Atenção à saúde mental na Estratégia Saúde da Família no Município de Parnamirim/RN: opinião dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population´s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user´s care and the promotion of family health

Atenção à saúde da pessoa idosa na estratégia saúde da família no município de Santo Antônio/RN: um estudo de caso

According to demographic estimates, by the year 2025 Brazil will be the sixth country in the world in number of elderly. For this reason, it is a purpose of public policies to help people to reach that age being healthier. The current health care model of health surveillance through the Family Health Strategy (EFS, in portuguese) is configured as a gateway into the care of the elderly in the Unified Health System (SUS, in portuguese). It is also an area of development of practices to promote health, prevention and control of chronic nondegenerative diseases. The aim of this study was to analyze the health care of the elderly provided by ESF professionals for the achievement of a full care. The study is descriptive case study with a quantitative approach, performed in the city of Santo Antônio/RN. The population included all health professionals, who are FHS members of the city that agreed to participate of the survey, a total of 80 professionals. Data were collected using a structured questionnaire, having mostly closed questions and divided into two parts: one containing sociodemographic information of health professionals and vocational training and the other, the activities carried on by the professionals in senior care, being analyzed from a database tabulated in a spreadsheet and discussed according to the descriptive statistics in tables, graphs and charts using frequencies, medians and values of central tendency. It was verified a predominance of professionals who finished highschool, mostly female, aged from 30 to 34 years old, with training completed in the last 10 years, without being graduated in the field of geriatrics or gerontology and mostly without training in gerontology. Family members and caregivers were the components of the social support network most identified by the professionals (66.3%).The elderly access to the Family Health Basic Unit was considered by83.8% of professionals as the most important factor that interferes in the activities of health care of the elderly. Considering the inclusion of the family in care: 98.8% of professionals consider the family as one of the goals of care, but 82.5% assist the family to know their role and participate in the care of the elderly, emphasizing that no professional makes use of tools for evaluating the functionality of the family. Regarding the actions taken to assist the elderly, 91.25% have home visits program to the elderly, 88.75% use the host program; 77.5% know the habits of life, cultural, ethical and religious values of the elderly, their families and their community ;51.25% complement the activities through intersectoral actions, 50%participate in groups of living with the elderly; 33.75% keeps track and maintain updated the health information of the elderly; 11.25% of the professionals perform the Single Therapy Planning (PTS, in portuguese) and few implement the actions to promote health according to PTS; there is a deficit in the number of professional categories in the identification and monitoring of the frail older people in their households. It is concluded that the health care of the elderly developed by ESF professionals differs among the professional categories. It was identified weaknesses in the promotion of an active and healthy aging and also in the establishment of an integrated and full care of the elderly. It is recommended the adoption of permanent educational activities by the City Management, initially for ESF professionals in the the perspective of the guidelines of the National Policy of Health Care for the Elderly and later to the other professionals that are part of the health care network of the elderly, at all levels of care in the city for the development of strategies and practices that promote the improvement of the quality of healthcare for the elderly, expecting concrete and effective results in terms of promoting health within Brazilian reality

Atuação do enfermeiro na estratégia de atenção integrada às doenças prevalentes na infância

This study aimed to describe nurses' actions in the strategy of Integrated Management of Childhood Illness in the city of Natal, Rio Grande do Norte. This is a qualitative study with descriptive approach. The universe consisted of nurses from the Family Health Strategy, totaling 16 participants. For the research project was submitted for approval by the Ethics Committee of the Universidade Federal do Rio Grande do Norte, obtaining Opinion No. 187/2012. Data were obtained in two ways: a questionnaire survey to profile the training of nurses and an interview guided by a structured interview. Interviews were treated in the light of analysis of thematic category Bardin. The results showed the central thematic study "Integrated Management of Childhood Illness in the context of nursing activities" category and three analyzes: "Understanding the Integrated Management of Childhood Illness", "Difficulties invibializam use IMCI "and" Working conditions for nurses in the Integrated Management of Childhood Illness. " It is observed that nurses consider the Integrated Management of Childhood Illness useful, effective and important to keep sick children within the logic curative. However disregard the character of health promotion and disease prevention thereof. It was found that the participants still hold the attendance of crinaças within the biomedical model and that these same professionals are subjected to increasingly precarious working conditions and unhealthy due to lack of human and material resources. It was found that the interviewees do not follow the protocols of strategy because of barriers related to prescription medications by nurses, the medical, the lack of incentives, training and supervision by the municipal health and the Regional Nursing Council

