Made available in DSpace on 2015-04-14T13:35:25Z (GMT). No. of bitstreams: 1 339444.pdf: 761403 bytes, checksum: 08d078cde0751e1b5f9b053081a8b12f (MD5) Previous issue date: 2005-08-30 / INTRODU??O: O papel do exerc?cio f?sico como estrat?gia auxiliar no tratamento das doen?as circulat?rias vem sendo cada vez mais estudado na comunidade cient?fica. Aos poucos v?o sendo elucidadas como o exerc?cio auxilia no tratamento de doen?as como HAS, Dislipidemias entre outras. Hoje, com o envelhecimento populacional, essas doen?as est?o ficando cada vez mais prevalentes. OBJETIVO: O objetivo desse trabalho foi avaliar como o exerc?cio f?sico ? capaz de influenciar algumas vari?veis em diferentes grupos de praticantes de exerc?cios. Foram analisadas o Consumo M?ximo de Oxig?nio (VO2m?x), o equivalente metab?lico (METS), a dura??o do teste ergom?trico, as Press?es Sist?lica e Diast?lica m?ximas, o Duplo Produto m?ximo, a Freq??ncia Card?aca m?xima e o ?ndice de Massa Corp?rea (IMC). MATERIAL E M?TODOS: A amostra foi de 40 pacientes, todos do sexo masculino, divididos em tr?s grupos: Grupo 1 PREVEN??O, composto de pacientes que n?o sofreram infarto do mioc?rdio (IAM), apresentaram um n de 25 homens; Grupo 2 ANGIOPLASTIA, composto por pacientes que tiveram IAM e realizaram procedimento de angioplastia coronariana com a coloca??o ou n?o de Stent, com n de 7 homens; Grupo 3 CRM, composto por pacientes que tiveram IAM e foram submetidos ? Cirurgia de Revasculariza??o do Mioc?rdio (CRM), apresentaram um n de 8 pacientes. Todos realizaram exerc?cios com o mesmo tipo de prescri??o ao longo de um ano. RESULTADOS: Dentre as vari?veis estudadas, o grupo CRM teve altera??o estatisticamente significativa e foram elas: o VO2m?x, o METS e a dura??o do exerc?cio. J? o grupo 2 apresentou varia??es significativas na freq??ncia card?aca m?xima, VO2m?x e METS. Vale ressaltar que quando ocorre aumento dessas vari?veis sem altera??es significativas nas press?es sist?lica e diast?lica, freq??ncia card?aca m?xima e duplo produto que s?o indicadores de consumo de oxig?nio do mioc?rdio, demonstra-se que esses pacientes conseguem atingir um n?vel de esfor?o maior sem correr maiores riscos cardiovasculares. CONCLUS?O: Atrav?s da melhora desses indicadores demonstra-se a possibilidade de melhora e prote??o ao sistema cardiovascular, independente da gravidade das patologias e do n?vel de condicionamento dos pacientes.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-06-30T17:28:08Z No. of bitstreams: 1 TES_GIOVANA_HENRICH_COMPLETO.pdf: 2014416 bytes, checksum: 122f0f0edee1f2255d1a0e374743347a (MD5) / Made available in DSpace on 2016-06-30T17:28:08Z (GMT). No. of bitstreams: 1 TES_GIOVANA_HENRICH_COMPLETO.pdf: 2014416 bytes, checksum: 122f0f0edee1f2255d1a0e374743347a (MD5) Previous issue date: 2016-03-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The present study has as the central object the evaluations for granting benefits to subjects in deprivation of liberty, which purpose was configured to investigate how about the evaluations in the 4th Penitentiary Region of Rio Grande do Sul contributes to the rights effectiveness. The research that has an explanatory and qualitative nature, is based on the critical dialectical method and is conducted in the Prison System, bounded by the 4th Penitentiary Region of Rio Grande do Sul/Brazil. As a data source for the conduction of the study, an empirical research was made through interviews with social workers and psychologists from the prison system , in which the duty is aimed to the processes of evaluation, interviews with subjects in deprivation of liberty evaluated in 2014 and a documentary research through the evaluations made by the professionals about the same interviewed subjects in deprivation of liberty. The data analysis was done through the content analysis technique, based on Laurence Bardin?s theoretical framework. The obtained results reveal critical positioning by the professionals and by the subjects in deprivation of liberty, who were interviewed especially because such processes indicate historical characteristics relative to the prison system that guides the way the evaluations are made. Besides revealing the precarious working conditions to carry out such professional duty, the results also point to the moralizing and to the social adaptation perspective still intrinsic in the context, which is analyzed taking into consideration the contradictions of the system, as well as the reflections made by the professional categories involved in the issue. This way,it is observed that the evaluations for granting benefits to subjects in deprivation of liberty may contribute to the guarantee of rights as well as they may corroborate to the reproduction of processes that place the subjects as objects of a system socially excluding, reiterating practices of domination and discrimination once it also joins the professional practices carried out in such place. It is possible to verify through the research the professional critical understanding about that, however it is also possible to see the difficulty in translating the critique in the context of the evaluations, which shows that facing the reproduction of the violence in this object is still incipient, thus, demanding strengthening to consolidate practices less hierarchical - from the professionals to the penal system, and from the subjects in deprivation of liberty to the professionals and to the system ? through new strategies to carry out the evaluation processes. In this sense emerges the