Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-04-03T14:47:02Z No. of bitstreams: 1 GustavoAdolfoLealCosta_DISSERT.pdf: 9145007 bytes, checksum: 096b1a92a513994e4d22f82a35b800d6 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-04-10T19:45:43Z (GMT) No. of bitstreams: 1 GustavoAdolfoLealCosta_DISSERT.pdf: 9145007 bytes, checksum: 096b1a92a513994e4d22f82a35b800d6 (MD5) / Made available in DSpace on 2018-04-10T19:45:43Z (GMT). No. of bitstreams: 1 GustavoAdolfoLealCosta_DISSERT.pdf: 9145007 bytes, checksum: 096b1a92a513994e4d22f82a35b800d6 (MD5) Previous issue date: 2017-12-11 / O presente trabalho discorre sobre o procedimento contratual e as discuss?es que resultaram na assinatura do Contrato Organizativo de A??o P?blica Ensino-Sa?de (COAPES) nas 4? e 5? regi?es de sa?de do Rio Grande do Norte, visando viabilizar a estrutura??o de servi?os de sa?de em condi??es de ofertar campo de pr?tica suficiente e de qualidade aos cursos e resid?ncias da ?rea da sa?de, permitindo o fortalecimento da integra??o ensino-servi?o-comunidade. Utiliza-se da teoria de interpreta??o qualitativa, observando-se as posi??es ?ticas e pol?ticas dos diversos interessados no processo contratual, buscando, a partir delas, compreender de forma interpretativa as decis?es decorrentes da pr?pria natureza humana, norteadas a priori pelos interesses sociais, como tamb?m pol?ticos, e em que n?vel a mudan?a almejada foi alcan?ada. Promove-se an?lise das informa??es coletadas, dada atrav?s de uma revis?o integrativa da literatura, envolvendo um aprofundamento descritivo do COAPES e dos seus fundamentos; da an?lise de documentos e instrumentos, como atas de reuni?es, of?cios, portarias, decretos e leis; e da interpreta??o e discuss?o dos resultados, com a finalidade superveniente de gerar um produto que apresente relev?ncia para outras institui??es interessadas em iniciar o processo de contratualiza??o. Destaca-se durante o procedimento contratual a import?ncia da pactua??o, discuss?o e qualifica??o da inser??o de estudantes no territ?rio. Verifica-se na problematiza??o a n?o linearidade procedimental, em detrimento ? orienta??o em cartilhas do SUS, observando-se estagna??o com a mudan?a na gest?o administrativa durante e ap?s o per?odo de elei??es municipais. Torna-se poss?vel, ent?o, afirmar que o processo de produ??o do COAPES em estudo ainda precisa avan?ar enquanto um processo dial?gico com reconhecimento, comprometimento e participa??o dos atores envolvidos, numa constante busca pela qualifica??o do cuidado em sa?de de maneira integrada ao processo de forma??o em servi?o e de educa??o permanente da rede. / This paper explores the contractual procedure and the discussions that resulted in the signing of the Organizational Contract of Public Action for Teaching-Health (COAPES) in the 4th and 5th health regions of the state of Rio Grande do Norte, aiming to make possible the structuring of health services in conditions to offer sufficient field of practice and with quality to the courses and residencies of the health area, allowing the strengthening of the teaching-service-community integration. The qualitative theory of interpretation is used, observing the ethical and political positions of the various parts involved in the contractual process, seeking, from them, to understand in an interpretative way the decisions deriving from human nature, at first guided by social interests, as also political, and at what level the desired change was achieved. The analysis of the information collected is promoted through an integrative review of the literature, involving a descriptive deepening of the COAPES and its foundations; analysis of documents and instruments, such as minutes of meetings, letters, ordinances, decrees and laws; and the interpretation and discussion of the results, with the supervenient purpose of generating a product that presents relevance to other institutions interested in starting the process of contracting. The importance of the agreement, discussion and qualification of the insertion of students in the territory stands out during the contractual procedure. Procedural non-linearity is verified during the problematization, against the orientation present in the Unified Health System (SUS) guides, stagnating with the change in administrative management during and after the period of municipal elections. It is possible, then, to affirm that the COAPES production process under study still needs to progress as a dialogical process with recognition, commitment and participation of the involved actors, in a constant search for the qualification of health care in an integrated way to the process of in-service training and permanent education of the health network.