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

e-Resíduos: A influência da norma européia WEEE na estratégia da indústria de celulares no Brasil e no mundo e o impacto ambiental do descarte inadequado

This present Thesis, is explorer work and presents an analysis of e-wastes of the industry of cellular mobile telephony, evaluating the evolution of the telecommunications nets and as if it holds the global and Brazilian market of cellular telephony. It approaches the elements gifts in the cellular devices that can badly cause to the environment and the health, the discarding of the devices in end of life cycle is made. It analyzes the new European regulation of electric equipment residues and electronic, the WEEE, as it influenced the strategy of the companies manufacturers of mobile phone cellular and of that she forms is possible to create a Brazilian national industry for recycling of devices of cellular, with conditions to globally competition. For this some possible models of being implanted in Brazil are presented. The project of law 203/91 on solid residues is argued and as it would be interesting if to persist some proposals presented to the project, to create a Brazilian market of recycling with capacity of global competition for use to advantage of the European regulation if to get a competitive advantage

Suplementação como estratégia de produção de carne de qualidade em pastagens tropicais

O manejo do pastejo e a suplementação estratégica permitem maximizar a produção de carne bovina em pastagens de forma sustentável. A intensidade de pastejo influencia diretamente o crescimento individual, taxas de aparecimento e mortalidade de perfilhos, a determinar o acúmulo de forragem e a estrutura do dossel. Dessa forma, nas águas, é função do manejo do pastejo adequar a frequência e intensidade de desfolhação para que o animal possa colher forragem com idade fisiológica e valor nutritivo adequados. A idade e tamanho dos perfilhos determinam a proporção de tecidos de suporte lignificados que reduzem a digestibilidade da forragem. No período seco, o manejo do pasto e a estratégia de diferimento, ao final do período das águas, são determinantes na obtenção de forragem de melhor valor nutritivo. Assim, o manejo das pastagens visa, primeiramente, à produção de forragens com altos teores de fibra potencialmente digestíveis. A partir de então, a caracterização da quantidade e qualidade da forragem são primordiais à adequação dos nutrientes fornecidos, via suplementos, para otimizar a utilização dos recursos forrageiros basais. A suplementação da dieta dos animais em pastejo, com concentrado, permite aumentar o desempenho dos animais, o que reduz a idade de abate e melhora a qualidade da carcaça e da carne obtida, além dos benefícios na preparação dos animais terminados em confinamento. Portanto, o manejo do pastejo e a suplementação da dieta dos animais permitem aumento de produtividade e maior qualidade dos produtos.

Turismo de eventos como estratégia no combate à sazonalidade: uma análise na hotelaria de Natal - RN

The aim of this work is to analyse the tourism events and the performance of this segment from market as strategy in the combat of Natal's hotel seasonality, in the executives/managers's vision from this sector. Two searches were realized to turn available this study: Inicialy a bibliographic search involving the concepts associated with the tematic in question so that it arranges the embasament theoric-scientific and a survey from facts through the country search, where it was applicable in the establishments of work's population with the auxiliary from a formulary answered by a personal interview. The analyses techniques through facts were: estatistic descritive and Kolmogorov-smirnov test.Among the results found, it was verified that the main reasons alleged by the hotels to ingress in the segment from the events were the alinement from the competitive company, the diversification in the options in the sense of occupy the establishments during the period of low season and answer to the demand of market. Investigated the profile from the events occured in the Natal hotels referring to the port, public origin , kinds of events and frequency from their realizations, as well as , the capacity from these establishments to attend this segment.It was noticed that in spite of the hotels agree that the events are important estrategies to combat the seasonality, the establishments still suffer with the flutuation, what can be justified from the moment that it's considered that the events also behave from seasonal manner, having more concentration in certain periods from the year. It was evaluated that the main advantage noticed by the realization from the hotels's events is the utilization from alimentation and drinking services, surpassing the advantage from elevation of taxes occupation from the apartments

Análise de critérios de decisão em estratégia de arranjos produtivos locais: um estudo aplicando o processo de hierarquia analítica (AHP) no setor de cerâmica

This master thesis has the objective of investigating the strategic decision criteria of participants of Local Production Arrangements (LPA) in Brazil. The LPA s are an initiative of support agents to enterprises with the purpose of organizing joint actions for the development of groups (clusters) of enterprises. The choice of the actions is a decision of the participating enterprises and this paper aims at applying a Multi-criteria Analysis Method to analyze the criteria of entrepreneurs that are participating of a LPA. The used method is the Process of Analytical Hierarchy (PAH) and an application is presented along with questionnaires to participants of a ceramic LPA in the northeast of Brazil. The main results show that, in first place, from the implicit strategy of each enterprise there is only one objective for the LPA group and so, at the beginning, an action decided by all of them tends to favor some more than others. In second place, it was observed that there are general inconsistencies between the strategic objectives and the importance as to criteria, even though there have been cases of coherency. As the main conclusion it is pointed that the use of Methods of MCDA is useful to improve the decision making process and to bring more transparency to the logic of the found results

