Questa tesi descrive lo stato delle conoscenze degli effetti tossici da micotossine su animali d allevamento, ed alcuni esperimenti condotti per valutare gli effetti indotti da esposizione cronica da micotossine sui ruminanti. Uno studio è stato condotto su 15 aziende specializzate in sistemi di produzione intensiva di carni bovine, situate nel Nord Italia (province di Verona e Mantova), con l'obiettivo di individuare i rischi d esposizione a contaminazione da micotossine. Alcuni metodi di laboratorio sono stati sviluppati: un metodo per la determinazione di ocratossina A (OTA) accumulata in tessuti e organi; Un metodo per valutare gli effetti delle fumonisine sulla biosintesi delle basi sfingoidi sfingosina (So) e sfinganina (Sa); Un metodo per rilevare l addotto AFB1-albumina. La razione totale mescolata (TMR) è risultata positiva alla AF e FB. Tra i singoli alimenti, il mais e la semola glutinata di mais sono stati i principali responsabili della contaminazione del TMR. Il livello di contaminazione è positivamente correlato al contenuto di umidità di mais. Il metodo per la determinazione dell OTA nei tessuti ed organi ha mostrato un buon recupero medio. L'analisi del rapporto Sa/So nel sangue non ha mostrato alcun effetto negativo delle fumonisine sulla biosintesi lipidica. L'addotto AFB1-albumina è risultato positivo per il 18% dei campioni totali di sangue. / The thesis describes the state of knowledge about toxic effects of mycotoxins on farm animals, and some experiments conducted to assess effects induced by chronic exposure to mycotoxins on ruminants. A field study for was carried out on 15 farms specialised for intensive beef production system, located in Northern Italy (provinces of Verona and Mantova), with the aim to identify risks of exposure to mycotoxins contamination. Some laboratory methods were performed: a method for the detection of ochratoxin A (OTA) concentration in tissues and organs; a method for evaluating the effects of fumonisin on biosynthesis of the two sphingoid bases sfingosine (So) and sphinganine (Sa); a method to detect the AFB1-albumin adduct. Total mixed rations (TMR) resulted positive for AF and FB contamination. Among single feedstuffs, corn and corn gluten feed were the main responsible for TMR contamination. Level of contamination was positively related to corn moisture content. The method for the determination of OTA in tissue and organ showed a good mean recovery. The analysis of ration Sa/So in blood did not show any negative effect by fumonisin on the lipidic biosynthesis. The AFB1-albumin adduct was positive on 18% of total blood samples.

Bakalauro baigiamajame darbe nagrinėjama socialiai atsakingo verslo koncepcija, pateikiami socialinės atsakomybės modeliai, kuriais remiantis įmonės gali įgyvendinti socialinę atsakomybę. Apžvelgiama Lietuvos patirtis socialinės atsakomybės srityje. Pateikiama ne tik socialinės atsakomybės nauda įmonei ir visuomenei, bet ir kritiškas požiūris į socialinę atsakomybę. Darbe analizuojamas AB „Lietuvos draudimas“ įgyvendinamas socialinės atsakomybės modelis. Nustatyta, kad įmonė socialinę atsakomybę įgyvendina trijose srityse: rūpinasi darbuotojais, aplinka bei visuomene. Remiantis anketinės darbuotojų apklausos duomenimis įmonė turi visas galimybes savo veikloje pritaikyti socialinės atsakomybės standartą SA 8000. / The Bachelor’s final thesis analyses the conception of socially responsible business, presents the models of social responsibility basing on which enterprises can implement social responsibility. The study reviews the experience of Lithuania in the sphere of social responsibility. It presents not only the use of social responsibility to an enterprise and society but also critical attitude towards social responsibility. The study analyses the model of social responsibility in AB “Lietuvos draudimas”. The research established that the enterprise implements social responsibility in three spheres: takes care about the employees, environment and the society. Basing upon the data of employee questionnaire survey the enterprise has all the possibilities to adapt the social responsibility standard SA 8000 in its activity.

