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

This essay seeks to discuss political participation in the Single Health Service (SHS) based on the problematization of the options and conceptions that guide its definition as social control, made operational by means of mechanisms of representation of interests. As such, the goal was to drive reflection on how political participation in the SHS is transferred to daily institutional life, as a challenge to build modes of participative management. The Policy concept we adopt is defined not in terms of equality (formal), which opposes differences (social), rather as the co-production of a reality that is made concrete in the relationship between equality and difference, such as the access to and use of common goods, in its undetermined capacity, one that is open to the creation of value. Thinking of participation in these terms means to weave participation as the possibility to institute norms, and not only as the control of the execution and inspection of the existing norms. As such, participation in health is thought out based on the problem of constituting a public policy that can remain open and unpredictable, safeguarding, nonetheless, the material conditions of equality. In this regard, a public policy that breaks away from the modern sovereignty mechanisms by incorporating itself into its institutional design the unpredictability of normative production, becoming an ethical device for the production of value.

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.

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

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.

The main objective of the National Policy for Permanent Education in Health (PNEPS) is qualifying and developing workers for the health sector. Base on the assumptions of this policy, an attempt was made to analyze the reality of permanent education (PE) in the public health services in the municipality of Florianópolis, state of Santa Catarina, via a qualitative descriptive survey. A semi-structured interview was carried out with 16 subjects who are in charge of the basic care PE initiatives, of the hospital sector and of municipal and state public agencies. Content analysis was adopted as the analytical data procedure, organized in three categories: planning of the PE in health proposals; the teaching and learning methodology and techniques used in PE actions; and the assessment of the PE action process and results. The results show that the health services in Florianópolis are progressing, even if slowly, with interesting, although punctual PE initiatives. It was seen that PE is not prioritized on account of the 'vicious cycle' of the difficulties in the health services. Therefore, it is fundamental to have a critical, freeing education, one that allows for the perception of changes among the workers, in the work environment, and among the users, with reflexes on health service quality.

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.

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.