Brani Rozemberg

Comunicação relacionada ao uso de agrotóxicos em região agrícola do Estado do Rio de Janeiro

OBJECTIVE: To assess communications aspects related to pesticide use in a rural area of the Rio de Janeiro state, Brazil. METHODS: The study was carried out in the area of Sao Lourenco stream. It was based on methodological triangulation comprising: semi-structured interviews and observation of a local population sample (about 600 inhabitants); structured questionnaire to collect data on the local community; and records of lectures given by agronomic engineers, pesticides traders and other public service professionals. RESULTS AND DISCUSSION: This study pointed out to the historical misinformation on pesticides in rural areas; the emphasis on technical language in educational and training activities available which constitutes a barrier for rural workers knowledge acquisition and empowerment; and the industry/commerces pressure to legitimate pesticide trading, reinforcing the existing communication process, resulting in unfavorable inclusion of the rural worker into a broader market economy.OBJECTIVE To assess communications aspects related to pesticide use in a rural area of the Rio de Janeiro state, Brazil. METHODS The study was carried out in the area of São Lourenço stream. It was based on methodological triangulation comprising: semi-structured interviews and observation of a local population sample (about 600 inhabitants); structured questionnaire to collect data on the local community; and records of lectures given by argonomic engineers, pesticides traders and other public service professionals. RESULTS AND DISCUSSION This study pointed out to the historical misinformation on pesticides in rural areas; the emphasis on technical language in educational and training activities available which constitutes a barrier for rural workers knowledge acquisition and empowerment; and the industry/commerces pressure to legitimate pesticide trading, reinforcing the existing communication process, resulting in unfavorable inclusion of the rural worker into a broader market economy.

Percepção das condições de trabalho em uma tradicional comunidade agrícola em Boa Esperança, Nova Friburgo, Rio de Janeiro, Brasil

The impact of pesticide use on human and environmental health has received attention from the international scientific community for some time, especially in developing countries where such chemical agents are used extensively and indiscriminately. The present study adopts a methodological approach to risk perception analysis based on rapid surveys, including: participatory observation; semi-structured interviews with key informants; and evaluation of local work processes. Field data analysis revealed several issues related to the risk perception profile of the study population, including the development of defensive strategies toward work hazards, subjective responses to potentially hazardous situations, and the role of individual risk perception as a determinant of human exposure to pesticides.

Significados e usos de materiais educativos sobre hanseníase segundo profissionais de saúde pública do Município do Rio de Janeiro, Brasil

This article reflects on the communications processes in the Hansen Disease Control Programs under the Unified National Health System (SUS) in Brazil, analyzing how professionals at two public health services in Rio de Janeiro perceive the educational materials on the disease. The article discusses how analysis of printed materials favors negotiation of prevailing meanings and practices on Hansen disease in the programs. Thirty-eight different educational materials were analyzed (produced from 1993 to 2005 by governmental and nongovernmental institutions) through two focus groups with program staff. Six materials were examined during the focus groups. The findings showed the communications processes are vertical and fragmented, with an emphasis on campaigns, centralized production of materials, homogenization of target publics, and a focus on biomedical knowledge. Horizontal and participatory activities were uncommon. A gap was identified between the institutionalization of the discourse on Hansen disease as an alternative to leprosy terminology and its circulation and uptake among different social actors.

O processo de construção de mapas de risco em um hospital público

The paper presents a discussion about the experience of building a risk map by workers in a public hospital, in Rio de Janeiro city, resting on concepts of occupational health surveillance, total quality and biosafety. It goes from the first step to persuade the workers and managers, to identify the potential sources of risk in the work environment, the elaboration of the map, until the discussion about the preventive measures and the presentation of the results by the workers at a scientific meeting in the hospital. The elaboration of the risk map acted as a learning opportunity to socialize concepts in the work health area, to integrate workers, to systematize the work process and to discuss work organization, having practical consequences which have furthered changes in the working environment.

O saber local e os dilemas relacionados à validação e aplicabilidade do conhecimento científico em áreas rurais

Based on previous experience from two research projects on schistosomiasis in rural populations, this article focuses on the relations between scientific health knowledge and health-related common sense in farming communities. The article discusses factors that affect the meaning of participation by these communities in exogenous programs, as well as the dilemmas related to the appropriation, validity, and applicability of multiple and non- contextualized health information offered by such programs. The article discusses how the acritical aggregation of large amounts of information, a feature of globalization, deepens the feeling of uncertainty in rural communities and the trend to impute diseases to fatality. Meanwhile, the consumption of medical technologies is viewed as a symbol of progress and is highly valued by these groups. The discussion addresses the important role of health personnel in valuing local empirical knowledge, fostering the incorporation of useful technical knowledge without compromising the cultural heritage on which the identity and health of such groups are based.

Entre a fragmentação e a integração: saúde e qualidade de vida de grupos populacionais específicos

This paper was elaborated to support a broad debate on health and quality of life regarding specific population groups. It presents examples from the authors’ experiences in specific issues of public health, such as: a) medicalization of the rural health experience; b) proposals of intervention in mental health; c) basic sanitation in rural populations; and d) occupational health. The analysis of such examples address the interrelations between science, quality of life, health and environment. It deals with the balance between universal and the particular; between the subject and the object; the articulation between objective and subjective approaches; and the interaction between man and his social, cultural, and environmental context. The examples presented in this paper simultaneously encompass problems from diverse disciplinary fields challenging scientific knowledge fragmentation and its deep divorce from institutional practices and from the population’s real needs, knowledge and experience. The authors reinforce the fragility of reductionism and non-contextualized analysis, in trying to analyse quality of life exclusively through quantification, disregarding how subjectivity is the concept of quality of life. Such concepts, frequently used both by specialists and lay people is marked by imprecision and is still to be discussed in terms of conceptual basis, demanding a constant negotiation of meaning among social actors. The central challenge stressed by the authors is to avoid extremes of relativism, but at the same time to generate analysis grounded in the actual life context, creatively contributing to transformations and broadening of the alternatives for health promotion.