thesis that the evaluations for granting benefits to individuals in deprivation of liberty imposed the questioning about the dynamics of the place that they occupy historically defining the professional assignments related to the theme. The professional assignments determined institutionally as well as the necessary conditions for the development of this work in the light of current legislation portray and are portrayed by the prison context setting up maintenance strategy and reproduction of the contradictions of institutional and social order that was historically constructed. / estudo em evid?ncia possui como objeto central as avalia??es para concess?o de benef?cios a sujeitos em priva??o de liberdade, cujo objetivo configurou-se em investigar sobre como as avalia??es na 4? Regi?o Penitenci?ria do Rio Grande do Sul contribuem para a efetiva??o de direitos. A pesquisa, de cunho explicativo, qualitativo com base no m?todo dial?tico cr?tico, tem por lugar o Sistema Prisional, delimitado atrav?s da 4? Regi?o Penitenci?ria do Rio Grande do Sul/Brasil. Como fonte de dados para a produ??o do estudo realizou-se pesquisa emp?rica atrav?s de entrevistas com assistentes sociais e psic?logos do sistema prisional, cuja atribui??o est? direcionada aos processos de avalia??o, entrevistas com sujeitos em priva??o de liberdade avaliados no per?odo de 2014 e pesquisa documental atrav?s das avalia??es constru?das pelos profissionais acerca dos mesmos sujeitos privados de liberdade entrevistados. A an?lise de dados foi constru?da a partir da t?cnica de an?lise de conte?do, com base no referencial te?rico de Laurence Bardin. Os resultados obtidos revelam posicionamentos cr?ticos por parte dos profissionais e sujeitos em priva??o de liberdade entrevistados especialmente porque tais processos denotam caracter?sticas hist?ricas relativas ao sistema prisional que direciona o modo como as avalia??es s?o constru?das. Al?m de revelarem as parcas condi??es de trabalho para a realiza??o desta atribui??o profissional, os resultados apontam para a perspectiva moralizadora e de adapta??o social ainda intr?nseca ao contexto, o que passa a ser analisado considerando-se as contradi??es do sistema, bem como, as reflex?es realizadas pelas categorias profissionais envolvidas acerca do tema em quest?o. Desse modo, observa-se que as avalia??es para concess?o de benef?cios aos sujeitos em priva??o de liberdade podem contribuir para a garantia de direitos, como tamb?m podem corroborar com a reprodu??o de processos que colocam os sujeitos como objetos de um sistema socialmente excludente, reiterando pr?ticas de domina??o e discrimina??o j? que este enla?a, inclusive, as pr?ticas profissionais desenvolvidas nesse espa?o. Atrav?s da pesquisa ? poss?vel verificar a compreens?o cr?tica profissional a respeito, por?m tamb?m ? vis?vel a dificuldade em traduzir a cr?tica no contexto das avalia??es, o que mostra o enfrentamento ? reprodu??o da viol?ncia nesse objeto como ainda incipiente, necessitando de fortalecimento para que se consolidem pr?ticas menos hierarquizadas - dos profissionais ao sistema penal, e dos sujeitos em priva??o de liberdade aos profissionais e ao sistema ? atrav?s de novas estrat?gias de realiza??o dos processos avaliativos. Nesse sentido, emerge a tese de que as avalia??es para concess?o de benef?cios para sujeitos em priva??o de liberdade imp?em a problematiza??o acerca da din?mica do lugar que historicamente elas ocupam definindo as atribui??es profissionais relativas ao tema. As atribui??es profissionais determinadas institucionalmente, bem como as condi??es necess?rias para o desenvolvimento desse trabalho ? luz das legisla??es vigentes retratam e s?o retratadas pelo contexto prisional, configurando-se em estrat?gia de manuten??o e reprodu??o das contradi??es de uma ordem institucional e social que foi historicamente constru?da.

Submitted by Sandra Pereira (srpereira@ufrrj.br) on 2016-10-05T17:36:37Z No. of bitstreams: 1 2011 - Jaqueline da Luz Ferreira.pdf: 1165394 bytes, checksum: 070be4cb2b1887d709e6272f02554b70 (MD5) / Made available in DSpace on 2016-10-05T17:36:37Z (GMT). No. of bitstreams: 1 2011 - Jaqueline da Luz Ferreira.pdf: 1165394 bytes, checksum: 070be4cb2b1887d709e6272f02554b70 (MD5) Previous issue date: 2011-03-25 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico - CNPq / This work aims to describe and reflect on the experience of implementing the Program of Technical Assistance to Social and Environmental Reform (Ates) in some settlements in the northern region of Esp?rito Santo by a cooperative established and managed by members of the Landless Workers Movement. The institutional format of the program enabled entities other than public agencies to receive resources for service provision in the settlements, under the coordination of the National Institute of Colonization and Land Reform (INCRA). Since then, many expectations about how to provide assistance appear everyday during the provision of services in the settlements. In the case of Espirito Santo, for instance, the LWM takes on the task of providing technical assistance in settlements where it is present through Cooptraes. With this, the movement brings in the subject of political activism, which becomes the characteristic of the work of the cooperative's technical staff. Thus, this setup program Ates in Esp?rito Santo causes significant changes in the relationship between the actors involved, which can be seen everyday in services, either through dispute over material and symbolic resources, the