Submitted by Aline Batista (alinehb.ufpel@gmail.com) on 2018-04-12T14:09:13Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Tese_Maria_Carolina_Pinheiro_Meirelles.pdf: 12582888 bytes, checksum: 7f15bb6109e4317d5e9e9159b77a7ded (MD5) / Made available in DSpace on 2018-04-12T14:56:25Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Tese_Maria_Carolina_Pinheiro_Meirelles.pdf: 12582888 bytes, checksum: 7f15bb6109e4317d5e9e9159b77a7ded (MD5) Previous issue date: 2016-12-16 / Sem bolsa / Na presente tese avaliaram-se os processos de gestão de uma rede de atenção psicossocial (RAPS) à luz da Teoria da Ação Comunicativa. Estudo de avaliação qualitativa, realizado em um município da Região Sul do Rio Grande do Sul. A coleta de dados incluiu 19 entrevistas individuais semiestruturadas com participantes do Colegiado Gestor e 20 horas de observação participante em oito reuniões do colegiado,de maio a setembro de 2015. A análise foi de abordagem hermenêutica-dialética com auxílio do Ethnograph V6. Os resultados apontaram uma complexa rede de atenção psicossocial, com vários pontos de atenção e equipes multiprofissionais de diversas formações. Identificaram-se ações de planejamento e avaliação de estruturas, práticas e políticas de saúde mental,em reuniões de equipe,do colegiado e Seminários, que auxiliam tomadas de decisão;ações de produção de cuidado em rede que promovem integração, articulação da rede, e compartilhamento do cuidado, destacando-se o Apoio Matricial da Atenção Básica; e ações de Educação Permanente em Saúde—seminários, eventos culturais, reuniões de equipe, colegiados, matriciamento, cursos de residência multiprofissional e de psiquiatria —e o percurso formativo de redes. Nas categorias de análise apontou-se relação com o agir instrumental nas discussões sobre a utilização rígida de fluxos, normas e protocolos, as ações prescritivas sem negociação coletiva e sem inclusão do usuário, e a medicalização baseada apenas em critérios técnicos. Quanto ao agir comunicativo observou-se predominância sobre o agir instrumental,apontando pactuação de fluxos, discussões e encaminhamento de casos, pactuações com o judiciário, e ênfase nas deliberações do colegiado sobre questões da gestão ou da singularidade dos casos, próprias do mundo da vida, que não se resolvem somente com o tecnicismo. Destaca-se a relevância de manter e fortalecer os espaços de comunicação e de encontro entre os sujeitos que operam a rede - as reuniões de equipe, os seminários e principalmente as reuniões semanais do colegiado-, ampliando a participação da rede intersetorial e de usuários. Os processos de gestão da RAPS lourenciana são possivelmente produtores de cuidado em rede,coordenando e promovendo a integração de diversos pontos de atenção, à medida que operam de modo participativo e democrático mediante ação comunicativa linguisticamente mediada, buscando um poder criativo, protagonista e emancipatório dos sujeitos e da produção do trabalho em saúde. Processos de gestão de uma Rede de Atenção Psicossocial são ações do mundo da vida, orientados por um agir comunicativo, e ainda que pautados também pelo mundo do sistema, requerem a superação de um agir capturado por ações estratégicas ou instrumentais. / The aim of this thesis was to evaluate the management processes of a psychosocial care network (RAPS) in the light of the Theory of Communicative Action. A qualitative evaluation study was carried out in a municipality in the Southern Region of Rio Grande do Sul. Data collection included 19 individual semi-structured interviews with participants from the Colegiado Gestor and 20 hours of participant observation at 8 meetings of the collegiate from May to September 2015. The analysis was hermeneutic-dialectical with the help of the Ethnograph V6. The results pointed to a complex network of psychosocial attention, with several points of attention and multiprofessional teams of diverse formations. It was identified actions of planning and evaluation of structures, practices and mental health policies in team meetings,collegiate and Seminars, that help in decision making; Actions for the production of care in a network that promote integration, network articulation, and sharing of care, highlighting the Matrix Support of Primary Care; And actions of Permanent Educationin Health, such as seminars, cultural events, team meetings, collegiate, matriciamento, multiprofessional and psychiatry residency courses and the formative course of networks. In the categories of analysis, it was pointed out a relation with the instrumental action in the discussions on the rigid use of flows, norms and protocols, prescriptive actions without collective negotiations and without inclusion of the user, and medicalization based only on technical criteria. As far as communicative action was concerned, it was observed a predominance of the instrumental act, pointing to the agreement of flows, discussions and referrals of cases, agreements with the judiciary, and emphasis on the deliberations of the collegiate on management issues or the uniqueness of cases, specific to the world of life, Which are not only solved with technicality. It is important to maintain and strengthen the communication and meeting spaces between the individuals who operate the network, such as team meetings, seminars and especially the weekly meetings of the collegiate, increasing the participation of the intersectoral network and users. The management processes of RAPS Lourenciana are possibly network care producers, coordinating and promoting the integration of several points of attention, as they operate in a participatory and democratic way through a linguistically mediated communicative action, seeking a creative power, protagonist and Emancipation of the subjects and the production of health work. Management processes of a Psychosocial Attention Network are actions of the world of life, guided by a communicative action, and although also guided by the system world, require by a communicative action, and although also guided by the system world, require the overcoming of an action captured by strategic or instrumental actions.

