O Sistema de Gestão do Ressarcimento ao SUS: análise de seu desempenho no período 2011-2014

O ressarcimento ao Sistema Único de Saúde (SUS), criado pela Lei n. 9.656, de 1998, apresentou resultados expressivos no período 2011-2014, em contraposição ao período 2007-2010. O presente estudo, de caráter exploratório, buscou analisar o ressarcimento ao SUS, sua origem, base legal, fundamentação jurídica, organização, funcionamento, desempenho operacional e efetividade, com foco nos resultados alcançados no período 2011-2014. Para isso, o autor apoiou-se em estudos anteriores, em documentos e relatórios oficiais, na legislação em vigor, nos acórdãos do Tribunal de Contas da União e nas ações ajuizadas perante o Supremo Tribunal Federal. As análises efetuadas indicam que os resultados alcançados nos últimos quatro anos são promissores, refletindo um cenário favorável à consolidação do ressarcimento ao SUS como um importante instrumento de regulação para o setor de saúde suplementar.

A estrutura burocrática de poder no stricto sensu em administração no Brasil: o caso do mestrado profissional em administração pública em Rede Nacional - PROFIAP

This study approaches bureaucratic organizational structures with the aim to understand the adherence procedure to virtual technologies in the stricto sensu educational administrative process. Thus, the author navigates through the formation of these organizations in Brazil with the intent to demonstrate the bureaucratic organizational culture and the consequent form of domination of those who detain power. In this epistemological construction, the author explores the culture s bureaucratic environment and the organizational power. In the analyses, it was observed the technological phenomenon in the ODL s administrative environment, which can explain the adherence procedure to structures and technological instruments for stricto sensu courses that, hypothetically, dilutes the traditional inherited organizational axiom. Therefore, it was utilized as object of study the Professional Master s degree in National Scale Public Administration PROFIAP, hence analyzing the documental content and the legislation related to institutionalization as well as the positioning of professors/coordinators and of the director of CAPES/MEC. Considering this axioms, it was concluded that the bureaucratic structures can admit ODL in the stricto sensu s environment. However, this can only be done as long as the adherence does not imply in a dilution of the traditional forms of power and institutional bureaucratic inherited dominance, as well as the alleged hegemony of the governmental structure in the educational administration adopted in person by the stricto sensu courses in Brazil

GÊNERO E RELAÇÕES DE PODER NO PENTECOSTALISMO: ESTUDO COMPARATIVO ENTRE A IGREJA DE CRISTO NO BRASIL E A COMUNIDADE EVANGÉLICA SARA NOSSA TERRA

Based on the empirical comparative study between two churches from Pentecostal guidance - both located in Parnamirim/RN - and supported on a dialogic interaction between my interlocutors and theoretical references, I proposed me to reflect about how this protestant segment represents and articulates questions such as gender and power relationships, and the daily impact of that in their followers life. In other words, this dissertation aims to understand the reason of the asymmetry attributed to male and female, especially in what concerns the distribution of ecclesiastic works and the authority given to male, as well as the implication of this reality in the reconfiguration of morality and religious praxis in daily life of individuals and involved groups. From this perspective, this work was divided in three chapters, in which I investigate the tension/relationship between faith and secularism, for from this question on concessions and/or prohibitions related to the limits and involvement of the followers with the world and with the very Pentecostal ethos arise. I also analyze here aspects concerning to both ecclesiastic hierarchy and power, with the objective of elucidating how it occurs, what kind of criteria and implications they consider as well as about the nature of the religious labor division between men and women and, finally, I try to understand how the conversion/adhesion of members is reflected in the redefinitions of gender and its relationship between the ecclesiastical and domestic spaces. The diligence and energy spent in this work is in the hope that its fruits can corroborate in the expansion of anthropological knowledge which, in this particular case, involves the Brazilian Pentecostal phenomenon

Permanências e perspectivas no ensino de projeto de arquitetura no Brasil: uma análise a partir da produção científica dos Seminários UFRGS (1985) e Projetar (2003-2011)

