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

This article discusses the recent progress made in the counter-reform of the State in health, particularly in the privatization of the management for social organizations, and it also presents an explanatory theoretical focus on this phenomenon today.The new settings of the Brazilian health system resulting from the interactions between the State and the market are investigated by addressing the years beginning in the first Lula administration, from 2003 to the present, and the focus of the social organizations based or active in the states of Rio de Janeiro and São Paulo. Despite the expectations created for substantial changes in the economic and social policies, the Lula administration maintained important elements of governments that preceded him from the 1990s. At the state level, the Sérgio Cabral Filho administration clearly prioritized outsourcing. A critical analysis of the arguments used to boost this counter-reform is made based on a few case studies. At the end, an explanatory thesis is presented on the progress made in the light of the transformations of the material base, of the political superstructure of contemporary capitalism, and of the Brazilian social formation.

Healthcare regulation is a complex activity that includes many tools and strategies and can be divided into two dimensions: Socioeconomic and managerial. This theoretical-conceptual study discusses how the references of the ergological approach contribute epistemologically to healthcare regulation. Ergology is considered as an attempt to understand how the microcosm of human activity flows into and out of the macrocosm of social life. This perspective discusses the debate concerning norms and values and the ongoing crisis among the economic, political, legal and human activity that exists in society. In this sense, this study discusses how the dialectic approach of ergology, i.e. a perspective that considers that historical and social progress occurs through opposition, can contribute to the understanding of the arena of disputes that the regulatory activity in health is turned into, in the consequent strengthening of its social, economic and managerial objectives, and in minimizing its main limitations.

The purpose of this article was to identify the education proposals in the hospital environment, their implementation directed to chronically ill children and adolescents, and to understand their perception about their schooling in this environment. A survey was carried out at a pediatric referral hospital in Fortaleza, state of Ceará, Brazil, from March to May 2013, using semi-structured interviews and involving eight children and adolescents hospitalized because of a chronic condition. The data were analyzed and two categories listed: the view hospitalized children and adolescents have of their schooling, and the gap between theory and practice in the education of hospitalized children and adolescents. It was noticed that the sadness emanating during the children and adolescents’ hospitalization, associated with nostalgia and distance from school, with the restrictions imposed by the routines established by the institution, and with patients’ clinical condition generated immense suffering among these youth. Little is done about the education of these subjects, as the recreational and educational activities carried out by health professionals do not meet this need. Therefore, we conclude it is essential that the hospital offer this population educational follow-up, continuing the educational process through classes at the hospital in order to provide comprehensive assistance in view of the prerogatives prescribed by law.

This study presents the difficulties, challenges, and overcoming of nurses of the Family Health Strategy in the practice of health education. Eight professionals from family health teams of the municipality of Montes Claros, state of Minas Gerais (Southeast Brazil), were interviewed based on unstructured interviews. The data were transcribed and analyzed pursuant to the discourse technique. The results were grouped into analysis categories. In these subjects' view, there are difficulties in the teamwork process, barriers in the physical structure, and a lack of material resources at the healthcare facilities. They also report inconsistencies in the relationship with the users when undertaking health education. A dialectical movement of reality is noted because, while there are difficulties to be overcome, substantial advances have been made with new practices that may potentially transform the reality being studied. The dynamic nature of the change process is taken into account, with its advances and setbacks, which translate into a reality that is constantly under construction.

The study assesses the knowledge of a Family Health Strategy team from Montes Claros, state of Minas Gerais (Southeast Brazil), on the National Policy for Integral Attention to Men's Health. This is an exploratory, descriptive study with a qualitative approach, characterized as a case study conducted with professionals from a health care facility. The data were collected through interviews in the first half of 2011. Most respondents had minimal knowledge on this policy, which was attributed to the limitation in informational materials, the lack of guides from the Ministry of Health, of trained professionals, and to the absence of the municipal, state or federal spheres. Some of the respondents were aware of the composition of the policy, while all of them could describe actual and extensive knowledge of the characteristics of male healthdisease process. Thus, it is important to consider these professionals' prior knowledge on this population and to invest in their training strategies, thereby subsidizing the effectiveness of health promotion, rehabilitation, and recovery actions, reducing morbidity and mortality, as prescribed by National Policy for Integral Attention to Men's Health.

This article examines the knowledge and use of herbal medicines by physicians in the Family Health Strategy at Caicó, state of Rio Grande do Norte (Northeast Brazil). This is a descriptive study with a qualitative approach carried out with nine physicians in January and February 2011 using semistructured interviews. The data were subjected to thematic content analyses: the respondents' profiles; the physicians' knowledge about herbal medicines, and the use such physicians made of herbal medicines. Most respondents (77%) reported knowing herbal medications and recommend them to Strategy users; however, knowledge on this topic was limited. Sixteen herbal medicines were mentioned, with the highest applicability rate for Ansiopax and Calman, prescribed for anxiety disorders and insomnia. The importance of having integrative, complementary practice approaches in place in undergraduate healthcare courses was evident, as was the need for investments in training human resources, by offering continuing education in health and ensuring basic support (physical and structural) for the deployment, maintenance, and consolidation of the National Policy for Medicinal and Herbal Plants.

This essay addresses the intentions and theoretical and political developments surrounding the use of the term 'exclusion' and its counterpart, inclusion. It addresses the conceptual statute of the expression 'social exclusion' and its association with a 'new social issue' and concepts such as citizenship and poverty. It points to the potential explanatory, transformative use of the concept of 'secondary expropriations' to reflect on the diversity of contemporary social situations that express the structural inequality of the capitalistic system. Additionally, it seeks to pinpoint the debate on issues that are linked with the notion of social exclusion, such as the end of the centrality of work, the new morphology of the working class, and the composition of the reserve army. It concludes by breaking down questions that update the demand for the deepening of fundamental Marxian categories.