A educação permanente em saúde para a institucionalização de uma rede-rizoma

Esta dissertação é resultado de uma pesquisa-intervenção cuja produção de dados ocorreu com o Grupo Condutor Regional da Rede Cegonha (GCR) no DRS III de Araraquara - SP, parte do Projeto de Pesquisa para o Sistema Único de Saúde (PPSUS): O processo de implantação da rede de atenção à saúde materno infantil no DRS III de Araraquara: a atenção básica como ordenadora da atenção em rede. Nosso objetivo foi compreender este coletivo como espaço de Educação Permanente em Saúde (EPS) para a institucionalização dessa Rede, e também caracterizar a EPS no território de abrangência deste DRS, compreender suas fragilidades-potencialidades e também os processos de EPS produzidos no interior do GCR para a implementação da Rede Cegonha (RC), diante de desafios como a redução da morbimortalidade materno infantil e o atendimento integral e humanizado a mulheres e crianças. Esta pesquisa qualitativa compreendeu a análise de documentos e a pesquisa-intervenção, utilizando método cartográfico, e a produção dos dados ocorreu no ano de 2014 com os integrantes do GCR e outros pesquisadores PPSUS. As análises tiveram como referenciais o Processo de Trabalho em Saúde e conceitos do movimento institucionalista, das correntes da Análise Institucional e da Esquizoanálise. Esta pesquisa de cunho cartográfico explorou o contexto sócio-histórico da EPS e da RC no DRS III e paisagens que compõem o mapa do aprendizado no que chamamos Rede-rizoma, entremeadas por análises de implicações e aprendizados na experiência, tanto de construção da pesquisa como da RC. Nos planos do rizoma houve momentos de aprendizado significativo, ecos nos municípios, interferências da pesquisa-intervenção, dentre outros componentes de tessitura da rede que envolveram seus atores, seus pontos de conexão, de tensão, de apoio. Nesse emaranhado quente e frio, interessou-nos explorar as singularidades do encontro e os movimentos de forças instituintes e do instituído com o compromisso de entender a EPS como ferramenta de trabalho para a institucionalização da RC. Percebemos a existência de microprocessos de institucionalização disparados no cotidiano do GCR, caracteristicamente paralisantes e mobilizadores, como a importância da participação social, ainda tímida, as tensões com a imobilidade municipal, as fragilidades-potencialidades dos recursos humanos e financeiros, e também resultados que refletem em alargamento e participação de novos atores, cooperação intermunicipal, fortalecimento dos Grupos Condutores Municipais da rede cegonha e uma gestão estadual disposta a deflagrar processos de formação participativos. Trata-se de movimentos que se revelaram em implicações de múltiplas bifurcações e em processos de EPS que se fazem de forma mutante, conformando a rede-rizoma

O \"si\" da técnica psicanalítica: uma análise institucional do discurso de O mal-estar na civilização

Partindo das considerações de que os termos sujeito e subjetividade permeiam o discurso psicanalítico contemporâneo e de que são, direta e indiretamente, atribuídos a Freud a despeito de ele próprio nunca tê-los conceituado, esta pesquisa tem como objetivo caracterizar um perfil de sujeito a partir do discurso freudiano. O trabalho orientou-se pela metodologia da Análise Institucional do Discurso, uma analítica do domínio subjetivo que toma o discurso em seu caráter de ato e acontecimento. Primeiramente se realizou um estudo de As técnicas de si, de Michel Foucault, de modo a permitir o circunstanciamento da psicanálise como uma técnica que produz um si, um sujeito este circunstanciamento permitiu, então, tomar sujeito e subjetividade na qualidade de produções histórica, geográfica e analiticamente contextualizadas, não como formas de imanência ou transcendência. A partir desse pressuposto, elaborou-se uma análise institucional do discurso de O mal-estar na civilização que privilegiou não apenas seu conteúdo, mas principalmente seu modo de produção, colocando em relevo o contexto presente no texto, as interlocuções que se criam, os lugares atribuídos e ocupados, as expectativas assim mobilizadas, as estratégias discursivas utilizadas, os jogos de poder e verdade exercidos, bem como os efeitos de reconhecimento e desconhecimento então facultados. Esta análise mostrou que Freud exerce uma perspectiva de interioridade, pois o mal-estar que acomete a civilização é compreendido em analogia à concepção psicanalítica de desenvolvimento individual, explicando, em suma, a cultura pelo prisma do indivíduo; evidenciou que as teorizações sobre a vida instintiva são a principal sustentação do discurso sobre o mal-estar da civilização; apontou como as estratégias discursivas utilizadas por Freud promovem a subjetivação, por parte do leitor, daquilo que seu discurso produz como verdade; e que o conceito de indivíduo é ocasião de exercício daquela perspectiva de interioridade e de atualização dos pressupostos teóricos. Com base nisso, pôde-se caracterizar um sujeito universal; psicologizado; determinado sobretudo pelos movimentos da sexualidade e da agressividade; cuja tônica recai sobre o dito mundo interno; dotado de origens e propósitos concernentes à vida instintiva; e cujo perfil é delimitado pela tarefa de administração dos instintos, isto é, cujo perfil se dá entre os imperativos superegóicos de renúncia e a margem de liberdade de que dispõe para satisfazer as exigências do princípio de prazer. Observou-se também, na esteira do pontuado por Guirado (2010), que em geral Freud naturaliza os termos do discurso teórico, fazendo de sua universalização a condição e o limite para se pensar o domínio subjetivo e a singularidade; diferentemente de Foucault, que compreende esse domínio em referência às relações de poder e saber, de forma contextualizada. Do ponto de vista da análise institucional do discurso freudiano, concluiu-se, finalmente, que o si ao qual a técnica psicanalítica dá lastro é efeito da perspectiva exercida por Freud, que promove o reconhecimento da interioridade instintiva como crivo da civilização, de um modo de vida e de si mesmo