O objeto de estudo desta tese é o ensino de projeto de arquitetura no contexto acadêmico brasileiro. O trabalho procura analisar esse objeto nos aspectos relativos ao ensinar a fazer e ao aprender a fazer , por meio de uma perspectiva epistemológica e cognitiva, a partir da produção científica dos Seminários UFRGS (1985) e Projetar (2003-2011) sob o olhar de três estados constitutivos: conservação, permanência e transformação. A metodologia de investigação é qualitativa e seus pressupostos são investigad os por meio do método hipotético-dedutivo em busca de um conhecimento aproximativo. Dentro do universo pesquisado, as hipóteses conduzem: primeiro, à investigação e caracterização de estruturas que se conservam; segundo, à investigação e levantamento de valores e conceitos que permanecem adequados por sua capacidade de adaptação às mudanças e paradigmas; e, terceiro, por procurarem destacar práticas pedagógicas que indicam novos caminhos na maneira de agir e de se pensar o ensino de projeto de arquitetura. A pesquisa demonstrou que, embora em menores proporções, ainda se conservam ações e posturas pedagógicas que: valorizam os ideais funcionalistas e racionalistas da arquitetura; adotam posturas deterministas, caminhos prescritivos ou intuitivos no ensino da concepção arquitetural; não apresentam clareza metodológica na abordagem da problemática arquitetônica; os contextos urbanos são pouco explorados na experimentação; utilizam um sistema de concepção baseado em princípios estéticos canônicos e universais, sem problematizar as causas da transformação da arquitetura contemporânea e qual o seu papel numa sociedade complexa e diversificada. Com relação às novas perspectivas encontradas, a análise da produção científica demonstrou que a prática pedagógica do ensino de projeto de arquitetura no Brasil passa por transformações críticas valiosas. Essa constatação foi percebida, por meio, também, de reflexões e de práticas pedagógicas que valorizam a integração de conteúdos; que possuem um discurso crítico e conciliador com relação à necessidade de renovação de práticas, paradigmas, meios e conteúdos; que estão abertas às posturas cooperativas e às estratégias para a constituição de um corpo teórico-prático para o ensino do projeto que não se limite ao campo da arquitetura; que reconhecem a importância das novas tecnologias computacionais na concepção projetual e no ensino do projeto, assim como, as tecnologias e estratégias que atualizam as soluções projetuais no uso adequado dos recursos ambientais; que consideram o espaço acadêmico como um lugar propício para as experiências projetuais e pedagógicas; que manifestam um esforço em considerar a participação do usuário, assim como em realizar um processo de apreensão de contextos complexos como objeto de estudo, adotando uma postura de valorização do processo projetual. O trabalho conclui que a educação do arquiteto deve estar atenta aos aspectos relativos à inclusão da realidade sociocultural e ambiental como referência para o fazer arquitetural em detrimento da primazia dada à racionalidade técnica, uma vez que essa realidade permite a mediação, entre o ser e o mundo , como uma estratégia que supera qualquer antecipação programática e viabiliza a transformação e a construção do próprio ser e do mundo . Assim, se o aprender fazendo é necessário para a formação do arquiteto, que esse fazer seja refletido e retroalimente a prática

Gerald Thomas e a (des)encenação do mundo : as paisagens visuais como grafia de intertextualidades, citações e hipertextos

This work is the result of a personal uneasy about the form and development taken by contemporaneous theater concerning its relationship with other media to create new hybrid organisms and organizing itself through new possibilities, connections, as well as with different levels of arrangements in the construction of the scene. The purpose of this research is to study the connections between the scene and the media within the context of the formation of hybrid organism wich is the key element. That stands for an aesthetic characteristic of the post-dramatic condition of contemporary theatre in Brazil. Thus, this work will investigate the concept of visual landscapes within the context of Gerald Thomas Sievers work in Brazil in the period of the first decade of twenty-first century having the play Rainha Mentira (2007) (Queen Liar, 2007) as the main empirical object of analysis, discussion and application of the framework developed in the text

