Reconfigurações industriais das regiões metropolitanas do Nordeste: uma análise a partir do emprego formal

Industrial development experienced by Brazil from the 1950s, changed the concentration of population in the country. The process of development of domestic industry, concentrated in urban areas, crowded growing portion of the population.The Southeast region during the first stage of industrialization driven by the state, with the implementation of Plan goals, captained the major industrial projects implemented in the period and became the main industrial center of the country.In the decade from 1960 to 1980 the state action was marked by numerous regional development projects, softening the industrial concentration and Brazilian investment redirected to the Northeast.The second National Development Plan implemented in the 1970s led to major investments Northeast.This period marked the widespread urban growth and institutionalization of the first metropolitan areas in Brazil.The change of this developmental process is altered with the fiscal and financial crisis of the state in the 1980s and 1990s and spending cuts aimed at national development, reorienting the economy to liberal policies of economic liberalization and reduction of activity in the economy.Industrial policy was relegated to local development plans from the 1990s to the federating units fitting the wide use of tax incentives, the "war tax" to the continued industrialization process.In this context of the national economy work seeks to analyze the industrial setting in the metropolitan areas of Fortaleza, Recife and Salvador between 1995 and 2010.Although the metropolitan areas of Fortaleza, Recife and Salvador are the main urban centers of the Northeast, responsible for the advancement of industrial development, reconfigurations occurred between 1995 and 2010 by changing the level of industrial specialization built by regional division of labor in these regions.The work will be carried out by the method of descriptive analysis of the literature review on regional and urban development.Constitute quantitative method as the secondary data analysis of formal employment from the Annual Social Information (RAIS) Ministry of Labour and Employment (MTE).Using data RAIS / MTE analyzes the industrial specialization index using the Locational Quotient (LQ).Thus, it is assumed as a parameter analysis QL> 1, when the region has become specialized in a particular sector or QL <1, when the region does not have expertise in industrial sector analyzed.The conclusion of study indicates that there was in these metropolitan areas maintained the same bias hub.Fiscal policies, the states, was not successful in diversifying the productive structure and the Northeast region itself.This result is demonstrated by the need and dependence on state investments in the region to promote development.Industrial policies of recent years have been positive to meet the objectives of employment generation, but there must be specific policies for better diversification of production, in addition to integrating the economy of the Northeast sector and regionally

Universidade e educação ambiental

The society consists of the inter-relations between diverse symbolic fields of performance, where some agents if identify for values, habits and goals. The present thesis analyzed, taking for base the Theory of the Social Field of Pierre Bourdieu, the ambient field and the university, leaving of the principle that the university is one of the propitious places for the quarrel, study, knowledge elaboration, and that the ambient education is one of the ways of dissemination of knowledge and action in favor of the ambient question. It was looked to contextualize and to identify the main factors that configure the university while a social field, and to evidence the conflict and connector links with the ambientalism. It is perceived university as space of tensions, whose produced capital stock in the academic scope must be enough convincing in the direction of the social transformation, of the expansion of conscience, the critical matureness, and thus to appear as agent of social transformation. The joint between the diverse social fields, promoted for the university, will be able to contribute for knowledge formularization that can consist base for elaboration of politics and programs to answer to the problems of the society contemporary. It has the inter-relationship between the two fields, however, this relation still is fragile, needing that a continuity practical social that they make possible that the ambient question is part of the culture of the university. This will be able to give with the intensification of the actions and the inclusion of the ambient questions in the communication mechanisms and administrative management. To surpass discontinuities caused for changes of groups leading and for interests politician conjunctural are necessary that they create habitus, what passes for the institutionalization of practical and the constitution of a culture that the agents allow if to reorganize defending the interests of social transformation front to the economic interests, as much in the university how much in the ambient field

