A Educação Permanente em Saúde (EPS) vem sendo considerada como importante estratégia para transformação das práticas de saúde, colocando em destaque a educação em serviço como recurso estratégico para a gestão do trabalho e da educação na saúde. Entende-se que os processos educativos, se construídos a partir das realidades locais, envolvendo os diversos atores vinculados direta ou indiretamente ao trabalho- os trabalhadores, o ensino, a gestão e o controle social- contribuem para o fortalecimento do SUS. A EPS passou a ser considerada política pública de âmbito nacional a partir de 2004, data da publicação de Portaria que a institui. No presente estudo investigamos como vem se dando a condução desta Política em um Núcleo de Educação Permanente do município de São Paulo- o NEP Leste-, entendendo como seus pressupostos a reflexão sobre o processo de trabalho como desencadeador dos processos educativos, a formação em serviço e a aprendizagem significativa como estratégia pedagógica. Utilizamos como opção metodológica o estudo de caso. Num primeiro momento realizamos análise documental das atas das reuniões do NEP e demais documentos relacionados às ações de EPS na região, tais como projetos e relatórios de cursos. Procedemos à observação de seis reuniões ordinárias do NEP, entrevistas semiestruturadas com os participantes do NEP, ou seja, os representantes da gestão, das instituições de ensino e das Escolas Técnicas de Saúde da região. Com relação aos componentes ensino, gestão, atenção e controle social (o quadrilátero da formação) observamos predomínio na participação do componente gestão, a presença das instituições de ensino da região e a ausência de participação de usuários e trabalhadores. A construção da Política regional de EPS se dá através de um processo por vezes burocrático e descendente, embora experiências bem sucedidas tenham sido observadas, no sentido de serem processos que envolvam as equipes multiprofissionais, estejam relacionados diretamente aos processos de trabalho e trabalhem com a metodologia da problematização. A incorporação de Organizações Sociais de Saúde no modelo de gestão na área da saúde da cidade de São Paulo traz um elemento novo para a implantação da Política Municipal de Educação Permanente em Saúde, implicando na necessidade de novas formas de discutir, pactuar e definir papéis. A função principal do NEP Leste vem sendo a de ser um fórum para apresentação dos projetos de capacitação propostos para a região e a construção destes processos vem se dando muito mais a partir do ponto de vista da gestão, deixando, portanto, de reconhecer sua estreita vinculação com a reflexão sobre os processos de trabalho. Entendemos que o conhecimento produzido através deste estudo poderá contribuir para refletir sobre o papel de outros Núcleos de Educação Permanente, assim como para a criação de indicadores em âmbito nacional / Permanent Education in Health (PEH) is considered nowadays as an important strategy for transforming health practices, and highlights in-service education as a strategic resource for the management of work and education in health services. Educational processes, when built from regional realities and involving different actors directly or indirectly involved in health work (which include workers and people related to education, management and social control), will contribute to the strengthening of Brazilians National Health Service (SUS Sistema Único de Saúde). In 2004, Brazilian government passed a bill that instituted PEH as a public policy in a national scope. This research we have investigated how this public policy is being conducted in one of the São Paulos Permanent Education Nucleus (PEN-East). The assumptions are that reflection upon work processes initiate educational processes, in-service training and significant learning as pedagogical strategy. Methodological choice was the case study. Initially we have done documentary study of reunions minutes transcriptions, and other documents related to PEH actions in the region, such as projects and courses reports. Observations of PEN-East six ordinary meetings were conducted, as well as semistructured interviews with its members managers, colleges and technical schools representatrainingplanstives. Regarding formation and training cornerstones teaching, management, work and social control , predominance of the management and schools components and the absence of workers and users were noted. Planning of regional PEH policies is made through a sometimes bureaucratic, descending process, although some well-succeeded experiences in the sense of being processes that included multiprofessional teams, related directly to work processes and used problem-based methods. São Paulo Town management model for health services includes the presence of Health Social Organizations, which bring a new element to concretize PEH town policy. This establishes the necessity of new forms of discussing, agreeing and defining roles. PEN-Easts main function is of being a forum for presentation of training plans proposed to the region, and their implementation is being made basically from the managements point of view, with a lack of recognition of their close linking with work processes. It seems to us that knowledge raised from this research will contribute to the understanding of other PEN in the town of São Paulo, as well as for the creation of national scope evaluation indicators development