Estrutura e dinâmica do fitoplânctone bacterioplâncton em cultivos de camarão no Rio Grande do Norte-Brasil: impacto sobre o ambiente natural

This work aimed to study the structure and dynamic of Phytoplankton and Bacterioplankton in a complete cycle of shrimp cultivation (Litopenaeus vannamei) and determine the environmental factors responsible for the structural changes of these communities. The study was realized in a saltwater shrimp farm (Macaíba, RN), between September/2005 and February/2006, and in a freshwater shrimp farm (Ceará Mirim, RN), between May/2007 and September 2007. The samplings were collected weekly in saltwater farm and every fifteen days in freshwater farm. Total phosphorus, chlorophyll a and environmental parameters (pH, dissolved oxygen, salinity, temperature, depth and water transparency) were measured. Qualitative and quantitative analysis of the phytoplankton and bacterioplankton were carried out. The Shannon-Wiener ecologic indexes of diversity and the Pielou equitability indexes were calculated to the phytoplankton. Bacterial density was determined by epifluorescence microscopy. The data were statistically analyzed by Pearson correlation and t-Test. Chlorophycea were predominat in salt water and in the captation/drainage point (24 to 99%). Diatoms had higher wealth. The species Choricystis minor had the highest occurrence (100%) and dominance (90-100%), thus showing its adaptation to the high temperatures, salinity and low water transparency conditions. Filamentous Cyanobacteria like Oscillatoria sp., Pseudoanabaena sp. and Phormidium sp. had constant levels. The negative correlation between chlorophycea and water transparency, and the positive correlation between chlorophyll a and salinity, showed that the phytoplankton was well adapted to the low transparency and to the high salinity. The bacterioplankton was negatively correlated with the total phosphorus and salinity. In freshwater, Cyanobacteria were predominant (>80%), presenting some producers of toxins species like Microcystis sp., Aphanizomenon sp., Cylindrospermopsis raciborskii e Anabaena circinalis. Cyanobacterial density and total phosphorus and chlorophyll a concentrations exceeded the maximum value allowed by legislation. The means of total phosphorus varied from 264 to 627 Wg.L-1 and the means of chlorophyll a oscillated between 22 and 182 Wg.L-1. The phytoplankton species were selected by low availability of the light, high pH, temperature and high availability of total phosphorus. The bacterioplankton showed high densities (5,13 x 107 to 8,50 x107 Bac.mL-1). The studied environments (ponds and rivers) presented a high level of trophic state based on the high concentrations of chlorophyll a and total phosphorus and cyanobacteria dominance. The composition of species in the ponds and rivers was similar, as well as high concentrations of total phosphorus and chlorophyll a, highlighting the pollution caused by the discharges of the farms in natural environment

Diversidade de macroalgas marinhas bentônicas dos recifes de Maracajaú, área de preservação ambiental dos recifes de corais, Rio Grande do Norte, Brasil

