Trabalho, Educação e Saúde - TES (Work, Education and Health) is an open access scientific journal, edited by the Joaquim Venâncio Polytechnic School of Health, from Oswaldo Cruz Foundation.
Editorial
Article
The job insecurity is a phenomenon with dynamics markedly accentuated since the 1970s, in response to the structural crisis of capital. With the emergence of the COVID-19 pandemic, its dimensions gained visibility, worsening, in particular, the issue of workers’ health. Therefore, the research that originated
this article aimed to analyze aspects of the relationship between insecurity and pandemic, taking the Brazilian reality as an analytical feature. It is a theoretical research, carried out based on official documents and news published on the internet, submitted to a historical materialist analysis. We found that all dimensions of precarious work establish reciprocal determination with the pandemic. The simulacrum of combating unemployment through precariousness, the home office and uberization are components that stand out in the pandemic situation, including provoking workers’ reactions against this process, see demonstrations during the pandemic. Because of this, these aspects should be the object of special attention by science and, above all, by the struggles of the working class, with even greater emphasis after the pandemic.
Article
The aim of this study was to identify the socioeconomic and occupational characteristics and self-reported health conditions associated with the reduction in the income of basic education teachers in the state of Minas Gerais, Brazil, during the COVID-19 pandemic. This was a websurvey-type epidemiological survey. A total of 15,641 teachers participated in the study, the responses were obtained from August to September 2020. The data was subjected to descriptive statistics, chi-squared test to assess the association between variables and multiple Poisson regression model, with robust variance, to estimate the magnitude of the associations. The results showed that the reduction in family income affected 40.9% of teachers, mainly in the urban area. The reduction in family income during the pandemic was more prevalent among eachers who lived with their partner, who had a precarious relationship (hired) with the school, with up to twenty years of teaching experience, who worked for up to ten hours/week and among teachers with hypertension, episodes of sadness, anxiety and sleep difficulties.
Article
The capitalist crisis intensified with the emergence of the COVID-19 pandemic had devastating effects on the world economy and, in the case under analysis, on the Brazilian labor market, especially with the increase in unemployment and informality. This article, based on bibliographical, documentary and secondary data research, presents a recent overview of the labor market in an ultraliberal context of regressive reforms approval in the scope of Brazilian social protection. These reforms contributed to the loss of social rights, the weakening of union organizations, the increase in unemployment and the deepening of social inequalities.
Article
This article aimed to discuss the proposals for reorganizing pharmaceutical assistance during the Coronavirus disease-19 (COVID-19) pandemic by the health departments of the Brazilian states and the Federal District. To this end, a documentary search of the files made available on the websites of the aforementioned departments was carried out. The interpretation of the data showed three categories of discussion on the reorganization of pharmaceutical assistance in the Unified Health System: ensuring access to health technologies, tele-pharmacy and promoting the rational use of medicines and safety in dispensing. In addition to offering a system of supply of essential technologies for the functioning of health services, pharmaceutical assistance actions were cited as strategic for the dissemination of evidence-based information, contributing to the completeness, resolvability and efficiency of health interventions.
Article
The proximity of Primary Care to the territories where people live makes it strategic in fighting the COVID-19 pandemic. In this research, care management in a basic health unit was analyzed in the context of COVID-19 in a municipality in the Zona da Mata of Pernambuco, Brazil. It is a qualitative research identified as a case study, carried out from August to November 2020 through semi-structured interviews with seven health professionals. Data was analyzed using the content analysis technique. Three terminal categories were defined: organization of the work process, involving the cancellation of group activities and the scheduling of appointments, as well as the rethinking of reception and continuing education; technologies used, with a predominance of light technologies for the reorganization of care; and greater difficulties in the management of care, which ranged from the problem of fake news to the lack of personal protective equipment. It is necessary to invest in the strengthening of Primary Health Care with an emphasis on the use of care management tools such as reception, health education, continuing education and digital technologies in order to increase its resolution in crisis scenarios such as the COVID-19 pandemic.
