Sistema de treinamento: proposta para um tratamento integrado do meio instrucional

Este trabalho procura desenvolver uma nova concepção para a compreensão de meio instrucional,particularmente quando utilizado em sistemas de treinamento. Está comosto por quatro capitulos. O primeiro deles denominado Bases de Estudo apresenta o porquê da preocupação com o problema e fornece alguns elementos justificativos. Quanto ao segundo denominado Influências Consideradas na Definição do Capacitor lnstrucional Aspectos Teóricos, descreve alguns aspectos relevantes das teorias da Intormação da Aprendizagem e da Administração, inclusive o enfoque sistemico da organização com vistas a proporcionar uma compreensão interdisciplinar da questão central deste trabalho

Contribuição para a analise do tratamento dos resultados não realizados em vendas da investidora para a investida: um estudo de caso

Esta pesquisa objetivou analisar os efeitos dos resultados não realizados em vendas da investidora para a investida nos relatórios de uma entidade situada no Rio de Janeiro. Enfatizaram-se as técnicas de cansolidação das demonstrações contábeis e avaliação do investimento pelo patrimônio líquido (equivalência patrimonial). Na revisão da literatura foram aborda dos os principais conceitos relacionados com o estudo e caracterizados os três tratamentos considerados nesta pesquisa (cap.2). Para a realização da pesquisa, adotou-se o metodo do estudo de caso, devido à necessidade de uma identificação aprofundada dos efeitos causados pelo problema enfocado (cap.3 ) . Posterionnente, apresentou-se o caso onde foram identificadas as características da transação, das empresas e os procedimentos adotados(cap .4). A seguir, aplicaram-se os demais tratamentos ao caso e elaboraram-se alguns comentários cabiveis (caps. 5 e 6). Os resultados obtidos possibilitaram analisar os tratamentos aplicados e os respectivos efeitos nos relatórios contábeis (cap . l). Isso feito, chegou-se a algumas conclusões e recomendações para novos estudos relacionados com o tema abordado (cap.8).

Atribuição de causalidade e de controle a loucura por diversos profissionais e por religiosos

O presente trabalho objetivou conhecer a percepção de profissionais de nível superior e religiosos sobre as causas e o controle da doença mental. Levantou-se opiniões de 360 profissionais (psicólogos, médicos e médicos psiquiatras, enfermeiros e enfermeiros psiquiatras, assistentes sociais, sociólogos, técnicos de administração, economistas e engenheiro s) e 60 religiosos (padres e freiras). Foram utilizadas duas escalas em forma de questionário: a Mental Health of Locus of Origin (MHLO) e a Mental Health Locus of Control (MHLC). Foi feita a distribuição dos sujeitos de acordo com os pontos obtidos em cada escala; discriminou-se o número de sujeitos que acreditam mais nas causas orgânicas da doença mental e o número de sujeitos que acreditam nas causas ambientais, segundo cada item da MHLO. Também discriminou-se quantos sujeitos acreditam que o sucesso da psicoterapia depende mais do comportamento do cliente e os que acreditam que tal sucesso depende mais da capacidade do terapeuta, segundo cada item da MHLC. Caluulou-se o coeficiente de correlação entre locus de origem e locus de controle da doença mental, e coeficiente de confiabilidade das duas escalas. As principais conclusões indicam que os psicólogos, assistentes sociais e ·sociólogos acreditam mais que os médicos e enfermeiros e estes mais do que os religiosos e os tecnólogos que a doença mental e causada por fatores ambientais e que o seu controle depende mais do comportamento do cliente do que d a capacidade do terapeuta.

Participação do usuário no seu cuidado: realidade ou ficção?

A participação do paciente no cuidado é uma importante ferramenta para melhoria dos processos em uma organização hospitalar, pois aumenta a segurança do paciente. Este estudo teve como objetivo analisar se o paciente participa de seu cuidado. Esta análise foi feita por meio de entrevistas estruturadas com 243 pacientes internados em quatro hospitais com certificado de qualidade da Grande São Paulo e com a aplicação de questionário com perguntas abertas a três gestores destas organizações. Os resultados demonstram que os pacientes tem alta participação no cuidado, porém 17,3% dos pacientes referem que participaram do cuidado menos do que queriam e 43,6% não sabiam o nome do médico responsável pelo seu tratamento. Os gestores hospitalares reconhecem que a participação do paciente é importante, mas não há ações proativas efetivas nestas organizações hospitalares para identificar as necessidades dos pacientes.

