Reflexões sobre a política de descentralização em saúde: uma análise a partir do Hospital Monsenhor Walfredo Gurgel em Natal (RN)

The process of decentralization of health policy in Brazil has evolved throughout the second half of the twentieth century, advancing by leaps and bounds in the last two decades. The various public institutions have assumed the function of responding to a growing demand for medical care and hospital. Monsenhor Hospital Walfredo Gurgel - H.M.W.G. fits into this context as an institution par excellence-oriented service the demand for medium and high complexity. This paper presents some questions about the process of decentralization and devolution occurred in Brazil. To do so is a brief historical background and politics, showing the concepts of reform and counter-reform and how the processes mentioned in the Country Correlates develop local social development of the decentralization process and discusses the modifications in policies social intervention in recent decades and the state health policies. Presents the implementation of a Health System in Brazil and the state showing how the decentralization of health policy occurs in Rio Grande do Norte. Finally, it explores the role of H.M.W.G. in health policy in RN. For this, portrays the institution and is located within the decentralized structure of health policy in the state and capital. An analysis of the demand for hospital care and the budget situation is realized at the close of work, correlating the role of HMWG with the decentralization of health policy in Brazil and Rio Grande do Norte. The methodology used for the preparation of this work was based on documentary research, systematic nonparticipant observation, field diary and analysis of data, documents and content. This set shows a quantitative and qualitative methodology that strips the institution, enabling the understanding of their role, boundaries, threats and opportunities

A articulação da instrumentalidade no exercício profissional do assistente social em Natal/RN

Presents the discussion of practical and social dimensions that comprise the instrumentality (formative; theoretical and intellectual; investigative; technical-instrumental; and ethical-political) Social Work from research in social and occupational areas in which they operate social workers in Natal in Rio Grande do Norte. Chapters expose positions, experiences and reality of the respondents and the theoretical constructs and analytical, to understand: the evaluation of the training process, relating the teaching practice, the role of knowledge and the importance of research in professional practice of social workers, the seizure of technical-instrumental dimension, articulating demands, duties, powers and instruments, as elements that comprise it, and finally the ethical-political dimension, discussing the challenges of ethics and materialization of the ethical-political in daily work. In this sense, the dissertation sought add to production and academic debate about the work of the social worker, as well as contribute to their own professional practice, revealing how professionals articulate the practical and social dimensions that comprise the instrumentality in their daily work

O Serviço Social e a exclusão/inclusão social dos portadores de HIV/AIDS :demandas e desafios nos hospitais públicos

This research presents the labors developed by the Social Service unto socially excluded HIV/Aids positives at public hospitals in Rio Grande do Norte (RN). It purposes to identify and to analyze the demands brought by the holder onto the Social Service professional as well as the challenges the latter face to minister to the former. It privileges, from the methodological viewpoint, the qualitative and quantitative analysis with the application of questionnaires, direct observation, semi-structured interviews and bibliographic references. Data were collected from 12 (twelve) social assistants who work at Giselda Trigueiro Hospital in Natal (7) and Rafael Fernandes Hospital in Mossoró (5). The central hypothesis that guided this study is that the social inclusion/exclusion process experienced by the HIV/Aids positive on society implies a demand for the Social Service that is inserted in the public health context (specially in HIV-referred public hospitals), whose agents, however, when attempting to answer those demands, meet obstacles due to both the precariousness of public health services and the social complexity that concerns the HIV/Aids epidemic. Results point out that, de facto, the HIV/Aids epidemic, because of the social exclusion/inclusion process to which the holder is subject results a demand for the social agents at hospitals. Demands rise principally from the patient s life condition, considering the increasing pauperization in the epidemic context. As to what it is concerned, social assistants, responding to the needs, come across concrete twofold challenges: the illness in itself, for all social, negative aspects that make part of quotidian life of holders; and the precarious state of the public health service in RN State, since that working conditions are unsatisfactory

Competitividade de destinos turísticos e o imperativo sustentável: avaliação de dimensões e atributos condicionantes no Pólo Costa das Dunas, RN, Brasil