Cartografia do trabalho de agentes penitenciários: reflexão sobre o “dispositivo prisão”

The Brazilian prison system is going through a serious crisis, not only due to the growth in the number of prisoners and the consequent overcrowding of prisons, but also for the violation of human rights, institutionalization and difficulty in social rehabilitation of inmates. Furthermore, the harmful effects of the prison system affect their workers, who generally are not prioritized by researchers, health programs and government policies. The literature pointing to some consequences of work in prison, among them, the mental illness, stress, alcohol abuse, etc., but little is known about this profession, their problems, the difficulties of their work routine, so as subjective processes involved. So, what are the effects of this work in the prison in the lives of correctional officers? What strategies developed to address the work in prison? This research aims to analyze the effects of this work in the prison in the lives of correctional officers from the state prison in Parnamirim, located in the metropolitan region of Natal-RN. Within the theoretical and methodological perspective of institutional analysis and cartography were carried conversation circles, interviews, in addition to participant observation of the correctional officers work’s routine. The results point to a working routine marked by the performance of procedures that involve risk to the worker, generating situations of tension and stress. Besides, the culture of violence (which is implemented in jail everyday) as well as the training and initial learning of the profession, are responsible for the militarization process of the subjectivities of the correctional officers, producing hard subject, disciplined, stiff, likely to violent practices and other rights violations. Other mapped effects relate to the acquisition of knowledge about the human (“psy” knowledge) responsible for forging the conception of the criminal as "dangerous subject", which, in turn, acts as subjectivity vector in the daily life of prison guards by setting up a way of life crossed by fear and insecurity outside the work environment. Produces a control in the open about their lives and their families, limiting them with regard to family and community life and the realization of leisure activities in public spaces. In this sense, it appears that the arrest acts producing “bad meetings” (from Espinosa's perspective), once it produces sad affections responsible for weakening the conatus, limiting the possibilities of action of these subjects. Although agents develop some strategies to deal with the difficulties of working in prison (among which stand out the development of other professional or leisure activities, spirituality / religiosity and the ability to separate the labor moments from those of their the personal lives, is advocated that such strategies do not offer significant resistance, since they do not question the contemporary legal-criminal logic. The thesis presented supports the proposals of penal abolitionism to present other conceptions of crime and justice through the invention of other practical and conceptual strategies.

Between Principle and Practicality: A Dynamic Realist Examination of Independence in the Canadian Justice System

This work examines independence in the Canadian justice system using an approach adapted from new legal realist scholarship called ‘dynamic realism’. This approach proposes that issues in law must be considered in relation to their recursive and simultaneous development with historic, social and political events. Such events describe ‘law in action’ and more holistically demonstrate principles like independence, rule of law and access to justice. My dynamic realist analysis of independence in the justice system employs a range methodological tools and approaches from the social sciences, including: historical and historiographical study; public administrative; policy and institutional analysis; an empirical component; as well as constitutional, statutory interpretation and jurisprudential analysis. In my view, principles like independence represent aspirational ideals in law which can be better understood by examining how they manifest in legal culture and in the legal system. This examination focuses on the principle and practice of independence for both lawyers and judges in the justice system, but highlights the independence of the Bar. It considers the inter-relation between lawyer independence and the ongoing refinement of judicial independence in Canadian law. It also considers both independence of the Bar and the Judiciary in the context of the administration of justice, and practically illustrates the interaction between these principles through a case study of a specific aspect of the court system. This work also focuses on recent developments in the principle of Bar independence and its relation to an emerging school of professionalism scholarship in Canada. The work concludes by describing the principle of independence as both conditional and dynamic, but rooted in a unitary concept for both lawyers and judges. In short, independence can be defined as impartiality, neutrality and autonomy of legal decision-makers in the justice system to apply, protect and improve the law for what has become its primary normative purpose: facilitating access to justice. While both independence of the Bar and the Judiciary are required to support access to independent courts, some recent developments suggest the practical interactions between independence and access need to be the subject of further research, to better account for both the principles and the practicalities of the Canadian justice system.

