Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2018-03-23T17:53:05Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) carole_gusmao_almeida.pdf: 2424928 bytes, checksum: 67d863472b7a8b3959f22add291f705d (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2018-03-29T14:01:57Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) carole_gusmao_almeida.pdf: 2424928 bytes, checksum: 67d863472b7a8b3959f22add291f705d (MD5) / Made available in DSpace on 2018-03-29T14:01:57Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) carole_gusmao_almeida.pdf: 2424928 bytes, checksum: 67d863472b7a8b3959f22add291f705d (MD5) Previous issue date: 2017 / O Diabetes Mellitus (DM) ? considerado um problema de sa?de p?blica, os principais fatores de risco para seu desenvolvimento s?o sedentarismo, excesso de peso, tabagismo e alimenta??o inadequada. A necessidade no desenvolvimento de estudos com ?nfase na preven??o prim?ria, controle da incid?ncia e complica??es do DM demonstra a import?ncia deste estudo que teve como objetivo, tra?ar o perfil epidemiol?gico do paciente diab?tico usu?rio da rede p?blica no munic?pio de Diamantina- MG no decorrer do ano de 2015. Os dados foram coletados a partir de 112 prontu?rios armazenados nas ESFs deste munic?pio, onde se constatou que: aproximadamente 50% dos pacientes receberam cerca de 2 consultas ao ano (?ndice considerado baixo), a m?dia de idade destes pacientes era de 63 anos sendo prevalente o sexo feminino e predom?nio do diabetes tipo 2, cerca de 60% destes foram classificados como acima do peso. Foram consumidos em m?dia 5 medicamentos/dia por paciente; 10,7% apresentaram relatos de automedica??o, 30% dos pacientes entre 51-60 anos tiveram algum tipo de rea??o aos medicamentos. A politerapia foi o esquema terap?utico dominante, sendo a metformina associada com glibenclamida os hipoglicemiantes mais utilizados; aproximadamente 25% dos indiv?duos tiveram altera??es na dose do medicamento consumido no decorrer do estudo. Sobre as comorbidades, destacaram-se: hipertens?o, acometendo cerca de 80% dos usu?rios e problemas oftalmol?gicos abrangendo 23% dos usu?rios. Houve elevado ?ndice de pacientes com valor glic?mico alterado e defici?ncia no monitoramento atrav?s de an?lises laboratoriais. Ao todo 17 pacientes apresentaram diabetes de forma descompensada. Averiguou-se atrav?s dos dados defici?ncia na implanta??o de grupos de acompanhamentos coletivos assim como falhas nos registros por meio de prontu?rios, houve tamb?m limita??o na disponibilidade da oferta de acompanhamento atrav?s de equipe multiprofissional. Tais an?lises trouxeram como conclus?o a defici?ncia da equipe em fornecer atendimento integral aos usu?rios do SUS, com falhas na padroniza??o de atendimento e implanta??o das normas preconizadas pelos protocolos fornecidos pela Secretaria de Estado da Sa?de - Minas Gerais. Ressalta-se tamb?m a import?ncia de se registrar os procedimentos o que propiciaria a continuidade de informa??es colaborando para um atendimento ?ntegro ao paciente. / Disserta??o (Mestrado) ? Programa de P?s-gradua??o em Ci?ncias Farmac?uticas, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / Diabetes mellitus (DM) is considered a public health problem, the main risk factors for its development are sedentary lifestyle, excess weight, smoking and inadequate diet. The need in the development of studies with emphasis on primary prevention, control of the incidence and complications of DM demonstrates the importance of this study that aimed to trace the epidemiological profile of the diabetic patient user of the public network in the municipality of Diamantina-MG during the year Of 2015. Data were collected from 112 records stored in the FHS of this municipality, where it was found that: approximately 50% of the patients received about 2 visits per year (index considered low), the mean age of these patients was 63 Being prevalent the female gender and predominance of type 2 diabetes, about 60% of these were classified as overweight. An average of 5 medications / day per patient were consumed; 10.7% presented reports of self-medication, 30% of patients between 51-60 years had some type of reaction to the medications. Polytherapy was the dominant therapeutic regimen, with metformin associated with glibenclamide being the most commonly used hypoglycemic agents; Approximately 25% of subjects had changes in the dose of the drug consumed during the study. On comorbidities, hypertension, affecting about 80% of users and ophthalmological problems, were observed, covering 23% of users. There was a high index of patients with altered glycemic value and deficiency in monitoring through laboratory analysis. Overall, 17 patients presented with decompensated diabetes. It was found through the data deficiency in the implantation of groups of collective follow-ups as well as failures in the registries by means of medical records, there was also limitation in the availability of the offer of accompaniment through multiprofessional team. These analyzes led to the conclusion of the team's failure to provide comprehensive care to SUS users, with failures in standardization of care and implementation of the standards recommended by the protocols provided by the State Health Department - Minas Gerais. It is also important to register the procedures, which would allow for the continuity of information, collaborating for a complete care to the patient.