Proposta de um modelo de gestão da qualidade para micro e pequenas empresas integrando a estratégia seis sigma à NBR ISO 9001

This work has as its main purpose to set a model of Quality Management for micro and small companies integrating the management models: Six Sigma strategy to NBR ISO 9001:2000. An exploratory research is developed to collect technical and bibliographical information on both methods, emphasizing their integration. Then, a survey is carried out on 65 analysts/consultants of Quality Management Systems and it has detected, besides other factors, that current methodologies must be associated in order to reach better results. At last, it proposes the Sigma 9001 model, which aims to make it possible for micro and small companies to objectively and with low costs, implement a Quality Management System, able to assure competitive advantage through improvement identification in the processes, as well as an improvement in the companies management

Estratégia pública de gestão ambiental :uma contribuição para a realização de eventos públicos

The present study is included in the environmental international theme, approaching the search for the environmental conformity in public events. It describes the main environmental impacts, objects of the study Sound Disturbances, implications concerning the increase in the Volume of Traffic and in the volume of Solid Residues generated in the surroundings of the event. The methodology used consists of the report of the case study of the festivity called Carnatal, held in Natal/RN, in December of 2001. As a work method, it was used a quantitative evaluation of the sound intensity level, according to the effective legislation, an electronic count of volume of traffic and an evaluation of the productive performance of the means of production of public urban sanitation company used in the event. The results pinpoint the recognition of the impacts generated by the event and the proposition of a Program of Environmental Management, aiming at, in addition to the establishment of the instruments and goals for the mitigation of the impacts, defining the role of the social actors in the search for the environmental conformity of festivities

Estratégia de produçãp agroindustrial :um estudo dos fatores que afetam a exportação do mel

This thesis approaches the situation of small and medium Brazilian companies facing the exportation process, focusing honey (Apis Mellifera). The world economy has had growing market internationalization, known as globalization. In this context, the exportation has to be faced as a way to minimize the inner market difficulties and increase the levels of quality and productivity to attend the external markets in a competitive way. A company exportation process is not linked to its dimensions, but connected to the commitment with quality, creativity and professionalism. The search for new productive frontiers has benefited Brazilian beekeeper, mainly the northeast ones. Besides, the claim for products that are free of chemical remains, with a bigger aggregate value has increased every day, and the Apismel Company is benefited for having potential to produce organic honey. This paper approaches a case study realized with Sixty-nine beekeeper from Serra do Mel, RN, that make the Apismel Company and it aims to investigate the competitive factors that affects honey exportation. In order to obtain subsidies to execute the objective of this work, it was chosen a questionnaire as instrument of research. The questionnaire was structured from variables that were considered as directions of competition in honey exportation. The results were tabled in Software (Statistics version 11.0). The descriptive, exploiter and Kolmogorov-Smirnov analyses were used to analyze the obtained results. At the end, this work recommends that the Apismel Company promote capacitating courses and technical consultations at the many villages that make the county, to ripen and add efficiency in handling implementation in order to equilibrate production factors and to attract inner and external markets

Estratégia ambiental e agências de viagens e turismo :um estudo sobre a importância de práticas ambientais na escolha de um pacote turístico

The objective of the work was to investigate, from the vision of travel agents, the importance of environmental practices as a decision factor in the purchase of a tourist package. For in such a way, it was established as target population, the travel agencies and tourism linked to he Brazilian Association of Travel agencies ABAV, hearing the Brazilian travel agents that exerted the function in Natal, city in 2005. The election of the sample was accomplished using the simple random sampling technique. The amount of agents effectively searched was of 150 agents being distributed 150 questionnaires, with closed and opened questions, applied during the month of November in 2005. Results showed great variability of interviewed answers in that if it relates for sale of package tourist where the customer demonstrates enviromental concern with the environmental quality. Through multiple regression analyses, it was environmental concern with the environmental quality of the place and the perception of the practical importance of the existence environmental practices in the place as important factor in the decision of tourist package purchase

Os princípios da organização focada na estratégia: um estudo em empresas vencedoras do prêmio nacional de qualidade

