A diretriz de hierarquização do SUS: mudando a antiga perspectiva do modelo médico-assistencial privatista

O Sistema Único de Saúde foi criado em 1988, época em que vigorava no Brasil, um modelo de saúde hospitalocêntrico. Tal modelo era curativo, centrado na doença, e distribuído geograficamente em locais-chave. O acesso dava-se de forma desordenada, causando grande insatisfação da população e enormes gastos por se tratar de complexos hospitalares de alta tecnologia. Buscando uma contrapartida a esse modelo, o SUS criou, entre outros princípios e diretrizes, a diretriz da hierarquização a qual segmentou o sistema de saúde em níveis de complexidade. Os principais objetivos foram aumentar a abrangência do atendimento médico, otimizar sua prática e proporcionar qualidade aos usuários, além de reduzir os custos para o Estado. O modelo foi bem estruturado e beneficiou enormemente a saúde pública, mas ainda enfrenta desafios como os altos custos, a ineficácia da atenção básica, a heterogeneidade do serviço e as dificuldades de fluxo pelos níveis de atenção. Estes estão em constante aprimoramento para que o SUS funcione efetivamente e garanta saúde e qualidade de vida a todos os brasileiros.

A tarefa crítica: uma nova perspectiva em analise ocupacional

Uma nova abordagem sobre Análise de Trabalho é o que norteia esta dissertação. Partindo de uma. avaliação preliminar sobre as metodologias existentes, visa oferecer uma perspectiva inovadora no plano técnico e metodológico, através de um m:x3.elo especifico, aqui, denominado - TAREFA CRÍTICA. Nesta trajetória a temática envolve, preliminarmente, uma. reavaliação em termos organizacionais dos aspectos administrativos e comportamentais, vinculados ao estudo do trabalho humano. Sucessivamente, são postos em discussão os problemas específicos das metodologias utilizadas em Análise de Trabalhe, revistos em suas noções básicas. Esta primeira avaliação permite enfrentar uma análise subsequente englobando uma revisão dos métodos, através de termos coordenadores aptos a levantar a diretriz lógica dos processos classificatórios existentes. Desta forma, são fixados e discutidos critérios destinados a classificar as classificações dos métodos, no intuito de se entender a própria lógica subjacente ao sentido e aos objetivos de cada um. A Análise, até certo ponto, exaustiva desses termos, além de propiciar a sistematização conceitual da relação e interação dos métodos frente aos seus objetivos e respectivos resultados, conduziu à proposta metodológica que constitui objeto desta tese. A TAREFA CRÍTICA pretende conciliar, definitivamente, a análise do binômio trabalho-trabalhador, pelo emprego de um raciocínio em parte construtivista, e em parte essencialista; superando, de um lado, os radicalismos operacionais e, de outro, os impasses empiristas em análise de Trabalho. Seu desenvolvimento se originou da hipótese de que sempre há um núcleo fundamental no comportamento do trabalhador a ser definido a partir dos eventos ou dados positivos do trabalho, e susceptivel de explicitar uma significação enucleada nas metas organizacionais que lhe correspondem.

A dois passos do paraíso?: análise sobre a construção da favela Paraisópolis (São Paulo-SP) como destino turístico Rio de

Essa dissertação versa sobre a construção da favela Paraisópolis (São Paulo- SP) como destino turístico. Estevão, Berbela e Antenor, moradores da favela, realizam “trabalhos artísticos” que compõem o elemento principal da atratividade turística de Paraisópolis. A partir do trabalho de campo, do tipo observação participante, descrevo os posicionamentos divergentes dos artistas, guias de turismo e a União de Moradores de Paraisópolis. Aponto que esses posicionamentos geram disputas simbólicas e relações de poder entre os diversos atores envolvidos no processo de transformação de Paraisópolis em um destino turístico. A intenção principal é entender como esse processo é perpassado por conflitos, tanto de ordem econômica quanto de ordem política e ideológica. A perspectiva de análise tem como enfoque central as visões em disputa sobre o turismo e as práticas que as tomam por base. Assim, procuro entender como os valores e práticas locais se articulam com ações e discursos exógenos voltados para o desenvolvimento do turismo.