Artists in interaction: creation processes in official collaborative projects is a doctoral thesis that explores the creation processes of artists, when the project owner defines the purpose, theme and framework. The area is explored from the artists' perspective and the overall research question deals with the opportunities and obstacles that artists face when working in collaborative projects. To be able to explore the artists' working processes, in which sketches and models were tools, concepts from the visual research field were combined with knowledge theories that derive from the area of practice-based research. The knowledge theories draw on an updated understanding of ancient philosophy developed by, among others, the philosopher Martha Nussbaum. Rudolf Arnheim’s concepts of visual thinking are also vital for the interpretation of the visuals. The results indicate that skills in different sketching techniques build trust and enable communication. However, the artists experienced that it was more difficult to integrate the more indefinable parts of their knowledge, which relates to improvisation and intuition, even though this was highlighted as the most vital force in their working processes. The consequence is that the artists have not always followed their artistic intentions, which in some cases also meant compromising the quality of the works of art  they produced. The collaboration between the artists and the project-owner representatives could be more enriching for both parties if the artists' implicit knowledge is respected as a resource and given some room, although this may involve certain risks. The study also provides results regarding the interpretation of models and sketches, and discusses in what way different sketches can support (or hinder) communication in different stages of a design process, i.e. what aspects are important to consider when sketches are used to support communication. Particularly interesting is that the findings demonstrate that spoken and written language has a significant impact on how sketches are interpreted; the use of verbal language is therefore an important factor in presentations built on visuals. / Avhandlingen Konstnärskap i samspel: om skapande arbetsprocesser i myndighetsledda samverkansprojekt undersöker konstnärers arbetsprocesser i projekt där uppdragsgivaren formulerat tema, syfte och ramar för gestaltningsarbetet. Genom tre fallstudier har konstnärers arbetsprocesser i samverkansprojekt, med inriktning på utställning och gestaltning i musei- och kulturmiljö undersökts. Den övergripande frågeställningen behandlar vilka möjligheter och begränsningar konstnärer upplever i sin praktik i myndighetsledda samverkansprojekt. Materialet till studien har samlats in via intervjuer, observationer, artefakter och dokument. Till artefakter räknas skisser, modeller och verk. För att undersöka konstnärernas arbetsprocesser, där olika typer av skisser är ett verktyg, har teorier från det visuella fältet kombinerats med teorier om praktisk kunskap. Från det visuella fältet är Rudolf Arnheims teorier om visuellt tänkande centrala och vad gäller kunskapsteorier är utgångspunkten en samtida tolkning av Aristoteles teori om olika kunskapsformer som utvecklats av bland andra filosofen Martha Nussbaum. På en övergripande nivå visar studien att skicklighet i hantering av olika skisstekniker möjliggör kommunikation och skapar förtroende, medan mer svårbeskrivbara delar av konstnärers kunnande med improvisation och intuition som vitala krafter är svårare att integrera i samverkansprojekten. Följden av detta är att konstnärerna inte alltid valt att genomdriva sina intentioner i projekten till fullo, vilket i ett par fall också inneburit avkall på gestaltningens kvalitet. Samverkan mellan offentliga uppdragsgivare och representanter från den kreativa sektorn (som konstnärerna i projekten representerar), skulle kunna bli mer berikande för båda parter om konstnärers implicita kunnande ses som en resurs och om uppdragsgivaren ger utrymme för improvisation, även om detta innebär visst risktagande. Studien förmedlar också ny empiribaserad kunskap beträffande olika skiss- och presentationsformers funktion i kommunikationsakten mellan konstnär (skissproducent) och uppdragsgivare (beställare). Detta kan komma till nytta i flera sammanhang där skissmaterial används vid presentationer av idéer, i kommunikationen med en beställare eller som ett verktyg i grupprocesser. Intressant nog demonstrerar resultaten också att talat och skrivet språk har stor inverkan på hur skisser tolkas. Därför är detta en viktig aspekt att beakta i presentationer som inkluderar visuella material, både för skissproducent och beställare.