Representação social do ensinar: a dimensão pedagógica do habitus professoral

Teaching is an activity inherent to the human condition. Historically, from the institutionalization of education, the key role to pursue that activity has been attributed to the teacher, who is required to adapt to the demands of each historical conjuncture. Currently, according to the new paradigmatic requirements, the teacher must possess various skills in order to handle the complex and challenging act of teaching. Assuming the existence of a gap between what the State and the scientific discourse recommend the teacher act upon in the classroom, a decision was made to identify the configuration and structure of social representation in the act of teaching, put forth by elementary school teachers in the public schools of Natal, RN, Brazil. Therefore, the research relied on the theoretical model developed by Domingos Sobrinho (1998, 2000, 2003), which articulates the praxeology of Pierre Bourdieu with the theory of social representations of Serge Moscovici (1978). It was intended to demonstrate how teachers habitus, in its due historical context, directs the construction of social representations in the act of teaching which guides the actions of the teacher, particularly in the classroom context. At the methodological level, the following methods and techniques were used: bibliographic and documentary review in order to identify the scientific discourse on the subject matter and the official parameters of educational regulation and the act of teaching; the Procedure of Multiple Classifications PMC in order to capture the configuration and structure of the representational content in focus, the direct observation of the classroom to identify in actual terms the social representation as "guide to action" as the theory preaches. From the standpoint of the analysis, quantitative data were analysed through Multidimensional Scaling MDS, covering in this study the Multidimensional Scale Analysis MSA and Smallest Space Analysis SSA; and non-parametric statiscal techniques. Additional data of qualitative value had to undergo categorical content analysis. It was then concluded that the teachers investigated guided themselves by social representation, the product of collectively constructed and shared assumptions about the act of teaching, forming a synthesis of different sources of information and knowledge acquirement, involving elements of common sense, religious habitus, pedagogic models considered outdated, the agencies responsible for teacher training and the hegemonic discourse about education today

Mãe-esposa e professora: educadoras no final do século XIX

This text is organized through discussions undertaken in the area of the History of Education in Rio Grande do Norte, circumscribed to the History of Women from the first decades of the Brazilian Republic, and to the analysis of what was expected of this education. We examined representations of women in Natal, between 1889 and 1914, with the goal of configuring relations between the sexes with the emphasis on moral, intellectual and pedagogical aspects required of these women. As documental sources we utilized the educational, civil and criminal Legislation, on a National scope, as well as on a State and Municipal scope. We circumscribed our search to the newspaper A República, in which we found literature that circulated in Natal in the form of pamphlets, short stories and poetry, as well as other texts by authors that were part of the corpus of analysis of this study, located in public and private archives in Rio Grande do Norte, such as the Historical and Geographic Institute of Rio Grande do Norte (IHGRN) and the State Public Archive of Rio Grande do Norte (APE-RN). The use of the indexing method and the propositions of Cultural History were the appropriate theoretical-methodological framework to complete studies of this nature. This operational perspective permitted us to elaborate nuances about this time of transition from the 19th to the 20th Century, and to spotlight the fire of the women from this period. The basis of the argument that related women to maternity and domesticity, and within the ideals of abnegation and religious leadership, aligned to a demand coming from the increase in the quantity of schools for women, allocated women as the most appropriate for superior in educational performance in the country, based on its foundations: primary education. Beyond the universe of formal education, the other side of women appeared in republican politics. The mother-spouse and the institutionalization of domestic education associated the female gender with the role of educator at home as well. Be it in the public sphere, as a teacher, or in private, as mother-spouse, female care is perceived in this configuration, as an educational base that the Republic, and in transition, bequeathed to the Brazilian 20th Century