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-29T19:35:33Z No. of bitstreams: 1 MariaClaraDeOliveiraFigueiredo_DISSERT.pdf: 987894 bytes, checksum: f79a2cbcf91b29980dd39ac1f2419d9e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-29T19:40:14Z (GMT) No. of bitstreams: 1 MariaClaraDeOliveiraFigueiredo_DISSERT.pdf: 987894 bytes, checksum: f79a2cbcf91b29980dd39ac1f2419d9e (MD5) / Made available in DSpace on 2017-03-29T19:40:14Z (GMT). No. of bitstreams: 1 MariaClaraDeOliveiraFigueiredo_DISSERT.pdf: 987894 bytes, checksum: f79a2cbcf91b29980dd39ac1f2419d9e (MD5) Previous issue date: 2014-09-29 / O Apoio Matricial (AM) foi pensado pelo professor e pesquisador Gast?o Wagner de Souza Campos no ano de 1999 com o intuito de sugerir uma reforma na organiza??o do trabalho em sa?de. A proposta parte de uma perspectiva explorat?ria que indica modelos assistenciais que superem as incapacidades do modelo hegem?nico de car?ter tecnicista, hospitaloc?ntrico e m?dico-centrado, o chamado Modelo Biom?dico. A proposta em foco emerge de uma das alternativas gestadas no campo de Sa?de Coletiva: o Modelo em Defesa da Vida (MDV). Este modelo resulta dos estudos e trabalhos de um grupo de profissionais que fundaram o Laborat?rio de Planejamento e Administra??o em sa?de (LAPA) no final da d?cada de 80 e prop?e a cria??o de metodologias e instrumentos de gest?o e organiza??o dos servi?os que construam novas rela??es entre os sujeitos. No n?vel operacional, capturando as contribui??es e as bases do MDV, o AM se completa com o processo de trabalho das Equipes de Refer?ncia (ER), configurando-se como uma proposta centrada no trabalho interdisciplinar e na Clinica Ampliada. A partir de 2008, o Minist?rio da Sa?de incorpora essa metodologia, na Estrat?gia de Sa?de da Fam?lia (ESF) como um dos componentes centrais da proposta dos N?cleos de Apoio a Sa?de da Fam?lia (NASF). O objetivo geral desse trabalho foi analisar o AM como estrat?gia organizacional e assistencial na sa?de, especificamente no contexto da ESF/NASF. O estudo se utilizou da pesquisa bibliogr?fica como forma de apreender o movimento do objeto de investiga??o. Para tanto, foi necess?rio discutir te?rico-conceitualmente o AM com o intuito de identificar suas bases e propor uma reflex?o cr?tica sobre as mesmas, identificar como est? situada nos NASF e, por fim, identificar e analisar seus limites e potencialidades. Constatamos que nessa busca pela supera??o ao modelo vigente e de questionamentos ?s suas prerrogativas e investidas v?-se, al?m dos avan?os, alguns retrocessos e desafios. Suas bases te?ricas nos mostram uma busca de estabelecer uma l?gica mais humanit?ria nos servi?os, quando n?o nega que os indiv?duos s?o imbu?dos de desejos e afetos e os considera part?cipes no modo de pensar e agir em sa?de. Acaba por partir de uma constru??o te?rica ecl?tica e finda por propor um resgate do sujeito, indicando em alguns momentos, solu??es individuais para problemas coletivos, quando secundariza problemas estruturais e focaliza em medidas que buscam modifica??es na subjetividade. Por outro lado, ? uma proposta que busca criticar a heran?a Taylorista e tenta superar o saber disciplinar e fragmentado da? decorrente, buscando desenvolver mecanismos para valorizar com mais equil?brio os diversos profissionais, dando corpo ? l?gica de interdisciplinaridade nos servi?os de sa?de. No ?mbito dos NASF apesar da clara vincula??o com o AM a metodologia ? pouco conhecida e na pr?tica percebemos equivocadas interpreta??es e modos peculiares de desenvolver essa proposta nos munic?pios. A consequ?ncia disso est? sendo uma heterogeneidade de NASF no Brasil muitas vezes atuando de modo funcional ao modelo biom?dico. Assim, em meio ?s diversas estrat?gias e modelos em suas potencialidades, limites e inflex?es, s?o ineg?veis as contribui??es da ferramenta de AM na pol?tica de sa?de no Brasil, por?m a proposta n?o passa imune ?s invas?es conservadoras na SC e demarca alguns desafios oriundos do pr?prio modo capitalista de conduzir a pol?tica de sa?de.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-03T23:50:31Z No. of bitstreams: 1 JoseaneDaRochaDantasCavalcanti_DISSERT.pdf: 2930362 bytes, checksum: 34e772aa1eb2ca5ff06d2876b8c69aad (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-12T18:53:25Z (GMT) No. of bitstreams: 1 JoseaneDaRochaDantasCavalcanti_DISSERT.pdf: 2930362 bytes, checksum: 34e772aa1eb2ca5ff06d2876b8c69aad (MD5) / Made available in DSpace on 2017-04-12T18:53:25Z (GMT). No. of bitstreams: 1 JoseaneDaRochaDantasCavalcanti_DISSERT.pdf: 2930362 bytes, checksum: 34e772aa1eb2ca5ff06d2876b8c69aad (MD5) Previous issue date: 2016-12-05 / A pretensa invulnerabilidade masculina v?m se constituindo em fator de vulnerabiliza??o ao adoecimento, acrescido ao fato da invisibilidade de suas demandas pelos servi?os de sa?de, no que diz respeito a organiza??o dos servi?os e as cren?as em rela??o a masculinidade significar sin?nimo de n?o cuidado. Temos nesse contexto, a necessidade de cria??o e intensifica??o de estrat?gias na aten??o b?sica que contemple de maneira singular os homens. Diante desse cen?rio, realizamos uma pesquisa qualitativa de car?ter interventivo visando compreender se a pr?tica inventiva da Tenda do Conto pode se configurar como um espa?o de cuidado humanizado e integral para a sa?de dos homens usu?rios da Estrat?gia Sa?de da Fam?lia. O estudo foi realizado com nove homens em uma Unidade de Sa?de da Fam?lia, no munic?pio de Cuit?