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

Protagonismo silencioso: a presença da OPAS na formação de recursos humanos em saúde no Brasil

The aim of this study is to assess the contribution of the Pan American Health Organization (PAHO) to the field of human resources for health in Brazil. The assumption is that this organization not only influenced the development of this field, but but that it was also influenced by Brazilian institutions and by national political movements, through the interaction of its consultants with these movements. Four projects were selected, through which the contribution of PAHO was evaluated: the Program for the Strategic Preparation of Health Personnel (PPREPS), the Project for the Large Scale Formation of Middle and Low Level Personnel (Large Scale Project), the Project for Qualification in the Development of Human Resources in Health (CADRHU) and the Project for the Managerial Development of Basic Units of the National Health System (GERUS). To operacionalize the study, we used three basic complementary procedures: a bibliographic research, documental research and an interview. The time frame considered was from 1975, the year an agreement was signed between PAHO, the Ministry of Health and the Ministry of Education and Culture, establishing PPREPS. It was through this program that the first PAHO team of national human resource consultants was contracted. The period between 1975 and 1999 was marked by political and social movements that changed the course of health in the country; among these was the Movement of Sanitary Reform in Brazil, which culminated in the implementation of the National Health System (SUS). This paper shows the connections of the PAHO consultants with this movement and the implications that this had for the Program of Cooperation in the Development of Human Resources of PAHO/Brazil. It also demonstrates that as the program became contaminated by national movements of health system reorganization and of democratization of Brazilian society, it proposed, in cooperation with national institutions, an organization of determinate areas of operation of these same institutions. The manuscript further reveals that, with the Large Scale Project, the human resources program determined the pedagogical and methodological option that would be the model for various other educational projects undertaken by a number of Brazilian institutions with the technical cooperation of PAHO. And finally, the repercussions and contributions of these projects, which strengthened the the field of human resources in the public health services of the country, are identified. Data analysis was based mainly on the theories of Bourdieu, Gramsci and Freire

As relações entre o público e o privado no processo de expansão do ensino superior no Brasil: democratização ou mercantilização?

The present study analyzes the expansion of Brazilian superior education, investigating how the public and the private sectors are inserted in this process, taking as analysis dimensions the philanthropic actions, the democratization and the mercantilism. The study had for general objective to analyze the dynamics of the expansion of superior education in Brazil, investigating how it configures the overlap between the public and the private in this process. More specifically was tried: a) to understand the process of participation of the non-state public, state and private sectors with lucrative goals in the expansion of superior education; b) to analyze the limits between the democratization and mercantilism in the process of expansion of superior education; c) to analyze the mechanisms that express the privatization in the process of expansion of superior education; d) to investigate, in a program of the government, how is materialized the overlap between the public and the private, in the expansion of superior education. In the development of the study, was adopted as theoretician and methodological way a historical and critical perspective, because is considered it allows to understand the mediations between the inquiry subject and the historical context in which it is developed, allowing, this way, the true explanation of the studied object. About the technician procedures, it was adopted documentary and bibliographical research. Also, secondary data were searched on the main governmental web sites (INEP, SISPROUNI, INEP, PNUD; IBGE) which produce statistics on superior education and sponsors of private institutions of superior education, as example ABMES and the Court of Accounts of the Union, amongst others. The study results had delineated a picture that allows to evidence that has been occurring, in the country, a process of expansion of superior education, marked for the articulated participation of the public state, private with lucrative ends and private without lucrative ends sectors, but it is distinguished in recent years the prevalence of the private sector with lucrative ends. In result, it is concluded that this process of expansion cannot be considered as dimension of the democratization because it occurs by means that move it away from the education as a right to be placed in the scope of the market, changing the right into a service that is appropriated by mercantile relations

Gestão de satisfação e fidelidade do cliente na hotelaria :um estudo sobre os fatores que influenciam a satisfação e a fidelidade do turista internacional no Brasil

