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
Studies on nursing assistants are rare, even on nursing assistants in family health teams. The article is based on a study that intended to determine the profile of Nursing Assistants in the Family Health Program in the Metropolitan Area of São Paulo, to identify their level of satisfaction with work, to seek suggestions for improving the Family Health Program, and to assess their expectations as to their professional future. In 2004, the Department of Primary Health Care and Family Health Program of the Municipal Health Secretariat of São Paulo sent out a questionnaire to the members of the city's teams. The analysis of the answers of 901 nursing assistants received support from Unesco. The major results presented in this article are the predominance of women, young individuals and individuals only with secondary school education in the teams; most of whom had been through basic training for the Family Health Program; and only a small number of whom had completed technical courses. Nurses are satisfied with work relations and work processes, but dissatisfied with work conditions. The most mentioned reasons for having chosen the profession were solidarity and the care for other people. On the other hand, the reasons for having entered the Family Health Program were the fact that it was an alternative in the job market and because of society's appreciation of the field. Most of them intend to continue training, later completing undergraduation in Nursing and specializing in Public Health or Family Health.
Article
This article is about the interrelation between labor conditions and health. The growing intensity of labor causes serious damages to the health of the worker. The concept of immaterial labor provides proper ground for the hypothesis that the intensification of immaterial activities has created a new category of health problems for workers. An empirical analysis was conducted on data from 825 surveyed workers in the Federal District area, in Brazil. The analysis showed the existence of two different health problems: the first illustrated by construction workers, the best example of a material worker, and, the second, by phone-company workers, performing a recently privatized immaterial activity that was exposed to the severity of international competition. The intensification of material labor primarily affects the body of the worker - i.e. the uncountable cases of work accidents - and immaterial labor causes problems with unique characteristics involving cognitive, emotional, relational and social aspects of the worker and the groups that he/she belongs to.
Article
This article investigates the incorporation of the notion of 'skills' in the development of the Vocational Course on Laboratory in Biological Diagnosis in Health of the Joaquim Venâncio Polytechnic Health School (EPSJV), a technical and scientific unit of the Oswaldo Cruz Foundation (Fiocruz). The conducted research focused on determining validity and viability of understanding the skill-based curriculum in the light of the critical/emancipatory approach proposed by Deluiz, Ramos and Kuenzer. The qualitative research was comprised of interviews with teachers of the institution. Results show that the implementation of skill-based ideas was the result of legal determination, not an agreed pedagogical approach. Besides that, the identification, selection and development of skills guiding the development of the curriculum were performed with a totalizing perspective in mind, that is, encompassing all of the many existing dimensions of knowledge. Implementing this model and the subjective scope of skills were the most difficult challenges for teachers.
Article
The Family Health Program aims at - and is responsible for - changing the current doctor-centered/disease-healing notion of health care to a health-promoting/disease-preventing notion that is carried out by a multidisciplinary team. Home visits are the main tools for understanding the totality of determinants affecting people's lives. The article discusses the notions of "home visits" as understood by the three major categories of Family Health Program workers - that is, doctors, nurses and community workers - and the interrelation between these notions and training received in basic courses. The "Discourse of the Collective Subject" methodology was applied during interviews. The authors concluded that disparities in the understanding of what home visits would be may hinder the changes proposed to the current health care model. The article also comments these different understandings and their influence on how teams organize work.
Article
One thing stands out in the first decades of the 20th century: the dissemination of medical discourses addressing the relation between medicine and education. The present article analyzes medical discourses on the many multiple aspects of education. It focuses on discourses that examine schools and students and underline that social preventive medicine would be unattainable without proper education. These discourses also remark that educating would not be possible without the incorporation of advancements accomplished by science - which were, in turn, personified by the medical profession. The article not only shows how the medical science was anatomy-centered and became physiological, but also demonstrates how the discussion and the mission of the medical science and profession started encompassing Education and Pedagogy. In this new paradigm, doctors legitimately guided pedagogists and created scientific theories and practices for education. The questioning looks of doctors over school and the tests and examinations they performed - only to display science's capabilities - confirm the precariousness of pedagogy and the prominence of medicine in caring after children and adolescents in school.
Review
Ensaio
This essay reflects on how the Paideia method handles the relation between the development of subjects and the life-world, presenting a few concepts used in its analysis in actual situations. The essay also discusses criteria for evaluating political or institutional development and comments on the implications of the adoption of this method on the health field - especially on clinical practice and public health
Memory
Debate
This article furthers the discussion on the training of health professionals according to the guidelines of the Psychiatric Reform by reviewing the steps taken by the country from the appearance of the first reform movements until the development of the current care model, an alternative to hospital-centered models. The article also presents the experience acquired in the Training Course on Day-Care in Mental Health, whose objective is to train health care professionals in mental health. Moreover, it also discusses possible strategies and proposals for assuring that the received training also involves practice, which would be reflected in differentiated multidisciplinary care and in a possibly larger autonomy of clients.
Debate
The present essay is about problems in the Brazilian health system that originate from differences in understanding and practices of the relations between public and private spheres. The proposed hypothesis suggests that conserving political, institutional and financial arrangements for providing public support to private enterprises and HMOs is considered as important as implementing universal access to health. The article also analyses the argument that the existence of a private health sector and the financial aid given to assistance programs unburden the Unified Health System and, thus, lead to the efficient use of resources in providing care to those "who cannot pay". In light of recent information on tax-breaks and direct public expenditures destined to private HMOs, the author considers the possibility that a public health system for the poor may preclude the existence of the Unified Health System as proposed by the Brazilian Constitution of 1988.
Debate
The present article intends to produce a general overview of a few moments of the Brazilian history in order to point out what influences our intersubjectivity and ethic codes to have formed and maintained an unhealthy pattern. It seeks, therefore, to explain why the Brazilian political elite is almost chronically unskilled in the republican government model, that is, a model in which the public interest democratically overcomes all private interests - either financial, electoral or corporative. Since the public virtue of Brazil is not yet fully constituted neither matured, the country has had major difficulties to promote its democratic and republican development. However, Brazil is a community that recognizes the flaw, that shares a rich and expressive culture and, for good or bad, has a political and government system.
Debate
This article intends to address a few important issues for comprehending the public/private relation in education and teaching. To do so, the current law was investigated and this relation assessed. This revealed an understanding of education as a public service, which would, thus, explain the authorization required from private schools. The article also provides a comparison with similar notions in the area of health.
Interview
Helena Hirata is a sociologist and researcher of the Groupe d'Etudes sur la Division Sociale et Sexuelle du Travail at the Centre National de la Recherche Scientifique, in France. In the last few years, she has been devoted to analyzing the social process of globalization in production systems, in the organization of labor and in labor relations. Her latest works approached relevant themes for Brazil and the country's academic work, such as the study of the increase in the vulnerability of labor relations, the divergence between productive and unproductive labor, the relations between unemployment and underemployment and the rearrangements of production and organization. These themes are dear to the sociology of labor and Helena Hirata has revisited them through the viewpoint of gender studies and on the perspective of the discussion of gender relations. In the interview, she speaks of the increasing relevance of gender matters for the sociology of labor, of power relations, of the social division of labor and of gender relations in the western world. She also comments on the influence of the workplace in the development of the identity of the woman.