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 purpose of this article is to rescue aspects related to the construction of health education as a scientific field. It presents the main changes that have occurred since the early authoritarian and ethnocentric views concerning its target groups to the current proposals for popular education to value popular knowledge, inspired by the thought of Paulo Freire. It argues that the anthropologist's stance in the field, seeking to value the knowledge of the Other as just as legitimate as the academic one, can help health professionals practice dialogic health education for the groups to which it is intended.
Article
This study aimed to understand the limits and possibilities for intersectorality that were created in the process of structuring the Brazilian social protection system. It is justified on the account of the potential attributed to intersectorality to overcome the fragmentation of knowledge and structures of society, creating the sharing and dialog spaces needed to solve complex issues and the ability to understand the challenges faced with the dilemma of operating intersectoral issues in traditionally sectoral environments. The text is divided into three parts: First, the notion of 'intersectionality' is worked on; the authors then outline the construction and characteristics of the Brazilian social protection system; finally, they discuss how the institutional conformation resulting from its configuration interferes in the form of joint social policies. It was concluded that the development process and the history of the construction of the Brazilian social protection system were marked by elements that produced an environment that is little favorable to intersectorality. A first draft of the intersectoral coordination occurred under the scope of the discussion on 'social development,' which took place late in Brazil and seems to have tried to reverse the stigma of little efficient and effective social policies. However, little progress has been made in this direction, and the current way of designating the State's social intervention remains plural (social policies) and sectorally referenced.
Article
This paper examines the weaknesses that permeate the interrelationships established in the work process Italian family physicians use to get to know potential ethical conflicts. This field study used a qualitative approach, was exploratory-descriptive in nature, and was conducted in 2007 in the province of Rome, region of Lazio, Italy, among Italian family physicians hired under the National Health Service. Analyzed in the light of everyday bioethics, the results show ethical conflicts generated directly by the health care organization model used by the National Health Service, by the pharmaceutical industry's market, and indirectly by the society, with the backdrop of neoliberal capitalism.
Article
This study aimed to understand the meanings that the nursing workers attribute to the aging process in the labor market, identifying implications for individual and family health. The thematic oral history method was used with twenty nurses at a public hospital in the city of Marília, state of São Paulo, Brazil. The analysis revealed three categories: work history in life; stories about health and illness in and/or through work; history of aging and/or for work. We inferred that work is a major concern; in addition to allowing one to earn a living, it promotes participation in society. We found reports of dissatisfaction with work related mainly to the way it is organized. We conclude that work remains an important activity throughout life, and the environment and the way work is organized influence the aging process. The major challenge for nursing is to formulate propositions that afford real improvements to the workers' conditions.
Article
This article analyzes the uniqueness of the action of the community health workers when circulating through the territory in the municipality of Porto Alegre, state ofRio Grande do Sul, Brazil. It was considered that the meetings between agents and the territory go beyond the requirements and expectations of the health policies. The production of an idealized image of the agents, who are seen as the 'driving force' of the changes expected from Primary Care, was problematized. When analyzing the complexity of the demands in their daily work, the highlight was the multiplicity of care strategies community workers produce. The uniqueness of each territory and of the health and management teams, among several other variables, puts pressure on the agents and other workers who are part of the Family Health Strategy teams to face a reality that is very different from the one that one may suppose exists. Therefore, the emphasis was on the importance of producing a critical and reflexive position, calling into question the limits and possibilities of this practice in order to enhance the care strategies in use there.
Article
Promoting health is a global policy that has been proposed, is contemporary in public health, and addresses health from a broader viewpoint. The National Policy for Full Attention to Men's Health is based on male uniqueness. This study aimed to analyze men's discourse on disease prevention, on health, and on the need to promote it. Descriptive and exploratory qualitative research conducted with 57 men, residents assigned to a Family Health Strategy unit in the municipality of Marília, state of São Paulo, integrated with Education through Work for Health Program. The researchers used the discourse of the collective subject technique, which is based on the questions 'what do you do to maintain your health?' and 'what do you consider harmful to your health?' In the results, the discourses analyzed showed that most men do not fully understand the sense of health or disease and prevention, besides the fact that they base themselves on biological scaling. The National Policy for Full Attention to Men's Health is an important health promotion strategy; however, it still requires professionals and institutions from different areas, over and beyond health, to be agile, creative, and qualified to deal with such uniqueness and vulnerabilities.
