Classes sociais e eleições presidenciais no Brasil contemporâneo (2002-2010)

This work aims to analyze, in terms of class, the social composition of the constituency of the presidential candidates of the Workers Party in 2002, 2006 and 2010 elections. Such research object is constructed from a preliminary critical debate with recent Brazilian electoral studies, especially the literature on the infl uence of social programs on voting and Singer’s formulations about the lulismo phenomenon. Incorporating advances and pointing out gaps in such research efforts, is formulated a roadmap for empirical research constituted of three key elements - the measure ment of the dimensions of class structure in Brazilian capitalism; the observation of material interests related to the constituents locations of such structure; the development of measures of association between the insertion in class groupings and indivi dual voting behavior. Based on the neo - Marxist approach of class analysis, especially as formulated by Wright, it is made an adaptation of the typology formulated by such approach (mainly developed by Santos to the Brazilian case) to the data available fro m databases of censuses of 2000 and 2010. This theoretical construct reveals that during the period considered for the analysis, the structure of class - relations in Brazil became more proletarized and consequently had a decrease of the dimensions of the de stitute class locations. In addition, it was found, in relation to the objective class interests, widespread increments of economic welfare that allowed advances in relation to the material conditions of the proletariat, without, however, incurring losses to the privileged class positions. Such changes in the structural sphere focused in various ways on the political arena. Based on an adaptation to electoral analysis of the concept of "class formation", also formulated by Wright, associated with the use of techniques of ecological inference (especially those proposed by King and associates), it was possible to draw up an overview of class voting in period studied. As main results, three general patterns of individual voting behavior, related to each of the three analyzed class groupings were identified - a contraposition against PT candidates, by voters in privileged class locations; the adhesion, recurring throughout the study period, of workers to Lula and Dilma Rousseff; a favorable electoral shift unde rtaken by economically deprived voters in favor of those candidatures in the 2006 election.

Avaliação da usabilidade e da arquitetura da informação do site do Instituto do Cérebro da UFRN: um estudo de caso com base nas opiniões dos usuários da instituição

The objective of the current piece of research presents was draw up a list of recommendations for the site of the Instituto do Cérebro da Universidade Federal do Rio Grande do Norte, with an emphasis on fault identification in usability and information architecture, through the application of design techniques with users of the institution. From the use of the following techniques: Cardsorting, applied to a group of six people as target public, such as professor, administrative technicians and graduate student of the institution; Interviews, carried out with the director of the Instituto do Cérebro, secretaries of the undergraduate and graduate courses; Cooperative Evaluation applied in two ways: in group and individually. The evaluation in group was fulfilled in four sessions that occurred with a group composed of six people who are part of the technical staff of the Instituto do Cérebro. In the Individual Cooperative Evaluation, eight users (graduate students and administrative technicians of the Instituto do Cérebro da UFRN) performed tasks which are frequently fulfilled by users from the public target in the site of the Instituto do Cérebro. After each session of the Individual Cooperative Evaluation, a questionnaire of the user´s satisfaction was used about his or her perception in regard to the site usability and utility of the mentioned institute site. Therefore, it was concluded that, by means of the analysis of the results and the triangulation of the obtained data in each one of the techniques applied with the users, in the present piece of research, problems were verified, among others; all related to the unsuitable use of the interface elements, navigation, labeling of some menu terms, and still, the lack of search space and integration with the social networks – besides the lack, positioning and inappropriate formatting of information that would be of high relevance to the users. Finally, a list of recommendations is presented and this can be used in a future interface redesign with the goal to improve the information architecture and the usability of the site of the Instituto do Cérebro da Universidade Federal do Rio Grande do Norte.