Automação e robótica nas indústrias brasileiras: um estudo exploratório

A Automação e o processo de Robotização vêm, cada vem mais, se tornando pauta nas discussões de centenas de indústrias brasileiras, onde a tendência clara e identificada é a de investimentos expressivos na melhoria de processos e produtos, por intermédio dessas tecnologias; com foco, sempre que possível, na nacionalização de equipamentos. O presente trabalho tem como objetivo avaliar o modelo proposto por Paul Kennedy (1993) com relação à tendência de Automação e Robotização nas Indústrias Mundiais, analisando o estudo realizado diante de uma economia emergente como a brasileira. Para tanto, foram pesquisadas empresas no Brasil, em diferentes segmentos industriais, o estado da arte em termos de tecnologia de automação e robótica aplicada a processos industriais, e sugerido um modelo diferente do idealizado originalmente por Kennedy. A análise do autor se baseou no teorema que, na matemática discreta, chamamos de “law of the excluded middle”, ou seja, segundo Kennedy, o Brasil estaria vivendo hoje uma migração gradual das indústrias para os países ricos. O Brasil é um exemplo de país industrializado, de economia emergente, que investe intensamente em processos automatizados, mas que não é classificado dentro do grupo desses países ricos. Através da pesquisa realizada será apresentado um novo modelo, no qual países emergentes como o Brasil têm acesso à tecnologia de ponta em automação e robótica, aplicando a mesma em seus processos industriais.

The analysis of foreign market entry strategies on the basis of different cultural backgrounds and environments: a qualitative study characterising the differences and similarities of Brazilian and European firms

Moving into a new and foreign market can be challenging, especially when such market has a different culture and working environment in comparison to the home market. Thus, it is of utter importance to adjust a company’s strategy to the new market conditions. Currently, there are no concrete guidelines of what aspects are most important when moving from a developing market such as Brazil into a more sophisticated market like Europe, or vice versa. The present study will examine two companies from the same industry, but with different cultural backgrounds and its strategic similarities and differences for operating in multiple international markets. The data was collected via semi-structured interviews with the Chief Executive Officers (CEOs’) from both companies, using an interview guideline that is based on three different theoretical frameworks. The aim is to give recommendations to these two industries of how to efficiently use existing theoretical frameworks and which aspects are most significant when moving into a new market while keeping in mind a company’s size and background.

O papel sócio empreendedor da ONG Sodireitos em defesa dos direitos sexuais e migratórios na Amazônia

This paper presents a case study from the Society for the Defense of Sexual and Migrate Rivers Amazônia - Sodireitos, whose central problem is to understand how it the works the social entrepreneur of the NGO Sodireitos in defense of sexual rights and migrate rivers in Amazônia. The central objective is to analyze the practices Social Entrepreneurship at the NGO Sodireitos on sexual rights and migrate rivers. The method adopted examined the entire creation process at the NGO the present day. Primary and secondary dates were used allowing the viewing of the dynamic intervention Social Sodireitos practiced by the fields of human rights and migrate rivers. Categories of analyses were given, and possible perceive in works of the strong Sodireitos flags that converge to social entrepreneurship as a guideline in the search for a model of human development, social and mainstay vel.

O papel sócio empreendedor da ONG sodireitos em defesa dos direitos sexuais e migratórios na amazônia

This paper presents a case study from the Society for the Defense of Sexual and Migrate Rivers Amazônia - Sodireitos, whose central problem is to understand how it the works the social entrepreneur of the NGO Sodireitos in defense of sexual rights and migrate rivers in Amazônia. The central objective is to analyze the practices Social Entrepreneurship at the NGO Sodireitos on sexual rights and migrate rivers. The method adopted examined the entire creation process at the NGO the present day. Primary and secondary dates were used allowing the viewing of the dinamic intervention Social Sodireitos practiced by the fields of human rights and migrate rivers. Categories of analyses were given, and possible perceive in works of the strong Sodireitos flags that converge to social entrepreneurship as a guideline in the search for a model of human development, social and mainstay vel

