A intervenção do poder judiciário no acesso a medicamentos no Rio Grande do Norte: uma análise sob a ótica das políticas nacionais de medicamento e de assistência farmacêutica

The present study aimed to evaluate the inclusion of the principles of the National Medicines Policy - PNM and the Pharmaceutical assistance - PNAF in the prosecution of lawsuits involving medicines. To fulfill this necessity , data collection was performed on the website by the Tribunal Rio Grande do Norte - TJ RN ( Rio Grande do Norte Court) , in 2012 . It was obtained 115 judgments, which were analyzed in order to generate Monitoring Indicators from lawsuits and conduct content analysis proposed by Bardin (2006). The results showed that : a) 100 % of the decisions were favorable to the author , b) 76 % of decisions were requests by the trade name of the drug , c) only one drug (eculizumabe) had not granted by ANVISA , d) 36 % of drugs were present in the list of standard medicines in SUS , 16 % of primary care block and 20 % of specialized component , e) 76 % of the decisions presented the request of at least 01 non-standard medicine. With regard to decentralization of PNM and PNAF we observed a commitment to this principle at judicial decisions, to see that municipalities and states are often forced to buy medicines of responsibility from another federal entity or other tertiary units as CACONs and UNACONS. The content analysis revealed that the argument from the judges used when you utter their decisions was that the right to health is recognized by Brazilian law as a fundamental right and should be guaranteed by the State for all its citizens. So, health is more than budgetary constraints of federal entities, which are severally liable for lawsuits , regardless the medication requested belongs or not to a particular block of a pharmaceutical assistance funding. Given these data, it is observed that there are gaps in the judgment when it comes to the insertion of the words and principles of PNM and PNAF, creating then the need for greater dialogue between the executive and judicial, so that they may consider relevant the effectiveness and application of such principles to minimize the negative consequences of the phenomenon of health judicialisation. Keywords: Judicialisation, Medicines, Public Policy, Pharmaceutical Care

Formação ética para a cidadania: uma investigação de habilidades sociais medidas pelo inventário de habilidades sociais

O objetivo desta pesquisa foi investigar se o repertório de habilidades sociais importantes para a formação ética de um grupo de estudantes de ensino médio, curso pré-vestibular e curso de graduação em psicologia evidenciava mudanças relacionadas à diferença de idade e características específicas dos contextos interativos oferecidos pelas instituições de ensino participantes desse processo. Foi aplicado o Inventário de Habilidades Sociais a uma amostra de 45 estudantes e questionários semiestruturados a nove professores. Entre os alunos, os resultados indicaram diferença estatisticamente significativa entre as classes das categorias de ensino investigadas em relação a diferentes conjuntos de habilidades sociais. Dos resultados obtidos com os professores, pode-se depreender que estes possuem noção clara das capacidades que o aluno deve obter para agir com ética e ser cidadão, mas esses professores não propiciam condições, no contexto escolar, para a promoção de tais habilidades. Isso indicou a necessidade de melhorias na capacitação dos docentes, visando à ampliação do repertório de habilidades sociais de seus alunos.

A educação permanente em saúde na ótica dos cirurgiões dentistas

This study aimed to examine the perception of dentist-surgeon about the Permanent Education in Health (PEH). It is characterized as a qualitative research with focus in the field of public health policies. It refers specifically to the development of Permanent Education policy in Health in the state of Rio Grande do Norte. They were participants of this research 42 dentist surgeons and 83.3% females and 16.7% males, participants in Specialization courses approved and agreed by the Permanent Education Center in Health (PEC-RN) in the period 2005 to 2007. These professionals are part of the Family Health Strategy (FHS), and 11.9% work in management at the central level and 88.1% are directly related to oral health care in the Basic Health Units of the Family, 30 cities in the state. Data collection was through a questionnaire, with questions that guided the research development and achieve the objectives proposed. The socio-demographic data were analyzed using the descriptive statistics and subjective content was subjected to content analysis by Bardin. The emerging categories from the textual material generated by respondents were: program content, methodological approach and concepts of Permanent Education in Health. The subjects surveyed reported that the program content is more comprehensive and directs to the reflection of everyday practices, with regard to the methodological approach, concern that occurs through discussion and reflection with dynamic, participative, varied and constructive activities, questioning and putting as the main focus. As for understanding of the concepts of the PEH, there was a consensus that define as education stable strategies which contributing to transform and improve the health workers to have the upgrade, improvement of practices, being based on everyday experience and taking into account the accumulation and renewal of these experiences. Therefore, results presented showed that there is a clear understanding of the subjects on the proposals and guidelines of the PEH. It was concluded that lack continuous access to the policies proposed by Ministry of Health involving health workers, managers, communities, through social control and the teaching-service integration and that they are worked within the health system and can classify all these segments of society favor the existence of a more participatory, effective, fair and better quality health service

