Fisioterapia no sistema único de saúde : estudo etnográfico de representações e práticas em saúde em Porto Alegre

Este trabalho aborda as representações e práticas dos fisioterapeutas inseridos no Sistema Único de Saúde. Com o intuito de desvendar o modo de pensar e agir, além do nível de inserção que alcançou a fisioterapia dentro do Sistema Único de Saúde, busquei compreender a lógica orientadora de suas ações terapêuticas bem como sua adequação às diretrizes desse Sistema. Para tal, utilizei uma abordagem antropológica de cunho qualitativo com o privilégio da observação participante e entrevistas semi-estruturadas realizadas em dois serviços de saúde de Porto Alegre: um hospital e um ambulatório de nível secundário. A revisão histórica da profissão ajudou na contextualização e, deste modo, entender por que os fisioterapeutas estão centrados na abordagem física das pessoas. Esse modo de tratar as pessoas é ensinado aos profissionais no processo de formação e reforçado na prática profissional dirigida à reabilitação, tendo o manuseio do paciente um valor importante para o fisioterapeuta. Por sua vez, este tipo de trabalho manual associado a um papel feminino do cuidado são fatores de demérito frente as outras profissões da saúde. Isto reforça a posição hierárquica inferior que o profissional possui dentro do Sistema Único de Saúde, que em alguns momentos é confundido como um especialista da medicina física. Desse modo, este trabalho contribuiu para repensarmos as concepções de saúde que são ensinadas na academia, o que vem a ser o “fazer fisioterapêutico”, bem como, a integralidade das ações terapêuticas dentro do Sistema Único de Saúde.

Modelo estratégico de gestão de pessoas e resiliência organizacional: uma análise do processo de mudança de uma empresa brasileira de energia

A pesquisa teve como objetivo realizar um estudo de qual é o modelo de gestão e quais são os principais desafios na implementação do novo modelo de gestão de pessoas por competências em empresa do setor de energia, reconhecida pela excelência técnica e inovação, com operação no Brasil e em outros países, denominada neste estudo como EBE S.A. O método utilizado foi o de estudo de caso. A problemática respondida foi: Quais são os principais desafios na implementação do novo modelo de gestão de pessoas estratégico também denominado gestão por competências em uma grande empresa do setor energético, na visão dos entrevistados? A coleta de dados estruturou-se através de análise documental de fontes primárias e secundárias; observação e observação participante; e entrevistas em profundidade semiestruturadas. A partir da categorização dos dados coletados, foi criada uma tipologia com a definição de três grupos organizacionais distintos. A resposta de cada um desses grupos ao processo de mudança que está ocorrendo na EBE S.A., referente à implementação do modelo de gestão estratégica de pessoas, foi analisado à luz de três perspectivas de análise organizacional: participação e autonomia; desenvolvimento de competências; incentivos organizacionais e trocas sociais. Os resultados da pesquisa evidenciam que a resposta dos grupos organizacionais ao processo de mudança que está em curso na empresa estudada tem relação com o modelo de gestão de pessoas vivenciado por cada grupo, ressaltando que o modelo estratégico de gestão de pessoas contribui para a criação de um ambiente resiliente de aprendizagem e inovação, capaz de gerar redesenhos radicais (técnicos e sociais) constantes que possibilitem o alcance de vantagens competitivas sustentáveis.

Análise do mercado de trabalho e carreira nas indústrias criativas do Estado de São Paulo

O objetivo desta investigação foi estender o conceito de carreiras sem fronteiras para compreensão das carreiras de artistas selecionados num core de setores pertencentes às indústrias criativas do Estado de São Paulo. Complementarmente, buscou mapear características ocupacionais desses setores. Para tanto, combinou técnicas qualitativas, com entrevistas semiestruturadas com vinte artistas do core criativo em questão, e quantitativa, analisando descritivamente os microdados extraídos da PNAD/IBGE 2006. Os resultados desta análise estatística mostram que o núcleo de ocupações criativas analisadas representa apenas 1,5% das ocupações do Estado de São Paulo, e que 65% delas são de ocupações autônomas, com 70% de seus ocupantes ganhando até três salários mínimos por mês. Os resultados qualitativos mostram que os artistas tendem a entrar precocemente para o mundo das artes, são, em geral, autodidatas, usam a diversificação de atividades como estratégia de carreira, quando não uma dupla carreira. Adicionalmente, revelam-se afetivamente mais comprometidos com o trabalho, o qual diferenciam de emprego. Entre as qualidades negativas desse mercado, esta pesquisa confirma a oscilação e instabilidade financeira e a luta árdua pela construção da reputação e reconhecimento profissional. O estudo traz ainda algumas hipóteses para posterior investigação.