Article
The study aimed to characterize health education groups conducted for hypertension and diabetes patients in Campo Mourão, Paraná, Brazil. This is a quantitative study conducted among 121 professionals with ties to the Family Health Strategy. The researchers used a form containing descriptive and evaluation variables, like the holding of groups with the community, issues discussed, professionals participating, suggestions, and issues. The results showed that 70 percent of the units offer health education groups; however, such groups are focused on curative themes. Professionals who were involved most were community health workers and nurses. Although group setup should be changed in order to better promote health education, few professionals recognized the importance of making such changes. It is essential that family health team professionals are trained to realize that the health education process is not limited to the transfer of information, rather that it includes the shared construction of knowledge between the user and the health provider.
Article
This paper develops the idea that the integrated curriculum and the education of youth and adults, associated with the National Program for the Integration of Vocational Education with Basic Education in the Education of Youth and Adults Mode, act as analyzers, showing how education constitutes and enables the emergence of other forms of educational organization. The proposed curriculum integration contained in this program enables a discussion on how education has organized its relationships, practices, times, and spaces. It also allows discourses that reaffirm the need to adapt 'regular' education projects to the specificities of the education of youth and adults student to be surpassed, questioning other forms of education. Besides questioning the transformative potential of the integrated curriculum, the text examines the reactions and movements arising in clashes between instituted and the instituting, which can either intensify or reduce the critical property of the proposal, seeking to make it equivalent to the already existing social forms. It concludes by highlighting that education, while it owes to the way society is structured the conditions that make it possible, contributes to producing the subjectivities that circulate in this very same society.
Article
An attempt was made to get to know the views professors have on the experience of teaching in health courses at a federal university located in northern Brazil. Using a qualitative approach, six professors working at the university's health courses were interviewed, and their data were subjected to content analysis. Most professors were female, and the role was valued as it represents a stable employment status, a source ofincome, and a social function. In the teaching activity, most focus on developing the students' technical and scientific skills, expressing the need for ongoing training and insufficient institutional support. Personal relationships among these professors and students and with other professors and technical administrators are known to mediate the quality of the teaching/learning and work processes. Insofar as health is concerned, most feel vulnerable and worn, particularly in psycho-emotional aspects, a fact that influences their social relations within and outside of the workplace. Although the professional practice has been identified as a source of stability and of personal and financial realization, the precariousness and work overload stand out and tend to induce suffering and illness. This reflection among professors, labor union movements, and educational institutions may support institutional, legal, curriculum and social adjustments in order to improve the process of teaching and learning and the professors' quality of life.
Article
A new type of relationship that has developed between science, technology, and industry in modern life encourages a strong expansion in the consumption of specialized goods and services, building diverse ethical issues in this process. This article aims to analyze the relationship between ethics, specialization, and the labor market in the productive post-restructuring of dentistry. It is an exploratory-descriptive qualitative study involving the application of a questionnaire among thirty students of a specialization course in southern Brazil. The categories were constructed through the ethical issues highlighted in the discourse ofprofessionals and analyzed using the discursive textual method. The categories studied were the pursuit of specialization as an imperative to stand out on the market and ethical issues in the construction of new needs for aesthetic and specialized consumption based on singular patient-patient convincing schemes. A picture of a paradigmatic crisis in the dental profession encourages the expansion of specialties guided by aesthetic consumption, which, in turn, amplifies the importance of the ethical debate in the lato sensu training and, also, in continuing education in work in oral health. There is a need for a proactive participation of professional councils, professional associations, and government institutions related to oral health in the construction of the ethical and bioethical debate focused on professional work and training.