Tidigare forskning visar att två huvudsakliga faktorer som leder till förändring är framväxande innovation på marknaden och teknologin. Digitaliseringen ökar förändringstakten i både samhället och organisationer vilket ställer nya krav. Tidigare forskning visar också att förändringsarbete i organisationen är svårt att genomföra. Forskning om digitaliseringen inom ekonomi- och managementområdet är begränsad men visar att digitaliseringen har påverkat organisationer och därför har den här studien fokuserat på hur organisationen har påverkats. Syftet med studien är att undersöka hur digitaliseringen har påverkat organisationer med avseende på arbetsprocesser och organisationsstruktur. För att uppnå syftet med studien har en kvalitativ metod använts där elva chefer från åtta olika organisationer har intervjuats. För att få en förståelse för hur digitaliseringen har påverkat organisationer har vi utvecklat en teoretisk referensram. Studien utgår från centrala teorier som behandlar digitalisering, kunskap- och tjänstesamhället, organisationsförändringar samt institutionalisering. Analysen bygger på jämförelser mellan teori och insamlad empiri. Utifrån analysen är vår slutsats att digitaliseringen har förändrat organisationer genom en ökad automatisering av arbetsprocesser. Även kundkraven har förändrats vilket ställer nya krav på tillgänglighet, flexibilitet och ett ökat digitalt utbud. Det i sin tur har förändrat organisationsstrukturen och arbetsprocesser då nya yrkesroller har framkommit som har mer fokus på kunden, utveckling och förändring. / Previous research has shown that the two predominant factors contributing to change management are emerging technologies and market innovations. Digitalization increases the rate of change in both society and in organizations thus continually putting new demands on them both. Previous research also demonstrates that organizational change is hard to implement. Research on digitalization within the fields of Economics and Management is limited but still shows that digitalization has influenced organizations. This study, therefore, focuses on how organizations have been effected by digitalization. The purpose of this study is to examine how digitalization has impacted upon the work processes and organizational structures of an organization. To this end, the study is based on qualitative methodology in which eleven managers from eight different organizations where interviewed. To get an understanding of how digitalization has effected these organizations we have developed a theoretical frame of reference. The study draws on relevant theories that discuss digitalization, knowledge- and service-society, organizational change and institutionalization. The analysis is based on comparisons between theory and empirical data. From the analysis we draw the conclusion that digitalization has changed the organizations through increased automation of work processes. What’s more, customer demands have changed, placing new demands on availability, flexibility and increased digital offers. This, in turn has changed the organizational structure and work processes by creating new job roles that focus on the customer, development and change.

Purpose: Low productivity, poor quality and rising costs are some of the problems within the building industry. These problems can be attributed to the complexity of the building industry, low digitisation and outdated ways to manage building projects. Virtual Design and Construction (VDC) is a way of working which can reduce these problems and lead to improvements and higher efficiency.  VDC is used by several actors in the building industry, mainly during the design process but not so much during construction even though it would render an even bigger effect if used then as well. The aim of this study is therefore to investigate difficulties and incentives regarding implementation of VDC in construction. Method: This qualitative study is based on a literature study and a case study which provides good validity and reliability. The case study includes observations and interviews with personnel at two different building projects as well as a design process manager. Findings: Difficulties found in this study are the building industry´s high level of institutionalization, lack of information concerning the meaning of VDC and poor communication of the educations, guidelines and management documents that exists regarding the use of VDC. Further difficulties are the low level of VDC knowledge within the construction teams and compatibility issues and costs that may arise when introducing new technology. Among the incentives found are the way VDC contributes to a greater product through more thought-through solutions, increased understanding and increased involvement of all concerned. Using VDC leads to clearer communication, easier management and a better overview of projects and safer workplaces as risks are more easily detected. Another important incentive found is the positive attitude among the construction team members towards the use of VDC. Implications: The result of the study provides a basis for successful implementation of VDC in production. To overcome the difficulties noted, clear communication about what VDC is and how it is used is recommended, as well as designing management documents and developing and communicating VDC education to construction team members. It is also important to involve the staff in changes of work procedures, take notice of their opinions and to take advantage of their experience. Limitations: The result ought to be applicable to companies where VDC is used in the design process and that has similar ambitions as the company this study was carried out in cooperation with. Keywords: Virtual Design and Construction, building virtually, 3D-models, construction management, change in work-processes. / Syfte: Byggbranschen har problem med bland annat låg produktivitet, bristande kvalitet och stigande byggkostnader. Många av dessa problem kan härledas till branschens komplexitet, låga digitalisering och omoderna sätt att styra projekten.  Virtual Design and Construction (VDC) är ett arbetssätt som kan minska dessa problem och leda till förbättringar och effektiviseringar. VDC används av flertalet aktörer i branschen men då till största delen under projekteringsfasen av ett projekt trots att det skulle ge ännu större effekt om det även användes under produktionen. Målet med detta arbete är därför att undersöka hinder och drivkrafter gällande införande av VDC i produktionen. Metod: Arbetet är en kvalitativ studie och bygger på en litteraturstudie och en fallstudie vilket ger god validitet och reliabilitet. Under fallstudien har observationer gjorts och semistrukturerade intervjuer har genomförts med personal från två olika projekt samt med en projekteringsledare. Resultat: Arbetet visar på hinder som byggbranschens höga grad av institutionalisering, bristande information om innebörden av VDC samt bristande kommunikation om de utbildningar, riktlinjer och styrdokument som finns kring VDC-användning i projekt. Andra hinder är den bristande kunskapen hos produktionspersonalen och de kompabilitetsproblem och kostnader som kan uppstå vid införandet av ny teknik. Drivkrafter som arbetet belyser är bland annat att VDC bidrar till en bättre slutprodukt genom mer genomtänkta lösningar, ökad förståelse och ökat engagemang av samtliga berörda. Att använda VDC leder till bättre och tydligare kommunikation, enklare styrning och bättre översikt av projekten och säkrare arbetsplatser då risker lättare upptäcks. En annan viktig drivkraft är de anställdas positiva attityd till VDC. Konsekvenser: Arbetets resultat ger förutsättningar för en lyckad implementering av VDC i produktionen. För att övervinna de hinder som uppmärksammats rekommenderas en tydlig kommunikation om vad VDC är och hur det ska användas, att styrdokument utformas och att VDC-utbildningar till produktionspersonalen vidareutvecklas och förmedlas. Det är även viktigt att involvera personalen i förändringsarbetet, ta hänsyn till deras åsikter och dra nytta av deras erfarenhet. Begränsningar: Resultatet bör vara tillämpbart på företag där VDC används i projekteringen och har liknande ambition som företaget arbetet utförts i samarbete med. Nyckelord: Virtual Design and Construction, virtuellt byggande, 3D-modeller, produktionsplanering, förändringsarbete.

