Perfil demográfico e condições sanitárias dos idosos em área urbana do Sudeste do Brasil

São apresentadas séries históricas de indicadores demográficos e sanitários para a população com 60 anos e mais do Brasil, Estado de São Paulo e Município de Araraquara, de porte médio. em 1991, os idosos eram 7,8% da população brasileira e 9,7% de Araraquara, superando em número as crianças menores de 5 anos (8,9%). Aumentou o peso relativo do segmento com mais idade (70 anos e mais), que já representa 40% do total, assim como o índice de urbanização dos idosos, 93,7% no Estado e 96,3% no Município, acima da média da população em geral em 1991. As principais causas de morte são as doenças do aparelho circulatório (40% do total de óbitos) e os neoplasmas (15%). São sugeridas medidas para a assistência à saúde dos idosos: a) expansão da capacidade atual de atendimento, através do treinamento gerontológico de médicos generalistas e enfermeiros da rede pública e privada; b) incremento das atividades educativas já existentes, dirigidas aos idosos, profissionais da saúde e educadores do ensino médio; c) incremento do programa de visita domiciliar aos idosos e criação de hospital-dia para evitar internações necessárias e garantir a manutenção dos baixos níveis atuais de institucionalização em asilos (0,7% em Araraquara). A existência de pelo menos 35% dos idosos de Araraquara, com acesso à assistência privada à saúde, reforça a importância da inclusão desses serviços nos programas locais de saúde da terceira idade.

Caminhos para a universalização dos serviços de água e esgotos no Brasil: a atuação das entidades reguladoras para indução da eficiência dos prestadores de serviços

The deficit of water and sewerage services is a historic problem in Brazil. The introduction of a new regulatory framework, in 2007, presented ways intending to overcome these deficits, among them, the providers efficiency improvement. This thesis aims to analyze the regulators performance regarding its ability to induce the efficiency of the Brazilian water and sewerage services providers. To this end, an analytical approach based on a sequential explanatory strategy was used, and it consists of three steps. In the first step, the Data Envelopment Analysis ( DEA ) was used to measure the providers efficiency in 2006 and 2011. The results show that the average efficiency may be considered high; however significant inefficiencies among the 29 analyzed providers were detected. The ones in the Southeast region showed better performance level and Northeast had the lowest. The local and the private providers were more efficient on average. In 2006 and 2011 the average performance was higher among non-regulated providers. In 2006 the group regulated by local agencies had the best average performance, in 2011, the best performance was the group regulated by the consortium agencies. To analyse the second step was used the Malmquist Index, it pointed that the productivity between 2006 and 2011 dropped. The analysis through decomposing Malmquist Index showed a shift of technical efficiency frontier to a lower level, however was detected a small provider s advance towards the frontier. Only the Midwest region recorded progress in overall productivity. The deterioration in the total factor productivity was higher among regional providers but the local ones and the private agencies moved quickly to the frontier level. The providers regulated from 2007 showed less decrease on the total productivity and the results of the catch up effect were more meaningful. In the last step, the regulators standardization activity analyses noted that there are agencies that had not issued rules until 2011. The most standards topics discussed in the issued rules were the tariff adjustments and the setting of general conditions for the provision and use of services; in another hand, the least covered topics were new technologies incentive and the introduction of efficiency-inducing regulatory mechanisms and productivity gains for price reviews. Regulators created from 2007 were more active proportionately. Even with the advent of the regulatory framework and the creation of new regulatory bodies, the evidence points to a reality in which the actions of these agencies have not been ensuring that providers of water and sewage, regulated by them, has achieved better performance. The non- achievement of regulatory goals can be explained by the incipient level of performance of the Brazilian regulatory authorities, which should be strengthened because of its potential contribution to the Brazilian basic sanitation department

Inserção e atuação profissional do psicólogo no campo das políticas sociais no Rio Grande do Norte