Gestão do trabalho das pessoas com deficiência no campo da saúde pública

Em virtude da reserva de vagas prevista em legislação, a presença de pessoas com deficiência - PcDs é cada vez mais frequente nas organizações públicas. Percebe-se que nem sempre essas organizações estão preparadas, quer seja arquitetonicamente quer seja por uma cultura de inclusão, para receber e gerir essa força de trabalho. Diante desse contexto, o presente estudo procurou discutir as práticas de gestão das pessoas com deficiência na área pública, a partir do enfoque da inclusão, utilizando o caso do Instituto Nacional de Câncer José Alencar Gomes da Silva - INCA. Para a construção do estudo foi realizada uma pesquisa qualitativa com análise documental e com entrevistas semiestruturadas. No intuito de abarcar a visão dos diferentes grupos de pessoas que estão diretamente envolvidos com a temática no INCA foram entrevistados três tipos de profissionais, a saber: servidores com deficiência, chefias diretamente ligadas a essas PcDs e chefia da área de gestão de pessoas. Constata-se uma preocupação do instituto em cumprir a determinação legal de ocupação das cotas reservadas no quadro de pessoal para as PcDs, porém ainda não foram desenvolvidos ou adaptados instrumentos institucionais de gestão que permitam a inclusão efetiva desses profissionais. Verificou-se também que a adaptação do INCA às dimensões de acessibilidade - arquitetônica, comunicacional, metodológica, instrumental, programática e atitudinal – ainda é incipiente. Formalmente não há nenhum elemento que impeça a participação das PcDs nos subsistemas de gestão de pessoas do INCA, contudo nem sempre são criadas e institucionalizadas as ferramentas necessárias à autonomia e à plena participação desses profissionais.

Development of a dynamic headspace solid-phase microextraction procedure coupled to GC–qMSD for evaluation the chemical profile in alcoholic beverages

In the present study, a simple and sensitive methodology based on dynamic headspace solid-phase microextraction (HS-SPME) followed by thermal desorption gas chromatography with quadrupole mass detection (GC–qMSD), was developed and optimized for the determination of volatile (VOCs) and semi-volatile (SVOCs) compounds from different alcoholic beverages: wine, beer and whisky. Key experimental factors influencing the equilibrium of the VOCs and SVOCs between the sample and the SPME fibre, as the type of fibre coating, extraction time and temperature, sample stirring and ionic strength, were optimized. The performance of five commercially available SPME fibres was evaluated and compared, namely polydimethylsiloxane (PDMS, 100 μm); polyacrylate (PA, 85 μm); polydimethylsiloxane/divinylbenzene (PDMS/DVB, 65 μm); carboxen™/polydimethylsiloxane (CAR/PDMS, 75 μm) and the divinylbenzene/carboxen on polydimethylsiloxane (DVB/CAR/PDMS, 50/30 μm) (StableFlex). An objective comparison among different alcoholic beverages has been established in terms of qualitative and semi-quantitative differences on volatile and semi-volatile compounds. These compounds belong to several chemical families, including higher alcohols, ethyl esters, fatty acids, higher alcohol acetates, isoamyl esters, carbonyl compounds, furanic compounds, terpenoids, C13-norisoprenoids and volatile phenols. The optimized extraction conditions and GC–qMSD, lead to the successful identification of 44 compounds in white wines, 64 in beers and 104 in whiskys. Some of these compounds were found in all of the examined beverage samples. The main components of the HS-SPME found in white wines were ethyl octanoate (46.9%), ethyl decanoate (30.3%), ethyl 9-decenoate (10.7%), ethyl hexanoate (3.1%), and isoamyl octanoate (2.7%). As for beers, the major compounds were isoamyl alcohol (11.5%), ethyl octanoate (9.1%), isoamyl acetate (8.2%), 2-ethyl-1-hexanol (5.9%), and octanoic acid (5.5%). Ethyl decanoate (58.0%), ethyl octanoate (15.1%), ethyl dodecanoate (13.9%) followed by 3-methyl-1-butanol (1.8%) and isoamyl acetate (1.4%) were found to be the major VOCs in whisky samples.