O presente estudo aborda a introdução de ações de regulação na gestão de saúde de um município do interior do estado do Rio de Janeiro, de 2009 a 2012. Mais especificamente, são analisadas a responsabilização sanitária do ente municipal a partir da aquisição da gestão plena do sistema (Pacto de Gestão) e as ações desencadeadas pela implantação do Controle, Avaliação e Auditoria, e pela criação do Complexo Regulador, tendo como referência a Política Nacional de Regulação. A metodologia empregada envolveu análise documental e entrevistas com informantes-chave. Os resultados demonstram o desenvolvimento de ações em todas as dimensões da regulação e o amadurecimento da função reitora da secretaria municipal de saúde sobre o sistema, através do direcionamento qualitativo e quantitativo dos prestadores privados. / The present study focus on the introduction of regulatory actions on health management in a municipality of the state of Rio de Janeiro, 2009-2012. More specifically, it analyses the new health responsibility taken by the municipal administration after acquiring the full management of the system (Management Pact) and the actions triggered by the implementation of control, evaluation and auditing, as well the creation of a regulatory complex, with reference to regulation national policy. The methodology included documental analysis and interviews with key informants. The results demonstrated the implementation of actions in all aspects of regulation and the progress of the local health system stewardship function at the municipal health department through the qualitative and quantitative guidance on the private providers.

Thesis (MSc.) Zoology)) -- University of Limpopo, 2019 / In South Africa, a high anthropogenic demand of water for domestic, recreational, agricultural, urbanisation and industrial purposes has placed enormous pressure on freshwater resources and has led to a decline in water quality. In addition to measuring water quality variables, the health assessment index (HAI) advocated by AvenantOldewage and Swanepoel (1993), and modified by Crafford and Avenant-Oldewage (2009) by incorporating the inverted parasite index (IPI), and adapted further by Madanire-Moyo et al. (2012) who excluded the white blood cells counts, has been used as a rapid and inexpensive means of assessing and monitoring fish health and, in turn, the state of aquatic ecosystems. However, few studies have evaluated the latter approach in conjunction with other biomonitoring indices to assess the water quality of impoundments. Thus, the aim of this study was twofold. The first was to evaluate the HAI adapted by Madanire-Moyo et al. (2012) as a means to establish the health status of Oreochromis mossambicus (Peters, 1852) sampled from various impoundments based on a once-off survey. The second was to establish if the adapted HAI, in conjunction with selected biomonitoring indices and environmental variables, could describe monthly and seasonal fluctuations of O. mossambicus health. Once-off surveys were conducted between April and May 2016 at five impoundments. The Luphephe-Nwanedi Dam located in the upper catchment of the Limpopo River System and Rhenosterkop Dam situated in the Elands River, a tributary of the Olifants River System, served as control sites due to little or no anthropogenic activities occurring in their catchment areas. In addition, surveys were conducted at Loskop and Flag Boshielo dams and Phalaborwa Barrage situated in the main stem of the Olifants River for comparison purposes. The latter three impoundments were selected because they vary in water quality and pollution levels. Monthly surveys were carried out at Flag Boshielo Dam from February 2016 to February 2017 to establish if the biomonitoring tools and the quantification of water and sediment quality variables, could describe and predict seasonal fluctuations in the health of O. mossambicus. To this end, water quality variables were measured during each survey. Water and sediment samples were collected for analysis of nutrients and metals. Oreochromis mossambicus were collected using gill nets. Fish health was assessed using the adapted HAI that was based on observing parasite burden, haematocrit determination and anomalies in body tissues and organs in conjunction with determining gonad and iv hepato-somatic indices, the condition factor, blood glucose levels, microscopy analyses of fish gills and metal concentrations in fish muscle tissues. Water quality in terms of pH, total dissolved solids and electrical conductivity, nutrients and some aqueous and sediment metals exhibited significant differences (p ˂ 0.05) between impoundments surveyed with water quality from good to poor being in the order of: Luphephe-Nwanedi