Sankt Gallen, Univ., Diss., 2003.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-01-16T19:16:34Z No. of bitstreams: 1 MariaDeFatimaLucenaDosSantos_DISSERT.pdf: 630611 bytes, checksum: c5bd6e4022718d2909cb6f55a1a80fcb (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-01-22T13:36:48Z (GMT) No. of bitstreams: 1 MariaDeFatimaLucenaDosSantos_DISSERT.pdf: 630611 bytes, checksum: c5bd6e4022718d2909cb6f55a1a80fcb (MD5) / Made available in DSpace on 2018-01-22T13:36:48Z (GMT). No. of bitstreams: 1 MariaDeFatimaLucenaDosSantos_DISSERT.pdf: 630611 bytes, checksum: c5bd6e4022718d2909cb6f55a1a80fcb (MD5) Previous issue date: 2017-08-29 / Os profissionais de sa?de s?o fundamentais para o processo de fortalecimento do Sistema ?nico de Sa?de e, principalmente, na Aten??o Prim?ria em Sa?de ? necess?rio que o trabalhador possa garantir a continuidade das a??es, com longitudinalidade do cuidado. Diante disso, a gest?o do trabalho constitui um ponto cr?tico na implanta??o do SUS e os trabalhadores vivenciam desafios que precisam ser discutidos e enfrentados. A presente pesquisa tem como objetivo analisar a rela??o entre a gest?o do trabalho na Aten??o B?sica em Sa?de e o desempenho das equipes participantes do segundo ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade na Aten??o B?sica. As vari?veis do estudo foram o tipo de v?nculo de trabalho, tempo de atua??o na equipe de ABS, agente contratante, forma de ingresso no trabalho e a presen?a de Planos de Carreira, Cargos e Sal?rios. Como fonte de dados foram utilizados os bancos do PMAQ-AB e do Programa das Na??es Unidas para o Desenvolvimento. Os dados coletados foram submetidos a uma an?lise descritiva explorat?ria e inferencial, com um n?vel de signific?ncia de 5%. Para avaliar quantitativamente a rela??o entre as vari?veis empregou-se testes de associa??o de qui-quadrado de Pearson. Verificou-se a maior presen?a de v?nculos de trabalho precarizados em munic?pios de pequeno porte populacional e a implanta??o dos PCCS ainda ? baixa em todo Brasil. Os profissionais com v?nculos protegidos apresentaram melhores desempenhos na avalia??o do PMAQ-AB. Este tipo de v?nculo garante a perman?ncia no emprego e autonomia e isso pode contribuir para um maior envolvimento do profissional com a problem?tica de sa?de da sua ?rea de atua??o. Quanto ao porte populacional foi identificado que houve resultados mais negativos para os munic?pios de pequeno e m?dio porte. Apesar do desempenho das equipes terem sido melhores nos munic?pios de pequeno porte, deve-se considerar que h? uma maior concentra??o destes e que a certifica??o ? feita com base em c?lculo feito por desvios-padr?o. As limita??es do estudo apontam para a avalia??o do PMAQ-AB, a qual se apresenta de forma mais direta e objetiva sem intera??o aprofundada com o objeto de estudo para compreender mais detalhadamente o que est? sendo avaliado. Prop?e-se, assim, que a tem?tica seja aprofundada atrav?s de estudos qualitativos. / Health professionals are fundamental to the process of strengthening the Unified Health System and, especially, in Basic Health Care, it?s necessary that the worker can guarantee the continuity of the actions, with longitudinality of care. Thus, the work management is a critical point in the implementation of the SUS and workers experience challenges that need to be discussed and faced. The present research aims to analyze the relationship between work management in Basic Health Care and the performance of the participating teams in the second cycle of the National Program for Improving of Access and the Quality in Basic Care. The variables of the study were the bond kind of work, time of action in the ABS team, contracting agent, form of entrance into work and the presence of Career Plans, Positions and Salaries. As data source the banks of PMAQ-AB and the United Nations Development Program were used. The collected data were submitted to descriptive exploratory and inferential analysis, with a level of significance of 5%. To quantitatively evaluate the relationship between the variables, Pearson's chi-square association tests were used. It was verified the greater presence of precarious work links in counties of small size population and the implementation of PCCS is still low throughout Brazil. Professionals with protected links presented better performance in the PMAQ-AB assessment. This type of bond guarantees the permanence in employment and autonomy and this can contribute to a greater involvement of the professional with the health problem of its occupation area. About the population size, it was identified that there were more negative results for small and medium size counties. Although the performance of the teams was better in small counties, it should be considered that there is a greater concentration of these and the certification is made based on calculus realized by standard deviations. The limitations of the study point to the evaluation of PMAQ-AB, which presents more direct and objectively without deep interaction with the object of study to understand more minutely what is being evaluated. It?s proposed, therefore, that the thematic be deepened through qualitative studies.