-PB. Como estrat?gia metodol?gica, utilizamos a entrevista e a participa??o dos homens na Tenda do Conto, mediada pela pesquisadora; e o di?rio de campo da pesquisadora e sua assistente. A Tenda do Conto se configura como um espa?o aberto, atrav?s de encontros onde usu?rios e profissionais de sa?de partilham sabedorias e experi?ncias de vida, estimulando a co-responsabilidade na busca de solu??es e supera??o dos desafios, constituindo uma estrat?gia de otimiza??o no acolhimento e estabelecimento de v?nculo alicer?ado no princ?pio de humaniza??o. Para a an?lise e interpreta??o das narrativas recorremos ? Hermen?utica Gadameriana. A partir do di?logo com as narrativas dos homens nas tendas e entrevistas obtivemos alguns eixos tem?ticos: 1) Ser homem ? dar conta de tudo! Nesse eixo constatamos a responsabilidade para com tudo e a centralidade do trabalho na constru??o das masculinidades, o ter car?ter configurando a for?a do ser homem e ? Ser normal, ? n?o ser machista ao falarem em respeito ?s diferen?as como algo que deveria ser normal na constitui??o do masculino. 2) Concep??es sobre sa?de: viver bem e n?o sentir nada. Eles partiam da aus?ncia de doen?a, indo ao bem estar, com destaque no decorrer das tendas para a presen?a da m?sica, do lazer, e da conviv?ncia entre eles como aliados em sua sa?de. 3) Concep??es sobre bom atendimento: a busca pela resolutividade surgem ao lado do acolhimento. 4) Os homens na/da Tenda, carecem de que?: Demandas de sa?de masculinas: os carecimentos expl?citos - observamos hipertens?o arterial, gastrite, problemas de pr?stata, dor f?sica e ansiedade. Revelando necessidades: eles carecem de que? Eles (re)conhecem a necessidade de dar visibilidade e cuidado as suas quest?es emocionais. 5) A tenda do Conto para homens e a produ??o de vida! Neste eixo, da timidez inicial ao (re)conhecimento do outro e a alegria de poder falar o que vem de dentro do cora??o, evidenciam os ganhos obtidos com a Tenda para a express?o de suas singularidades e subjetividades. / The alleged male invulnerability has become a factor of vulnerability to illness, added to the fact of the invisibility of their demands by the health services, regarding the organization of services and beliefs regarding masculinity signify synonymous with non-care. In this context, we have the need to create and intensify strategies in basic care that contemplate men in a unique way. In view of this scenario, we conducted a qualitative research of an interventional character in order to understand if the Tale Tent inventive practice can be configured as a space of humanized and integral care for the health of men who use the Family Health Strategy. The study was carried out with nine men in a Family Health Unit, in the city of Cuit?-PB. As a methodological strategy, we used the interview, and the men's participation in the Tale Tent, mediated by the researcher; and the researcher's field diary and her assistant. The Tale Tent is an open space, through meetings where users and health professionals share wisdom and life experiences, stimulating co-responsibility in the search for solutions and overcoming challenges, constituting a strategy of optimization in the reception and establishment Based on the principle of humanization. For the analysis and interpretation of the narratives, we turn to the Gadamerian Hermeneutics. From the dialogue with the narratives of the men in the tents and interviews, we obtained some thematic axes: 1) To be man is to give account of everything! In this axis, we find the centrality of work in the construction of masculinities, and the responsibility towards everything and character having the force of being man; 2) Conceptions about health: living well and feeling nothing. They started from the absence of illness, going to well-being, with emphasis in the course of the tents for the presence of music, leisure, and coexistence among them allies in their health. 3) Conceptions about good service: the search for resolution and access arise alongside the reception and quality of communication. 4) Health demands and the tent: revealing needs. Of the demands, we observe hypertension, gastritis, prostate problems, physical pain and anxiety. They highlight their needs for resorting to health services and (re-) know the need to give visibility and care to their emotional issues. 