Hospital humano: etnografia da humanização hospitalar na perspectiva de usuários

This ethnographic work studies the experiences of patients admitted in public (PUH) and private (PRH) hospitals in the Brazilian northeastern region. 28 adult patients of different clinics participated in the study. Data were analyzed by the patient path method, consisting in a combination of complemented and articulated techniques free observation, participating observation, ethnographic interview and patient testimonials collected prospectively during the patients admissions, from their arrival and until their discharge. The analysis was carried out according to the Thematic Categories Analysis Technique and the data were interpreted pursuant to medical anthropology, healthcare humanization and healthcare promotion theoretical references. The ethical principles of Resolution 196/96 were followed. The human hospital, as revealed by the patient, highlights the significance of subjectivity. 225 (54.7%) out of 411 mentioned concepts were collected in a public hospital (PUH) and 186 (45.3%) in a private institution (PRH). The results show that the patient at the PUH and PRH ethnoevaluates different aspects of the healthcare professionals´ human and technical competence, the hospital´s functioning structure, the access to and the ethics in the financial management, and develops overcoming strategies for his stay at the hospital. This ethnoevaluation is mediated by different factors, namely: social and economic status, personality, religiosity, ironic speech, somber diagnosis and satisfied needs, prior hospital experiences and the conditions under which the interview was carried out. A pedagogic proposal for the hospital humanization must include structural, managerial and organizational changes of the offered services and use active methodologies aimed to the political resolution of problematic situations at work and the inclusion of affective and subjective factors, and become as well a tool for the collective learning. This study shows the importance for the user´s ethnoevaluation to be incorporated into the hospital management and care as a guideline in the decision making and clinical action, thus promoting practices that shall lead to a decent and humanized care. The multidisciplinary nature of this study allowed a wide understanding of the user´s perspective as a socially critical ethnoevaluator

Ingestion rates of Artemia nauplii for different larval stages of Macrobrachium rosenbergii

The functional response between ingestion rate and food concentration was determined for each larval stage of Macrobrachium rosenbergii. Artemia franciscana nauplii were supplied at 2,4, 6, 8, 10 and 12 per milliliter. The nauplii were counted by sight using a Pasteur pipette and transferred to Petri dishes containing 40 ml of brackish water (12 parts per thousand) lying on the top of black plastic. One larva at each stage was individually placed into each Petri dish containing different food density. After 24 h, each larva was removed from the Petri dish and the leftover nauplii were counted. The amount consumed was determined by the difference between the initial and final number of nauplii. Ingestion rate (I) increased as food density (P) increased and was defined by the model I=I-m(1-e(-kP)). The results suggest four levels of ingestion during larval development. The first level includes stages II, III and IV, with average maximum consumption of about 40 nauplii/day; the second level includes stages V and VI, with consumption of approximately 55 nauplii/day; the third level includes stages VII and VIII, with consumption of 80-100 nauplii/day. The fourth level includes stages IX, X and XI, in which the high values for maximum ingestion (Im) exceed the load capacity of the medium. The low values for constant k (that may correspond to the adaptability of the food to prey characteristics, such as, size, mobility, etc.) obtained for stages IX, X and XI indicated that Artemia is not an adequate prey and there is necessity of a supplementary diet. The best relationship between predator and prey seemed to occur during stage IV Results obtained in the present work may subsidize future researches and serve as a guideline for practical considerations of feeding rates. (C) 2003 Elsevier B.V. B.V. All rights reserved.

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

Ciência e espiritualidade: conversas com pacientes terminais

It has been reflected on Science and spirituality having as focus the relation between them and the process lived by terminal patients after the confirmation of the finitude of their lives. It has searched with this research to excite discussions that corroborate the tematization of a possible dialogue between science and spirituality, signaling perspectives of debates and formation of an understanding of the problematic that involves these human constructs in the development of alternatives for the understanding of the life finitude. We point out the moment of split between science and spirituality through the cartesian paradigm from a historical approach and after focusing the illness and death as foundation for our discussion. We use as methodological strategy, focal talks with terminal patients having as guidance a guideline with five punctuations: the singular citizen, diagnosis impacts, indicators of science, spirituality marks and death fear that served of base for analysis and data interpretation in according to selected theoretical foundations. Thus, it was possible to perceive that science, although not to keep an explicit dialogue with spirituality, it has pointed through is representation forms to the process indicatives that will culminate with the death. And these indicators had shown that in this direction it is efficient. We believe that the confrontation of the death can happen through of a new science that dialogues with the spirituality, where does not have separation between reason and emotion on the part of science; as well as it does not have reason disdain on the part of the spirituality

A política pública de segurança em Mossoró-RN: uma avaliação de processo da implantação da guarda civil (2009-2013)