Dams ˂ Rhenosterkop Dam ˂ Loskop Dam ˂ Phalaborwa Barrage ˂ Flag Boshielo Dam. The HAI scores varied significantly (p ˂ 0.0001) between impoundments and substantiated water quality variables results during once off surveys, indicating that the health of fish from Flag Boshielo Dam were most affected when compared to the health of fish surveyed from the other impoundments. Findings from monthly surveys conducted at Flag Boshielo Dam indicated better conditions in terms of water quality variables during a period of high inflow as opposed to periods of low inflow. The HAI scores obtained for fish exhibited significant (p ˂ 0.0001) differences between the months surveyed and were found to be in agreement with the water quality findings, indicating that flow regimes and water quality of an impoundment have an impact on fish health. The condition and somatic indices findings did not seem to be sensitive enough to discriminate between the impoundments during the once off surveys. While during monthly surveys, these indices were significantly (p ˂ 0.0001) different between the months, showing to be affected by seasonal fluctuations. Knowledge of the HAI in conjunction with blood glucose levels, gill histopathology and the arithmetic mean thickness of gill epithelium (Har) best described the health of fish in both the once off and monthly surveys. In conclusion, the findings of this study emphasised the HAI premise that fish from more polluted sites would be more impacted as opposed to less impacted sites, making the HAI adapted by Madanire-Moyo et al. (2012) an effective and rapid biomonitoring tool that can be used in the field. Furthermore, this study proved that the HAI can be used either solely or in association with the parasite index (PI) or IPI depending on the objectives of the study, as no pronounced differences were evident when using HAI, HAI with PI and HAI with IPI. / National Research Foundation (NRF) and Water Research Commission (WRC)

The dissertation deals with the accounting aspects of assessing the financial health of a company with a focus on agriculture. The main objective of this study is to assess individual methods designed to evaluate the financial health of a company, to determine their sensitivity to risk data in accounting. The study is focused on the field of agriculture mainly as a result of knowledge about the difficult process of compiling and using agricultural accounting. Agriculture fall within the primary sector of the economy, is very important for landscaping and a lot of subsidies flow from the budget of state and the European Union. Due to the specifics and stated problematic areas, which cannot be fully captured by legislation, incomplete or distorted information is transmitted, being also transferred to the methods of the financial health assessment of the company. Attention is also paid to the influence of legislative changes on the values in accounting as well as creative accounting. Following the findings from the theoretical basis, the application part analyses the impact of different accounting solutions on the financial statements. A paired t-test, used for the analysis, was preceded by data normality testing using the histogram and Shapiro-Wilk test. According to these tests, statistically significant differences were found com-paring the current method of accounting used for investment subsidies and leases with the IFRS accounting, between the accounting of changes in inventories and capitalization before and after 1 January 2016, and in land valuation using historical cost and market price. All these areas influence the values of all the analysed methods of financial health assessment. Only the CH-index showed no statistically significant difference in land valuation and accounting solution of inventory activation and changes. Furthermore, the reliability and controllability of the selected methods used for the evaluation of financial health in the field of agriculture is assessed. According to the results, none of the evaluated models can be used in its original variant, but it is possible to use them to compare the company with similar enterprises or over time thanks to the proven dependence of partial indicators and even the whole models on the productivity. Another type of analysis is designed to determine the indicators that have a statistically significant impact on the actual financial situation of businesses. The method of generalized linear models - multinomial linear regression - is used for this test. To determine whether an enterprise is at risk or not, it would be possible to use the stock / income and short-term liabilities / income indicators, and the cash flow / assets indicator to determine the type of threat.