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-05-30T23:30:21Z No. of bitstreams: 1 MariaJacquelineAbrantesGadelha_TESE.pdf: 6588612 bytes, checksum: ddc48ea47fcdd306616eb67e82362d43 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-02T20:26:23Z (GMT) No. of bitstreams: 1 MariaJacquelineAbrantesGadelha_TESE.pdf: 6588612 bytes, checksum: ddc48ea47fcdd306616eb67e82362d43 (MD5) / Made available in DSpace on 2016-06-02T20:26:23Z (GMT). No. of bitstreams: 1 MariaJacquelineAbrantesGadelha_TESE.pdf: 6588612 bytes, checksum: ddc48ea47fcdd306616eb67e82362d43 (MD5) Previous issue date: 2015-04-30 / A pesquisa explora uma pr?tica n?o convencional, inventiva, de cuidado na Aten??o B?sica ? a Tenda do Conto ? onde trabalhadores e usu?rios do Sistema ?nico de Sa?de revelam atitudes que apontam para abertura de possibilidades de outros modos de produ??o de sa?de, em dire??o ? constru??o de novas modalidades de v?nculos institucionais e sociais. Produ??o de afetos e processos de subjetiva??o ganham relev?ncia nesse enfoque. A pesquisa-interven??o, na qual saberes do cotidiano e saberes acad?micos se entrela?am est? circunscrita na referida experimenta??o em que usu?rios e trabalhadores compartilham sentidos de vida, pela circula??o de relatos de experi?ncias comuns. No percurso da pesquisa acompanhamos os movimentos micropol?ticos produzidos nos lugares onde a pr?tica vem sendo experimentada por meio da viv?ncia em ato, atrav?s de entrevistas e junto aos participantes da Rede HumanizaSUS (rede colaborativa de pessoas envolvidas na humaniza??o da gest?o e aten??o do SUS), de modo a compreender como essas experimenta??es se desdobram em meio ?s conting?ncias do modelo institu?do homogeneizador e medicalizante das pr?ticas em sa?de. Procuramos, assim, identificar tanto os limites impostos quanto as capacidades de promo??o de micro transforma??es no processo de trabalho, evidenciando as linhas de tens?es que afetam tanto o plano objetivo das pr?ticas institucionais como o plano subjetivo dos usu?rios e trabalhadores. Concebendo como arte ? o fazer, o contar e o inventar ? o estudo explora os percursos da experimenta??o Tenda do Conto no per?odo de 2008 a 2014, destacando que a escuta de narrativas de vida reverte figuras an?nimas de desejo de reconhecimento em figuras de reconhecimento do (seu) desejo. Pelo recurso narrativo, nota-se a tentativa de, por um lado, alcan?ar-se a almejada amplia??o do di?logo entre saberes de diferentes registros e, por outro, conseguir o necess?rio deslocamento de olhares sobre a sa?de em dire??o a uma partilha de sentidos, tendo a vida e a afetividade como ingredientes primordiais. / This research explores an innovative and non-conventional Basic Attention caring practice ? Tenda do Conto (Tale Tent) ? where workers and users of the Sistema ?nico de Sa?de (Brazilian Public Healthcare System) reveal attitudes that point to new possibilities of making healthcare promotion towards the building of new social and institutional bonds. Creating affections and subjectivity processes gain importance in this focus. The research-intervention, in which daily and academic knowledge intertwine, is outlined in the referred experimentation where users and workers share life senses through facts and common experiences. During this research, we followed the micropolitical movements produced in the places where the practice has been experimented through act in experience, interviews and along with the Rede HumanizaSUS members (a collaborative network of people involved in SUS?s management and care humanization), in a way to understand how those experimentations unfold through the limitations of a standardizing and medicalizing healthcare model. Thus, we look forward to identify the limits imposed and the promotion capabilities of micro transactions in the work processes, highlighting tension lines that affect both the institutional practice objective plan and subjective plan of workers and users. Conceived as art ? doing, telling, inventing ? the study explores the paths of the Tenda do Conto, from 2007 to 2014, showing that listening to life narratives turns anonymous characters into recognized ones. Through narrative source, we are able to notice the attempt to reach the desired expansion of dialogue between different records and, on the other side, achieve the look displacement in health towards sharing senses, having life and affection as primordial ingredients.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T20:02:06Z No. of bitstreams: 1 PhilippiSedirGriloDeMorais_DISSERT.pdf: 2021949 bytes, checksum: fb571784a0286972d20358c2346ae7c5 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-27T19:49:25Z (GMT) No. of bitstreams: 1 PhilippiSedirGriloDeMorais_DISSERT.pdf: 2021949 bytes, checksum: fb571784a0286972d20358c2346ae7c5 (MD5) / Made available in DSpace on 2016-06-27T19:49:25Z (GMT). No. of bitstreams: 1 PhilippiSedirGriloDeMorais_DISSERT.pdf: 2021949 bytes, checksum: fb571784a0286972d20358c2346ae7c5 (MD5) Previous issue date: 2015-06-19 / O Programa Telessa?de Brasil Redes foi institu?do pelo Minist?rio da Sa?de, em 2007. Seu principal objetivo ? apoiar os profissionais da Aten??o Prim?ria em Sa?de (APS) com ofertas educacionais de qualifica??o, resultando em condi??es mais favor?veis na fixa??o do profissional em ?reas remotas. A formula??o e gest?o dos servi?os de telessa?de s?o realizadas por n?cleos t?cnico-cient?ficos, que s?o administrados por institui??es p?blicas de ensino superior e respons?veis por prover ferramentas e servi?os no contexto das regi?es em que se encontram. Entretanto, os problemas gerados por essa descentraliza??o ? o desenvolvimento de v?rias ferramentas, com diferentes tipos de linguagem, arquitetura, sem qualquer regulamenta??o e integra??o das informa??es com o Minist?rio da Sa?de. Com o objetivo de resolver o problema exposto, prop?e-se a especifica??o, implementa??o e valida??o de um modelo arquitetural para o desenvolvimento e distribui??o de ferramentas de software do Programa Telessa?de Brasil Redes. Essa arquitetura proposta permite que as ferramentas desenvolvidas nos n?cleos sejam partilhados entre os demais n?cleos, evitando, dessa forma, a utiliza??o desnecess?ria de recursos. / The Brazil Telehealth Networks Program was established by the Ministry of Health in 2007. Its main objective is to support professionals in Primary Health Care (PHC) by offering educational qualification, resulting in more favorable conditions to fixate the professional in remote areas. The formulation and management of telehealth services are performed by scientific and technical centers that are operated by public institutions of higher education and responsible for providing tools and services in the context of the regions where they are. However, one of the problems generated by this decentralization is the development of various tools with different types of language, architecture and without any regulation and integration of information with the Ministry of Health. Aiming to solve the above problem, we propose the specification, implementation and validation of an architectural model in the development and distribution of the Unified Health System software tools. This proposed architecture enables tools developed in telehealth center to be shared among the other centers, thereby preventing the unnecessary use of resources.