Made available in DSpace on 2014-12-17T14:46:38Z (GMT). No. of bitstreams: 1 IldoneFM.pdf: 388086 bytes, checksum: c062baf398bccd2e553102291f1ac5dc (MD5) Previous issue date: 2008-11-27 / The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caic?, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors / O presente estudo tem como objetivo analisar, na vis?o de enfermeiros, as mudan?as no processo de produ??o dos servi?os de sa?de, ap?s a implanta??o do Programa Sa?de da Fam?lia (PSF). Trata-se de uma investiga??o de natureza qualitativa, que utiliza entrevistas semi-estruturadas como principal ferramenta de abordagem emp?rica. Foram entrevistadas seis enfermeiras da cidade de Caic?/RN, que trabalhavam na aten??o b?sica, antes da implanta??o do PSF, e continuam trabalhando. Pela an?lise empreendida, as principais mudan?as verificadas no processo de produ??o dos servi?os de sa?de com a implanta??o do PSF, no contexto da aten??o b?sica, foram: a adscri??o e v?nculos com a comunidade; acolhimento e humaniza??o do atendimento; diminui??o das interna??es hospitalares; fortalecimento da preven??o de agravos e promo??o da sa?de; melhoria dos indicadores de sa?de; enfim, a??es que sinalizam para a realiza??o dos princ?pios da integralidade, eq?idade e universalidade, conforme preconiza o Sistema?nico de Sa?de (SUS). No entanto, apesar dos aspectos positivos identificados, o PSF apresenta algumas fragilidades, tais como: a dificuldade do trabalho coletivo; descompasso entre a forma??o dos profissionais e as exig?ncias do modelo de sa?de atual; alta rotatividade dos profissionais de sa?de e precariza??o do trabalho. Al?m disso, foram apontadas algumas estrat?gias que podem ser utilizadas para melhor orienta??o do processo de produ??o dos servi?os de sa?de, como a intersetorialidade, educa??o permanente, desprecariza??o do trabalho e melhoria na condu??o da gest?o dos servi?os de sa?de. Assim, conclu?mos que o PSF apresenta mudan?as significativas no processo de produ??o dos servi?os de sa?de para a consolida??o do SUS, embora esteja inserido em um contexto de adversidades que podem ser superadas atrav?s da luta coletiva dos distintos atores sociais

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-08-22T20:55:36Z No. of bitstreams: 1 AndiaraAraujoCunegundesDeBrito_DISSERT.pdf: 1397248 bytes, checksum: 851123a5b1fc1b6aa1ffba80ba212008 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-22T21:01:53Z (GMT) No. of bitstreams: 1 AndiaraAraujoCunegundesDeBrito_DISSERT.pdf: 1397248 bytes, checksum: 851123a5b1fc1b6aa1ffba80ba212008 (MD5) / Made available in DSpace on 2016-08-22T21:01:53Z (GMT). No. of bitstreams: 1 AndiaraAraujoCunegundesDeBrito_DISSERT.pdf: 1397248 bytes, checksum: 851123a5b1fc1b6aa1ffba80ba212008 (MD5) Previous issue date: 2014-12-16 / No contexto de ruptura com a institui??o manicomial, a Reforma Psiqui?trica brasileira ? um processo hist?rico de reformula??o dos saberes e pr?ticas em sa?de mental. Contribuindo com o fortalecimento desse processo, os N?cleos de Apoio ? Sa?de da Fam?lia (NASF) atuam na oferta de apoio matricial em sa?de mental. Nesse sentido, a presente pesquisa objetiva analisar as a??es desenvolvidas pelo NASF referentes ao apoio matricial em sa?de mental no munic?pio de Natal/RN. Trata-se de uma pesquisa descritiva e explorat?ria com abordagem qualitativa. Para a coleta de dados, foram realizadas as t?cnicas de observa??o direta n?o participante e entrevista semiestruturada junto aos profissionais de sa?de dos NASF?s. Os dados foram tratados ? luz do m?todo de an?lise tem?tica, que consiste em investigar n?cleos de significados que comp?em a comunica??o referente ao objeto investigado. Foram organizadas tr?s categorias de an?lise, cujos t?tulos foram inspirados na perspectiva do efeito Paid?ia e da cl?nica ampliada, a saber: 1. ?Doen?a mental entre par?nteses: dimens?es de trabalho do NASF em interface com o sujeito concreto?, abordando o processo de trabalho do NASF; 2. ?Liberdade e engajamento no arranjo do apoio matricial em sa?de mental?, explorando as limita??es do matriciamento em sa?de mental em Natal/RN a partir dos profissionais entrevistados dos NASF?s; 3. ?Entre o desejo e o interesse: influ?ncia do matriciamento em sa?de mental na Rede de Aten??o Psicossocial (RAPS)?, referente ao apoio matricial em sa?de mental como um arranjo organizacional incumbido de garantir intersetorialidade e integralidade do cuidado, estrat?gias inerentes ? constitui??o da RAPS. Podemos extrair e considerar que as a??es das equipes de NASF em Natal-RN ainda n?o comp?em um elo estruturado junto ?s redes de aten??o ? sa?de, pois acontecem com car?ncia de discuss?es e