Promoção da saúde: estratégias para a autonomia e qualidade de vida do sujeito com diabetes

O diabetes é uma doença crônico-degenerativa de grande prevalência na população mundial configurando-se enquanto sério problema de saúde pública. Por ser crônico exige dos sujeitos autocuidado e autogoverno longitudinal. A autonomia, por sua vez, é um direito fundamental e também um dos princípios da bioética mais discutidos na atualidade. Seu conceito é complexo e leva em conta a vida experimentada ao longo dos anos. Quando a discussão sobre autonomia se trata de diabetes, a dependência do outro e os conflitos no controle da doença, diante de novas regras e estilos de vida, nem sempre condizentes com os valores dos pacientes, torna-a fragilizada. Embora a autonomia seja claramente parte integrante do tratamento e alicerce para uma vida digna e de qualidade, observamos que os sujeitos se tornam ainda mais dependentes dos serviços de saúde, quando se deparam com o diagnóstico e não têm confiança para tomar suas próprias decisões diante da patologia limitadora. Por isso, há a necessidade dos serviços de atenção primária à saúde traçarem estratégias para promover a saúde desses sujeitos. Os Grupos de Promoção da Saúde são estratégias recentemente utilizadas para influenciar no nível de autonomia dos sujeitos, pois possibilitam, respeitando os limites éticos, a garantia de participação decisória no grupo, através de estratégias e treinamentos de habilidades com competências claramente definidas, que favorecem o empowerment e o protagonismo dos sujeitos. Desse modo, este trabalho objetiva identificar estratégias no âmbito da promoção da saúde na ESF, que contribuam para melhor autonomia e qualidade de vida dos sujeitos com diabetes mellitus, a partir de sua percepção. E, mais especificamente, analisar o perfil clínico e socioeconômico dos portadores de diabetes da ESF; identificar as experiências, necessidades e expectativas dos sujeitos com diabetes sobre autonomia, autocuidado e qualidade de vida; e realizar um levantamento em conjunto com os sujeitos com diabetes, sobre aspectos que sirvam de evidências para construção de propostas para implantação de um Grupo Estratégico de Promoção da Saúde GEPS, com foco na autonomia. Para isto, foi realizada uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, com 65 sujeitos com diabetes acompanhados por uma Unidade de Saúde da Família do Município de Santa Cruz/RN. A pesquisa foi realizada em três etapas interdependentes: 1) coleta de dados clínicos e socioeconômicos, para o qual foi utilizado entrevista estruturada e análise retrospectiva dos registros feitos em seu prontuário; 2) a análise das experiências, necessidades e expectativas dos sujeitos sobre autonomia, autocuidado e qualidade de vida, que se utilizou de entrevista semiestruturada com 6 sujeitos, sendo 3 com mais e 3 com menos complicações autorreferidas e verificadas no prontuário; e 3) a construção coletiva de propostas para melhor autonomia e qualidade de vida dos próprios participantes do estudo, por meio de roda de conversa. Para a análise dos dados utilizamos software de estatísticas simples para os dados das questões fechadas de cunho quantitativo e os dados qualitativos foram analisados através da análise de conteúdo. Observamos que o perfil clínico e socioeconômicos dos sujeitos com diabetes aproximam-se das estatísticas nacionais, embora existam variáveis, como cor da pele, com variação significativa. A autopercepção dos sujeitos diante de algumas complicações divergem de registros encontrados em seu prontuário o que aponta uma possível desvalorização de queixas como hipoglicemia e disfunção sexual, como também baixa adesão ao tratamento por, muitas vezes, não terem suas opiniões valorizadas. As categorias encontradas: vida, qualidade de vida, diagnostico e enfrentamento do problema, autonomia, limites e dependência assim como as práticas coletivas de promoção da saúde, apontam para a necessidade de estratégias por meio de grupos que considerem as crenças e valores dos sujeitos, favoreçam sua emancipação e torne-os protagonistas de sua própria história e de seu processo saúde doença. A autonomia é fundamental para o exercício da cidadania efetiva. É por meio dela que os sujeitos transformam sua realidade e a si mesmo. A contribuição desta pesquisa consiste em identificar estratégicas que se propõe a potencializar a autonomia dos sujeitos, através dos GEPS, norteando a atuação dos profissionais na atenção primária à saúde, que deve sustentarse em ações de prevenção e promoção da saúde e também no incentivo à participação popular e protagonismo dos sujeitos

As pessoas com deficiência no mercado de trabalho: expressão das desigualdades sociais