Article
This is a theoretical study with the aim of evaluating the role of telemedicine (and similar) in the health work process, with emphasis on the particular context of the COVID-19 pandemic and its relationship with uberization processes. A bibliographical research was carried out within the scope of the sociology of work with a Marxist bias, in order to specify the structural processes that produce this particular way of organizing health work. Subsequently, legal documents and news about the situation of the pandemic were analyzed, with a view to describing how telemedicine is situated in this context and then submitting it to the scrutiny of Marx’s social theory. It was found that this way of organizing health work consists in a way of increasing work precarization, now called uberization, developed under the subordination mediation of digital platforms to the interests of capital, in convergence with the biomedical model.
Article
Emergency remote pedagogical work was implemented in many schools in Brazil during the COVID-19 pandemic, as a way to reduce contacts between individuals and, consequently, reduce the rate of disease transmission, maintaining classes and educational activities. In many situations, teachers and teachers carried out activities that mischaracterize their teaching identity and conflict with domestic activities, producing discomfort and suffering. In a two-phase cohort study, the psychological suffering of Basic Education teachers were analyzed as a function of the amount of remote work, gender, the amount of housework and previous experience. Emergency remote work had effects on State Anxiety, Negative Affect and Perceived Stress − and these responses were moderated by previous experience. Women had higher responses than men, an effect mediated mainly by the amount of housework performed by the teacher. Participants mainly referred to negative work dimensions and affective dimensions when led to think about remote work, with less saturation of answers related to positive work dimensions, learning and political-economic issues. These results suggest that emergency remote work exacerbates teacher stress, pointing to the precariousness of teaching work and the need to implement policies that mitigate these impacts.
Article
The goal was to analyze the trajectory of mental health policies in Brazil. We systematize historical
periods based on the analysis of socio-political contexts, the organization of the health system and
the characteristics of mental health care. We identified seven periods from the institutionalization of
madness, in the imperial period, until 2019. The trajectory of politics reveals a process of dispute of
epistemological and symbolic conceptions about madness and mental illness, which in interaction with
other contextual factors influence the care models and care practices. Subsequently, we discussed the
plurality of approaches to deinstitutionalization in the international scenario and the influences on the
mental health model proposed by the Brazilian Psychiatric Reform. We present a synthesis of the idea of
deinstitutionalization considering the various dimensions that involve the comprehensive perspective
of the term. Finally, we reflect on the advances and challenges of the Brazilian Psychiatric Reform.
Despite the significant achievements, problems related to financing, stigmatization, fragile intersectoral
articulation and the reproduction of asylum logic in substitute services persist. In addition, the current
changes in the National Mental Health Policy are the main threats to the deinstitutionalizing model.
Article
This study aimed to compare anxiety and depression scores in health professionals in telehealth and/or
face-to-face care at a Brazilian university hospital during the COVID-19 pandemic and to identify factors associated with anxiety and depression. For this, an observational and cross-sectional study was carried out. Participants responded to the “Patient Health Questionnaire-9” and “General Anxiety Disorder-7” and a sociodemographic questionnaire and divided into three groups: telehealth professionals (G1), faceto-face care (G2) and professionals who work in both ways (G3). 159 health professionals participated, 36 men, 123 women, the majority of whom were nurses and the average age was 42 years. G2 participants had higher anxiety and depression scores when compared to the others. However, there were no statistically significant differences and associations between these groups (p> 0.05). “Age”, “profession” and “being diagnosed with COVID-19” had statistical associations with anxiety and depression. It was concluded that there was no significant difference between anxiety and depression between health professionals who work by telehealth and/or face-to-face, as well as there were no associations between protocols and groups. Age, profession and being diagnosed with COVID-19 can interfere with these scores.
