Atenção ao usuário em um centro de referência HIV/Aids: perspectiva de profissionais e usuários

We study the health care focused on care in an intercessor and dialogical relationship with the User, which involves the construction of therapeutic projects essential to the quality of the treatment of the user in health services, and it is necessary individual and collective actions. It is intended to acknowledge and analyze the perception of social subjects, users and professionals on the treatment given to a user of a Specialized Outpatient Service (Serviço Ambulatorial Especializado SAE) in STD/HIV/AIDS state reference in Natal, RN. The study is structured in a transdisciplinary vision of science and knowledge, theoretical and methodological principles that give meaning to the expression of the institutional features of care and health care reconnecting them to the social context. As a research strategy we seek the expressions of 56 subjects of social research, which agreed to participate in the sample, from a symbolic map of the attention, coupled with the techniques of observation and semi-structured interview. For the analysis of the results, five categories of analysis were established: the meaning of the service, care perception, process of communication and interaction, treatment perception and organization and evaluation of the service. It is argued that the attention and care are developed in a technical health care assistance to the disease, focusing on attention based on treatment, on diagnostic and drug therapy of antiretroviral drugs, reflecting the traditional biomedical paradigm of attention to the disease. This is also the mode of organization of practical actions in daily SAE: the therapy proves to be fragmented in several specialties, vertical and feeds the same model, generating tension and overload for professionals; showing impersonal care focused on structured and informative technology, unrelated to an interactive dialogic. From the speech of the subjects, the SAE is understood as the place of confrontation with the disease, but also enables greater elaboration of the illness by meeting their peers. Living with HIV and AIDS is living with concern, apprehension and fear, but mainly with the stigma, prejudice and exclusion, which require that the disease is kept in secret. There is a movement of forces and power, expressed in the knowledge-power of those who dominate the technical and administrative capabilities, devices that concentrate the maintenance of the medicalization of care, rapid consultations and with little attention, making it difficult to interact with and listen to, combined with structural failures, organizational and inadequate management of the service. We conclude that there are dimensions that are not considered in the internal dynamics of the care service multiple forms, characterized by care conflicting models, marked by individual interventions related to the disease. The subject is not considered together with his speech as technical discourse is imposed and care production based on material technology is observed

A missão política do Supremo Tribunal Federal: análise de sua importância como corte constitucional para o controle do poder no Brasil

The following study proposes an analysis of the politic process which the brazilian constitutional justice faces, emphasizing the Supremo Tribunal Federal . For that purpose, we start by examining the intimate relationship between Politics and Law, in view of the most recent social systems theories, so that the political system is distinguished by the exclusiveness of using the physical force, intending to make coletive tying decisions, and the juridical system as a congruent generalization of the expectations towards the rules and principles, brought together under an interdependence by which both gather legitimacy and effectiveness. In this manner we can notice the political effects of the constitutional interpretation conducted by Judges as well as by other juridical professionals, because these ones decrease the overload of expectations which are pointed to the Judicature. Constitutional interpretation is democratized since the participative democracy arises and stablishes a permanent state of awareness around the exercise of power and favours the preservation of the pluralism (counter-majoritary principle) where we can find the origin of the democratic nature of constitutional courts, once, in most cases, their members are not elected by the people. After that, we analyse the historical posture of the Supremo Tribunal Federal as a constitutional court in Brazil, so we can realize the attempts to make it vulnerable to the appeals of governability and economical aims, agains which this court somehow has resisted, stressing its particularities. At the end, it s concluded that even the so-called acts of government, whose judiciary control is mostly repelled, are subjected to a constitutional analysis, last frontier to be explored by the Supremo Tribunal Federal in its role of exposing our republican Constitution