This work was developed in the extent of the Post Graduation Program in Social Service of the Federal University of Rio Grande do Norte. It talks about the process of inclusion of the disabled people in the Job market in Mossoró-RN, bringing for the academic debate relevant thematic for the Brazilian society, for the profession of Social Service and similar areas and for the people with deficiency. It has the objective to apprehend the determiners that make possible the process of the disabled people's inclusion in the Job market in Mossoró, having as parameter the National Politics for the Integration of People Bearers of Deficiency. The critical theoretical perspective is backed in Marx's ideas for the understanding concerning the work, as well as in Pochamann, concerning the job market, regarding the exclusion/inclusion category is based in Martins, Yasbek and Sposati and on deficiency in the National Politics for the Integration of the Disabled People. The research is of qualitative nature and it took as subjects 26 (twenty-six) people, being 09 (nine) people with deficiency, inserted in the formal job and regulated market, and 17 (seventeen) managers of private companies and public institutions of the city of Mossoró-RN. For the collection of data we used techniques of nonsystemic observation, semi-structured interview and documental analysis. The results of the research mark that any modality of the human workforce used in the current context, they are functional to the capitalism and they move forward towards exploration, alienation and subordination of the work to the capital; the National Politics for the Integration of the People with Deficiency expresses and reproduces the contradictory dynamics of the class society, it reflects the neo liberal shades through the selectivity and of the articulation among the federated beings and organizations of the civil society for its operational system; there is a misproportion between the percentages of the quotas and the amount of people with deficiency inserted in the job market, just corresponding to a tiny numeric magnitude; the developed activities are of low social status and it is expressive the amount of workers that receives between one and two minimum wages. These data drive us to infer that the mentioned politics make possible, partly, the inclusion of the disabled people in the job market, though, such inclusion is executed in the selective or focused dimensions, marginal, precarious and unstable

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

Desafios e limites da prática política do sindicalismo rural: um estudo de caso em São Paulo do Potengi/RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Serviço Social Audit Saúde no SUS/RN: projeto ético político profissional e de reforma sanitária

Health policies in Brazil, the decentralization of SUS management responsibilities for the three spheres of government has driven the creation and regulation of the audits of health services in the National Audit Office, this is a trend of neoliberal policies imposed by international bodies like the World Bank and IMF to peripheral countries characterized by productive restructuring and reforming the state focuses on the presence of two competing projects in the area of health: Health Sector Reform Project which is based on the democratic rule of law with the assumption of health as social right and duty of the State in defending the extension of the conquest of rights and democratization of access to health care guaranteed through the public financing strategies and the effective decentralization of decisions pervaded by social control and privatized Health Project which is based on the state minimum, with a reduction in social spending or in partnerships and privatization, stronger nonprofit sector, subject to capitalist interests, is made effective through strategies targeting health policy and refilantropização actions. In this context, the present study is an analysis on the work of social audits of public health in infants from a qualitative and quantitative approach, embodied by the critical method of dialectical Marxist social theory that enabled us to unveil the characterization, the demands, challenges and outline the profile of Social Work in teams inserted audits of SUS in RN, but also provided evidence to demonstrate the prospects and possibilities of this area of activity of social workers. It was also found that through the audit work that the state fulfill its role as bureaucratic and regulator of health services with efficiency, effectiveness and economy. Yet, paradoxically, the audits of SUS may provide a vehicle for enforcing rights and ensuring the fundamental principles contained in the project of health reform, because it can be configured in a space of political struggle as representing a new field of knowledge production that needs to be appropriate for a theoretical critic able to redirect the social interests in favor of the user. From this perspective, it is concluded that the work of social audits of public health in infants despite the social relevance that prints, as they constitute an activity study of reality and its transformation proposition requires a transformative political action guided the discussion Marxist theory holds that the ethical project professional politician of Social Work

A gestão do Sistema Único de Assistência Social em Currais Novos (RN)

The present paper analyses the social assistance management in small cities, starting from the reality of Currais Novos City. Its main objective is to analyse the management of this politic in the context of the Nacional Sistem of Social Assistance (SUAS) through the management instruments materialized in the city: Social Assistance Plan, Budget, Management Report, Information Management, Monitorizing and Evaluation. It reveals a discrepancy between the instruments purpose and their concretude, and it identifies the main challenges in order to make them real, revealing the contradictions of such politic, through which the advances relate with the retrocesses. It remarks, in this context, the debate about Public Management and some aspects of the trajetory of the Social Assistance management in the brazilian context and the configurations of (SUAS) and of the politics in Currais Novos city. Such path allows us to identify the feebleness in the city ways to adopt the (SUAS) criteria, which is much more effective in burocratic aspects than in the change of the Social Assistance conception and in the effective incorporation of the (SUAS) principles and guidelines. Thus, problems are identified in what concerns to the important aspects for its effectivation, with the human resources, financing and social control mechanisms. It makes possible to reafirm the importance of the analysed management instruments for the effectivation of one participative and democratic management, as well as the urgency of its materialization as one of the important ellements for this politic to happen as a right and to make a stop to the unconformities between the (SUAS) determinations and its materialization

