Fragilidades dos mecanismos de controle das organizações sociais de saúde no município do Rio de Janeiro

Nosso problema de pesquisa neste trabalho é a avaliação do funcionamento dos principais mecanismos de controle das organizações sociais de saúde, no caso específico do Município do Rio de Janeiro. As reiteradas denúncias de irregularidades e ilegalidades pelo Tribunal de Contas do Município do Rio de Janeiro e pelo Ministério Público do Estado do Rio de Janeiro levantaram dúvidas acerca da adequação dos processos de monitoramento, fiscalização e controle dessas entidades. Disto decorre nosso objetivo central de pesquisa, que é identificar as fragilidades do novo modelo de gestão por organizações sociais de saúde, no caso da cidade do Rio de Janeiro. Para isso, foram analisados: o arcabouço jurídico-normativo do modelo local, a partir de análise comparativa da legislação municipal que regulamenta seu funcionamento (Lei 5.026/09) e sua contraparte federal (Lei 9.637/98); indicadores de saúde que mensurassem o desempenho das OSS; todas as inspeções realizadas pelo TCM-RJ até o fim de 2015; e o conjunto de recomendações enviado pelo MP-ERJ para a Prefeitura após deflagração da Operação Ilha Fiscal, que acarretou a desqualificação da OS BIOTECH e a prisão de seus dirigentes, acusados de desviar mais de R$48 milhões em recursos públicos. Ao final, constatouse que as fragilidades da legislação municipal e dos decretos executivos que regulamentam a atuação das OSS no MRJ não permitem o exercício efetivo do comando da parceria, em afronta, portanto, ao dispositivo constitucional que determina que a atuação de entidades privadas no âmbito do SUS pode se dar apenas de modo complementar. Ademais, verificou-se total inadequação da estrutura de controle pela Prefeitura, cuja principal consequência foi tornar o modelo de reforma gerencialista em um modelo que incentiva o comportamento patrimonialista no âmbito da saúde pública, uma vez que o controle de meios é absolutamente negligenciado.

Do tratamento das reclamações à gestão da insatisfação: o comportamento de empresas hoteleiras mediante a insatisfação de seus clientes

Consumer dissatisfaction, when properly handled, is a significant information source for the manager. Studies in this area allow broadening the understanding of certain customer attitudes and behaviors, such as loyalty, repurchase intention or satisfaction and trust increase. Above and beyond supporting consumer feedback, dissatisfaction can provide significant opportunities for organizational learning. Starting from dissatisfied customer information, companies can detect service flaws and develop new products. This work presents the results of an investigation on the behavior of businesses belonging to the hotel sector in Natal, RN, through the dissatisfaction of their customers. We have sought to map the main problems presented by customers to hotels, in the perception of managers and employees, as well as to understand both the process of dissatisfactionrelated data collection, analysis, and processing, and the utilization of such information by businesses. Beyond this, we have compared the habits of organizations to the company reaction approaches described in the literature: Complaint Handling, Complaint Management, and Dissatisfaction Management. The used methodology has been based on case study. Data was collected via indepth interviews with managers and employees in six hotels, two independent ones and four belonging to national and international hotel networks. We have also made use of documents provided by the organizations, such as guest complaint registers and reports from satisfaction surveys on which content analysis was subsequently performed. The results of the investigation point to a high level of awareness in the companies concerning the importance of consumer dissatisfaction. Even though the maximum grade in the procedure scale is not achieved, it has been observed that answer to dissatisfaction is given in planned and systematic form, geared towards consumer satisfaction and improvement of products and processes. Hotel businesses still have to look into other possibilities for mapping consumer dissatisfaction, which implies, among other aspects, articulation with a range of public and private organizations in such a way as to guarantee sustainability of touristic activities in the long term

Práticas sócio-ambientais no espaço escolar: uma reflexão sobre a percepção dos usuários de duas escolas do ensino fundamental em João Pessoa, Paraíba