Rules for the governance of coastal and marine ecosystem services: An evaluative framework based on the IAD framework

There is an increasing need for a comprehensive institutional understanding pertaining to ecosystem services (ESs) in coastal and marine fields. This paper develops a systematic framework to inform coastal and marine governance about the integration of ES concepts. First, as a theoretical basis, we analyze the generic rules that are part of the Institutional Analysis and Development (IAD) framework. Second, by an extensive literature review, we formulate a set of ES-specific rules and develop an evaluative framework for coastal and marine governance. Third, we examine this evaluative framework in a specific action situation, namely coastal strategic planning concerning Qingdao, China. Results from the literature review and the case study reveal that when designing ES-specific rules for coastal and marine governance, there are several socio-spatial and economic aspects that should be taken into account: (1) conceive of stakeholders as ES users, (2) capture the effect of ecological scaling, (3) understand ES interactions and clarify indirect impacts and causalities, (4) account for ES values, and (5) draw on economic choices for use rights to deal with ES issues.

Soft Budget Constraints and Regional Industrial Policy: Reinterpreting the Rise and fall of De Lorean

The rise and fall of De Lorean Motor Cars Limited (DMCL) has been traditionally interpreted as either the result either of John De Lorean’s psychological flaws or as confirming the supposed limitations of activist industrial policy. However, when the episode is examined in greater historical detail, neither of these interpretations are compelling. The reinterpretation outlined here draws on institutional analysis as well as a range of archival sources, much of it previously unreleased. The inefficiencies within the original contractual agreement are highlighted. The lack of credibility associated with this agreement was in turn traceable to the institutional environment (with its associated risk-reward implications) under which industrial policy operated. This environment had a political element - it had been distorted by the Troubles and the resulting fears policymakers had of a cumulative causation relationship between violence and unemployment. Officials in Belfast, against Treasury opposition, advocated state-led entrepreneurship as a policy response.

Polityka Turcji wobec mniejszości muzułmańskich i niemuzułmańskich w świetle standardów Unii Europejskiej

Wydział Nauk Politycznych i Dziennikarstwa

De la Teoría Institucional del Arte a la Curaduría Creativa: revisión de una aproximación institucional a la definición de lo "artístico"

Es una revisión e interpretación profunda de la Teoría Institucional de Arte cuya reflexión se extiende hasta la Curaduría Creativa, un fenómeno del arte contemporáneo, del que podría predicarse un estatus de obra de arte. El objetivo principal pretende defender las condiciones bajo las cuales la curaduría puede considerarse una obra de arte.

Contradictions : Genre, causal layered analysis and analysis of institutional change

In what follows, I put forward an argument for an analytical method for social science that operates at the level of genre. I argue that generic convergence, generic hybridity, and generic instability provide us with a powerful perspectives on changes in political, cultural, and economic relationships, most specifically at the level of institutions. Such a perspective can help us identify the transitional elements, relationships, and trajectories that define the place of our current system in history, thereby grounding our understanding of possible futures.1 In historically contextualising our present with this method, my concern is to indicate possibilities for the future. Systemic contradictions indicate possibility spaces within which systemic change must and will emerge. We live in a system currently dominated by many fully-expressed contradictions, and so in the presence of many possible futures. The contradictions of the current age are expressed most overtly in the public genres of power politics. Contemporary public policy—indeed politics in general-is an excellent focus for any investigation of possible futures, precisely because of its future-oriented function. It is overtly hortatory; it is designed ‘to get people to do things’ (Muntigl in press: 147). There is no point in trying to get people to do things in the past. Consequently, policy discourse is inherently oriented towards creating some future state of affairs (Graham in press), along with concomitant ways of being, knowing, representing, and acting (Fairclough 2000).