O trabalho em equipe na atenção primária à saúde: situação de Portugal e do Brasil

Introdução: Na Atenção Primária à Saúde, nos contextos internacional e nacional, o trabalho em equipe tem sido reconhecido como estratégia decisiva para a organização de processos que visam à integralidade do cuidado, além de possibilitar melhorias na satisfação dos usuários com os serviços de saúde. Neste sentido, o objetivo, deste estudo, é analisar o trabalho em equipe na Atenção Primária à Saúde. Método: Trata-se de uma pesquisa em banco de dados secundários. Realizou-se três estudos: a) O trabalho em equipe na Atenção Primária à Saúde, em Portugal, pesquisa avaliativa, de natureza qualitativa, tipo estudo de caso descritivo, que representou um recorte dos resultados derivados da pesquisa integrada ao projeto “Implantação das Unidades de Saúde Familiar em Portugal”, que teve como procedimentos entrevistas semiestruturadas, roteiro de coleta de informações (check list) e análise documental. Foi realizada a estratégia de triangulação dos dados com análise de conteúdo; b) trabalho em equipe, acesso e qualidade na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 17202 profissionais e 65391 usuários. Utilizou-se entrevista estruturada, com análise estatística realizada pelas frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. c) satisfação dos usuários com o trabalho em equipe na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 65391 usuários. Realizou-se análise estatística das frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. Utilizou-se, ainda, o Teste X2 , com nível de significância de 5%; análise de regressão logística múltipla. O modelo final foi ajustado pelo teste de Hosmer/Lemeshow, o qual indicou um ajuste de 66%. Resultados: Sobre o trabalho em equipe na Atenção Primária à Saúde, em Portugal, destacou-se a formação das equipes de forma voluntária, por meio de afinidades pessoais, a existência de “carteira básica de serviços”, juntamente com x intervenções de vigilância, promoção da saúde e prevenção de doença, cuidados em situação de doença aguda, acompanhamento clínico de doença crônica e de patologia múltipla, cuidados domiciliares, interligação e colaboração em rede com outros serviços (cuidados hospitalares), sistemas informatizados nas unidades de saúde. Os dados revelaram dificuldades quanto ao atendimento domiciliar. No Brasil, foi destaque o processo de trabalho, com avanços relacionados a realização de planejamento e programação das ações e o apoio da gestão. Existência de território definido e de prontuários familiares. É destaque a agenda compartilhada e pactuada entre os profissionais. As equipes realizam acolhimento e reuniões, cujos temas, discutidos, giram em torno do processo de trabalho e planejamento. Os desafios, enfrentados, estão relacionados ao agendamento dos usuários; ao número de pessoas sob a responsabilidade das equipes; à existência de população descoberta nas áreas adscritas à Unidade de Saúde; à incipiência na ação intersetorial e ao pouco envolvimento da comunidade pelas equipes. Quanto aos fatores associados à satisfação do usuário foi marcante: a faixa etária; a escolaridade; a raça; se a falta de material prejudica o atendimento e se a equipe consegue marcar consulta para outros profissionais. Conclusões: Constatou-se o trabalho em equipe como elemento central no processo de mudança na Atenção Primária à Saúde, tanto no contexto de Portugal quanto no do Brasil, o qual ampliou o acesso e a qualidade na oferta de serviços de saúde e obteve, ainda, o reconhecimento social, mesmo que, em ambas as realidades, não tenha avançado na coordenação do cuidado e no estímulo à participação social. Os fatores, associados com a satisfação do usuário, estão relacionados diretamente ao cuidado prestado e refletem a expectativa, por parte do usuário, de resolução concreta de suas necessidades.

O direito fundamental à igualdade no contexto da identidade sexual no Brasil: um estudo da situação jurídico-constitucional com ênfase no exame da suposta inconstitucionalidade por omissão do legislador civil

This dissertation analyses the Brazilian Supreme Court’s judgement in the Non-compliance Action of the Fundamental Precept 132/RJ and in the Direct Action of Unconstitutionality 4277/DF, which created in the country the same-sex civil union. In This decision, the STF interpreted according to the constitution Article 1.723 of the Civil Code, invoking several fundamentals reaffirmed in the Constitution. From all these laws invoked by the Supreme Court to support the pretorian creation, the content of consitutional Law regarding equality is the only that corresponds, and it is sufficient to evidence the necessity of the creation, by legislator, of the institute for civil rights, since the Constitution forbids distinctions that is not expressly provided for in the Constitution (Art. 3º, IV, of Federal Constitution). In this way, Article 226, § 3º is not an exception capable of satisfying the condition of the consitutional foresight because although it protect, according its content only the civil union “between the man and the woman”, it is not able to forbid the creation, by legislator, of another kinds of families, including the same-sex civil union. As such, the reasoning, now legitimate according to the legislator, is not support the creation of institute by Constitutional Court, because the Court may enforce the Law, interpreting in the purviews allowed by the legal text and its constitutionality. In regard to the civil union of individuos of the same sex, the Court could not deduce that such union was implied by Law, like the interpretation according to the Constitution given by judges, on grounds of semantic purviews of the words man and woman, existents in both articles. The Court could not created it either, exceeding the legal system role. So, upon the institute creation, the STF, exceeded two limits: the interpretation and Law enforcement.