Conselho de Escola: cenários e desafios de uma escola pública de Natal

This dissertation work studies the Board of Director , created in 1995, in the public schools of the Rio Grande do Norte. It aims to analyze if the creation of this collegiate at Berilo Wanderley State School contributes to accomplish the participation of school segments, democratizing the decision-making in the interior of the institution. This research configures itself as a study of case with information collected together to the representatives of Board through of semi-structuralized interviews. Also they had been essential in the investigation , the informal talks and the registered direct comments in a field diary. For the data analysis we contemplate the following dimensions of the object: the institutionalization process of the Board at Berilo Wanderley State School; the insertion form of the representatives in the collegiate one; the participation of the members in the Board decisions ; the Board s role in the school management and the Board as democratization space. Based in the theoretical and empirical information that we made use, we look for to identify the limits and possibilities of the Board performance in a state public school. The research results indicate that the institutionalization of the Board of Director at the Berilo Wanderley State School presents limits to materialize an effective participation of school community in the essential decisions to the functioning of the school. Also it was possible to underline the fragility of an understanding on the part of school community, the potentialities that the Board in the process of democratization of the school has, translated in the discrepancy between the saying and making of the council members. It can be highlighted that the Board in the school only exists to correspond to a educational policy guideline, with a little significant role , without corresponding to the democratizing possibilities of the collegiate participation. In spite of all the evidenced debilities in the Board of Director experience of the Wanderley Berilo State School , it is worth clarifying that the actor participation, for more limited than either, it represents new something in the setting of the school. In this direction we detach the importance to invest in the improvement of the Board s role, because it can form itself in an educative space for the building of democratic practices in the scope of the school

As relações de poder na gestão da Escola Estadual Presidente Kennedy em Natal/RN: as ações decisórias dos órgãos colegiados - o conselho de escola e o caixa escolar

The present study examined the relations of power in the management of the Escola Estadual Presidente Kennedy, including the deliberate decisions on the School Council and School Fund, which guided the organization of the school. We sought to understand the management models that influenced the school organization, promoting contradictions in the decision making process. The school management is intensely marked by management models from the business logics as in the case of managerialism of bureaucracy. The formulation of educational policies based on managerialism has proposed a school-centered management with intense accountability of the school community in planning and monitoring the public services. The influences of these models subsidize hierarchical power relations that undermine the actions of decision-making of the collegiate bodies for the democratization of school management. To develop a research on the power, the investigation was based on studies of Bourdieu and Foucault. These authors understand the power in a relational system in a double sense, both in terms of discipline and the possibility of resistance. A theoreticalmethodological matrix was developed focusing on literature review, document analysis, structured interviews with twelve representatives of the segments belonging to the School Council and School Fund, as well as observations in meetings with the production of field notes. It was found that power relations experienced in the organization and activities of the school boards are marked by changes in public management over the years, promoting the contradictions between the concepts of corporate management originated in the business logics and the perspective of democratic management subsidized by official legislative documents at the national and state levels. The observations in meetings and analysis of the records showed that representatives related to management (president and manager of the school) have a privileged position with regard to exposure of their propositions, and are more likely to take a position in the political game of the collegiate bodies of work. It was also seen that the irregularity of meetings, particularly of the School Fund meetings, limits the experience of operation of the representatives in discussions concerning the planning and monitoring the actions of school management. Reports from representatives of the School Council showed that certain segments related to the management recognize their power of decision, however others have little interfere in the decision-making process in order to expound the desires of those who are represented by them. In the School Fund, the analysis of the records and interviews showed restricted moments of the meeting of representatives, and these only being aimed at choice or approval of the implementation plan prepared by the school management. The results showed no indications of moments of reflection to study the best chance for applicability of resources. This collegiate body (School Fund) has a questionable action when planning and monitoring the applicability of the financial resources of the School. To sum up, it was found that the Escola Estadual Presidente Kennedy still lives hierarchical power relations that undermine the institutionalization of democratic management in the various representative segments may take place in the game of political decision-making processes necessary for the organization of the school

