Sistemas certificáveis de gestão ambiental e da qualidade: práticas para integração em empresas do setor moveleiro

O principal objetivo deste artigo é propor, a partir do referencial teórico e de um estudo de caso em uma empresa moveleira, práticas para integração de sistemas certificáveis de gestão ambiental e da qualidade. A coleta de dados do estudo de caso se deu por meio de entrevistas semiestruturadas com o responsável direto pelos dois sistemas e com alguns colaboradores-chave do nível operacional, além de análise documental e de visitas in loco. Ao final deste artigo, são propostas práticas para integração desses sistemas, relacionadas aos seguintes elementos: alta administração; apoio administrativo, financeiro e pessoal; serviço de consultoria; coordenação do programa de integração; interface entre os sistemas; capacitação técnico-gerencial; sistema de liderança, prospecção, avaliação e desenvolvimento de fornecedores; sistema de informação; indicadores; comunicação com o cliente, e integração contínua.

O Serviço Ambulatorial Móvel de Urgência (SAMU) no contexto da reforma psiquiátrica: em análise a experiência de Aracaju/SE

This research investigated professional practices from Mobile Urgency Care Service (Serviço Ambulatorial Móvel de Urgência - SAMU) at psychiatric cases of the city of Aracaju/SE, Brazil and its possible articulations to psychosocial services network. The regulation no. 2048 of 11/05/2002 from Ministry Health establishes National Urgency Policy and designates that psychiatric cases are SAMU's responsibility. Then, it is necessary to propose an analyze of psychiatric urgency service under anti-asylums social movements standpoint, mainly because this service is responsive in assisting a person in crises. Fieldwork was developed in two phases. First one was made with SAMU workers and the information were produced by recorded semi-structured interviews. Results of this first phase indicate that urgency psychiatric conception from SAMU workers is based on aggressiveness concept; delays at psychiatric cases support and low training in mental health care which means several difficulties to emergency service. Although, we noticed that SAMU use asylum procedures at psychiatric cases like ropes and odder instruments to contain people. The second step of our research was to attend meetings to build a new psychiatric urgencies protocol for SAMU to define practices to auxiliaries, vehicular conductors and medical support regulation. Therefore, open interviews were accomplished with some participators and follows-up to psychiatric case on board of SAMU's cars. Afterwards we discussed how the urgency paradigm, that influence the protocol draw and as consequence distort what we believe is the essentially function of this device, that is to give care support to persons in crises and produce articulation to psychosocial services network

Dependência química em mulheres :um estudo sobre o consumo de medicamentos ansiolíticos no serviço público de saúde de Natal/RN

This work was concerned to investigate the meaning attributed to anxiolytic drugs by women, in public health service. It proposes a joint analysis through a link between three dimensions: the woman, the drug, and public health service itself, in an hegemonic medical assistance model. It is observed that the relation between these elements has a great influence over the use and construction of a particular meaning, by the user. The medication is analysed as a consumption merchandise and as an health symbol. In this way, it reflects a biologized vision, which believes the drug as a solution for all health problems. It tries to analyse the generalized medical prescription for anxiolythics and it s consequences. It focalizes also the production and utilization of public health services by patients, mainly women. The question related to the use of anxiolytics and the meaning construted by women is analysed focusing the way that relations of masculine/feminine gender are organized in our society. At this point of view, it tries to understand the dimension that these questions have in subjectivity production, and how it acts in the health/disease process. Finally, this work tries to understand, in a broad sense, the use of anxiolytics looking at the problem not only as a biological question, but also as a cultural matter. The research was done over seventeen women, all of them anxiolytic users. It was used, as research instrument, semi-structured interview associated with methodological analysis of user s speeches

