O presente estudo teve como objetivo descrever e analisar relatos de jovens aprendizes e estagiários sobre condições de trabalho, escola e saúde após ingresso no primeiro emprego. Foram utilizados diferentes instrumentos para a coleta de dados. Os dados qualitativos foram obtidos por meio de entrevistas individuais e coletivas com roteiro semi-estruturado. As análises desses dados foram realizadas a partir da metodologia de análise de conteúdo. Foi aplicado um questionário para a obtenção dos dados sócio-demográficos, condições de saúde, sono, hábitos e estilos de vida. Esses dados foram tabulados em planilhas ExcelTM. Participaram deste estudo quarenta jovens, aprendizes e estagiários, entre 14 e 20 anos, que trabalhavam há pelo menos seis meses, em diferentes setores e ramos de empresas, com jornada entre seis e oito horas diárias de trabalho. Todos os participantes estudavam no período noturno, curso técnico, ensino médio, ou faculdade e que, concomitantemente ao estudo e trabalho, frequentavam os programas de aprendizagem e estágio em uma Organização Não Governamental situada na zona Sul de São Paulo, capital. Os resultados desse estudo apontam o ingresso de adolescentes no trabalho cada vez mais cedo em busca de melhores condições financeiras para si e para família. Os jovens relataram passar por muitos desafios para conciliar as atividades pessoais, profissionais e acadêmicas. A extensa jornada diária de trabalho somada ao período de estudo noturno comprometeu, na maioria dos casos, o desempenho acadêmico e a saúde dos participantes. Os principais fatores prejudiciais à saúde relatados pelos jovens foram: falta de tempo para dormir, para se alimentar adequadamente, para praticar atividade física e a redução do tempo de lazer e convívio social com amigos e família. Os aprendizes e estagiários também mencionaram a falta de treinamento e o desconhecimento da legislação pertinente ao seu trabalho como fatores que contribuíram para as dificuldades apresentadas nos relatos sobre a realização de suas atividades laborais, na identificação de acidentes e doenças relacionadas com o trabalho / This study aimed to describe and analyze reports of young apprentices and trainees on employment conditions, health and school after entering the first job. Different instruments were employed for data collection. Qualitative data were collected through individual and collective interviews with a semi-structured interview. The data analyzes were performed using the content analysis methodology. A questionnaire was applied to obtain the socio-demographic data, health status, sleep habits and lifestyles. Data were tabulated in ExcelTM spreadsheets. The study included forty young people, apprentices and trainees, ranging from 14 to 20 years old, who worked for at least six months in different sectors and branches of companies, with journey between six and eight hours of work. All participants studied in the evening, technical course, high school or college and, simultaneously to study and work, attending learning programs and educational work in an NGO located in the south of Sao Paulo, Brazil. The results of this study showed that getting better financial conditions for themselves and their families were the major reasons for start working earlier. One of the major challenges faced by the participants was dealing with work concomitantly to personal and academic activities. Long daily working hours in addition to the period of study undertaken at night had, in most cases, a reflex, upon academic performance and health of the participants. The main factors detrimental to health reported were: lack of time for sleeping, eating properly, for physical activity and for recreation and socializing with friends and family. Apprentices and trainees also have mentioned the lack of training, and/or not knowing the legislation regarding to their work as the main factors related to the difficulties for doing their task properly, identification of illnesses and work-related accidents

This thesis focuses on the findings of sex workers provided services in the Czech Republic and especially in the capital city Prague. It describes the different types of service, defines prostitution, its legislative basis, the historical development of approaches to the problems, and also theoretical approaches in social work focusing on the matching needs and service contracts. The practical part is then implemented survey among sex workers and district social workers. It aims to identify problem areas of sex workers, whether services adequately respond to them, or what service is in the list of missing. Finally, respondents' answers are evaluated from both groups and to create hypotheses about the "state service" and to draw the possible outcomes for practice. Keywords Prostitution, sex workers, social and health services, social work, matching.