Being available as a tourist destination is a necessary condition but not enough for the expansion and success of tourism activity. To be successful, tourism requires investment, inputs, appropriate planning and management, like any other economic activity. A fundamental goal of the destination management is to understand how the competitiveness of a tourist destination can be improved and sustained. Competitive position of tourism can be measured and assessed by various models. Evaluating the indicators of competitiveness of a tourist destination involves a multivariate analysis, ranging from issues directly related to tourism activity itself to the indirect factors. These are elements that are interrelated and that together will point out the competitive condition of this destination. From the definition and characterization of competitiveness, sustainability and management in the context of tourist destinations, understood as the main concepts of this study, we present the main theoretical and methodological models of assessment of competitiveness of tourist destinations in the literature and represent the state of the issue in the scientific treatment of the subject. These models, designed by researchers from several countries and applied in different tourist destinations, are confronted about their structure, indicators considered and localities in which they were applied. The aim of this study was to know and evaluate the condition of tourist competitiveness of the destination Pólo Costa das Dunas, from the constraints attributes of superior performance of the evaluation model of tourist competitiveness of destinations Competenible, suggested by Mazaro, and that suit the requirements of international market aware of the strength and importance of sustainability. The condition of competitiveness of tourist destination in Rio Grande do Norte Pólo Costa das Dunas was moderate. The competitive strengths and weaknesses of the destination Pólo Costa das Dunas revealed through the dozens of sustainable attributes of the model Competenible showed guidelines and initiatives that can be taken to guide strategic decisions related to their planning and management. Thus, this study should serve as support for strategic planning and long-term management of the sector and as a crucial tool for making decisions related to public policies, sectoral investments, monitor processes, strategic planning, direction and control of the local and regional tourism development of destinations

O ecoturismo sob a égide da sociedade do consumo: um estudo das Unidades de Conservação de uso sustentável do RN

Ecotourism, in face to environmental demands and discussions, has achieved prominence in the tourism market and wide global development, occasioning a concern about the need for a scientific deepening through a critical approach of the dynamics of consumption and conservation that permeate this practice. This study addresses the ecotourism under aegis of consumer society, in which is perceived that it constitutes a contester practice of society in which it is embedded, nevertheless has been subjected to the logic of capital through commodification of nature. In order to comprehend the reality presented, this study had as geographical cutting two Conservation Units of Sustainable Use in Rio Grande do Norte state: the Jenipabu Environmental Protection Area (APAJ) and Ponta do Tubarão State Sustainable Development Reserve (RDSEPT). The research sought to investigate the relationship between conservation and consumption and their influences on ecotourism held in the Conservation Units (UCs) of sustainable use selected for this study. To this aim it was made a critical reflection about the relationship conservation versus consumption constant in the practice of ecotourism in UCs in the context of current society, analyzing the historical process of formation of UCs of sustainable use in RN state under the light of the contradictory pair conservation-consumption, as well as looking to apprehend the perception of ecotourism of the actors involved with this practice. It was adopted a qualitative approach under a critical perspective based on bibliographical and documentary research and realization of semi-structured interviews with three groups of actors, namely managers/technician, community and ectourists involved with ecotourism in the selected UCs. The analysis was made using two basic units of analysis (consumption and maintenance) and twelve categories. For definition of units of analysis and categories were taken as reference the authors Santos (1987; 1988; 1994; 2001; 2006), Guerreiro Ramos (1989) and A. B. Rodrigues (1996; 2003), which perform critical to society of consumption and describe the key characteristics of the technical-scientific-informational predominant means, and Diegues (1998; 2000), A. B. Rodrigues (2001), Pires (2002) and Neiman and Rabinovici (2010), which discusse historic and scientifically about the emphasis on conservation present in origins and discourse of ecotourism, describing also its founding characteristics. The main results show that the marketing use of the prefix eco has acted as a new dress for what in reality is in fact ancient, ie, the conservation is used as a justification for another new type of consumption. The results also show that despite the coexistence of commercial and symbolic intentions in both UCs, one can observe the predominance consumer society characteristics in the process of creation and the production activities of APAJ, while in RDSEPT we note the predominance of the conservationist characteristics proclaimed by ecotourism. It can be inferred therefore that tourism held in the APAJ can not be called ecotourism, while the practice found in RDSEPT show an alignment with the guidelines of ecotourism