Article
The article aimed to investigate how Brazilian municipalities developed measures to face the COVID-19 pandemic. To this end, a survey was conducted with data from the National Confederation of Municipalities collected in the second semester of 2020. The results showed that measures were initially adopted, such as the implementation of sanitary barriers, social isolation and the rise of the mask use; however, most municipalities have made these actions more flexible over time. In addition, it was observed that municipal entities developed actions to respond to the pandemic in a heterogeneous and uncoordinated way. It is concluded that this phenomenon is due to the fact that the federal government and the states of the federation developed precarious mechanisms to encourage inter-federative cooperation and little stimulated the coordination of activities in order to guarantee uniformity of the actions developed in the Brazilian territory.
Article
The weaknesses of Primary Health Care can be recognized by analyzing the work of community health workers. Since the situation faced by these professionals represents structural challenges in the health system, this article aims to analyze the situation of these professionals when facing the COVID-19 pandemic in Brazil. We analyze their challenges based on data collected from an online survey and netnography. For data analysis, we opted for content analysis, inspired by grounded-theory. We observed three dimensions that represent how community health workers experience the pandemic: changes in work practices, as well as in the interactions between workers and users and the expectation of the future in post-pandemic work. The analyses show that in order to protect these professionals and guarantee the functioning of Primary Health Care, it is necessary to have new strategies to make the dynamics of the workplace feasible.
Article
This is a theoretical research based on official documents produced between 2015 and 2020 by multilateral organizations and civil society organizations, as well as news published on the Internet that deal with issues related to education, especially during the period of the new coronavirus pandemic. There is a call for the use of technologies and education in Distance Learning, combined with speeches that highlight socio-emotional competences and teacher training from the perspective of flexibility and centrality in the student as the protagonist of their own choices in light of increasing social inequalities and new requirements from the labor market. Historical materialism was used as the method of analysis, under which the relationship between work and education and the resulting educational policies are apprehended as an expression of the order of capital. In the current historical moment, capital in crisis determines the new training conditions and needs for the working class, materialized by the action of the private hegemonic apparatus and collective intellectuals of capital, these examined in the light of Gramsci’s contributions.
Article
The study aimed to describe characteristics of remote work, mental health status and sleep quality in the COVID-19 pandemic among teachers in Bahia, Brazil. A websurvey was conducted, following the CHERRIES protocol, with teachers from all levels of education in the state’s private network. A total of 1,444 professors participated, from June 18 to July 30, 2020. There was a predominance of women (76.1%), 21-41 years (61.6%), black (71.9%), ten years or more in the profession (56.9%). In the pandemic, 51.4% reported changes in the employment contract and 76.8%, an increase in working hours. The home environment and equipment had a low level of suitability for remote work: physical space (19.6%), furniture (21.7%), noise level (17.2%), computers (44.5%) and internet broadband (36.7%). Among women, 42.3% reported high housework burden; among men, 17.4%. The women presented a worrying health situation, highlighting anxiety crises (53.7%), bad mood (78.0%), common mental disorders (69.0%) and poor sleep quality (84.6%). The pandemic remodeled the ways of exercising the teaching profession. The work transferred to the home, was superimposed on domestic and family activities, producing consequences for the health of teachers that, although little known, are alarming. The results strengthen the need for actions to deal with situations of public calamity, measures to regulate remote work and protect teachers’ health.
Review
CASE, Anne; DEATON, Angus. Deaths of Despair and the Future of Capitalism. Princeton University Press: Princeton, NJ, 2020. 312 p.
Review
BATISTA, Eraldo L.; ZANARDINI, Isaura M.; SILVA, João C. da (orgs). Estado, sociedade e educação profissional no Brasil: desafios e perspectivas para o século XXI. Porto Alegre: Unioeste e Evangraf, 2018. 323p
Review
LAZZARATO, Maurizio. Fascismo ou revolução? O neoliberalismo em chave estratégica. São
Paulo: N-1 Edições, 2019. 208 p.