5) The Tale Tent and the recognition of the other by the word. In this axis, from the initial shyness to (re) knowledge and the joy of being able to speak, evidence the gains obtained with the Tent for the expression of its singularities and subjectivities. Through the account of these men, their stories of joys and pains, we verified how much it was possible to take care of the masculine health besides the illness and the instrumental care. By enhancing and welcoming the dimensions of masculine subjectivity, protagonism in health, and promoting a dialogical encounter, the Tent of Tale has exercised a place of humanized and integral care for these men within the scope of the ESF and can continue to inspire more practices that Favor the reception of existential pains and the reunion with the power of encounters, because these needs are too human.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-03T23:50:32Z No. of bitstreams: 1 RafaelSoaresChaves_DISSERT.pdf: 919425 bytes, checksum: 9de0144c3d14bd1f23ad957f686c3442 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-12T19:09:57Z (GMT) No. of bitstreams: 1 RafaelSoaresChaves_DISSERT.pdf: 919425 bytes, checksum: 9de0144c3d14bd1f23ad957f686c3442 (MD5) / Made available in DSpace on 2017-04-12T19:09:57Z (GMT). No. of bitstreams: 1 RafaelSoaresChaves_DISSERT.pdf: 919425 bytes, checksum: 9de0144c3d14bd1f23ad957f686c3442 (MD5) Previous issue date: 2016-12-19 / No Brasil, o uso e o desenvolvimento de instrumentos e tecnologias em sa?de para a garantia do acesso ? sa?de como direito de todos bem como a resolubilidade das diferentes e complexas demandas observadas nos territ?rios representam ponto-chave para o desenvolvimento do SUS em seus princ?pios fundamentais nas diferentes regi?es brasileiras. O Projeto Terap?utico Singular (PTS) ?, atualmente, uma pr?tica ainda n?o incorporada na rotina da maioria das equipes de sa?de na aten??o b?sica e ainda pouco difundida e desenvolvida, apesar de seu grande potencial na produ??o de novas realidades, sobretudo no que diz respeito aos casos complexos. Em virtude disso, justificam-se estudos no sentido de lan?ar luz sobre as realidades das equipes em rela??o ao uso do PTS como ferramenta de gest?o do cuidado em sa?de no ?mbito da ESF. Nesse sentido, o presente trabalho trata de uma pesquisa qualitativa explorat?ria a qual buscou investigar como uma equipe da ESF e uma equipe do NASF que a apoia utilizam o PTS no seu territ?rio, tendo como objetivos espec?ficos: conhecer os sentidos atribu?dos pelos profissionais (das equipes NASF e ESF) ?s no??es de Cl?nica Ampliada, de Apoio Matricial e de Projeto Terap?utico Singular; identificar como as equipes se comunicam e se vinculam para a constru??o do PTS e a realiza??o do apoio matricial; e identificar as potencialidades e dificuldades vividas pelas equipes para o uso do PTS como ferramenta de gest?o do cuidado. Para tanto, a abordagem metodol?gica foi desenvolvida atrav?s de entrevistas individuais semiestruturadas e Grupos Focais com os profissionais das equipes de um munic?pio de pequeno porte do RN. Os dados produzidos pelas entrevistas e pelos Grupos Focais foram organizados e categorizados mediante a an?lise de conte?do proposta por Bardin. Os tr?s eixos de an?lise foram: 1) multiprofissionalidade, corresponsabilidade e resolutividade; 2) concep??es de PTS, dificuldades, falta de experi?ncia e desconhecimento sobre PTS; e 3) articula??o e planejamento das a??es. De modo geral, o estudo apontou a constru??o de PTS como uma pr?tica pontual, sendo uma ferramenta que pouco comp?e o cotidiano das equipes e dos servi?os de sa?de na aten??o b?sica, apesar de ser reconhecidamente importante para a amplia??o das a??es e resolutividade dos problemas dos usu?rios. Al?m disso, o PTS, mesmo n?o sendo uma ferramenta de uso cotidiano, ? desconhecido por muitos e as equipes s?o carentes de experi?ncias que potencializem o seu uso de forma sistem?tica e compartilhada nos espa?os de produ??o do cuidado em sa?de. Desse modo, coloca-se como importante que a??es de qualifica??o da aten??o sejam desenvolvidas junto ?s equipes para o uso do PTS entre outras ferramentas para gest?o do cuidado de forma integral e compartilhada. / In Brazil, the use and development of health instruments and technologies to guarantee the access to health as a right for all its citizens, as well as the solvability of the different and complex demands observed in the territories represent a key point for the development of Sistema ?nico de Sa?de (SUS) in its fundamental principles in different Brazilian regions. The Singular Therapeutic Project (STP) is a not yet currently incorporated practice into the routine of most health care teams in the basic health attention and it is still poorly widespread and developed, despite its great potential in the construction of new realities, especially with regard to complex cases. Taking this context into consideration, studies in this area are justified in order to shed some light on the realities of these teams in relation to the use of STP as a health care management tool within the Family Health Strategy (FHS). In this sense, this study presents an exploratory qualitative research that sought to investigate how a team of FHS and another one of a Family Health Support Nucleus (FHSN), which supports