Made available in DSpace on 2016-06-02T19:51:22Z (GMT). No. of bitstreams: 1 DissMRS.pdf: 2404732 bytes, checksum: fdcaf8adcf90eda2f62755874b55222a (MD5) Previous issue date: 2006-10-02 / Historically, one verifies the appropriation of management tools for the attainement of plusvalue. Among them, the ones related to the organization and the processes of work stand out. However, it is noted that the appropriation of these management tools is carried out not only by capitalist enterprises, but by enterprise of solidary economy (ESE) as well. This master´s degree dissertation purpose is to analyze the common and specific characteristics of the organization and the processes of work in their different models in the capitalist enterprises and ESE. So, it was used a theoretical-empirical research through bibliographic review to characterize the two variables in both social structures, and, through the case study and the participative methodology, identify the specific characteristics of a type of ESE, a cooperative of land reform, in this case, the Cooperativa de Produção Agropecuária Vitória LTDA (COPAVI). In the bibliographic review, it was found that, for the attainment of the plus-value in the capitalist economy, the organization and the processes of work are subjected to constant changes, starting from the development of the method of capitalist production, and among them, simple cooperation, manufacturing, machinery and microelectronic automation, besides the taylorist, fordist, Italian, Swedish and Japanese models, among others. In the EESs, changes also occur, but in the perspective of selfmanagement and the subordination of the technical rationality to the social rationality, through the cooperativism. In the comparative analysis performed, it was found that cooperation is a commom factor for the two types of organization. The capitalist enterprises use the concept of cooperation as simplification and parceling of work activities of each worker for the complementation of the productive process, that is, the cooperation comes through a management imposition. This kind of cooperation is alienating and subordinate, and produces evolution and improvement as time goes by, through corporate competitiveness. To the ESE, cooperation has the meaning of democratic management, collective participation in the processes of work, of collective management and decision making, that, as for the capitalist enterprises, undergo changes for a better insertion of their products in the market. So, at COPAVI, the analysis focused the way changes occur in the organization and work processes, oriented to the implementation of integrated arrangements of productive chains, keeping the characteristics of cooperation as a proposition of non-alienation of the worker. It should be emphasized that this dissertation has not the purpose of creating a model, but show that it is possible to create and develop alternatives for organization and work processes on the basis of self-management. / Historicamente verifica-se a apropriação de ferramentas de gestão para a obtenção de maisvalia. Entre elas destaca-se as relacionadas à organização e aos processos de trabalho. No entanto, é notado que a apropriação dessas ferramentas de gestão não é só feita por empresas capitalistas, mas também por empreendimentos de economia solidária (EESs). Esta dissertação de mestrado tem por finalidade analisar as características comuns e específicas da organização e dos processos de trabalho em seus diferentes modelos nas empresas capitalistas e nos EESs. Para tanto, utilizou-se da pesquisa teórico-empírica por meio de revisão bibliográfica para caracterizar as duas variáveis nas duas estruturas sociais, e ainda, por meio do estudo de caso e da metodologia participativa, identificar as características específicas de um tipo de EES, uma cooperativa de reforma agrária, no caso, a Cooperativa de Produção Agropecuária Vitória LTDA (COPAVI). Na revisão bibliográfica observou-se que para maior obtenção da mais-valia na economia capitalista, a organização e os processos de trabalho sofrem constantes mudanças a partir do desenvolvimento do modo de produção capitalista, dentre eles pode-se destacar: cooperação simples, manufatura, maquinaria e automação microeletrônica, além dos modelos taylorista, fordista, italiano, sueco e japonês, entre outros. Já nos EESs ocorrem mudanças, porém na perspectiva da autogestão e a subordinação da racionalidade técnica à racionalidade social, através do cooperativismo. Na análise comparativa realizada, verificou-se como fator comum para os dois tipos de organização a cooperação, porém com significados e propostas diferenciadas em cada um dos tipos de organização. As empresas capitalistas utilizam-se do conceito de cooperação como simplificação e parcelamento das atividades de trabalho de cada operário para a complementação do processo produtivo, ou seja, é uma cooperação via imposição da gerência. Este tipo de cooperação é de forma alienante e subordinada, que tem evoluções e melhorias ao longo do tempo via competitividade empresarial. Para os EESs cooperação tem o sentido de gestão democrática, participação coletiva nos processos de trabalho, de gestão e tomada de decisão coletiva, que do mesmo modo que as empresas capitalistas, sofrem mudanças para melhor inserção de seus produtos no mercado. Desta forma, foi analisado na COPAVI, como ocorrem as mudanças na organização e nos processos de trabalho orientados para a implementação de arranjos integrados de cadeias produtivas, mantendo-se as características de cooperação como proposta de não alienação do trabalhador. Destaca-se que esta dissertação não tem a finalidade de criar um modelo, mas mostrar ser possível criar e desenvolver alternativas de organização e de processos de trabalho a partir da autogestão.

