EDITORIAL

The reflection of Zilma Fonseca, in the essay titled Perverse circularity of exclusioninclusion in contemporary Brazil, which opens the second issue of 2014, begins with a criticism of the dissemination of the concept of social exclusion, which is built in opposition to the framework of the division of society into social classes and joins the 'new social issue' paradigm. The author states that the concept has been appropriated operationally in several studies that focus on specific topics, thus leading to a generalization of social phenomena that have unique processes and bases. Fonseca stresses the context of productive restructuring, and confronts us with overlapping forms of primary and secondary exploitation of capital. Her analysis highlights the relevance of the concept of secondary expropriations, configured to bring to discussion ways to radicalize worker availability on the market, typical of the exploitative relations of capitalism.

Since the 1990s, when the family health program gained national scale, Primary Health Care (PHC) has been under the limelight on the national agenda. From 2000, more emphatically, PHC has been incorporated as a priority focus for the reorganization of the health system in Brazil. In this process, general and specific policies have been established in direct dialog with health practices and the organization of primary care. Thus, the presence of four articles that research the Family Health Strategy (FHS) can be read as an expected unfolding of this process, which takes place in the setting of the Unified Health System (UHS) and has impact on the investigations. The four articles are based on the qualitative methodology and address many topics through direct interaction with FHS professionals.

In the first, Difficulties, challenges, and overcoming in health education in the view of family health nurses, by Cinara Moutinho et al., the authors bring up issues such as maintaining a prescriptive approach to health education, which may discourage community participation in group activities and points to the dismantling of team work. In Danielle Sousa Silva Varela and Dulcian Medeiros Azevedo's article titled Herbal knowledge and practice of physicians in the family health strategy, the authors investigate the impact caused by the policy of inserting integrative and complementary practices in the UHS. In Caiapó, state of Rio Grande do Norte (Northeast), the researchers investigated how physicians have appropriated knowledge on herbal medicine. In the discussion, the limelight is on the professionals' willingness to use herbal medications in conjunction with a low level of knowledge about this type of medicine, studies of which are rarely part of medical training.

In Knowledge of a family health strategy team on the policy on attention to men's health, Luís Paulo Souza et al. bring up two issues that go handinhand: Knowledge on the National Policy for Integral Attention to Men's Health (PNAISH) and about the healthdisease process specifically related to men. The results show that the professionals are unaware of the policy; however, this does not mean they are unable to recognize the specificities involved in providing care to men. The authors point to the relevance of disseminating the policy due to the contributions it makes to reflecting on and organizing the work process.

The fourth article in this issue allows the reader to get to know the important points that the PHC approach took on in Venezuela during the period covered by the study. Model of Primary Health Care In Venezuela, Misión Barrio Adentro I: 20032006, by Flávia Henry et al., brings a panel that covers various aspects – team training, activities carried out, characteristics of the physical structure, for example –, including elements to analyze with regard to this process, which included the participation of 15,000 Cuban physicians.

In the study that gives rise to Ideal characteristics of the dental surgeon in the family health strategy, by Erika Smith, Sandra Cristina Reis, and Maria do Carmo Freire, the authors investigate perceptions that FHS professionals share on the desirable characteristics for a dentist to work under this model. Many personal qualities stand out, over and above valuing technical capabilities.

In the next article, authored by Mirelle Finkler, João Caetano, and Flavia Ramos and titled Models, market and power: Elements of the hidden curriculum that show through in training in dentistry, the authors resume the discussions on the dentistry work context seeking to question the ethical dimension of the training these professionals get. The research turns to the hidden curriculum on account of the authors' recognition of its importance in molding the professional identity. The final argument favors the inclusion of its elements in the discussions concerning teaching management spaces.

The next two articles analyze scientific production. The first, Health education and citizenship: an integrative review, by Viviane Ferreira et al, identified, from thematic analyses, two central categories based on the articles that were analyzed: the first indicates the historicity and conceptual foundations of health education; the second, meanwhile, positions popular education as an engine for citizenship. The authors report on the attempt to change the axis of health education towards a reflexive action, although the educational practices retain the traditional features that characterize the asymmetry between the health professional and the user of the services. The dialogic approach discussed in the literature blends with popular health education, which contributes to destabilize the normativity of the educational practices.

Neuza Macêdo, Paulette Albuquerque, and Kátia Rejane de Medeiros' article, The challenge of implementing continuing education in health education management, in addition to scientific papers features ordinances relating to the training processes. The research is conducted based on questions concerning: The meaning given to vocational training; the change of position that points toward the health worker; the theoreticalconceptual option assimilated in these formations, and ways to implement changes in health education. The authors argue that the conceptual changes made in the management of health education remain a challenge for managers and professionals.

To deepen the understanding on the challenges involved in continuing health education (CEH), Luiz Anildo da Silva, Marinês Tambara Leite, and Camila Pinno's article titled Contributions of teachingservice integration commissions in continuing education in health focuses on a management tool for the CHE policy, the regional CHE plans, seeking to understand how members of the teachingservice integration committee from Rio Grande do Sul (South Brazil) characterize the potential and difficulties of developing these plans. The authors provide readers conditions to think about various aspects of the process of enabling the CHE policy and emphasize the low level of participation of the managers, who not only know little about, but do not attribute enough value to educational actions conceived to improve the work process in health.

Continuing education in health according to management professionals from Recife, Pernambuco, by Sayonara Lima, Paulette Albuquerque, and Leandro Wenceslau, speaks directly with key actors working in managing the Municipal Health Department of Recife (Northeast Brazil). The authors show that the conceptual shift proposed by CHE is difficult to assimilate, with perspective of reflection and questioning based on everyday life coexisting with the centrality of scientific and technical updates on specific topics. The study also shows that devices that have been being implemented, such as institutional support, matrix support, and the unique therapeutic project are identified as ways of materializing CHE. In their conclusion, they address the need for management to assume the continuing health education policy as a whole.

This issue also publishes the account Narratives in the common training of health professionals, by Angela Aparecida Capozzolo et al., which discusses a pedagogical device incorporated into the training of different health professionals.

Two reviews close this edition. The one on Democracia, federalismo e centralização no Brasil (Democracy, federalism and centralization in Brazil), a book written by Marta Arretche, is by Francisco José da Silveira Lobo Neto; the one on Dicionário de Trabalho e Tecnologia (Dictionary of Work and Technology), organized by Antonio David Cattani and Lorena Holzmann, meanwhile, is by Raphael Jonathas da Costa Lima.

Angélica Ferreira Fonseca

Carla Macedo Martins

Marcela Alejandra Pronko

Publication Dates

• Publication in this collection
  23 May 2014
• Date of issue
  Aug 2014