The subject of public safety is part of the academic and popular discussions, due to several factors that act in society culminating in an increasing criminality. The importance of the evaluation of public policies in this context consists in a possible control tool, monitoring and necessary adjustments to the government to make the necessary changes. Given this reality, it is thought the research problem: how Mossoró (RN) city has implemented his public security policy? In general guideline of the research, we work with the following hypothesis: the own formulation of the National Policy of Public Safety there are elements that hinder the implementation of a public policy of municipal security in Mossoró. The objective of this research is to evaluate the existing security public policy in the city of Mossoró, by the elements that facilitate and/or hamper its implementation, through the actions of municipal government in the activities of the Mossoro Civil Guard (GCM). For this, a review of the implementation process was conducted, specifically its subprocesses of selection, training, and logistical or operational. Was used bibliographical research, documental primary and secondary, and field research, with conducting of interviews. It was found that with a staff of 197 guards, and with five years of creation, the actions developed by this institution refer to an early implementation of the municipal security policy. The guard has the basic pattern selection, part of function relocation and part of public tender. The formation occurs in an introductory way, however, not complete and specific, for the function performance. Its operability is limited by the number of existing effective and by the physical structure that has not matching the demand yet, which touches on the municipal budgetary reality of direct resource intended to safety. It was found the absence of a municipal plan of public security with principles, guidelines and goals that could direct the actions of the guard. It is concluded that despite of the implementation of the GCM Mossoró have not achieved, within the parameters of efficiency, efficacy and effectiveness have played their actions, projects and programs, it could trigger a process of opening for construction of a municipal security policy. As well as break with the paradigm of municipal actions just meant for surveillance of public property, interaction affirmative for the prevention of violence and crime

Direito à moradia em cidades sustentáveis: parâmetros de políticas públicas habitacionais Natal 2013

The right to housing is included in several international human rights instruments and in Brazilian legal system integrates the constitutional catalog of fundamental social rights (art. 6) and urban development policy (art. 182 and 183). Besides, it is for all federative governments its effectiveness by building programs and improvement of housing conditions and sanitation (art. 23, IX), which justifies the investment in urban planning and public policy of housing affordability because they are tools for achieving this right. Newer strategies in this area have been based on tax incentives, combined with the mortgage as a way to induce the construction of new housing units or reform those in a precarious situation. However, there is still a deficit households and environmental soundness, compounded with the formation of informal settlements. Consequently, we need constant reflections on the issue, in order to identify parameters that actually guide their housing policies in order to meet the constitutional social functions of the city and ensure well-begins of its citizens (art. 182). On the other hand, the intervention of the government in this segment can not only see the availability of the home itself, but also the quality of your extension or surroundings, observing aspects related to environmental sanitation, urban mobility, leisure and services essential health, education and social assistance. It appears that the smoothness and efficiency of a housing policy condition to the concept of adequate housing, in other words, structurally safe, comfortable and environmentally legally legitimate, viable from the extensive coordination with other public policies. Only to compliance with this guideline, it is possible to realize the right to housing in sustainable cities

Direito fundamental à saúde: parâmetros e alternativas para sua concretização no Brasil

If, on one hand, only with the 1988 Federal Constitution the right to health began to receive the treatment of authentic fundamental social right; on the other, it is certain since then, the level of concretization reached as to such right depicts a mismatch between the constitutional will and the will of the rulers. That is because, despite the inherent gradualness of the process of concretization of the fundamental social rights, the Brazilian reality, marked by a picture of true chaos on public health routinely reported on the evening news, denatures the priority status constitutionally drew for the right to health, demonstrating, thus, that there is a clear deficit in this process, which must be corrected. This concern regarding the problem of the concretization of the social rights, in turn, is underlined when one speaks of the right to health, since such right, due to its intimate connection with the right to life and human dignity, ends up assuming a position of primacy among the social rights, presenting itself as an imperative right, since its perfect fruition becomes an essential condition for the potential enjoyment of the remaining social rights. From such premises, this paper aims to provide a proposal for the correction of this problem based upon the defense of an active role of the Judiciary in the concretization of the right to health as long as grounded to objective and solid parameters that come to correct, with legal certainty, the named deficit and to avoid the side effects and distortions that are currently beheld when the Judiciary intends to intervene in the matter. For that effect, emerges as flagship of this measure a proposition of an existential minimum specific to the right to health that, taking into account both the constitutionally priority points relating to this relevant right, as well as the very logic of the structuring of the Sistema Único de Saúde - SUS inserted within the core of the public health policies developed in the country, comes to contribute to a judicialization of the subject more in alignment with the ideals outlined in the 1988 Constitution. Furthermore, in the same intent to seek a concretization of the right to health in harmony with the constitutional priority inherent to this material right, the research alerts to the need to undertake a restructuring in the form of organization of the Boards of Health in order to enforce the constitutional guideline of SUS community participation, as well as the importance of establishing a new culture budget in the country, with the Constitution as a compass, pass accurately portray a special prioritization directed constitutional social rights, especially the right to health