The objective of this thesis was studying the factors which contribute to customer s satisfaction and loyalty, focusing the Norwegian model of satisfaction and loyalty of the consumer, applied in the sector of hotel services in Natal/RN, Brazil. The theoretical research was led through the concepts of service quality, customer satisfaction and loyalty, models of quality management systems, national index of customer s satisfaction and methods which evaluate the customer s satisfaction. The field research was carried through from December 1st of 2004 to 24 st, among 381 international tourists who had been housed in the hotels of Natal. The analyses of the data had been made through the descriptive statistics and analysis of multiple regression. The results had evidenced that the main precedents variables of satisfaction had been: hotel s room, staff friendliness, hotel restaurant food and price paid; these are factors which explained, in 56,0% the variation of satisfaction with hotels. In relation to the constructs which had influenced the tourist s loyalty, were founds: tourist s satisfaction, hotel image and affective commitment, which had explained 53.0% of the data variability. The complaint management resulted as a basic factor for the tourist s satisfaction and loyalty

Um Estudo de Politicas e Práticas do uso do GNV no transporte público urbano do Brasil

The use of Natural Gas Vehicle has had a fast increase lately. However, in order to have a continuous success this Program needs to develop converting devices of Otto-cycle engines, gasoline or alcohol, to the use of NGV (Natural Gas Vehicle) that presents low cost, maintaining the same original development of the vehicle and low level of emissions, considering the PROCONVE rules. Due to the need to diversify the matrix in order to avoid energetic dependence and due to strict pollution control, it has increased in the Brazilian market the number of vehicles converted to the use of NGV. The recent regulation of the PROCONVE, determining that the converted engines with kits should be submitted to emission testing, comes to reinforce the necessity of the proposed development. Therefore, if we can obtain kits with the characteristics already described, we can reach a major trust in the market and obtain an increase acceptance of the vehicle conversion for NGV. The use of natural gas as vehicle fuel presents several advantages in relation to liquid fuels. It is a vehicle fuel with fewer indexes of emissions when compared to diesel; their combustion gases are less harmful, with a major level of safety than liquid fuels and the market price is quite competitive. The preoccupation that emerges, and the motivation of this project, is to know which are the main justifications for such technology, well accepted in other countries, with a low index or emission, with a high level of safety, where its maintenance becomes low, reminding that for this it is necessary that this technology has to be used properly, and once available in the market will not motivate interest in the urban transportation companies in Brazil, in research centers in general. Therefore this project exists to show the society in a general way the current vision of the main governmental factors, of the national research centers and of the private companies concerning the use of natural gas vehicles in urban transport vehicles, in order to give a major reliability to the population as well as to motivate national market competitiveness with a low cost and reliable product and to enrich the national technology

As origens da psicanálise de crianças no Brasil: entre a educação e a medicina

O presente artigo tem por objetivo investigar a forma como as primeiras informações relativas à psicanálise de crianças foram introduzidas no Brasil, bem como delinear como estas idéias foram apropriadas pelos teóricos nacionais e incorporadas nas práticas de assistência à criança desenvolvidas no País nas primeiras décadas do século XX. Para isto foi desenvolvida uma pesquisa histórica de natureza qualitativa, mediante a realização de um levantamento bibliográfico que buscou identificar a produção de autores nacionais sobre psicanálise de crianças entre as décadas de 1920 a 1950. Os resultados indicam que a inserção da psicanálise de crianças no país ocorreu por duas vias: primeiramente através da educação, mediante a utilização deste referencial teórico com o intuito de melhor gerir a educação das crianças e solucionar seus problemas escolares; e, posteriormente, por intermédio da medicina, mediante o desenvolvimento de uma prática psicoterápica destinada ao tratamento de crianças com transtornos emocionais.