appearance of new demands or through the actors' own adaptation to the dynamics of the program's execution. The aim of this study was to analyze the position and understanding of the actors on this process, and from this analysis, to examine the limits and possibilities of this experience. For both aims, we interviewed Incra employees, technicians, leaders and LWM settled families, and monitored the work of a technicians team of Cooptraes in four settlements in the northern region of the state. From the analysis of data and from the dialogue with the literature and policy documents of the Program (laws, operating manuals, executive standards, among others) we could identify a field of tensions between the actors, which is directly related to the fact that LMV is the executor of the Program, due to the way the movement operates. From this field research we could identify new practices and meanings in the relationship between the actors involved (especially Incra and MST). On one hand we observe that the the presence of LWM has enhanced the performance of the service (because of its proximity to the target population), on the other hand, we found there are also some continuities in the experience with regard to the history of technical assistance in the settlements, for example, the poor conditions in which the services are provided / Esta disserta??o buscou descrever e refletir sobre a experi?ncia de implementa??o do Programa de Assessoria T?cnica Social e Ambiental ? Reforma Agr?ria (Ates) em alguns assentamentos da regi?o norte do Esp?rito Santo por uma cooperativa criada e gerida por integrantes do Movimento dos Trabalhadores Sem Terra - MST. O formato institucional do Programa Ates possibilitou que outras entidades al?m dos ?rg?os p?blicos recebessem os recursos para a presta??o do servi?o nos assentamentos, sob a coordena??o do Instituto Nacional de Coloniza??o e Reforma Agr?ria (Incra). A partir de ent?o, diversas expectativas sobre como prestar a assessoria s?o conjugadas no dia a dia da presta??o dos servi?os nos assentamentos. No caso do Esp?rito Santo, por exemplo, o MST toma para si a tarefa de prestar a assessoria t?cnica nos assentamentos em que se encontra presente por meio da Cooptraes. Com isso traz para esta experi?ncia a dimens?o da milit?ncia, que passa a ser a caracter?stica do trabalho da equipe t?cnica desta cooperativa. Dessa forma, essa configura??o do Programa Ates no Esp?rito Santo promove altera??es significativas nas rela??es entre os atores envolvidos, que podem ser percebidas no cotidiano da presta??o dos servi?os, seja por meio de disputa em torno dos recursos materiais e simb?licos, da gera??o de novas demandas, ou por meio da pr?pria adapta??o dos atores ? din?mica da execu??o do Programa. O objetivo deste trabalho foi analisar o posicionamento e compreens?o dos atores sobre este processo, e a partir desta an?lise pensar os limites e potencialidades desta experi?ncia. Para tanto, foram entrevistados servidores do Incra, t?cnicos, dirigentes do MST e fam?lias assentadas, assim como acompanhou-se o trabalho de uma das equipes t?cnicas da Cooptraes em quatro assentamentos da regi?o norte do estado. A partir da an?lise dos dados produzidos e do di?logo com a bibliografia e documentos normativos do Programa (leis, manuais operacionais, normas executivas, entre outros) foi poss?vel perceber um campo de tens?es entre os atores que est? diretamente relacionado ao fato do MST entrar em cena como executor do Programa, por conta de sua forma de atua??o. A partir deste campo de tens?es a pesquisa conseguiu identificar novas pr?ticas e significados nas rela??es entre os agentes envolvidos (em especial Incra e MST). Se por um lado observamos que a entrada em cena do MST potencializou a execu??o do servi?o (por conta da sua proximidade com o p?blico benefici?rio), por outro lado, observamos tamb?m existem nesta experi?ncia algumas continuidades, no que diz respeito ao hist?rico da assist?ncia t?cnica nos assentamentos, como por exemplo, a precariedade das condi??es de execu??o do servi?o.

Submitted by PPG Servi?o Social (servico-social-pg@pucrs.br) on 2018-09-26T12:32:45Z No. of bitstreams: 1 Disserta??o - Clarissa da Silva de Paula.pdf: 2055497 bytes, checksum: e782dddd4829328434eaa69f2bfafe73 (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-09-27T14:24:48Z (GMT) No. of bitstreams: 1 Disserta??o - Clarissa da Silva de Paula.pdf: 2055497 bytes, checksum: e782dddd4829328434eaa69f2bfafe73 (MD5) / Made available in DSpace on 2018-09-27T14:35:38Z (GMT). No. of bitstreams: 1 Disserta??o - Clarissa da Silva de Paula.pdf: 2055497 bytes, checksum: e782dddd4829328434eaa69f2bfafe73 (MD5) Previous issue date: 2018-07-13 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / This dissertation aims at analyzing how conceptions of sexual violence, professional interventions and care flow to children and adolescents victims of sexual abuse are configured in municipalities with only Basic Social Protection and in municipalities with Basic Social Protection and Special Social Protection instituted. It was decided to sample two municipalities with different protection organizations, because, within the scope of SUAS, the requests of the violations arising from the rights violations must be performed by the Specialized Protection and Welfare Service for Families and Individuals (PAEFI), having as a locus the Specialized Reference Center for Social Assistance (CREAS). However, in the state of Rio Grande do Sul, only 24% of the municipalities have this