Volatile flavour constituent patterns of terras madeirenses red wines extracted by dynamic headspace solid‐phase microextraction

A suitable analytical procedure based on static headspace solid-phase microextraction (SPME) followed by thermal desorption gas chromatography–ion trap mass spectrometry detection (GC–ITDMS), was developed and applied for the qualitative and semi-quantitative analysis of volatile components of Portuguese Terras Madeirenses red wines. The headspace SPME method was optimised in terms of fibre coating, extraction time, and extraction temperature. The performance of three commercially available SPME fibres, viz. 100 lm polydimethylsiloxane; 85 lm polyacrylate, PA; and 50/30 lm divinylbenzene/carboxen on polydimethylsiloxane, was evaluated and compared. The highest amounts extracted, in terms of the maximum signal recorded for the total volatile composition, were obtained with a PA coating fibre at 308C during an extraction time of 60 min with a constant stirring at 750 rpm, after saturation of the sample with NaCl (30%, w/v). More than sixty volatile compounds, belonging to different biosynthetic pathways, have been identified, including fatty acid ethyl esters, higher alcohols, fatty acids, higher alcohol acetates, isoamyl esters, carbonyl compounds, and monoterpenols/C13-norisoprenoids.

Characterization of volatile substances in apples from rosaceae family by headspace solid‐phase microextraction followed by GC‐qMS

The volatile composition of different apple varieties of Malus domestica Borkh. species from different geographic regions at Madeira Islands, namely Ponta do Pargo (PP), Porto Santo (PS), and Santo da Serra (SS) was established by headspace solid-phase microextraction (HS-SPME) procedure followed by GC-MS (GC-qMS) analysis. Significant parameters affecting sorption process such as fiber coating, extraction temperature,extractiontime,sampleamount,dilutionfactor,ionicstrength,anddesorption time,wereoptimizedanddiscussed.TheSPMEfibercoatedwith50/30 lmdivinylbenzene/carboxen/PDMS (DVB/CAR/PDMS) afforded highest extraction efficiency of volatile compounds, providing the best sensitivity for the target volatiles, particularly whenthesampleswereextractedat508Cfor30 minwithconstantmagneticstirring. A qualitative and semi-quantitative analysis between the investigated apple species has been established. It was possible to identify about 100 of volatile compounds amongpulp(46,45,and39),peel(64,60,and64),andentirefruit(65,43,and50)inPP, PS,andSSapples,respectively.Ethylesters,terpenes,andhigheralcoholswerefound tobethemostrepresentativevolatiles. a-Farnesene,hexan-1-olandhexyl2-methylbutyratewerethecompoundsfoundinthevolatileprofileofstudiedappleswiththelargestGCarea,representing,onaverage,24.71,14.06,and10.80%ofthetotalvolatilefractionfromPP,PS,andSSapples.InPPentireapple,themostabundantcompoundsidentified were a-farnesene (30.49%), the unknown compound m/z (69, 101, 157) (21.82%) andhexylacetate(6.57%).RegardingPSentireapplethemajorcompoundswere a-farnesene(16.87%),estragole(15.43%),hexan-1-ol(10.94),andE-2-hexenal(10.67).a-Farnesene(30.3%),hexan-1-ol(18.90%),2-methylbutanoicacid(4.7%),andpentan-1-ol(4.6%) werealsofoundasSSentireapplevolatilespresentinahigherrelativecontent.Principal component analysis (PCA) of the results clustered the apples into three groups according to geographic origin. Linear discriminant analysis (LDA) was performed in order to detect the volatile compounds able to differentiate the three kinds of apples investigated. The most important contributions to the differentiation of the PP, PS, and SS apples were ethyl hexanoate, hexyl 2-methylbutyrate, E,E-2,4-heptadienal, pethylstyrene,andE-2-hexenal.