the team of FHS investigated, use the STP in its territory, with specific objectives of: getting to know the meanings assigned to the notions of Expanded Clinic, Matrix Support and Singular Therapeutic Project by the FHSN and FHS teams? professionals; identifying how teams communicate and team up for the construction of the STP and for the execution of matrix support; and identifying the potentialities and difficulties experienced by the teams in using STP as a care management tool. For this, the research methodological approach was developed through semi-structured individual interviews and focus groups with the professionals of the teams of a small city of the state Rio Grande do Norte. The data produced by the interviews and the focus groups were organized and categorized based on the content analysis proposed by Bardin (2011). The three axes of analysis were: 1) multiprofessionality, co-responsibility and resolvability; 2) conceptions of STP, difficulties, lack of experience and knowledge about STP; and 3) articulation and planning of actions. In general, the study pointed to the construction of STP as not being a regular practice, being a tool that does not take part in the daily life of the health teams and services in basic health attention, although it is recognized as important for the expansion of actions and solution of the users? problems. In addition to that, besides the STP is not seen as a tool of daily use, it is unknown by many professionals and the health teams lack experiences that potentialize STP use in a systematic and shared way in the health care production spaces. In this way, it is important that actions towards qualification on health attention for the use of STP are developed together with the teams, among other tools for care management in an integral and shared way.

Please read the abstract in the section 00front of this document / Thesis (D Com (Econometrics))--University of Pretoria, 2007. / Economics / unrestricted

Please read the abstract in the section 00front of this document. / Thesis (PhD)--University of Pretoria, 2006. / Humanities Education / PhD / Unrestricted

Please read the abstract in the 08summary part of this document / Thesis (DPhil (Zoology))--University of Pretoria, 2006. / Zoology and Entomology / unrestricted

This study has a dual purpose. Firstly, it is aimed at determining the need for the effective management of outdoor information transfer as an important resource in the aesthetic environment. Effective management is seen as an optimisation of the benefits of outdoor information transfer, as well as a minimisation of its negative impacts. Secondly, this study was aimed at providing user-friendly guidelines to achieve this. The South African Manual for Outdoor Advertising Control (SAMOAC) was developed in 1998 as a national guideline document to provide detailed conditions for the management and control of outdoor advertisements and signs. This manual recognises the differences in local needs and circumstances and suggests that controlling authorities should adapt the prescribed conditions in this regard. Up till now this document has not been implemented successfully by the relevant controlling authorities. Outdoor advertisements of all sizes are increasing at an alarming rate in South Africa to the detriment of the perceptual environment and tourism resources. One of the most obvious reasons for this is the lack of motivation amongst the controlling authorities together with the persistency of the outdoor advertising industry. This study provides the necessary motivation for involving controlling authorities, the outdoor advertising industry and the public in the meaningful and sustainable management of outdoor information transfer. It looks at the benefits and impact of outdoor information transfer in a holistic manner by taking the variety and interrelationship of such impacts and benefits into consideration. Most previous studies have only concentrated on a single aspect of outdoor information transfer namely the correlation between billboards and road accidents. A key finding of this study is that the effective management of outdoor information transfer is unnegotiable. A laissez faire approach by controlling authorities and self-control by the outdoor advertising industry will lead to visual chaos. A balanced and responsible approach should be followed in managing outdoor information transfer. Outdoor advertising should never be aimed at utilising and maximising every available advertising opportunity and implementing whatever is technologically achievable at the cost of the perceptual environment. The effective management of outdoor information transfer is in the interest of both the perceptual environment and the outdoor advertising industry. It has been found that sense of place and placeness play an important role with regard to the impacts and benefits of outdoor information transfer. The lack of sufficient environmental