Psychological evaluations administered by forensic psychologist in personal injury cases are surrounded by complex issues. Although empirically-based research has legitimized that psychological damages do exist in personal injury cases there is a missing link in the way forensic psychologists are conducting these evaluations. Prior researchers suggested that some personal injury evaluations had been dismissed or overlooked due to a lack of a standard of care. Addressing the current literature, this study examined how a diverse group of 14 licensed forensic psychologists, operating in different judicial jurisdictions (Daubert, Frye, and Independent) were conducting personal injury evaluations and their perspectives on the implementation of a standard of care. A qualitative thematic analysis design was used to gain a more in-depth understanding of this phenomenon. Systems theory was the conceptual framework that informed this study and guided the methodology employed. The identified themes were organized into steps reflected in an adapted version cube model. The study promotes positive social change by fostering confidence in the field of psychology and personal injury evaluations with regard to bolstering the overall credibility, reliability, and validity of the practice and processes involved. Further, positive change can occur through the development of framework that assists in leveling the practice by keeping evaluations flexible, but consistent; basing the decision regarding implementing a standard of care on the utility of the framework, along with future findings and developments in the field.

The purpose of this quantitative study was to examine whether the post-deployment screening instrument currently utilized to assess active-duty Marines for symptoms of PTSD upon their return from a combat deployment can be solely relied upon to accurately assess for PTSD. Additionally, this study sought to compare the number of Marines who have sought trauma-related mental health treatment based on their answers on the Post-Deployment Health Assessment (PDHA) to the number who have sought trauma-related mental health treatment based on their answers on their PTSD Checklist - Military Version (PCL-M). The participants in this study were comprised of a sample of active-duty Marines that had recently returned from a combat deployment. A quantitative secondary data analysis used Item Response Theory (IRT) to examine the answers provided by the participants on both the PDHA and PCL-M. Both instruments proved to be effective when assessing symptoms of PTSD and the participants identified as having symptoms of PTSD were referred for mental health services as required. According to the results, more Marines were identified as having symptoms of PTSD using both assessment instruments (PDHA and PCL-M) compared to those identified using just the PDHA. The result was a better understanding of predictors of Marines who may later develop PTSD. The results of this study can also assist the Marine Corps with its post-deployment screening for symptoms of PTSD which in turn can provide appropriate mental health referrals for Marines if deemed appropriate.

In European countries, people, whatever the socio-economic group or nationality they belong to, men or women, the young or the elderly without distinction, should be guaranteed the right to health as well as its promotion and support measures (Javtokas, 2009). Personal health promotion reflects the general idea stating that in order to enhance health it is necessary to change the way of life (Tones, Tilford, 1994; Donev et al., 2007). In this era of radical modernity related to the increased personal anxiety and uncertainty, there appear new alternative ways to enhance a person’s health: taking a variety of medications, trying different diets, engaging in traditional and non-traditional forms and ways of physical education (Cavill et al., 2006). In turn, physical education specialists and health educators bring out the importance of exercise encouraging a person to understand the social value and significance of their health promotion and physical development (Schneider and Becker, 2005; Netz et al., 2005). It is widely recognized that a major health risk factor associated with a person’s lifestyle, is low physical activity, the importance of which for human health has been shown in numerous scientific studies. They have emphasized the positive interface between active leisure time physical activity and a range of health indicators (Kalėdienė et al., 1999; Domarkienė, 2000; Borodulin, 2006; Kallings, 2008; Klumbienė, 2008, Gill et al., 2010; Weiler et al., 2010). The... [to full text] / Visuotinai pripažįstama, kad esminis sveikatos rizikos veiksnys, susijęs su asmens gyvensena, yra mažas fizinis aktyvumas, kurio svarba žmogaus