diversity socioeconomic and cultural, it is essential to understand the reality of patients undergoing bariatric surgery in less economically privileged regions of Brazil. Objectives: To evaluate the epidemiological, clinical outcomes and mortality of patients undergoing videolaparoscopic bariatric surgery through the public health system in the Brazilian state of Rio Grande do Norte- Brazil. Methods: Observational descriptive study of a prospective, carried out from February 2009 to February 2011, the Clinic Obesity and Bariatric Surgery at Universitary Hospital Onofre Lopes - Federal University of Rio Grande do Norte (HUOL-UFRN). Anthropometric measures, comorbidity and deaths register were made in the postoperative period. Results: Seventy patients (54 women) with low income aged 22 to 63 years completed the study. We recorded the death of three patients during the study period. The results show significant decrease anthropometric parameters, especially in relation to body weight, waist circumference and hipin both sexes. Only Waist / Hip ratio showed no difference after intervention in male patients It had a resolution of comorbidities. No significant differences in reports of daily sleepiness and the snoring male patients. Conclusion: Our findings attest laparoscopic bariatric surgery as an effective method reducing weight and comorbidities in morbidly obese patients

Custos e benefícios de um programa de exercício aeróbios na doença pulmonar obstrutica crônica: ensaio cliníco aleatório controlado

Pulmonary Rehabilitation, especially due to aerobic exercise, positive impact in reducing morbidity/mortality of patients with COPD, however the economic impact with costs of implementing simple programs of aerobic exercise are scarce. This is a blind randomized clinical trials, which aimed to evaluate the costs and benefits of a simple program of aerobic exercise in individuals with COPD, considering the financial costs of the Public Health System and its secondary endpoints. We evaluated lung function, the distance walked during six minutes of walking, the respiratory and peripheral muscle strength, quality of life related to health (QLRH), body composition and level of activity of daily living (ADL) before and after eight weeks of an aerobic exercise program consisting of educational guidance for both groups, control and intervention and supervised walks to the intervention group. The health costs generated in both groups were calculated following table Brazilian Public Health System. The sample consisted of forty patients, two being excluded in the initial phase of desaturation during the walk test six minutes. Were randomized into control and intervention group thirty-eight patients, three were excluded from the control group and one was excluded from the intervention group. At the end, thirty-four COPD comprised the sample, 16 in the control group and 18 in the intervention group (FEV1: 50.9 ± 14% pred and FEV1: 56 ± 0.5% pred, respectively). After for intervention, the intervention group showed improvement in meters walked, the sensation of dyspnea and fatigue at work, BODE index (p <0.01) in QLRH, ADL level (p <0.001) as well as increased strength lower limbs (p <0.05). The final cost of the program for the intervention group was R $ 148.75, including: assessments, hiking supervised by a physiotherapist and reassessments. No patient had exacerbation of IG, while 2 patients in the CG exacerbated, generating an average individual cost of R $ 689.15. The aerobic exercises in the form of walking showed significant clinical benefits and economic feasibility of its implementation, due to low cost and easy accessibility for patients, allowing them to add their daily practice of aerobic exercises

Saúde e saneamento no município de Galinhos-RN

The state of health and sanitation in the city de Galinhos/RN is alarming, considering that access to public water supply and sanitation is absent. This condition is further exacerbated by the demand of that area as a tourist destination, especially to celebrate the festivities as the carnival, catholic festival and activities of summer. The city population growth, at times above cited, carries the collapse of poor sanitation system. The work now directs the foregoing discussion to the links between health, sanitation and environment, understood as built environment. In this context, the understanding of socio-sanitary conditions of the council is essential in the process of examining the actions of human rebut on the quality of life of local people. Thus, we developed the analysis of primary and secondary data, to conduct a holistic analysis of the health and sanitation in the city in the existing scenario. We verified, in the course of the research, that the conditions for solve part of the problem are already evident. However, the lack of political and popular demobilization contribute to the maintenance of the status quo

As representações sociais da Geografia escolar: um olhar sobre a prática didático-pedagógica

To present research had for study object to understand the social representations of the school geography for the students of the Municipal Schools Lions Prata and Dr. Francisco Brasileiro, located in the neighborhood of Catolé, and in Santa Terezinha District, respectively, in the municipal district of Campina Grande/PB. The objective of that study consisted of identifying, to understand and to analyze those apprehensions in the form as they are communicated and executed at the school and in the society. That search is due to the fact that the constant reproduction of the same ones in the current world context in that we are inserted doesn't to the understanding of the being's complexity and of the knowledge in the educational and social extent. Like this, we considered urgent their dialogues in practice didactic-pedagogic of the geography for ressignificar the geographical knowledge produced in the city. Authors as Moscovici; Jodelet; Bourdieu; Tuan; Foucault; Castoriadis; Morin among others contributed in the reflexive mediation of the imaginary symbolic emitted by the interior speeches of the 281 (two hundred and eighty and a) researched students. Those corresponded to 64,0% (sixty four) integral of the enrolled ones in the two schools of the municipal public system of teaching (INEP, 2005). A qualitative-quantitative survey was used and its answers were categorized by using the statistical description of the Statistical Package for the Social Sciences SPSS Program. The freeassociation of words technique was also used in order to verify some information. The results revealed that the social representations of geography are still grounded in fragmented, content-based, positivistic and functional conceptions of man, society and the world. Manifestation of a traditional and organicistic teaching, this unveiling excludes the historical capacity of the students creative construction of knowledge, as well as a competent and demanding educational mediation