Ensaio
This essay has as main objective to problematize changes occurred in the work of teachers and private school teachers in the context of a pandemic and its relationship with health. It presents new forms of resistance and collective organization, such as the virtual strike, from the point of view of the teachers themselves who are in remote teaching activities and also in the exercise of union leadership. It was built in a shared way, between professors and researchers. It is based on Freire’s critical and dialogical pedagogy, whose processes value mutual and emancipatory formation. From the dialogues undertaken during the construction of the text, we come to four important points of analysis and problematization, namely: teaching work in times of social isolation; changes in the work process and organization; generational aspects and gender issues; teaching health, resistance and virtual strike. In the end, it is observed that the type of teaching activity, not in person, through platforms and other digital resources, constitutes a current configuration of work that deepens in the context of a pandemic and makes exacerbated use of technology, articulating new control modes, extraction of overwork and social added value.
Ensaio
The recurring expressions of Covid-19 negationism in Brazil are connected to the growth of the extreme right and produces a significant expansion of necropolitics. We realized a “crisis of interpretation” according to which “ignorance” is responsible for the spread of negationism. We sought to go beyond this interpretation, as we problematize the phenomenon in its complexity. Anchored in an absence of a shared world, negationism grows out of the “deficit in common practices”. However, it is necessary to differentiate the positions involved: there are those who deny seeking profit, from a desire for death and extermination, and those who enter into denial because of such a harsh reality of which they are victims. In view of this, education actions that have popular health education as a reference are important strategies to face this phenomenon, mobilizing the freirian notions of dialogue and conflict. These actions allow not to “deconstruct” health care, but “add reality” to them, bringing the importance of considering the living conditions of the popular classes. Finally, understanding the inseparable link between popular education and social movements, we present how favela movements have faced negationism in defense of life.
Ensaio
Latin America has become one of the epicenters of the COVID-19 pandemic, with a health and humanitarian crisis. The objective of the article is to analyze the strategies implemented by countries in the Region to face the pandemic and the role of Primary Health Care, considering obstacles and potential. The cases of Bolivia, Brazil, Chile, Colombia, Cuba, Uruguay and Venezuela were analyzed. The seven countries have adopted diverse social distancing strategies with varying degrees of sustainability. The responses emphasized hospital care more than surveillance, case identification, contact tracking, and enabling adequate conditions for isolation. In almost all cases studied, the capacity of primary care services in the territory was underestimated. Even so, primary care initiatives with a territorial and community focus sought to integrate health surveillance with promotion, prevention and care, despite partial implementation. In this context, comprehensive and integrated primary care takes on new meaning and requires new developments in order to contribute to the recovery of the balance between society and the environment. The pandemic showed the need to rethink health care systems and the importance of primary care for comprehensive and integrated health.
Ensaio
The mental health policy in Brazil is threatened by the return of asylum logic and this constitutes a risk to users and family members, as the subject diagnosed with mental disorder no longer enjoys full rights. The purpose of this essay is to propose that the rescue of the memory of asylum barbarism is a fundamental part of human rights education; in addition, it should be present in the training of health professionals to strengthen social movements that give legitimacy and strength to the anti-asylum model. It starts with a critical conception of human rights to argue that they constitute the historical sedimentation of social struggles in a society in conflict. The conclusion points out that the enjoyment of the right to mental health is closely related to the education of health agents, users and social movements.
Conjuncture Note
In this brief presentation, we intend to discuss how the political-economic crisis combined perfectly with the pandemic to build profitable solutions for big capitalists. Based on the analysis of recent data, the text shows how the Brazilian State, under the Bolsonaro government, is committed to deepening the adjustment program, through privatization of state enterprises and downgrading the workforce’s rights and value, as the basis of a political-economic and fiscal program. The Note also explores the hypothesis that such a platform has the potential to ensure the continued support of the great bourgeoisie to the government of Bolsonaro and Guedes.
Erratum
No artigo <Entre o encalusuramento e a desinstitucionalização: a trajetória da saúde mental no Brasil>, com número DOI: <10.1590/1981-7746-sol00313>, publicado no periódico Trabalho Educação e Saúde, <v. 19:e00313145, na página <1>, disponível em: <https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1981-77462021000100502&lng=pt&nrm=iso&tlng=pt>
Onde se lia: “encalusuramento”
Leia-se: “enclausuramento”
Acknowledgements