Processo de trabalho na estratégia saúde da família: potencialidades e fragilidades da atuação do enfermeiro

The present study aims to analyze the nurse s work process at Family Health Strategy, considering its basic elements and dynamic, and searching to identify aspects that may constitute strengths and weaknesses in its development. This is an analytical case study, with qualitative approach and theoretical-conceptual mark grounded in Dialectic Hermeneutics. Empirical research fields were the Family Health Units of Natal, RN, Brazil. The subjects are nurses working in this Strategy. Data collection was conducted through semi-structured individual interviews combined with field observation. The research was initiated after approval by the Ethics Committee of Universidade Federal do Rio Grande do Norte, according to the guidelines and rules for research involving humans (Resolution 466/12), ensuring proper ethical precepts. The project was approved by register number 398.929, CAAE 19588813.7.0000.5537. From the 9 interviewed nurses, 8 were female and 1 male, average age of 52 years, average graduation time of 27 years and average time they stayed at the same Family Health territory of 7 years. It was found that it is up to the professional nurse in the Family Health care the important role of taking care of human beings in their life, family and community contexts, producing conditions to meet their needs through therapeutic act in health, using for such purpose both materials and immaterial instruments. It was possible to relate aspects that characterize strengths and weaknesses in the work process of nurses in the ESF, according to the speech of the interviewed workers, including the meanings and contradictions. Among the potentialities observed, it was possible to highlight the wide role of the nurse at Family Health; the perception of nurses about teamwork; the relative autonomy of nurses; the commitment of professionals to work; Humanization as a technology; the presence of other agents at work, such as directors and officers at the primary health units; the professional s experience time and contract type in the case studied. As weaknesses in the work process of nurses at Family Health Strategy, were highlighted the limited skills of the workforce; the difficulty in 10 identifying specific limits of the work of nurses in this scenario; the disturbances that occur in the process, the existing gaps in multiprofessional teams; Structural deficits of the units in the studied case, the low coverage of the Family Health in the county, and the political vulnerability of the work conditions. It is considered necessary to understand the dilemmas experienced in everyday life of nurses at Family Health Strategy as part of multiprofessional teams, facing actual achievement of changes in work processes necessary for the reorientation of health care in Brazil. In accordance, it is necessary to promote proper working conditions and welfare of labor agents which are protagonists the work at the United Health System

O Mitsein e as perspectivas decisórias da autenticidade segundo a analítica existencial: ponderações ontológicas para além dos limites éticos e políticos do ser-com

The present work focuses in the question of being-wit-others (Mitsein) on Martin Heidegger s philosophy. To do so, it takes base on his pivotal scripts, such as Being and Time and Na Introduction to Philosophy, in which this theme is scrutinized. The development line adopted in this work consists in advancing the existential connection between the being-with-others question attained to Dasein s ontological relation in its terms of authenticity and inauthenticity. So on, it is necessary to comment é others philosophical elements that surround this alterity relationship, analyzing phenomenologically how being-in-the-world inflicts the Dasein in its deepest and more important choice aspects, which can direct Dasein to its authenticity or inauthenticity. Facing this decisory context, also shall be observed the way Dasein finds to share the truth in accordance with its interaction with others, and how this mode of being summarizes all ontological structure of man s comprehension. The truth works as an integrative element from which the Dasein cannot escape, being-with-others is an existential situation that Dasein is not able to stop itself from living (its life-in-progress). This work also contemplates the apparent contradiction of Dasein s been always unfolded in The They mode of being, in its everydayness and being like that interacting with others. As along as this question is developed, the work explains how it is possible to be authentic and resolute (as much as inauthentic) as the Dasein interscts with others, even though, there is no pre-defined rule for these ways of relationship between the Dasein and the others

