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

Knowing how is organized the working process in any productive activity is essential to understand the impact on health workers. This knowledge is associated with the form how society is organized, which may result in the full development of the being, but also contribute to estrangement/alienation. The study that originated this article aims to understand how is organized the peasantry working process in two settlements, influenced by distinct factors: the Agribusiness and the Agroecology and, from this relationship, the labor’s estrangement/alienation and its impacts on the settlers’ health. It’s a multiple cases study, based on a qualitative approach, using semi-structured interviews and focus groups. The study was made between January and May 2016, in two sets of the Metropolitan Region of the Recife, Pernambuco, Brasil. Data processing and analysis followed a perspective that considers the totality and historicity of social relations and their articulation with particular social processes guided the data processing and analysis. The results show that thecondition of estrangement (and the struggle against it) occurs in different ways in the two settlements, but, in both cases, it’s related to the settler’s health. When influenced by agribusiness, presented in a specialized production, almost exclusively of goods and intensive use of pesticides. Regarding the influence of agroecology, has a diversified production, abolishing the use of pesticides and with less intensity at work.

Tuberculosis is one of the main grievances to be combated throughout the world, and the high incidence among the population that is deprived of freedom (904.9/100 thousand inhabitants, in 2013) contributes to increase the dimension of the problem. This study presents the analysis based on action research, which was developed through an institutional intervention that used Ongoing Education in Health to reorganize the care provided to those deprived of freedom who have tuberculosis. The participants of the research were the nursing workers at a penitentiary in the state of Paraná, Brazil; the workers participated in seven Ongoing Education in Health workshops. Three of the workshops were on team work, user embracement and joint responsibility; two other workshops discussed the current aspects of the disease, the care practice developed, and a new work proposal was established by the team. The last two workshops monitored the implemented proposal and corrected mistakes. The action research combined with the Ongoing Education in Health was adequate regarding the development of the intervention, and enabled the change in the practices of the workers and the transformation of the care for people with tuberculosis in that institution.

The article is the result of a cross-sectional study about care in mental health with 29,778 teams from the Family Health Strategy from all over Brazil (87.1% of the total of teams), including a normative evaluation of the data of the second cycle of the National Program for the Enhancement of Access and Quality in Primary Health Care (2013-2014) in the dimensions of the profile of the professionals, promotion of mental health, management, and offer of care. The results showed that 33.8% of the interviewees had precarious labor relationships, and that 60.3% of them did not feel prepared to work in mental health. The offer of the set of actions evaluated only occurred in 9.5% of the teams in all of Brazil (2.2% in the Northern region). Around half of them did not develop strategies to promote health, and only 9.8% actually carried out the management of care. We concluded that the low percentages of implementation on the national level coexist with significant regional inequalities, with the worst results coming from the Northern region. It is necessary to strengthen the actions of promotion of health, the qualification of the teams, to reverse the precariousness of the labor relationships, and to reorganize the management of care.

Brazilian higher education has been historically marked by the presence of private institutions. During the unhindered expansion that took place over the past two decades, the private sector presented a growth in the number of enrollments and in the percentage of participation. This article describes the private participation in the undergraduate courses in health in the period between 1993 and 2013. The review of the literature on Brazilian higher education and the descriptive analysis of the secondary data evinced that the participation of the private sector in the training in health, in many aspects, has been compatible with the dynamics of the higher education sector. In the 1990s, the growth of the private sector was a trend in all undergraduate courses in health, and, in most courses, the growth rates were higher than the national average. In the period between 2003 and 2013, the courses of Medicine, Odontology and Social Services presented growth rates that were higher than those of the preceding period, and the other courses presented a decrease in the growth rates; as for the courses of Biology, Speech and Language Therapy and Occupational Therapy, a decrease in the number of enrollments in private institutions was observed.

The expansion of the influence of medicine on social demands and moral issues has been the subject of intense discussions, but many experts claim that the analysis has lost rigor. By this essay, we recover the deeper senses of the term medicalization and discuss two interrelated assumptions: if public policies with a positive impact on the population health levels would meet a demedicalizing role and if the deepening of democracy could be considered an essential condition to face the medicalizing processes. We summarize core concepts related to the main driving forces of medicalization processes and also changes associated with increased control over nature transforming life as we know it, highlighting the advance of capitalist economic order on other spheres as the state and the community. We argue that any long-range demedicalizing perspective would depend at least two hypotheses interrelated, corresponding to the model that guides the response to health needs, and the strength of democracy in its double meaning, either as a politics category able to put the majority sectors of society at the heart of state decisions, either as an economic category able to change the economic effects of capitalism in the state-society relations.