Distribuição e uso de habitat por peixes recifais em um gradiente ambiental: estudo de caso em recifes areníticos

There are several abiotic factors reported in the literature as regulators of the distribution of fish species in marine environments. Among them stand out structural complexity of habitat, benthic composition, depth and distance from the coast are usually reported as positive influencers in the diversity of difentes species, including reef fish. These are dominant elements in reef systems and considered high ecological and socioeconomic importance. Understanding how the above factors influence the distribution and habitat use of reef fish communities are important for their management and conservation. Thus, this study aims to evaluate the influence of these variables on the community of reef fishes along an environmental gradient of depth and distance from shore base in sandstone reefs in the coast of state of Rio Grande do Norte, Brazil. These variables are also used for creating a simple predictive model reef fish biomass for the environment studied. Data collection was performed through visual surveys in situ, and recorded environmental data (structural complexity of habitat, type of coverage of the substrate, benthic invertebrates) and ecological (wealth, abundance and reef fish size classes). As a complement, information on the diet were raised through literature and the biomass was estimated from the length-weight relationship of each species. Overall, the reefs showed a low coverage by corals and the Shallow reefs, Intermediate I and II dominated by algae and the Funds by algae and sponges. The complexity has increased along the gradient and positively influenced the species richness and abundance. Both attributes influenced in the structure of the reef fish community, increasing the richness, abundance and biomass of fish as well as differentiating the trophic structure of the community along the depth gradient and distance from the coast. Distribution and use of habitat by recifas fish was associated with food availability. The predictor model identified depth, roughness and coverage for foliose algae, calcareous algae and soft corals as the most significant variables influencing in the biomass of reef fish. In short, the description and understanding of these patterns are important steps to elucidate the ecological processes. In this sense, our approach provides a new understanding of the structure of the reef fish community of Rio Grande do Norte, allowing understand a part of a whole and assist future monitoring actions, evaluation, management and conservation of these and other reefs of Brazil.

Estudo de viabilidade técnico-ambiental para implantação de parques eólicos: um estudo de caso em um fragmento do litoral setentrional do Rio Grande do Norte/Brasil

The use of energy from renewable sources is increasingly demanded by society, especially aeolian - whose raw material is wind. Investments in wind power have become significant in Brazil with emphasis on the Northeast and in particular the Rio Grande do Norte state. According to the Empresa de Pesquisa Energética (Energy Research Company) (2012 ) , investments in the state grew significantly since 2002 with a total accumulated power, by 2013, of approximately 3,400 MW . Even with the early experiences of exploitation of wind energy in 2002, it is still considered new and requires further study referring to the likely changes in the environment and society. In this case, it is of growing and urgent importance to deeply study the wind still in the survey phase of the project, ie , at the beginning of decision making on the most feasible to implement these parks site. Given the above, the question is: from a technical and environmental analysis, how to identify viable areas to install Aeolian parks, taking into account the factors of the environmental dynamics that are relevant to minimize the negative results to the environment and the society? Thus, this study conducted a study on technical and environmental feasibility, proposing a methodology of exploration of feasible wind farms in coastal areas. The study area was a fragment of the northern coast of Rio Grande do Norte and its natural landscape units were identified through the environmental characterization of the area, as well as it was elaborated the map of the land cover, restriction homes and urban areas and Permanent Preservation Areas - PPAs. The environmental fragility was subdivided in the fragility of the natural dynamic, mapped through relief, soils and geology of natural units, and the fragility of the ecosystem, originated by the land cover map. In addition to these maps, it was generated the wind resource for an area from a height of 50 and 100 meters. The intersection between the fragility maps, PPAs and Restriction of homes superimposed on maps of wind potential, provided the map of feasibility of Aeolian parks, resulting in the most favorable areas for its facilities in a technical and environmental point of view. From this study, the entrepreneur can evaluate whether or not to proceed with the studies in this area and especially decrease potential conflicts with society.