Ética: neurocência e neuroética

L étude de la neuroétique, est placée dans le champs de l étique philosophique, où l émotion et la ration se trouve comme des elements important dans le processus des decition moral. Les champs d étude de la neuroscience et neuroéthique ouvre la discussion sur le changement et les emergences conceptuels, le progrés da la science, le devéloppement de la tecnique, de la tecnhologie et la biotecnologie, et ses relations vis-a-vis des dilemes morales concernat au champs des études et recherches dans ce domaine. On compprende que les procedures adoptés em ces études et recherches ne sont pas concernant solement aux individus soumises aux procedures et or traitement, mas a tout la societé. Le champs d étude de la neuroscience comme quelque d outre est soumis a des principles morales et étiques, sourtout c est relatifs aux prises de decition par rapport aux êtres vivants. Dans ces processus les scientifiques sont charchées des responsabilités et des risques, en face des dilemes morales concernat a tout les recherches. L analise a été faite, appui dentre outres, en la pensée de Immanuel Kant et Jonh Stuart Mill em ce que dit respect au devoir et l utilité

Bioética e odontologia: um perfil dos problemas éticos vividos por cirurgiões-dentistas

Bioethics studies human behavior in the fields ofbiological sciences and health care. Tt strives for humanization in health services along with promoting the rights of patients. In view of the lack of dental research dealing with this topic, the present study was undertaken to identify, from the viewpoint of dental surgeons, ethical problems experienced in dental practice,understand how they occur and how professionals deal with them. It is a descriptive exploratory investigation within a qualitative approach. Empirical material was collected through semi-structured interviews performed with 15 dental surgeons who work both in private and public practice in the state of Rio Grande do Norte, Brazil. The content of the interviews was systemized and organized, resulting in the identification of topics, from which were grouped the ethical problems reported by the participants. The resu1ts indicate that many of the ethical problems coincide with infringements of the norms and mIes of the Dental Code of Ethics, confirming a dental ethic acquired during professional formation and therefore, inadequate for solving the problems that emerge in professional practice. Other questions stand out such as low salaries, competition and poor working conditions. Associated to these problems are lack of commitment and professional responsibility with the patients. Concem with maintaining user autonomy, guaranteeing access to specialized services, and the need for performing only procedures for which they are technically qualified arise in the responses, leading to difficulties in consolidating the principIes proclaimed by bioethics: autonomy, justice, nonmaleficence and beneficence. We concluded that the ethical problems identified in professional practice need to be understood beyond the dental dimension, towards a human approach. It is therefore necessary to incorporate health care management technologies into health practices, including dentistry, which implies recognizing the difTerent dimensions that surround individuaIs, that is, social, economic, political and cultural

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

Análise dos aspectos éticos da pesquisa em seres humanos contidos nas Instruções aos Autores de 139 revistas científicas brasileiras

OBJETIVO: Estudar as normas relativas à ética da pesquisa em seres humanos contidas nas Instruções aos Autores de revistas científicas brasileiras. MATERIAL E MÉTODOS: As Instruções aos Autores de 139 revistas científicas brasileiras das áreas de medicina, biomedicina, enfermagem, odontologia e ciências gerais foram analisadas com relação às suas recomendações sobre os aspectos éticos. RESULTADOS: Das 139 revistas estudadas, 110 (79,1%) não fazem referências aos aspectos éticos; 17 (12,2%) exigem aprovação prévia pela Comissão de Ética; três (2,1%) fazem referência à Declaração de Helsinque; uma (0,7%) recomenda adotar o consentimento esclarecido; cinco (3,5%) seguem orientações dos requisitos uniformes para manuscritos submetidos a revistas biomédicas e três (2,1%) seguem princípios, normas e padrões éticos não especificados. Nas 29 revistas que fazem referências à ética, as exigências são solicitadas sob as seguintes formas: 15 (51,7%) exigem a inclusão da informação no texto do artigo; duas (6,8%) pedem carta assinada pelos autores; uma (3,4%) solicita cópia da autorização da Comissão de Ética; uma (3,4%) afirma supor que o autor cumpriu as exigências e dez (34,4%) não fazem qualquer referência específica. CONCLUSÕES: Os resultados do estudo indicam que na maioria das revistas científicas brasileiras há pouca preocupação em relação aos aspectos éticos da pesquisa em seres humanos, contidas nas Instruções aos Autores. Nas revistas que fazem referência aos aspectos éticos, as exigências são muito variáveis.

