Preceptoria em profissionais de saúde: viabilizando meios para uma formação pedagógica em hospitais públicos em Natal-RN

This study aimed to construct and carry out a distance course of pedagogical training for health professional performing preceptorship functions in public health institutions. The preceptorship in health is a pedagogical practice that occurs in workplace, led by assistance professionals with teaching position or not, where the vast majority of these acts intuitively, reproducing their own training, confusing transmitting information with education. These preceptors often do not dominate the pedagogical knowledge, necessary for the organization of training activities, such as the various teaching-learning processes and the different assessment types. Student supervision is essential in the training process of students in the health field, and on the occasion of supervised internships that the teaching-learning process is based on practical experience with participation in real life situations and professional work. It was realized an exploratory study, descriptive with qualitative approach, with the development of tutoring teaching course in health as final product. Applied semi structured research instrument from may to july 2014. It were evaluated 162 health professionals who perform the preceptorship, which made it possible define the preceptor's profile and identify the educational requirements related to the educational process, which justified the construction of the program content and the professionals’ perception analysis about preceptorship through identification of three categories: clinic knowledge valuation; valuation of professional orientation and valuation of professional future. The course was available on distance mode through Moodle platform with forty hours of work load from October to November 2014. With the aim of capacitate the health professionals to development of necessary abilities and skills to tutoring performance through thoughts about tutoring concepts, professional training within the curricular guidelines and SUS precepts, the role of health professionals as educators, application of active teaching methodologies, and evaluation methods. The applications were done online through the provided link; 300 vacancies offered, 243 professionals applied, chosen 134 that works on tutoring, where 49 represented professionals that works on the location of the study. The course lasted 45 days, and counted with tutors responsible to interact and evaluate the students. 28 professionals joined the course, 12 concluded. Opportunities were identified to stimulate the involvement, however the professionals’ satisfaction shows that, make an investment on tutors education, starting from the Permanent Education precepts, will provide a bigger appropriation of the knowledge to the education and therefore the awareness of their role as an educator on work ambit, proportioning essential tools to tutors act while enabler of integration between theory and practice and result better teaching-learning process.

Trabalho e saúde: análise da relação entre condições de trabalho e motivação no emprego e suas interfaces com a saúde dos profissionais nos hospitais públicos

Health results from the interaction of biological, social, economic, political and cultural factors. Under this perspective, we aim to analyze the relationship among working in public emergency hospitals and the health-sickness of the professionals who work there. We are based in a quantitative and qualitative research, in which 240 health professionals (doctors, nurses, social workers, psychologists, dentists, nutritionists, audiologists, physiotherapists and occupational therapists) answered a survey. All of them recognize the importance of work to guarantee favorable conditions to good health. However, they highlight its physical and mental wear effects on workers like stress, absence of a healthy life-style, high blood pressure, musculoskeletal, gastrointestinal and sleep disorders. It becomes urgent to face this reality, to enhance professionals' health and, consequently, the quality of user’s assistance, since the illness of health workers is strongly correlated with the existing health model in society.

Gastos públicos em educação municipal: uma análise da eficiência-custo na gestão dos recursos no ensino fundamental no estado do Rio Grande do Norte

This study evaluates the cost effectiveness of municipalities in the state of Rio Grande do Norte in the execution of spending in basic education carried out in 2011, as well as analyze the determinants of the inefficiency of the same. For this, we used two methodological approaches (i) stochastic frontier cost, and (ii) analyze data envelopment (DEA), which allows to identify the efficient frontier of the municipalities analyzed non-parametrically. Results show that municipalities under review achieved low efficiency rates in the stochastic frontier cost, while the DEA method they achieved higher rates where nineteen among them reached full efficiency. The results suggest that a significant portion of the Potiguar municipalities should review its administrative practices, especially the means of allocation of resources. In regard to determining the efficiency observed distinct results by the two methods.