Gestão e mapeamento de processos nas instituições públicas: um estudo de caso na Diretoria de Administração de Pessoal da Universidade Federal do Rio Grande do Norte

The new management models have led to the reorganization of institutions today. Much is made in improving the delivery of public services entities, and they have sought to adopt these new initiatives in order to improve the quality of the product or service offered to users. The modernization of the management model at the Federal University of Rio Grande do Norte (UFRN) strengthened by the accession of the institution to GesPública Program, which focuses on the management modernization leading institutions to seek ways to fit to meet the demands proposed the Program. Therefore, the Department of Personnel Administration (DAP) has structured its processes and procedures using the mapping tool processes. This research starts from the question: what were the results obtained with the implementation of the management and process mapping of PAD? It is proposed as a general objective to analyze the management and the mapping of that Board processes, identifying the possible benefits in improving the quality of the services provided to users. The specific objectives to achieve results, are pointed out: describe how you carried out the implementation of the management and process mapping in DAP and how it is working at the moment; examine the line in the relationship between the actions developed by the DAP and modern theories of this theme; identify the evolution of the sector with the measures adopted and the results obtained with the implementation of the mapping tool. In the theoretical framework, it was approached a brief history of the evolution of public administration in Brazil, GesPública program and its importance for process management in public institutions as well as the Management and Process Mapping. The context of the study was the DAP, and participants were managers of the institution in the survey. Data collection was done through the study of the institution's documents, bibliography analysis available on the topic, questionnaires and semi-structured interviews with professionals of the institution involved with the object of study, since its inception until July 2015, when it was finished the search. As a result, were listed: the motivation, importance, benefits and innovations that management and the mapping of processes brought to the institution, point out what has been improved in the service users and the tools used. We also analyze the main problems identified during the implementation of the mapping. As a suggestion, it was analyzed how these procedures can, if possible, be extended to other sectors of UFRN.

Gestão e mapeamento de processos nas instituições públicas: um estudo de caso na Diretoria de Administração de Pessoal da Universidade Federal do Rio Grande do Norte

The new management models have led to the reorganization of institutions today. Much is made in improving the delivery of public services entities, and they have sought to adopt these new initiatives in order to improve the quality of the product or service offered to users. The modernization of the management model at the Federal University of Rio Grande do Norte (UFRN) strengthened by the accession of the institution to GesPública Program, which focuses on the management modernization leading institutions to seek ways to fit to meet the demands proposed the Program. Therefore, the Department of Personnel Administration (DAP) has structured its processes and procedures using the mapping tool processes. This research starts from the question: what were the results obtained with the implementation of the management and process mapping of PAD? It is proposed as a general objective to analyze the management and the mapping of that Board processes, identifying the possible benefits in improving the quality of the services provided to users. The specific objectives to achieve results, are pointed out: describe how you carried out the implementation of the management and process mapping in DAP and how it is working at the moment; examine the line in the relationship between the actions developed by the DAP and modern theories of this theme; identify the evolution of the sector with the measures adopted and the results obtained with the implementation of the mapping tool. In the theoretical framework, it was approached a brief history of the evolution of public administration in Brazil, GesPública program and its importance for process management in public institutions as well as the Management and Process Mapping. The context of the study was the DAP, and participants were managers of the institution in the survey. Data collection was done through the study of the institution's documents, bibliography analysis available on the topic, questionnaires and semi-structured interviews with professionals of the institution involved with the object of study, since its inception until July 2015, when it was finished the search. As a result, were listed: the motivation, importance, benefits and innovations that management and the mapping of processes brought to the institution, point out what has been improved in the service users and the tools used. We also analyze the main problems identified during the implementation of the mapping. As a suggestion, it was analyzed how these procedures can, if possible, be extended to other sectors of UFRN.