Trabalho e formação docente na rede municipal de ensino de natal

The study Teacher work and education in the municipal schools of Natal objectifies the analysis of the education and work conditions of the teachers in the municipal schools of Natal, placing them within the scenario of the public policies outlined for Basic Education (2005-2010). The thesis is based on the perspective that the educational reforms implemented by the Brazilian government in an attempt to answer to the new contextual demands originated from the world of work and globalization, demanding increasingly higher levels of qualification and constant extension of the teaching functions in school from the teachers, have been configured withal as a strategy for intensifying the teacher s work. The empirical field of study was constituded by thirteen municipal schools that offer basic education. Four hundred and seventeen teacher subjects that work in the municipal school system of Natal, two representatives of the Secretaria Municipal de Educação de Natal (SME)1 that work in the pedagogical team and one representative of the Sindicato dos Trabalhadores em Educação do Rio Grande do Norte2 took part in the study. The procedures/instruments used in the research were: bibliographic review, document research, questionnaires and recording of information in a field journal. The study confirmed that the majority of the teachers that work in the municipal school system were admitted by means of public entry exams, therefore meeting the requirements set by Law 9.394/96. Most of the teachers have the initial education demanded to work in basic education, although with some limitations due to the fact that they do not correspond to the needs of the educational system. The SME has a plan for continued training of the teachers in accordance to the current ideas defended by researchers of this field. There is, although, a disconnection between the purpose of the plan and the training strategies, because, in truth, predominate repetitive and specific actions that do not contemplate the training needs of the teachers, nor the demands of the system. Although the work conditions are evaluated, by the teachers, as relatively good, limits in relation to the physical structure of the schools are observed (dirty walls with holes in them, broken ceiling fans, old chairs and desks, old and stained black boards, inadequate restroom installations, poor maintenance of the computers, amongst other items). It was also verified the an increase in the functions of the teachers and an intensification of their work, materialized through an overburden of activities undertaken daily at school (and outside of it) and through the demand in taking part in activities that go beyond those inherent to the teaching process, such as the elaboration of political-pedagogical projects, participation in collegiate, registration of student information solicited by the SME and the participation in commissions, has been happening

O trabalho do gestor escolar: intensificação e implicações administrativas e pedagógicas na gestão da escola

Analyze the work of the school manager who now faces the changes experienced in school management for the last two decades. We propose that there have been changes in school management that have generated a larger number of activities to be developed by managers, causing both the intensification of work and a greater involvement of professionals in the financial-administrative dimension of their work in opposition to the political and pedagogical dimension. This study has a historic-critic approach. That is why we performed semi-structured interviews with school managers of the city schools in Natal RN, BR as a methodological procedure. We also analyzed the literature as well as the documentation relevant to this subject. From the study it was possible to conclude that changes in the field of school management and also teaching have led to an intensification of work of school managers and that such changes have not been followed by corresponding improvement in working conditions and teaching career of these professionals. They, as a rule, are considered by controlling agencies and by the school community as the primarily responsible for the school condition and for creating actions or projects that may improve the institutional objectives and results, including even the maintenance of the institution. Moreover, the growing number of administrative activities represents for obvious reasons extra work for these managers, who, when trying to cope with the growing bureaucratic situations, end up misplacing other political and educational aspects of school work, which may undermine the final purpose of school itself. We stress that we must broaden the discussions on the functions of the school manager, so that this worker can actualize a pedagogical project more committed to an emancipatory nature, despite all the challenge in keeping the school running in often-precarious conditions

Descompassos nas políticas educacionais: a reorganização da educação rural em Jardim de Piranhas/RN

The present work has as aim to analyze the reorganization process of the rural education in Jardim de Piranhas-RN, on the context of the education policies, in particular of the period of 1999-2006, having as reference the transformations in the political, cultural and socio-economic setting in the national, regional and local level, above all from the decade of 1990. The studies carried out in diverse sources made possible to understand from the context in which they had developed the education policies, in particular, that one directed for the rural way, as well as the mediation of this with the education reorganization in the local scope. Besides these research procedures, we carry out interviews - semi-structuralized - with managers and teachers, and we analyze documents from the produced ones in national level to those local ones. From the viewpoint theoretician-methodological, we focus the national discussion that comes developing under a new ideological political configuration and, being entitled by the Field Education, understood as a policy directed to education specifities in this sector and consolidated in the Operational Guidelines for the Basic Education in the Field Schools (CNE/MEC/2002). As particularity of this object in Jardim de Piranhas-RN, we emphasize events occurred that had marked the rural education reorganization in that city, especially from the creation of the Rural Education named Center Teacher Maria Edite Batista. Studies make possible to realize that until the Center creation, the schools functioned in rather precarious infrastructure and physical conditions, that is, without electric energy and water supplying, as well as the lack of school snack and the management structure. There was not a project or specific pedagogical accompaniment for the sector. Moreover, the teachers worked predominantly with several grade classes and still they fulfilled the manager functions, caretakers, and cook- in some cases as school secretary. However, exactly with the creation of the Rural Education Center, the education municipal system did not become capable to overcome problems as of the evasion and school failure, as well as decreasing the work overload of teachers, neither to give greater consistency to the pedagogical project of the field schools in that city