In the social-historical moment we live in, it is each time more evident the necessity of the people to learn to deal with the environment in conscientious way, taking care of themselves properly through it. In this direction, considering the school as a place where children, young and adolescents spend great part of their time, this work had as objective to examine the perception of school environment for students, professors and employees of two schools in João Pessoa city - Centro Estadual Experimental de Ensino-Aprendizagem Sesquicentenário and Escola Estadual de Ensino Fundamental e Médio Presidente Emílio Garrastazu Médici (Experimental State Center of Learning-teaching Sesquicentenário and Basic and High State School Education Emilio Garrastazu Médici President). From the presupposed that the environments in which and with which people live reflect their daily practices, the field work searched to identify the social-environmental practices that characterize the relation of these users with the school and, from this understanding, to infer some of their concerns regarding the environment as a whole. To analyze the use of the available physical space in the two institutions it was opted the use of the After-Occupation Evaluation, one of the approaches that feed the process of building production or built set, rescuing aspects related to its use, operation and maintenance. Besides analyzing diverse school environments (such as classroom circulations/accesses, library, pedagogical and sportive spaces) in relation to the environmental comfort and the perceptions of the main users of the schools (pupils, professors and employees), the dissertation tried to inquire the care (ambient education) of these users with the school space. In general, it was verified that the two schools have evaluations and perceptions really different for four reasons: (i) management of the schools; (ii) the users perception; (III) localization of schools and (IV) feeling of place, territoriality and appropriation

Da promessa à realidade: a cidade potiguar do século XIX, a partir do olhar da elite

The purpose of this research is to apprehend the perception that the ruling elite, especially the Presidents of the province of Rio Grande do Norte/Brazil, had about the potiguar city, that is, the urban localities existing in the province along the 19th century. By interweaving political, administrative, socioeconomic and spatial aspects, the study of this perception involves two distinct moments, which are also linked: a moment of apprehension of the city, that is, how the elite seizes, describes and criticizes the city; and, a second moment, which occurs simultaneously or after the first moment, of intervention in the city, in which the elite exposes its vision and projects for the city and for the territory. Rather than describing the potiguar city in itself, the research is an attempt to reveal how it was perceived along this process from a particular standpoint or discourse, official and elitist, which did not correspond necessarily or completely to what it was in reality. We tried to understand, always through the lens of the discourse, how the ruling elite perceived the potiguar city based on what their members thought about other urban realities, particularly of the advanced countries; how, within an integrated vision, this city was characterized in political, administrative, socioeconomic and spatial terms and how it consolidated itself along the period established for the research. Qualitative and historical in nature, this study was also methodologically developed based upon bibliographical and documental research. Given the fact that this research works with descriptions, comparisons and interpretations, it was necessary to make use of tools such as the discourse analysis in order to apprehend, as much as possible, what lay behind the words of the elite. The primary sources used were essentially the official documents produced by the Presidents of the province, as well as other documents written by top government officials and other members of the administration staff, all of them composing the so-called ruling elite of Rio Grande do Norte. Secondary sources were books and other publications, theses and dissertations, among others. The research made possible the identification of a certain perception of the potiguar city in the 19th century, which is certainly limited because it is grounded on a specific discourse - that of the political and administrative elite, but which, in spite of such a limitation, is still useful to understand the city and its evolution along the period established, among other noteworthy remarks

O terciário (re) desenhando a periferia: a região administrativa norte de Natal/RN, na última década do século XX, servicializada na Av. Dr. João Medeiros Filho

The tertiary sector has been (re)defining and (re)qualifying, in an impacting way, the urban spaces in the cities, introducing new elements for the discussion of the relationship center/periphery. In Natal, as an inducing economic activity of its development, it conforms to the new needs of the capital, expanding, being materialized through several processes and spatial forms. We aim at analyzing one of those processes, which has taken its Northern Administrative Area to (re)define the design of its urban space, through the actions developed by the agents involved with the spatialization of the tertiary activities, at the same time as it redimensions its role as a periphery of Natal, contributing to the study of the recent and growing transformations of the Brazilian capitals. The studied district corresponds to 39.4% of the municipal area and, until recently, was composed by precarious reproduction spaces, unprovided of relevant economical activities. After the boom of the development of extensive housing complexes by SFH/BNH, the area, gradually stopped being a dependent area, and it imposed itself as an economically participant region, with the increase of the trade and services sectors, as well as a favorable place for the appearance of new activities. Its reflexes are noticeable in the achieved spatial configuration. As the main road to induct changes, Dr. João Medeiros Filho Avenue presents these new tendencies in the production of the intraurban space, concentrating the largest goods and services equipments of the area, through investments of the private and public sectors, which guarantee the capital allocation for the construction of a new centrality