Foraminíferos como ferramenta de estudo na geologia ambiental do estuário do Rio Potengi e da plataforma interna, RN, Brasil

The Potengi River estuary has been affected by various anthropogenic factors over the years, as periodic dredging, industrial and domestic waste, traffic and other factors, causing various environmental disasters, including the notorious ecological accident in July 2007, which covered the municipalities of São Gonçalo do Amarante, Macaíba and Natal. Foraminifera serve as viable study tools in these environments; they are able to identify ecologically stressed environments, pointing out hydrographic changes and depositional environments in estuaries. The necessity to check the differences in environmental gradients in places anthropically impacted in Potengi River and adjacent inner shelf through species of foraminifera, and, the responses of these organisms to physical, chemical and geological factors is to provide baseline in the diagnosis of environments. The results show the dominance of opportunistic Ammonia tepida, Bolivina striatula, Quinqueloculina patagonica and Q. miletti especially in regions close to shrimp farms and Baldo Channel sewage in fine grain environments; and Q. lamarckiana indicates penetration of the saline waters in Potengi River. The occurrence of low-salinity tolerant foraminiferal species typical of mangrove environments as Trochammina inflata and T. squamata in Potengi River Channel suggest they probably could have been transported from mangrove area near the Potengi river mouth to the inner shelf regions. These findings suggest Potengi River is able to export mixohaline and mangrove organisms to inner shelf. Two distinct environments were observed, the outermost area is more influenced by marine influence and the innermost area is less influenced. Calcareous and agglutinated species dominate Potengi River, while mouth and inner shelf areas are dominated by calcareous, agglutinated and porcelaneous species, which are typical of highly saline and hydrodynamic environments and the contributive factors that controls foraminiferal distribution were balance of marine and freshwater currents, grain size, availability of CaCO3 and organic matter.

Foraminíferos como ferramenta de estudo na geologia ambiental do estuário do Rio Potengi e da plataforma interna, RN, Brasil

The Potengi River estuary has been affected by various anthropogenic factors over the years, as periodic dredging, industrial and domestic waste, traffic and other factors, causing various environmental disasters, including the notorious ecological accident in July 2007, which covered the municipalities of São Gonçalo do Amarante, Macaíba and Natal. Foraminifera serve as viable study tools in these environments; they are able to identify ecologically stressed environments, pointing out hydrographic changes and depositional environments in estuaries. The necessity to check the differences in environmental gradients in places anthropically impacted in Potengi River and adjacent inner shelf through species of foraminifera, and, the responses of these organisms to physical, chemical and geological factors is to provide baseline in the diagnosis of environments. The results show the dominance of opportunistic Ammonia tepida, Bolivina striatula, Quinqueloculina patagonica and Q. miletti especially in regions close to shrimp farms and Baldo Channel sewage in fine grain environments; and Q. lamarckiana indicates penetration of the saline waters in Potengi River. The occurrence of low-salinity tolerant foraminiferal species typical of mangrove environments as Trochammina inflata and T. squamata in Potengi River Channel suggest they probably could have been transported from mangrove area near the Potengi river mouth to the inner shelf regions. These findings suggest Potengi River is able to export mixohaline and mangrove organisms to inner shelf. Two distinct environments were observed, the outermost area is more influenced by marine influence and the innermost area is less influenced. Calcareous and agglutinated species dominate Potengi River, while mouth and inner shelf areas are dominated by calcareous, agglutinated and porcelaneous species, which are typical of highly saline and hydrodynamic environments and the contributive factors that controls foraminiferal distribution were balance of marine and freshwater currents, grain size, availability of CaCO3 and organic matter.