Despite the importance of coral reefs to humanity, these environments have been threatened throughout the world. Several factors contribute to the degradation of these ecosystems. The Maracajaú Reef Complex, in Rio Grande do Norte state is part of the Coral Reefs Environment Preservation Area in northeastern Brazil. This area has been receiving an increasing influx of tourism and the integrity of the local reefs is a matter of concern. In this study, the reef macroalgae communities were studied and compared within two areas distinguished by the presence or absence of tourism activities. Two sample sites were chosen: the first one, where diving activities are intense; and the other, where these practices do not occur. Samples were collected at both sites within a quadrate of 625 cm2 of area randomly thrown 5 times along a 10 meters transect line. Richness, Shannon-Hill diversity and Simpson dominance indices were determined based on biomass data. Similarity between sites was analyzed with Bray-Curtis similarity and distance index. Fifty-eight macroalgae species were observed, including 7 Chlorophyta, 13 Phaeophyta and 38 Rhodophyta. In the non-disturbed site, 49 species were found, while at the disturbed site, there were 42 species. Dictyotaceae and Corallinaceae were the most representative families at the non-disturbed site, and Rhodomelaceae and Dictyotaceae at the disturbed site. The non-disturbed site presented a higher biomass and the greatest richness and diversity indices. In the disturbed site the dominance index was greater and Caulerpa racemosa was the dominant species. The dendogram based on similarity index showed two major clusters, and an isolated element at the center that corresponds to a sample from the disturbed site. In the first cluster, samples from the non-impacted site were predominant and fleshy brown algae were more conspicuous. The second cluster was composed primarily of samples from the impacted site, where C. racemosa and red filamentous and erect calcareous algae associations (turf forming) were observed covering large extensions. These associations are represented by groups of algae adapted to environments where disturbances are frequent. They can grow rapidly on substrate where benthic community was removed and do not allow the establishment of other species. The results of the present study show that tourism activity is an impacting factor that has been causing shifts in macroalgae communities in the Maracajaú Reef Complex

Atividade antiplasmódica e toxicológica de plantas medicinais usadas popularmente no Brasil : uma abordagem etnobotânica

Malaria is a disease of global distribution, recognized by governments around the world as a serious public health problem, affecting more than 109 countries and territories and endangering more than 3.3 billion people. The economic costs of this disease are also relevant: the African continent itself has malaria-related costs of about $ 12 billion annually. Nowadays, in addition to chloroquine, Plasmodium falciparum is resistant to many drugs used in the treatment of malaria, such as amodiaquine, mefloquine, quinine and sulfadoxine-pyrimethamine; resistance of Plasmodium vivax to treatments, although less studied, is also reported. Nature, in general, is responsible for the production of most known organic substances, and the plant kingdom is responsible for the most of the chemical diversity known and reported in the literature. Most medicinal plants commercialized in Brazil, however, are of exotic origin, which makes the search for endemic medicinal plants, besides a patent necessity, a fascinating subject of academic research and development. This study aimed to: (i) verify the antimalarial activity of ethanolic and hydroalcoholic extracts of Boerhavia paniculata Rich. And acetonic extract of Clethra scabra Pers. in Swiss albino mice infected by Plasmodium berghei NK65, (ii) observe possible combined effects between the course of infection by P. berghei NK65 and administration of these extracts in Swiss albino mice, and (iii) conduct a preliminary study of the acute toxicity of these extracts in Swiss albino mice. All extracts notable pharmacological activities - with parasite infections inhibitions ranging from 22% to 54%.These characteristics suggest that the activities are relevant, although comparatively lower than the activity displayed by the positive control group (always above 90%). The general framework of survival analysis demonstrates an overall reduction in survival times for all groups. Necroscopy has not pointed no change in color, shape, size and/or consistency in the evaluated organs - the only exception was the livers of rats submitted to treatment to hydroalcoholic extracts: these organs have been presented in a slightly congestive aspect with mass increasing roughly 28% higher than the other two groups and a p-value of 0.0365. The 250 mg/Kg ethanolic group has been pointed out by the Dunn s post test, as the only class with simultaneous inequalities (p<0.05) between positive and negative control groups. The extracts, notably ethanol extract, have, in fact, a vestigial antimalarial activity, although well below from the ones perceived to chloroquine-treated groups; nevertheless, the survival times of the animals fed with the extracts do not rise by presence of such therapy. Both the toxicopharmacological studies of the synergism between the clinical course of malaria and administration of extracts and the isolated evaluation of toxicity allow us to affirm the absence of toxicity of the extracts at the level of CNS and ANS, as well as their non-influence on food and water consumption patterns, until dosages of 500 mg/Kg. Necroscopic analysis leads us to deduct a possible hepatotoxic effect of hydroalcoholic extract at dosages of 500 mg/Kg, and an innocuous tissue activity of the ethanol extract, in the same dosage. We propose a continuation of the studies of these extracts, with protocol modifications capable of addressing more clearly and objectively their pharmacological and toxicological aspects