A formação graduada em psicologia no Brasil: reflexão sobre os principais dilemas em um contexto pos-DCN

Criticism done to the undergraduate training process of the psychologist in Brazil raised debates known as "dilemmas of training". In recent years the classic training model, based on the Minimum Curriculum has undergone a series of changes after the National Curriculum Guidelines (DCN), modifying the context of courses. Thus, this paper aimed to investigate, in a post- DCN context how undergraduate courses in Psychology in Brazil have been dealing with the dilemmas of training. So, we decided to analyze the Course Pedagogical Projects (CPPs) of Psychology in the country. Forty CPPs, selected by region, academic organization and legal status were collected. The data was grouped into three blocks of discussions: theoretical, philosophical and pedagogical foundations; curriculum emphases and disciplines; and professional practices. The results were grouped into four sets of dilemmas: a) ethical and political; b) theoreticalepistemological; c) professional practice of the psychologist and d) academic-scientific. Courses claim a socially committed, generalist, pluralistic training, focusing on research, non-dissociation of teaching-research-extension, interdisciplinary training and defending a vision of man and of critical and reflective and non-individualistic psychology. The curriculum keeps the almost exclusive teaching of the classical areas of traditional fields of applied Psychology. Training is content based. The clinic is hegemonic, both in theory and in application fields. The historical debate is scarce and themes linked to the Brazilian reality are missing, despite having social policies present in the curricula. Currently, DCNs have a much greater impact on courses due to the influence of the control agencies, fruit of current educational policy, and the result is felt in the homogenization of curriculum discourses

A Psicologia do trabalho e das organizações na formação do psicólogo no Brasil

This research has aimed to analyze the presence of the Work and Organizational Psychology (WOP) at the psychologist s undergraduate education after 2004 s National Curricular Guidelines in Brazil. It has investigated in 43 Brazilian undergraduate courses of Psychology how their Course Pedagogical Projects (CPPs) approach the WOP issues. For that investigation, the CPPs, the subjects programmes related to the WOP and the curriculum grid have been accurately read and analyzed. Categories created by similar studies have also been used. The studied knowledge field has been cited by 41 courses, mainly on the definition of the egress s professional profile, on the expected competences and on the psychologist s formation process lines. Moreover, 28 courses have disposed curricular emphasis on the WOP and 12 have provided professional practices on that Psychology s field. All the courses have displayed, at least, one subject related to the WOP and in 29 cases there have been found between two and six subjects concerned to that field of Psychology, occupying nearby 10% of the whole courses credit hours. It has been verified that the Work and Organizational Psychology is allied to discussions about Quality of Life and Health of the Worker, bonded to work prescriptions at the Personnel Management departments and in other places such as syndicates. Additionally, 37% (147) of the WOP s subjects concerns to the contents of the Work Psychology, 21% (81) relates to the Organizational Psychology, 18% (71) are about Industrial Psychology s topics and 14% (55) debates the field generically. The most often issues are: Recruitment and Selection (25 courses); Training, Development, Learning and Education (24); and Work and Mental Health (24). Those topics have assumed three functions: providing principles for the acting at the WOP field; tutoring psychologists to analyze their own workplaces; and offering a comprehension of the human being mediated by the Work. It has been concluded that the WOP is incorporated on the psychologist s undergraduate education by considering the increasing of its presence and the occurrence of its traditional and emergent topics

A organização sindical dos assistentes sociais no Brasil: dilemas e desafios contemporâneos

This paper discusses the dilemmas and challenges of the union of social workers in contemporary Brazil. The study is supported by the theme in a literature search, especially productions that deal with the trade union movement of workers in the brazilian reality, as well as on field research, which consisted of interviews with national trade union leaders of the CUT and CONLUTA as also representatives of national organizations representing the professional category of social workers, notably CFESS, ABEPSS ENESSO and a labor union and the national category, FENAS. The analysis of the object is oriented in the perspective of totality, considering its founding and contradictory aspects of the current socio-historical dynamics. The inflections occurred in the razilian Labor Movement in the early 1990s, during which the offensive of capital, characterized by the fusion of flexible accumulation and the dictates of neoliberal policy is established in the country, caused a profound shock in life and organization of the class working. The major repercussions of this process are evident today in the form of defensive organization of trade union struggles, notably fragile and fragmented. In the case of the category of social workers is symptomatic of the political backlash, experienced the process of reopening their unions and the creation of FENAS. This definition, part of the analysis that considers more strategic perspective of class organization, corporate antiunionism of the mass of the 1980s, built, largely, by category and expressed by the extinction of their union and unification to the broader struggles of workers with transition to unionization by industry. Given this reality, we analyze the performance of the political perspectives of the brazilian labor movement, from the characterization of organizational arrangements for trade union struggles and situate this process, the motion to reopen union of social workers, from the emergence of FENAS. Therefore, we aimed to identify the particular and the ideological and political perspectives that make up the dilemma of the trade union movement from this reopening, as corresponds to a political trend, largely, overcome within the brazilian social work