Utilização de sismos regionais para a determinação de um modelo 1D de velocidades da onda P na Província Borborema - NE do Brasil

In this work it was performed a study to obtain parameters for an 1D regional velocity model for the Borborema Province, NE Brazil. It was used earthquakes occurred between 2001 and 2013 with magnitude greater than 2.9 mb either from epicentres determined from local seismic networks or by back azimuth determination, when possible. We chose seven events which occurred in the main seismic areas in the Borborema Province. The selected events were recorded in up to 74 seismic stations from the following networks: RSISNE, INCT-ET, João Câmara – RN, São Rafael – RN, Caruaru - PE, São Caetano - PE, Castanhão - CE, Santana do Acarau - CE, Taipu – RN e Sobral – CE, and the RCBR (IRIS/USGS—GSN). For the determination of the model parameters were inverted via a travel-time table and its fit. These model parameters were compared with other known model (global and regional) and have improved the epicentral determination. This final set of parameters model, we called MBB is laterally homogeneous with an upper crust at 11,45 km depth and total crustal thickness of 33,9 km. The P-wave velocity in the upper crust was estimated at 6.0 km/s and 6.64 km/s for it lower part. The P-wave velocity in the upper mantle we estimated at 8.21 km/s with an VP/VS ratio of approximately 1.74.

Utilização de sismos regionais para a determinação de um modelo 1D de velocidades da onda P na Província Borborema - NE do Brasil

In this work it was performed a study to obtain parameters for an 1D regional velocity model for the Borborema Province, NE Brazil. It was used earthquakes occurred between 2001 and 2013 with magnitude greater than 2.9 mb either from epicentres determined from local seismic networks or by back azimuth determination, when possible. We chose seven events which occurred in the main seismic areas in the Borborema Province. The selected events were recorded in up to 74 seismic stations from the following networks: RSISNE, INCT-ET, João Câmara – RN, São Rafael – RN, Caruaru - PE, São Caetano - PE, Castanhão - CE, Santana do Acarau - CE, Taipu – RN e Sobral – CE, and the RCBR (IRIS/USGS—GSN). For the determination of the model parameters were inverted via a travel-time table and its fit. These model parameters were compared with other known model (global and regional) and have improved the epicentral determination. This final set of parameters model, we called MBB is laterally homogeneous with an upper crust at 11,45 km depth and total crustal thickness of 33,9 km. The P-wave velocity in the upper crust was estimated at 6.0 km/s and 6.64 km/s for it lower part. The P-wave velocity in the upper mantle we estimated at 8.21 km/s with an VP/VS ratio of approximately 1.74.

A prescrição de medicamentos por enfermeiros na atenção primária à saúde no Brasil: caracterização, normatização, formação e lições aprendidas.

O papel do enfermeiro como prescritor vem se ampliando em muitos países nos últimos anos, em diferentes situações e amplitudes de ação, se configurando como prática avançada na enfermagem. No Brasil, a prescrição de medicamentos por enfermeiros está prevista na Lei do Exercício Profissional desde 1986, e permite a esse profissional, a prescrição de medicamentos estabelecidos em programas de saúde pública. Esse estudo tem como objetivo geral analisar as determinações e perspectivas da prescrição de medicamentos por enfermeiros nos protocolos da Estratégia Saúde da Família. Os objetivos específicos são: apreender a atual situação internacional da prescrição de medicamentos por enfermeiros em comparação a essa prática no Brasil identificando semelhanças e diferenças; identificar os contornos legais e normativos da prescrição de medicamentos por enfermeiros no Brasil apontando sua história, tendências e desafios; caracterizar o modelo de prescrição de medicamentos por enfermeiros nos protocolos de Atenção Primária à Saúde no Brasil; investigar possíveis lacunas entre formação, capacitação, autoavaliação e prática da prescrição de medicamentos na Atenção Primária à Saúde na perspectiva do enfermeiro. Trata-se de Estudo de Caso Exemplar com abordagem qualitativa através de Revisão Bibliográfica, Análise Documental e Grupo Focal com enfermeiros. A análise dos dados deu-se por meio da Análise de Conteúdo e Análise Qualitativa de Conteúdo. Os resultados revelam que a categoria da enfermagem contribuiu para a legalização da prescrição, porém não para a sua legitimação; na Atenção Primária à Saúde, essa atribuição está consolidada por meio de protocolos e legislação, embora sem estratégia clara de acompanhamento pelo Ministério da Saúde; observa-se resistência em algumas normatizações dentro do setor saúde. Quanto aos protocolos, observou-se não há exigência de pré-requisitos na maioria deles; há possibilidade de diagnóstico pelo enfermeiro na gravidez, nutrição infantil e doenças sexualmente transmissíveis; observou-se variados graus de autonomia; amplo grupo de medicamentos prescritos por enfermeiros. Dos 37 participantes do Grupo Focal, 97,3% eram do sexo feminino; 54% formados há menos de 10 anos, 27% entre 10 e 20 anos, 16,2% há mais de 20 anos; 83,8% com especialização em Saúde Pública. Todos os enfermeiros relataram insuficiência da disciplina de farmacologia para instrumentalizar a prática prescritiva. Destacou-se a necessidade de pós-graduação; a importância da experiência clínica; falta de discussões e capacitação. Apenas alguns se autoavaliaram como competentes para prescrever, outros revelam medo de reação adversa a medicamentos. Conclui-se que há tendência da prescrição de medicamento por enfermeiros permanecer apenas na legalidade e o principal desafio é alcançar a legitimidade. Confirma-se uma prática prescritiva sem requisitos, diversidade de orientações induzindo a multiplicidade de ações que pode afetar a qualidade da prescrição. Há lacunas entre formação, capacitações e exigências cotidianas da prescrição de medicamentos por enfermeiros na Atenção Primária à Saúde. No Brasil se faz premente pesquisa para avaliar o impacto, a qualidade e a segurança da prescrição de medicamentos por enfermeiros. A experiência internacional sugere também que essa prescrição deve ser apoiada pelo coletivo de enfermeiros, com robusto plano de capacitação nacional, além de governança e apoio local.