Vivências de familiares do paciente internado em unidade de terapia intensiva: estudo fenomenológico

This study originated from my concerns as critical care nurse, regarding the lived experience of the family member of the patient that is hospitalized in the intensive care unit - ICU. The purpose of the study was to comprehend the experience of the family members while having a loved one interned in an ICU, and to identify the common elements of the phenomenon, based on the descriptions of their experiences. Considering that the object of study involves subjective and social questions, the study was conducted using some fundamental ideas of descriptive phenomenology as a referential and the situated phenomenon as suggested by Martins and Bicudo (1989). Ten (10) family members of patients that were interned in the ICU of private hospital in Natal, RN were interviewed using the following leading question: What is it like to have a member of your family interned in the ICU? Five thematic structural categories emerged from the comprehensive analysis of the interviews: Fear of the family member s death; Lack of humanization; Social isolation; Confidence in the ICU; and Overload to the personal life. The description of the phenomenon enabled a new look at how the care team relates to the family members of the patients interned in the ICU, providing some guidance on how to construct a humanized care that involves the family and that is based on affective human relations. This involves a rethinking of the care provided by team to the family and stimulates the reformulation of personal and social attitudes, and of hospital organizational norms

A banalização da injustiça social no cotidiano de trabalho : a propósito da violência no trabalho e ameaça à saúde do trabalhador

Analyzes the factors that unleash violence by banalization of the problems and health questions of workers in a federal public institution, in Natal/RN. It analyzes transformations in the world of the work, with its politic, social and economic determinatives and its relation to the worker health. Boarding the violence in the work enviroment and its implications to the worker health, focusing on the banalization of problems faced by the workers as a kind of violence in and with the work. It was chosen an analitic methodology with qualitative approach, through the collection tecnic and information analyzes according to the thematic oral history, with recorders of authorized personal narratives, through individual interview with a semi-structured guide. In the analyzis of results it were made empiric cathegories: the daily work enviroment and its influence to the worker profession and life; the violence presents in the work enviroment and its consequences to the worker life and health; the banalization of the social injustice, due to violence against the worker that broked their dreams concerned to the nursing contribution. The results revealed the ordinary work of these workers showing enviromental and organizational unhealthy conditions, caracterized by physical and tecnical insecurity; absence and disqualification of instrumental and human supplies; overload and complexity service; bad distribution of the duties and pressure to the deadline and productivity, producing tension, conflict and anxiety related to the users, colleagues, superiors and to the duties. In the work enviroment, it were identified a external violence, caracterized by physical and verbal aggresion, psychic suffering, worker depreciation; and internal, caracterized by: moral and psychological molestations and accupational structural violence. These kinds of violence bring consequences to the life, that is, professional, economic and moral order of factors and to the health by biological, mental and emocional factors. The banalization of social injustice during the daily work was discussed in the aspects of banalization of problems and work conditions, the health, qualification banalizations and professional valorization. The workers expectatives pointed out to the necessity of: secure conditions of work; trainning and tecnical assistance; politics of attention to the physical, mental and social health to the workers and their family. We conclude the enviromental and organizational conditions of the workers interviewed do not offer physical and tecnical security that they need to the execution of their activities, neither offer comfort or physical and psychological satisfactions. The politic the instituition has used points out to the depreciation and inhumanization of them producing feelings as unsatisfaction, frustation and indignation related to the institution and the work, bringing suffering and physical and mental sicking. We noticed the most terrible violence found in the work enviroment is the banalization of social injustice related do the problems and health of these workers, producing a slowly debility and simbolic death of their lifes. Therefore, it is necessary the implementation of a politic that promotes assurance, health and integral education, valorization and humanization of these workers

Atuação dos enfermeiros da estratégia de saúde da família frente à violência intrafamiliar contra a criança