Qualidade de vida de pacientes com deformidade dentofacial

In the last decade, an increasing number of studies focusing on the impact of oral deformities on quality of life have been published. However, the evaluation of patients at different phases of the treatment has not been performed. Therefore, the purpose of this study was to determine the impact that dentofacial deformities have on patients` quality of life, as well as the influence exerted by social, economic, demographic and orthodontic factors, type and severity of malocclusion. A bicentric study - of the cross-sectional type of repeated panels - involving two cities - Natal and Rio de Janeiro - was carried out. A total of 227 patients participated in the study: 71 patients in the initial phase of the treatment (before any orthosurgical procedure), 115 patients in the pre-surgical (with braces) phase and 41 patients in the postoperative phase. The quality of life was measured using the Orthognatic Quality of Life Questionnnaire - OQLQ, translated and validated into Portuguese. The normative and aesthetic need for treatment was assessed with the Index of Orthodontic Treatment Need (IOTN) and the Dental Aesthetic Index (DAI); the social, economic and demographic factors, the type of service and malocclusion were also assessed. The data were analyzed through χ2/ Fisher`s exact test to seek the association between the nominal categorical variables in the three phases of treatment, Mann Whitney and Kruskal-Wallis test for gauging the existence of significant differences between two and three groups regarding each domain of OQLQ, respectively. For all tests, it was adopted a significance level of 5%. There was a statistically significant difference (p <0.001) in the general scores of OQLQ and in the domains of social aspects, facial aesthetics and oral function, when the "postoperative group" was compared to the "initial" and "orthodontic preparation" groups. Women, single, aged between 31 and 59 and living in Natal had the greatest impact on quality of life among patients in the "orthodontic preparation" group. Only the variable "income" (2 to 3 minimum wages), for the "initial" group, and gender (female) for the "postoperative" group, showed significant association with quality of life. The normative variable IOTN (DHC and AC) showed significant association with the OQLQ for the "initial" group, and the IOTN-AC-auto in the group of orthodontic preparation, being less important to women. We conclude that the ortho-surgical therapy has positive effects on quality of life after orthognathic surgery

Satisfaçã dos Usuários e a qualidade da atenção primária à saúde no Rio Grande do Norte

O presente estudo tem por objetivo avaliar a satisfação dos usuários em relação à qualidade da Atenção Primária à Saúde no Rio Grande do Norte. Trata-se de Pesquisa Avaliativa observacional transversal, com abordagem quantitativa, a qual faz parte da Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ), da Universidade Federal do Rio Grande do Norte. Foram utilizados dados secundários de todas as entrevistas com usuários das equipes que participaram da Avaliação Externa do PMAQ no Estado do RN. A pesquisa foi realizada em 167 municípios do Estado do Rio Grande do Norte, na qual a população foi composta por 1.650 usuários. A amostra se deu por conveniência a partir dos seguintes critérios: usuários que estavam presentes na Unidade Básica de Saúde (UBS) para realizar qualquer tipo de procedimento e que consentisse em participar da avaliação. Foram excluídos os que tinham ido pela primeira vez na unidade e aqueles que não frequentaram há mais de 12 meses. A coleta dos dados foi realizada no período de setembro a novembro de 2013. Para tanto, foi elaborado um protocolo de pesquisa contendo as seguintes dimensões: organizacional, interpessoal e estrutural. Em relação à dimensão organizacional os resultados mostram que a marcação de consultas tem se configurado em empecilho ao acesso do usuário ao serviço de saúde, uma vez que se faz necessário para o atendimento, enfrentar filas, antes da abertura da unidade para pegar fichas. No tocante ao funcionamento da unidade, se destaca o fato dos usuários referirem que o horário de funcionamento da unidade atende à suas necessidades, apesar de funcionar 5 (cinco) dias por semana, a maioria das unidades permanece fechada no horário de almoço. Outro dado importante refere-se à coordenação do cuidado, cujos resultados apresentam diferenças maiores entre os usuários da região metropolitana e do interior do Estado em relação à Capital. Essa diferença se expressa principalmente em relação de marcação de consulta com outros profissionais especialistas. A dimensão interpessoal, no que diz respeito à categorias interação usuário-serviço-equipe e vínculo, demonstraram alguns avanços, contudo os melhores resultados foram observados em relação a satisfação com o cuidado, onde mais de 50% dos usuários se mostraram satisfeitos com o cuidado recebido nas unidades. Em contrapartida, o estudo mostrou que, na opinião de 56% dos usuários da capital, a falta de materiais e equipamentos influencia negativamente no cuidado. Por fim, o estudo contribuiu para reforçar a ideia de que a avaliação da satisfação dos usuários dos serviços de saúde pode ser uma ferramenta importante para subsidiar o processo de decisão compartilhada, de forma a se repensar as práticas profissionais, reorganizar o processo de trabalho desenvolvido, realocar recursos, readequar ações e redefinir objetivos que estejam coerentes com o projeto de saúde estabelecido