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-13T14:15:28Z No. of bitstreams: 1 AdrianaTorquatoDaSilva_DISSERT.pdf: 4802911 bytes, checksum: 94d7a16df5fbb789540c23c8ae0b352e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-26T11:48:41Z (GMT) No. of bitstreams: 1 AdrianaTorquatoDaSilva_DISSERT.pdf: 4802911 bytes, checksum: 94d7a16df5fbb789540c23c8ae0b352e (MD5) / Made available in DSpace on 2017-01-26T11:48:41Z (GMT). No. of bitstreams: 1 AdrianaTorquatoDaSilva_DISSERT.pdf: 4802911 bytes, checksum: 94d7a16df5fbb789540c23c8ae0b352e (MD5) Previous issue date: 2016-05-30 / No Brasil do s?culo XXI, vinte e sete anos ap?s a promulga??o da Constitui??o Federal, ainda ? desafio a concretiza??o dos direitos fundamentais sociais, onde por excel?ncia, encontra-se o direito ? sa?de. A crescente busca do cidad?o pela aten??o integral em sa?de prometida pela Constitui??o de 1988 evidenciou as dificuldades encontradas entre a promessa constitucional e a capacidade pol?tica, administrativa e financeira do Estado brasileiro em cumpri-la. Os cidad?os que n?o encontram nas redes de aten??o resposta para suas necessidades de a??es e servi?os de sa?de buscam, atrav?s da interven??o do Poder Judici?rio, a solu??o para o seu problema, o que tem resultado em fen?meno denominado de ?Judicializa??o da Sa?de?. Paralelo a esse fen?meno outra situa??o se confirmou: as dificuldades pr?prias do sistema de justi?a em lidar com os direitos sociais. O modelo de justi?a apresenta-se incompat?vel com a natureza de urg?ncia que envolve as a??es judiciais em sa?de, desafiando a criatividade dos operadores do direito, profissionais de sa?de e gestores na busca de solu??es alternativas para lidar com a complexidade do tema. Esta pesquisa teve o objetivo de analisar a tecnologia social da media??o aplicada ao fen?meno da judicializa??o da sa?de como solu??o extrajudicial de conflitos, a partir da experi?ncia do Programa SUS MEDIADO NATAL. A pesquisa, de abordagem qualitativa, realizou an?lise documental dos registros do Programa e entrevistas com atores envolvidos no mesmo - operadores do Direito, representantes da Magistratura, t?cnicos colaboradores do Programa e gestores do SUS, das esferas municipal e estadual. O per?odo do estudo incluiu os anos de 2012 a 2014. Foi realizado um perfil da demanda e encaminhamentos realizados, no per?odo estudado, em rela??o aos quantitativos de atendimentos, acordos, a??es propostas pela DPE, encaminhamentos de a??es ? DPU, ?ndice de resolutividade e ?ndice de demandas n?o ajuizadas contra estado e munic?pio, e percep??es sobre as pr?ticas vivenciadas pelos atores envolvidos. Os resultados demonstraram que as percep??es dos atores ligados ao Direito e ? Sa?de s?o contradit?rias quanto ao fen?meno da judicializa??o da sa?de, entre aspectos negativos e positivos. No que se refere ? cria??o e desenvolvimento do Programa SUS MEDIADO em Natal houve consenso de que o mesmo ajudou a concretizar o direito ? sa?de. Quanto ? media??o foram identificadas vis?es semelhantes considerando que ? uma ferramenta adequada para se lidar com a judicializa??o, pois reduz o n?mero de a??es propostas no Judici?rio, direciona melhor as compet?ncias aos entes federativos, enquanto busca a solu??o administrativa dos casos. Foi observado que os problemas que permeiam a media??o s?o praticamente os mesmos identificados no funcionamento do Sistema de Sa?de: insufici?ncia de ofertas, dificuldade do acesso a novas tecnologias, d?ficit e necessidade de uma melhor capacita??o de recursos humanos, dificuldades na organiza??o dos processos de trabalho. Conclui-se que para essas quest?es nem a judicializa??o nem a media??o se apresentar?o como resposta resolutiva. Considera-se, por fim, o potencial educativo da media??o como importante contribui??o do Programa, na medida em o di?logo sobre as quest?es do sistema de sa?de permitem uma orienta??o ao usu?rio e, ao mesmo tempo, divulga positivamente o SUS junto ao cidad?o, reconciliando-o com o sistema de sa?de. Essa comunica??o ? cara ao SUS e poder? contribuir, simultaneamente, na otimiza??o da Justi?a e da Gest?o da Sa?de, e em avan?os na cidadania e na efetiva??o de direitos sociais. / In Brazil of the twenty-first century, twenty seven years after the promulgation of the Constitution, the achievement of fundamental social rights it is challenging, where par excellence, is the right to health. The growing demand of citizens to full health care promised by the Constitution of 1988, highlighted by the difficulties between the constitutional promised and the political, administrative and financial capacity of the Brazilian State to fulfill it. Citizens who do not find the answer to your attention needs actions and health services networks seek, through the judiciary intervention, the solution to your problem, which has resulted in a phenomenon called "Legalization of Health." Parallel to this phenomenon other situation was confirmed: the difficulties of the justice system in dealing with social rights. The model of justice shows to be incompatible with the urgent nature involving lawsuits in Health, challenging the creativity of legal professionals, health professionals and managers in the search for alternative solutions to deal with the complexity of the issue. This research aimed to analyze the social technology of mediation applied to the phenomenon of legalization of health as an extrajudicial settlement of conflicts, from the experience of SUS MEDIATED NATAL Program. The research, in its qualitative approach, accomplished documentary analysis of the Program records and interviews with people involved in the same - Law operators, representatives of the Magistracy, technical colaborators and SUS program managers, the municipal and state sphere. The study period included the years 2012 to 2014. This was a profile and