A documentação odontológica sob a ótica dos cirurgiões-dentistas de Natal-RN

The dental documentation or handbook is a collection of documents produced by the professional with diagnostic and therapeutical purpose where the inherent information to the buccal and general health of patients are registered. The register and proper filling of these documents, taking care of the ethical and legal requirements, provide to the dentist the possibility to contribute with justice in cases of human identification and makes of these documents an essential element of evidence in the ethical processes, administrative, civil and criminal against the dentists. Ahead of this fact, understanding such requirements and the importance of the dentist to register himself adequately, this research verified the knowledge of Natal (RN) City s dentists with relation to the elaboration of the dental handbook, investigating the concepts and the importance attributed to the handbook, identifying the documents more used and filed by these professionals, besides inquiring the legal value of filed documents and the filling time of these ones. The sample was constituted by 124 dentists, who had answered a questionnaire, after having been randomly selected ITom a list of professionals subscribed in the Dentistry Local Council/RN Section. The analysis of the results showed that majority of the participant citÍzens (52,3%) confers to the dental documentation the clinical importance, followed by the legal and forensic-dentistry importance; 59,3% of the searched professionals do not distinguish satisfactorily or they do not observe differences between the dental handbook and the clinical filing card, the X-rays, the dental certificates, the prescriptions, the directions and the receipts; between the documents of common use to clínical and specialist ones, the contract of rendering of services and term of ITee and cleared up consent are the documents less used by the professionals. It was still verified, that only 13,1% of the sample register the signature of the patients in the clinical filing card, making it more credibility to be presented in judgement. In the same way, copies of dental certificates and prescriptions evaluated and signed by the patients are filed respectively by only 13,5% and 9,4% ofthe searched professionals and 50% ofthe sample, keep these documents filed for an indeterminate period of time, that is, these professionals have the guard of the handbook and they do not intend to disdain it, although 85,5% of the sample does not recognize the real proprietor of the handbook. It is concluded that a great part of the dentists is unaware about the importance of the dental documentation, and neglect its elaboration, leaving themselves exposed to several kinds of penalties foreseen in the legislation

Estilos de aprendizagem sob a ótica da Psicologia Evolucionista

Among a variety of learning conceptions, David Kolb´s Experiential Learning Theory proposes four different learning styles: diverging, characterized by orientation towards people and multi-perspective vision; assimilating, concerned with ideas and abstract concepts as well as theory formulation; converging, expert in dealing with technical tasks and problem solving; and accommodating, risk taker and good at getting things done. Interesting correlations have been pointed out between Kolb s learning styles, professional careers and genders. With respect to behaviors, specific cognitive skills and interests, sex differences are widely known, and explained by Evolutionary Psychology as the result of distinct selective pressures acting on each gender. The aim of this research was to assess adolescents learning styles and their relation with interests on school and career choices, analyzing possible gender differences. We distributed questionnaires to 221 senior high school students to research their preferences for school disciplines, professional activities and career choices. The Learning Style Inventory specified the learning style of each individual. Our results showed a high frequency of reflective styles, with predominance of females as diverging and males as assimilating. Concerning school and professional interests, there were correlations between styles oriented towards the abstract and technical interests. Moreover, females preferred disciplines related to languages and interpersonal activities while males preferred disciplines related to science and technical activities. There were more males in exact science and engineering careers, and more females in social science and applied social science. Correlations found between learning styles, school and professional interests corroborate Kolb´s propositions, and the findings about gender differences are supported by Evolutionary Psychology theories

Influência do pré-aquecimento na adaptação marginal de dois materiais seladores de fóssulas e fissuras, analisada através de tomografia de coerência ótica

Among the non-invasive techniques employed in the prevention of caries highlights the sealing pits and fissures which is a conservative maneuver, in order to obliterate them to protect them from attack acid bacteria. Influenced by the studies of pre-heating composite resin, which has experienced great improvement in some of their physical properties, this study aimed to evaluate in vitro the superficial and internal marginal adaptation of different materials and sealants in pre-heating or not. A total of 40 extracted human third molars (n=10) that had their occlusal surfaces prepared to receive sealant. We tested two types of sealing materials: resin sealant (Fluoroshield) and low-viscosity resin (Permaflo), where 50% of previously received heated material and the other half received sealant material at room temperature. All samples were subjected to thermal cycling and pH, simulating a cariogenic oral environment, and later were analyzed appliance OCT (optical coherence tomography). The images obtained alterations were recorded and analyzed statistically. Change was considered as the emergence of bubbles, gaps and cracks in the sealant. Comparisons of the same material, assessing the fact that it is not sealed or preheated material, as well as comparisons between different materials subjected to the same temperature were carried out. The nonparametric Tukey test was used (p < 0,05). The results showed that there was statistically significant difference between both the materials analyzed, as between the situations in which the sealant material was submitted (preheated or not). On the issue of marginal adaptation and internal surface, seen through Optical coherence tomography, may suggest that there is a difference between the use of one type or another of the sealing material analyzed, with superiority attributed to resin Permaflo compared to sealant Fluroshield, telling is the same for the different techniques used