<p>Background: Globally, neonatal mortality (i.e. deaths occurring during the first month of life) accounts for 44% of the 11 million infants that die every year (Lawn, Cousens &amp / Zupan, 2005). Early&nbsp / detection of illness and referral of mothers and infants during the peri-natal period to higher levels of care can lead to substantial reductions in maternal and child mortality in developing&nbsp / countries. Establishing effective referral systems from the community to health facilities can be achieved through greater utilization of community health workers and improved health seeking&nbsp / behaviour. Study design: The Good Start Saving Newborn Lives study being conducted in Umlazi, KwaZulu-Natal, is a community randomized trial to assess the effect of an integrated home&nbsp / visit package delivered to mothers during pregnancy and post delivery on uptake of PMTCT interventions and appropriate newborn care practices. The home visit package is delivered by community health workers in fifteen intervention clusters. Control clusters receive routine health facility antenatal and postpartum care. For any identified danger signs during a home visit,&nbsp / community health workers write a referral and if necessary refer infants to a local clinic or hospital. The aim of this study was to assess the effectiveness of this referral system by describing&nbsp / community health worker referral completion rates as well as health-care seeking practices and perceptions of mothers. A cross- sectional survey was undertaken using a structured&nbsp / questionnaire with all mothers who had been referred to a clinic or hospital by a community health worker since the start of the Good Start Saving Newborn Lives Trial. Data collection: Informed consent was obtained from willing participants. Interviews were conducted by a trained research assistant in the mothers&rsquo / home or at the study&nbsp / offices. Road to Health Cards were reviewed to confirm referral completion. Data was collected by means of a cell phone (mobile researcher software) and the database was later transferred to Epi-info and STATA IC 11 for analysis.&nbsp / Descriptive analysis was&nbsp / conducted so as to establish associations between explanatory factors and referral completion and to describe referral processes experienced by caregivers. Significant&nbsp / associations between categorical variables were assessed using chi square tests and continuous variables using analysis of variance. Results: A total of 2423 women were&nbsp / enrolled in the SNL study and 148 had received a referral for a sick infant by a CHW by June 2010. The majority (95%) of infants were referred only once during the time of enrolment, the&nbsp / highest number of which occurred within&nbsp / the first 4 weeks of life (62%) with 22% of these being between birth and 2 weeks of age. Almost all mothers (95%) completed the referral by taking&nbsp / their child to a health facility. Difficulty in breathing and rash accounted for the highest number of referrals (26% and 19% respectively). None of the six mothers who did not complete referral recognised any danger signs in their infants. In only 16% of cases did a health worker give written feedback on the outcome of the referral to the referring CHW.&nbsp / Conclusion: This study found&nbsp / high compliance with referrals for sick infants by community health workers in Umlazi. This supports the current primary health care re-engineering process being undertaken by the South&nbsp / African National Department of Health (SANDOH) which will involve the establishment of family health worker teams&nbsp / including community health workers. A key function of these workers will&nbsp / be to conduct antenatal and postnatal visits to women in their homes and to identify and refer ill children. Failure of mothers to identify danger signs in the infant was associated with&nbsp / non-completion of referral. This highlights the need for thorough counseling of mothers during the antenatal and early postnatal period on neonatal danger signs which can be reinforced by&nbsp / community health workers. Most of the referrals in this study were&nbsp / neonates which strengthens the need for home visit packages delivered by community health workers during the antenatal&nbsp / and post-natal period as currently planned by the South African National Department of Health.Recommendations: This study supports the current plans of the Department of Health for greater involvement of CHWs in Primary Health Care. Attention should be given to improving communication between health facilities and CHWs to ensure continuity of care and greater&nbsp / realization of a team approach to PHC.</p>

<p>Background: Globally, neonatal mortality (i.e. deaths occurring during the first month of life) accounts for 44% of the 11 million infants that die every year (Lawn, Cousens &amp / Zupan, 2005). Early&nbsp / detection of illness and referral of mothers and infants during the peri-natal period to higher levels of care can lead to substantial reductions in maternal and child mortality in developing&nbsp / countries. Establishing effective referral systems from the community to health facilities can be achieved through greater utilization of community health workers and improved health seeking&nbsp / behaviour. Study design: The Good Start Saving Newborn Lives study being conducted in Umlazi, KwaZulu-Natal, is a community randomized trial to assess the effect of an integrated home&nbsp / visit package delivered to mothers during pregnancy and post delivery on uptake of PMTCT interventions and appropriate newborn care practices. The home visit package is delivered by community health workers in fifteen intervention clusters. Control clusters receive routine health facility antenatal and postpartum care. For any identified danger signs during a home