Análise do estado da arte dos aspectos diagnóticos, periciais e jurisprudenciais das LER/DORT no contexto previdenciário das doenças do trabalho no Brasil

Objetivo: analisar o estado da arte dos aspectos diagnósticos, periciais e jurisprudenciais das LER/DORT (Lesões por Esforços Repetitivos / Distúrbios Osteomusculares Relacionados ao Trabalho) no Brasil. Materiais e Método: trata-se de pesquisa descritiva, de natureza qualitativa, com formato documental, utilizando-se a técnica de análise de conteúdo. A avaliação evolutiva da legislação previdenciária relacionada as LER/DORT foi realizada através da pesquisa no banco de dados disponibilizado pelo Governo Federal e mediante a consulta ao DATAPREV/Sislex. A avaliação dos aspectos diagnósticos foi instrumentalizada através, principalmente, de artigos científicos publicados entre 2003 e 2008, nas línguas portuguesa, inglesa, espanhola e francesa, relacionados com os métodos de diagnósticos complementares das LER-DORT (ressonância magnética, tomografia computadorizada, ultrassonografia e eletroneuromiografia). As jurisprudências foram obtidas através da busca dos julgados sobre o tema, entre 2003 e 2008, pertencentes ao Supremo Tribunal Federal, Superior Tribunal de Justiça, Tribunais Regionais Federais, Tribunal Superior do Trabalho e Tribunais Regionais do Trabalho. Resultados: foram identificados 48 artigos abordando os aspectos diagnósticos das LER-DORT, observando-se que os exames por ressonância magnética, ultrassonografia e eletromiografia demonstraram ser mais efetivos, dentro das suas especificidades, para a complementação do exame clínico de patologias relacionadas às LER-DORT. A análise das 123 jurisprudências selecionadas demonstrou, de forma geral, que as LER-DORT equiparam-se ao acidente de trabalho, devendo apresentar nexo de causalidade (atestado através de laudo médico-pericial) e, ainda, ensejam a ação por danos morais, a qual, devido à EC nº 45 passou a ser competência da Justiça do Trabalho. O Estado da arte dos aspectos periciais encontra-se representado pela vigência da Instrução Normativa n. 98/2003, a qual traz como aspecto fundamental a determinação de novos parâmetros a serem considerados na definição de um quadro de LER-DORT, dispondo, ainda, sobre a conduta ética que deve ser adotada pelo médico perito, bem como chama a atenção para a necessidade dessas doenças do trabalho serem comunicadas às autoridadades competentes, através da emissão da Comunicação de Acidente de Trabalho (CAT). Conclusão: as LER-DORT representam, hoje, um problema de importante impacto, não apenas previdenciário, mas também econômico em diversos países, nos quais o Brasil encontra-se inserido. Estudos sobre o estado da arte relacionados às LER-DORT são fundamentais para auxiliar na construção de um modelo crítico e consciente que colabore com a garantia de sustentabilidade do sistema previdenciário no Brasil

Legislação de rotulagem nutricional: instrumento de informação na promoção de escolhas alimentares - Natal-RN