Assentamento Hipólito: realidade e perspectivas dos jovens assentados

Analisa a inserção da população jovem em assentamentos rurais, tomando como referência o Assentamento Hipólito, no município de Mossoró, no Estado do Rio Grande do Norte (RN). O contato com alguns jovens assentados levou à inquietação frente à problemática situação por eles descrita, em relação aos seus cotidianos e às suas perspectivas, o que aponta para o entendimento de que faltam políticas públicas, ou estas não estão sendo adequadas para a população em estudo. As políticas de juventude são, além de recentes, ainda muito escassas; sobretudo, quando se trata da juventude rural. Nessa perspectiva, procura rastrear a trajetória dos jovens no referido Assentamento, visando a uma melhor percepção da inserção social destes na condição de assentados, com a atenção voltada para as suas relações com o seu meio, e com o poder público (local, estadual e federal), as condições de vida, as perspectivas de futuro e as ações governamentais, frente às suas demandas. Os resultados dessa análise apontaram para a ausência de políticas públicas condizentes com a realidade dessa parcela da população, reforçando, mediante a precariedade das condições de vida em que se encontra, o argumento de que a luta pela terra não se encerra com a conquista desta. Pois a consolidação dessa posse vai depender da luta posterior em prol de melhores condições econômicas e sociais. Reforça ainda a necessidade de reconhecer a capacidade potencial dos sujeitos coletivos, na avaliação de seus problemas e necessidades, e fomentar a participação social e política dos trabalhadores, na conquista de seus direitos e na construção de sua cidadania. E ainda que a participação efetiva da juventude é fundamental a qualquer processo de transformação social. Portanto, os jovens rurais são atores inegavelmente importantes quando se pretende entender a dinâmica dos assentamentos rurais no seu contexto maior

Desafios e limites da prática do sindicalismo rural :um estudo de caso em São Paulo do Potengi/RN

The dissertation analyzes how the syndical practice of the workers rural Brazilians works your aspects of mobilization and claim in front of the execution of attendance services and providences, instituted in the marks of the military dictatorship, in the decade of 1970. We try to apprehend how these services have been interfering in the development of base works. Considering base works, as an enduring political formation of the rural workers, formation of new syndical leaderships and an effect participation of the workers in the political spaces. We trace the path of the rural workers' organization, starting from the previous period to the military stroke of 1964, while protagonists inserted in the national political conjuncture, organizing fight fronts and conquering rights. The research reveals that the rural workers' syndical movement, when it develops the activities coming from Funrural, established in 1971, they confront a dilemma that go through the political nature of your practice, which such activities can reduce the syndical rural workers, to a antity of assistance, and so interfere in the accomplishment of base works with the rural working class. The rural workers' syndical movement, inserted in the several conjunctures, since of your emersion in ante-64, when they have passed by growth and retrocession, they built along this period a structure to the national level, which makes possible the recognition of the rural workers' organization, as a class, and human being politicians of your own structure. It is in this context that the syndical practice is analyzed, emphasizing your limits and your possibilities while policy strenght nationally constituted

Arquitetura multiagente baseada em nuvem de partículas para hibridização de metaheurísticas

This thesis proposes an architecture of a new multiagent system framework for hybridization of metaheuristics inspired on the general Particle Swarm Optimization framework (PSO). The main contribution is to propose an effective approach to solve hard combinatory optimization problems. The choice of PSO as inspiration was given because it is inherently multiagent, allowing explore the features of multiagent systems, such as learning and cooperation techniques. In the proposed architecture, particles are autonomous agents with memory and methods for learning and making decisions, using search strategies to move in the solution space. The concepts of position and velocity originally defined in PSO are redefined for this approach. The proposed architecture was applied to the Traveling Salesman Problem and to the Quadratic Assignment Problem, and computational experiments were performed for testing its effectiveness. The experimental results were promising, with satisfactory performance, whereas the potential of the proposed architecture has not been fully explored. For further researches, the proposed approach will be also applied to multiobjective combinatorial optimization problems, which are closer to real-world problems. In the context of applied research, we intend to work with both students at the undergraduate level and a technical level in the implementation of the proposed architecture in real-world problems