Avaliação da qualidade da atenção primária à saúde da criança no Rio Grande do Norte: visão das usuárias

The study aims to evaluate the quality of the work processes of the teams from the Family Health Strategy regarding the comprehensive health care for children, in the view of users in the state of Rio Grande do Norte. This is a cross-sectional observational evaluative research with quantitative approach. The primary data are part of the External Review from the Program of Improving Access and Quality of Primary Care (PMAQ) in 2012. 190 women were interviewed. The inclusion criteria was the presence in the clinic at the time of the survey, have attended the service in the last 12 months and be a mother or companion of a child up to two years old. A research protocol was developed in the dimensions of Growth and Development, Breastfeeding and nutrition, and health problems and its variables. The results revealed that mothers / companions who responded to the questionnaire 71% were aged between 18 and 35 years, 92.1% were literate, 96.3% had a monthly income and 62.6% received financial assistance from the government. As for the children, 39.4% were aged between 13 to 24 months. In promotion and prevention actions for children, 64.2% had consultation up to the 7th day of life, 91.1% underwent the screening test, 95.3% had a health handbook, 98.9% had a vaccine, 17.9% breastfed or breastfeed from 6 to 24 months. As for link and continuity of care, 86.8% of the children were accompanied by the same professional staff and 59.5% left with next consultation scheduled. In acute situations 42.4% of the children went to the health unit and 64% of these were attended. It is concluded that the actions involving prevention and health promotion of children in RN, are evaluated positively by the service users and meet the requirements of MS, as well as link and continuity of care. The weakness in access and reception of users is evident, indicating the need to adapt the service to the demand of health and planning actions to welcome all who seeks basic health unit-UBS

Serviço Social e terceiro setor: considerações sobre as atuais relações e condições de trabalho para o Assistente Social em Natal

The present study analyses the actual relations and work conditions found in the third sector in Natal city, in the context of productive restoration and increasingly retraction from the State in providing Social Service before the new approach that has been destined to the social issue. The study talks about the work of the social worker when fighting the different expressions the social issue has, such as social service provision as a way of teamwork associated to work relations and conditions, to accessible resources and quality control management. These are elements that affect and interfere in the accomplishment and in the work of the social worker itself. The State s improvement, according to neoliberal-political precepts and increasingly retraction from the public investment in the areas of social concern (health, social welfare, assistance) and in the wage and employment policy, besides expanding the partnership with the public and private areas, in search for social services with quality, it has diversified the structures of the professional work with the growth of the so called third sector institutions. However, the absorption of the social workers by the third sector groups in general, has as major features the impoverishment of work relations, the maintenance of an unequal salary model, pointing out the deadline contracts and/or single tasks that generate work instability. The research debates, with a critical view and full perspective, over the conception of the third sector, interpreted as an action that expresses functions and values, treated as a real phenomenon generated from the restoration of the capital based on neoliberal principles. This study aims for responding what the established work relations are and under what work conditions the social worker has been fitting in the third sector and how such a reality echoes in the current work conditions for a social work in the city of Natal, before this new model of state intervention that transfers part of the social service provision to distinctive divisions of society, among them the so called third sector. The research results have shown that like the other workers the social worker passes through the same crises, dilemmas, advances and challenges that occur in the world of employment and which are expressed in the drop of salary average in the growth of contemporary contracts, unemployment, and in the ever more selective requirements to one be included in the social spaces, where the professional work is done, having as a result a greater impoverishment of work relations and conditions as well as more vulnerability as a salaried occupation

Movimento estudantil e serviço social no capitalismo contemporâneo: tendências e particularidades