visit,&nbsp / community health workers write a referral and if necessary refer infants to a local clinic or hospital. The aim of this study was to assess the effectiveness of this referral system by describing&nbsp / community health worker referral completion rates as well as health-care seeking practices and perceptions of mothers. A cross- sectional survey was undertaken using a structured&nbsp / questionnaire with all mothers who had been referred to a clinic or hospital by a community health worker since the start of the Good Start Saving Newborn Lives Trial. Data collection: Informed consent was obtained from willing participants. Interviews were conducted by a trained research assistant in the mothers&rsquo / home or at the study&nbsp / offices. Road to Health Cards were reviewed to confirm referral completion. Data was collected by means of a cell phone (mobile researcher software) and the database was later transferred to Epi-info and STATA IC 11 for analysis.&nbsp / Descriptive analysis was&nbsp / conducted so as to establish associations between explanatory factors and referral completion and to describe referral processes experienced by caregivers. Significant&nbsp / associations between categorical variables were assessed using chi square tests and continuous variables using analysis of variance. Results: A total of 2423 women were&nbsp / enrolled in the SNL study and 148 had received a referral for a sick infant by a CHW by June 2010. The majority (95%) of infants were referred only once during the time of enrolment, the&nbsp / highest number of which occurred within&nbsp / the first 4 weeks of life (62%) with 22% of these being between birth and 2 weeks of age. Almost all mothers (95%) completed the referral by taking&nbsp / their child to a health facility. Difficulty in breathing and rash accounted for the highest number of referrals (26% and 19% respectively). None of the six mothers who did not complete referral recognised any danger signs in their infants. In only 16% of cases did a health worker give written feedback on the outcome of the referral to the referring CHW.&nbsp / Conclusion: This study found&nbsp / high compliance with referrals for sick infants by community health workers in Umlazi. This supports the current primary health care re-engineering process being undertaken by the South&nbsp / African National Department of Health (SANDOH) which will involve the establishment of family health worker teams&nbsp / including community health workers. A key function of these workers will&nbsp / be to conduct antenatal and postnatal visits to women in their homes and to identify and refer ill children. Failure of mothers to identify danger signs in the infant was associated with&nbsp / non-completion of referral. This highlights the need for thorough counseling of mothers during the antenatal and early postnatal period on neonatal danger signs which can be reinforced by&nbsp / community health workers. Most of the referrals in this study were&nbsp / neonates which strengthens the need for home visit packages delivered by community health workers during the antenatal&nbsp / and post-natal period as currently planned by the South African National Department of Health.Recommendations: This study supports the current plans of the Department of Health for greater involvement of CHWs in Primary Health Care. Attention should be given to improving communication between health facilities and CHWs to ensure continuity of care and greater&nbsp / realization of a team approach to PHC.</p>

While agricultural work is hazardous for all workers, migrant workers face additional challenges that make them more vulnerable than domestic workers. The lack of access to permanent immigration status in the Seasonal Agricultural Worker Program (SAWP) and the agricultural stream of the Temporary Foreign Workers Program (TFWP) makes workers’ jobs hinge on retaining their employers’ favour and creates a particular type of job insecurity that overshadows their behaviour, decisions, and agency to assert their rights for safe and healthy workplaces and workers’ compensation. While researchers argue that the TFWP competes with the SAWP as employers search for the cheapest and most docile workers, less research has examined whether workers’ health and safety exposures and experiences differ within the two programs. Drawing primarily from interviews with advocates and system stakeholders and participant observation at advocate-organized events, this research will offer preliminary answers to discovering whether the programs pose different obstacles to improving health and safety and access to compensation that affect migrant workers’ experiences in Ontario before and after injury. The research will help gather information about possible avenues to improve the health and safety of migrant workers given how the two programs operate within both federal and provincial frameworks. Advocates’ experience assisting workers in both programs offers important insights about whether differences between the programs create particular vulnerabilities for some migrant workers. / Thesis / Master of Arts (MA) / This research identifies opportunities and barriers that migrant agricultural workers and their advocates face in improving occupational health and safety and access to workers' compensation in the Seasonal Agricultural Workers Program (SAWP) and the agricultural stream of the Temporary Foreign Workers Program (TFWP). Through semi-structured interviews, participant observation, and document review, the research will help identify whether interplay between the programs causes additional vulnerabilities for some workers. The research will help gather information about possible avenues to improve the health and safety of migrant workers given how the two programs operate in a federal and provincial framework.