Dilemas e angústias de enfermeiros plantonistas evidenciados em grupo focal

A finalidade deste estudo foi desenvolver reflexão crítica sobre a experiência de enfermeiros plantonistas. Os objetivos foram: apreender como os enfermeiros plantonistas descrevem e interpretam seus conhecimentos e experiências sobre esta realidade; e refletir sobre possíveis caminhos para a superação dos problemas identificados. Este estudo foi qualitativo, utilizando-se a técnica de grupo focal. O grupo foi formado por treze enfermeiros plantonistas. O referencial metodológico foi o do Discurso do Sujeito Coletivo. Foram identificadas importantes dificuldades para a construção do trabalho coletivo e solidário: incompreensões entre o pessoal de enfermagem; entre enfermagem e outros profissionais que atuam no hospital; falta ou inadequação de materiais para a prestação de assistência; e ausência de apoio, dentre outras. Verificou-se a pertinência da criação de espaços comunicativos e de reflexão, visando o fortalecimento do coletivo profissional e a redução das angústias no trabalho do enfermeiro plantonista.

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.

Pesquisa em educação ambiental: panorama da produção brasileira e alguns de seus dilemas

A partir de textos publicados em periódicos e de levantamentos já realizados em bancos de dissertações e teses, procuramos indicar tendências e perspectivas na produção da pesquisa em educação ambiental (EA) no Brasil. Fica evidente o aumento do número de trabalhos produzidos nos últimos 10 anos. do ponto de vista metodológico, observa-se que a maioria das pesquisas faz uso de abordagens qualitativas, orientadas, muitas vezes, para uma ação colaborativa. Fica também evidente a concentração de trabalhos em certas regiões do país. O sistema universitário público, e neste a pós-graduação, constitui-se no lócus privilegiado dessa produção. A estreita relação entre pesquisa em EA e os sistemas de pós-graduação indica que, para compreender tal produção, torna-se necessário compreender o sistema de pós-graduação brasileiro. Salienta-se a importância de se construir espaços múltiplos que se constituam em lócus de discussão e divulgação da pesquisa em EA no país e de mobilização política de pesquisadores da área.

A redefinição democrática através da praxis intencional: a conscientização dos valores éticos

Procurando-se reafirmar a importância da teoria marxista, este artigo propõe-se a redefinição da democracia enquanto método e a possibilidade de sua superação para democracia-condição social através da praxis intencional exercida no cotidiano. A compreensão da vida cotidiana requer a sua reconstituição ontológica pela via da conscientização dos valores éticos contidos na genericidade.

Infecção hospitalar--aspectos éticos.

The author focuses the question of hospital infection, analysing the background on which the control committees were created. The hospital infection is discussed under bioethical principles and the Medical Ethics Code, examining the aspects related to the government, the Hospital Directorship, the Committee and the Control Service of Hospital Infection, and the assisting physician. A closer integration between the activities of the Program of Control of Hospital Infections and those of the Medical Ethics Committee is proposed, aiming at the patient and at the community, targets of total medical attention.

Princípios éticos na experimentação animal

The treatment of animals used in research or in education tests requires proper care, scientific judgment and qualified professionals to understand the needs of the animals and the special requirements of the research, tests, and educational programs. The established guidelines aim the development of knowledge necessary for the improvement of health and wellbeing of humans as well as animals to get precise and accurate results. The techniques should not be performed with inappropriate procedures that cause pain or suffering. Some principles should be considered to have an appropriate animal care and treatment.

Los dilemas de la equidad social en la Argentina finisecular

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Crisis, recuperación y nuevos dilemas. La economía argentina 2002-2007

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