referrals made during the period studied, in relation to quantitative consultations, agreements, actions proposed by the DPE, referrals actions to DPU, resoluteness index and demands index not filed against state and county, and perceptions about the practices experienced by the people involved. The results showed that the perceptions of people linked to the field of Law and Health are contradictory as to the legalization of health phenomenon, between negative and positive aspects. In regards to the creation and development of the program SUS MEDIATED NATAL, there was a consensus that it helped to realize the rights to health. As far as the mediation, similar views were identified considering that it is an appropriate tool to deal with the legalization, because it reduces the number of actions proposed in the Judiciary, directs better the competence of the federative while searching the administrative resolution of the cases. It was noted that the problems that pervade the mediation are much the same identified in the operation of the Health System: insufficient offers, difficulty of access to new technologies, deficit and need for better training of human resources, difficulties in the organization of work processes. It is concluded that for these issues neither the legalization nor mediation will provide a resolute response. It is considered, finally, the educational potential of mediation as an important contribution of the Program, as the dialogue on the health system issues allow the user orientation and at the same time, positively discloses SUS to the citizen, reconciling it with the health system. This communication is expensive to SUS and can contribute simultaneously to the optimization of Justice and Health Management, and advances in citizenship and the affecteviness of social rights.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-09-05T19:56:02Z No. of bitstreams: 1 TatianaDeMedeirosCarvalhoMendes_DISSERT.pdf: 1735087 bytes, checksum: dbd78e1a7933b82934b22ed6974f1bd3 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-09-16T00:07:05Z (GMT) No. of bitstreams: 1 TatianaDeMedeirosCarvalhoMendes_DISSERT.pdf: 1735087 bytes, checksum: dbd78e1a7933b82934b22ed6974f1bd3 (MD5) / Made available in DSpace on 2017-09-16T00:07:05Z (GMT). No. of bitstreams: 1 TatianaDeMedeirosCarvalhoMendes_DISSERT.pdf: 1735087 bytes, checksum: dbd78e1a7933b82934b22ed6974f1bd3 (MD5) Previous issue date: 2017-07-04 / A integra??o ensino-servi?o-comunidade mostra-se como uma importante estrat?gia para se alcan?ar as mudan?as apontadas pelas Diretrizes Curriculares Nacionais (DCN) na forma??o de profissionais de sa?de que atendam ?s necessidades sociais. Este estudo objetivou analisar a integra??o ensino-servi?o-comunidade na vis?o de docentes dos cursos de gradua??o de Enfermagem, Medicina e Odontologia da Universidade Federal do Rio Grande do Norte (UFRN). Trata-se de um estudo de natureza explorat?ria e descritiva, com abordagem quantitativa e qualitativa. A coleta de dados foi realizada por meio de um formul?rio de entrevista com 106 docentes, sendo 21 docentes do curso de enfermagem, 56 do curso de medicina e 29 do curso de odontologia, todos da UFRN, Campus Natal. A an?lise dos dados quantitativos foi realizada considerando as vari?veis ?idade?, ?curso?, ?tempo de doc?ncia?, ?per?odo e ?local de realiza??o de aulas pr?ticas/campo?, usando o SPSS, vers?o 22. No que se refere ? an?lise qualitativa, foi utilizado o software Iramuteq, e as entrevistas foram analisadas ? luz da An?lise de Conte?do de Bardin. Os resultados mostraram que, na vis?o dos entrevistados, o curso de enfermagem ? o que possui forma??o mais condizente com as DCN. A vari?vel ?local de atua??o? foi mais destacada quando consideramos a forma??o de acordo com o preconizado pelas atuais DCN, o uso de metodologias ativas e os avan?os na integra??o ensino-servi?o-comunidade. Os docentes reconhecem que a integra??o contribui para a forma??o de profissionais de sa?de que atendam as necessidades sociais, e proporciona experi?ncias multiprofissional e interdisciplinar em cen?rios reais de pr?tica. No entanto, v?rios desafios precisam ser superados a fim de se garantir uma forma??o de qualidade com inser??o dos graduandos nos servi?os em meio ? infraestrutura prec?ria do SUS, modelo hospitaloc?ntrico ainda predominante, curr?culos fragmentados em disciplinas, ?nfase na forma??o t?cnica, pouca valoriza??o e incentivo ?s pr?ticas extramuros, resist?ncia de alguns docentes em participar da integra??o, dentre outros. Fica evidente a necessidade de institucionaliza??o da intera??o ensino-servi?o-comunidade, bem como da valoriza??o de iniciativas que dinamizem e flexibilizem o ensino em atividades multiprofissionais e interdisciplinares, a fim de que haja o envolvimento de todos os atores ? docentes, discentes, profissionais de sa?de, usu?rios e gestores, bem como o compromisso de todas as institui??es envolvidas na modifica??o da forma??o em sa?de e na transforma??o dos processos de aten??o ? sa?de. / The teaching-service-community integration proves to be an important strategy to achieve the changes outlined by the Brazilian Curriculum Guidelines (DCN, as per its acronym in Portuguese) for the training of health professionals able to meet the social demands. This study was intended to analyze the teaching-service-community integration from the perspective of the Medical, Nursing and Dentistry teachers from the Federal University of Rio Grande do Norte (UFRN). This is an exploratory and descriptive study, with a quantitative and qualitative approach. Data collection took place through an interview form with 106 teachers, of whom 21 were teachers from the nursing course, 56 were from the medical course and 29 from the dentistry course, all from UFRN, Natal Campus. The analysis of the quantitative data was performed taking into account the variables ?gender?, ?age?, ?course?, ?teaching time?, ?period and place of practical/field classes?, using SPSS, version 22. With respect to the qualitative analysis, we used the Iramuteq software, and the interviews were analyzed in light of the Bardin?s Content Analysis. The results unveiled that, from the perspective of the interviewees, the