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

O trabalho em saúde como espaço pedagógico: desafios e possibilidades

The ongoing transformations in brazilian society, arising from technical and organizational changes in the working world, are making, with much emphasis, heated debates resurge related to themes and issues that refer to the relationship between work, skills and education. Thus, this study is inserted in the link between education and work, pointing to the work as an educational principle according to Antonio Gramsci. This paper aims to discuss the interfaces between education and work in the everyday health care teams and learn about the activities developed by health teams related to the learning processes in and with the work to analyze the opportunities and challenges of transforming spaces of health work in an environment of lifelong learning. This is a descriptive, exploratory with a qualitative approach case study developed from semi-structured interviews with the health staff professionals of the Unidade de Terapia Intensiva da Casa de Saúde Dix-Sept Rosado in Mossoró / RN , who answered open questions about the relationship between education and work. The interviews were conducted during the month of January 2010, the same being recorded, transcribed and analyzed, culminating in the production of new knowledge on the subject. It is understood that work and education activities are eminently human, therefore only the human being works and educates. Given the statements of participants, it is noticed that all work processes in health are learning moments. This happens through new demands imposed by the everyday of the services, by interaction with a multidisciplinary team, participation in educational activities and individual study. It was noticed that the institution in this case does not promote study courses related to Intensive Care and that there are obstacles to the realization of educational activities on and with the work, such as: excessive workload, inability to release staff to participate in events, low pay, which leads the worker to have more than one employment, rejection of new knowledge by some workers and lack of physical infrastructure and incentives for the activities. The daily situations must be transformed in learning, selfanalyzing the problems of practice and valuing the work process itself in its intrinsic context. We conclude that dealing with the web of relationships between educational processes and production processes of health services, unraveling the intricacies of the world of work and education requirements in this sector are increasingly on the agenda of Sistema Único de Saúde workers and managers. The continuing consideration of this issue becomes an essential condition for the proper discharge of their responsibilities. We consider that bringing the education to everyday life is the result of recognition of the educational potential of the work situation

A motivação e o significado do trabalho de bancários: estudo comparativo entre dois momentos do processo de reestruturação produtiva

This master s dissertation deals with motivation and the meaning of work amongst bank employees. This is done considering a cognitive perception. Work is understood here under a social and subjective comprehension, once it deals with significance attribution. Motivation is the process that rules choice of the different possibilities of individual behavior, all of which according to the Expectation Theory. This study aims to analyze the implications of the productive restructure, since it is related to technological innovation, organizational changes and management, in motivation and work significance. Thus, the objective of the research is to verify motivational differences and the meaning of work amongst bank employees. This is done in two distinct moments of the productive restructure of bank employees in Natal-RN. The research is divided in two parts. In the first one, changes that occurred in banks between 1999 until 2005 were identified by the means of interviews with 7 bank managers. The analyzed perspective was training intensifying, quality emphasis of customer attendance, the use of automation/technology, staff stabilization, change in staff profile, work intensification, etc. In the second study the Inventory of Motivation and Work Meaning was applied. Thus, questions related to work focus, social demographic data, in 187 bank employees were dealt with. The collected data was compared to data from previous work. It was observed that productive restructure has a reflection in the meaning of work increasing self-expression, economical reward, and responsibility in work conditions. All of the item mention beforehand maintain the level of inhumanness and consummation and respond as being the characteristics of the real work environment. On the other hand, bank employees value less justice, self-expression and more the survival perspective, implying instrumental values to work. As for motivation, it is increased among bank employees. These employees have greater expectations that their work produce results since they believe in their interference in work results

Gestão por Competências em Organizações Públicas: O Processo de Transformação Organizacional e seus Impactos Junto aos Servidores na Secretaria Estadual de Administração e Recursos Humanos (SEARH/RN)

The state has changed over time in order to meet a society with increasingly stringent demands. Techniques of private means begin to be employed in an attempt to overcome the dysfunctions entrenched bureaucracy, making the machine faster. By federal law by the People Management Skills was established as a reference for the administration of Human Resources of the public sector in an attempt to develop professionally servers, based mainly on the three pillars of the model: the knowledge, skills and attitudes. This thesis aims at understanding, in the view of employees, the perceived impacts on the organizational changes occurring in the Department of Administration and Human Resources of the State of Rio Grande do Norte in order to implement a People Management Skills-based. It is a simple case study, characterized by the research during a certain period of time, collecting data in a real environment of an organization, in this case SEARH/RN. The procedures used in collecting data were the literature review, documental research and field research. We used a qualitative approach with exploratory and descriptive approach. Every reform was implemented in the institution and reported from there analyzed the impacts observed by the servers. As a result we observed a considerable advance in institutional activities, mainly relating to physical structure / organizational and human resource policies, with minor advances on labor policies, in much the result of the guiding focus of the reform on SEARH/RN. The impacts in total were more positive than negative and direct paths to improvement in public organizations. Making a general analysis of the modernization program implemented in SEARH/RN, we can conclude that there was a distinct change in all dimensions studied, mostly pointing out positive aspects, and contrary to the opinion of some authors, who claim to be very difficult to implement reforms in public organizations, since they are highly institutionalized environments. What was found was a big organization, with gaps and weaknesses, but with a much larger number of hits and recognition from institutional actors