A produção do cuidado no período gravídico-puerperal: experiência de mulheres usuárias de serviços públicos de saúde

Despite numerous government projects aimed at reorganizing and qualifying obstetric and neonatal care in Brazil, it remains problematic, with repercussions for maternal and newborn mortality and humanized care of both the mother and child. The objective of this study was to analyze the care provided to women during the pregnancy-puerperium cycle, based on reports of public health service users regarding their pregnancy and delivery experiences, using comprehensiveness and humanization as reference. The study applied a qualitative approach and the methodological strategy consisted of listening to the women, in order to identify, based on the meanings of their discourse concerning their experiences with health services, continuities and discontinuities of care during the pregnancy-puerperium cycle. Study participants were women who gave birth at a municipal public maternity, residents of Natal, Brazil, who at the time of the interviews, were between 10 and 42 days postpartum. Seven women reported their pregnancy and delivery experiences at public services. As interviews and observation took place, the material produced was also analyzed, in order to achieve simultaneous production and data analysis. Using systematization, a dialogue was established between the women’s discourses and production in the field of Collective Health, with respect to concepts and discussion about obstetric and neonatal care as well as the Comprehensiveness and Humanization of such care. Participant discourses underscored aspects related to prenatal care starting at pregnancy and its repercussions as well as prenatal monitoring by health services; aspects associated with care during labor and delivery, as well as those involved in postpartum in the maternity, both with respect to newborn and maternal careç and lastly, puerperium care after discharge from the maternity. Analysis of results sought to identify lines of continuity and discontinuity in the comprehensiveness and humanization of care. Based on these lines and as final contributions of the study, the following paths were proposed to achieve comprehensive and humanized production of health care for women during the pregnancy-puerperium cycle: Path 1- Reassess care in the maternal and newborn health network, aimed at comprehensiveness in terms of guaranteeing access to the various services and technological resources available to enhance health and life. Path 2- Reorganize work processes in order to attain comprehensive and humanized care for women in the pregnancy-puerperium cycle. Path 3 – Qualify the professional-user relationship in care management during the pregnancy-puerperium cycle. Path 4 – Invest in the qualification of communication processes in the different dimensions of care during the pregnancy-puerperium cycle.

A produção do cuidado no período gravídico-puerperal: experiência de mulheres usuárias de serviços públicos de saúde

Despite numerous government projects aimed at reorganizing and qualifying obstetric and neonatal care in Brazil, it remains problematic, with repercussions for maternal and newborn mortality and humanized care of both the mother and child. The objective of this study was to analyze the care provided to women during the pregnancy-puerperium cycle, based on reports of public health service users regarding their pregnancy and delivery experiences, using comprehensiveness and humanization as reference. The study applied a qualitative approach and the methodological strategy consisted of listening to the women, in order to identify, based on the meanings of their discourse concerning their experiences with health services, continuities and discontinuities of care during the pregnancy-puerperium cycle. Study participants were women who gave birth at a municipal public maternity, residents of Natal, Brazil, who at the time of the interviews, were between 10 and 42 days postpartum. Seven women reported their pregnancy and delivery experiences at public services. As interviews and observation took place, the material produced was also analyzed, in order to achieve simultaneous production and data analysis. Using systematization, a dialogue was established between the women’s discourses and production in the field of Collective Health, with respect to concepts and discussion about obstetric and neonatal care as well as the Comprehensiveness and Humanization of such care. Participant discourses underscored aspects related to prenatal care starting at pregnancy and its repercussions as well as prenatal monitoring by health services; aspects associated with care during labor and delivery, as well as those involved in postpartum in the maternity, both with respect to newborn and maternal careç and lastly, puerperium care after discharge from the maternity. Analysis of results sought to identify lines of continuity and discontinuity in the comprehensiveness and humanization of care. Based on these lines and as final contributions of the study, the following paths were proposed to achieve comprehensive and humanized production of health care for women during the pregnancy-puerperium cycle: Path 1- Reassess care in the maternal and newborn health network, aimed at comprehensiveness in terms of guaranteeing access to the various services and technological resources available to enhance health and life. Path 2- Reorganize work processes in order to attain comprehensive and humanized care for women in the pregnancy-puerperium cycle. Path 3 – Qualify the professional-user relationship in care management during the pregnancy-puerperium cycle. Path 4 – Invest in the qualification of communication processes in the different dimensions of care during the pregnancy-puerperium cycle.