Publicações indexadas geradas a partir de resumos de congressos de angiologia e cirurgia vascular no Brasil

CONTEXTO: Grande parte da produção científica apresentada em congressos não é publicada. Mesmo nos países do primeiro mundo, os números demonstram que essa perda é expressiva. OBJETIVO: Dimensionar o número de artigos publicados e indexados em bases de dados nacionais e internacionais, a partir dos títulos e autores de temas livres ou painéis dos congressos brasileiros de cirurgia vascular de 2001 e 2003. MÉTODOS: Foram pesquisados os 541 e 567 resumos apresentados, respectivamente, no XXXIV Congresso Brasileiro de Angiologia e Cirurgia Vascular, em 2001 e no XXXV Congresso de Angiologia e Cirurgia Vascular, em 2003. Foi realizada pesquisa computadorizada através dos seguintes instrumentos de busca: Scirus, Bireme, LILACS, SciELO, MEDLINE-PubMed e Biblioteca Cochrane, Google Acadêmico e índices remissivos e onomásticos do Jornal Vascular Brasileiro. Os artigos foram classificados em internacionais ou nacionais e em completos ou modificados. RESULTADOS: Foram encontrados 21 (3,89%) e 49 (8,64%) artigos publicados, a partir dos congressos de 2001 e 2003, respectivamente. A média de publicação dos dois congressos foi de 6,32%. CONCLUSÕES: Os números revelados nessa amostra revelam o quanto a publicação das pesquisas no Brasil é relegada a segundo plano. Muitos trabalhos deixam de ser publicados pela falta de prioridade e tradição em escrever, falta de tempo, empenho e de incentivo.

Adaptação sociocultural de gestores espanhóis expatriados no Brasil

This study aims at understanding how sociocultural adjustment occurs in the case of managers, and their spouses, expatriated to Brazil by private and public Spanish organizations. To do so, it adopts as main theoretical frame the expatriate adaptation model proponed by Parker & McEvoy (1993), based on Black, Mendenhall & Oddou s model (1991), which establishes three dimensions of adaptation: adjustment to work; adjustment to general environment and adjustment to interaction with host country nationals. This work, of exploratory and descriptive nature, used field research to gather primary data subsequently analyzed with a qualitative approach. Data collection came from individual in-depth interviews with three Spanish managers expatriated in Brazil and two of their spouses. Resulting data were analyzed through one of content analysis procedures, thematic analysis. This research shows that adjustment is obstructed by cultural distance or cultural novelty rather than by work role characteristics, being more successful in expatriates that carry previous solid sociocultural knowledge about host country. It also verifies that the degree of expatriate adjustment is enhanced by the comprehension of cultural differences that originate values and behaviors different from those of the expatriate. It points out that individual factors such as perception and relation skills, flexibility, empathy and self-efficacy are positively linked to the three dimensions of adjustment: work, general adjustment and interaction adjustment. It finds expatriate adjustment to be lowered by spouse unsuccessful adjustment and shows that location in an environment perceived as short in key infrastructures is negatively linked to adjustment in expatriates coming from strongly urban environments. It concludes that expatriate adjustment occurs through progressive understanding of host country environment and through comprehension of the sociocultural context that explains differences between host country behaviors and values and those from the country of origin, a process which is favored by expatriate individual characteristics not directly linked to his/her technical qualification, such as perception and relation skills, flexibility and empathy, together with solid sociocultural knowledge about the host country. This research propones, therefore, that organizations involved in expatriation processes should include in their selection criteria the degree to which candidates possess personal characteristics and sociocultural knowledge that may facilitate adaptation