Condutas de profissionais que realizam a consulta pré-natal na Estratégia Saúde da Família quanto à detecção, tratamento e acompanhamento da gestante com sífilis

The objective of this exploratory descriptive quantitative study was to analyze the behaviors in the detection, treatment and followup of the pregnant woman with syphilis, by health professionals that conduct the pre-natal consultation in the Family Health Strategy, as to the adherence to the recommendations of the Ministry of Health. The study was conducted in nine municipalites of the Trairi region in the state of Rio Grande do Norte. Data were collected during the months of July through September 2007, by means of a questionnaire with a population of 53 health professionals, 30 nurses and 23 physicians. Data were analyzed by descriptive statistics. The results were organized in three major items: knowledge of the health professionals about the symptomatology of syphilis and their actions in the detection of the disease; actions in the treatment of the pregnant woman with syphilis; and the actions of followup of the desease. We identified that 81,2% of the professionals have knowledge about the symptomatology of syphilis in the pregnant woman;79,2% request the VDRL exam in the adequate intervals and approximately 50% conduct the treatment in conformity with the recommendations of the Ministry of Health. For the followup care of the infected woman, 79,2% request a monthly VDRL examination, 69,8% explain the disease to the pregnant woman, and 20,7% affirm that they conduct a proper reception to the woman.We conclude that the majority of the health professionals have knowledge of the detection, treatment and followup of the pregnant woman with syphilis. However, the actions of some professionals diverge from the conduct procedures recommended by the Ministry of Health, as to the requesting of the examinations, medication prescription and notification of the iesease. This indicates the need for improved

Representações sociais sobre a prática do cuidado para enfermeiros da saúde indígena: um estudo transcultural

The desire to research on this subject arisen from the experience as nursing in the indigenous health, where I observed that many professionals from all regions of Brazil chose to work within this zone. It was notorious the nurse s difficult to settle in only one place for a long length of time. Probably due to health care in indigenous zones happens from a cultural confront. This confront materialize because both sides are imbued with their own culture: in one hand the nurse professional with its scientific knownledgment on the other the indigenous with their rituals and peculiars habits. In this context nurses should delineate and negotiate the reality through symbolic representations of life, and then make questions on the new reality. In this way, this study set out with the aim of apprehends the nurse s social representations of transcultural care in indigenous health. This knownledgment is important to avoid possible conflicts, shocks, difficulties and health care incongruence within this context. The data collect was carried out on a range of non structured interview guided by a pre-elaborated questionnaire with four questions and a hand drawing related to nurse s health care in the indigenous health. This research had a sample of 17 nurses from the Indigenous Sanitary District of Manaus in the Amazon State. To interpret data we used the Discourse of the Collective Subject, which findings were presented in three chapters: characterization of participants, discussion on themes prevalent in discourse; social representation of nursing care through infographics. The analysis revealed that the care in the indigenous health is challenging because the native people imbued in its world are perceived and processed according to the nurse s cultural lens, leading to materialize of some strangeness and adaptation difficulties, especially in the first contacts. The Social Representation on nursing practice, in many cases, is projected and contrived on the basis of scattered believes and on perception derived from common sense. The findings shows that representions are essential to mitigating the initial strangeness and help nurses to better situate themselves in the new universe. The nurse s practice in the indigenous health care should merge into each other. From the Social Representations is possible to perceive that assimilation, also comprehension on indigenous health system and its traditional knowledge are important to developing strategies to improve access and quality of care for indigenous peoples. After analysis the nurse s discourses and drawings, it is possible to represent the nurse s practice in the indigenous health as anthropophagism, since nurses should literally consuming its patients culture, digesting it and seize it as means to provide culturally congruent care. We highlight the urgent need for preparation and training of professionals to work more effectively with indigenous peoples

Registro de enfermagem no prontuário em um hospital universitário: uma busca pela humanização do cuidado

T he aim of this study is to analyze the view of nurses about nursing records in the patient chart, in perspective of the record of humanized care. This is a case study, with qualitative approach. For its achievement, was sought and granted authorization from the direction of the Hospital Universitário Onofre Lopes (HUOL) and the Ethics Committee in Research of HUOL as Statement No. 422/10. During data collection, interviews were conducted with 20 nurses of the institution. The data analysis was based on the theoretical framework of Minayo to thematic content analysis, grounded in authors who work with themes, nursing records and quality care. With the empirical material, we constructed a framework of analysis, which was identified four categories thus nominated, "Reading and learning from those who register," "nursing records and quality of care," "the essence of nursing records" and "intention and action on the record of the subjective aspects of the patient." The results show that the records are insufficient, even in the case of the procedures performed with the patients often do not inform about the aspects that deal with the subjectivity that surround it, and admit that the records do not represent a parameter for evaluating the quality of care at least at that institution. In summary, the respondents recognize the importance of valuing subjectivity of the patient in their treatment, yet admit to neglect this aspect as significant for comprehensive health care, humane and quality