escassez de profissionais empenhados no apoio matricial. Al?m disso, uma dificuldade marcante para se realizar matriciamento em sa?de mental ? a insufici?ncia de recursos humanos e de servi?os substitutivos, trazendo ? tona a discuss?o acerca da consolida??o e amplia??o da RAPS na realidade investigada. / In the context of break with psychiatric hospitals, the Brazilian Psychiatric Reform is a historical process of reformulation of knowledge and mental health practices. In this way, the Centers of Support for Family Health (NASF) have been acting in the supply of matrix support in mental health. So, the present research aims to analyze the actions which the NASF is taking for the matrix support in mental health in the city of Natal/RN. This is a kind of research descriptive, exploratory and qualitative. The data collection, was made by a direct observation of the professional pratices and semi-structured interviews with health professionals NASF's. The Data were analyzed according to thematic analysis technique, with the support of the content analysis method, which is a way to investigate clusters of meanings which make up the communication of the investigated object. Three analytical categories were organized by this method, whose titles were inspired in two theories in the health field called ?Health to Paid?ia? and ?Expanded Clinic?. The name of the categories are: 1. ?Mental illness in brackets: working dimensions of the Centers of Support for Family Health interfaces with the concrete subject?, which is about the work process of NASF; 2. ?Freedom and engagement in the arrangement of matrix support in mental health?, which explore the matrix support limitations in mental health in Natal/RN from the professionals interviewed at the NASF?s; 3. ?Between the desire and interest: influence of expert orientation in mental health in Psychosocial Care Network? (RAPS), which is related to matrix support in mental health, as an organizational arrangement responsible to ensure intersectoral and comprehensive care, strategies inside of context of the constitution of RAPS. We can extract and say that the actions of NASF teams in the brazilian city called Natal/RN, still not part of a structured link with health care networks, as happens with the absence of discussions and lack of professionals in the matrix support. In addition, there is a difficulty to do an specialized orientation in mental health because of the lack of human resources in this area and of the insufficient number of the replacement services for psychiatric hospital pratices, bringing up the discussion about the consolidation and expansion of RAPS in fact investigated.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-08-26T22:54:47Z No. of bitstreams: 1 KamilaSiqueiraDeAlmeida_DISSERT.pdf: 2282628 bytes, checksum: 3ebd4db3cf6799f2e946bf49fe83b6f8 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-30T19:46:00Z (GMT) No. of bitstreams: 1 KamilaSiqueiraDeAlmeida_DISSERT.pdf: 2282628 bytes, checksum: 3ebd4db3cf6799f2e946bf49fe83b6f8 (MD5) / Made available in DSpace on 2016-08-30T19:46:00Z (GMT). No. of bitstreams: 1 KamilaSiqueiraDeAlmeida_DISSERT.pdf: 2282628 bytes, checksum: 3ebd4db3cf6799f2e946bf49fe83b6f8 (MD5) Previous issue date: 2015-04-23 / As desigualdades em sa?de constituem o centro da rela??o entre condi??es de vida, recursos sociais, assist?ncia e situa??o de sa?de, sobretudo em contextos urbanos. Destaca-se a import?ncia de compreender as ra?zes, mecanismos e din?micas das desigualdades sociais e como est?o dispostas de forma singular nos territ?rios. No Brasil, atualmente, mais de 85% da popula??o ? urbana. O processo acelerado de urbaniza??o produziu cidades extremamente desiguais, marcadas pela for?a do capital imobili?rio, informalidade, pobreza, infraestrutura inadequada e degrada??o ambiental. Esse quadro nos leva a questionar de que forma tais aspectos condicionam a sa?de e, mais especificamente, o sofrimento ps?quico da popula??o. Sendo assim, realizamos uma pesquisa na Vila de Ponta Negra, localizada em Natal/RN, devido ao seu processo de urbaniza??o e configura??o comunit?ria peculiar. Objetivou-se analisar a determina??o social da sa?de mental e as estrat?gias de enfrentamento de seus moradores. Foram realizadas 11 entrevistas com moradores da comunidade e 11 com profissionais da Unidade B?sica de Sa?de de Ponta Negra, mapeamento dos recursos comunit?rios, registros fotogr?ficos, observa??o participante nas ruas e participa??o em grupos comunit?rios. A hist?ria da antiga comunidade de pescadores e agricultores foi marcada pelo conflito de terras e privatiza??o do espa?o em fun??o das atividades tur?sticas