ethics in Western society has been identified as an underlying problem. A non-pragmatic environmental world-view has therefore been provided based on Christian axioms to serve as a basis for environmental management including perceptual resource management and the management of outdoor information transfer. In order to actualise the need for the effective management of outdoor information transfer general principles and user-friendly guidelines are provided that will be universally applicable. It will make the management of outdoor information transfer less subjective and will serve as a basis for legislative and control measures. These principles and guidelines are flexible enough to accommodate a variation in local conditions, lifestyles and aspirations. It can therefore serve as an instrument to adapt SAMOAC to suit local circumstances and needs. The recommendations provided in this study are aimed at creating an appreciation for the perceptual environment as well as the role and aesthetic contribution of outdoor advertisements and signs. It is also aimed at involving the public, controlling authorities and the outdoor advertising industry in the sustainable management of outdoor information transfer as an important part of the perceptual environment. / Thesis (PhD (Regional Planning))--University of Pretoria, 2006. / Town and Regional Planning / unrestricted

Submitted by Carolina Neves (carolinapon@uefs.br) on 2016-08-11T23:51:59Z No. of bitstreams: 1 DISSERTA??O CARDOSO, MARIANA.pdf: 2574488 bytes, checksum: 9bb271940c329bf7d98ec32b338d8535 (MD5) / Made available in DSpace on 2016-08-11T23:51:59Z (GMT). No. of bitstreams: 1 DISSERTA??O CARDOSO, MARIANA.pdf: 2574488 bytes, checksum: 9bb271940c329bf7d98ec32b338d8535 (MD5) Previous issue date: 2015-03-27 / Considering the work as a determining factor in the health / illness physical and mental this study aimed to describe the main actions in mental health related to work in Brazil based on information provided by professionals from the Worker's Health Reference Centers (Cerest) and the following objectives: a) identify the main actions of mental health related to work carried out by state and regional Cerest in the areas of care, occupational health surveillance and health education; b) identify the actions related to health care workers with Mental Disorders Work Related (TMRT) held by Cerest, by regions of Brazil.A survey was conducted with state and regional Cerest implemented in Brazil from October to December 2014 through a questionnaire on ?line, 161 Cerest participated. Among statewide response rate was 96.2% and 77.7% among regional. It can be observed that the actions in the area of mental health related to work performed by Cerest occur primarily in the area of assistance, health surveillance of the worker, and TMRT of notification. Overall the actions were carried out mostly by regional Cerest and in the Southeast and Northeast. The actions in mental health is still poor, highlighting the assistance measures for establishing diagnosis and nexus of suspected cases of Mental Disorders Work Related (TMRT) were not being carried out by most of Cerest of Brazil (53.1%), and this case distributed differently by regions of the country. The treatment of mental illnesses related to work was sent to the Caps, but Cerest not followed its evolution. SUS health services are not prepared to receive this demand that has been increasing cases of TMRT. Highlighted the importance of actions in mental health-related work being undertaken by all SUS voltage levels, and inter and intrasectoral actions need to be expanded and strengthened between Cerest and the Health Care Network, especially the Psychosocial Care Network devices to ensuring full attention to these workers. It is necessary to build new research instruments and public policies that help the flow of shares to the ratio of the nexus of the establishment of these diseases with the work in the health services, as well as Occupational Health Surveillance actions in mental health, as illnesses related to work are preventable through improvements in work environments. / Considerando o trabalho como fator determinante no processo de sa?de/doen?a f?sica e ps?quica, este estudo teve como objetivo geral descrever as principais a??es em Sa?de mental relacionadas ao trabalho no Brasil, com base nas informa??es prestadas pelos profissionais dos Centros de Refer?ncia em Sa?de do Trabalhador (Cerest) e como objetivos espec?ficos: a) identificar as principais a??es de sa?de mental relacionadas ao trabalho realizadas pelos Cerest estaduais e regionais nas ?reas: da assist?ncia, vigil?ncia em sa?de do trabalhador e educa??o em sa?de; b) identificar as a??es relacionadas ? aten??o a sa?de dos trabalhadores com Transtornos Mentais Relacionados ao Trabalho (TMRT) realizadas pelos Cerest, por regi?es do Brasil. Foi realizado um inqu?rito com os Cerest estaduais e regionais implantados no Brasil