Revisão por pares na Revista Brasileira de Educação Especial

O artigo discute algumas questões relativas ao procedimento de revisão por pares na avaliação de originais submetidos a um periódico. Essa avaliação é aceita como necessária para assegurar a qualidade científica de artigos publicados, já que a integridade da literatura especializada é considerada essencial para o desenvolvimento da ciência. Entretanto, há críticas à revisão por pares, incluindo o longo tempo decorrido entre a entrega dos originais e a publicação, o tempo e a energia despendidos pelos autores e revisores, a subjetividade na avaliação e outros problemas que podem introduzir vieses na área. A Revista Brasileira de Educação Especial, que adota a avaliação cega por pares, tem-se mostrado relativamente versátil. O tempo médio entre o recebimento dos originais e o aceite final, depois de passar pela revisão por pares e conseqüente ajuste por parte dos autores, é de cerca de cinco meses e meio. Na literatura especializada, encontram-se sugestões como a eliminação de avaliação e publicação de todos os textos submetidos, em meios eletrônicos, menos onerosos e mais versáteis, deixando que os próprios leitores façam a sua avaliação. A análise procedida conclui que a revisão por pares é necessária. Aponta a necessidade de se realizarem discussões sobre a própria avaliação, para que se desenvolvam procedimentos mais eficientes de controle de qualidade das publicações. Sugere que a avaliação efetiva é feita pela própria comunidade acadêmica, após a publicação, mediante reconhecimento coletivo do valor científico da publicação, na forma de impacto que pode causar sobre novas investigações e construção do conhecimento na área.

Nós e os gregos

Este artigo responde afirmativamente à questão, vez por outra retomada, da efetiva contribuição que o estudo do pensamento político dos antigos gregos pode trazer ao debate dos problemas com que se defrontam as modernas sociedades democráticas.

Normas - o estabelecimento dos direitos humanos

Habermas entende os direitos humanos como produtos do mundo da vida; e é no interior do debate público, com a participação efetiva dos cidadãos, que deve ocorrer a produção deles como normas e princípios. A questão central abordada inicialmente no texto concerne ao status dessas normas e ao seu modo de instituição, dependente das relações de reciprocidade entre os sujeitos. Uma vez que, em sociedades complexas, apenas idealmente parece ser possível sustentar a participação de todos os sujeitos no processo de elaboração de normas, o texto procura analisar a viabilidade da concepção de Habermas. Ao considerar os elementos conceituais que orbitam essa questão, processa-se no curso do texto um deslocamento para outra, a saber, a relativa ao quanto o modo de sustentação da normatividade jurídica de um ordenamento social o determina como democrático ou não. Este é o ponto decisivo ao tratamento das normas relativas aos direitos humanos: a análise de Habermas é ideal, mas o pêndulo entre moral e empiria se mantém sempre, de modo que, pelo escopo conceitual, se não há como confirmar a identificação entre legitimidade dos direitos humanos e direitos humanos produzidos democraticamente, torna-se impossível querer negá-la.

Turismo, capital social e produção do espaço: uma leitura a partir do município de Natal/RN no período de 1980 a 2012