Fatores que afetam o apoio de residentes ao desenvolvimento do turismo em sítios arqueológicos: um estudo no Seridó Potiguar

The tourist activity , which appropriates spaces and natural , cultural , social and economic scenarios in a given locality , requires a model of integrated development necessarily reconciling the support of residents. In this perspective , this study aims to analyze the factors influencing the support of residents in tourism development in archaeological sites , specifically in the two counties of Parelhas and Carnaúba dos Dantas , in Rio Grande do Norte, in the region of Seridó Potiguar as well as the interrelationship existing between these factors . To achieve the proposed objective of the research , a descriptive -exploratory and quantitative study based on the study of Nunkoo and Hamkisson (2012 ) , using the technique of Structural Equation Modeling - SEM to explain the relationships of the constructs used in this research. Data collection was performed during the periodof May 2013 to July 2013. Among other studies, results indicate that , for the profile of the interviewees used , the higher the confidence of the community residing in the government agencies responsible for, the largest tourism will support the resident to the tourism development and that this supply relationship institutions and government agencies an opportunity to enhance their development strategies and social thinking of the resident agent of tourism . It was also found that the analysis model proposed has a better structural relationship when used interviewees who have knowledge about the activities in the archaeological sites , then suggesting the need for further research on the effect of the level of knowledge of the interviewee on the object and support of residents to tourism development

Em busca do estado participativo: os desafios da participação social na gestão ambiental

The existence of several negative indicators such as deforestation, pollution of rivers and urban growth disorderly suggest a scenario of serious environmental degradation in Brazil, allowing that the model of public management of the environment here is not practiced efficiently, despite to be a recognition-of environmental legislation as one of the best and most comprehensive in the world. One of the main causes of this problem is the low social participation in environmental management that often exists only in the formal plan. Thus, although defined as Democratic State, in practice, it is only a Figurative State. Based on the study of the origin of the state and social participation in the Brazilian State, in general scope, and some environment committees and public hearings in Rio Grande do Norte, as instruments of social control, in particular scope, it is possible to build a real Democratic State in environmental management, a Participative State, in which all players are aware of the responsibility and committed to the duty assigned to them by the constitutional text with the present and future generations

Vegetação dunar: caracterização estrutural de dunas do município de Natal-RN como subsídio para implantação de técnicas de reflorestamernto, recuperação e conservação do ecossistema

The Brazilian coast has a wide variety of complex environments and ecosystems along the coast, about 80% are represented by sandbanks and dunes. The coastal ecosystems were the first to suffer the impacts man and places, as the very fragile ecosystems, are somehow altered. Are few areas of restinga well as natural features, very few protected in conservation units. Only in the last two decades the Brazilian restinga have been studies that are showing their importance for biodiversity of the country, though its economic importance remains largely unknown. In Rio Grande do Norte in the restinga vegetation and dune environments extend for almost the entire coast. The dunes are distinguished in the coastal landscape of the state due to the exuberance of its forms, heights and coating plants. The dune system is of fundamental importance for the maintenance of coastal urban settlements, especially for the city of Natal, acting on the hydrological dynamics of water table and reducing the effect of wind and movement of grains of sand to the interior and thus avoiding the burial City. However, the ecosystem of restinga and dune environments have been weakened and destroyed according to the intense urbanization and the knowledge of the vegetation of restinga installed on the dunes are still scarce. Thus, the objective of this study was to characterize the structure and floristic composition of vegetation established on a dune in the Dunes State Park Christmas and gather information to develop a model of recovery of the dune ecosystem. This dissertation is composed of 2 chapters, the first being: Structure of the vegetation of the dunes Dunes State Park in Natal, RN with the objective of describing the structure and composition of species of tree-shrub vegetation of restinga dunes of the Parque das Dunas and second: Recovery of degraded areas in a sand dune, which aimed to review the terms and concepts used in the theme of recovery and the techniques for recovery of degraded areas with emphasis on sandy environments and poor in nutrients, reporting some experiences within and external to Brazil the country, mainly in the Northeast and dunes positive and negative aspects that should be followed in building a model to be adopted for the recovery of local dunes