socio-welfare equipment. Since sexual abuse is a historical, multicausal phenomenon occurring in all societies, there is a need to think about victim care independently of the organizational structure of the municipalities. In this sense, this study sought to contribute to the discussion of how to fight such phenomenon in the face of the complexity of the theme and of society. As specific objectives, we sought to analyze the national and state plan for children and adolescents victims of sexual violence; mapping the municipal service network, as well as identifying the violence committed against the victims who access the care network in the surveyed cities, in order to problematize the limits and possibilities of care for children and adolescents in situations of sexual abuse in the social welfare area. Considering the given objectives, we chose qualitative research, in which we sought to know: the specificities of sexual abuse against children and adolescents, the perception of the subjects interviewed about the phenomenon, as well as the advances, challenges and possibilities for the effectiveness of the integrality of the service to the sexually victimized children and adolescents. For the collection of data, six semi-structured interviews were carried out, using forms, technical reference teams of social welfare services (social workers and psychologists), and the municipal managers of the policy. After the interviews, the data were transcribed and analyzed, using content analysis as methodology. Complementing the systematization of empirical research, the study of the legislation, thematic plans and authors with theoretical relevance was carried out with regard to the Social Welfare Policy and the phenomenon in question. As a result of the research, we highlight the need for budget allocation for actions to prevent and respond to sexual violence against children and adolescents. There is a need to expand the teams of the protection network, predict resources for the execution of actions and, especially, offer permanent education for professionals who act directly with the demands of violence. It emphasizes in this study, stand out the facilities and difficulties in articulation with the protection network, as well as the strategies used for the accomplishment of the consultations in the social welfare services. / A presente disserta??o de mestrado tem como objetivo geral analisar como se configuram as concep??es de viol?ncia sexual, interven??es profissionais e fluxo de atendimento ?s crian?as e adolescentes v?timas de abuso sexual, em munic?pios com apenas a Prote??o Social B?sica institu?da e em munic?pios com a Prote??o Social B?sica e Prote??o Social Especial institu?das. Optou-se, como amostra, por dois munic?pios com organiza??o de prote??es diferentes, pois, no ?mbito do SUAS, os atendimentos das demandas advindas das viola??es de direitos devem ser executados pelo Servi?o de Prote??o e Atendimento Especializado a Fam?lias e Indiv?duos (PAEFI), tendo como l?cus o Centro de Refer?ncia Especializado de Assist?ncia Social (CREAS). No entanto, no estado do Rio Grande do Sul apenas 24% dos munic?pios disp?em desse equipamento socioassistencial. Sendo o abuso sexual um fen?meno hist?rico, multicausal e que ocorre em todas as sociedades, h? a necessidade de pensar sobre o atendimento ?s v?timas independente da estrutura organizacional dos munic?pios. Nesse sentido, neste estudo buscou-se contribuir com a discuss?o de como enfrentar tal fen?meno diante da complexidade da tem?tica e da sociedade. Como objetivos espec?ficos, buscou-se analisar o plano nacional e estadual de enfrentamento e atendimento ?s crian?as e adolescentes v?timas de viol?ncia sexual; mapear a rede municipal de atendimento, e tamb?m identificar as viol?ncias cometidas contra as v?timas que acessam a rede de atendimento nos munic?pios pesquisados, a fim de problematizar os limites e possibilidades do atendimento ?s crian?as e adolescentes em situa??o de abuso sexual no ?mbito da assist?ncia social. Quanto ao m?todo de pesquisa, optou-se pela vertente qualitativa, buscando-se conhecer: as especificidades do abuso sexual contra crian?as e adolescentes; a percep??o dos sujeitos entrevistados sobre o fen?meno; e os avan?os, desafios e possibilidades para a efetiva??o da integralidade do atendimento ?s crian?as e adolescentes vitimizados sexualmente. A coleta de dados contou com seis entrevistas semiestruturadas, utilizando-se formul?rios, realizadas com as/os equipes t?cnicas de refer?ncia dos servi?os socioassistenciais (assistentes sociais e psic?logas), e com as/os gestoras/es municipais da referida pol?tica. Para a an?lise dos dados obtidos utilizou-se, como metodologia, a an?lise de conte?do. Complementando ? sistematiza??o da pesquisa emp?rica, realizou-se o estudo das legisla??es, planos tem?ticos e autores com relev?ncia te?rica no que se refere ? Pol?tica de Assist?ncia Social e ao fen?meno em quest?o. Como resultados da pesquisa destaca-se a necessidade de: destina??o or?ament?ria para as a??es de preven??o e atendimento ? viol?ncia sexual contra crian?as e adolescentes; amplia??o das equipes da rede de prote??o, previs?o de recursos para as execu??es das a??es e, principalmente, oferta de educa??o permanente para as/os profissionais que atuam diretamente com as demandas de viol?ncias. E, por fim, destacam-se as facilidades e dificuldades percebidas na articula??o com a rede de prote??o, e as estrat?gias utilizadas para a concretiza??o dos atendimentos nos servi?os socioassistenciais.