Fiat voluntas tua! Vício e pecado na ética de Abelardo

Abélard, à son éthique, préfère, à la notion de vice, celle de péché. Ce mouvement n'est pas um préssupposé de l'auteur, mais se suit, nécessairement, à sa position de logicien et, aussi bien, à sa critique aux philosophes stoïciens qu'il a pu connaître.

Ética na pesquisa em turismo: percepções de discentes de programas de pós-graduação stricto sensu em turismo UFRN, UCS e UNIVALI

This study analyzed the perception of ethics on the part of students of Post-graduation in Tourism, to develop their academic research. It is characterized as exploratory-descriptive, being considered quantitative with some elements analyzed qualitatively. Data were collected through an electronic questionnaire, originated in google docs and sent via e-mail to 54 students in three graduate programs in Tourism: The Tourism Master of the Federal University of Rio Grande do Norte (UFRN), the Master in Tourism and Hospitality of the University of Vale do Itajai (UNIVALI) and Master of Tourism at the University of Caxias do Sul (UCS), resulting in 22 responses. The study presents a profile of the dissertation research of post-graduate students, their perception about research ethics, as well as the difficulties encountered in the research process. Notes that research of dissertation are geared mostly for the historical and cultural aspects of tourism and the choice of topics for the essays came in first place, due to the influence of the guiding lines of research and, secondly, due to social relevance. The methods used in post-graduate research are descriptive, the literature and exploratory. It also notes that most students graduate in tourism (81%) attaches great importance to ethics in carrying out their dissertation research, students claim that ethics brings credibility and seriousness to research. Furthermore, it was realized that they have no knowledge about the practice of misconduct by researchers in the field of Tourism. Demonstrate that the major ethical challenge encountered by students is in relationship with the research subject, what happens during data collection. It also notes that none of the respondents sent any project to be evaluated by an Ethics Committee (CEP), moreover, most do not know the resolution 196/96, which has the main guidelines on research ethics at national level. Concludes that the students post-graduate in tourism have little knowledge about the standards and guidelines on research ethics. They demonstrate ignore the benefits of research ethics in regarding the protection and preservation of the participant, as well as the benefits it generates for society

Utilização de indicadores financeiros e não-financeiros na gestão de hotéis no Rio Grande do Norte: um estudo sob a ótica do Balanced Scorecard

This study presents the results of a research on the use of financial and non-financial performance indicators used by medium and large hotels. The research was conducted in Rio Grande do Norte, a Brazilian State. The objective is to identify the usage of performance measures by these companies. Hotel industry is one of the most important sectors in the Rio Grande do Norte economy. The research takes the Balanced Scorecard as a conceptual framework, since it represents an original contribution to the literature of managerial accounting, for rethinking old issues, pointing out themes that were forgotten or badly interpreted, to discuss the requirements imposed by the economy environment, dominated by competitive companies, and increasing the understanding of the relationship between strategy and operation. The objective of the research is to investigate if the hotel managers make use of a managerial information system or not, when evaluating the performance of their business unit. The research reveals the usage of performance evaluation using a large variety of measures. Among them is worth mention: the usage of accounting profit altogether with the EVA/MVA, the process cycle time, total quality management, process transformation, strategic mission, vision, strategic measures, measures related to feedback, risk, costs, productivity, incomes, customers retention, customer satisfaction and profitability, measures using time as a component, quality of the process, cost of the processes, employees capabilities, information systems, motivation, empowerment and alignment. The research leads to the conclusion that the usage of the deriving concepts of Balanced Scorecard can improve the performance measurement systems used by hotels