Zoneamento agroecológico do município e Apodi/RN

The aim of the paper is to carry out a geo-environmental characterization of Apodi District, in Rio Grande do Norte State, as a support to agro-ecological zoning studies on that region. The first methodology action was to accomplish a comprehensive bibliography review on the subject, followed by observation of satellite images and their processing throughout geographic information systems (SIG), as well as technical visits to various places in order to verify in loco the preset conditions of the soil and the environmental degradation problems in those areas. The paper also presents data about the socio-economy and physic-natural local aspects of the land, required to the implementation of zoning studies which are one the most important tool to the planning and organization of the use of the soil containing a sustainable cattle-raising activity. As a result, thematic maps describing the physic-natural features and analysis of the socio-environment data, indispensable to the agro-ecological zoning, have been provided

Participação social e designação de espécie-bandeira: ações complementares à conservação de um parque estadual em área urbana

Facing environmental problems the planet appears several alternative preventive and control on behalf of the equation between development and environmental protection. One of the alternatives implemented in Brazil to conservation of biodiversity was the creation of protected natural areas regulated by the National System of Conservation Units (SNUC). This is an integrated study of the Comunication / Environmental Conservation, which prioritizes social participation as a complementary in the conservation process, the particular case of the Dunas do Natal State Park, the first conservation area in Rio Grande do Norte, for full protection. It takes into account the roles environmental, scientific and Park, which harbors a unique biodiversity, including endemic species and the fact being located in an urban area. It proposes the use of two complementary instruments, such as strategies for conservation. Considering the various individual experiences, it was analyzed the perception that the community is directly related to the Park. From this promoted the democratization of information about the park, its biodiversity and conservation. As another conservation tool, it was suggested the use of a flagship species for the park, or a body chosen symbol for environmental or social reasons, in order to protect and conserve certain natural environments, from the understanding and co -community participation. In this case, as proposed flag Coleodactylus natalensis species, the lizard-the-litter, to be endemic remnants of Atlantic Forest Park as having the type locality, be one of the smallest species of the world, South America's lowest-dependent shadow of the forest, sensitive to human action and therefore very vulnerable. This suggestion finds support in the degree of public acceptance that interacts directly with the Park, as a result of the evaluation of their perceptions. It was further observed in this study that this symbology to be used in order to promote the democratization of the Park and its biodiversity has an identification result, curiosity and probable involvement of the population with the issues of the Park

Educomunicação: uma estratégia para promover o ambiente em uma área de proteção ambiental costeira

This study aimed to evaluate the potential of two public schools in Educommunication related to Environmental Protection Area Jenipabu (APAJ) located in Rio Grande do Norte / Brazil, based on perceptions of educommunicatives practices on the environment as well as perform an action included in the school APAJ. In the first phase of the research were three separate questionnaires designed to identify the actions, practices and experiences of three sets of audiences: teachers, students and parents from both schools. In the second phase, activities were carried out as educomunicatives class actions involving ride, maps of environmental design and construction of a mural on the school newspaper APAJ. We opted for the participant, making the observation in a previous visit to knowledge of the schools, where they made the first contacts with the administrative team, teachers and students, and then the application of semi-structured questionnaire to teachers, students and parents of the 4th and 5 years of elementary school the morning hours. The results showed the detachment of these actors in the knowledge, participation and involvement with APAJ, caused by the absence of actions and actions involving teaching practices educomunicatives students to interact with the environment, taking as its starting point the living space.