Since the first years of the regulation of Psychology as a profession in Brazil, it has been carried out studies on the academic graduation, practice, workplace and the social commitment of the category. Despite the diversity of goals and propositions, these studies show that psychologists have been significantly inserted into the social policies field, implying changes in the profession. Since the 1980s, researches in Rio Grande do Norte corroborate the results of national studies. The aim of this paper is to study the insertion and professional career of psychologists in the social policies field in Rio Grande do Norte. In order to accomplish the final results of this paper, it was developed an exploratory research, with the use of a questionnaire, comprised of four parts: general data, academic graduation, complementary graduation and professional experience. The results show three groups of information: characterization, insertion and professional performance. It has been verified expressive insertion of psychologists into the social policies field (41%). The socio-demographic and graduation characteristics are not different from those shown by literature: women, young, from families with an average of 7 to 15 minimum wages. Most of them graduated from public institutions and with post-graduation studies in clinical area. The professionals studied seem to be in worse working conditions compared to the rest of the category, which are also in unfavorable conditions, especially the psychologists who work in social assistance institutions, which present greater problems in its structure. The activities developed do not show anything new, reserving conservative practices instead of effective innovations, emphasizing the discussion on the profession for not considering demands presented to the psychologists in the social policies field. With unique scenario, the eproduction of liberal values corroborates classic performance standards; an unpolitical and uncritical practice is diffused. It is then reconsidered the importance of critical studies that organize goals to the category, with the aim of political transformation concerning the current scenario.

Produção de subjetividade em trabalhadores rurais na condição de luta pela terra no Rio Grande do Norte

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Psicologia e pobreza no Brasil: limites e perspectivas da produção de conhecimento e atuação do psicólogo

Poverty is a main theme in Brazil: according to official data, poverty reachs 70 million Brazilian people, and, between them, 20 million are unable to provide their basic needs. Psychology, as a welfare profession, and given its historical concerns with social actions, could not be away from this theme. Based on this, we ask: Which answers Psychology can provide, toward both the production of knowledge and the practice about social reality? The purpose of this paper is to investigate the psychological scientific production on poverty and the propositions, limits and impacts of psychological actions. We carried out a three stages documental based study analyzing Brazilian psychological literature: (1) online databases survey (312 papers identified); (2) 109 scientific abstracts accessed and coded; (3) selected 47 scientific papers read and analyzed. Results are presented in three sections: general description of the selected scientific production; characterization of the role of poverty in psychological literature; and themes presented at the papers. The academic production about the main theme (poverty) is dispersed, heterogeneous, and related to other fields of knowledge. Poverty is presented at these studies in many ways, such as: a criterium for sample design and the assessment of its psychological impacts; reports on professional experience with poor population; descriptions of this population group; relationship between poverty and others social themes; developmental and learning problems of poor children. In general, it appears that Psychology has improved the scientific production and experiences with poor population. However, it is necessary to build up theories and technical innovations and also to understand structural boundaries for professional practice with this population group

Entre a hegemonia e a polissemia: a Política de Educação e Desenvolvimento para o SUS no contexto do Brasil contemporâneo

The proposal of the Unified Health System Policy (SUS) has been considered one of the most democratic public policies in Brazil. In spite of this, its implementation in a context of social inequalities has demanded significant efforts. From a socio-constructionist perspective on social psychology, the study focused on the National Policy for Permanent Education in Health for the Unified Health System (SUS), launched by the Brazilian government in 2004, as an additional effort to improve practices and accomplish the effective implementation of the principles and guidelines of the Policy. Considering the process of permanent interdependencies between these propositions and the socio-political and cultural context, the study aimed to identify the discursive constructions articulated in the National Policy for Permanent Education in Health for the Unified Health System (SUS) and how they fit into the existing power relations of ongoing Brazilian socio-political context. Subject positionings and action orientation offered to different social actors by these discursive constructions and the kind of practices allowed were also explored, as well as the implementation of the proposal in Rio Grande do Norte state and how this process was perceived by the people involved. The information produced by documental analyses, participant observation and interviews was analyzed as proposed by Institutional Ethnography. It evidenced the inter-relations between the practices of different social actors, the conditions available for those practices and the interests and power relations involved. Discontinuities on public policies in Brazil and the tendency to prioritize institutional and personal interests, in detriment of collective processes of social transformation, were some of obstacles highlighted by participants. The hegemony of the medical model and the individualistic and curative intervention practices that the model elicits were also emphasized as one of the drawbacks of the ongoing system. Facing these challenges, reflexivity and dialogism appear as strategies for a transformative action, making possible the denaturalization of ongoing practices, as well as the values and tenets supporting them