Digitalisering är ett hett ämne idag och framförallt i offentlig sektor. Sverige arbetar väldigthårt med att digitalisera och det avspeglar sig i kommunerna och dess arbete. Ett relativt vanligtfenomen idag är att kommuner inför surfplattor till dess förtroendevalda politiker. Surfplattanersätter den tidigare pappersprocessen gällande handlingar inför möten ochbeslutssammanträden. Kommunerna själva och media menar att detta ska effektivisera arbetet,vara ett bättre miljöalternativ och föra med sig papperslöshet. Dock är studier kring dettabegränsat. Det finns inga studier som påvisar vad som egentligen effektiviseras eller hursurfplattan bidrar till detta. Däremot finns det studier avseende surfplattan som substitut förpapper som visar att papperslöshet är en myt och omöjligt att uppnå. Andra studier visar ävenbrister med surfplattan vid exempelvis läsbarhet, att använda på möten och att en surfplattaegentligen inte effektiviserar någonting.Då det fanns väldigt begränsat med forskning kring det här fenomenet kände vi att vi ville grävadjupare i det och titta på hur övergången från papper till surfplatta verkligen upplevs avanvändarna. Vi ansåg att aspekter kring vad surfplattan bidrar med, hur den är som substitut förpapper, läsbarheten på den och vilka möjligheter som finns med surfplattan. Vi kände att dessaaspekter var obesvarade men också viktiga att beröra då detta blir allt mer förekommande blandSveriges kommuner. Vilket då blev vårt syfte med den här studien och realiserades genom enmixad studie på Mjölby kommun.Vi valde att göra en mixad, abduktiv och tolkande studie med både intervjuer och en enkät föratt få en så god bredd som möjligt. Detta utfördes i samarbete med Mjölby kommun som relativtnyligen genomfört en övergång som denna. Vi valde att fokusera på aspekter som berörts itidigare studier avseende surfplattan som arbetsverktyg och sådant som dök upp underintervjuerna.Den slutsats vi kunde dra var först och främst att surfplattan faktiskt är ett väldigt bra substitutför papper då den har flera karaktärsdrag som liknar pappret. Surfplattan fungerar även utmärktatt läsa och arbeta på, åtminstone enligt respondenterna på denna kommun. Surfplattan harresulterat i flexibilitet, mobilitet och en smidighet för politikerna, då pappret nu till stor del harförsvunnit. Surfplattan har även bringat nytta för den administrativt arbetande personalen påMjölby kommun då de nu kunnat minska förbrukningen på papper och kunnat effektivisera sittarbete i distributionen av handlingar. Dock drog vi slutsatsen att allt för lite av justeffektiviseringen når användarna, det är tydligt att det krävs verksamhets- ocharbetsprocessförändringar för att effektiviteten ska gynna både administrationen ochpolitikerna. Angående förbättringar och problem kring surfplattan kunde vi identifiera attmycket handlade om att översätta funktionaliteten från pappret. Det som var bra och smidigtmed pappret måste även existera i surfplattan för att användarna ska vara nöjda. Sen handlardet även om att ta tillvara på de möjligheter som finns när man gör en övergång från analogttill digitalt. Det räcker inte med att vara nöjd när digitalisering av ett tidigare analogt arbete ärutfört, fortsatt utveckling öppnar upp för många möjligheter. / Nowadays digitalization is a hot topic, especially in the public sector. Sweden as a country isworking hard with digitalization, and is reflected in the municipalities and their work. Arelatively common phenomenon today is that the municipalities implements tablets for theirelected representatives (politicians). The tablet replaces the previous paper processes regardingdocument management at meetings and decision making for political matters. Themunicipalities themselves and the media means that this should streamline and make the workmore efficient, be a better environmental alternative and contribute to the paperless office.However, previous studies regarding this is limited. There are no previous studies thatdemonstrates what is being streamlined nor how the tablet contributes to this. However, thereare some studies of the tablet as a substitute for paper which shows that the paperless office isa myth and almost impossible to reach. Other studies also show flaws with the tablet, regardingreadability, as a tool at the meeting and that the tablet itself is not streamlining anything.Since