Inhibition of 5-alpha-reductase activity induces stromal remodeling and smooth muscle de-differentiation in adult gerbil ventral prostate

Prostatic differentiation during embryogenesis and its further homeostatic state maintenance during adult life depend on androgens. Dihydrotestosterone, which is synthesized from testosterone by 5alpha-reductase (5alpha-r), is the active molecule triggering androgen action within the prostate. In the present work, we examined the effects of 5alpha-reductase inhibition by finasteride in the ventral prostate (VP) of the adult gerbil, employing histochemical and electron microscopy techniques to demonstrate the morphological and organizational changes of the organ. After 10 days of finasteride treatment at a dose of 100 mg/kg/day, the prostatic complex (VP and dorsolateral prostate) absolute weight was reduced to about 18%. The epithelial cells became short and cuboidal, with less secretory blebs and reduced acid phosphatase activity. The luminal sectional area diminished, suggestive of decreased secretory activity. The stromal/epithelial ratio increased, the stroma becoming thicker but less cellular. There was a striking accumulation of collagen fibrils, which was accompanied by an increase in deposits of amorphous granular material adjacent to the basal lamina and in the clefts between smooth muscle cells (SMC). Additionally, the periacinar smooth muscle became loosely packed. Some SMC were atrophic and showed a denser array of the cytoskeleton, whereas other SMC had a highly irregular outline with numerous spine-like projections. The present data indicate that 5alpha-r inhibition causes epithelial and stromal changes by affecting intra-prostatic hormone levels. These alterations are probably the result of an imbalance of the homeostatic interaction between the epithelium and the underlying stroma.

Os descaminhos da estrada: a organização do trabalho dos caminhoneiros no porto de Santos

Pós-graduação em Ciências Sociais - FFC

Gestão ambiental: um estudo referenciado na A3P em uma secretaria do município de Bauru - SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

As metamorfoses das tradições operárias: trabalhadores do calçado frente à reestruturação produtiva

Pós-graduação em História - FCHS

A ideologia da nova educação profissional no contexto da estruturação produtiva

Pós-graduação em Ciências Sociais - FFC

Descentralização da gestão ambiental no estado do Pará e suas implicações no licenciamento ambiental (1988-2010)

O Presente trabalho analisa as mudanças institucionais e organizacionais na gestão ambiental no Pará e em Belém de 1988 a 2010. Ao analisarmos os fundamentos teóricos do debate ambiental e quais as influências presentes na concepção de gestão ambiental no Brasil, chegamos às mudanças institucionais e organizacionais no cenário ambiental nacional, estadual e municipal. Dentro dessas mudanças, o processo de descentralização da gestão ambiental trouxe grandes repercussões às esferas estadual e municipal, cuja analise dedicou maios atenção. Assim, buscamos na analise do instrumento de licenciamento ambiental os principais efeitos desse processo de descentralização e como esse instrumento é reflexo do debate ambiental, da concepção de gestão ambiental no Brasil, espelhando isomorficamente as mudanças institucionais e organizacionais nessas esferas.

Contribuições da teoria das restrições para gestão da mudança

Pós-graduação em Engenharia de Produção - FEB

Influência da cultura organizacional na implementação de um programa de melhoria contínua de uma empresa de grande porte

The objective of this study was to identify the facilitators and restrictive factors promoted by the organizational culture on the implementation of a continuous improvement program in a company. The influence of organizational culture on tools used to improve processes and results demonstrate critical factors for international competitiveness, reflecting a company's strategy. Depending on how new working methods are implemented, organizational changes to reduce variation and waste, such as lean production, can affect the employee experience in the workplace and their learning conditions. Changes and formalization of the work process can be coercive, characterized by forced compliance, introduction of rules, and focus on technical and financial methods; or may be favorable, encouraging employee involvement in problem solving and stressing learning and innovation. The basis of the analysis lies with two models for assessing organizational culture - Denison Model and Competing Values Framework. The methodology used was: conducting interviews, a questionnaire, literature review and documentary analysis of a large company equipment industry. Results suggest that organizational culture plays an important role in the adoption of Lean practices. It can contribute to its effectiveness and job satisfaction, but it is not decisive feature of their success. The conclusion is that the organizational culture becomes a driving factor when aligned to the proposed practices and when taken into consideration for planning, acting as a limitation when it does not promote development and a participative environment