The family violence against children became visible, in the context of public health, due to the damage and injuries generated in the lives of children and to the growing need of investment in physical and human resources to fill this demand. In this context, it is believed that intervention could prevent such events and are configured as primary strategies to prevent the corollaries generated by the violence. In this perspective, this study aims to analyze the performance of nurses dealing with the Strategy of Family Health viewing to identify actions based on the paradigm of health distribution. This is a descriptive, exploratory and qualitative research. The data were analyzed based on the content analysis about the method proposed by Bardin. The study was conducted in Mossoró-RN and the participants were 14 nurses working for the Family Health Strategy in Health Units of this town. The instrument for data collection was a semi-structured questionnaire, with questions answered by the participants themselves. It was evident to the study that the nurses believe that health education are the main tool for dealing with domestic violence against children, being developed, however, in its positivist and vertical way. The actions used to develop health performed by the team on their daily lives are limited to educational activities and are carried exactly when cases of family violence against children are notified. Barriers to the practice emerged from fear of reprisals from the agressor, overwork, lack of management support and difficulty for the realization of interdisciplinary, intersectorality and comprehensive care.

Sofrimento psíquico: representações sociais dos enfermeiros em ambiente hospitalar

We believe that the dissatisfaction arising from the lack of belief in the possibilities of change in the workplace, which cause difficulties to achieve professional results in the professional psychological distress that currently fits into the context of mental health. This is a qualitative, descriptive and representational research aiming to discover how the professional nurses represent the very psychological distress from work in the hospital environment. Aided and supported by specific objectives of identifying factors that generates this suffering and strategies for defense and confronting these professionals in the hospital. 22 nurses participated in this research, officials of the University Hospital Onofre Lopes, located in the city of Natal / RN, with length of service in the institution more than one year and less than five, and they accepted, by signing the Term of Free and Informed Consent, participate in the study. We use plurimethodological approach: a questionnaire, a semi-structured interview and the design-story with a theme adapted from Trinca with the support of the Theory of Social Representations and that nurses do in their psychological distress of the Central Core. We reviewed the data from the results generated by the ALCESTE software, based on hierarchical categorization downward, leading seven classes used as categories: Work process: completeness vs. incompleteness; labor contradiction of the nurse; qualitative aspects of interpersonal relationships; hospital surveillance: Challenges, muteness and neglect; Expectations, conflicts and feelings in the work process; Leisure: the other side of the work process, and Suffering generating aspects of in the work process. We consider the analysis of quarters generated by the program, which SLQ houses in the central core of the representations; the SRQ and the DLQ the intermediaries elements and the DRQ the peripheral elements that nurses do in their psychological distress. We analytically adequate results in the three belonging dimensions of social representations: the Subjectivity, the Intersubjectivity and Trans-subjectivity. We infer that the interpersonal relationship, the extra work, the deviation in the role of nurse show themself as the factors responsible for psychological distress of it. In that sense, the central core of SR of this profession is based on the level of trans-subjectivity and understood as a Social Representation controversy

Ensino do processo de enfermagem: visão dos discentes de graduação de Natal/RN

The nursing process (NP) it s the systematized way of offering humanized care with the objective of reaching the expected results. The concern of the health and education institutions of elaborating implementation strategies of it is growing. The objective of this research was to know the vision of the senior students of the nursing graduation courses from Natal/RN, about the teaching of the NP. It s about a descriptive and exploratory study of the qualitative and quantitative type, done in five teaching institutions of the undergraduate nursing course of the municipality of Natal- RN in 2011. The research was composed by 48 students of the last 2 years of the nursing course. The gathering of the data was done through an online survey with open and closed questions via SurveyMonkey. For the quantitative data it was used the descriptive statistics from Microsoft Office Excel and for the qualitative data the Content Analysis of Bardin. The results pointed a predominance of female students (81,25%) with an age between 21- 39 years old (75,00%) and in the last year of the course (62,50%). As the opinion of the students about the NP two categories emerged: 1) Nursing Process as grounded method in scientific knowledge and established in two stages; 2) Nursing Assistance Quality, with two subcategories: Nursing Process as Nursing Practice and Nursing Process as instrument of improvement of the aid quality and promotion of well-being. In relation to the tuition of the NP the students (45,83%) said that the knowledge on the subject of the instructor was good; 81,25% reported that the professors use a traditional teaching methodology with the problem solving components and 45,83% answered that is addressed in specific disciplines in an isolated way starting from the professional line. The phase of NP that the nursing students have more difficulties of learning and implementing, being mentioned 22 times (29,70%). In relation to the student s difficulties, in the fields of supervised internships, in applying the NP it was stated for 83,50% that the barriers were related to the non implementation of the practice, overwork and the lack of trust of the nurse in the NP. The teaching-care strategies described as the internship fields were: the training of nurses to be able to contribute with the University in the implementation of the service and teaching; and the need of the universities to focus, continuously throughout the course, the NP with the involvement and incentive of the instructors in this process. These results show that the NP for the nursing students is a work methodology of the profession that needs to be implemented effectively in the practical reality for its teaching to turn effective and for the future professionals to be able to bring real contributions in the achievement of systematized actions trying to improve the assistance quality and the nursing actions. It is expected that this study could help bringing some strategies to facilitate the merging between theory and practice in teaching the NP and stimulate a discussion about the topic at the Nursing Schools where the research was held together with the coordinators, instructors and students