Condomínios fechados: a produção habitacional contemporânea e a auto-exclusão dos ricos no espaço urbano de Natal RN (1995 2003)

The present work analyzes the fast evolution of gated communities in Natal-RN´s urban space. Characterized by the occupation of large areas, providing private security and utilities, this kind of real estate use arises a long list of questions and issues from society and scholars, due to privatization of urban space, bending of law constraints and the lack of an integrated planning of the cities where they are built. The reasons for its fast growth in Brazil s urban areas are analyzed, considering the impact on formal urban planning and municipal services and on the identification of urbanistic, architectural pattern and constraints, as well as legal, social and economic issues. This study is based on the detailed analysis of the first three units of gated communities built in the urban space in Natal, between 1995 and 2003, including their evolution throughout time and the specific social and economic reasons for its present widespread adoption in Brazilian real estate market and, particulary, in our city. The main objective of this piece of work is to answer the why s and how s these phenomena evolved, setting a basis for the definition of adequate public policies and regulation of this kind of urban land use

Diagnóstico ecotoxicológico dos efluentes lançados no complexo estuarino do Jundiaí/Potengi, Natal/RN

Untreated effluents that reach surface water affect the aquatic life and humans. This study aimed to evaluate the wastewater s toxicity (municipal, industrial and shrimp pond effluents) released in the Estuarine Complex of Jundiaí- Potengi, Natal/RN, through chronic quantitative e qualitative toxicity tests using the test organism Mysidopsis Juniae, CRUSTACEA, MYSIDACEA (Silva, 1979). For this, a new methodology for viewing chronic effects on organisms of M. juniae was used (only renewal), based on another existing methodology to another testorganism very similar to M. Juniae, the M. Bahia (daily renewal).Toxicity tests 7 days duration were used for detecting effects on the survival and fecundity in M. juniae. Lethal Concentration 50% (LC50%) was determined by the Trimmed Spearman-Karber; Inhibition Concentration 50% (IC50%) in fecundity was determined by Linear Interpolation. ANOVA (One Way) tests (p = 0.05) were used to determinate the No Observed Effect Concentration (NOEC) and Low Observed Effect Concentration (LOEC). Effluents flows were measured and the toxic load of the effluents was estimated. Multivariate analysis - Principal Component Analysis (PCA) and Correspondence Analysis (CA) - identified the physic-chemical parameters better explain the patterns of toxicity found in survival and fecundity of M. juniae. We verified the feasibility of applying the only renewal system in chronic tests with M. Juniae. Most efluentes proved toxic on the survival and fecundity of M. Juniae, except for some shrimp pond effluents. The most toxic effluent was ETE Lagoa Aerada (LC50, 6.24%; IC50, 4.82%), ETE Quintas (LC50, 5.85%), Giselda Trigueiro Hospital (LC50, 2.05%), CLAN (LC50, 2.14%) and COTEMINAS (LC50, IC50 and 38.51%, 6.94%). The greatest toxic load was originated from ETE inefficient high flow effluents, textile effluents and CLAN. The organic load was related to the toxic effects of wastewater and hospital effluents in survival of M. Juniae, as well as heavy metals, total residual chlorine and phenols. In industrial effluents was found relationship between toxicity and organic load, phenols, oils and greases and benzene. The effects on fertility were related, in turn, with chlorine and heavy metals. Toxicity tests using other organisms of different trophic levels, as well as analysis of sediment toxicity are recommended to confirm the patterns found with M. Juniae. However, the results indicate the necessity for implementation and improvement of sewage treatment systems affluent to the Potengi s estuary

Protagonismo juvenil: uma avaliação do programa agente jovem de desenvolvimento humano na cidade de Natal RN (2006/2007).