Prevalência, fatores associados e efeitos da violência doméstica na mobilidade em idosos: evidências do estudo imias (international mobility in aging study) sob a perspectiva epidemiológica do curso da vida

A capacidade de mover-se com independência e segurança é fundamental para a execução das atividades de vida diária e manutenção da qualidade de vida do indivíduo. Diversos fatores, dentre eles o envelhecimento podem contribuir para seu declínio. Estudos têm demonstrado associação entre experiências de violência doméstica (VD) e diversos problemas de saúde física e mental. Até o momento, não há estudos que tenham avaliado a associação entre experiências de VD no curso de vida e limitações de mobilidade na senescência. OBJETIVOS: estimar a prevalência da VD (física e psicológica) em idosos, e avaliar o impacto da VD no curso de vida na limitação de mobilidade. MATERIAIS E MÉTODO: Estudo observacional analítico a partir da primeira coleta de dados do estudo longitudinal International Mobility in Aging Study (IMIAS). Idosos (n = 1995) de ambos os sexos entre 65 e 74 anos de cinco localidades distintas (Kingston e Saint-Hyacinthe, Canadá; Tirana, Albânia; Maniazales, Colômbia; e Natal, Brasil) participaram do estudo. Dados sobre variáveis sociodemográficas, econômicas, condições de saúde e experiências de VD (física e psicológica) durante o curso de vida foram coletados. A limitação de mobilidade na senescência foi avaliada pelo Short Physical Performance Battery (SPPB) e pela dificuldade de andar 400 metros e/ou subir um lance de escadas. As prevalências foram avaliadas mediante frequências absolutas e relativas das exposições à VD, limitação de mobilidade e co-variáveis. Diferenças de gênero, bem como entre cidades foram analisadas utilizando o teste de qui-quadrado. Associação entre exposição à VD e limitação de mobilidade foi avaliada utilizando a regressão logística binária multivariada, ajustando pelas co-variáveis. Análise de mediação foram utilizadas, para avaliar possíveis caminhos entre a exposição à VD no curso de vida e a limitação de mobilidade. RESULTADOS: A violência física foi rara, com valores entre 0,63 e 0,85%. Relatos de violência psicológica variaram entre 3,2% e 23,5% (homens) e de 9% para 26% (mulheres). Mulheres experimentaram mais violência do que os homens em Saint-Hyacinthe (homens: 3,2% vs mulheres: 14%, p <0,001), Tirana (homens: 4,3% vs mulheres: 10,3%, p = 0,017), em Manizales (homens: 8,3 % vs mulheres: 18,3%, p = 0,004) e Natal (homens: 11,1% vs mulheres: 26%, p = 0,002). Em geral, o baixo suporte social pelo parceiro foi associado com a VD. Estar trabalhando foi associado a vitimização entre os homens, enquanto o oposto foi verdade para as mulheres. Arranjos de vida Multi-familiares e baixo suporte pelos parceiros, filhos e família foram associados com a VD. Baixo suporte social foi da maior importância para as mulheres do que os homens. A VD física foi associada tanto com o SPPB < 8 (OR 1,623 95%IC 1,161-2,269) como com a dificuldade para andar 400 metros e/ou subir um lance de escadas (OR 1,394 95%IC 1,063-1,829). A limitação de mobilidade decorrente da violência física no curso de vida pelo parceiro íntimo foi mediada pelas condições crônicas (efeito 25,56% 95%IC 0,036-0,277) e depressão (efeito 33,05% 95%IC 0,087-0,333). No caso da violência física por outros familiares, a limitação de mobilidade foi mediada pelas condições crônicas (efeito 20,85% 95%IC 0,022-0,202), não adesão à prática de atividades físicas (efeito 34,14% 95%IC 0,076-0,351) e depressão (efeito 44,40% 95%IC 0,144-0,315). CONCLUSÕES: A violência doméstica no curso de vida é uma realidade, que pode acarretar consequências que favorecem a limitação de mobilidade em idosos. São necessárias políticas públicas que combatam efetivamente a violência doméstica, garantindo um envelhecimento mais digno e independente funcionalmente.