A responsabilidade civil extracontratual do estado na prestação de serviços públicos de saúde

This study aims to examine the Brazilian legal model for the non-contractual liability of the state in providing public health services, from the perspective of threedimensional theory of law. Up based on bibliographical and documentary research, with emphasis on legislation, doctrine and Brazilian jurisprudence, the following conclusions were reached. The right to health is typified in the Constitution as a social fundamental right, and understands the pretension to obtain from the State, the supply of goods or the provision of services that reduce the risk of disease and other health problems; or promote, protect and recover the physical and mental well-being. Once violated the fundamental right to health, provides the managed, among other fundamental guarantees, the non-contractual liability of the state. The provision of public services by the state can be made directly through the Direct or Indirect Public Administration, or by recourse to private entities. In any case, the provision of public health services is entirely subordinate to the principles of administrative law and should be fully funded by tax revenues. As the provision of public health services is part of the administrative activity of the State, there is no way to exclude the application of the guarantee of non-contractual liability of the state in the face of the damage suffered by administered as users of these services. Therefore, it applies the theory of administrative risk, even in the event of harmful and illegal state failure.

O crucifixo nos tribunais: a neutralidade religiosa e o uso dos espaços públicos

This thesis aims to analyze the cross exhibition in sessions halls and audiences of the judiciary, considered the religious freedom and the limitations arising from the idea of State neutrality. It is known that the 1988 Constitution protects freedom of expression of thought, conscience and religion, in its various aspects, proclaiming, on the other hand, the neutrality of the state, to reinforce these same freedoms. Thus, the aim is to avoid confusion between state and religion, admitted, however, collaboration of public interest, in respect of attitude to the beliefs and individual choices of citizens. In modern societies, the dualism between the civil power and religion has to do with laicity and a broader phenomenon that took the name of secularism, meaning the loss of space of religion in societies or even decreased idea religious belonging. It is based on this finding that the work develops with reference to concepts such as civil society and rule of law relevant to an accurate understanding of the problem. The methodology consists of bibliographic and documentary research through books and thesis, in addition to the legislation and some precedents related to the topic in question, looking to investigate whether, even though the predominantly Catholic Brazilian people and recognized the strong influence that Christian values exercise on the public authorities, it is possible to sustain the symbolic differentiation state, a republic that is said secular and democratic and which has as one of the fundamental objectives to promote the good of all, without any form of discrimination. Starting from the idea that the presence in buildings and public institutions, symbols and Catholic imagery, like the crucifix, has some difficulty in reconciling the guarantee of religious freedom and the principle of laicity, the idea is to exactly propose a solution who can respect pluralism and diversity in a context where Catholicism remains a strong presence.

CLIMA ORGANIZACIONAL E BURNOUT: UM ESTUDO COM SERVIDORES PÚBLICOS FEDERAIS

As condições inadequadas vivenciadas nas organizações afligem não só os trabalhadores da iniciativa privada, pois são igualmente encontradas no segmento estatal, contrariando a expectativa de que o aparato governamental eliminaria as condições insalubres e criaria outras melhores nas quais prevalecesse à promoção de saúde. Diante desse panorama questionou-se porque, uma vez que, pelo menos do ponto de vista da sociedade leiga, esses servidores estão submetidos a condições privilegiadas de trabalho. O presente estudo objetivou identificar e descrever possíveis relações entre o clima organizacional e o burnout em servidores públicos de uma instituição federal de ensino. Objetivou-se ainda descrever o clima organizacional predominante. A pesquisa realizada teve cunho quantitativo, tipo estudo de caso e exploratória. A coleta de dados deu-se por meio das escalas ECO (escala de clima organizacional), ECB (escala de caracterização do burnout) e um questionário sociodemográfico, todos os instrumentos autoaplicáveis eletronicamente disponíveis à instituição. Participaram do estudo 201 servidores públicos federais, com idade média de 37 anos, majoritariamente de nível superior e casados. Os resultados revelaram que cerca de um quarto dos participantes raramente experimentaram burnout, no entanto outra quarta parte deles frequentemente experimentaram altos níveis de burnout, resultado bastante expressivo. Os servidores perceberam clima organizacional mediano, destacando-se a boa coesão entre os colegas de trabalho e a percepção de baixa recompensa. Merece destaque a grande dispersão entre as percepções de clima, o que permite inferir haver subclimas não identificados nesta investigação, possivelmente ocasionados por uma força de clima fraca e pela participação dos servidores de unidades de ensino geograficamente distintas, geridas por gestores locais com relativa autonomia. Os resultados dos cálculos de correlação revelaram que, quanto menos os participantes percebem apoio da chefia e da organização, coesão entre colegas, e mais controle/pressão, mais exaustos se sentem, mais desumanizam as pessoas com quem tratam e mais se decepcionam no trabalho e vice-versa. Conforto físico menor está associado a maior desumanização e a mais decepção no trabalho e vice-versa; e que controle/pressão, relaciona-se positiva e fracamente com desumanização e vice-versa. Desta forma, a hipótese de que existe associação entre burnout e clima organizacional foi confirmada. Os resultados também revelaram que os servidores com burnout, perceberam pior clima organizacional que os seus pares sem burnout, confirmando a segunda hipótese. Esses servidores também se mostraram neutros quanto à percepção de apoio da chefia e conforto físico; não percebem controle pressão, nem recompensa; todavia percebem coesão entre os colegas. Esses resultados sugerem que os participantes têm se apoiado nessas relações para suportar a indiferença e ausência de estímulos experimentados no trabalho. Os resultados obtidos nesse estudo permitiram concluir que o clima organizacional é fraco, provavelmente influenciado por uma cultura organizacional fraca, explicando a heterogeneidade da percepção do clima organizacional pelos servidores. Além disso, embora haja burnout entre poucos participantes, há que se atentar que cerca de um quarto deles, encontra-se acometido desta síndrome e isto poderá contagiar os demais.