This paper presents a critical rescue of the term youth, while simultaneously is presented as the lifetime of between 15 and 24 years. Rescue two features in the literature. The first considers youth as a transition period and the second phase work that from a predisposition to rebellion. Discusses the design plural of that term, youth recital to this social and historical aspects of different societies to which it relates and highlights the importance of realizing the diversity of it. Where the object of investigation, the Young Agent Program, the overall objective of the study is to evaluate the effectiveness of the actions of the Young Agent Program for Human Development in Natal-RN. Specifically aims to evaluate the effectiveness of the Young Agent Program: a) as an enhancer of the integration of young people in social spaces of family, school and community, b) as to (re) insertion and the incorporation of issues related to health in adolescence, and c ) regarding the work of young people as multipliers of the actions of the program. With regard to the methodological procedures presents a review of the literature on youth, and the categories of human development, leadership and evaluation of youth policies for the construction of theoretical and analytical approach, using documentary data collection in the Municipal Labor and Social Services - SEMT on the Young Agent Program, and interviews with actors involved in the program. Finally, evaluates the effectiveness of the Young Agent Program from the perspective of participants

Processo participativo da população na construção da agenda 21 local:o caso de Parnamirim

One of the agreements assumed at the conference of the United Nations for the Environments and Development which took place in Rio de Janeiro in 1992; through Global Agenda 21, was that the signatory countries would create a national Politics of sustainable development, by means of their national Agenda 21. Demonstrating the relevance of municipal districts and the local communities, during the definitions of new development standards compromised to the transformation of the society, socia1ly and environmentally well-balanced world, it was also agreed on that places under the responsibilities of the municipal districts would promote their own local Agenda 21. We need to point out though that the government has the prerogative and the responsibly of facilitating the population participation process in the construction of national and local Agenda. This made it possible again, to plan the scheming process directly towards the insertion of population participation at the different levels, involving the entire local sectors while establishing a new local partnership through the local municipal government. Thus, we decide to verify the participation of the population in the construction of their local Agenda 21, choosing for the study case Parnamirim municipality from RN. The question which originated the objectives and analysis was formulated on the following terms: Up to which stage was the process of population participation effective in the elaboration of Parnamirims's local Agenda 21? Based on this uneasiness, it was defined as the general objective, the verification of population participation process during the elaboration of Parnamirims's local Agenda 21, aiming at its effectiveness as well as specific objectives; to identify the population representivity, the construction of the local AG 21 in order to identify on which level is the participation based, to verify the strategies used in order to promote the process participation, to identify the motives guiding those involved in the construction of the local Agenda 21. This case study at Parnamirim municipal district demonstrated that there was effective population participation as far as the local Agenda 21 is concerned

Finanças públicas na nova ordem constitucional brasileira: uma análise comportamental dos municípios potiguares, nos anos antecedentes e posteriores à lei de responsabilidade fiscal LRF

The object of the present dissertation is to analyze the behavior of the public finances of the districts of the state of Rio Grande do Norte (RN), taking as reference a period fundamentally previous to the implementation of the Fiscal Responsibility Law LRF, comparatively to the first years, immediately after the advent of the mentioned institutional milestone. The central hypothesis of this study proposes that, from the institutions' viewpoint, the LRF sets securely consistent rules, in the orchestration of the behavior of the municipal revenues and expenses. These regulations, on the other hand, might be effective and reach the districts of the RN indiscriminately, apart from stabilizing tendencies and which are sustainable in the long run. In spite of this, the indicators calculated reveal that the districts researched show, during all the period under analysis, a diminished capacity of self-tax collection , and consequently, a high participation of the intergovernmental transfers in the composition of the current revenues. This behavior indicates that the goal of strengthening the municipal public finances, forecast in the LRF, tends to be only partially accomplished, due to the fiscal decentralism. The analysis and interpretation of the data are conducted from the literature of institutionalist orientation and in descriptive statistical tools applied to the municipal strata of the state of Rio Grande do Norte. Further on, it's used the econometrical method Pooled OLS, which demands the elimination of the municipal strata in order to allow the use of the model, in the attempt to strengthen and/or ratify the results of the research. Finally, the evidence reached in the dissertation show that the LRF brings better conditions to the potiguar municipal public finances, predominantly to the economically stronger districts; whereas the less dynamic municipal entities show rather divergent evidence, that is, their economies seem to be more oriented to a more pronounced state participation; therefore, it generates in the state of RN a certain antithesis in the results reached in the dissertation