A pessoa com tuberculose e o cuidado de si

Tuberculosis is a serious disease with high incidence and prevalence, and in many countries a priority public health problem, with persisting high epidemiological significance. Seeing the person with tuberculosis it is important to observe his/her self care, as well as the difficulties intertwined in this process, since it can be directly impacting the health/disease process. The aim of this study was to analyze the self care of people with tuberculosis. Descriptive study with qualitative approach, conducted in West Sanitary District of the city of Natal, RN. Data collection occurred through a semi-structured interview guided by questions concerning sociodemographic and about the disease, treatment, and self care, between the months of July to September 2012 and met the ethical precepts of research with human beings. To analyze the results we used the technique of thematic content analysis of Laurence Bardin, through the prism of the theoretical-philosophical self care discussed by Michel Foucault. From the analysis emerged two categories, the first being, Meaning of tuberculosis, with subcategories: tuberculosis as sadness and unhappiness and tuberculosis as a normal issue, and the second, Beware yourself to tuberculosis, which had subcategories: self care as attention to the health care of oneself as satisfaction of basic needs and difficulties to self care. Tuberculosis represents for some people, something really sad, causing psychological suffering, however the other presents as normal. Self care of persons with tuberculosis in this study are related in great part to seek health care and the satisfaction of basic needs. About the difficulties related to the practice of self-care, it is observed that these are tied to food, time for rest, slowness of health services for scheduling appointments and tests, as well as related habits and dependencies in the lives of these people. This study contributed to a reflection of the users with tuberculosis and self care, revealing aspects that healthcare professionals should pay attention to watch these people, being able to see everyday on the run, the need for a space and time for oneself

Efeitos do tratamento com Hidrogel na cicatrização de úlceras venosas de membros inferiores: revisão sistemática

Chronic venous disease (CVD) is evident among the chronic diseases and affects the elderly population and primarily is responsible for leg ulcers in this population. The use of dressings in the care of a venous ulcer is a fundamental part of the treatment for healing, however, evidence to assist in choosing the best dressing is scarce. The main objective of this study was to evaluate the effectiveness of treatment with hydrogel in the healing of venous ulcers using search methods, synthesis of information and statistical research through a systematic review and meta-analysis. Randomized controlled trials were selected in the following databases: CENTRAL; DARE; NHS EED; MEDLINE; EMBASE; CINAHL. Beyond these databases three websites were consulted to identify ongoing studies: ClinicalTrials.gov, OMS ICTRP e ISRCTN. The primary outcomes were analyzed: complete wound healing, incidence of wound infection and the secondary were: changes in ulcer size, time to ulcer healing, recurrence of ulcer, quality of life of participants, pain and costs of treatment. Four studies are currently included in the review with a total of 250 participants. The use of hydrogel appears to be superior to conventional dressing, gauze soaked in saline, for the healing of venous leg ulcers; 16/30 patients showed complete healing of ulcers (RR 5,33, 95%CI [1,73,16,42]). The alginate gel was shown to be more effective when compared to the hydrogel dressing in reduction of the wound area; 61,2% (± 26,2%) with alginate e 19,4% (± 24,3%) with hydrogel at the end of four weeks of treatment. Manuka honey has shown to be similar to the hydrogel dressings in percentage of area reduction. This review demonstrated that there is no evidence available about the effectiveness of the hydrogel compared to other types of dressings on the healing of venous leg ulcers of the lower limbs, thus demonstrating the need of future studies to assist health professionals in choosing the correct dressing.

A loucura interrompida nas malhas da subjetividade manicomial

Psychiatric reform occurring in Brazil has progressed significantly during the last two decades, both in the transformation of the help structure and in the treatment of madness. At the same time a paralell movement is observed marked by the maintenance of the hospital centered or psychiatric ward ideology present not only in the psychiatric institutions but also in the substitute services in the cities and , above all, in the ways of contemporary subjectivation. We affirm that the idea of deinstitutionalization is intertwined with capitalistic agent both from the epistomological, assistance, and legal aspect as from the cultural one. This work aims mainly to discuss madness and subjectivity from the ethic esthetic-political perspective, specially the wishes of the psychiatric hospital, which we inhabit and who inhibits our interactions and our desired and creative productivity. We do also want to access the invisible threads that capture and modify madness, which make our cities a means for the production of pathologies, and those that, on the contrary, insinuate a process of resistance, facilitating life and health

Contando histórias de cuidado à infância em unidade de terapia intensiva pediátrica