Submitted by Guilherme Marini Perpétua null (geomarini@yahoo.com.br) on 2016-11-29T18:54:10Z No. of bitstreams: 1 Tese_Guilherme Marini Perpetua_Final.pdf: 7304127 bytes, checksum: 19caede8e6f62b2963332efe102acb12 (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-12-02T14:58:47Z (GMT) No. of bitstreams: 1 perpetua_gm_dr_prud.pdf: 7304127 bytes, checksum: 19caede8e6f62b2963332efe102acb12 (MD5) / Made available in DSpace on 2016-12-02T14:58:47Z (GMT). No. of bitstreams: 1 perpetua_gm_dr_prud.pdf: 7304127 bytes, checksum: 19caede8e6f62b2963332efe102acb12 (MD5) Previous issue date: 2016-11-16 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O presente trabalho teve como objetivo compreender o processo de territorialização recente da produção de celulose associada ao monocultivo arbóreo (eucalipto) no Brasil, com ênfase em suas implicações para a segurança e a saúde dos trabalhadores(as). Com este intuito, foram analisados os mais novos megaempreendimentos do segmento no país, localizados em diferentes espaços regionais (Extremo Sul da Bahia, Oeste do Maranhão e Nordeste de Mato Grosso do Sul), os quais compuseram o recorte empírico da pesquisa. Em termos metodológicos, a pesquisa buscou combinar o uso de procedimentos quantitativos (levantamento e análise de dados secundários) àqueles de natureza qualitativa (análise documental, diário de campo, entrevistas semiestruturadas), de modo a considerar os aspectos estruturais sem deixar de enfocar o papel exercido pelos sujeitos sociais concretos. Os resultados alcançados permitem defender a tese de que, em função de suas características estruturais inerentes e nos moldes atuais, a produção de celulose só pode se dar na exata medida em que for capaz de se apropriar e exercer controle vertical e autoritário sobre territórios contíguos e de grande extensão, de modo a fruir de maneira monopolista dos recursos existentes. Para tanto, o capital tem lançado mão de uma estratégia deliberada e sistemática composta por um conjunto de táticas que, observadas à luz do materialismo dialético, revelam a combinação entre distintas formas de acumulação (primitiva, por espoliação e ampliada), dando corpo ao que chamamos de pilhagem territorial. Além da escassa geração de empregos mal remunerados e instáveis, para os trabalhadores o resultado não poderiam ser outro senão um trabalho visceralmente precário e degradante, contraditoriamente e até certa medida adequado às exigências de mercado (certificações internacionais) conformadoras das políticas internas de saúde e segurança do trabalho das grandes corporações do segmento. Tudo isso, no período analisado, foi ampla e generosamente assegurado de diversas formas (concessão de financiamentos, incentivos fiscais, investimentos em infraestrutura, flexibilização da legislação ambiental etc.) pelo modelo novo-desenvolvimentista fundado num verdadeiro pacto conciliatório de classes e adotado pelos governos do Partido dos Trabalhadores. / This study aimed to understand the recent territorialization process of pulp production associated to tree monoculture (eucalyptus) in Brazil, with emphasis on the implications for the safety and health of workers. To this end, the newest mega-enterprises of the segment in the country were analyzed, located in different regional areas (southernmost Bahia, West Maranhao and Northeast of Mato Grosso do Sul), which formed the empirical object of the research. In terms of methodology, the research sought to combine the use of quantitative procedures (survey and analysis of secondary data) to those of a qualitative nature (document analysis, field diary, semi-structured interviews), in order to consider the structural aspects while focusing on the role of concrete social subjects. The results obtained allow to make the case that, due to their inherent structural characteristics and current patterns, pulp production can only take place on the exact extent that it is able to appropriate and exert vertical and authoritarian control over contiguous territory and large extension, in order to enjoy the existing resources in a monopolist mode. Thus, the capital has made use of a deliberate and systematic strategy consisting of a set of tactics that, seen in the light of dialectical materialism, reveal the combination of different forms of accumulation (primitive by dispossession and expanded), forming what we called territorial plunder. In addition to the low generation of low-paid and unstable jobs to workers the result could not be other than a viscerally precarious and degrading, contradictory and even to a certain extent appropriate to market demands (international certifications) conforming internal health and safety policies of work of the large corporations of the segment. All this, in the analyzed period, was widely and generously provided in various forms (funding grant, tax incentives, infrastructure investments, easing of environmental legislation etc.) by the new development model based on a true conciliatory pact of classes and adopted by governments of the Workers' Party. / Este estudio tuvo como objetivo comprender el reciente proceso de territorialización de la producción