Resolutions of the Board of numbers 359 and 360, of December 23, 2003, relating to Nutrition Labelling for Packaged Foods, establish quality standards and provide the education activities for health consumption, since one of the factors that enable the selection of healthier foods are the food labels as an important part in nutrition education. This is a descriptive study with a cross-sectional design. To calculate sample size, it was considered a margin of error of 20%, confidence level of 95% and prevalence of 52.5% for verifying nutritional information in a pilot study conducted in 2007. A total of 145 subjects were interviewed, resulting in 371 consumers in Natal, Rio Grande do Norte, Brazil, in order to determine prevalence of consulting nutritional information contained on food labels as a nutritional guideline for consumers and its association with sociodemographic variables as well as identify the intervention measures suggested by intervieweds so that this information can be better used to select healthy foods. Twenty-five of the 69 supermarkets belonging to the Supermarket Association of Rio Grande do Norte (ASSURN) were randomly selected. Data collection relied on interviews and extensive direct observation, using a semi-structured form composed of eight closed questions, some of which were multiple choice, and ten open questions. The chi-square test was performed for statistical analysis, using Statistical Package for Social Sciences (SPSS) 15.0 software. Label information most consulted was: expiry date (91.6%); product brand (49.4%); nutritional information (47.0%); zero trans fat (32.9%); zero sugar content (12.8%); zero fat content (3.0%); rich in fibers (2.7%); whether light or diet (30.4%); list of ingredients (16.8%); whether the product contained gluten or not (4.1%). When asked about the importance of nutritional information, 96.8% of the subjects responded important or very important ; of these 46.6% and 3.8% reported partially or totally understanding the information presented. It was found that 41.6% of the consumers consulted nutritional information for dietary reasons related to nontransmissible chronic diseases and 35.7% to be able to choose healthier foods. The data show a significant association between motivation to choose healthier foods and higher family income and schooling (p<0.0001). The intervention measures mentioned to make nutritional information better understood and used were: information and orientation about nutritional information, provided by qualified professionals in the supermarkets, the commercial establishment or the product manufacturer (73.9%) and media disclosure about the nature, importance and purpose of nutritional information (42.9%). In despite of communication noises the consumers use the nutrition claim for the nutritional guidance, showing association with some demographic variables. However, they desire the implementation of intervention measures that can be contextualized in the political construction of nutrition education to promote healthy food choices

Modo de aplicação e eficiência de inseticidas granulados sistêmicos para o controle de cigarras (Hemiptera: Cicadidae) do cafeeiro

Avaliou-se a eficiência de métodos de aplicação de inseticidas granulados sistêmicos para o controle das cigarras Quesada gigas (Olivier) e Dorisiana drewseni (Stål) do cafeeiro (Coffea arabica). O ensaio foi conduzido em cafezal cv. Mundo Novo com idade de seis anos, espaçamento de 3,5 X 1,5 m, com uma planta/cova, no ano agrícola 1992/1993. Utilizou-se um delineamento em blocos casualizados, com 21 tratamentos e 4 repetições, cada uma contendo parcelas de cinco plantas. Os tratamentos consistiram nas aplicações dos produtos triadimenol + disulfoton 1,5% + 7,5% (26 g/cova), aldicarb 150G (10,00 g/cova), ethoprophos 100G (30,00 g/cova), phorate 5G (80,00 g/cova) e terbufos 5G (40,00 g/cova) em quatro modalidades de aplicação: aplicador costal manual Mebuki TF8; canequinha, lançando o produto para o ápice da planta; aplicador tratorizado Kamaq CK2-AG; e sulcos em meia lua, abertos manualmente, na projeção da copa. As avaliações foram realizadas aos 70, 105 e 140 dias após aplicação dos produtos, onde foram efetuadas aberturas de trincheiras de 50 X 50 X 50cm por cova, procedendo-se a contagem do número de ninfas vivas. Concluiu-se que o aplicador costal manual e canequinha revelaram-se os mais eficientes (86,0 - 93,5% e 76,8 - 86,7%, respectivamente); aplicação tratorizada e sulcos na projeção de copa tiveram sua eficiência variável com o produto utilizado; terbufos apresentou maior redução da população (98,2 - 100%) e phorate (79,6 - 99,1%) e a mistura triadimenol + disulfoton (82,3 - 97,3%) apresentaram alta eficiência, não diferindo do terbufos. Aldicarb apresentou desempenho satisfatório (68,1 - 85,0%) conforme o modo de aplicação e ethoprophos não foi eficaz quando aplicado com o aplicador costal manual (58,4%), canequinha (45,1%) e sulco (31,9%).