Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

The Joaquim Venâncio Polytechnic School of Health, which belongs to the Oswaldo Cruz Foundation (EPSJV/Fiocruz), has polytechnics as an axis for its technical formation, also incorporating research as an educational principle and education of sensibility, of the senses, and of feelings as its basic premises. These premises, articulated with the concept of work as an educational principle, are the base for a political and pedagogic project that fights against a historically hegemonic worker qualification project. The article reports on the experience of elaborating a first semester of technical qualification for EPSJV students, common in all technical accreditations, and that seeks to develop critical knowledge about the field of health with emphasis on Public Health. Created in 2002, the Basic Module, the first strategy with this objective, was evaluated in 2006 and turned into the Initiation to Polytechnic Education in Health in the following year. This report also reflected critically on such process.

The article discusses the importance communications have in the pharmacist/patient relationship in the Pharmaceutical Care process, in the ambit of this professional's performance in commercial and private pharmacies in both public and private systems. The article identifies factors that interfere with the communication process and discusses the importance of the health professionals' attitudes as allies in valuing communications with the patient, which, in turn, favors the therapeutics to be used. The goal is to discuss the importance of communications in the pharmacist/patient relationship as a professional pedagogic resource to develop a Pharmaceutical Care process. The relationship is formed by a learning process in which the pharmacist is a learning facilitator for his or her patient. His or her function is to provide proper information on medication use; to teach by not only conveying the information, rather by creating conditions for the patient to receive such information in a useful, effective manner, organizing strategies to learn the prescribed therapy.

The main purpose of this contribution is with regard to a few of the main elements contained in the commented text. The first derives from the possible insufficiency of the notion of inclusion/exclusion to be considered as the base to interpret challenges such as of the policy for professional education in the Brazilian society, which is predominantly under the flexible accumulation system in a globalized order such as the current one. The second element, considered as of great meaning, is in the place the author puts for tension surrounding basic education in the debate on education for work in conditions such as those that were experienced in productive restructuring and productive process reorganization as the accelerated scientific and technological development that is occurring in all spheres of human life. Finally, to go deeper into the theme, it makes suggestions. The first would be through the character of the actual conflict of interests between those that live off of capital and those who live off of work, while the second via the concrete social movement of these actors as actions that extend beyond their legal formalization and of programs put in place, but, above all, what they represent in terms of contradictions, conflicting demands, confrontations, and co-options.

This article brings up two issues brought about by the instigating text by Kuenzer published in this edition. The first has to do with a few matters regarding professional qualification evoked in the introduction, unfolding in the discussion on professional education in the flexible production ambit. While dealing with such issues, extensive use was made of an article published a few years ago by this article's author dealing with the relationships established by educators with the relativistic concept of professional qualification. The second theme, which complements Kuenzer's discussion, has to do with the process of implementing educational reforms regarding middle education and technical-level professional education, put into motion in the 1990's and continued by the Lula administration. Elements involved in the two surveys the author participated in recently were used to develop the article.

The pharmaceutical industry, advertising agencies, communication companies, and the retail market have implemented an intense marketing strategy aimed at boosting medication consumption. The scientific and technological revolution, in turn, changed illnesses treatment standards and its impact on the health sector gave rise both to the medicalization phenomenon and to the logic that these goods and services should be considered as merchandise, as any other. This fact brings a challenge about: in medication use, to what extent should therapeutic requirements aimed strictly at controlling diseases prevail? At what point does market pressure begin encouraging drug consumption? The media's exploitation of the symbolic value there is behind the drugs is a powerful instrument to induce behavior to increase product consumption. The magnitude of the problem has forced the State to regulate drug advertisements via laws, decrees, and codes which, through the years, have been being disrespected. On November 30 2000, the National Health Surveillance Agency (Anvisa) published Collegiate Board Resolution (CBR) 102, once again in an attempt to impose limits on the sector. Over and beyond the stepped-up inspection efforts, this article discusses the regulation model itself, which has been unable to reach the goals it was designed to achieve.

Miguel Márquez, sanitary doctor, born in Ecuador, has participated in the process of reorganisation of the health systems of several Latin-American countries, including Nicaragua after the Sandi-nist revolution, and Brazil, which resulted in the Single Health System. His experience in such processes is a result of his intense participation in the construction of the Cuban system after the socialist revolution. Living and working in Cuba for some years, Márquez works as a consultant for international health agencies. In the 1970s Doctor Márquez joined the Pan-American Health Organization to work with Human Resource development. At that time he met Brazilian health researchers and managers and took part in the structuring of the Large Scale Project (Projeto Larga Escala). His relationship with Brazil is earlier, though, dating back to his friendship with Brazilian sanitary doctors, such as Sergio Arouca, who lived in Cuba, a time when they both worked together. Miguel Márquez was interviewed during his visit to Joaquim Venâncio Polytechnical School of Health (EPSJV/Fiocruz) in March 2006, when he presented the inaugural class. The interview discusses issues that have distinguished Doctor Márquez as researcher and consultant for decades. Classical health issues are updated, taking into account globalised economies and the impasses reached by national States.

This text is part of a survey carried out regarding the relationship between midtier workers and their work in public health organizations, which was aimed at rethinking the current health work management proposals. The goal was to understand the impact the current changes made in the labor world had on administrative agents, a professional health service group that is important from the quantitative viewpoint. The analysis' theoretical point of reference is a line in labor sociology which Dubar denominates as professional group sociology and is situated between traditional labor sociology, very centered on the salary issue, and a new organizational sociology that focuses less intensely on analyzing internal modes of management. The field work, which involved detailing the professional track records of 18 administrative workers, was carried out in two public health units. It was noticed, among them, that there is a great diversification in the forms of employment, professional backgrounds, and identity dynamics. It was clear, therefore, that multiple variables must be taken into account to understand how worker modes are built: professional qualifications, job ties, sector of professional performance, the amount of time the person has been in the area, and how the work is organized.

This study is based on a critical analysis of work management in the public health sector in Joinville (State of Santa Catarina), with regards to the daily work situation of health care workers in the basic Unified National Health System (SUS) units. It identifies a few of the health service's operating principles, as set forth by the management such as work domination mechanisms, and which result from its division, as follows: the fragmentary nature of work organization in the health sector, management's conflict domination, worker control by production goals, and health care worker resistance to imposed workloads. The study uses the following research techniques to show the work division: interviews and direct observation of the work.

In advanced capitalism, in all industries the labour process has become essentially semiotic, that is, in all steps of the productive chain, from engineering to machine adjustment and control, workers are employed to process information to which they can attribute meanings related to concrete labour situations. Understanding this process helps to understand the Marxian concept of concrete labour and can contribute to a better understanding of the nature of the informational capitalism that has been emerging in the beginning of this century.