Editorial

The reorganization of the world of labor has a strong impact over the life and health statuses of the working class. Teachers, as well as other workers, have been going through a process of precarization of labor, among other consequences of flexible accumulation, with the increase in the requirements without a sufficient increase in the resources that are needed in order to perform the work. The significant increase in mental suffering among teachers seems to be connected to the new working conditions. With the goal of providing elements in order to face this issue, we developed a research with the aim of observing the association between the increase in exploitation in the work of the teachers and mental suffering. We performed a cross-sectional study using the Limesurvey online survey tool, in which 1,201 teachers of the state school system answered 2 online questionnaires: the Self-Reporting Questionnaire-20 and another one, developed by the researchers, about the working conditions of the teachers. The weekly working hours, the amount of students per classroom and the amount of classes of students per teacher showed an association with minor psychological disorders. The association between the amount of students per classroom and the presence of a minor psychological disorder was statistically significant. We concluded that the prevalence of cases that indicate psychological disorders is very high among teachers, and there are signs of an association with many different kinds of exploitation in the work of teachers.

What is the relationship between urgencies and chronic care? This question, which is appa-rently paradoxical, was approached in an ethnography conducted at the largest emergency care hospital of a Brazilian metropolis; the ethnography investigated medical care from admission to the confirmation of the clinical and functional condition of the patient with severe sequelae. Between December 2012 and August 2013, we conducted interviews and participant observation with 43 physicians: 25 men and 18 women, aged between 28 and 69 years. The analysis, which was guided by the signs, meanings and actions model, led to the realization that the care varies according to the context: at the ‘gateway’ and at the ‘intensive therapy center’, the struggle to maintain life is intense; at the “chronic patient” sector, care is provided to people who survive, but who have a high degree of dependence. For the physician, ‘life’ means regaining previous function, while survival with dependence would mean a ‘living death.’ The physician refrains from dealing with a highly-limited human being, for he/she feels somehow guilty of the clinical picture, even though he/she feels compassion towards the patient who requires chronic care. The insufficiency of a long-term care network and the lack of palliative training on the part of the physicians cause suffering in those who care and in those who are cared for.

The goal of this study is to assess the elements associated with the negative self-assessment of health among nursing workers. We performed a cross-sectional exploratory study, with a probability sample composed of 451 Primary Health Care nursing workers. We applied a questionnaire with sociodemographic data, as well as data on life habits, occupations, psychosocial aspects and satisfaction at work and morbidity of the workers. The self-assessment of health was measured through the question “Overall, in comparison with other people your age, how would you consider your own health status?” The data was analyzed using the model of logistic regression in blocks. We identified a prevalence of 15.8% of negative health self-assessments. The factors associated to it were: incompatibility of the activities developed with the position, medium and high housework overload, active work situation (high control, high demand), poor assessment of the quality of life, and common mental disorders. The findings confirm the relationship between the health-disease process and the life and working conditions, and point to a need for public policies of prevention and promotion of the health of nursing workers. By constituting favorable work situations, these policies may be highly relevant for the quality of the care provided to the users of the Brazilian Unified Health System (Sistema Único de Saúde, SUS, in the Portuguese acronym).

The research analyzed the process of socialization and transformation of nursing technicians into nurses through a descriptive and exploratory study, with a qualitative approach, conducted with 24 nursing technicians enrolled in an undergraduate course at a university in the state of Ceará, Brazil. The study was conducted between September and October 2016, through individual semi-structured interviews, with a thematic analysis in order to organize the data, which were discussed according to the presuppositions of the sociology of professions. Based on the results, three categories emerged: motivations for career progression; the dissimilarities between the work of the nurse technician and the nurse; and professional growth in the course of their studies. We noticed a process of professional socialization in the educational path of a nurse technician, which was motivated by a desire for career progression. The gradual transition is important so the technician can adapt to a new identity in the making, which can facilitate the migration among individuals with different levels of complexity in the nursing practice.