Constitucionalismo internacional: direitos humanos sob a ótica da globalização

The work presented here is the result of research on the issue of human rights in the face of conflicting issues such as the incorporation of international treaties, the sovereignty of states, globalization and multuculturalism. Specifically, we will investigate the origin of human rights, alongside his growing recognition, from the Revolutions until its completion in the Universal Declaration of Human Rights in 1948. The question, however, has become broader, when analyzed from the perspective of the internationalization of these rights as conditions and limits of democracy. Given the convergence on the reception of international treaties on human rights, we analyze a series of positions, including recent placements of the Supreme Court, and Constitutional Amendment n.45/2004. The study aims to review the classical concept of sovereignty, now within a new perspective based on the appearance of certain limitations of the state and a crisis in the face of the protection of human rights. We analyze the phenomenon of globalization in light of its complexity and its relation to sovereignty and human rights in pursuit of an expansion of democracy. The theme is consistent also with the line of contemporary constitutionalism, since their approach has a close connection with the issues of sovereignty and globalization, as well as a current relationship with the protection of human rights. The research aims to analyze the formation of a new society within a global vision of the constitutionalization of international law. It seeks to glimpse the invocacion model of foreign precedents and the possibility of dialogue betweem States as a way of protecting and enforcing the protection of human rights

A doação de sangue sob a ótica de escolares: concepções e valores

Nesta pesquisa investigou-se o nível de informação, percepção, motivos e sentimentos de escolares sobre a doação de sangue. 145 escolares do pré, 2ª, 4ª séries com seis, oito e 10 anos de idade foram submetidos a provas piagetianas, responderam uma entrevista, se posicionaram frente a um dilema. Verificou-se pouca informação e informações errôneas sobre a doação. A escola foi a fonte de informação menos citada. A maioria dos entrevistados tanto na entrevista, como no dilema, justificou a doação de sangue como um ato solidário, permitindo supor que valores como generosidade podem ser adquiridos na fase pré-operatória. Discute-se o papel da escola nos programas de Educação em Saúde voltados a comportamentos que serão emitidos a longo prazo e que beneficiam a coletividade.

Prática profissional e ética no contexto das políticas de saúde

Foram estudadas práticas profissionais em saúde, no contexto das poilítcas sociais em um município paulista. Objetivou-se conhecer as influências dessas políticas nas práticas profissionais e na observância de princípios éticos e de preceitos legais do Sistema Único de Saúde. Foram entrevistados profissionais de saúde, responsáveis pela gestão do sistema de saúde do município, coordenação de instituições de saúde e chefias de unidades. Os entrevistados fizeram referências à gravidade da situação atual do sistema de saúde, manifestando percepção fatalista e visão mecanicista dos fatos, influenciadas pela concepção liberal. Como conseqüência, buscam soluções alternativas individuais, nem sempre lícitas ou éticas.

A importância da saúde bucal na ótica de pacientes hospitalizados

A percepção da condição bucal é um importante indicador de saúde, pois sintetiza a condição real de saúde, as respostas subjetivas, os valores e as expectativas culturais. O estudo avaliou a importância da saúde bucal segundo a percepção de pacientes internados em um hospital da cidade de Araçatuba (SP). Foi aplicado um questionário semi-estruturado para a coleta de dados e utilizado para análise estatística o programa Epi Info 2000. Os resultados mostraram que metade dos pacientes haviam realizado a última visita ao cirurgião-dentista em um período compreendido entre seis a doze meses devido a problemas periodontais (35%) e cárie dentária (20%). Observou-se que, embora todos os pacientes considerassem ter uma boa higiene bucal, o tratamento periodontal foi identificado como o de maior necessidade entre os pacientes (67,93%). A presença do cirurgião-dentista no corpo clínico hospitalar foi considerada por todos os entrevistados como fundamental para contribuir no cuidado integral à saúde dos pacientes hospitalizados. Quanto ao papel do dentista em um hospital, a grande maioria dos pacientes (90,63%) afirmou ser o cuidar dos dentes. Assim, conclui-se que todos os pacientes têm conhecimento do quão é importante a manutenção das condições adequadas de saúde bucal, principalmente em pacientes hospitalizados.

Ciência e ética: alguns aspectos

A discussão sobre ciência e ética, se colocada em nível radical, necessita previamente passar pela concepção filosófica de 'ser humano', 'ética' e 'ciência'. Na perspectiva existencialista, o homem é um ser capaz de autodeterminação, ou seja, ser sujeito do conhecimento e da ação. em conseqüência, no campo ético, tudo aquilo que tira ou diminui essa dimensão de sujeito é considerado violência. Por sua vez, a ciência moderna ocidental contém em si um amplo projeto de dominação: da natureza, de si mesmo e do outro. Portanto, uma ciência ética só é possível a partir de uma nova postura diante da própria ciência e dos valores da sociedade construída sob seu signo.

Ética e moral como modos de produção de subjetividade

Deleuze e Guattari entendem as idéias de Ética e Moral como movimentos produtores de realidade psicossocial ou sentidos de produção da vida psicossocial. Buscamos entender como os modos de funcionamento psicossociais produzem sentidos e podem ser captados nas práticas psicossociais éticas e morais. Nossa intenção é demonstrar, a partir da literatura kafkiana, os modos de subjetivação ética e moral.