Grado de satisfacción de los pacientes hospitalizados con las dietas basales y terapéuticas en centros sanitarios públicos

La satisfacción de las necesidades y expectativas de los pacientes se considera un indicador fundamental de la calidad de la asistencia proporcionada, entendida como una medida de eficacia, confort, pertinencia y control del funcionamiento del sistema sanitario (Donabedian, 1966; Monteagudo et al., 2003; Feldman et al., 2007). Los hospitales españoles están enfocados en la mejora de los cuidados y atención al paciente ingresado; por ello, la alimentación que el hospital presta está reconocida como un indicador importante de la satisfacción de los pacientes. La Alimentación Hospitalaria tiene como objetivo ayudar al personal sanitario a que el paciente se encuentre bien lo antes posible. Para lograr esto, es necesario proporcionar alimentos de buena calidad que hayan sido preparados y cocinados cuidadosamente para retener al máximo el valor nutritivo y presentados al paciente de forma apetitosa (Herrera et al., 2004). Es problemático definir la calidad de los alimentos porque depende de la evaluación del consumidor. A pesar de ello, se ha demostrado que las percepciones de un alimento están afectadas por muchos factores individuales que incluyen el sabor, olor, información del etiquetado, actitudes y recuerdos de experiencias anteriores (Imran, 1999). Las características sensoriales como aspecto, flavor, textura y temperatura se ha visto que son también importantes para los pacientes hospitalarios cuando juzgan la calidad de la comida (Clark, 1998). Textura y flavor tienen un efecto profundo sobre la percepción y la aceptabilidad; sin embargo, el papel de la textura es muy dependiente del producto de que se trate. Adjetivos sobre sus atributos como empapado, acuoso, grumoso, pegajoso, baboso, desmoronado y duro que proporcionan una pérdida de control en la boca no suelen normalmente gustar (Cardello, 1996b). La importancia relativa de un atributo es dependiente de un alimento particular. Las comidas de los pacientes son una parte integral del tratamiento hospitalario y el consumo de una dieta equilibrada es crucial para ayudar a su recuperación (Stratton et al., 2006). En los servicios de alimentación de los hospitales se sirven millones de comidas a diario (solamente en España, donde ese estima que existen unos 1000 hospitales, podemos esperar que el número de pensiones completas cada día ronde las 300.000) y el número atendido en un establecimiento puede variar de 20 a 2.000 personas...