Nowadays, there is a tourism phase in the city of Natal/RN called internationalization of tourism , which shows a tourism model with a planning and an administration, based on the needs of the visitors. Such process shows that the production as well as the reproduction of the city spaces with the goal of favor tourism excludes of its composition the effective participation of local subjects. Thus, the research is a result of the perception of tourism as an activity with a meaningful power of transformation of the social and natural space taking into account the low participation of the residents in the decisions of the tourism activities in the city of Natal/RN. Despite that reality, it is possible to note Natal that civil society, starts to mobilize its citizens trying to develop collective actions to low the negative impacts caused by the bad planning as wells not efficient tourism administration, trying to put in action the right of the local population to take part in the decisions of the city activities. Having this panorama as background, this paper aims at investigating in which way the mobilizing action of the social capital in Natal has contributed to change the spatial production which is part of the process of expansion of tourism in Natal/RN? The research presents a temporal picture which starts in the year of 1980, when occurs the first effective state intervention aiming to develop tourism in the capital, taking into account an analysis of 2012. Concerning the spatial picture, the research investigates the beaches of Natal which concentrates criteria and actions such as: visitation, tourism appeal and focus of investments, highlighting the following beaches: Ponta Negra, Areia Preta, Praia dos Artistas, Praia do Meio, Praia do Forte and Redinha. This study is of a descriptive and exploratory nature concerning its goals. With respect to the treatment of its object it is a qualitative research. The data was collected through structural interviews, with open questions. Regarding the methodological choices, it was used the content analysis proposed as well as the collective discursive subject methodology. The results show that there´s not yet in Natal a meaningful social capital related to tourism, capable to change the spatial production related to the activity. It should be stressed that Natal social capital presents difficulties concerning the incentive to trust, spontaneous cooperation and the civic participation, which are the foundation for the development of an effective social capital, which makes it harder for a more expressive articulation in the reality in Natal/RN. It should be stressed, as an answer to the research questions, that tourism in Natal/RN is represented by social and spatial segregation. In other words it emphasizes mainly the action of hegemonic agents (State and market), leaving little room for the participation of society. It can be noticed that the actions related to tourism in Natal keeps the popular participation out of the way. Thus, it can be said that the social capital in Natal/RN does not yet contribute to a more fair spatial production related to the expansion of the tourism as well as the well being of the population of Natal/RN. In conclusion, it should be taken into account that this participation do exists but not in a meaningful way. In other words, it´s not enough yet to cause meaningful changes in the actions which tourism needs nowadays in Natal/RN

Atuação e interação de stakeholders no processo de implantação do turismo: um estudo no município de Sitio Novo/RN

The present work is a study which deals about the stakeholder approach towards the issue of tourism development in a city of Rio Grande do Norte state: Sítio Novo. As a goal, we sought to understand the stakeholders action and interaction mechanisms in the implementation process and, consequently, tourism planning in the municipality. Regarding to the methodology, the study is characterized as an exploratory and descriptive research with a qualitative approach, given the intention of trying to understand meanings and situational characteristics presented by the research subjects. The interview was the instrument used to collect information, and it was performed with 10 (ten) actors of tourism in the municipality, documents about tourism development (Proceedings of the Regional Council of Polo Agreste Trairi were analyzed Sítio Novo municipality incorporates the Polo, and the Strategic Plan for Tourism). The study shows that public actors are the majority in the destination, notes that there is a minimal involvement of civil society in actions for tourism in the municipality, highlights that representatives of the municipality participate effectively in meetings of the Regional Council of Tourism Polo Agreste Trairi, to discuss actions related to the development of the activity in the locality, and attests that local actors interviewed, mostly understand their functions regarding to tourism development, however, do not perform actions consistent with the role they have, which have as purpose the planning and development of tourism. For that matter, this paper concludes that the participation and coordination among the stakeholders of the municipality should be reconsidered in order to seek and/or propose alternatives that gather in a more adequate way the local actors, so that something more effective about the tourism development in the destination could be done

Atores sociais e política ambiental urbana do Município de Mossoró/RN pelo prisma das cartografias sociais analíticas

It starts with the understanding that the relationship between society / nature is largely problematic in a context of socio-environmental crisis. In this context, we use the principle of hope to plan and work out new ways of understanding social reality, the relationship between science and alternative knowledge. The research is to investigate how the actors influence the social construction of urban environmental policy of the city of Mossoró / RN with reference to the processes of implementing the Master Plan and Agenda 21 of the municipality. The hypothesis of this research is that the Environmental Policy in Mossley has a normative character that is expressed primarily in the creation of an institutional political framework to manage environmental issues involving so incidental and or functional society participation mossoroense. Thus questioned who are the actors that build environmental policy Mossoró / RN. The specific objectives of this research are: Identify the environmental dimension of the Master Plan Agenda 21 articulated Mossoró / RN mapping information from the managers, engineers and members of the Municipal Environment and Municipal Council of Cities on the operation of urban environmental policy mossoroense and how it is performed by the Manager of Environmental Management in conjunction with the Department of Environment and Territorial Development (SEDETMA) and Executive Management of Urban Development. As a methodology, we used the method of the sociology of absences and emergencies in conjunction with the ecology of knowledge and productivity. It is a qualitative research and documentary, which was used as the Master Plan documents Mossoró / RN, minutes of meetings of boards and complementarity were carried out 12 semi-structured interviews with managers and directors of the Urban Environmental Policy of the Municipality of Mossoró / RN. They used also the social analytical or thematic maps for the translation of the dialogue among social partners, managers and directors who make the Environmental Policy Council. We conclude that these dialogues and experiences point to the construction of an environmental policy more participatory and effective, committed to individual and collective transformation of society mossoroense