nursing course is the one that has the training most compatible with DCN. The variable ?place of work? was more prominent when we considered the training according to what is recommended by the current DCN, the use of active methodologies and the advances in the teaching-service-community interaction. The surveyed teachers recognize that the interaction contributes to the training of health professionals able to meet the social demands, in addition to providing multiprofessional and interdisciplinary experiences in real practice scenarios. Nevertheless, several challenges should be surpassed in order to ensure a quality education capable to insert the undergraduate students into the services in a context of poor infrastructure of SUS, predominant hospital-centered model, curricula fragmented in disciplines, emphasis on technical training, little appreciation and stimulation to practices outside the walls, refusal of some teachers in participating in the interaction, among others. Thus, we can highlight the need to institutionalize the teaching-service-community interaction, besides the appreciation of initiatives that foster and soften the teaching in multiprofessional and interdisciplinary activities, with a view to involving all actors ? teachers, students, health professionals, users and managers, in addition to awakening the commitment of all institutions involved in changing the health training and in transforming the health care processes.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-10-18T22:00:57Z No. of bitstreams: 1 DISSERTA??O ANDREI SOUZA TELES.pdf: 1414050 bytes, checksum: 2b5b002664ea70e3c434943166993948 (MD5) / Made available in DSpace on 2016-10-18T22:00:57Z (GMT). No. of bitstreams: 1 DISSERTA??O ANDREI SOUZA TELES.pdf: 1414050 bytes, checksum: 2b5b002664ea70e3c434943166993948 (MD5) Previous issue date: 2015-03-13 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / The health care financing consists of a structural and structuring element that underpins economic social practices that take care of human life. Considering the importance of funding the conduct, implementation and success of health policies, this work aimed to analyze the Public Expenditure of the Unified National Health System (SUS) in the state of Bahia, from 2009 to 2012. It is a quantitative study of a descriptive and analytical perspective, comparative and retrospective, covering all 417 municipalities in Bahia. The main data on funding for the health sector were declared by municipalities to Information System Public Health Budgets (SIOPS), collected between 2013 and 2014, and tabulated with the help of the National Health Accounts model (National Health Accounts - NHA), specifically using the Table 1 (Funding Sources for Finance Professionals), which was adapted to the reality of funding and Brazilian information systems. The results revealed that in Bahia public spending on the SUS, accumulated over four years of study, was about R$ 29,23 billion, 30% of which (8,66 billion) for the year 2012. In considering only the resources declared by municipalities to SIOPS, expended by the three spheres of government, there was an increase of 50,58% in the Public Expenditure on Health (GPS), totaling in the period from R$ 17,105 billion. The macro-East draws attention to the large volume of spending, surpassing the mark of R$ 1 billion every year, and two of its health regions, Salvador and Cama?ari, have been in the GPS ranking apex in the period. The health expenditure by size analysis showed that the vast majority of municipalities, about 70% did not reach the level of R$ 5 million. It was found in 2010 that 20% of resources, about R$ 410,30 million, were transferred to the 219 municipalities with the lowest Municipal Human Development Index (IDHM) the state, on the other hand, the 37 cities with the best IDHM received approximately 60% of federal funds, that is, more than R$ 1,23 billion. It was evident also that 30% of resources, approximately R$ 615,45 million, was allocated to 40% of the population, which is spread over 348 municipalities of the total of 417 present in Bahia and 50%, equivalent to more than R$ 1 billion, were also transferred to 40% of the population, but that is distributed in only 17 municipalities. With regard to the volume of federal funds specifically for the Mobile Emergency Service (SAMU), from 2009 to 2012, noted an increase of 148,31%, highlighting the East macro-region. However, half of the state health regions did not show whether spending records with this service. The relative share of SAMU as Average funding block component and high complexity grew in the period, reached 6,67% in 2012. Data analysis identified the existing inequalities in the distribution of resources among regions, health regions and municipalities in the state of Bahia, but also inequalities, as municipalities and regions were favored already privileged socioeconomic at the expense of locations where populations are greater risks of illness and death, which remained being contemplated with proportionally fewer resources in relation to their health needs. It is not intended to generalize these results, but it is expected this study to contribute in the formulation of health policy, planning and management of resources within the SUS. / O financiamento da aten??o ? sa?de consiste em um elemento estrutural e estruturante que alicer?a economicamente as pr?ticas sociais que cuidam da vida humana. Considerando a import?ncia do financiamento na condu??o, na execu??o e no ?xito das pol?ticas de sa?de, esta disserta??o teve como objetivo analisar o Gasto P?blico do Sistema ?nico de Sa?de (SUS) no estado da Bahia, no per?odo de 2009 a 2012. Trata-se de um estudo quantitativo do tipo descritivo-anal?tico, comparativo e retrospectivo, que abrangeu todos os 417 munic?pios baianos. Os principais dados acerca dos recursos financeiros destinados ao setor sa?de foram declarados pelos munic?pios ao Sistema de Informa??es sobre Or?amentos P?blicos em Sa?de (SIOPS), coletados entre 2013 e 2014, e tabulados com o aux?lio do modelo de Contas Nacionais de Sa?de (National Health Accounts ? NHA), especificamente com uso a Tabela 1 (Fontes