Passado e presente: a enfermagem do Hospital Universitário Onofre Lopes

This is a historically focused study with a qualitative approach whose main purpose is to investigate the trajectory of Nursing at the Hospital Universitário Onofre Lopes (HUOL) and how it associates with the teaching of Nursing at the Federal University of Rio Grande do Norte (UFRN). Motivation for carrying out this study is due, firstly, to a liking for history and, secondly, to the nonexistence of records on Nursing in one of the institutions with the most teaching tradition in the area of health and nursing in the state of Rio Grande do Norte. The objectives of the study were to analyze the historical development of Nursing at the HUOL and its association with the teaching of Nursing at the UFRN; describe the historical development of the Hospital referred to; and to establish a relationship between the development of nursing at the HUOL and the teaching of Nursing at the UFRN. Empirical investigation was carried out based on the study of historical documents such as reports, minutes, letters, by-laws, decrees and administrative directives, as well as photographs and interviews with people who lived through this history or who kept vivid memories of it. From this research it can be gathered that Nursing at the HUOL was at first closely identified with the empirical stage of the profession. Its development is a result of the institutionalization of teaching whose starting point is an authorization for running the Nursing Aid School of Natal in 1955. Since then, gradually, teaching has enabled those who practiced nursing at that institution to become professionals through a partnership between the Nursing Aid School and the Nursing Department at the Hospital whose administration had been in charge of a professor for many years. Upon the creation of the undergraduate program in Nursing in 1973, nursing at the HUOL underwent a new transformation process with new nurses being hired. Likewise, the creation of post-graduate specialization and master s degree programs in 1982 and 1996, respectively, opened the way to the growth of the academic qualifications of nurses at that institution. Therefore, it must be asserted that Nursing at the HUOL has, over the years, gone through a continuous process of qualification of its members and in such trajectory the teaching of Nursing that is carried out at different levels at the UFRN stands as a hallmark

Viabilidade do processo de enfermagem no contexto hospitalar

The Nursing Process (NP) is considered as the dynamics of the systemized and inter-related actions of human care. We believe that the nursing manager, as the representative of all the nursing care provided in the hospital setting, is an important agent for the implementation of institutional policies, such as the NP, in the service. However, there is little information in the literature about the NP in the perspective of the nurse manager. The objective of this study was to analyze the viability of the Nursing Process in the hospital context based on the attitudes of the nurse managers toward the Process. We conducted a descriptive-exploratory research study, of quantitative approach, with a population of 45 nurse managers that worked in the state hospitals located in Natal, RN and in the university hospitals of the UFRN. Two instruments were used for the collection of data: a nursing process questionnaire, constructed for use in this study, and the scale for the measurement of the attitudes titled Positions on the Nursing Process. The population is predominantly feminine (91,0%) and have relative nursing practice experience (Mean=17,6 years). However, they have little experience in management (Mean=8,6 years). They express little knowledge of the PE nursing terms and little experience with the Process. They have a positive atitude toward the NP (Mean = 110,9); are favorable to its developement in the service (86,7%); 48,9% indicated little possibility of institutionalization in the service and 37,8% indicated large possibility. The Spearman test for association between the variables of attitude about the NP and the possibility of its institutionalization demonstrated a weak negative association in the total individual scores of the attitudes (-,316) as in the 20 itens of the instrument, with coefficients varying from 0,014 to 0,464. Factorial analysis of the instrument identified three underlying factors to the attitudes of the managers in this study: relevance, operationalization and collaboration, with Cronbach Alpha coeficients of 0,955, 0,844 and 0,807, respectively, and 0,956 for the whole instrument, indicating that the scale and its factorial subscales have internal consistency. We conclude that there is a weak tendency for the managers with a favorable attitude to have a negative perception about the possibility of institutionalization of the NP in the service. The favorable position does not appear to be sufficient for the viability of this methodology in the hospital sector, results that is worrisome for nursing. This situation suggests that the difficulties with the institution of the NP in the hospitals may be related to other factors, including the organizational conditions. We believe that the institucionalization of the NP in a servisse where it is not known and not practiced, constitutes the introduction of an innovative work technology that involves many demands, among them the adherence of the persons to the proposed innovation. This demands time and the institutional adjustments and the human resources necessary. In this process, the involvement of the health professional of the institution is necessary. This situation brings to light the discussions of professional autonomy, the action limits and perspectives, the redefinition of roles, delimiation (or consensus) of the objects of study and of the work processes, among others.