Headspace solid-phase microextraction-gas chromatography-quadrupole mass spectrometric methodology for the establishment of the volatile composition of Passiflora fruit species

Dynamic headspace solid-phase microextraction (HS-SPME) followed by thermal desorption gas chromatography-quadrupole mass spectrometry analysis (GC-qMS), was used to investigate the aroma profile of different species of passion fruit samples. The performance of five commercially available SPME fibres: 65 μm polydimethylsiloxane/divinylbenzene, PDMS/DVB; 100 μm polydimethylsiloxane, PDMS; 85 μm polyacrylate, PA; 50/30 μm divinylbenzene/carboxen on polydimethylsiloxane, DVB/CAR/PDMS (StableFlex); and 75 μm carboxen/polydimethylsiloxane, CAR/PDMS; was evaluated and compared. Several extraction times and temperature conditions were also tested to achieve optimum recovery. The SPME fibre coated with 65 μm PDMS/DVB afforded the highest extraction efficiency, when the samples were extracted at 50 °C for 40 min with a constant stirring velocity of 750 rpm, after saturating the sample with NaCl (17%, w/v — 0.2 g). A comparison among different passion fruit species has been established in terms of qualitative and semi-quantitative differences in volatile composition. By using the optimal extraction conditions and GC-qMS it was possible to tentatively identify seventy one different compounds in Passiflora species: 51 volatiles in Passiflora edulis Sims (purple passion fruit), 24 in P. edulis Sims f. flavicarpa (yellow passion fruit) and 21 compounds in Passiflora mollissima (banana passion fruit). It was found that the ethyl esters comprise the largest class of the passion fruit volatiles, including 82.8% in P. edulis variety, 77.4% in P. edulis Sims f. flavicarpa variety and 39.9% in P. mollissima. The semi-quantitative results were then submitted to principal component analysis (PCA) in order to establish relationships between the compounds and the different passion fruit species under investigation.

Eficiência, gestão e meio ambiente na carcinicultura do Rio Grande do Norte

SILVA, J. L. M. da; SAMPAIO, L. M. . Eficiência, Gestão e Meio Ambiente na Carcinicultura do Rio Grande do Norte. In: Congresso da Sociendade Brasileira de Economia, Administração e Sociologia Rural - SOBER, 40., 2007, Londrina. Conhecimentos para a Agricultura do Futuro, 2007.

Inserção de fornecedores locais como fonte de desempenhos em custos de transação e legitimidade: estudo de caso na cadeia produtiva do petróleo e gás do Rio Grande do Norte

The inclusion of local suppliers in production chains has considerable impact on its performance, but most notably in its main actors. The results of this process may be of different kinds and can be analyzed from economic or institutional approaches. This study aimed to verify the existence of different performances of Petrobras due to the inclusion of local suppliers in the oil and gas production chain in the state of Rio Grande do Norte, from the viewpoints of transaction costs and the Institutional Theory. In order to this, were made the characterization of the PROMINP, the description of its actions and results, the mapping of its institutional context of reference, and identification of results obtained by Petrobras in terms of transaction costs and legitimacy. The theoretical framework is based on authors dealing with industrial concentration, as like Marshall, Krugman, Porter and Schmitz, from the sociological perspective of neoinstitucional theory, as like DiMaggio and Powell and Scott and Meyer, and transaction costs, as like Williamson. This is a qualitative research, with data collection done by consulting secondary fonts and semi-structured interviews with nineteen actors of three groups, namely: actors involved in actions of the program, representatives of enterprises and representative of Petrobras. To analyze the content was used the Suchman s model (1995) for categories associated with strategies of legitimation and fourteen variables associated with the three variables assets specificity, bounded rationality and opportunism (Williamson, 1995, 1989) in the case of transaction costs. The results indicate that PROMINP has achieved its objectives by encouraging the increased participation of local companies in the oil and gas production chain, reflecting in the economic development of the state. The Redepetro/RN, fostered and built upon the interaction of the participants, is presented as a solution of continuity to the participation of enterprises in the chain, after the closure of the actions of the program. PROMINP demands responses to coercive, legislative and regulatory pressures of the organizational field, whose institutional context of reference is wide. From the point of view of legitimacy, through strategies to gain cognitive legitimacy and maintaining pragmatic legitimacy, Petrobras can manipulate the environment, ensuring the compliance of the constituents to their technical and institutional demands. Enterprises, in turn, respond to the demands through compliance with technical demands, mainly through the certification of processes, and cultural changes. There aren t clear gains related to the transaction costs, however, gains in legitimacy can be seen as a cumulative capital that can serve as a competitive differential that generates economic gains. In terms of theoretical findings, it was found that, due to its explanatory power for actions that are difficult to explain only in economic terms, Institutional Theory may be used as theoretical support concurrent with other theories. TCE model has limitations in explaining the program actions. In the case, it s emphasized that Petrobras doesn t seek only economic efficiency, but has in its mission the commitment to social development.