Influência da cultura organizacional na implementação de um programa de melhoria contínua de uma empresa de grande porte

The objective of this study was to identify the facilitators and restrictive factors promoted by the organizational culture on the implementation of a continuous improvement program in a company. The influence of organizational culture on tools used to improve processes and results demonstrate critical factors for international competitiveness, reflecting a company's strategy. Depending on how new working methods are implemented, organizational changes to reduce variation and waste, such as lean production, can affect the employee experience in the workplace and their learning conditions. Changes and formalization of the work process can be coercive, characterized by forced compliance, introduction of rules, and focus on technical and financial methods; or may be favorable, encouraging employee involvement in problem solving and stressing learning and innovation. The basis of the analysis lies with two models for assessing organizational culture - Denison Model and Competing Values Framework. The methodology used was: conducting interviews, a questionnaire, literature review and documentary analysis of a large company equipment industry. Results suggest that organizational culture plays an important role in the adoption of Lean practices. It can contribute to its effectiveness and job satisfaction, but it is not decisive feature of their success. The conclusion is that the organizational culture becomes a driving factor when aligned to the proposed practices and when taken into consideration for planning, acting as a limitation when it does not promote development and a participative environment

Retribuzione flessibile e contrattazione collettiva

Nel presente lavoro vengono esaminate le forme impiegate dalla contrattazione collettiva per rendere aleatorio il trattamento economico dei lavoratori subordinati. Dapprima ci si occupa del limite alla “flessibilizzazione” della retribuzione dei lavoratori subordinati che viene individuato nella “retribuzione sufficiente” di cui all’art. 36 Cost., qualificata come elemento essenziale del contratto. Di seguito si sofferma l’attenzione sulla retribuzione di produttività e di redditività dei lavoratori del settore privato e sul trattamento accessorio dei dipendenti pubblici privatizzati. Nonostante a queste quote della retribuzione sia astrattamente conferita una funzione incentivante, in concreto non la svolgono: nel lavoro privato a causa della politica egualitaria del sindacato e della “modalità” di determinazione degli obiettivi, nel lavoro pubblico perché questa parte della retribuzione è stata tradizionalmente erogata “a pioggia”. Nel terzo capitolo si prendono in considerazione le liti che possono sorgere se, nel periodo di tempo che va dalla fissazione degli obiettivi a quando si deve verificare il loro conseguimento, il datore di lavoro apporti modifiche organizzative in grado di ripercuotersi sulla capacità dei prestatori di raggiungere i risultati. Al fine di risolvere tale questione, in chiusura del secondo capitolo, la clausola in tema di retribuzione flessibile è stata classificata come condizione sospensiva in quanto una parte del trattamento economico, aggiuntiva alla retribuzione “base”, viene subordinata al conseguimento di obiettivi di produttività e redditività qualificabili come eventi futuri ed incerti. Tale qualificazione è volta a consentire l’applicazione dell’art. 1359 c.c. nelle controversie sopra descritte: se i lavoratori non conseguono gli obiettivi a causa di modifiche che il datore di lavoro ha apportato all’organizzazione, si può fingere che l’evento (che non si è verificato per una condotta imputabile al datore di lavoro) si sia verificato e, di conseguenza, erogare la retribuzione di risultato ai prestatori.

A threshold hypothesis of institutional change: collective action in the Italian Alps during the 13th - 19th centuries.

This dissertation is about collective action issues in common property resources. Its focus is the “threshold hypothesis,” which posits the existence of a threshold in group size that drives the process of institutional change. This hypothesis is tested using a six-century dataset concerning the management of the commons by hundreds of communities in the Italian Alps. The analysis seeks to determine the group size threshold and the institutional changes that occur when groups cross this threshold. There are five main findings. First, the number of individuals in villages remained stable for six centuries, despite the population in the region tripling in the same period. Second, the longitudinal analysis of face-to-face assemblies and community size led to the empirical identification of a threshold size that triggered the transition from informal to more formal regimes to manage common property resources. Third, when groups increased in size, gradual organizational changes took place: large groups split into independent subgroups or structured interactions into multiple layers while maintaining a single formal organization. Fourth, resource heterogeneity seemed to have had no significant impact on various institutional characteristics. Fifth, social heterogeneity showed statistically significant impacts, especially on institutional complexity, consensus, and the relative importance of governance rules versus resource management rules. Overall, the empirical evidence from this research supports the “threshold hypothesis.” These findings shed light on the rationale of institutional change in common property regimes, and clarify the mechanisms of collective action in traditional societies. Further research may generalize these conclusions to other domains of collective action and to present-day applications.