Contratos públicos adjudicados a sociedades cooperativas en el País Vasco entre 2010 y 2012

La Contratación Pública constituye una fuente muy importante de la demanda de bienes y servicios, especialmente en la Comunidad Autónoma del País Vasco en donde el Gobierno Autonómico, también llamado la Administración General Vasca, desarrolla un papel capital como impulsor de dicha contratación pública. Por otro lado, la Economía Social, y especialmente el movimiento cooperativo, tiene en ese mismo ámbito geográfico un papel de gran peso en el conjunto de la Economía Vasca, por sus cifras de empleo y aportación al PIB, así como por tradición y arraigo social. Cabe preguntarse en tal caso, cuál es el papel que desempeñan las cooperativas en la Contratación Pública en aquella Comunidad Autónoma, cómo y cuáles son los contratos de los que resultan adjudicatarias, qué importes suponen esos contratos para las cuentas públicas y, en definitiva, si su papel de adjudicatarias se corresponde con el que desempeñan en el conjunto de la Economía Vasca. Del examen de los contratos publicados en el Perfil del Contratante del Gobierno Vasco, se obtienen datos suficientes que, una vez procesados y analizados, se visualizan en tablas y porcentajes que constituyen la base de un diagnóstico que responde a las preguntas planteadas y evidencia la situación de debilidad de las cooperativas en el campo de la contratación pública vasca.

Animales sueltos en los espacios públicos : una lectura para El torito de los Muchachos

En El Torito de los Muchachos aparece, desde el título mismo, un despliegue de figuras animales, las cuales se exponen sostenidas en el concepto de enemigo, de fuerte connotación para la situación política del contexto de publicación del periódico. Al mismo tiempo, presenta la singularidad de que el uso de animalizaciones, tradicionalmente orientadas al no letrado, son aplicadas desde una voz plebeya y federal al sujeto que representa a la civilización y la ciudad, el unitario. El periódico escenifica una arena pública en sus páginas teniendo presente un público particular, sostenido en lecturas orales. En un marco de fusiones e intercambios entre la literatura y la prensa periódica, este trabajo propone una lectura para este periódico gauchesco.

La agenda de la seguridad en revisión : casos conmocionantes, temas y problemas públicos en el actual período democrático argentino (1983-2016)

El trabajo explora la emergencia de temas y la constitución de problemas públicos que integran la agenda de la seguridad en Argentina en la etapa democrática a partir de procesos vinculados a la problematización pública de muertes violentas constituidas como casos conmocionantes. Con estos fines, el análisis integra la reconstrucción en el registro de la acción pública de casos conmocionantes con una revisión de trabajos que desde las ciencias sociales abordan dimensiones de la muerte violenta y problemas vinculados a la agenda nacional de la seguridad. Como punto de llegada del análisis destacamos la capacidad que en la actualidad manifiesta la inseguridad para absorber e integrar dimensiones en tanto problema que se constituye como un guion cultural privilegiado para la comprensión de la violencia, que sintetiza sentidos sociales circulantes sobre el riesgo y que sirve de plataforma para la demanda política de amplios sectores de la ciudadanía.

Animales sueltos en los espacios públicos : una lectura para El torito de los Muchachos

En El Torito de los Muchachos aparece, desde el título mismo, un despliegue de figuras animales, las cuales se exponen sostenidas en el concepto de enemigo, de fuerte connotación para la situación política del contexto de publicación del periódico. Al mismo tiempo, presenta la singularidad de que el uso de animalizaciones, tradicionalmente orientadas al no letrado, son aplicadas desde una voz plebeya y federal al sujeto que representa a la civilización y la ciudad, el unitario. El periódico escenifica una arena pública en sus páginas teniendo presente un público particular, sostenido en lecturas orales. En un marco de fusiones e intercambios entre la literatura y la prensa periódica, este trabajo propone una lectura para este periódico gauchesco.

A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”

Competências na gestão pública: uma avaliação dos servidores públicos do Grande ABC Paulista

A presente pesquisa tem por objetivo verificar a percepção de funcionários de órgãos públicos do Grande ABC Paulista, acerca das características e competências necessárias ao administrador público. Os dados foram obtidos por meio de 100 questionários aplicados aos funcionários públicos, que foram solicitados a expressar sua opinião acerca da importância de 11 características dos administradores públicos. Para a análise dos dados, procedeu-se ao cálculo do nível de significância, bem como à verificação da correlação dos dados, por meio do teste de X2 e o Coeficiente de Q de Yule, respectivamente. Constatou-se que os funcionários públicos consideram como características mais importantes do administrador público a comunicação e a disposição para trabalhar em equipe. Há de se reconhecer que os funcionários consideram essas competências como essencialmente técnicas, e não como interpessoais. Cabe ainda ressaltar que manifestações conservadoras dos funcionários públicos já apresentam o gênero e idade como as variáveis mais requeridas como forma de avaliar suas competências.