Submitted by PPG Ci?ncias Sociais (csociais-pg@pucrs.br) on 2018-09-28T18:38:48Z No. of bitstreams: 1 Fab?ola_Mattos_Pereira_Tes.pdf: 11933374 bytes, checksum: f94630b46262f7986df8390e4b02812d (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-10-01T13:08:55Z (GMT) No. of bitstreams: 1 Fab?ola_Mattos_Pereira_Tes.pdf: 11933374 bytes, checksum: f94630b46262f7986df8390e4b02812d (MD5) / Made available in DSpace on 2018-10-01T13:12:20Z (GMT). No. of bitstreams: 1 Fab?ola_Mattos_Pereira_Tes.pdf: 11933374 bytes, checksum: f94630b46262f7986df8390e4b02812d (MD5) Previous issue date: 2018-08-21 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / "Under which terms grant is requested" is a documental ethnography study of intervention practices about poor children, taking as the starting point the documental collection about an agricultural educational institution located in the municipality of Pelotas/RS, Brazil. The Agricultural Educational Institution is about one hundred years old. The expression frequently found in the studied documents, inspires the thesis title. This expression submits deeper bureaucratic process around the selection and inclusion of the students. I tried to investigate in that documents, the voices that, in dialogue with the public power, was documented in the official agencies, with the intention to answer "Who were the students and what were they searching for?" This investigation had an anthropologic way, focused in the individual who was object standarly of government intervention - the poor children and their families. Over those people concerned conceptions, practices, regulations, decisions and rules that not depended on their will, and is about this dynamic that this research pondered, an ethnography the routine lived by boys and girls that found the Visconde da Gra?a Educational Institution. Stablished with the Agricultural Patronage Visconde da Gra?a in the 1920s decade. Nowadays, the Institution works and has boarding school vacancy for young people who wants to live in, but notice the profile stablished to entrance is needed, the first of all, those poorest children as the beginning. Long years go by and the Institution has been going throughout changes as its name, in accordance with government and then changed the working dynamics, and as in the boarding school. Besides the changes in the Educational Institution, this investigation approachs the boarding school as the study object, with the aim of relativize it. Studying the intern dynamics and particularities of boarding school practice in the context of an agricultural Educational Institution, was the way to realize others aspects that could introduce the boarding school over the poverty, of the abandonment and the vulnerability. Without however to leave the perspective that notice the boarding school with the antique strategy and with extensively used for state agents to solve the problem of poor children and their families. / ?Nestes termos, pede deferimento? ? um estudo etnogr?fico-documental das pr?ticas de interven??es sobre crian?as pobres, tomando como ponto de partida o acervo de documentos relativos a uma institui??o de ensino agr?cola na cidade de Pelotas / RS, com quase cem anos de exist?ncia. A express?o, frequentemente encontrada nos documentos estudados, al?m de inspirar o t?tulo da tese, foi reveladora de aspectos mais profundos que cercaram as din?micas burocr?ticas de sele??o e inclus?o. Procurei investigar, nesses documentos, as vozes que, em interlocu??o com o Estado, ficaram registradas nos ?rg?os oficiais, com a inten??o de responder ?quem foram os alunos e o que buscavam??. Este estudo teve uma abordagem antropol?gica, focando sobre aqueles sujeitos que foram tradicionalmente objeto de interven??o estatal ? as crian?as pobres e suas fam?lias. Sobre esses sujeitos, incidiram concep??es, pr?ticas, estatutos, medidas, regulamentos que independiam de sua vontade, e ? sobre tais din?micas que este estudo se debru?ou, procurando etnografar o cotidiano vivido por meninos e meninas que recorreram ao Visconde da Gra?a. Fundada como Patronato Agr?cola Visconde da Gra?a na d?cada de 1920, a institui??o, ainda em funcionamento, mant?m a oferta do internato para jovens que nela desejarem permanecer, desde que observado o perfil estipulado para ingresso, priorizando, tal como em sua funda??o, aqueles mais pobres. Ao longo dos anos, a institui??o passou por diferentes transforma??es em sua nomenclatura, de acordo com as pol?ticas estatais e, viu alteradas suas din?micas de funcionamento, dentre as quais o internato se insere. Mais que apresentar as transforma??es da? decorrentes, esta investiga??o tomou a pr?tica de internamento como objeto de estudo, com a inten??o de relativiz?-la. Observar as din?micas internas e particularidades da pr?tica de internamento, no contexto de uma institui??o agr?cola, foi o caminho que permitiu perceber outros aspectos que justificaram/justificam o internamento, al?m da pobreza, do abandono e da vulnerabilidade, sem contudo, deixar de lado a perspectiva que coloca o internamento como estrat?gia antiga e amplamente utilizada pelos agentes estatais para lidar com o problema das crian?as pobres e suas fam?lias.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2015-08-06T21:47:24Z No. of bitstreams: 1 BRUNO_ALENCAR_Disserta??o_final.pdf: 3349456 bytes, checksum: ef922100f6f85f8fd1ccf7b1cc376d83 (MD5) / Made available in DSpace on 2015-08-06T21:47:24Z (GMT). No. of bitstreams: 1 BRUNO_ALENCAR_Disserta??o_final.pdf: 3349456 bytes, checksum: ef922100f6f85f8fd1ccf7b1cc376d83 (MD5) Previous issue date: 2013-03-27 / This is a study about working process of Family Health Program (PSF ? Programa Sa?de da Fam?lia) focusing pharmaceutical services. The objectives were to understand workers meanings about pharmaceutical services of PSF, to analyze health working process focusing actions about pharmaceutical services. Else, to discuss how workers do technical assistance and technical management actions to production of care, and to identify difficulties, facilities, limits, advances and perspectives found in the pharmaceutical services. This is a qualitative research. Eleven health units of