previous studies regarding this phenomenon was limited, we felt that we wanted to digdeeper into this and study how the transition from paper to tablet is experienced by the users.We felt that aspects regarding what the tablet is really contributing with, how well of a substitutefor paper it is, readability and what possibilities there is with a tablet. We felt that these aspectswere unanswered but also important since the implementation of tablets is more and morecommon among municipalities in Sweden. Which became our purpose with this study and wasrealized through a mixed method study at the municipality of Mjölby.We chose to do a mixed, abductive and interpretative study with both interviews and aquestionnaire in order to reach as good width as possibly. The study was conducted at themunicipality of Mjölby since they recently did a transition, just as the one that we wanted tostudy. We chose to focus on aspects discussed in previous studies regarding the tablet as awork tool and the ones that appeared during the interviews.The first and foremost conclusion we could draw was that the tablet actually is a good substitutefor paper since it got multiple and similar characteristics as the paper. The tablet is also a goodartefact to read on and to use for everyday work, at least according to the interviewees at thismunicipality. The experienced effects of the tablet are flexibility, mobility and simplicity forthe politicians, since a lot of the paper is now gone. The tablet has also been beneficial for theadministration and the administrative personnel at Mjölby duo to less consumption of paper,more streamlined work process of distributing all the documents. However, we concluded thattoo little of the actual efficiency is reaching the users. It is clear that business and workflowprocesses requires change so efficiency will benefit both administration and the politicians.Regarding improvements and problems with the tablet we identified that a lot is concerned withthe ability to translate and transfer functionality from the paper to the tablet. What is good andsimple with the paper must also exist with the tablet, in order for the users to be pleased. Butalso, the importance to take advantage of the possibilities that arises with the transition from ananalog to a digital work environment. It is not enough to just be pleased with the digitalizationitself, continuous development opens up for many possibilities.

Made available in DSpace on 2016-12-23T14:41:19Z (GMT). No. of bitstreams: 1 Dissertacao de Catharina Hoffmann.pdf: 1326464 bytes, checksum: da4e2915d4fefdae3deac216786954ec (MD5) Previous issue date: 2009-03-19 / Companhia de Desenvolvimento de Vitória / Esta pesquisa abrange os processos de produção de saúde, tendo como objeto de estudo os discursos e práticas de saúde relacionados ao acolhimento. O contexto de análise é a Atenção Básica do município de Vitória/ES e o campo de pesquisa, o cotidiano da Unidade de Saúde da Família da Ilha do Príncipe. O estudo utilizou como referência os aportes teóricos da Análise Institucional e da Saúde Coletiva. Buscou-se analisar o modo como os trabalhadores fazem acolhimento no cotidiano do serviço, além de escutar as concepções e os discursos produzidos a respeito, na relação com suas práticas cotidianas, o que inclui os processos de trabalho e as interações com os usuários. Para isso, utilizou-se a Cartografia como estratégia metodológica. Os dados foram produzidos no período de fevereiro a setembro de 2008, por meio de observação, diário de campo e entrevistas realizadas com usuários e trabalhadores da USF. Os resultados produzidos expressam que o processo de trabalho e sua gestão são fragmentados e burocratizantes. Há intenção dos trabalhadores de rever os processos de trabalho, entretanto, isto encontra obstáculos na prática. No tocante ao acolhimento, a exigência que os trabalhadores sofrem para que atendam a uma certa produtividade é um aspecto que compromete a qualidade da relação entre as equipes e destas com o usuário, afetando o atendimento às necessidades destes e a própria oferta de ações de saúde. As necessidades que os trabalhadores esperam acolher estão circunscritas à doença ou sintoma manifesto fisicamente. Demonstrou-se que ir ao serviço para conversar constitui-se em uma demanda valorizada pelos usuários, sendo acolhida por alguns trabalhadores. Evidenciou-se que a comunicação nas equipes é restrita às discussões de questões administrativas e procedimentos. A hierarquização entre os níveis de formação contribui para entender o acolhimento como uma atividade ou procedimento que é atribuição de uma categoria específica (auxiliares de enfermagem), a qual supõe-se, tem capacidade técnica para fazê-lo no ato de recepção do usuário. Constatou-se que as ações de saúde não são pactuadas com os usuários, de modo que o PSF não garante o acolhimento. Porém, os tensionamentos nas relações cotidianas entre trabalhador e usuário favorecem a problematização do acolhimento como ação que pode ultrapassar a recepção. Fica evidente a necessidade de reorganização dos