This dissertation aims to analyze the social direction in which the Student Movement in Social Work in Brazil (ENESSO) has gone through. This is done considering how the functioning of the National Executive, the Brazilian Social Work Student union has operated. The research analyzed their political position regarding the university as well as professional education in the period of 2003 to 2008. The study s theoretical and methodological object was obtained according to its structural, juncture, and time determinants. All of the mentioned elements considered the contemporary capital crisis and its implications towards the State and Society emphasizing specifically the changes that occurred in the University regarding professional education. For the purpose of data collection and production, a documental and field research was realized. Thus, interviews were done considering one manager of each management period of the ENESSO group in the time span of 2003 to 2008. Some subjects that represented the Brazilian Social Work Teaching and Research Association (ABEPSS) as well as were also interviewed. These subjects have had a relevant role in partnership with these entities and represented students in the contemporary scene. Results suggest that ENESSO has developed work that defends a project of a public, free and laic quality university. This entity also defends a project that considers the 1996 Curricular Guidelines. Currently, there is internal dispute in the social direction of the MESS, this is seen amongst political groups that diverge in opinions related to the analysis done by the Lula government regarding the political role that the National Student Union-UNE has taken in the counter-reform of higher education. This current juncture is seen as extremely individualist and it results as in unfavorable for the collective organization of the working class, especially regarding student movement. MESS has been going through a moment of profound instability and this dimension is being expressed by the absence of national coordinator for the 2008/2009 management period at ENESSO. Even though there are difficulties, it is possible to point out partnership of the entities that represent the national Social Work in Brazil. These partnerships are all related to a struggle and search for the development of a professional project that leads towards the sociability awareness that goes beyond capital.

Serviço Social e Política: uma análise da participação dos assistentes sociais no Conselho Regional de Serviço Social 14ª região

This paper analyzes the political participation of Social Workers at the Social Service Regional Council Region 14th. The theoretical and methodological framework of this investigation has as its perspective the totality of social life and its determining relations within the object of study. To the production, analysis and collecting of data it was used a qualitative approach considering a bibliographical and documental research as well as a series of twelve interviews with 2005-2008 and 2008-2011 managing counselors of CRESS/RN. It was also used the data obtained from other special interviews held with the social workers in the period between 2007 and 2008. The results of this study allow and affirm the political dimension of Caseworkers and the CRESS/RN as a space of political activity with opportunities for effective and collective elaboration of strategies in order to reach the fulfillment of the ethical and professional policy of the Social Work. From a historical viewpoint, the beginning of this process is marked by the struggle for democracy, the end of military dictatorship, the establishment of the State of Human Rights. The Democratization of the so called Federal Council of Social Workers and its Regional Councils of Social Workers, CFAS / CRAS, respectively, area a result of the participation of the category in an effort to fight for democratization in Brazil. The objective of this research, so, is to understand which the socio-historical determinants are, that focus objectively and subjectively in the demobilization of social workers in CRESS Region 14th - in the contemporary and historical context. Among the results obtained we identified the ignorance of some professional workers and also of some advisors, regarding the existence and the role of the Council, as well as the commercialization of Education that compromises the quality of the professional training in its theoretical and methodological, ethical and political dimensions. According to our understanding, this shows a the presence of a non-critical professional profile based on a false reality, on the precariousness of employment contracts which undermine the political organization and submit the worker to various social exploring mechanisms such as double shift and ultimately the fragility of the management of the Regional Council -, as a consequence of the offensive capitalist system that ideologically invests to stop the political organization founded in a critical and democratic perspective. The low participation of some advisors and, in general, the category in CRESS / RN, despite its objective conditions, is a reality and it is presented to us as a challenge to future managements and policy consolidation to society. Inasmuch as the category intends to guarantee the high quality of its social workers, the demands of future counselors, their skills and abilities in dealing with regulatory issues, administrative policies that pervade the everyday life of CRESS / RN are necessary

A política de assistência estudantil no contexto de expansão do ensino superior: as particularidades do Programa de Pós-Graduação em Serviço Social da UFRN