Gestão colegiada da cadeia produtiva da cajucultura: o papel do comitê gestor no Rio Grande do Norte à luz do desenvolvimento regional sustentável

The theme of this dissertation is the collegiate management in the cashew cultivation s productive chain by the reading of the Managerial Committee s role in accordance with Sustainable Regional Development. The research had as aim to reveal the way as Managerial Committee s members of cashew cultivation s productive chain interpret the economic, social and environmental dimensions to the sustainability of entrepreneurships, using as interpretative base Sachs (2004) theoretical model. The theoretical reference is based in precepts of Solidarity Economy as a strategy to the Sustainable Regional Development. To reach this aim was done a case study, based in analysis of contents and semi-structured interviews with the solidarities economic entrepreneurships that integrate the Committee and with the group of Entities of Support and Fomentation responsible for formulating and conducting actions in favour of development of the chain. The research permitted to conclude that the economic, mainly, and social dimension, secondly, to super-impose the environmental dimension. The actions in favour of the chain are yet restricted and with low effectiveness when interpreted, in an integrated way, by a side, by the informers of this research and, by another side, in accordance with precepts of sustainable development

Estrutura de organizações sociais: adaptação aos projetos sociais ou às pressões institucionais?

This is a study concerning in the structure of non governmental organizations, based on the institutional theory. It aims to understand the relation among structure, social projects and environmental influences, analyzing if there is coherence with project social or expresses adaptation to the institutional pressures of the environment. It introduces as theoretical support for the themes, studies about institutional theory and social structure. The research is descriptive and exploratory; it also applies to a study of case, based on the technical procedures. From the research universe, that was compound by non governmental organizations from Natal, RN, Brasil, it was chosen the Casa Renascer, a non governmental organization that works with the combat to the violence and sexual exploration of children and teenagers. The data collection process employed includes documental research, observations and semi structured research devices, guided by the organizational process proposed by Serva (1996) and by the institutional theory. The collected data were qualitatively treated. The analysis was divided into three parts, following the research matters. The social project characterization demonstrated that the organization went by three main phases. The first one, characterized by focus in women and girls education and health; the second shows the emphasis on girls in social risk situation, with preventive approach; and the last one, characterized by victims assistance of violence and sexual exploration. From the analysis using the institutional theory mechanisms, the results showed that exists coherence between structure and environmental influences, but a weak coherence between structure and social projects. It indicates as main determinant of the structure, an aspect forgotten by the institutional theory, the power. It was observed the presence from normative, coercive and mimetic mechanisms, highlighting normative influences

A comunicação interna numa organização pública

The present study compose an analysis on the process of internal communication at a public organization, built on the survey data originary of administrative conduct, observation on the cultural model of the organization and how the interdepartmental and interpersonal relations shows up. The research, exploratory descriptive kind, had theoretical basis on two knowledge areas Administrative Science and Social Communication and was developed at Instituto do Desenvolvimento Econômico e Meio Ambiente IDEMA, in Rio Grande do Norte. During data collection, were conducted spontaneous and semi structured interviews with directors and coordinators, besides the application of directed questionnaire to functionaries in two unites of the institution. Through the analysis and interpretation of the data, we came to the conclusion that the process of internal communication at a public organization fall in with same challenges of private organizations, but with peculiarities that attracts the scientific look specially, in concern of the attitude assumed by the administrators in the conduction of communication functions inside the organization, the profile of social actor and the communication channels used. Although the organizational communication represents more and more a strategic function, as an administration tool, the point that research gets to shows that in public organizations the communication refrains from administrative purpose and with the major objective of giving publicity to the institutional acts and actions