processos de trabalho e de se engendrar subjetividades por uma humanização que valorize os processos de singularização, de modo a se promover uma real democracia no acesso à saúde, na qualidade da assistência e na garantia dos princípios do SUS / This research discusses the plans of health production processes, aiming the health discourses and practices related to embracement. The context for the analysis is the Primary Health Care in the city of Vitória/ES and the research field are the everyday activities of the Family Health Service in Ilha do Príncipe. As reference it was used Institutional Analysis and Collective Health. It was analyzed the way how workers embrace the users of the health service as well as listened to their conceptions and discourses produced upon embracement, in relation to their everyday practices, which includes work processes and the interaction with the users. It was used Cartography as the methodological strategy. Data was produced from February 2008 to September 2008, through field observation, field diary and interviews with the users and health workers from the Family Health Service. The results show that the process of work and its management are fragmented and bureaucratized. There is the intention, from the workers, to revise the work processes, however they find obstacles in this practice. Concerning Embracement, the requirements the workers have to fulfill to obtain a certain amount of productivity is one aspect that compromises the quality of the relation between the Family Health Teams and their relation towards the users, affecting the response to their needs and the offer of actions in health care. The everyday activities show that the needs the workers are willing to welcome are related to disease or symptoms physically expressed. It was revealed that users have conversation as a valued demand and it is embraced by some workers. It was highlighted that communication in the Family Health Teams is restricted to discussions on administrative issues and procedures. The informal hierarchy order according to the level of graduation contributes to understand Embracement as an activity or procedure attributed to a specific category (nursing assistants), which supposedly have the technical capacity to do it in the action of receiving the user in the establishment. It was noticed that there isn t a pact between the actions in health offered and the users, in a way that the Family Health Program doesn t guarantee embracement. However, the tension in the everyday relations between worker and user favor the discussion of embracement as an action that may surpass reception. It is evident the need of reorganizing the process of work and engendering subjectivities for a humanization that values the singularization processes in a way of promoting a real democracy in the access to health, in the quality of health care and in the guarantee of the principles of SUS (Public Health System)

Introdução: A violência contra a criança tem aumentado progressivamente no mundo, requerendo todos os esforços para a intervenção. As crianças constituem a parcela mais vulnerável e por extensão mais propensa a sofrerem todo tipo de violência, desde a menor negligência até o extremo da agressão física. O enfrentamento da violência contra a criança requer o desenvolvimento de processos de trabalho que considerem o processo saúde-doença na sua interface social, a partir do contexto em que ocorrem as situações de violência, sendo a Atenção Básica o locus privilegiado para a visibilização e enfrentamento do fenômeno. Objetivos: analisar as diferenças e semelhanças nos modos de enfrentamento da violência infantil nos municípios de Curitiba e São Paulo, por meio das redes de proteção, dos processos de trabalho e dos significados atribuídos pelos profissionais da Atenção Básica. Método: o estudo se pautou pela metodologia de natureza qualitativa, dado o seu caráter descritivo e exploratório. A base teórica está fundamentada na Teoria da Intervenção Práxica da Enfermagem em Saúde Coletiva TIPESC, proposta por Egry, que busca a intervenção da Enfermagem através de uma metodologia dinâmica e participativa. Os cenários de pesquisa foram distritos de saúde dos municípios de Curitiba e São Paulo, onde realizou-se entrevistas semi-estruturadas junto aos profissionais da Atenção Básica. Utilizou-se do WebQDA ((Web Qualitative Data Analysis) para tratamento dos dados oriundos das entrevistas, da hermenêutica dialética para a análise dos discursos e do Fluxograma Analisador do Modelo de Atenção para investigar os processos de trabalho no enfrentamento da violência infantil na perspectiva da rede de atenção e proteção. Resultados: os significados da violência infantil emergiram vinculados a quatro núcleos de sentido principais: ambientes familiares desestruturados, drogadição e álcool, precárias condições de existência material das famílias e o despreparo para os cuidados parentais. Foram apontadas dificuldades, facilidades e fragilidades da rede assistencial para o enfrentamento, a necessidade de ações intersetoriais e de