A eficiência do gasto e da qualidade da saúde pública: uma análise nos municípios do estado do Rio Grande do Norte (2004 e 2008)

The overall objective of this study is to analyze the efficiency in the use of resources and the quality of public health in the municipalities of Rio Grande do Norte, from 2004 to 2008. It also seeks to identify the determinants of municipal inefficiency and measure the productivity of public spending on health. To this end, three methods of analysis are used: the DEA, the Malmquist index and the Tobit regression model. Among other findings, it appears that municipalities considered more inefficient in the measurement of expenditure on health make the largest expense in this function. On the other hand, from 2004 to 2008, only 13 municipalities showed an increase in the productivity of public spending. It is also noted that municipalities considered efficient in quality of health, although having more physical and human resources, offer fewer health services to the population. In all, the major determinants of health spending inefficiencies are the variables: age of the mayor, coalition, population density, literacy race and budget revenues. Regarding the inefficiency of the health quality, variables such as: coalition, literacy race have strong influence on this behavior. Thereby, the hypotheses proposed by the study have been fully accepted. In other words, for the efficiency of the quality and health spending it is needed more than resources, i.e., the expenditure shows itself as essential, but not enough, for political and economic aspects also interfere with the performance of spent and in the quality of health care offered to the population

Políticas públicas de atendimento à criança: desafio da ação articulada no Projeto Belém Criança (2001-2004)

Public politics of Service to the Child: The Challenge of the Action Articulated in the Project Belém Criança (2001-2004) if it constitutes in a study on the politics directed toward the children of 0 the 6 years. It has as objective to analyze the configuration of the politics of integral attention to the child, evidencing the form as the same ones they had been redimensioned by the neoliberal ideas and by the lines of direction of the international organisms. The work has like empiric reference the project Belém Criança, developed by county of Belém from a partnership with the Deep of United Nations for Infancy (UNICEF), in the period of 2001 and 2004. The project intends to develop an articulated action among the several county departments which offer assistance to the children looking for to rationalize the resources and to optimize the services. Amongst the methodological procedures that materialized the research distinguished: The bibliographical review and documental allowed to analyze the contextualization of the public politics and, between them, the social politics of attendance to the child; the historical revolution this attendance; the paper of the UNICEF how articulator of the politics in municipal scope; and the paper of county how executer these politics. Still it was utilized, the half-structuralized interview, Having like subjects: the representative of the UNICEF in Belém, the municipal co-managers and actors of community in which the project was implemented. The result of the analyzes review that, historically, the politics destined to the child they had been being dimensioned having like support the fight of social movements vindictive for publics politic which guarantee the fundamentals rights these citizen. Although legal dimension of current politics of attendance to the child, to assume a vision of completeness and the guarantee of the rights, it still has a great exaggeration between the speech and the practical one. Actually, the same one are elaborate inside the neoliberal optics, with ruled actions by the beginning in combat to the poverty, implanted with low costs and with practice which to lead to the excessive fragmentation, generating inadequate actions and punctual programs which don t guarantee the social quality of the attendance. This perspective was evidenced to the most of the actors which the Project Belém Criança don t constitute itself a real public politic toward the child of 0 the 6 years, although present innovating aspects, how the mobilization and participation. It was demonstrated yet, in the participant s depositions of the research, that the bureau had numberless of difficulty to develop the action preview in the project, it has seen the great complexity of articulation between the several organism responsible by politics of attendance

Habitus, representações sociais e a construção do ser professora da educação infantil da cidade de Campina Grande - PB