Trajetória de profissionais da saúde de um hospital colônia para hanseníase

Leprosy as a public health problem , there is still quite some time , even with treatment for decades . Your health-disease process is marked by a historical backdrop of stigma , prejudice, social exclusion and authoritarian decisionducts , in order to extinguish the disease milieu under the regime of compulsory confinement of the patient. In this perspective , the Brazilian public health twentieth century adopted policies of compulsory isolation , which meant that those who receive a diagnosis of leprosy were isolated from society and their families in hospitals colonies . Objective is, to the study, rescue the trajectory of health professionals in the Colony Hospital St. Francis of Assisi , in Natal / RN ; Identify the policy was perceived as compulsory institutionalization imposed for leprosy patients by health professionals ; describe the behaviors Professional Hospital adopted in Cologne ; Retrieve information about the existence and functioning of the Hospital and Create a documentary of historical fragments of leprosy from the point of view of professionals from a former colony. Exploratory - descriptive method with a qualitative approach , using the methodological framework thematic oral history was used . Obtained approval by the IRB of the Federal University of Rio Grande do Norte, under Protocol No 461 403 and CAAE 19476913.9.0000.5537 . Be interviewed during the period of November and December 2013 , five health professionals who worked in the hospital colony , using audio recorder and images to capture and record the statements. The interviews were transcribed , textualized, transcriadas and sent to reviewers to step conference of the reports. Subsequently , analysis of the stories was made from the proposed content analysis of Bardin . The results and discussion are presented in the form of article: Opinion of nursing professionals who worked in a hospital for leprosy colony , which aimed to : identify the opinion of nurses who worked in hospital colony on the lives of patients . In this article, three main themes were highlighted and discussed from the reports of colaboradoes : I - The socialization process of internal II - 16 Prejudice , stigma and discrimination III - Social exclusion versus inclusion . We conclude that , in the context of the colony hospital, the performance of health professionals contributed significantly to that stigma , prejudice and social exclusion would be minimized and that the experience of asylum seekers in the colony were not seen more traumatic

O cidadão técnico em enfermagem :analisando as mudanças na sua profissionalização

The study analyzes the changes occurring in the professional qualification of the Nursing Technician in the Natal School of Nursing. It provides a historical discussion of Brazilian professional education, of the pertinent legislation in this type of teaching, and the repercussions related to the institutionalization of the Educational Directives Law. It interprets the discourse of the graduates of the complementary course of nursing auxiliary to nursing technician, for the year 2002, using the collective subject analysis and individual interviews. These revealed changes in the areas of knowledge-learning, knowledge-doing, knowledge-being, and an awakening to other changes besides the challenges being confronted. In this sense, nursing as a participant in a society that is effervescent with process changes, interacts socially, politically and professionally in this context, able to experience advances and retrogrades, depending on its political competency

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

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

Análise comparativa de modelos de maturidade em gerenciamento de projetos: uma contribuição ao estudo da maturidade organizacional em setores de engenharia

The purpose of this dissertation is to formulate guidelines for the improvement of maturity models, or the development of new ones, aiming at its application to project departments. The maturity of project management has become critical for organizations that develop projects and want to stand out in the market they serve. For this purpose, maturity models provide paths in order to guarantee that the institutionalization of project management is achieved in the best possible way. Generally, these models assess the organization, define its current situation in managing projects and propose steps to be performed in the search of more advanced levels of maturity. With the objective of contributing to the improvement of maturity models for specific cases, a bibliographical research was conducted for the preparation of a comparative analysis matrix and performed a case study for application of two maturity models (MMGP and PMMM levels 2 and 3), selected based on criteria found in the literature, in an engineering department of an oil company. The case study supported the realization of a comparative analysis of models, from which guidelines were formulated for improvement. The results showed that thedepartment is evaluated in a medium stage of maturity, recording significant progress in some dimensions assessed. They also found that the results of applying the two models are presented as complementary, although the model is highlighted by the greater depth of MMGP diagnostic, considering many variables in their levels of maturity than model PMMM (levels 2 and 3).Finally, directions have been formulated that contribute to the improvement of maturity models, taking in account the organizational environment in which this work was developed