A humanização no parto e no nascimento: os saberes e as práticas no contexto de uma maternidade pública brasileira

The practice of medicine related to the gestational processes tend to be organized according to the context and the place of work, being thus dependent of the conditions both social and economical, and of the physical structure and the functionality of the services. The high mortality rate in this process has diminished, since 1986, the study made by the World Health Organization (WHO) as to the technical aspects and the social inequalities that influence this situation in different geographical contexts. This culminated recommendations that proposed the reorientation of the dynamical practice of medicine, with a focus on the safety of maternities. Brazil adopted, in the year 2000, the suggestions of the OMS, emphasizing the humanization as the main reason for these actions. However, this discussion tends to not consider the problems caused by the social inequalities and the epidemiological and social conditionings that define the actions of the Unified Health System (Sistema Único de Saúde SUS). In this area, this research seeks to analyze the practices, cares taken, and the universal symbol that promotes and rewards the assistance to the birth of children by the SUS. Besides the analysis of the public documents that deal with this subject, an ethnographic study was developed in a maternity in Natal/RN, considered a model of humanization after receiving the Galba de Araújo prize in 2002. In this stage, the methodological strategies were observed, and the focus of the individual interviews with workers and users of this service. In the analysis of the data, it became evident that the different professional workers and women who gave birth, tend to show concern of the standards the delimit production and reproduction of the practice of medicine, as they favor the absence of a critical posture of the actions destined to the population. Besides this, if became evident that the institutional difficulties associated to the economical, cultural, and political problems also difficult the involvement and the reflection of the workers in favor of assisting changes of the process. There is also a utilization of a perspective prescriptive of humanization in the everyday life of the social workers, without reflection of its meaning. Some workers present, in their statements, a preoccupation with the social and economical aspects that affect the practice of medicine, and with the limitations of the humanization discourse that disarticulates the necessities of those involved in the process of formation, and soon tend to return to the discussion of humanization while a kind practice characterized by the minimization of the interventionist actions. Now the users of the system show themselves before the dynamic of the services, submitting themselves to what is offered while assistance, without questioning and/or reflecting about their usual shortages. Therefore, to think of changes in the know and do of the practice of medicine destined to the birth of children implies reflection on the quotidian production of these practices and of the social contexts that influence the process of assistance in the practice of medicine. Herein it would be possible to predict the appropriation, by different workers concerning their exasperations and necessities, making them active in the pursuit of their rights as citizens

A desigualdade espacial do baixo peso ao nascer no Brasil

Background:Low birth weight(LBW) isa risk factor formorbidity, infant and child mortality. In Brazilthe highest percentages oflow birth weightoccur inregionsofbettersocio-economic status. Objective: to know the spatial distributionofrates of lowbirth weight andcorrelation withsocial indicatorsand service. Drawing: ecological, and Brazilian statesas units ofanalysis. Methodologyused thetechnique ofspatial analysis, data from 2009SINASC, IPEAandIBGE. Results:higher rates oflow birth weightare in the statesof the south/southeast,GlobalMoran: 0.267, p=0.02.Clustersofhigh-hightypein the Southeastandlow-lowstates ofthe Amazon region.Conclusion: Thespatial inequalityoflow birth weightreflectsthe socioeconomic conditionsof the states. More developed regionsholdhigher rates oflow birth weight, therefore,the presenceof the serviceandits usedodecrease infant mortalityandincrease theBPN

Relação das condições socioeconômicas com as condições de saúde bucal em capitais brasileiras