a district in the state of Bahia, Brasil. The subjects were organized in three groups: key informant (four subjects), health workers (fourteen subjects) and users (eight subjects). The technical data production was systematic observation, semi structured interview and documental analysis. The analysis method was content analysis. This study was approved by The Research and Ethics Committee of State University of Feira de Santana under the registration number 59/2012. The empiric data shows, about senses and meanings of pharmaceutical services, that subjects understand it as a health politics or government program. The agents mainly use hard and soft hard technologies. There is a predominance of management technical activities. The objects of working process were managing of medicines and disease or risk. The goals were to manage the pharmaceutical services, to educate the family health team and users, moreover taking care of them. Among the difficulties reported by subjects stood out insufficient financial resources and precarious forms of work. Furthermore, an insufficient support of pharmacists, which work on Family Health Support Core (NASF-N?cleo de Apoio ? Sa?de da Fam?lia), and in pharmaceutical services sector to the health units. Other difficulties were the absence of protocols and standardization of procedures about pharmaceutical services in PSF, improper disposal and steal of medicines, and inadequate structure of pharmacies. The limits were few pharmacist and many activities of workers team. Interpersonal relations and appropriate organization of medicines in the pharmacies were the facilities on the working process. The restructuring of Drug Supply Center, inclusion of medicines in Municipal List of Essential Medicines and creation of Pharmacy and Therapeutics Committee of Legal were the advances. The perspectives refer to the creation of a center of dispensing medicines and pilot project pharmacy. The working process shows disjointed between the agents, making it difficult the organization of pharmaceutical services in PSF. Moreover, noncompliance of health and professional law and difficulties in production of care on health. / Estudo sobre o processo de trabalho no Programa Sa?de da Fam?lia (PSF) com enfoque na assist?ncia farmac?utica. Os objetivos foram compreender o(s) sentido(s) e significado(s) dado(s) pelos trabalhadores de sa?de sobre assist?ncia farmac?utica no PSF; analisar o processo de trabalho em sa?de, no que concerne ?s a??es relacionadas ? assist?ncia farmac?utica; discutir como s?o realizadas as a??es assistenciais e gerenciais da assist?ncia farmac?utica para a produ??o do cuidado; identificar as dificuldades, limites, facilidades, avan?os e perspectivas. Trata-se de uma pesquisa qualitativa, tendo como campo de investiga??o 11 Unidades de Sa?de da Fam?lia, em um munic?pio do estado da Bahia, Brasil. Os sujeitos foram divididos em: Grupo I, informantes-chave (quatro); Grupo II, trabalhadores de sa?de (quatorze); e Grupo III, usu?rios (oito). As t?cnicas de coleta de dados foram observa??o sistem?tica, entrevista semi-estruturada e an?lise de documentos. O m?todo de an?lise foi a an?lise de conte?do. A pesquisa foi aprovada pelo Comit? de ?tica em Pesquisa da Universidade Estadual de Feira de Santana, sob protocolo no59/2012. Quanto aos sentidos e significados atribu?dos ? assist?ncia farmac?utica os sujeitos a compreendem como uma pol?tica de sa?de ou programa de governo. Os agentes utilizam principalmente as tecnologias duras e leve-duras, com predom?nio das atividades gerenciais, sendo os objetos do processo de trabalho o medicamento, a doen?a ou o risco. As finalidades foram gerir a assist?ncia farmac?utica, educar a equipe de sa?de e os usu?rios, al?m de cuidar dos indiv?duos para que tenham qualidade de vida. Dentre as dificuldades destacam-se recursos financeiros insuficientes, precariza??o de v?nculos, apoio incipiente de farmac?uticos no PSF, aus?ncia de protocolos e de padroniza??o da assist?ncia farmac?utica, descarte inadequado, estrutura inadequada das farm?cias e desinteresse dos usu?rios pelas atividades educativas. Os limites encontrados foram o n?mero reduzido de farmac?uticos e a sobrecarga de atividades dos trabalhadores. As rela??es interpessoais e a organiza??o dos medicamentos foram facilidades no processo de trabalho. A reestrutura??o da Central de Abastecimento Farmac?utico, as inclus?es de medicamentos na Rela??o Municipal e a cria??o da Comiss?o de Farm?cia e Terap?utica Jur?dica foram avan?os identificados. As perspectivas referem-se ? cria??o de um centro de dispensa??o especializado e implementa??o de projeto-piloto de farm?cia. O processo de trabalho revela-se desarticulado entre os agentes, refletindo em desestrutura??o da assist?ncia farmac?utica no PSF, descumprimento de determina??es sanit?rias e profissionais e dificuldades para produzir o cuidado em sa?de.

Made available in DSpace on 2015-04-14T14:34:00Z (GMT). No. of bitstreams: 1 448332.pdf: 321455 bytes, checksum: a213d9f54613da7ad15a66c9005e3b8c (MD5) Previous issue date: 2013-03-26 / Assuming that the normative model applicable to pleas of social security contributions immunity from publicly sponsored entities or endowed with hybridity, lacks some adjustments. In order to make this important stimulus mechanism more effective and fair reciprocation to the cooperative work which is being developed by the third sector in our country, becomes essential the study s deepening of some cases with more complexity in order to formulate a theoretical basis which contributes to structuring a normative standard that clearly defines hermeneutic standards of this relevant institute, in order that its application does not be distorted from the logic that led to their institution. Therefore, it is initially defined the central ideological line that will guide the course of this work, in the pursuit of semantic content best suited to consistent application of the rules governing the relationship between State and the third sector entities, passing, hereafter, the approach of introductory concepts, principles and greatest relevance issues related to the immunity s institute. Subsequently, the study