capacitação dos profissionais para o atendimento às situações de violência no âmbito da Atenção Básica. Conclusões: as diferenças e semelhanças nos modos de enfrentamento da violência infantil pelos profissionais da Atenção Básica ocorrem no âmbito das políticas de enfrentamento e das redes de atenção e proteção, onde há necessidade de adotar estratégias de ampliação da capacidade de monitoramento e acompanhamento dos casos notificados; no âmbito dos serviços, processos de trabalho e profissionais, onde há necessidade de formação qualificada dos trabalhadores e organização da rede de saúde para oferta de serviços assistenciais em quantidade e qualidade, além do aporte de profissionais para o enfrentamento da violência infantil. / Introduction: Violence against children has gradually increased in the world, requiring all efforts for intervention. Children are the most vulnerable part and so more likely to suffer all kinds of violence, since the minor negligence to the point of physical aggression. Coping violence against children requires the development of work processes that consider the health-disease process in its social interface, from the context in which situations of violence occur, being the Primary Care the privileged locus for the visualization and coping of the phenomenon. Objectives: To analyze the differences and similarities in the coping modes of violence against children in the cities of Curitiba and São Paulo, through the safety networks, the work processes and the meanings attributed by the professionals of Primary Care. Method: The study was guided by qualitative methodology, given its descriptive and exploratory nature. The theoretical basis is founded on the Theory of Praxis Intervention of Community Health Nursing (TIPESC, in Portuguese), proposed by Egry, that seeks the intervention of Nursing through a dynamic and participatory methodology. The research scenarios were health districts of the cities of Curitiba and São Paulo, where semi-structured interviews with professionals of primary care were conducted. The WebQDA (Web Qualitative Data Analysis) for processing the data from the interviews, the dialectic hermeneutics to analyze the discourses and Analysis Fluxogram of the Healthcare Attention Model to investigate the work processes in coping violence against children in the context of network of care and protection were used. Results: The meanings of violence against children emerged linked to four main units of meaning: unstructured family environments, drug addiction and alcohol, poor conditions of material existence of families, and the lack of preparation for parenting. Difficulties, facilities and weaknesses of the health care network to face the need for intersectoral action and training of professionals to attend to situations of violence in the context of Primary Care were identified. Conclusions: Differences and similarities in coping modes of violence against children by Primary Care professionals occur in the context of coping policies and care and protection networks, where there is need to adopt expansion strategies of monitoring capacity and monitoring of notified cases; and in the scope of the services, work processes and professionals, where there is need for qualified training of workers and organization of the health network for the provision of care services in quantity and quality, in addition to professional contribution to combat the violence against children.

Aus der Einführung: "Im Bereich der Informations- und Kommunikationstechnologien und im wissensintensiven Sektor finden sich häufig netzwerkartige Organisationsstrukturen, die durch informale Arbeitsorganisation und eine starke Betonung integrierter Kooperation unter Ausbildung unterschiedlicher Spezialisierungen [2] gekennzeichnet sind. Begleitet wird dieses Phänomen der Entgrenzung durch die Virtualisierung von Arbeitsplätzen oder Bürostandorten [15]. Ausgehend von der These, dass sich Organisationsformen von den traditionellen Formen hin zu kooperativen Strukturen fortentwickeln, schlagen wir vor, dass vor allem kreative und wissensintensive Prozesse durch Software unterstützt werden, welche die Besonderheiten dieser Arbeitsprozesse berücksichtigen."

Aus der Einleitung: "Intuition. Damit begründen Menschen häufig kühne Entscheidungen oder Pläne, an denen sie wider vernünftige Argumente stur aber erfolgreich festgehalten haben. Gesetzt den Fall, die Begründung „Intuition“ ist mehr als ein post hoc Argument von Hasardeuren, die zufällig Glück gehabt haben und stellt wirklich eine Qualität von Könnerschaft bei komplexen Anforderungen dar, so sollte man das Wesen des scheinbar nicht hinterfragbaren „guten“ oder „schlechten Gefühls“ beim Planen und Entscheiden ergründen. Denn ein Könner (oder in der Psychologie: „ein Experte“, vgl. Hacker, 1992) wäre dann ja eine Person, die ohne bewussten Zugriff auf ihr Wissen dennoch über Informationen verfügt, die sie zur Auswahl besserer Pläne und Entscheidungen befähigt. Es wäre daher lohnend herauszufinden, welche Informationen dies sind und wie sie verarbeitet werden."