Despite the improvement of Brazilian s living conditions in recent decades, this improvement occurred in a polarized way between groups of better social position. Then, there is still a health inequity´s panorama in Brazil which encompasses the oral health state. This panorama instigated the attainment of this ecological study that aimed to evaluate the relationship of socioeconomic conditions, and public health policies with oral health status in Brazilian capitals. Thus, we performed factor analysis and linear regression using oral health indicators collected from SB Brasil 2010, of socioeconomic conditions from Brazilian Census 2010 and related to water´s supply fluoridation from SISAGUA. Factor analysis with indicators of living conditions revealed two common factors, economic deprivation and socio-sanitary condition. Economic deprivation showed statistically significant positive correlation with DMFT 12 years (p= 0,03) and mean missing teeth (p = 0,002) and negative correlation with caries-free population (p=0,012). Socio-sanitary negatively correlated with DMFT (p <0,0001) and a positive correlation with caries-free population (p = 0.002). Fluoridated water had a significant association with DMFT (p <0,0001), mean missing teeth (p <0,0001) and caries free population (p <0.0001). Multiple linear regression analysis for the DMFT of capital was estimated by socio-sanitary condition and fluoridation, adjusted by economic deprivation, whereas the model for the mean missing teeth was estimated only by fluoridation and economic deprivation, and finally the model the rate for the population free of caries in Brazilian capitals was estimated by economic and socio-sanitary status adjusted fluoridated water supply. Therefore, factors related to living conditions and public policies are intrinsically linked to tooth decay issues. Thus, actions, beyond dental care assistance, must be development to impact positively in social and economic conditions, especially, between the most vulnerable populations

Fatores socioeconômicos contextuais associados à condição bucal de adolescentes no Brasil

Many surveys are conducted comparing oral health conditions with individual variables, such as socioeconomic and demographic factors. However, in the same way that individuals differ among themselves, the groups also have their own characteristics and the effects of this differentiation must be researched. Brazil, despite being one of the major economic powers of the world and shows an improvement in the average value of its health indicators, is also one of the most unequal and remains among the countries with the greatest health inequities. The purpose of this study was to investigate the importance of social determinants on the contextual level oral health among Brazilian adolescents, population not much researched by the literature. The research was made using an ecological approach in order to identify possible inequalities between cities and capitals. Using data from SBBrasil 2010 it was evaluated less common outcomes (loss of first molar, dental care index and T-Health) which provide information on the degree of morbidity of caries and health level of dental tissues, in addition to analyze the related services. The association of these oral health indicators with socioeconomic factors such as income, employment, education and inequality, collected from Census 2010, was analyzed by simple and multiple linear regressions. The study included the 27 state capitals and four clusters representing the municipalities of the country. It was possible to see better access to services in locations with better income distribution. However, the strong association of contextual factors related to poverty, low levels of education and poor housing and jobs with poorer levels of oral health in adolescents seems to overshadow the effects of income inequalities on dental caries in the country. In some locations, particularly within the North and Northeast, whichever one keeps dentistry mutilating, whose effects are already noticeable in its adolescent population. Access to restorative services in Brazil remains limited and unequal. The results of this study highlight the inequities in oral health in the country and show the need of the inclusion of new perspectives on the traditional approach of Preventive Dentistry and education models in Dentistry. Tackling health inequalities in oral health in the country requires the cooperation of various actors involved in the process and the inclusion of oral health in the context of overall health. The social determinants approach, as well as evaluating the distribution of oral diseases in the country and its inclusion in the context of overall health, should guide the implementation of programs and oral health practices in order to contribute to the reduction of inequalities

A produção das desigualdades: análise da relação entre trabalho infantil e indicadores sociais