Aspectos clínico-epidemiológicos da neurocisticercose no Brasil: análise crítica

Com o objetivo de mostrar as características da neurocisticercose (NCC) no Brasil, realizou-se análise critica da literatura nacional que mostrou incidência de 1,5% nas necropsias e de 3,0% nos estudos clínicos, correspondendo a 0,3% das admissões em hospitais gerais. em estudos soroepidemiológicos, a positividade para cisticercose foi de 2,3%. O paciente brasileiro com NCC pode apresentar um perfil clínico-epidemiológico geral (homem, 31-50 anos, procedência rural, manifestações epilépticas parciais complexas, LCR normal ou hiperproteinorraquia, calcificações ao exame de TC, constituindo a expressão da forma inativa da NCC) e outro de gravidade (mulher, 21-40 anos, procedência urbana, manifestações de cefaléia vascular e HIC, típica síndrome do LCR ou alteração de dois ou mais parâmetros, vesículas associadas ou não a calcificações ao exame de TC, constituindo a expressão da forma ativa da NCC). Os coeficientes de prevalência nacionais são muito subestimados, embora em duas cidades do interior de São Paulo tenham sido verificados os valores de 72:100.000 e 96:100.000/habitantes. Discutem-se aspectos relacionados à subestimação da prevalência desta neuroparasitose no Brasil.

Reflexões sobre a anticoncepção na adolescência no Brasil

Faz-se uma reflexão sobre a contracepção e suas conseqüências na adolescência, baseada em trabalhos nacionais e internacionais alertam para a precocidade do início da atividade sexual, a qual expõe os adolescentes aos riscos da gravidez e das doenças sexualmente transmissíveis e AIDS. Verifica-se que a maioria dos adolescentes recebe informações sobre contracepção, sendo a pílula e o preservativo os mais conhecidos e utilizados. Porém, registram-se elevada inadequação na utilização dos métodos contraceptivos, além da falta de serviços assistências, onde possam buscar orientações e atendimento. Tal realidade alerta para a necessidade de maior envolvimento de profissionais da saúde, da educação, família e comunidade, garantindo qualidade de vida aos adolescentes.

Hasemania piatan, a new characid species (Characiformes: Characidae) from headwaters of Rio de Contas, Bahia, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Bancos de sangue de cordão umbilical e placentário para uso familiar, de caráter privado, no Brasil: subsídios técnicos, legais e éticos para uma análise de implementação

Os bancos de sangue de cordão umbilical e placentário foram criados a partir da comprovação de que o sangue de cordão umbilical e placentário (SCUP) é uma fonte rica em células progenitoras hematopoéticas (CPH) e alternativa às células provenientes da medula óssea para transplante, fato que gerou o interesse pelo armazenamento das células nele contidas. A legislação brasileira distingue bancos para uso alogênico não aparentado (públicos) e para uso exclusivamente autólogo (privados). Por sua vez, o armazenamento de SCUP para uso familiar (doação dirigida) pode ser realizado em bancos de sangue de cordão umbilical e placentário públicos, serviços de hemoterapia ou centros de transplante, quando há um membro da família do nascituro com doença diagnosticada e que necessite de transplante de CPH como tratamento. Apesar de a legislação ser clara, a Anvisa tem identificado o interesse sobre a possibilidade da liberação de unidades de SCUP, armazenadas em bancos autólogos, para a utilização de outrem, familiar, além do recém-nascido beneficiário. O objetivo do trabalho visa promover a reflexão sobre uma possível modificação dos parâmetros legais nacionais que regem os bancos de SCUP autólogo, tornando-os bancos com vistas ao uso familiar, por meio da exposição dos principais elementos relacionados ao tema. O estudo analisou os critérios técnico-sanitários legais para regulamentação dos bancos; descreveu as características das CPH de diversas fontes e tipos de doação para transplante; contextualizou a relação com os princípios da Bioética; avanços sobre terapia e pesquisas relativas às CPH; e discutiu possíveis riscos envolvidos no processo.