Democratização do acesso a água no semi-árido: o caso da comunidade rural de Pendências dos Emídios no município de Serrinha/RN

Brazil lives a time of experimentation and maturity as it pertains to managing the use of water, which comes institutionalising increasingly social participation. In Rio Grande do Norte, since 1997, the government has been developing actions accordingly, through the State Department of Water Resources, which has implemented a programme of adutoras within the State and created Water Users Associations, in the installation of dessalinizadores for places where the Adutora was not necessary or not yet arrived, so that should be managed by communities through associations of users. Since 2003, Civil Society Organisations - CSOs come through ASA - Articulation in the Semi-arid Brazilian, implementing the P1MC - Program of Training and Mobilization for Social Living with the Semi-Arid (One Million Rural Cisternas), in its third year of implementation in Rio Grande do Norte, in the spirit of working together with the semi arid. In the municipality of Serrinha / RN which incorporates the Semi-arid region, we find in the rural community of Pendêcias dos Emídios the experience of the State and Civil Society, which referred to a discussion about the environmental sustainability of these initiatives. The general objective of this work is to examine the strategies for participatory management in the use and access to water in the community of Pendêcias dos Emídios of the municipality of Serrinha / RN, to understand how those experiences can contribute to environmental sustainability. The methodology used envolvel bibliographic research in categories involving each article, the analysis of the terms of reference of each strategy as part of the documentary research, the application forms covering 40 families benefited, and interviews based on comprehensive analysis of the speech. This study is divided into 02 articles, where the first is a discussion held on collective action and environmental sustainability, and the second is held a discussion about the sustainability of the initiatives underway to access water. The results of the discussion held on 02 articles that had their empirical built from the experience of the Commonwealth of Pendências dos Emídios revealed how far will the ability of the State to promote collective action and the limitations of the perception of sustainability that permeates these initiatives in the search for democratic access to water in semi-arid

Dois testes de imageamento com GPR em problemas de controle ambiental em regiões tropicais: migração de dunas e localização de dutos de óleo enterrados

Because the penetration depth of Ground Penetrating Radar (GPR) signals is very limited in high conductive soils, the usefullness of this method in tropical regions is not yet completly known. The main objective of this researh is to test the usefullness of the method in Brazil. Two typical problems where GPR has been used in Europe and North American were choosed for this test: the first one is to characterize the internal structures of a sand body and the second problem is the localization of old buried pipes lines. The first test was done near the city of São Bento do Norte, in the northern coast of Rio Grande do Norte state, NE Brazil. In this region, there is a sand dune that is migrating very fast in the direction of adjacent settling areas. To characterize the internal structure of the dune and its relationship to the prevailing wind direction, as a preliminary step to understand the dune migration, GPR profiles using the 400 MHz frequency were performed in E-W, N-S, NE-SW, and SE-NW directions over the sand dune intersecting at the top of the dune. The practical resolution of the GPR data is around 30 cm; this was sufficient to distinguish individual foresets inside the dune. After applying the elevation correction to the data, we identified that dips of bedding structures are smallest for the N-S profile, which is perpendicular to the dominant wind direction, largest for the E-W profile, and intermediate for the SW-NE and SE-NW profiles. Foresets in the E-W profile dip with angles varying from 2 to 6 degrees. In the E-W profile, the water table and a horizontal truncation interface separating two generations of dunes were identified, as well as an abrupt directional change in the foreset patterns associated to a lateral contact between two dune generations, the older one extending to the west. The used high frequency of 400 Mhz does not allow a penetration deep enough to map completely these internal contacts. The second test was done near Estreito, a small town near Carnaúbais city, also in Rio Grande do Norte state. In this locality, there are several old pipe lines buried in area covered by plantations where digging should be minimized. Several GPR profiles using the 400 and 200 MHz frequency were performed trying to intercept perpendicularly the possible pipe lines. Because of the high conductivity of the soil, the raw original data can hardly be use to identify the pipe lines. However, after an adequate processing over the 200 MHz profiles, six pipe lines were identified. As a global result of the tests, GPR can be very usefull if the conductivity of the ground is low or, in the case of medium conductivities of the soils, if adequate processing is performed