focuses on Jural relation of contributions release and certification of nonprofit and social assistance entities, with detailed analysis of the constitutional immunity of guidelines contributions, focusing on the scope of the concept of nonprofit and social assistance entities, the breadth of the activities provided for them as well as the formal instrument with the ability to regulates immunity, without neglecting the need of coping, or not, the formulation of a formal application for immunity, as well as the main criteria for certification of nonprofit and social assistance entities (EBAS). Then, the core of the analysis is the relation between the State and the third sector in respect to the activities provision performed by nonprofit and social assistance entities, starting from the study of the historical evolution experienced in the Liberal State, State Social and Democratic State, without neglecting a detailed analysis of the performance and the relevant aspects of the relation between the third sector in our country, including tracing a brief comparison with the model practiced in the U.S. and Spain. This chapter assumes particularly importance for a consistent theoretical framework of the elements for the non application of contributions immunity to public entities, because this mechanism is a incentive and compensation form by the cooperated performance of the entities that only, as by its form of constituition as the activity developed by them, are private entities. Further, looking up a deeper critical analysis of the main points of conflict extracted from hard cases related to the problematic focused on reconstruct a normative and hermeneutic peculiar model to each of the individual cases to determine the constitutional and legal standard of contributions immunity, greatly regarding the possibility or not to grant this boon to public entities, or essentially public, if the entity is formally constituted as a private legal entity. After the detailed analysis of three paradigmatic cases, it is concluded that the systematic interpretation of article 195, ? 7, of the Constitution immunity forbids the granting of this boon to public, or hybrid entity which, although formally constituted as a private legal entity, are essentially public or from the point of view of functional criteria, or by the narrow bond of entity, or its material legal action to the entity s legal public regime to which it binds. / Partindo da premissa de que o modelo normativo aplic?vel aos pleitos de imunidades de contribui??es ? seguridade social das entidades de natureza p?blica ou dotadas de hibridismo carece de alguns ajustes, a fim de tornar mais eficaz este importante mecanismo de est?mulo e de justa retribui??o ao trabalho cooperado que vem sendo desenvolvido pelo terceiro setor em nosso pa?s, torna-se imprescind?vel o aprofundamento do estudo de alguns casos dotados de maior complexidade com o objetivo de formular uma base te?rica tal que contribua para a estrutura??o de um padr?o normativo e hermen?utico que defina, de forma clara, as balizas desse relevante instituto, para que sua aplica??o n?o seja desvirtuada da l?gica que motivou a sua institui??o. Para tanto, ? definida, inicialmente, a linha ideol?gica central que guiar? os rumos deste trabalho, na busca do conte?do sem?ntico mais adequado ? aplica??o coerente das normas que regulam a rela??o travada entre Estado e entidades do terceiro setor, passando, a seguir, ? abordagem dos conceitos introdut?rios, dos princ?pios e dos aspectos de maior pertin?ncia relacionados ao instituto da imunidade. Posteriormente, o estudo centra-se na rela??o jur?dica de desonera??o de contribui??es e de certifica??o das EBAS, com an?lise aprofundada das diretrizes constitucionais da imunidade de contribui??es, focando a abrang?ncia do conceito de EBAS, a amplitude das atividades por elas prestadas, bem como o instrumento formal com aptid?o para normatiza a imunidade, sem descurar do enfrentamento da necessidade, ou n?o, da formula??o de requerimento formal de imunidade, assim como dos principais aspectos relacionados ? certifica??o das EBAS. A seguir, o cerne da an?lise recai sobre a rela??o do Estado com o terceiro setor no que toca ? presta??o de atividades desempenhadas pelas EBAS, partindo do estudo da evolu??o hist?rica vivenciada no Estado Liberal, no Estado Social e no Estado Democr?tico de Direito, sem descurar de uma an?lise particularizada da atua??o e dos aspectos relevantes da rela??o do terceiro setor em nosso pa?s, inclusive tra?ando um breve comparativo com o modelo praticado nos EUA e na Espanha nos aspectos de maior relevo para o objeto ora focado. Esse cap?tulo assume especial import?ncia para uma estrutura??o te?rica consistente dos fundamentos que embasar?o a afirma??o de que a imunidade de contribui??es n?o ? aplic?vel ?s entidades de natureza p?blica, por ser tal mecanismo uma forma de incentivo e retribui??o pela atua??o cooperada somente das entidades que, tanto pela sua forma de constitui??o quanto pela atividade por elas desenvolvida, sejam entidades privadas. Adiante, busca-se um aprofundamento da an?lise cr?tica dos principais pontos de conflito extra?dos de hard cases relacionados com a problem?tica focada para, a partir do arcabou?o te?rico desenvolvido at? ent?o, reconstruir um modelo normativo e hermen?utico peculiar para cada um dos casos concretos, que determine as balizas constitucionais e legais da imunidade de contribui??es, sobremodo no que tange ? possibilidade, ou n?o, de concess?o dessa benesse a entidades de direito p?blico, ou essencialmente p?blicas, no caso de a entidade estar constitu?da formalmente como uma pessoa jur?dica de direito privado. Derradeiramente, ap?s a detida an?lise de tr?s casos paradigm?ticos, conclui-se que a interpreta??o sistem?tica da imunidade do art. 195, ? 7?, da CF veda a concess?o dessa benesse a entidades p?blicas, ou de natureza h?brida que, embora formalmente constitu?das como pessoa jur?dica de direito privado, sejam essencialmente p?blicas ou sob o ponto de vista do crit?rio funcional, ou pelo estreito liame da entidade ou de sua atua??o material ao regime jur?dico p?blico do Ente a que ela se vincula.