Disability, deinstitutionalisation and discourse : an analysis of institutional reform policies in Queensland, 1994-1996

The closure of large institutions for people with intellectual disability and the subsequent shift to community living has been a feature of social policies in most western democracies for more than two decades. While the move from congregated settings to homes in the community has been heralded as a positive and desirable strategy, deinstitutionalisation has continued to be a controversial policy and practice. This research critically analyses the implementation of a deinstitutionalisation policy called Institutional Reform in the state of Queensland from May 1994 until it was dismantled under a new government in the middle of 1996. A trajectory study of the policy from early conceptualisation through its development, implementation and final extinction was undertaken. Several methods were utilised in the research including the textual analyis of policy documents, discussion papers and newspaper articles, interviews with stakeholders and participant observation. The research draws on theories of discourse and focuses on how discourses of disability shape policy and practice. The thesis outlines a number of implications for policy implementation more generally as well as for disability services. In particular, the theoretical framework builds on Fulcher's (1989) disabling discourses - medical, charity, lay and rights - and identifies two additional discourses of economics and inclusion. The thesis argues that competing disability discourses operated in powerful ways to shape the implementation of the policy and illustrates how older discourses based on fear and prejudice were promoted to positions of dominance and power.

Integrating biodiversity conservation into forestry : an empirical analysis of institutional adaptation

Integrating biodiversity conservation into forest management in non-industrial private forests requires changes in the practices of those public and private actors that have implementing responsibilities and whose strategic and operational opportunities are at stake. Understanding this kind of context-dependent institutional adaptation requires bridging between two analytical approaches: policy implementation and organizational adaptation, backed up with empirical analysis. The empirical analyses recapitulated in this thesis summary address organizational competences, specialization, professional judgment, and organizational networks. The analyses utilize qualitative and quantitative data from public and private sector organizations as well as associations. The empirical analyses produced stronger signals of policy implementation than of organizational adaptation. The organizations recognized the policy and social demand for integrating biodiversity conservation into forest management and their professionals were in favor of conserving biodiversity. However, conservation was integrated to forest management so tightly that it could be said to be subsumed by mainstream forestry. The organizations had developed some competences for conservation but the competences did not differentiate among the organizations other than illustrating the functional differences between industry, administration and associations. The networks that organizations depended on consisted of traditional forestry actors and peers both in planning policy and at the operational level. The results show that he demand for biodiversity conservation has triggered incremental changes in organizations. They can be considered inert regarding this challenge. Isomorphism is advanced by hierarchical guidance and standardization, and by professional norms. Analytically, this thesis contributes to the understanding of organizational behavior across the public and private sector boundaries. The combination of a policy implementation approach inherent in analysis of public policies in hierarchical administration settings, and organizational adaptation typically applied to private sector organizations, highlights the importance of institutional interpretation. Institutional interpretation serves the understanding of the empirically identified diversions from the basic tenets of the two approaches. Attention to institutions allows identification of the overlap of the traditionally segregated approaches.

An Institutional Approach to Donor Control: From Dyadic Ties to a Field‐Level Analysis

Literature on the nonprofit sector focuses on charities and their interactions with clients or governmental agencies; donors are studied less often. Studies on philanthropy do examine donors but tend to focus on microlevel factors to explain their behavior. This study, in contrast, draws on institutional theory to show that macrolevel factors affect donor behavior. It also extends the institutional framework by examining the field‐level configurations in which donors and fundraisers are embedded. Employing the case of workplace charity, this new model highlights how the composition of the organizational field structures fundraisers and donors alike, shaping fundraisers’ strategies of solicitation and, therefore, the extent of donor control.

Strategies for water pollution control in Dhaka, Bangladesh: an institutional and economic analysis

This paper presents primary data based on research carried out as part of a large World Bank project. Results from our survey show that water pollution in Dhaka watershed has reached alarming levels and is posing significant threats to health and economic activity, particularly among the poor and vulnerable. Rice productivity in the watershed area, for example, has declined by 40% in recent years and vegetable cultivation in the riverbeds has been severely damaged. We also found significant correlation between water pollution and diseases such as jaundice, diarrhoea and skin problems. It was reported that the cost of treatment of skin diseases for one episode could be as high as 29% of the weekly earnings of poor households. Given the magnitude of the contamination problem, a multi-agent stakeholder approach was necessary to analyse the institutional and economic constraints that would need to be addressed in order to improve environmental management. This approach, in turn, enabled core strategies to be developed. The strategies were better understood around three types of actors in industrial pollution, i.e. (1) principal actors, who contribute directly to industrial pollution; (2) stakeholders, who exacerbate the situation by inaction; and (3) the potential actors in mitigation of water contamination. Within a carrot-and-stick framework, nine strategies leading to the strengthening of environmental management were explored. They aim at improving governance and transparency within public agencies and private industry through the setting up of incentive structures to advance compliance and enforcement of environmental standards. Civil society and the population at large are, on the other hand, encouraged to contribute actively to the mitigation of water pollution by improving the management of environmental information and by raising public awareness.