nos meses de outubro a dezembro de 2014 atrav?s de question?rio on-line.Participaram 161 Cerest. Entre os de abrang?ncia estadual houve taxa de resposta de 96,2% e de 77,7% entre os regionais. Observou-se que as a??es na ?rea de sa?de mental relacionadas ao trabalho realizadas pelos Cerest ocorrem basicamente na ?rea da assist?ncia, vigil?ncia em sa?de do trabalhador e notifica??o de TMRT. No geral, as a??es eram realizadas em sua maior parte pelos Cerest regionais e nas regi?es Sudeste e Nordeste. As a??es em sa?de mental ainda s?o incipientes, destacando-se a assist?ncia para estabelecimento de diagn?stico e nexo de casos suspeitos de TMRT com o trabalho n?o estavam sendo realizadas pela maioria dos Cerest do Brasil (53,1%), sendo esta a??o distribu?da diferentemente pelas regi?es do pa?s. O tratamento do adoecimento mental relacionado ao trabalho era encaminhado para o Caps, mas os Cerest n?o acompanhavam sua evolu??o. Os servi?os de sa?de do SUS n?o est?o preparados para receber esta demanda que vem aumentando de casos de TMRT. Foi destacada a import?ncia das a??es em sa?de mental relacionadas ao trabalho serem realizadas por todos os n?veis de aten??o do SUS; assim, a??es inter e intrasetoriais necessitam ser ampliadas e fortalecidas entre os Cerest e a Rede de Aten??o ? Sa?de, principalmente os dispositivos da Rede de Aten??o Psicossocial, para a garantia da aten??o integral aos trabalhadores. S?o necess?rias novas pesquisas para a constru??o de instrumentos e pol?ticas p?blicas que auxiliem no fluxo de a??es para o estabelecimento do nexo da rela??o desses agravos com o trabalho nos servi?os de sa?de, como tamb?m a??es de Vigil?ncia em Sa?de do Trabalhador na ?rea de sa?de mental, pois o adoecimento relacionado ao trabalho s?o preven?veis atrav?s de melhorias nos ambientes de trabalho.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-08-25T20:50:25Z No. of bitstreams: 1 Dissertacao Aliana Simoes.pdf: 1387621 bytes, checksum: 87999ce8eadfd38b96c19a1cb2720983 (MD5) / Made available in DSpace on 2016-08-25T20:50:25Z (GMT). No. of bitstreams: 1 Dissertacao Aliana Simoes.pdf: 1387621 bytes, checksum: 87999ce8eadfd38b96c19a1cb2720983 (MD5) Previous issue date: 2013-03-25 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The health system Ensures the 1988 Constitution, the principles of the Unified Health System (SUS), universality, fairness, integrity cared for in the health of Individuals. Thus, the citizen has the right to life and health legitimized Becoming foundation for the realization of the fundamental right to life, human dignity and citizenship. However, the health system is facing gaps is putting its principles. From this perspective, the lawsuits go into this scenario an instrument for the realization of these rights. The research is Performed to describe the profile of the judicialization of health in the state of Bahia for the access to health technologies in the SUS, in the period from 2005 to 2010, and to discuss access technologies in relation to the demands of health care (drugs, food, admissions, treatments, surgeries and other) and the lawsuits filed by users of SUS. The methodology has two approaches: a quantitative approach, with retrospective descriptive study, from primary sources collected in the database of electronic consultation and free access to the website of the Court of Justice of the State of Bahia, the lawsuits. That demand for access to health technologies in the SUS, in the period from 2005 to 2010. These data comprised the General Headquarters and Analysis Analyzed were using Microsoft Office Excel 2007 for tabulation, build charts and tables for the distribution of absolute and relative frequencies, and the qualitative approach with an exploratory study, descriptive and analytical, using document analysis for the composition Summary Table of the Analysis of Thematic Content Analysis by Defining the Category Analysis. The results obtained by the design of the profile of Legalization of Health in the State of Bahia have 103 lawsuits. That demand for access to technologies in the SUS, in the period from 2005 to 2010. The year 2009 presented significant data entry with 47 stocks (45.6%). 75 actions were recorded (72.8%) Interlocutory Appeal and to the towns of origin, 74 shares (71.8%) were related to the city of Salvador. The drug delivery was more demand pled with 72 (60%). We found 63 cases (61.2%) related to degenerative diseases Chronic and 89, equivalent to 86.4% judgments granting the user access to the SUS. The year 2009 Showed 54 (52.4%) of the cases heard. With the discussion permeated by the Judiciary unveiling a path for access to health technologies in SUS can infer such access that provides the guarantee of the right to life and health to users, because the demands are met pled in almost all the shares. The Civil Society Organizations have great power in the realization of human rights act the key players in the mobilization