Submitted by Jorge Silva (jorgelmsilva@ufrrj.br) on 2018-08-23T21:37:07Z No. of bitstreams: 1 2017 - Victor dos Santos Freitas.pdf: 1450833 bytes, checksum: f5b416a0974053e04258bcad55e4e369 (MD5) / Made available in DSpace on 2018-08-23T21:37:07Z (GMT). No. of bitstreams: 1 2017 - Victor dos Santos Freitas.pdf: 1450833 bytes, checksum: f5b416a0974053e04258bcad55e4e369 (MD5) Previous issue date: 2017-07-18 / The present study aimed to investigate an emerging social phenomenon, aging with disability, with families as subjects producing social representations. This research is justified by the context of social deprotection experienced by Brazilian families in situations of social vulnerability, whether due to economic reasons, violations of rights or new family configurations. We use as main reference the Theory of Social Representations proposed by Serge Moscovici, seeking to identify the central and peripheral core of these representations according to the structural approach of Jean-Claude Abric. The issue of disability, aging and the family was approached from a conception of social protection of the State advocated by the National Social Assistance Policy. This research was qualitative, where we used a free evocation task from the term "aging with disability" and a focal group. The research was carried out in a Special Social Protection Service of the Social Assistance Policy for Persons with Disabilities in the city of Volta Redonda / RJ, involving 90 relatives who live directly with the person with intellectual disability and 08 participants to the focal group. The results reveal that the terms "love," "difficulty," "dedication," and "patience" were most often evoked as the likely central core of social representation. Family members also pointed out that during many years of care, families adapt to this reality, but still presenting difficulties in the legal, health, relationships with the extended family and in the conflictual experience of feelings towards the future caregiver. / O presente estudo teve por objetivo investigar um fen?meno social emergente, envelhecer com defici?ncia, tendo as fam?lias como sujeitos produtores das representa??es sociais. Esta pesquisa justifica-se pelo contexto de desprote??o social vivida pelas fam?lias brasileiras em situa??o de vulnerabilidade social sejam por quest?es econ?micas, viola??es de direitos ou novas configura??es familiares. Utilizamos como refer?ncia principal a Teoria das Representa??es Sociais proposta por Serge Moscovici, buscando identificar o n?cleo central e perif?rico destas representa??es segundo a abordagem estrutural de Jean-Claude Abric. Abordou-se a quest?o da defici?ncia, do envelhecimento e da fam?lia a partir de uma concep??o de prote??o social do Estado preconizado pela Pol?tica Nacional de Assist?ncia Social. Esta pesquisa foi de car?ter qualitativo, onde utilizamos na coleta de dados uma tarefa de evoca??o livre a partir do termo indutor ?envelhecer com defici?ncia? e um grupo focal. A pesquisa foi realizada em um Servi?o de Prote??o Social Especial da Pol?tica de Assist?ncia Social para Pessoas com Defici?ncia do munic?pio de Volta Redonda/RJ, envolvendo 90 familiares que convivem diretamente com a pessoa com defici?ncia intelectual e 08 familiares para o grupo focal. Os resultados revelam que os termos ?amor?, ?dificuldade?, ?dedica??o? e "paci?ncia" foram os mais frequentemente evocados figurando como o prov?vel n?cleo central da representa??o social. Os familiares tamb?m apontaram que no decorrer de muitos anos no cuidado as fam?lias se adaptam a esta realidade, por?m ainda apresentando dificuldades no ?mbito jur?dico, de sa?de, nas rela??es com a fam?lia extensa e na viv?ncia conflituosa de sentimentos em rela??o ao futuro cuidador.

This thesis describes the management of patients treated with mechanical circulatory support devices for short- or long-term use. Twenty-four patients suffering from postcardiotomy heart failure were treated with a minimally invasive axial flow pump. The device was effective in unloading the failing left ventricle and in maintaining an adequate systemic circulation. The principles of perioperative monitoring, and pharmacological therapy are outlined. The pump was also used as an alternative to the heart-lung machine in conjunction with coronary artery bypass surgery. Together with a short-acting β-blocker, esmolol, the heart was decompressed and heart motion was reduced, facilitating bypass surgery on the beating heart. The anesthesiological considerations using this method are described. An implantable left ventricular assist device was used as a bridge to heart transplantation in 10 patients. We were interested in assessing the possibility to establish such a treatment program at a non-transplanting center. A multidisciplinary approach was enabled thanks to the organization of our Heart Center and due the close collaboration with our transplant center at Lund University. As one of the first centers in Europe, we established a well-functioning program with good results. Nine out of 10 of the bridge patients, with treatment times varying between 53 to 873 days, survived pump treatment and were eventually transplanted. The device proved to be powerful enough to support the failing heart and enable rehabilitation of the patients. Outpatient management became simpler when using the electrical device with belt-worn batteries. The uncertain durability and the high risk of device-related complications are shortcomings that limit its potential for more permanent treatment of heart failure. A new generation of small implantable axial blood flow pumps has therefore been developed. The principles of these pumps are based on the first generation axial flow pumps evaluated in this thesis. After several years of basic research and experimental studies, the first human implants have been performed. In the thesis, the hemodynamic effects of such a novel axial flow pump have been evaluated in an acute heart failure model. This technology holds great promise, both as a bridge to heart transplantation, and as a permanent circulatory support system. / On the day of the public defence the status of the article IV was: Submitted for publication.

Purpose: Patients living with advanced heart failure experience dyspnea, fatigue, poor quality of life, depression and cognitive impairment which may threaten their ability to provide informed consent to undergo heart transplant (HTx) or mechanical support (LVAD). Using qualitative and quantitative methods, we asked how patients with advanced heart failure make decisions regarding HTx and LVAD. The variables chosen to reflect the elements of consent included quality of life and symptom severity (voluntariness), depression and cognitive impairment (capacity) and treatment preferences (decision-making). Methods: 76 patients enrolled in the quantitative arm completed the Minnesota Living with Heart Failure Questionnaire; Visual Analog scales for dyspnea, fatigue and overall health; Beck Depression Inventory; Montreal Cognitive Assessment; Standard Gamble and Time Tradeoff. Qualitative methods were used to discover concepts, relationships and decision-making processes described by 17 of the 76 patients considering HTx and LVAD. Results: Patients reported poor quality of life and high symptom severity scores which compelled them to consider surgery as a way to relieve unpleasant symptoms and improve quality of life. Although 30% of patients had evidence of depression and/or cognitive impairment, no patient was deemed incapable of decision-making. Patients were willing to take considerable risk (35%) and trade considerable time (4months) to improve their health. While heart failure-related concepts were important to the decision, entrustment emerged as the meaningful process for decision-making. Conclusions: Patients who participated in this study were capable of decision-making and understood the risks associated with the surgery. Voluntariness was diminished by disease but not absent, and decisions were free of coercion. These results suggest the entrustment model of decision-making is the dominant process for patients considering high-risk surgical procedures and meets criteria for informed consent. Understanding the process of decision-making will help clinicians support and enable treatment decisions made by patients living with advanced heart failure.