e imobili?rias. Isso produziu desigualdades s?cio espaciais que influenciam os modos de vida, consequentemente, na sa?de mental da popula??o. Identificamos mulheres com familiares em situa??o de consumo e tr?fico de drogas, que, somada ? sobrecarga de trabalhos dom?sticos est?o associados a sintomas de ?doen?a dos nervos?. Como maiores problemas da vila os moradores detectam o tr?fico de drogas e a viol?ncia; o lixo; a car?ncia de escolas e creches; a falta de seguran?a e de espa?os recreativos, o que ? associado ao aumento do consumo de drogas. H? uma contradi??o no bairro, ?cone do lazer e da frui??o, por?m faltam alternativas favorecedoras da conviv?ncia, das manifesta??es de cultura popular e pr?ticas desportivas para os moradores. Quanto aos profissionais de sa?de, identificamos um conhecimento superficial sobre a comunidade, indicando um trabalho desconectado do territ?rio, agravado pela aus?ncia de equipe de Sa?de da Fam?lia. Foram identificados 21 recursos comunit?rios, al?m de grupos de dan?a popular, por?m pouca articula??o entre eles. Como potencialidades, podemos citar a presen?a e proximidade de servi?os e com?rcio local, fortes rela??es de vizinhan?a e a riqueza cultural. Dentre os grupos encontrados, destacamos a atua??o de dois deles para mobiliza??o pol?tica e integra??o comunit?ria: o Coletivo das Dez Mulheres e a Feira Feito na Vila. Conclu?mos que a despeito de uma hist?ria marcada por uma desigualdade social ocasionada pela disputa pelo espa?o, o que afeta fortemente a sa?de dos seus moradores, a Vila resiste e traz em sua din?mica comunit?ria pistas importantes para sua pr?pria reabilita??o. / Health inequalities constitute the heart of the relationship between living conditions, social resources, assistance and health situation, particularly in urban contexts. We highlight the importance of understanding the roots, mechanisms and dynamics of social inequalities and how they're arranged in singular form in the territories. In Brazil, currently, more than 85 of the population is urban. The accelerated process of urbanization has produced extremely unequal cities, marked by the strength of real estate capital, informality, poverty, inadequate infrastructure and environmental degradation. This framework leads us to question how such aspects influence health and, more specifically, the distress of the population. Thus, we conducted a search in the Vila de Ponta Negra, located in Natal/RN, due to its process of urbanization and community configuration peculiar. Aimed to analyze the social determination of mental health and coping strategies of its residents. 11 interviews were held with community residents and 11 with professionals of Basic Health Unit of Ponta Negra, mapping community resources, photographic records, participant observation in the streets and participation in community groups. The story of the former community of fishermen and farmers has been marked by conflicting land and privatization of space depending on the tourist and real estate activities. It produced socioespacials inequalities that influence the ways of life, consequently, on the mental health of the population. Identify women with families in situation of consumption and drug trafficking, which, added to the overload of housework are associated with symptoms of "disease of the nerves". As major problems of village residents detect drug trafficking and violence; the trash; the lack of schools and kindergartens; the lack of security and recreational spaces, which is associated with the increase in the consumption of drugs. There is a contradiction in the neighborhood, the icon leisure and enjoyment, however they lack alternatives encourage coexistence, the manifestations of popular culture and sporting activities for the residents. As healthcare professionals, we identified a superficial knowledge about the community, indicating a work disconnected from the territory, compounded by the absence of family health team. 21 community resources have been identified, in addition to popular dance groups, but little coordination among them. As potential, we can cite the presence and proximity of services and local businesses, strong neighbourly relations and cultural richness. Among the groups found, we highlight the work of two of them for political mobilization and community integration: the Collective of Ten Women and the fair Feito na Vila. We conclude that in spite of a history marked by a social inequality caused by the dispute through space, which strongly affects the health of its residents, the village resists and brings in their community dynamics important clues to his own rehabilitation.

Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-07T17:51:00Z No. of bitstreams: 2 michele_cristina_sales_almeida_barbosa.pdf: 3457172 bytes, checksum: 9004819fe8ec7a52bf542fa1cc351458 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-07T17:51:39Z (GMT) No. of bitstreams: 2 michele_cristina_sales_almeida_barbosa.pdf: 3457172 bytes, checksum: 9004819fe8ec7a52bf542fa1cc351458 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-07T17:52:06Z (GMT) No. of bitstreams: 2 michele_cristina_sales_almeida_barbosa.pdf: 3457172 bytes, checksum: 9004819fe8ec7a52bf542fa1cc351458 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Made available in DSpace on 2015-01-07T17:52:06Z (GMT). No. of bitstreams: 2 michele_cristina_sales_almeida_barbosa.pdf: 3457172 bytes, checksum: 9004819fe8ec7a52bf542fa1cc351458 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Previous issue date: 2013 / Esta pesquisa apresenta um estudo qualitativo a respeito da compreens?o e aplica??o do conceito de integralidade pelos discentes do ?ltimo ano do curso de fisioterapia de uma institui??o de ensino superior federal. O objetivo principal desse estudo foi conhecer a vis?o dos acad?micos sobre o conceito de integralidade. Utilizamos a aplica??o de question?rio semi-estruturado, antes e depois dos discentes cursarem o est?gio curricular em sa?de p?blica. Os dados obtidos foram analisados pelo m?todo de an?lise de conte?do segundo Bardin. Emergiram cinco diferentes concep??es a respeito da integralidade: Humanizados, vis?o da humaniza??o do atendimento em sa?de; Profissionalizados, vis?o da amplia??o da forma??o profissional do fisioterapeuta; Teorizados, vis?o dos princ?pios que orientam e organizam as a??es do SUS; Limitantes, vis?o da limita??o da atua??o do fisioterapeuta na aten??o b?sica a sa?de e Hesitantes, vis?o da incerteza de estar preparado para atuar nos servi?os p?blicos de sa?de. O trabalho realizado revelou que as concep??es dos sujeitos n?o s?o constitu?das por uma ?nica tend?ncia, mas por um conjunto de tend?ncias que nos levam a inferir que o conceito de integralidade mostra-se confuso, por?m com uma forte tend?ncia para uma concep??o mais humanista na forma??o do fisioterapeuta, nesta institui??o. / Disserta??o (Mestrado) ? Programa de P?s-gradua??o em Ensino em Sa?de, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / ABSTRACT This research presents a qualitative study about the understanding and application of the concept of integrality by students of the last year of the course of physical therapy of a federal institution of higher education. The main objective of this study was to know the view of the scholars on the concept of integrality. We used the semi-structured questionnaire application, before and after the students attended the curricular internship in public health. The data obtained were analyzed by the method of content analysis according to Bardin. Emerged five different conceptions about the completeness: Humanized, vision of the humanization of health care; Professionalized, view of expansion of vocational training of physical therapist; Theorized, vision of the principles that guide and organize the actions of SUS; Vision restriction, limiting the physiotherapist in the basic attention to health and Hesitant, vision of uncertainty to be prepared to act in the public health services. The work showed that, the subjects concepts are not made up of a single trend, but by a set of trends that lead us to infer that the concept of completeness is confused, but with a strong trend towards a more humanist design in shaping the physical therapist, in this institution.

Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-08T15:36:43Z No. of bitstreams: 2 cleya_silva_santana_cruz.pdf: 3196384 bytes, checksum: ab5bc76d3c89cdad0a8a51f5bad61c79 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-08T15:37:58Z (GMT) No. of bitstreams: 2 cleya_silva_santana_cruz.pdf: 3196384 bytes, checksum: ab5bc76d3c89cdad0a8a51f5bad61c79 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-08T15:38:17Z (GMT) No. of bitstreams: 2 cleya_silva_santana_cruz.pdf: 3196384 bytes, checksum: ab5bc76d3c89cdad0a8a51f5bad61c79 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Made available in DSpace on 2015-01-08T15:38:17Z (GMT). No. of bitstreams: 2 cleya_silva_santana_cruz.pdf: 3196384 bytes, checksum: ab5bc76d3c89cdad0a8a51f5bad61c79 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Previous issue date: 2013 / Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG) / Funda??o Diamantinense de Apoio ao Ensino, Pesquisa e Extens?o (Fundaep) / O Programa de Educa??o Permanente para M?dicos da Estrat?gia de Sa?de da Fam?lia foi implantado na Regi?o Ampliada de Sa?de Jequitinhonha em outubro de 2010, com a finalidade de melhorar o n?vel de resolubilidade da Aten??o Prim?ria ? Sa?de, tomando como ponto de partida a aprendizagem significativa e integrada das diversas compet?ncias cl?nicas necess?rias aos m?dicos das equipes de sa?de da fam?lia. O objetivo deste trabalho foi avaliar as a??es de planejamento, execu??o e resultados do PEP na Regi?o Ampliada de Sa?de Jequitinhonha de Minas Gerais em interface com os objetivos propostos pelo Programa. O estudo foi desenvolvido em 14 munic?pios desta Regi?o, que possu?am m?dicos da Estrat?gia de Sa?de da Fam?lia com frequ?ncia de participa??o no PEP igual ou superior a 60,0%. Participaram da pesquisa 14 gestores municipais de sa?de, 31 m?dicos e 383 usu?rios. Tratou-se de uma pesquisa de triangula??o descritiva, quantitativa e qualitativa. Utilizou-se como instrumentos de coleta de dados: 1) Question?rios estruturados dirigidos aos usu?rios, m?dicos e gestores de sa?de; 2) Relat?rios de supervisores dos GAPs para o levantamento dos temas estudados nos encontros e 3) Atestos de gestores municipais de sa?de para calcular a rotatividade