Condições de vida e saúde mental na zona rural de Nova Friburgo - RJ

The aim of this research was to understand the conditions involved in the health-disease process of the rural workers from Nova Friburgo/Rio de Janeiro, studying specifically the complaints referred to as “nervousness” by the inhabitants as well as the related explanations given by them. We applied 102 questionnaires and found 24 complaints reported as “nervousness”.In order to understand the meanings involved in this particular complaint, we only interviewed the inhabitants that had mentioned suffering from “nervousness”. When “nervousness” was interpreted as a genetic inheritance, the options for treatments were diminished as a fatalistic dimension was imbued in their explanations. In other reports we perceived that the dwellers raised relations between the present changes in the socio-cultural environment and the “nervousness” emergence. This other association enables to think of “nervousness” as a non-fatalistic condition, which facilitates the ransom of the authorship of the word, recovered as an original knowledge, therefore allowing for the establishment of a relationship between their own personal history and the acquired illness. In this perspective, we have organized a mutual help group with the local inhabitants.

Comunicação por impressos na saúde do trabalhador: a perspectiva das instâncias públicas

O artigo apresenta os resultados de uma pesquisa que investigou os processos comunicativos mediados por impressos (cartazes, folderes, cartilhas) de instâncias publicas atuantes no binomio saude-trabalho. Objetivamos oferecer subsidios teorico-metodologicos para que a Saude do Trabalhador possa aprimorar as praticas comunicativas em curso. Realizamos a analise de 80 impressos produzidos por cinco instâncias e entrevistas com atores centrais de Programas de Saude do Trabalhador. Verificamos que a segmentacao do publico e raramente abordada pelo polo emissor, que discute simultaneamente uma serie de temas, privilegiando sua propria perspectiva. As intencoes do polo emissor sao as de informar o leitor sobre processo saude-doenca relacionado com o trabalho e orienta-lo quanto a adocao de procedimentos e comportamentos para promocao de saude. Consideramos que o polo emissor apresenta uma concepcao instrumental de comunicacao, fundamentada na transmissao de conhecimentos de forma linear e verticalizada. A saude e discutida de maneira restrita reproduzindo os discursos dos modelos sanitario e biomedico. Concluimos que ha uma tendencia a utilizar os impressos como um fim, o que contribui para demarcar a distância entre os interlocutores no processo comunicativo mediado.

As macropolíticas educacionais e a micropolítica de gestão escolar: repercussões na saúde dos trabalhadores

RESUMO O objetivo do presente artigo e analisar e interpretar as politicas de gestao do trabalho em vigor na rede de educacao publica do Rio de Janeiro, em sua relacao com a saude dos trabalhadores de escolas. Por intermedio de uma pesquisa de base qualitativa, foram entrevistados trabalhadores de doze escolas, sendo as entrevistas interpretadas segundo o enfoque da analise do discurso. As politicas mais citadas pelos entrevistados foram: as politicas administrativas relacionadas a saude dos profissionais da educacao, como a readaptacao funcional e a licenca medica; as politicas relacionadas a praticas pedagogicas, como a politica de aprovacao automatica, o sistema de ciclos e o Programa Nova Escola; e, ainda, as politicas relacionadas ao atual modelo de gestao publica, como a terceirizacao de funcionarios. Constatamos que o paradigma hegemonico de gestao do trabalho em escolas nao tem levado em consideracao o contexto do trabalho onde se efetiva a gestao micropolitica dessa atividade. A partir das entrevistas, verificamos o quanto as macropoliticas educacionais e as medidas governamentais podem ser determinantes das atuais circunstâncias de saude dos profissionais da educacao, sendo necessario um conjunto de medidas para modificar as condicoes e a organizacao do trabalho que sao geradoras de adoecimento, como o desenvolvimento de politicas participativas para diminuir os afastamentos por motivo de saude. Desenvolvemos o argumento de que e preciso conhecer e transformar os efeitos sociais e economicos originados da ausencia de uma macropolitica publica de saude voltada para o trabalho em escolas.

Cross-cultural adaptation of an environmental health measurement instrument: Brazilian version of the health-care waste management • rapid assessment tool

BackgroundPeriodic assessment is one of the recommendations for improving health-care waste management worldwide. This study aimed at translating and adapting the Health-Care Waste Management - Rapid Assessment Tool (HCWM-RAT), proposed by the World Health Organization, to a Brazilian Portuguese version, and resolving its cultural and legal issues. The work focused on the evaluation of the concepts, items and semantic equivalence between the original tool and the Brazilian Portuguese version.MethodsA cross-cultural adaptation methodology was used, including: initial translation to Brazilian Portuguese; back translation to English; syntheses of these translation versions; formation of an expert committee to achieve consensus about the preliminary version; and evaluation of the target audience’s comprehension.ResultsBoth the translated and the original versions’ concepts, items and semantic equivalence are presented. The constructs in the original instrument were considered relevant and applicable to the Brazilian context. The Brazilian version of the tool has the potential to generate indicators, develop official database, feedback and subsidize political decisions at many geographical and organizational levels strengthening the Monitoring and evaluation (M&E) mechanism. Moreover, the cross-cultural translation expands the usefulness of the instrument to Portuguese-speaking countries in developing regions.ConclusionThe translated and original versions presented concept, item and semantic equivalence and can be applied to Brazil