sveikatai yra įrodyta daugelyje mokslinių studijų. Jose pabrėžiama pozityvi aktyvios fizinės veiklos laisvalaikiu sąsaja su įvairiais sveikatos rodikliais (Kalėdienė ir kt., 1999; Domarkienė, 2000; Borodulin, 2006; Kallings, 2008; Klumbienė, 2008; Gill et al., 2010; Weiler et al., 2010). Nekelia abejonių faktas, kad dažnai deklaruojama sveikatos stiprinimo idėja yra tiesiogiai susijusi su gyvensenos ypatumais, kuriuos lemia tiek atskiro individo požiūris į savo sveikatą, tiek įvairūs išoriniai veiksniai, visų pirma gyvenimo sąlygos. Savaime suprantama, daugiausia dėmesio stiprinant žmonių sveikatą turėtų būti skiriama įvairiose sveikatos ugdymo (sveikatinimo) programose. Šių programų pagrindinis tikslas turėtų būti asmens elgesio keitimas panaudojant žiniasklaidos ir individualaus poveikio priemones (Van der Bij et al., 2002; Rise, 2004; Roux et al., 2008). Reiškiama nuomonė, kad supažindinus gyventojus su aktyvaus gyvenimo būdo principais, propaguojant ir skatinant pastovų jų realizavimą, tobulinant fizinę parengtį, pagerėtų ir žmonių gyvenimo kokybė (Aхвердова, Maгин, 2002; Taylor et al., 2002; Netz et al., 2005; Kallings, 2008; Miller, Miller, 2010). Kita vertus, kada kalbama apie fizinį aktyvumą laisvalaikiu kaip apie asmens visapusiškos gerovės sąlygą bei ligų profilaktikos veiksnį labiau akcentuojama jo reikšmė vaikystės ir... [toliau žr. visą tekstą]

Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2018-09-14T17:36:23Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) pollyanna_oliveira_silva.pdf: 1366051 bytes, checksum: a57e1b503feb9f787735becad9ca235f (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2018-10-01T19:14:51Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) pollyanna_oliveira_silva.pdf: 1366051 bytes, checksum: a57e1b503feb9f787735becad9ca235f (MD5) / Made available in DSpace on 2018-10-01T19:14:51Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) pollyanna_oliveira_silva.pdf: 1366051 bytes, checksum: a57e1b503feb9f787735becad9ca235f (MD5) Previous issue date: 2018 / No contexto das doen?as cr?nicas n?o transmiss?veis, que imperam no novo cen?rio epidemiol?gico, faz-se necess?ria a reformula??o do modelo de assist?ncia e a inclus?o de novas tecnologias com o objetivo de formar redes de aten??o ? sa?de capazes de responder de forma satisfat?ria a essa demanda emergente. Diante desse cen?rio, a Gest?o da Cl?nica traz ferramentas importantes, dentre elas as Linhas-Guia (LG) cujas recomenda??es orientam a pr?tica dos profissionais no manejo de condi??es cr?nicas priorit?rias no Sistema ?nico de Sa?de. Contudo, por motivos de ordem pol?tica e organizacional, a implanta??o dessas ferramentas acontece de forma incipiente, sem a efetividade e perenidade esperadas. O objetivo do estudo foi verificar, nos munic?pios da regi?o de sa?de de Itabira, a interfer?ncia na implanta??o das LG dos seguintes processos de trabalho da Aten??o Prim?ria ? Sa?de: territorializa??o, cadastro populacional, diagn?stico situacional, protocolos municipais, agenda, educa??o permanente, plano de cuidado, conselhos locais de sa?de, acesso e coordena??o da Aten??o Prim?ria. Para isso, a partir de um estudo quantitativo transversal, foi utilizada a metodologia multi-attribute utility theory (MAUT). Os resultados apontam para os processos de trabalho agenda, diagn?stico e acesso, os quais apresentaram uma correla??o de moderada a boa, estatisticamente significativa. Verificou-se a frequ?ncia de implanta??o das LG de forma individualizada, evidenciando um n?mero maior de munic?pios utilizando as LG da gestante, hipertens?o e diabetes. Observou-se ainda que, apesar de estarem sob uma mesma jurisdi??o, existem iniquidades na operacionaliza??o dos processos de trabalho entre os munic?pios. Por fim, foi encontrada uma rela??o direta, moderada (0,55) no que tange aos processos de trabalho da Aten??o Prim?ria e implanta??o das LG. Discute-se que os processos de trabalho citados como tendo melhor correla??o configuram estrat?gias fundamentais para fortalecimento de v?nculos e garantia do continuum do cuidado. As LG usadas mais frequentemente auxiliam os profissionais no manejo das condi??es de sa?de mais comuns e, por consequ?ncia, apresentam maior aplicabilidade na rotina assistencial. Buscou-se entender as iniquidades entre os munic?pios a partir das intera??es socioculturais locais. Os achados, de forma geral, contribuem para com a gest?o no ?mbito da Avalia??o em Sa?de municipal, regional e estadual, evidenciando condicionantes para uma efetiva implanta??o das LG. Al?m disso, fortalece a metodologia MAUT como ferramenta avaliativa na ?rea da sa?de. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2018. / In the context of chronic non-communicable diseases, in which prevails over the new epidemiological scenario, it is required to reformulate the assistance model and the inclusion of new technologies aiming healthcare networks capable of responding satisfactorily to this emerging demand. Given this scenario, the clinical management introduces important tools, among them, Linhas-Guia (LG/Guidelines), whose recommendations guide the practice of professionals in the management of priority chronicle conditions at SUS (Brazilian Health Service). However, political and organizational bureaucracy results in a lack of effectiveness and expected longevity of the implantation of these tools in an incipient way. The goal of this study was to verify the interference in the implementation of the Guidelines for the following Primary Health Care work processes in the municipalities under the jurisdiction of the Regional Health Management of Itabira: territorialization, population registry, situational diagnosis, municipal protocols, agenda , permanent education, care plan, local health councils, access and coordination of Primary Care. In this regard, it was used a multi-attribute utility theory (MAUT). The results indicate that the work processes agenda, diagnosis, and access presented a correlation of moderate to good, statistically significant. The frequency of LG implantation was verified in an individualized way, emphasizing a larger number of municipalities using pregnant women, hypertension, and diabetes? LG. It was also detected inequities in the operationalization of work processes between municipalities, even though belonging to the same jurisdiction. Finally, a direct connection, moderate relationship (0.55) was found regarding Primary Care working processes and LG implantation. It argues the work processes cited as having the best correlation constitute fundamental strategies to reinforce the bonds and guarantee the continuum of care. The most frequently used LGs help professionals in the management of the most common health conditions and, consequently, have a greater applicability in the care routine. The aim was to understand the inequities between municipalities based on local socio-cultural interactions. The findings widely contribute to the management, within the scope of Health Assessment, at municipal, regional and state level, highlighting the conditions for an effective implementation of LG. Moreover, it strengthens the MAUT methodology as an evaluation tool in the health area.

Submitted by Viviane Lima da Cunha (viviane@biblioteca.ufpb.br) on 2017-06-29T11:38:16Z No. of bitstreams: 1 arquivototal.pdf: 2050668 bytes, checksum: aa9f4f49b2d0bc58cf759bf50ee24e42 (MD5) / Made available in DSpace on 2017-06-29T11:38:16Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2050668 bytes, checksum: aa9f4f49b2d0bc58cf759bf50ee24e42 (MD5) Previous issue date: 2017-01-31 / The potential of Mental Health in Primary Care is defended in this work as a strategic issue for the consolidation of the Brazilian Psychiatric and Sanitary Reform. Considering that the process of the Brazilian Psychiatric Reform has prioritized de hospitalization through substitutive services as the strategic path to deinstitutionalization, the inclusion of mental health actions in primary care is fragile and needs to expand its actions. The general objective of the present work is to build a decision support system about prevailing profiles of several actions to support decision making in health management, contextualized with an analysis of mental health actions in basic care in Brazil. This work explores secondary data from the external evaluation base of the National Program for Improving Access and Quality in Primary Care with interviews of 29,778 family health and primary care teams. The analysis of the actions was systematized by the regions of the country. An index that generated ratings was constructed. The Decision Support System for Mental Health Actions in Primary Care has an algorithm called the "Partial Decision Tree" - PART. The presented tool can subsidize the decision making on actions of support matrix, institutional and permanent education. The scenario is that most health facilities do not perform a minimal scope of mental health records and actions. The most prevalent action profile is: they stated that they serve users in psychological distress, but lack actions aimed at users who abuse alcohol and other drugs and psychotropic drugs. With this, it highlights challenges for the expansion and consolidation of the Family Health Strategy and the Brazilian Sanitary and Psychiatric Reforms. Finally, there is no way to support the ideological, cultural, social and political-political struggle that advocates an assistance proposal if we can not provide evidence of its characteristics, development and results. The strengthening of the Brazilian Sanitary and Psychiatric Reforms certainly goes through the expansion of mental health actions in