Article
The study aimed to understand the perceptions and demands imposed on nutritionists active in the preparation of meals served at schools on their training in this area of nutrition. The research was conducted through a selfadministered questionnaire replied to by 39 participants in a training session held for nutritionists who worked under the National School Nutrition Program in 2008. Data were analyzed by means of a qualitative approach. Most professionals considered that their training had not prepared them adequately to act in the area, as issues relevant to the National School Nutrition Program were either not addressed at all or poorly discussed. Despite their difficulties and complaints, most said they were satisfied with their practice in school meals, but believed changes are needed and were not comfortable with the practice itself. This study underpins the importance of holding a broad discussion on the nutritionists' training and on the curricula's adequacy to address current demands.
Article
This paper presents the experiences of nutritionists in food and nutrition education activities at schools located in Duque de Caxias, a municipality of the state of Rio de Janeiro, Brazil, over the past ten years. The methodology for systematizing experience is based on the assumption that this collective learning activity takes place from the critical interpretation of practices in dialog with the theory. Personal collections and projects were queried and, later, individual and group interviews conducted with nutritionists. It was possible to note great diversity in the actions developed, in the interest in intersectoral action, and the progressive incorporation of the right to food discourse. The partnerships established between nutritionists and popular movements mark the description of the experiments. Food and nutrition education was affirmed as an interdisciplinary field of action. In contexts of great injustice, it is essential to incorporate principles of popular education, such as loveliness, dialog, and commitment to the oppressed. The systematization signals that nutritionists, guardians, teachers, cooks and other school professionals have been key players in the experiments, and indicates the potential for the increased participation of the students.
Article
This study aimed to evaluate the quality of life of Nutrition students in order to subsidize reflections on the process of training in health. This was a cross-sectional observational study conducted from August 2010 to August 2011 among forty students attending all course semesters. Data was collected using a specific questionnaire — sociodemographic characteristics — and the World Health Organization Quality of Life Instrument-Bref. Descriptive frequency, central tendency and dispersion statistical analyses were performed, as was the comparison inferential analysis among the domains. The scores were: environment (68.17), social (66.67), physical (66.07) and psychological (63.82) relations. The sleep, energy for daily activities, concentration capacity, opportunities for leisure activities, financial resources, physical environment and negative feeling facets affected the respondents' quality oflife adversely and interfered with their academic performance. These findings corroborate other studies involving undergraduates, revealing that the quality of life of these young people require improving physical and environmental structures and pedagogical, social, and psychological support in a context of social inclusion and of cultural multidiversity that is increasingly present in Brazilian public universities.
Ensaio
This essay seeks to contribute to the construction of a participatory and dialogical mode of health surveillance for the workplace, notably for the federal public service. A reflection is made in it based on a review of the literature and a focus on the legislation and on the policy in force in the country. The authors find that the historical achievements made in the scope of labor social movements favor the production of new relations between the state and society, favoring the emergence of participatory spaces in public institutions. In addition, it highlights the capital need for organizing occupational health commissions per workplace as an elementary way to implement the health surveillance policy in the work environments. Finally, under the aegis of the critical education field, it presents a few precepts of the theoretical contribution made by Freire's pedagogy to serve as a base for the creation of spaces for discussion at the workplace. The authors defend the idea that dialog and participation are the educational foundations of a democratic perspective of occupational health surveillance.
Review
Review
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Interview
Jaime Breilh es profesor de la Universidad Andina Simón Bolívar (Ecuador). Sin embargo, en el caso de la salud pública, el nombre de este investigador se vincula directamente con el pensamiento crítico en epidemiología, es decir que no ve simplemente a la salud como una producción social, sino que investiga y advierte acerca de las maneras en que la sociedad capitalista consolida la desigualdad, profundamente ligada a una “economía de la muerte”. En esta entrevista,1 concedida en el mes de marzo, cuando se encontraba en Brasil para participar en el V Seminario del Frente Nacional contra la Privatización de la Salud, Breilh hace un análisis crítico de los caminos que la epidemiología ha recorrido y propone reubicarla como un área de conocimiento comprometida con una “economía de vida”. Con esa finalidad, analiza las relaciones que se establecen entre las opciones teóricas y una acción política y ética dirigida al enfrentamiento de las inequidades sociales.