The tales of children's literature, in their plots, mark existential dilemmas belonging in human‟s lives, such as death, situations of separation, loss, abandonment, fear, challenges, achievements and other elements that make them suitable material to assist children in their developmental process. Such elements, present in children‟s storybooks, are close to the experiences lived by the children in the context of hospitalization in a special manner. With that said this study focus on the understanding of the therapeutic possibilities of the tales of children's literature in the care of hospitalized children in Pediatric Intensive Care Units (UTIPED) based on the Heidegger's concept of Care and adopting the Phenomenology as the method. The UTIPED of a state public hospital located in the municipality of Natal/RN was elected as the study site and four hospitalized children aged between six and nine years, all males, presenting different clinical conditions were selected to participate in the study following age and clinical conditions as the selective criteria. The procedure of corpus construction included eight individual sessions of storytelling accompanied by the use of ludic resources. The phenomenological understanding about the therapeutic possibilities of tales was structured under three main elements: (1) the ludic axis; (2) the reflective axis; and (3) the affective axis. The appropriateness of the proposed therapy in the context of the UTIPED and the potential of the tales as a protection factor to the child was evident. The storytelling activity framed a scenario of care unusual in the context of intensive care units, establishing a symbolic space for children‟s expression. Therefore, this study indicates this therapeutic proposal for children‟s care in the UTIPED that considers their evolutionary stage, their clinical conditions at the time and especially their emotional needs during their immersion in a diverse and foreign environment which is filled with potentially harmful elements to their full development.

O dispositivo alta nos Centros de Atenção Psicossocial/CAPS : loucura, vida cotidiana e organização social

The present paper proposes an analysis about the Brazilian Psychiatric Reform as a public policy and deriving from a research developed with the workers of a Psychosocial Attention Centre III (CAPS III) and the managers of the Psychosocial Attention Web (REAP) in Aracaju. This analysis is developed as an investigation of the discharge at those services, understood not as a procedure, but as a dispositive from which different elements can be articulated: users, knowledge, technical procedures, police measures, juridical decisions, laws, services edifying. This, form the background of the articulation between mental alienation and the subject of right alienation, in the ways through which this articulation develops to the relations between madness,citizenship, internment and substitutive practices. Our investigation about the discharge as a dispositive was built with some narrative constructions, as a discourse analysis inspired by Michel Foucault s method, from the perspective of some of the main dispositive operators: workers and managers. The main aspect observed were: the articulations built by the discharge as a dispositive based on two discursive grate, the Reform as a new treatment substituting internship, and the Reform as juridical insertion and users rights practice; the exercise of these discursive grades based on the workers and managers perspective; the transference of limitations and contradictions of these grades to the competence of the dispositive operators, emerged in an outstanding way, as sometimes those operators are liable for the emergent limitations and difficulties, and some other times they are restrained by their institutional role, which is to maintain the domination relations articulated by the dispositive; finally, some aspects extracted which the dispositive operators - when they were expected to act in a way to maintain certain power relations - were capable to resist, managing other power relations from the dispositive, that we call, as Agamben, dispositive profanity

Corpo, doença e biomedicina: uma análise antropológica de práticas corporais e de tratamento entre pessoas com HIV/AIDS

A epidemia do HIV/AIDS tem desafiado tanto a biomedicina como a ciência de modo geral. Tecnologias vêm sendo exploradas a fim de criar uma base terapêutica consistente às pessoas infectadas. Se os tratamentos exigem o consumo diário de medicamentos, os exames laboratoriais contemplam uma rotina a ser sempre mantida. Levam a um processo de mudança e adaptação pessoal junto de uma reorganização intensiva das formas de cuidado do corpo. As práticas clínico-terapêuticas devem ser entendidas, porém, como elementos particulares de processos culturais de grande alcance. Partindo de pesquisa etnográfica no Rio de Janeiro, discuto os efeitos sociais da biomedicina como um saber e uma cultura global sobre práticas sociais locais.

Motivos do abandono do seguimento médico no cuidado a portadores de hipertensão arterial: a perspectiva do sujeito

A hipertensão arterial é um expressivo problema de saúde pública enquanto fator de risco para as doenças cardiovasculares e principal grupo de causas de mortalidade no Brasil. A baixa adesão e o abandono do tratamento estão entre os principais obstáculos às estratégias individuais de controle. Estudam-se os motivos do abandono do seguimento médico em uma coorte de pacientes em tratamento de hipertensão arterial, em serviço de atenção primária à saúde, acompanhados por um período de quatro anos. Foram realizadas entrevistas semiestruturadas com cinquenta pessoas com hipertensão que abandonaram o seguimento médico. As respostas foram analisadas mediante a técnica de análise temática de conteúdo. Os motivos relatados para o abandono do seguimento mostraram predomínio de razões ligadas ao próprio serviço de saúde - sua organização, estrutura e a relação médico-paciente - e, ainda, tratamento em outro serviço de saúde. Razões de natureza psicossocial, como a ausência de sintomas, a melhora e/ou a normalização da pressão arterial e o consumo de álcool também contribuíram para o abandono do cuidado. Estudar os motivos do abandono na perspectiva do próprio sujeito permitiu verificar a riqueza e diversidade de problemas envolvidos no cuidado requerido.