de Financiamento por Agentes de Financiamento), que foi adaptada ? realidade do financiamento e dos sistemas de informa??o brasileiros. Os resultados revelaram que na Bahia o gasto p?blico com o SUS, acumulado nos quatro anos de estudo, foi de cerca de R$ 29,23 bilh?es, sendo 30% deste total (8,66 bilh?es) referentes ao ano de 2012. Ao considerar apenas os recursos declarados pelos munic?pios ao SIOPS, dispendidos pelas tr?s esferas de governo, verificou-se um crescimento de 50,58% no Gasto P?blico em Sa?de (GPS), totalizando no quadri?nio R$ 17,105 bilh?es. A macrorregi?o Leste chama aten??o pelo grande volume de gasto, ultrapassando a cifra de R$ 1 bilh?o em todos os anos, sendo que duas de suas regi?es de sa?de, Salvador e Cama?ari, estiveram no ?pice do ranking de GPS, no per?odo. A an?lise por porte de gasto em sa?de mostrou que a grande maioria dos munic?pios, cerca de 70%, n?o alcan?ou o patamar dos R$ 5 milh?es. Constatou-se, em 2010, que 20% dos recursos, cerca de R$ 410,30 milh?es, foram transferidos para os 219 munic?pios com os menores ?ndices de Desenvolvimento Humano Municipal (IDHM) do estado; por outro lado, os 37 munic?pios com os melhores IDHM, receberam, aproximadamente, 60% dos recursos federais, isto ?, mais de R$ 1,23 bilh?es. Evidenciou-se tamb?m que 30% dos recursos, em torno de R$ 615,45 milh?es, foi destinado a 40% da popula??o, que se encontra espalhada por 348 munic?pios do total de 417 presentes na Bahia e 50%, o equivalente a mais de R$ 1 bilh?o, foram transferidos tamb?m para 40% da popula??o, mas que se distribui por apenas 17 munic?pios. No que concerne ao volume de recursos federais destinados especificamente para o Servi?o de Atendimento M?vel de Urg?ncia (SAMU), de 2009 a 2012, notou-se um aumento de 148,31%, com destaque para a macrorregi?o Leste. Todavia, metade das regi?es de sa?de do estado n?o apresentou sequer registros de gasto com esse servi?o. A participa??o relativa do SAMU como componente do bloco de financiamento de M?dia e Alta Complexidade cresceu no per?odo, atingido 6,67%, em 2012. A an?lise dos dados permitiu identificar desigualdades existentes na distribui??o dos recursos entre macrorregi?es, regi?es de sa?de e munic?pios do estado da Bahia, e tamb?m iniquidades, uma vez que foram favorecidos os munic?pios e regi?es privilegiados socioeconomicamente, em detrimento das localidades onde as popula??es encontram maiores riscos de adoecer e morrer, as quais permaneceram sendo contempladas com recursos proporcionalmente menores em rela??o ?s suas necessidades de sa?de. N?o se pretende generalizar esses resultados, mas se espera com este estudo poder contribuir nos processos de formula??o da pol?tica de sa?de e de planejamento e gest?o dos recursos no ?mbito do SUS.

Made available in DSpace on 2015-04-14T14:46:20Z (GMT). No. of bitstreams: 1 390862.pdf: 678268 bytes, checksum: b7b4c731607b6b2a5185769e5d69a1c2 (MD5) Previous issue date: 2007-03-29 / No Brasil, desde o in?cio do s?culo XX, o Estado tem-se ocupado gradativamente com a quest?o da sa?de. Ao longo do s?culo, foram se consolidando conquistas relativas ? amplia??o ao direito ? sa?de. Num primeiro momento, esse direito foi incorporado pela classe trabalhadora urbana assalariada. Foi somente a partir da Constitui??o de 1988, por?m, que esse direito tornou-se universal. Passadas duas d?cadas da implementa??o do SUS, contudo, o acesso da maioria da popula??o ao direito ? sa?de ainda ? muito prec?rio. Diante disso, nos ?ltimos anos foram lan?adas algumas pol?ticas p?blicas, tais como as de humaniza??o do SUS, buscando incidir sobre o modelo de gest?o e aten??o do sistema como forma de garantir a melhoria da aten??o ? sa?de e a concretiza??o do direito ? sa?de. No Rio Grande do Sul, essas pol?ticas p?blicas n?o t?m obtido muita efetividade por conta da singularidade do sistema de sa?de no estado, centrado no modelo que prioriza o papel do hospital no atendimento ? sa?de

Made available in DSpace on 2015-04-14T14:52:30Z (GMT). No. of bitstreams: 1 448564.pdf: 2533296 bytes, checksum: fa7d8f8fe4d8a326e1ed6055cd06544c (MD5) Previous issue date: 2013-03-12 / The expansion of the use of the Information Systems (IS) in various areas of society and concomitantly the evolution of the needs in the health field resulted in the use of these Technologies to computerize data in the field of health, with the aim of processing them in a centralized way and also easily obtain information that can subsidize governmental actions. Therefore, this study aims to answer the following research issue: How are the Health Information System offered by DATASUS contributing to the management and planning of SUS? In order to answer that it was opt to use the qualitative approach, having as a research strategy the case study, being the studied cases the Health State s Secretary (HSS) of Rio Grande do Sul and the Health State s Secretary of Paran?. The researched Information Systems in these states were the Information System about Mortality (ISM) and the Information System in Decentralized Hospital (ISDH). This paper allowed verifying the existence of institutional factors which influenced either the conception or the system s use, making it possible to state the Strong presence of the coercive pressures to send the data of the investigatory systems monthly to the Federal government, because the dispatch leads to government cutbacks in the secretaries. Both investigatory IS are extensively used in the HSS seen, having specific areas responsible for the data processing. Due to the IS contributions it was found that the investigated systems contribute to the management and planning of the Unique Health System (UHS) management. However, these ISs present limitations regarding questions of quality of the information and impossibility of data interaction, which end up delimiting the action of the managers based on their evidences. These fragmented information subside in a satisfactory way the activities of sectors individual in the monitoring and position of specific actions, not providing the possibility of thinking in health in a bigger scale, involving intersectional politics aiming to promote better health conditions to the population. / A expans?o do uso de Sistemas de Informa??o (SI) nas mais diversas ?reas da sociedade e, concomitantemente, a evolu??o das necessidades na ?rea da sa?de acarretaram o uso dessas tecnologias para informatizar os dados na ?rea da sa?de, com o intuito de registr?