Dedução de Funções de Alívio para Priorização de Variantes de Chaveamento Adequadas à Eliminação de Sobrecargas

Eventually, violations of voltage limits at buses or admissible loadings of transmission lines and/or power transformers may occur by the power system operation. If violations are detected in the supervision process, corrective measures may be carried out in order to eliminate them or to reduce their intensity. Loading restriction is an extreme solution and should only be adopted as the last control action. Previous researches have shown that it is possible to control constraints in electrical systems by changing the network topology, using the technique named Corrective Switching, which requires no additional costs. In previous works, the proposed calculations for verifying the ability of a switching variant in eliminating an overload in a specific branch were based on network reduction or heuristic analysis. The purpose of this work is to develop analytical derivation of linear equations to estimate current changes in a specific branch (due to switching measures) by means of few calculations. For bus-bar coupling, derivations will be based on short-circuit theory and Relief Function methodology. For bus-bar splitting, a Relief Function will be derived based on a technique of equivalent circuit. Although systems of linear equations are used to substantiate deductions, its formal solution for each variant, in real time does not become necessary. A priority list of promising variants is then assigned for final check by an exact load flow calculation and a transient analysis using ATP Alternative Transient Program. At last, results obtained by simulation in networks with different features will be presented

Uma arquitetura P2P baseada na hierarquia do endereçamento IP com roteamento unificado

There are some approaches that take advantage of unused computational resources in the Internet nodes - users´ machines. In the last years , the peer-to-peer networks (P2P) have gaining a momentum mainly due to its support for scalability and fault tolerance. However, current P2P architectures present some problems such as nodes overhead due to messages routing, a great amount of nodes reconfigurations when the network topology changes, routing traffic inside a specific network even when the traffic is not directed to a machine of this network, and the lack of a proximity relationship among the P2P nodes and the proximity of these nodes in the IP network. Although some architectures use the information about the nodes distance in the IP network, they use methods that require dynamic information. In this work we propose a P2P architecture to fix the problems afore mentioned. It is composed of three parts. The first part consists of a basic P2P architecture, called SGrid, which maintains a relationship of nodes in the P2P network with their position in the IP network. Its assigns adjacent key regions to nodes of a same organization. The second part is a protocol called NATal (Routing and NAT application layer) that extends the basic architecture in order to remove from the nodes the responsibility of routing messages. The third part consists of a special kind of node, called LSP (Lightware Super-Peer), which is responsible for maintaining the P2P routing table. In addition, this work also presents a simulator that validates the architecture and a module of the Natal protocol to be used in Linux routers

SurRFE -Sub-rede de filtragens específicas

The increasing of the number of attacks in the computer networks has been treated with the increment of the resources that are applied directly in the active routers equip-ments of these networks. In this context, the firewalls had been consolidated as essential elements in the input and output control process of packets in a network. With the advent of intrusion detectors systems (IDS), efforts have been done in the direction to incorporate packets filtering based in standards of traditional firewalls. This integration incorporates the IDS functions (as filtering based on signatures, until then a passive element) with the already existing functions in firewall. In opposite of the efficiency due this incorporation in the blockage of signature known attacks, the filtering in the application level provokes a natural retard in the analyzed packets, and it can reduce the machine performance to filter the others packets because of machine resources demand by this level of filtering. This work presents models of treatment for this problem based in the packets re-routing for analysis by a sub-network with specific filterings. The suggestion of implementa- tion of this model aims reducing the performance problem and opening a space for the consolidation of scenes where others not conventional filtering solutions (spam blockage, P2P traffic control/blockage, etc.) can be inserted in the filtering sub-network, without inplying in overload of the main firewall in a corporative network