A dissertação versa sobre a Política de Assistência Estudantil e o processo de luta pela democratização do acesso à universidade, no contexto de expansão do ensino superior em tempos de crise estrutural do capital. Apresenta como unidade de análise as particularidades da pós-graduação em Serviço Social da UFRN e tem como objetivo principal apreender e analisar as condições de permanência disponibilizadas pela UFRN aos discentes de pós-graduação no contexto de expansão do Ensino Superior. O percurso teórico-metodológico de análise adotado na pesquisa se fundamentou numa perspectiva crítica do objeto de estudo a partir de uma concepção de totalidade, que pressupõe apreender as determinações socioeconômicas e políticas que incidem sobre a política de ensino superior e as condições de vida dos discentes do Programa de Pós-Graduação em Serviço Social (PPGSS). As análises fundamentaram-se em pesquisa bibliográfica como base teórico-metodológica da investigação, articulada com as reflexões que resultaram dos dados empíricos da pesquisa de campo na perspectiva de apreensão do objeto, em sua densidade histórica e num quadro de múltiplas determinações. Do ponto de vista metodológico foram entrevistados 26 discentes e realizada análise documental referentes a leis e documentos da política educacional em nível federal e dos organismos internacionais. A luta por ampliação do acesso à universidade está na agenda dos movimentos sociais no âmbito da educação, no entanto na conjuntura dos governos de Luis Inácio Lula da Silva (2003 a 2010) e Dilma Rousseff (2011 a 2012) a tendência tem sido seguir as orientações dos organismos internacionais e promover expansão de vagas sem assegurar estratégias de permanência compatíveis com as exigências de excelência acadêmica postas, por exemplo, na pós-graduação. Discentes entrevistados acessam o ensino superior e os cursos de pós-graduação e vivenciam dificuldades diárias para atender com qualidade às exigências acadêmicas em face de suas condições materiais de vida e de trabalho e dos limites da política de assistência estudantil que tem um perfil de programas e ações localizadas

Implantação do Serviço de Avaliação Pré-Anestésica em Hospital Universitário: dificuldades e resultados

JUSTIFICATIVA E OBJETIVOS: A avaliação pré-operatória é a chave principal para um bom preparo pré-operatório e manuseio intra-operatório. Quando realizada em nível ambulatorial permite uma análise melhor, possibilitando investigações adicionais, melhorando a qualidade do preparo e diminuindo os custos hospitalares. O objetivo deste estudo foi analisar a implantação e o desenvolvimento do Serviço de Avaliação Pré-Anestésica (SAPAN) em Hospital Universitário, verificando quais foram as dificuldades e os resultados positivos encontrados. MÉTODO: Foram avaliados os dados relativos aos pacientes atendidos no ambulatório do SAPAN, pelos médicos em especialização com supervisão de um docente, nos primeiros nove meses de instalação. A consulta era feita seguindo uma ficha padronizada. Ao término, os pacientes eram liberados para o procedimento cirúrgico ou encaminhados para consulta com outros especialistas para controle de doenças específicas. Analisou-se o número de pacientes avaliados e o número de procedimentos cirúrgicos eletivos realizados nesse período e as diversas especialidades cirúrgicas, porcentagem de pacientes com intervenção cirúrgica suspensa por necessidade de controle de doenças, e as especialidades clínicas mais solicitadas. RESULTADOS: Realizaram-se 913 consultas ambulatoriais e 5.409 intervenções cirúrgicas eletivas. Várias clínicas não encaminharam seus pacientes para a avaliação. Por necessidade clínica, 11,9% dos pacientes tiveram o procedimento cirúrgico suspenso, e as clínicas envolvidas foram cardiologia (43,08%), pneumologia (25,74%), hematologia (21,65%) e endocrinologia (9,52%). CONCLUSÕES: Embora grande parte dos pacientes não tenha sido encaminhada pelas especialidades cirúrgicas, os dados iniciais do SAPAN permitiram demonstrar os benefícios de um serviço de preparo ambulatorial dos pacientes.

PERFIS ESTRATÉGICOS E PERCEPÇÃO DA QUALIDADE: um estudo nos restaurantes da rota turística de Natal-RN

This work is a study of strategic management of catering establishments in the tourist route from Natal, through the study of the strategic profile of the manager and the level of satisfaction with the quality of services offered. Identifies the strategic profile prevalent in the studied sector, measures the level of customer satisfaction with services and associate the two constructs to distinguish the services of strategic profile. Uses population of 33 restaurants, built for convenience, from a list composed establishments associated with the Brazilian Association of Bars and Restaurants - ABRASEL, Veja magazine Christmas food and drink 2011/2012 and information from the natives. It presents statistical methodology used for descriptive bivariate analysis complemented by quantitative data. The quantitative characteristics of the population shows non-normality checked by the Shapiro-Wilks. Used the Kruskal-Wallis test for the realization of the association of variables and the Mann-Whitney test to perform post-test. It shows the strategic profile prevalent in the sector of restoration in Natal is the analyzer, although other types were detected. Notes that the level of satisfaction with the quality of service is getting a high score approximately 5 points in a 6-point Likert scale. Demonstrates that the client can tell the quality of services between the different strategic profiles. Identifies distinction between services provided by prospector profile compared to other profiles, indicating the size as the tangible aspects that presents noticeable difference. Certifies that these variables affect the environment of the restaurant in the building of strategic profile and reflect on the service provided. Concludes that the quality of services provided by catering establishments is influenced by the type of establishment and strategic profile of the study of this relation to establishments offering development opportunities and improving the quality of their services