O internato escolar O Ateneu: produção de subjetividade na instituição total

Dans cet article on cherche à identifier les effets de l'institutionnalisation dans la production de la subjectivité dans un établissement scolaire total. La recherche est basée sur le roman «O Ateneu » de Raul Pompeia, analysé à partir de la théorie de Goffman (1961-1987) relative aux institutions totales. on décrit l itinéraire moral que le personnage Sergio développe, à son entrée à l'internat, évoquant les vicissitudes par lesquelles il passe dans ce contexte institutionnel : période d'adaptation, crises évolutives, initiations sexuelles, problèmes de rivalités, etc. les établissements totaux semblent s'organiser d'une façon caractéristique et fonctionner de manière autonome. on pourra comprendre les problèmes sociaux et les effets sur la subjectivité produite par les institutions totales par l étude des relations de pouvoir subjacentes à ces types d'établissements. Le temps pendant lequel un individu vit comme interné peut laisser des marques profondes dans sa subjectivité et se configure comme un thème personnel approprié.

Perfil demográfico e condições sanitárias dos idosos em área urbana do Sudeste do Brasil

São apresentadas séries históricas de indicadores demográficos e sanitários para a população com 60 anos e mais do Brasil, Estado de São Paulo e Município de Araraquara, de porte médio. em 1991, os idosos eram 7,8% da população brasileira e 9,7% de Araraquara, superando em número as crianças menores de 5 anos (8,9%). Aumentou o peso relativo do segmento com mais idade (70 anos e mais), que já representa 40% do total, assim como o índice de urbanização dos idosos, 93,7% no Estado e 96,3% no Município, acima da média da população em geral em 1991. As principais causas de morte são as doenças do aparelho circulatório (40% do total de óbitos) e os neoplasmas (15%). São sugeridas medidas para a assistência à saúde dos idosos: a) expansão da capacidade atual de atendimento, através do treinamento gerontológico de médicos generalistas e enfermeiros da rede pública e privada; b) incremento das atividades educativas já existentes, dirigidas aos idosos, profissionais da saúde e educadores do ensino médio; c) incremento do programa de visita domiciliar aos idosos e criação de hospital-dia para evitar internações necessárias e garantir a manutenção dos baixos níveis atuais de institucionalização em asilos (0,7% em Araraquara). A existência de pelo menos 35% dos idosos de Araraquara, com acesso à assistência privada à saúde, reforça a importância da inclusão desses serviços nos programas locais de saúde da terceira idade.

Saúde física e emocional de cuidadores da cidade de Santa Cruz-RN: perfil epidemiológico e fatores associados

Taking care for an impaired elderly is a hard and costly task that could affect directly the caregiver health. The purpose of this study was to evaluate the physical and mental health of elderly caregivers from the city of Santa Cruz-RN and analyze the potential correlated factors through an observational analytic design of a crosssectional. A multidimensional questionnaire was used to evaluation of the social demographics characteristics and those related to the care activity, as well as the caregivers´ physical and mental health. It was realized a descriptive analyze using frequency distribution and measures of the central tendency and dispersion to description of the caregivers. To verify the magnitude of the association between the variables was used the bivariate analysis through the Pearson and Spearman correlations and qui-square test. To evaluation of the association of the correlated factors to the adverse outcome with the caregivers´ physical and mental health was made a multivariate analysis by logistic binary regression and multiple linear regression models. The final sample was constituted by 304 persons, mostly women with a mean age of 50.3 ±16.8 years. The principal factors related to the physical health were age, stress and life satisfaction. Be a male caregiver, caring for a little while the elderly with cognitive deficit and not been spouse were related to worse mental health. Have worse physical health, high stress, depressive symptomatology, burden and low levels of satisfaction were also related to the mental health. After adjust through multiple linear regression was observed R2 values of R2=0,21 for Stress, R2 =0,17 for Depressive Symptomatology, R2 =0,21 for Burden and R2 =0,16 for Satisfaction. The attainment of the factors associated with caregiver´s health can help in the elaboration of specifics politics witch the goal is the integral attention to the elderly and his caregiver. The inability of continuous taking care could result in adverse outcomes such as institutionalization, impairment and death