-los de forma centralizada e tamb?m obter facilmente informa??es que possam subsidiar as a??es governamentais. Considerando esse contexto, este estudo visa responder o seguinte problema de pesquisa: Como os Sistemas de Informa??o em Sa?de ofertados pelo DATASUS est?o contribuindo para a gest?o e o planejamento do SUS? Para respond?-lo optou-se por utilizar uma abordagem qualitativa, tendo como estrat?gia de pesquisa o estudo de caso, sendo os casos estudados a Secretaria Estadual de Sa?de (SES) do Rio Grande do Sul e a SES do Paran?. Os Sistemas de Informa??o pesquisados nesses estados foram o Sistema de Informa??o sobre Mortalidade (SIM) e o Sistema de Informa??o Hospitalar Descentralizado (SIHD). O trabalho permitiu verificar a exist?ncia de fatores institucionais que influenciaram tanto na concep??o quanto na utiliza??o dos sistemas, podendo citar a forte presen?a de press?es coercitivas para remeter os dados dos sistemas investigados mensalmente ao governo Federal, pois o n?o envio acarreta cortes or?ament?rios nas secretarias. Ambos os SI investigados s?o utilizados extensivamente nas SES averiguadas, tendo ?reas espec?ficas respons?veis pelo processamento dos dados. A respeito das contribui??es dos SI, constatou-se que os sistemas investigados contribuem para a gest?o e o planejamento do Sistema ?nico de Sa?de (SUS). Contudo, esses SI apresentarem limita??es frente quest?es como qualidade da informa??o e impossibilidade de intera??o dos dados, que acabam por delimitar as a??es dos gestores baseadas em suas evid?ncias. Essas informa??es fragmentadas subsidiam de forma satisfat?ria as atividades de setores individualmente no monitoramento e proposi??es de a??es espec?ficas, n?o proporcionando a possibilidade de pensar em sa?de de maneira mais abrangente, envolvendo pol?ticas intersetoriais com intuito de promover melhores condi??es de sa?de ? popula??o.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-04-27T11:54:33Z No. of bitstreams: 1 467660 - Texto Completo.pdf: 1696046 bytes, checksum: 92b4db07dbfd2011aaee90c0f42b52dc (MD5) / Made available in DSpace on 2015-04-27T11:54:33Z (GMT). No. of bitstreams: 1 467660 - Texto Completo.pdf: 1696046 bytes, checksum: 92b4db07dbfd2011aaee90c0f42b52dc (MD5) Previous issue date: 2015-02-26 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / The aim of this research is to discuss the process of curriculum environmentalization in college education, defined as the entrance of environmental concerns in undergraduate curriculum, at the university Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS). In the environmetalization processes we highlight the environmentally oriented disciplines, which state social and environmental dimensions in their teaching plans. The research sought to verify the role of these disciplines in the academic and professional students' training, from the perspectives of professors and students. In order to understand that, I've participated in a survey of environmental indicators, promoted by the Environmental Management Committee (CGA) which indicated the disciplines that were environmentally oriented in the twenty two academic units of PUCRS. I also attended three of these subjects in the Colleges of Education, Economics and Engineering. The methodology used in the research was participant observation, focal group, semi-structured interviews and I also held sets of talks about sustainability. In addition, I did a literature review, documents analysis such as education plans and the students' institutional assessments. The results show that the presence of environmentally oriented disciplines correspond to one concrete experience of the process of environmentalization curriculum at PUCRS. However, there is still a need to make progress in a more qualitative approach in the survey of the CGA, in order to define more precisely which disciplines the social-environmental issues are explicit. The data in the survey allow us to see that there is still a polysemic understanding of the terms of the disciplines environmentally oriented and environment sustainability. This polysemic understanding of the terms made the analysis difficult. Through the observation of the disciplines it was possible to perceive that its implementation encourages the student's interest for social-environment subject. I also identified that those disciplines helped students from different academic units to interact more, which has contributed to the expansion of their interest on sustainability. It is important to highlight that there is still a great deal of things that shall be done for the progress of the discussion about environmentalization of the curriculum at the universities. This can happen trough a more systemic and integrated approach of the disciplines contents, trough an increase of the students engagement in order to built together the curriculum and trough the progress of the incorporation of the ecological thematic area in the undergraduate course. / Esta pesquisa se prop?s a discutir o processo de a ambientaliza??o curricular na educa??o superior, definido como a internaliza??o da preocupa??o ambiental no curr?culo da gradua??o, tomando a Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS) como espa?o de an?lise. Dentro dos processos de ambientaliza??o destacamos as disciplinas ambientalmente orientadas, as quais explicitam dimens?es socioambientais nos seus planos de ensino. A pesquisa buscou verificar o papel destas disciplinas na forma??o acad?mica e profissional dos discentes, a partir das perspectivas de professores e de alunos. Para tanto, participei de um levantamento de indicadores ambientais, promovido pelo Comit? de Gest?o Ambiental (CGA), em que foram indicadas disciplinas ambientalmente orientadas nas 22 unidades acad?micas. Tamb?m acompanhei tr?s destas disciplinas nas Faculdades de Educa??o, Economia e Engenharia. A metodologia utilizada consistiu em observa??o participante, grupos