Violência institucional no âmbito da saúde reprodutiva : a percepção de mulheres usuárias do SUS, na cidade de Natal/RN

Institutional violence ranges from the most widespread lack of access to the poor quality of services provided. It includes abuses committed by virtue of the unequal power between patients and professionals within institutions. The aim of this study was to analyze the perception of women with regard to this type of violence, in the services offered at a reproductive health facility belonging to the National Health System (SUS) in Natal, Brazil. Interdisciplinary perspective is important, in that it provides interaction and complementarity between various disciplines, favoring, in an integrated way, a thematic approach in research activities, teaching and extension, involving professionals, students and researchers in medicine, social services, psychology, nursing, anthropology and physical therapy. A quantitative/qualitative approach was used, involving a sample of 401 women, as part of a transversal observational study. In the qualitative stage, which consisted of participatory observation and semi-structured interviews, we used an intentional sample of 10 individuals. The data were analyzed using logistic regression techniques, correspondence analysis and categorical thematic content analysis, showing that the 2 questions that investigated directly the perception of institutional violence obtained affirmative response frequencies of 28.2% and 31.8%, respectively. In regard to data collected in a field diary related to participatory observation, the main complaints referred to the health providerpatient relation, translated into dissatisfaction with the interpersonal relationship and with the resolution of the specific demand that required care. From content analysis, we classified 4 categories: Access; Information; Health professionalpatient relation; and Respect/dignity. We identified 6 subcategories: Impossibility of choice; Repressed demand; Communication difficulty; Asymmetric interpersonal relations; Privacy/confidentiality; Disrespect. We concluded, therefore, that the data presented show that in the reproductive health care programs, there are indicators of institutional violence. However, it is difficult to approach this phenomenon, mainly because of the power relations involved in the patient-health care provider interaction, resulting from unawareness that determinate situations violate sexual and reproductive rights. This can be explained by sociostructural questions that reveal marked inequalities, ratified by issues related to violation of the rights of National Health System (SUS) patients

Atenção ao usuário em um centro de referência HIV/Aids: perspectiva de profissionais e usuários

We study the health care focused on care in an intercessor and dialogical relationship with the User, which involves the construction of therapeutic projects essential to the quality of the treatment of the user in health services, and it is necessary individual and collective actions. It is intended to acknowledge and analyze the perception of social subjects, users and professionals on the treatment given to a user of a Specialized Outpatient Service (Serviço Ambulatorial Especializado SAE) in STD/HIV/AIDS state reference in Natal, RN. The study is structured in a transdisciplinary vision of science and knowledge, theoretical and methodological principles that give meaning to the expression of the institutional features of care and health care reconnecting them to the social context. As a research strategy we seek the expressions of 56 subjects of social research, which agreed to participate in the sample, from a symbolic map of the attention, coupled with the techniques of observation and semi-structured interview. For the analysis of the results, five categories of analysis were established: the meaning of the service, care perception, process of communication and interaction, treatment perception and organization and evaluation of the service. It is argued that the attention and care are developed in a technical health care assistance to the disease, focusing on attention based on treatment, on diagnostic and drug therapy of antiretroviral drugs, reflecting the traditional biomedical paradigm of attention to the disease. This is also the mode of organization of practical actions in daily SAE: the therapy proves to be fragmented in several specialties, vertical and feeds the same model, generating tension and overload for professionals; showing impersonal care focused on structured and informative technology, unrelated to an interactive dialogic. From the speech of the subjects, the SAE is understood as the place of confrontation with the disease, but also enables greater elaboration of the illness by meeting their peers. Living with HIV and AIDS is living with concern, apprehension and fear, but mainly with the stigma, prejudice and exclusion, which require that the disease is kept in secret. There is a movement of forces and power, expressed in the knowledge-power of those who dominate the technical and administrative capabilities, devices that concentrate the maintenance of the medicalization of care, rapid consultations and with little attention, making it difficult to interact with and listen to, combined with structural failures, organizational and inadequate management of the service. We conclude that there are dimensions that are not considered in the internal dynamics of the care service multiple forms, characterized by care conflicting models, marked by individual interventions related to the disease. The subject is not considered together with his speech as technical discourse is imposed and care production based on material technology is observed