A questão urbana e a produção acadêmica do Serviço Social brasileiro em foco

O artigo aborda a questão urbana como objeto de pesquisa do Serviço Social. Resulta de pesquisa teórica e de análise das produções sobre esta temática, tendo por base artigos dos anais dos Encontros Nacionais de Pesquisadores em Serviço Social (ENPESS), no período 2000-2010. A ampliação e diversidade de espaços sócio-ocupacionais não correspondem necessariamente ao desenvolvimento de pesquisas, com aprofundamento teórico-metodológico exigido pela complexidade da questão urbana na contemporaneidade. Há crescente interesse pela temática de pesquisadores, profissionais e estudantes e esforços de sistematização e pesquisa evidenciados no número de trabalhos e na busca de qualidade dos mesmos. Mas há também necessidade de aprofundamento teórico-metodológico para uma produção do conhecimento em consonância com o Projeto Ético-Politico, o que supõe construção de vias de superação da sociabilidade capitalista

Qualidade de vida em urticária crônica: inquérito em ambulatório público universitário, Botucatu (Brasil)

OBJETIVO: Avaliar o impacto da urticária crônica na qualidade de vida dos pacientes de ambulatório universitário a partir do questionário DLQI (Dermatology Life Quality Index). MÉTODOS: Inquérito sobre o impacto na qualidade de vida infligido pela urticária crônica a partir do questionário DLQI validado para a língua portuguesa. Pacientes foram entrevistados durante suas consultas em ambulatório especializado, entre maio de 2009 e maio de 2010, em serviço público brasileiro (Botucatu-SP). Os escores do DLQI foram analisados segundo subgrupos: idade, gênero, escolaridade, tempo de doença e presença de angioedema. RESULTADOS: Foram entrevistados 100 pacientes com urticária crônica. Predominou o gênero feminino (86%), a idade média foi de 41,8 anos, duração média da doença foi de seis anos e angioedema ocorreu em 82% dos pacientes. O escore médio do DLQI foi de 13,5, caracterizando grave impacto à qualidade de vida, superior a hanseníase, psoríase, eczema atópico e carcinoma basocelular. Presença de angioedema se associou a maiores escores: 14,5 x 9,9 (p < 0,01). Pacientes do gênero feminino referiram maior impacto quanto ao vestuário, já o gênero masculino referiu quanto ao tratamento, trabalho e estudo (p < 0,05). CONCLUSÃO: Urticária crônica inflige grave comprometimento da qualidade de vida nos pacientes avaliados em serviço universitário brasileiro, especialmente nos portadores de angioedema.

Perfil de usuários e percepção sobre a qualidade do atendimento nutricional em um programa de saúde para a terceira idade

Objetivou-se analisar o perfil dos usuários de um serviço de nutrição e a percepção dos mesmos sobre a qualidade do atendimento, em uma pesquisa quali-quantitativa, utilizando entrevistas semiestruturadas, conduzidas logo após o atendimento nutricional a 32 idosos de um programa para a terceira idade no município de Viçosa - MG. Predominou o sexo feminino, com idades entre 60 e 78 anos; a hipertensão arterial foi a doença de maior ocorrência; a maioria está satisfeita com o atendimento; 44,8% têm dificuldades para mudar a alimentação e 100% foram otimistas quanto ao resultado do acompanhamento nutricional; a maioria é portadora de doenças crônicas não-transmissíveis, possui autonomia, compreende o serviço como instrumento de auxílio na qualidade de vida e associa a satisfação com o atendimento a aspectos de cuidado e atenção. Estimular pesquisas com programas de nutrição na terceira idade se torna cada vez mais necessário, para que se busque qualidade nutricional e melhores estratégias de atendimento aos idosos.