Do reconhecimento à efetividade do direito fundamental à água: diálogos entre Nicarágua e Brasil

La humanidad está en un periodo de transición paradigmática, donde aún no existe acuerdo sobre en cual periodo nos encuadramos, sí modernidad o posmodernidad, pero el debate de ahí surgido se revela útil y transversal a los dilemas que enfrenta hoy la sociedad. Uno de esos dilemas tiene que ver con el reconocimiento del agua como derecho fundamental, ciertamente la era de la información ha permitido avanzar en armar el rompecabezas de la crisis hídrica mundial y sus riesgos, lo que ha develado una realidad importante, el acceso al agua tanto en naciones económicamente desarrolladas como en las menos desarrolladas constituye aun una aspiración, son varias las causas de esto, siendo una de las más comunes la atribuida al cambio climático, sin embargo, al profundizar en la materia surgen otras causas como la falta de voluntad política a nivel nacional, los intereses económicos que dan al agua tratamiento de mercancía y a nivel internacional la existencia de luces y sombras en el campo de los derechos humanos, estas constituyen las piezas del mencionado rompecabezas, aun por armar. Mientras tanto el Derecho tiene aquí un desafío de significativa importancia, adaptarse a fin de responder adecuadamente a las nuevas realidades: riesgos de diversas índoles. Esta investigación tiene como objetivo defender la existencia del derecho fundamental al agua en el ordenamiento jurídico brasileño y nicaragüense, comparando instrumentos que puedan asegurar su efectividad. Para la realización de este trabajo se utilizó un abordaje inductivo-comparativo, fuentes bibliográficas brasileñas, nicaragüenses y de países con experiencias relevantes para la comprensión del problema y que pudieran aportar propuestas de cara al reconocimiento y efectivación del derecho fundamental al agua. Este trabajo encontró que existen ambigüedades importantes en el campo del Derecho Humano al Agua motivadas por el trabajo de agencias que defienden el derecho pero a la vez establecen coordinaciones y normativas con quienes impulsan su privatización, fue posible presentar elementos que apoyan la fundamentalidad del derecho al agua desde un punto de vista material y de vinculación con otros derechos fundamentales, pero preocupa en el caso de Brasil y Nicaragua el poco avance jurisprudencial de cara al reconocimiento y finalmente la atribución de la crisis hídrica en muchos casos a la incertidumbre climática, cuando uno de los principales desafíos se encuentra en la explotación comercial del agua.