of the Judiciary for the satisfaction of their rights that have been denied or dissatisfied. For the health system, the demands, especially for drugs by judicial cause great harm to the planning and management of programs and services offered by SUS, and displacement of budget allocations for health to meet the individual lawsuits, the vast Majority. Moreover, there is an excessive medicalization of health care devaluing the relational technologies and the power of the subject active in directing the disease process. Thus, we conclude that traveled this alternative path by the user and allows access to the health system provides citizenship determined by the participation of the individual as a citizen who sections the fulfillment of their social rights established in the Constitution of 1988. However, we envision the need for a strong body of technical professionals in the health field to work together with the Judicial Authorities in the resourcefulness of actions. That require instructions for their acts embrasure decision-making glimpsing consistent and fair to all Involved in the search for a society with social justice. / O sistema de sa?de assegura na Constitui??o de 1988, pelos princ?pios do Sistema ?nico de Sa?de (SUS), a universalidade, equidade, integralidade no cuidado ? sa?de dos indiv?duos. Desta forma, o cidad?o possui seu direito ? vida e ? sa?de legitimado, constituindo-se como alicerce para efetiva??o do direito fundamental ? vida, dignidade humana e ? cidadania. Entretanto, o sistema de sa?de vem enfrentando lacunas para efetiva??o de seus princ?pios. As demandas judiciais entram nesse cen?rio como instrumento para efetiva??o desses direitos. Os objetivos s?o: descrever o perfil da judicializa??o da sa?de no Estado da Bahia para o acesso ?s tecnologias de sa?de no SUS, no per?odo de 2005 a 2010; e discutir o acesso ?s tecnologias em rela??o ?s demandas de aten??o ? sa?de (medicamentos, alimentos, internamentos, tratamentos, cirurgias e outras) e as a??es judiciais movidas pelos usu?rios do SUS. O caminho metodol?gico ? orientado pelas abordagens, quantitativa e qualitativa: a primeira trata de um estudo descritivo e retrospectivo, utilizando fontes prim?rias como base de dados por meio da consulta eletr?nica e de livre acesso, no s?tio do Tribunal de Justi?a do Estado da Bahia, dos processos judiciais que demandavam por acesso ?s tecnologias de sa?de no SUS. Estes dados compuseram as Matrizes Gerais de An?lise atrav?s do software Microsoft Office Excel 2007 para a tabula??o, constru??o de gr?ficos e tabelas. A an?lise descritiva foi baseada na distribui??o de frequ?ncias simples e relativas; e a segunda com estudo de natureza explorat?ria que utiliza como fonte de dados, documentos dos processos judiciais para a composi??o da An?lise de Conte?do Tem?tica. Os resultados obtidos pelo delineamento do perfil da Judicializa??o da Sa?de no Estado da Bahia apresentam 103 processos judiciais que demandavam por acesso ?s tecnologias no SUS, no per?odo de 2005 a 2010. O ano de 2009 apresentou dados significativos, com entrada de 47 a??es (45,6%). Foram registradas 75 a??es (72,8%) como Agravo de Instrumento e com rela??o ?s cidades de origem, 74 a??es (71,8%) estavam relacionadas ao munic?pio de Salvador. O fornecimento de medicamentos foi a demanda mais pleiteada com 72 (60%). Foram encontrados 63 casos (61,2%) relacionados a agravos Cr?nico-degenerativos e, 89, equivalente a 86,4% decis?es proferidas concedendo o acesso do usu?rio ao SUS. O ano de 2009 apresentou 54 (52,4%) dos processos julgados. Com a discuss?o permeada pelo Poder Judici?rio desvelando um caminho para o acesso ?s tecnologias de sa?de no SUS podemos inferir que esse acesso determina a garantia do direito ? vida e ? sa?de aos usu?rios, pois as demandas pleiteadas s?o atendidas em grande parte das a??es. A Sociedade Civil Organizada ? caracterizada por um poder significativo na efetiva??o dos direitos humanos, atuando como atores fundamentais na mobiliza??o do Poder Judici?rio para a satisfa??o de seus direitos que foram negados ou insatisfeitos. Para o sistema de sa?de, as demandas, principalmente, por medicamentos pela via judicial provocam grandes preju?zos ao planejamento e gerenciamento das a??es e servi?os ofertados pelo sistema, al?m de deslocamento das verbas or?ament?rias destinadas ? sa?de para o cumprimento das a??es judiciais individuais, na grande maioria. Ademais, h? uma demasiada medicaliza??o do cuidado ? sa?de desvalorizando as tecnologias relacionais e o poder ativo do sujeito no direcionamento do processo sa?de-doen?a. Assim, conclu?mos que esse caminho alternativo percorrido pelo usu?rio al?m de permitir o acesso ao sistema de sa?de, proporciona o exerc?cio da cidadania determinada pela participa??o desse indiv?duo como cidad?o, que vislumbra o cumprimento de seus direitos sociais estabelecidos na Constitui??o Federal de 1988, na busca da legitimidade de uma sociedade com justi?a social.