We present here the results of a study whose objectives were to identify the social representation of being a professor of early childhood education in Campina Grande - PB, in the public state and municipal levels, and detect structural diagrams of a possible mental habitus of professorial faculty of education child, which would form the basis for the construction of this representation. As a theoretical base, we adopted the model developed by Domingos Sobrinho (1998, 2000, 2003, 2010, 2011), which articulates the Theory of Social Representations, Serge Moscovici, and the foundations and concepts of Pierre Bourdieu praxiology. It is based also on the Central Nucleus Theory, which focuses on the structural approach of social representations. Thus, puts in evidence the relational dynamics and symbolic, through which individuals come into contact, describe, understand and reproduce the outside world in his image and likeness. 199 teachers participated in the study of child care and pre-schools of Campina Grande - PB and 109 of the state. The methods and techniques used were: a) participant observation of everyday life of teachers of kindergartens and preschools, b) semi-structured interview, c) free associations of words with inducing the expression 'being a professor of early childhood education is ...' and d) semi-structured questionnaire. The data were analyzed in the case of interviews through the categorical content analysis, as proposed by Bauer (2010); free-associations, using the software Ensemble L'Analyse des Programmes Permettant evocations (EVOC), developed by Vergès (2002), which combines frequency and average order of recall (or association) and the questionnaire data, the Statistical Package for the Social Sciences (SPSS). It was verified the existence of a unique social representation shared by the population studied, but its content is structured differently. For local teachers, the centrality of the content is given by the elements commitment, dedication, responsibility, and rewarding teachers for this state revolves around the elements of love, patience, and rewarding responsibility. However, it is constructed mainly based on the related produced by a religious habitus and maternal habitus, which are part of the genesis of the establishment of professorial habitus in focus, among other cultural references of secondary influence. We conclude that a teacher of early childhood education actually researched, is materialized in the practices of educating and caring, in a clear fusion of the role of teacher and mother

Atuação do enfermeiro na estratégia de atenção integrada às doenças prevalentes na infância

This study aimed to describe nurses' actions in the strategy of Integrated Management of Childhood Illness in the city of Natal, Rio Grande do Norte. This is a qualitative study with descriptive approach. The universe consisted of nurses from the Family Health Strategy, totaling 16 participants. For the research project was submitted for approval by the Ethics Committee of the Universidade Federal do Rio Grande do Norte, obtaining Opinion No. 187/2012. Data were obtained in two ways: a questionnaire survey to profile the training of nurses and an interview guided by a structured interview. Interviews were treated in the light of analysis of thematic category Bardin. The results showed the central thematic study "Integrated Management of Childhood Illness in the context of nursing activities" category and three analyzes: "Understanding the Integrated Management of Childhood Illness", "Difficulties invibializam use IMCI "and" Working conditions for nurses in the Integrated Management of Childhood Illness. " It is observed that nurses consider the Integrated Management of Childhood Illness useful, effective and important to keep sick children within the logic curative. However disregard the character of health promotion and disease prevention thereof. It was found that the participants still hold the attendance of crinaças within the biomedical model and that these same professionals are subjected to increasingly precarious working conditions and unhealthy due to lack of human and material resources. It was found that the interviewees do not follow the protocols of strategy because of barriers related to prescription medications by nurses, the medical, the lack of incentives, training and supervision by the municipal health and the Regional Nursing Council

Gestão do Conhecimento baseado na análise de GAP de competências: Um estudo de caso do DETRAN-RN

The Knowledge Management in organizations is a continuous process of learning that is given by the integration of data, information and the ability of people to use this information. The Management Skills is concerned to understand the powers of officials in the face of organizational skills (teams) and professionals (or tasks positions) want. Joints are located in the greater context of the economy of organizatio s and have the same assumption: that the possession of scarce resources, valuable and difficult to imitate gives the organization a competitive advantage. In this sense, this thesis proposes a model of knowledge management based on analysis of GAP of powers, namely the gap between the skills needed to reach the expected performance and skills already available in the organization, officials and trainees of Coordination of Registration of conductors of DETRAN-RN. Using the method of survey research could make an analysis of academic skills, techniques and emotional individual and a team of officials and trainees, identifying levels of GAP's competence in that sector of the organization and suggest a plan for training , A level of expertise for each sector of coordination, and propose a model for Knowledge Management to help the management of GAP's identified