Interpretação de dados de GPR com base na hierarquização de superfícies limitantes e na adaptação de critérios sismoestratigráficos

Due to its high resolution, Ground Penetrating Radar (GPR) has been used to image subsurface sedimentary deposits. Because GPR and Seismic methods share some principles of image construction, the classic seismostratigraphic interpretation method has been also applied as an attempt to interpret GPR data. Nonetheless some advances in few particular contexts, the adaptations from seismic to GPR of seismostratigraphic tools and concepts unsuitable because the meaning given to the termination criteria in seismic stratigraphy do not represent the adequate geologic record in the GPR scale. Essentially, the open question relies in proposing a interpretation method for GPR data which allow not only relating product and sedimentary process in the GPR scale but also identifying or proposing depositional environments and correlating these results with the well known Sequence Stratigraphy cornerstones. The goal of this dissertation is to propose an interpretation methodology of GPR data able to perform this task at least for siliciclastic deposits. In order to do so, the proposed GPR interpretation method is based both on seismostratigraphic concepts and on the bounding surface hierarchy tool from Miall (1988). As consequence of this joint use, the results of GPR interpretation can be associated to the sedimentary facies in a genetic context, so that it is possible to: (i) individualize radar facies and correlate them to the sedimentary facies by using depositional models; (ii) characterize a given depositional system, and (iii) determine its stratigraphic framework highligthing how it evolved through geologic time. To illustrate its use the proposed methodology was applied in a GPR data set from Galos area which is part of the Galinhos spit, located in Rio Grande do Norte state, Northeastern Brazil. This spit presents high lateral sedimentary facies variation, containing in its sedimentary record from 4th to 6th cicles caused by high frequency sea level oscillation. The interpretation process was done throughout the following phases: (i) identification of a vertical facies succession, (ii) characterization of radar facies and its associated sedimentary products, (iii) recognition of the associated sedimentary process in a genetic context, and finally (iv) proposal of an evolutionay model for the Galinhos spit. This model proposes that the Galinhos spit is a barrier island constituted, from base to top, of the following sedimentary facies: tidal channel facies, tidal flat facies, shore facies, and aeolic facies (dunes). The tidal channel facies, in the base, is constituted of lateral accretion bars and filling deposits of the channels. The base facies is laterally truncated by the tidal flat facies. In the foreshore zone, the tidal flat facies is covered by the shore facies which is the register of a sea transgression. Finally, on the top of the stratigraphic column, aeolic dunes are deposited due to areal exposition caused by a sea regression

Políticas de turismo e comunidade local no litoral potiguar

This research focuses on raise the discussion of existance tourism policies in Rio Grande do Norte and its contributions to the integration of local communities in the coastal tourist activity. Guided by the background of the neoliberalism and its influence on the model of tourism development adopted in Rio Grande do Norte. For that, were surveyed the concrete realities of coastal localities of the municipalities of Ceará-Mirim, Extremoz, Parnamirim and Nísia Floresta covered by Prodetur-RN I and II, by being part of the tourist portion of the state that have received domestic and international investment and, because are located in the geographical area of the Potiguar capital, Natal. We interviewed the municipal managers and the residents of local communities who live in municipalities more than ten years. Also, was raised a discussion on the role of the state as the main agent of public policies and hegemonic facilitator in the attraction of domestic and foreign investments, with the main scenario the neoliberal model of economic development. Here discuss ways and strategies of socio-political organization of local communities, with regard to the inclusion in the tourist and, pointing to the critical development model in question and signaling other concepts of development model, such as local basis, for example. By the ending of the research, was concluded that the model of development of the tourism in the Rio Grande do Norte is reflected of the way of life of the society, that the communities live in precarious conditions and that the way of inclusion in the tourism is almost incipient. Also, it was possible to detect the inexistence of public politics of tourism that promoted the planning of the tourist activity, as well as, the inclusion of the communities in the decision processes and that, searched the development on the basis of the principles of sustainable and local autonomy