primary care. / A potencialidade da Saúde Mental na Atenção Básica é defendida neste trabalho como uma questão estratégica para a consolidação da Reforma Psiquiátrica e Sanitária Brasileira. Considerando que o processo da Reforma Psiquiátrica Brasileira priorizou a desospitalização através de serviços substitutivos como o caminho estratégico para a desinstitucionalização, a inclusão de ações de saúde mental na atenção básica se mostra frágil e necessita de ampliação de suas ações. O objetivo geral do presente trabalho é construir um sistema de apoio à decisão sobre perfis predominantes de diversas ações para subsidiar tomadas de decisão na gestão em saúde, contextualizado com uma análise as ações de saúde mental na atenção básica do Brasil. Este trabalho explora os dados secundários da base de avaliação externa do Programa Nacional de Melhoria do Acesso e Qualidade na Atenção Básica com entrevistas de 29.778 equipes de saúde da família e atenção básica. A análise das ações foi sistematizada pelas regiões do país. Foi construído um índice que gerou classificações. O Sistema de Apoio à Decisão sobre Ações de Saúde Mental na Atenção Básica, tem como modelo um algoritmo chamado de “Árvore de decisão parcial” – PART. A ferramenta apresentada pode subsidiar a tomada de decisões sobre ações de apoio matricial, institucional e educação permanente. O cenário é que a maioria das unidades de saúde não realizam um escopo mínimo de ações e registros de saúde mental. O perfil de ações mais predominante é: afirmaram atender aos usuários em sofrimento psíquico, mas carecem de ações destinadas à usuários em uso abusivo de álcool e outras drogas e de medicamentos psicotrópicos. Com isso, evidencia desafios para a ampliação e consolidação da Estratégia Saúde da Família e das Reformas Sanitária e Psiquiátrica Brasileira. Por fim, não há como sustentar a luta ideológica, cultural, assistencial e ético-política que defenda uma proposta assistencial se não temos como dar evidências de suas características, desenvolvimento e resultados. O fortalecimento das Reformas Sanitária e Psiquiátrica Brasileira certamente passam pela ampliação das ações de saúde mental na atenção básica.

Made available in DSpace on 2014-12-17T15:30:56Z (GMT). No. of bitstreams: 1 SonemyVAP_DISSERT.pdf: 529055 bytes, checksum: 187a196865790ac0d19f46dcd0b896a1 (MD5) Previous issue date: 2000-02-25 / The objective of this study was to evaluate a baby dentistry program which has been in the city of Natal for five years. The research was based on two analysis: a quantitative one, which tried to check caries prevalence in 52 children supported by the program and a qualitative one, which, through interviews carried out with the mothers, using the focus group technique, tried to realize the effect of the program their attitudes related to the care of their children?s oral health. For the quantitative analyses of caries prevalence there was the use of def-s and knutson rates and the values obtained were shown in a descritive and analytical way.The results showed that 4.2% of babies ranging 24 to 36 months old presented carie disease. Children from 36 to 48 months old and above 48 months old presented 18.2% and 16.7% carie prevalence respectively.The def-s averages found in ages 24 to 36, 36 to 48 and 48 to 60 months old were 0.08; 0.40 and 1.16 respectively, considered as being equally low, going along with Knutson rates. The qualitative analyses showed a high level of the mothers` satisfaction, considering the access,practitioner-patient relationship and opportunity to keep the oral health. Children supported by the program showed a low carie prevalence and the program turned out to be effective under the mothers` point of view / O presente estudo teve como objetivo avaliar um programa de odontologia para beb?s em funcionamento h? cinco anos na cidade do Natal. A pesquisa foi pautada em duas an?lises, uma quantitativa que buscou verificar a preval?ncia de c?rie em 52 crian?as acompanhadas pelo programa e outra qualitativa que atrav?s de entrevistas feitas com as m?es, pela t?cnica de grupo focal, procurou apreender o efeito do programa nas atitudes relacionadas aos cuidados em sa?de bucal de seus filhos. Para a an?lise quantitativa da preval?ncia de c?rie foram aplicados os ?ndices CEO-d, CEO-s e Knutson e os valores obtidos apresentados de forma descritiva e anal?tica. A an?lise qualitativa do discurso das m?es foi feita segundo BARDIN. Os resultados apontaram que 4,2% dos beb?s de 24 a 36 meses apresentaram a doen?a c?rie. As crian?as de 36 a 48 meses e de 48 a 60 meses apresentaram respectivamente uma preval?ncia de c?ries de 18,2 e 16,7%. A an?lise qualitativa revelou um alto grau de satisfa??o das m?es relacionado ao acesso, rela??o profissional-paciente e possibilidade de manuten??o da sa?de bucal de seus filhos