profissional dos m?dicos. As entrevistas das consultas m?dicas foram filmadas e analisadas. Utilizou-se a an?lise descritiva dos dados, o teste do qui-quadrado e teste de Fisher (p = 0,05). A m?dia de idade dos m?dicos entrevistados foi de 39,5 anos, 67,7% eram do sexo masculino e 48,2% solteiros. Em rela??o ? titula??o, 45,2% dos m?dicos possu?am apenas gradua??o em medicina, sendo que 35,5% possu?am no m?ximo quatro anos de forma??o. A rela??o m?dicos inscritos/presentes nos encontros do PEP foi de 41,5% em 2011 e 38,4% em 2012. Os temas mais estudados nos encontros de GAP foram a metodologia do PEP (24,3%) e as doen?as cr?nicas n?o transmiss?veis (10,5%). Para os m?dicos participantes, o supervisor do GAP segue a metodologia proposta e os materiais atendem ?s necessidades dos grupos (100,0%). Os m?dicos (93,5% e 96,8%, respectivamente) relatam que ap?s a participa??o no PEP houve redu??o de encaminhamentos e de pedidos de exames desnecess?rios. Os m?dicos participantes (93,5%) afirmam ainda que suas consultas foram reestruturadas ap?s a participa??o no Programa. Segundo o ponto de vista de 35,7% dos gestores municipais de sa?de, os m?dicos vinculados a seus munic?pios participam do PEP apenas como forma de cumprir o Contrato do Programa Sa?de em Casa, mas para a maioria (62,5%) este n?o ? o motivo da participa??o, enquanto 50% dos Secret?rios Municipais de Sa?de afirmam que os m?dicos que s?o liberados para o PEP, n?o comparecem nos encontros. A maioria dos usu?rios (76,1%) relatou ter percebido melhora no atendimento ap?s a participa??o do m?dico no Programa. O ?ndice de rotatividade para os m?dicos que participam do PEP com frequ?ncia igual ou superior a 60,0% foi de 35,5%, enquanto para aqueles que n?o participam efetivamente do Programa o valor foi de 60,9%. Conclui-se, assim, que a Educa??o Permanente nos moldes do PEP pode melhorar o desempenho cl?nico dos m?dicos e envolver mais o usu?rio em seu tratamento, al?m de contribuir para a fixa??o de profissional na regi?o. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / ABSTRACT The Permanent Education Program for Physicians in the Family Health Strategy was implemented in the Jequitinhonha Extended Health Region in October 2010 for the purpose of improving the level of resolution capability in Primary Health Care. It took as the starting point the significant and integrated learning of the various clinical skills that the physicians in the family health teams need. The objective of this paper was to assess the planning and execution actions, as well as the results of the PEP in the Jequitinhonha Extended Health Region, in Minas Gerais state, in interface with the objectives proposed by the Program. The study was developed in 14 municipalities in this Region, which had physicians from the Family Health Strategy whose participation rate in the PEP was equal to or greater than 60 percent. 14 health managers, 31 physicians, and 383 users participated in the research. The research used a descriptive, quantitative, and qualitative triangulation approach. The following data collection tools were used: 1) Structured questionnaires addressed to users, physicians, and health managers; 2) Reports by supervisors from the Professional Development Groups (PDGs) for an overview of the topics studied in the meetings, and 3) Statements by municipal health managers to calculate the professional turnover rate of medical doctors. The interviews during medical appointments were filmed and analyzed. Descriptive data analysis, the?chi-square test? and the Fisher Test (p = 0.05), and the Pearson Correlation Test (p = 0.0.5%) were used. The average age of the interviewed physicians was 39.5 years; 67.7% were males, and 48% were single. As far as academic degree was concerned, 45.2% of the physicians only had a degree in Medicine, and 35.5% of them had graduated no more than four years prior to these interviews. The percentages of physicians who signed up for / participated in the meetings of the PEP were 41.5% in 2011 and 38.4% in 2012. The most widely studied topics in the Professional Development Group meetings were the methodology of the Permanent Education Program (24.3%) and chronic non-communicable diseases (10.5%). For the participating physicians, the supervisor of the Professional Development Group follows the proposed methodology, and the materials meet the needs of the groups (100%). The physicians (93.5% and 96.8%, respectively) reported that, after participating in the Permanent Education Program, there was a reduction in the number of unnecessary referrals and requests for medical examinations. The participating physicians (93.5%) also stated that their medical consultations were restructured after they participated in the Program. From the point of view of 35.7% of the municipal health managers, the physicians working in their municipalities attend the Permanent Education Program only to comply with the Home Health Care Program Agreement. However, for most of the municipal health care managers (62.5%), this is not the reason why physicians attend the PEP, while 50% of the Municipal Health Secretaries stated that physicians who are released to attend the PEP do not show up for the meetings. Most of the users (76.1%) reported that they noticed an improvement in the health care services after their doctor participated in the Program. The turnover rate was 35.5% for physicians whose participation in the PEP was equal to or greater than 60.0% , whereas for those who do not participate effectively in the Program the turnover rate was 60.9%. It is therefore concluded that permanent education, along the lines of the Permanent Education Program, can improve the clinical performance of the physicians and make users more involved in their treatment. Furthermore, it contributes to retaining professionals in the region.

Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-08T13:16:47Z No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) endi_lanza_galvao.pdf: 1678820 bytes, checksum: 33907d9247a67c52afa9d562f393c0ac (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-11T11:10:26Z (GMT) No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) endi_lanza_galvao.pdf: 1678820 bytes, checksum: 33907d9247a67c52afa9d562f393c0ac (MD5) / Made available in DSpace on 2016-01-11T11:10:27Z (GMT). No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) endi_lanza_galvao.pdf: 1678820 bytes, checksum: 33907d9247a67c52afa9d562f393c0ac (MD5) Previous issue date: 2014 / Desde a cria??o do Sistema ?nico de Sa?de (SUS), o tema regionaliza??o da sa?de tem sido discutido no intuito de implement?-la como estrat?gia de gest?o. Com o objetivo de ampliar a cobertura das a??es e melhorar a qualidade da oferta de servi?os de sa?de, os territ?rios t?m sido organizados regionalmente atrav?s de pactua??es ocorridas nas Comiss?es Intergestores Regional e Comiss?es Intergestores Regional Ampliada. No entanto, contribui??es cient?ficas acerca do planejamento da sa?de no Vale do Jequitinhonha/MG ainda s?o muito escassas na literatura. O presente estudo analisou o processo de planejamento regional desenvolvido por meio dessas comiss?es, durante os anos de 2010 a 2013, no territ?rio da Superintend?ncia Regional de Sa?de de Diamantina/MG. Foi realizado um estudo explorat?rio - descritivo atrav?s de an?lise documental al?m de um estudo epidemiol?gico das interna??es hospitalares por Acidente Vascular Cerebral (AVC), ocorridas em um hospital de refer?ncia da regi?o. Os elementos recolhidos neste estudo mostram que a regionaliza??o do SUS na Regi?o Ampliada de Sa?de Jequitinhonha ? conduzida pelas normatiza??es da Secretaria Estadual de Sa?de e Minist?rio da Sa?de e as Comiss?es Intergestores Regionais parecem configurar uma importante inst?ncia de articula??o entre estado e munic?pios. A rede urbana da regi?o ? formada principalmente por pequenos munic?pios, com destaque para os quatro centros emergentes, Diamantina, Capelinha, Itamarandiba e Ara?ua?, sendo que Diamantina representa o principal eixo articulador de fluxos no setor sa?de. Por?m, os resultados indicam inexist?ncia da pactua??o com a inst?ncia estadual, do fluxo para encaminhamento dos pacientes com AVC. Por?m, verifica-se que a refer?ncia para a cidade de Diamantina j? ocorre sistematicamente, ressaltando a necessidade de concretiza??o desta rede de assist?ncia. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2014. / ABSTRACT Since the creation of the Unique Health System (SUS), the regionalization of health has been discussed with a view to its implementation as a management strategy. In order to extend the coverage of actions and improve the quality of health services on offer, territories have been organized regionally through pacts reached in the Regional Intermanagement Commission and the Extended Regional Intermanagement Commission. However, scientific contributions regarding the planning of health in Jequitinhonha Valley/MG are still very scarce in the literature. The present study analyzed the regional planning process developed by these commissions between 2010 and 2013 in the territory of the Regional Superintendence of Health in Diamantina/MG. A descriptive exploratory study was carried out using documental analysis and an epidemiological study of hospitalizations for stroke in a hospital of reference in the region. The data collected in the present study show that the regionalization of the SUS in the Extended Health Region of Jequitinhonha is coordinated by standardizations of the State Secretary of Health and the Ministry of Health. The Regional Intermanagement Commissions seem to set a significant articulation request between state and city, particularly for smaller cities such as the four emerging centers of Diamantina, Capelinha, Itamarandiba and Ara?ua?. Diamantina represents the main axis of flux in the health sector. However, the results of the present study indicate that there are no pacts with state requests, from the flux to transferring stoke patients. However, it was confirmed that the reference for the city of Diamantina already occurs systematically, emphasizing the need to substantiate this service network.