The International Labor Organization (OIT) estimates that there are around 118 million children subjected to child labor around the world. In Brazil, there are 3.5 million workers aged between 5 and 17. This exploitation practice constitutes a serious social problem, including of Public Health, since these workers are exposed to a wide range of risks, such as those related to health, physical integrity and even to life, which may cause them to become sick adults and/or interrupt their lives prematurely. Therefore, this research aims to investigate the relationship between the frequency of child labor in the age group of 10 to 13 years and some socio-economic indicators. It is a quantitative research in an ecological study whose levels of analysis are the Brazilian municipalities grouped in 161 regions, defined from socioeconomic criteria. The dependent variable of this study was the prevalence of child labor in the age group of 10 to 13 years. The independent variables were selected after a correlation between the 2010 Census of child labor in the age group of 10 to 13 years and secondary data had been conducted, adopting two main independent variables: funds from the Family Allowance Program (PBF) per 1,000 inhabitants and Funds from the Child Labor Eradication Program (PETI) per a thousand inhabitants. Initially, it was conducted a descriptive analysis of the variables of the study, then, a bivariate analysis, and the correlation matrix was built. At last, the Multiple Linear Regression stratified analysis was performed. The results of this survey indicate that public policies , like the Bolsa Familia Program Features per 1000 inhabitants and Resources Program for the Eradication of Child Labour to be allocated to municipalities with HDI < 0.697 represent a decrease in the rate of child labor ; These programs have the resources to be invested in municipalities with HDI > = 0.697 have no effect on the rate of child labor. Other adjustment variables showed significance, among these the municipal Human Development Index (IDH), years of schooling at 18 years of age, illiteracy at 15 years of age or more, employees without employment contract at 18 years of age and the Gini Index. It is understood that the child labor issue is complex. The problem is associated, although not restricted to, poverty, the social exclusion and inequality that exist in Brazil, but other factors of cultural and economic nature, as well as of organization of production, also account for its aggravation. Fighting child labor involves a wide intersectoral articulation, shared and integrated with several public policies, among them health, sports, culture, agriculture, labor and human rights, with a view to guaranteeing the integrality of the rights of children and adolescents in situation of labor and of their respective families

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

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

O trabalho profissional dos(as) assistentes sociais no INSS pós as contra-reformas da Previdência Social

The present research study the work professional of the Social worker in the National Institute of Social Security of Rio Grande do Norte s State, especially about the working terms, the demands and working process of Social worker in consequence of the limits established with disorganization of his institutional space derived of the Counter-Reforms of the State and of Social Security. In decade of 1990 there was in Brazil adhesion to the neoliberal politics what configured a new organization of work and a new performance of the State. Inside this context, it was accomplished the Counter-Reforms with emphasis in the privatizations, reform of the Social Security and of the device of the Brazilian State, among other actions. Particularly, in Social Service reforms brought profound consequences for the Social workers of INSS, among it: reduction of professionals and in his institutional space. This study situates the Social Worker of Social Security in front of the contemporary modifications in the world of work as well as in front of the consequences come upon of the Counter-Reforms implemented and executed by the neoliberal governments in the country of way the of frame and to enter to the globalized world and the new order of the capital. From the qualitative research based in the critical and dialectic theoreticianmethodological perspective that study the phenomena from your relations, mediations and contradictions, was possible unveil the limits and the possibilities of the professional work of the Social worker in INSS placed the Counter-Reforms of Social Security. Synthetically, the results of this investigation indicate that, there is an worsening in the inconsistency of the work with relation to social worker's functional situation and his working terms in the institution

Trabalhadores por conta própria: O trabalho dos vendedores ambulantes da passarela do Natal shopping e do Via Direta

This study aid to understand the work conditions of street vendors located on the sidewalks of two malls in Brazil Northeast Natal / RN - Both malls Natal Shopping and Via Direta, to analyze their inclusion in the informal economy and to study the supposed autonomy provided by work as self-employment in its both aspects economic and social analyzing the importance on the condition of "masters of their own business" has for the street vendors, as an alternative to not submission to the figure of the boss, that represents the exploitation of one class over another. The theoretical and methodological aspects that support this study was aimed in discussion on the restructuring of production, considering its effects on the world of work, pointing to unemployment as one of the potencies element of excluded processes that exciting workers to engage in the informal market. Informality is presented as a survival strategy and as integrating part of the reproduction of capital. This research was conducted under a critical perspective, whish has been utilized quantitative and qualitative analyses. The results of this study format questions that provided during the research process the socio-economic characterization of workers, main cause of this study, and how street vendors expres their status of workers as self-employed for their work, and the perception that they have on their form of inclusion in the informal market.

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

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