focais, entrevistas semiestruturadas e roda de conversa sobre sustentabilidade, al?m de revis?o bibliogr?fica e da an?lise de documentos como os planos de ensino e as avalia??es institucionais dos estudantes. Os resultados indicam que a exist?ncia de disciplinas ambientalmente orientadas corresponde a uma das experi?ncias concretas de ambientaliza??o curricular da PUCRS. No entanto, ainda ? preciso avan?ar em uma abordagem mais qualitativa no levantamento do CGA, no sentido de definir com maior precis?o em quais disciplinas as quest?es socioambientais est?o explicitadas. Os dados desse levantamento nos permitem observar que ainda se conta com um entendimento poliss?mico dos termos disciplinas ambientalmente orientadas e sustentabilidade ambiental, o que dificultou a an?lise. Atrav?s do acompanhamento das disciplinas ambientalmente orientadas percebi que a sua realiza??o estimula o interesse dos alunos pela tem?tica socioambiental. Al?m disso, identifiquei que essas disciplinas possibilitam a intera??o entre estudantes de diferentes unidades acad?micas, o que tem contribu?do com a amplia??o das suas vis?es de sustentabilidade. ? importante destacar que h? muito a se avan?ar nas discuss?es acerca da ambientaliza??o do curr?culo no ?mbito universit?rio, o que pode ocorrer por meio de uma abordagem mais sist?mica e integrada dos conte?dos, do aumento do envolvimento dos alunos na constru??o curricular e do avan?o da incorpora??o da tem?tica ecol?gica nos cursos de gradua??o.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-02-12T10:16:38Z No. of bitstreams: 1 TES_PATRICIA_TERESINHA_SCHERER_COMPLETO.pdf: 1865206 bytes, checksum: 7323ed0f8dd5dde5de7de3d72dbfb452 (MD5) / Made available in DSpace on 2016-02-12T10:16:38Z (GMT). No. of bitstreams: 1 TES_PATRICIA_TERESINHA_SCHERER_COMPLETO.pdf: 1865206 bytes, checksum: 7323ed0f8dd5dde5de7de3d72dbfb452 (MD5) Previous issue date: 2015-12-21 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Obesity is considered a world epidemic and it implies severe consequences to health besides psychosocial difficulties. As an alternative for the treatment of obesidty, the bariatric surgery is recommended in cases of morbid or moderate obesity with related diseases.The present thesis introduces a research made for Doctorate Degree in Social Service at the Catholic University of Rio Grande do Sul carried out at the Center of Obesity and Metabollic Syndrome of S?o Lucas Hospital which belongs to PUCRS (COM). It is a qualitative research with the general objective of investigating the way how health social determinants interfere in the bariatric post-surgery process of people submitted to this procedure in the scope of the Unified Health System (SUS). The data collection was done by means of a form with semi-structured script that comprised open and closed questions. A total of 27 subjects were interviewed in the period from September 2013 to November 2014 and the answers were submitted to the technique of Content Analysis.The dialectical and critical background guided the construction of the research and the sistematization of the obtained results.The investigative proposal was submitted to the Scientific Commission of the School of Social Service of PUCRS and to the Ethics Committee in Research of the same University. Findings indicate that health social determinants may compromise the surgery results and the subjects undergoing vulnerability shall have difficulties of access and maintenance of the post-operative treatment as recommended by the bariatric team. Among the factors that make it difficult to meet the post-operative recommendations are: difficulties to attend the follow-up appointments, financial difficulties, lack of preparation of the healthcare network to serve the bariatric users, besides the need of specific and broad public policies for the bariatric process. Users point out positive changes and benefits like the post-operative slimming, especially regarding health and social relations, what evidences the importance of the public investment in the bariatric surgery. / A obesidade ? considerada uma epidemia mundial e acarreta graves consequ?ncias ? sa?de, al?m de dificuldades psicossociais. A cirurgia bari?trica, alternativa de tratamento para a obesidade, ? indicada nos casos de obesidade m?rbida ou moderada, com doen?as associadas. Nesta Tese apresenta-se a pesquisa desenvolvida para o Doutorado em Servi?o Social junto ? Pontif?cia Universidade Cat?lica do Rio Grande do Sul e foi desenvolvida no Centro de Obesidade e S?ndrome Metab?lica do Hospital S?o Lucas das PUCRS (COM). Trata-se de uma pesquisa qualitativa, que tem o objetivo geral de investigar a forma com que os determinantes sociais da sa?de interferem no processo p?s-cirurgia bari?trica das pessoas submetidas a esse procedimento, no ?mbito do Sistema ?nico de Sa?de (SUS). A coleta de dados foi realizada mediante um formul?rio, com roteiro semiestruturado, contemplando quest?es abertas e fechadas. Foram entrevistados 27 sujeitos, no per?odo de setembro de 2013 a novembro de 2014, e as respostas foram submetidas ? t?cnica de An?lise de Conte?do. O referencial dial?tico-cr?tico orientou a constru??o da pesquisa e a sistematiza??o dos resultados obtidos. A proposta investigativa foi submetida ? Comiss?o Cient?fica da Faculdade de Servi?o Social da PUCRS e ao Comit? de ?tica em Pesquisa da mesma Universidade. Os resultados apontam que os determinantes sociais da sa?de podem comprometer os resultados da cirurgia, e os sujeitos em situa??o de vulnerabilidade ter?o dificuldades de acesso e manuten??o do tratamento p?s-operat?rio, conforme recomendado pela equipe bari?trica. Entre os fatores que dificultam o cumprimento das recomenda??es p?s-operat?rias est?o: dificuldades para comparecer ?s consultas de acompanhamento, dificuldades financeiras, falta de preparo da rede b?sica de sa?de para atender os usu?rios bari?tricos, al?m da necessidade de pol?ticas p?blicas espec?ficas e abrangentes para o processo bari?trico. Os usu?rios apontaram mudan?as positivas e benef?cios com o emagrecimento p?s-operat?rio, especialmente quanto ? sa?de e rela??es sociais, demonstrando a import?ncia de investimento p?blico na cirurgia bari?trica.