The Balanced Scorecard (BSC) has been used as a communication tool and strategy monitoring, helping organizations alignment, inserting a new vision with integrated use of performance indicators nonfinancial together with some financial measures. Their proper use leads to a new management style, focused on management strategies, using for this, basically three dimensions: strategy, which should be translated as the primary responsibility for the organizational agenda, the focus that should be concentrated, and the organization with the mobilization of employees. This paper deals with theoretical considerations about strategies, strategic planning, BSC and principles of the organization focused on strategy (OFE). Describes a study of four companies that won the National Quality Award - PNQ, among which, three have adopted the BSC and adopts a particular model of strategic management. The research aimed to make an analysis of the companies regarding adherence to the five principles of OFE, proposed by the BSC, seeking to answer whether the use of BSC is a prerequisite for accession to the Principles of OFE. The results showed that the BSC is a strategic management model that promotes focus and organizational alignment and is a major facilitator in the process, however, cannot be considered a prerequisite for accession to the principles of the OFE, because the four companies studied, including the one that adopt its own model of strategic management, have great levels of adherence to such principles. Making the organization focused on strategy can be considered a natural movement essential for the strategic management, which is not necessarily conditioned by the use of BSC

Estratégia de operações no varejo: um estudo sobre perfilar mercado, produto e operações no setor de supermercados

The objective of this Thesis is to investigate the strategic alignment between market end operations in the retail supermarket sector applying the concept product profiling by Hill (1993). To the developing was utilized a methodology of the cases study had were a evolvement if the action research into on of the RedeMais supermarkets. Through the interview, discussion and direct action became possible collect information necessary to direction this work, absorbing and understanding the methodology and thought form, action and management. This work contribute to development the create of the model adapted of the manufactory to service, the product matrix of the Hill, in which serve a tool to uncover the origins of misalignment that occur over time and to illustrate the phenomenon to executives gone support to decision

Terceirização em tecnologia da informação sob os aspectos de estratégia, tomada de decisão e análise de investimentos :estudo de múltiplos casos em três organizações franqueadas da Coca-Cola do Brasil

Desde a criação da tecnologia e do seu uso pelas empresas, a relação custo e benefício nem sempre foi bem elucidada tanto para os responsáveis pela área de tecnologia quanto para a alta direção. Mas, apesar disto, cada vez mais as organizações investem maciçamente em tecnologia, esperando que esta seja a solução para diversos problemas. Por isto, esta questão tem se tornado crucial para o processo de tomada de decisões, visto que investimentos nesta área costumam ser dispendiosos e, na atual conjuntura, estas análises precisam ser extremamente criteriosas para que se miniminizem as possibilidades de insucesso dos projetos, principalmente numa economia estabilizada e de concorrência acirrada. Uma das alternativas que as empresas têm buscado para atingir o sucesso e correr menos riscos é a terceirização da área de TI. Partindo desta visão, a presente dissertação tem por objetivo realizar uma investigação sobre a terceirização dos serviços de TI em todos os seus aspectos, isto é, desde a sua motivação, serviços efetivamente terceirizados, vantagens, desvantagens e possíveis obstáculos, a visão do alinhamento estratégico da TI, os processos de gestão de contratos e formas de controle e, por fim, tendências futuras. Trata-se de uma pesquisa de múltiplos casos, envolvendo franquias do Sistema Coca-Cola no Brasil. O estudo apresenta uma pesquisa bibliográfica sobre o processo de tomada de decisão empresarial, a análise de investimentos, a gestão e a terceirização da TI, o que permitem definir as dimensões de análise da pesquisa. Na pesquisa de campo foram entrevistados os gerentes da área de TI, nas cidades de Brasília-DF, Goiânia-GO e Ribeirão Preto-SP. A pesquisa de campo permitiu identificar como as mesmas avaliam seus investimentos em TI, como esta área é gerenciada, o que as levou a optar pela terceirização e como os processos terceirizados afetam a organização. Por se tratar de uma pesquisa qualitativa, optou-se por analisar comparativamente as três organizações. Com a realização deste estudo, obtiveram-se, como principais resultados, que as organizações estão utilizando a terceirização em TI para focar no negócio principal e, mesmo encontrando diversas desvantagens, inclusive com relação a custos, acreditam que os benefícios justificam. Ainda identificaram-se alguns obstáculos internos para a terceirização, principalmente quanto ao receio de se perder a inteligência do negócio. O acompanhamento dessas atividades terceirizadas é realizado pela equipe interna e por critérios estruturados, onde se verificam os níveis de serviço