Análise de desempenho da rede neural artificial do tipo multilayer perceptron na era multicore

Artificial neural networks are usually applied to solve complex problems. In problems with more complexity, by increasing the number of layers and neurons, it is possible to achieve greater functional efficiency. Nevertheless, this leads to a greater computational effort. The response time is an important factor in the decision to use neural networks in some systems. Many argue that the computational cost is higher in the training period. However, this phase is held only once. Once the network trained, it is necessary to use the existing computational resources efficiently. In the multicore era, the problem boils down to efficient use of all available processing cores. However, it is necessary to consider the overhead of parallel computing. In this sense, this paper proposes a modular structure that proved to be more suitable for parallel implementations. It is proposed to parallelize the feedforward process of an RNA-type MLP, implemented with OpenMP on a shared memory computer architecture. The research consistes on testing and analizing execution times. Speedup, efficiency and parallel scalability are analyzed. In the proposed approach, by reducing the number of connections between remote neurons, the response time of the network decreases and, consequently, so does the total execution time. The time required for communication and synchronization is directly linked to the number of remote neurons in the network, and so it is necessary to investigate which one is the best distribution of remote connections

Decaimento bacteriano em lagoas de estabilização no Nordeste brasileiro

Stabilization pond system consisting in more sewage treatment used in Rio Grande do Norte (RN), Brazil, representing about 90% of all systems. Fecal bacteria are removed mainly facultative ponds and in maturation ponds. Many factors influence bacterial decay, such as the levels of pH and DO, temperature, light intensity, HDT and nutrient availability. The bacterial decay rate (Kb) is calculated considering many variables, but the hydraulic regime is a significant influence for microorganisms removal, and the dispersed flow which best characterizes a stabilization pond. However, some authors developed equations for the Kb accordant plug flow and complete mixing. This research study aimed to evaluate the bacterial decay of fecal coliform and Enterococcus sp. in stabilization ponds designed to treat domestic sewage, full-scale, in RN. All systems have assessed pretreatment, a facultative pond (LF) followed by two maturation (LM1 and LM2). The parameters availed were: temperature, pH, DO, BOD5, COD, fecal coliform, Enterococcus sp., Chlorophyll a, total suspended solids, fixed and volatile. In general, there were not significant differences for pH, DO and temperature in the ponds, except for the new systems, since they have low flow and hydraulic loads. The removal of organic matter in the ponds was low, about 70%, and nearly all are overloaded organic and operational problems. The bacterial removals were low, with average 96% for LF for fecal coliform, and 98% for Enterococcus sp.; LM1 were in itself a removal for fecal coliform about 71%, and 81% for Enterococcus sp.; LM2 have efficiency of 69% for fecal coliform, and 68% for Enterococcus sp. The equation proposed by Von Sperling (1999), according to the dispersed flow regime, generated empirical values of Kb more approximate to calculated values of Kb. On average, the calculated Kb to coliforms in the LF was 0.31 d-1, and for both maturation ponds were 0.35 d-1. For Enterococcus sp. the average was 0.40 d-1 for LF, 0.55 d-1 for LM1, and 0.58 d-1 for LM2. These results also showed that the Kb obtained in full-scale systems are smaller than those found in pilot-scale ponds. Moreover, one can say that the equation proposed by Marais (1974), according to the complete-mix regime, overestimates Kb. Actual results of Kb indicated that fecal coliforms are more resistant to adverse conditions present in stabilization ponds than Enterococcus sp., therefore, an indicator of microbiological safety and efficiency. The factors significant interventions in the rate of bacterial decay were concentrations of COD, the organic loading and HDT. The few Kb relationship between pH, DO and temperature were not significant. Finally, we conclude that it s essential to correct operation and maintenance, for not performing these activities is one of the main factors contributing to low rates of bacterial decay.