de pulpa asociado con monocultivos de árboles (eucaliptos) en Brasil, con énfasis en sus implicaciones para la seguridad y salud de los trabajadores. Con este fin, se analizaron las mega-empresas más recientes del segmento en el país, que se encuentra en diferentes áreas regionales (extremo sur de Bahia, oeste de Maranhão y noreste de Mato Grosso do Sul), que formaron el objeto empírico de la investigación. En cuanto a la metodología, la investigación trató de combinar el uso de procedimientos cuantitativos (encuestas y análisis de datos secundarios) a los de carácter cualitativo (análisis de documentos, diario de campo, entrevistas semiestructuradas), a fin de considerar los aspectos estructurales mientras se centra en el papel ejercido por los sujetos sociales concretos. Los resultados obtenidos permiten defender la tesis de que, debido a sus características estructurales inherentes y los patrones actuales, la producción de pasta sólo puede ocurrir a la medida exacta que es capaz de apropiarse y ejercer el control vertical y autoritario sobre territorios contiguos y de gran extensión, con el fin de disfrutar de manera monopolista de los recursos existentes. De este modo, el capital ha usado una estrategia deliberada y sistemática compuesta de un conjunto de tácticas que, visto a la luz del materialismo dialéctico, revelan la combinación de diferentes formas de acumulación (primitivas por desposesión y ampliada), dando cuerpo a lo llamamos despojo territorial. Además de la baja generación de puestos de trabajo con salarios bajos e inestables a los trabajadores, el resultado no podría ser otro que un trabajo visceralmente precario y degradante, contradictoriamente y hasta cierto punto adecuado a los requisitos del mercado (certificaciones internacionales) conformadoras de las políticas de salud y seguridad del trabajo de las grandes corporaciones del segmento. Todo esto, en el período analizado, fue ampliamente y generosamente verificado de diversas formas (subvenciones, incentivos fiscales, inversiones en infraestructuras, flexibilización de la legislación ambiental, etc.) por el nuevo modelo de desarrollo basado en un verdadero pacto de conciliación de clases y adoptado por los gobiernos del Partido de los Trabajadores. / FAPESP: 2013/04638-0

Questa tesi include tre capitoli che si concentrano sulle politiche pubbliche e la tutela della salute. Il primo capitolo esamina l’effetto dell’incremento delle aliquote dell’IVA su alcune bevande sul loro consumo. I risultati dell’analisi empirica suggeriscono che l'aumento dell'aliquota IVA ha ridotto il consumo di alcolici, birra e bevande gassate, mentre l’effetto sul consumo di vino non è statisticamente significativo. Tuttavia, questo risultato generale cambia se si considerano sotto-gruppi di individui. Il secondo capitolo studia l’impatto del salario minimo sulla salute della popolazione cinese. Le stime indicano che i salari minimi reali sono negativamente e significativamente correlati con lo stato di salute della popolazione sia nel breve che nel lungo periodo, un risultato che potrebbe essere spiegato dalle condizioni di lavoro più stressanti conseguenti all’introduzione di un salario minimo più elevato. Infine, il terzo capitolo analizza gli effetti dei meccanismi di incentivazione sui comportamenti degli operatori sanitari del settore delle cure primarie nell’ambito della gestione dell'ipertensione. La nostra indagine empirica suggerisce che gli incentivi finanziari negativi potrebbero motivare gli operatori sanitari a migliorare la qualità dei servizi legati alla gestione dell'ipertensione, mentre né gli incentivi finanziari né diverse modalità di valutazione delle prestazioni sembrano influenzare la qualità dei servizi. / This dissertation includes three chapters which focus on the relationship between public policies and healthcare. The first chapter examines whether tax policy is effective in changing the unhealthy drinking behaviours of individuals. My findings suggest that the VAT rate increase is effective in reducing the consumption of spirits, beer and carbonated beverages, while it is not effective for wine. However, this general result change when looking at sub-groups of individuals. The second chapter studies how real minimum wages affect population health in China. I conclude that real minimum wages are negatively and significantly related to population health, a result which might be explained by the role of more stressful working conditions as a consequence of a higher minimum wage. Finally, the third chapter analyses the effects of incentive mechanisms on the behaviours of primary health workers and the subsequent effects on the quality of hypertension management. The empirical investigation suggests that negative financial incentives could motivate primary health workers and improve the quality of hypertension management. However, neither positive financial incentives nor different modes of performance evaluation are significantly related to the quality of hypertension management.

All governments aim to ensure better health and nutrition to children. The Rajasthan state (India) has implemented a unique frontline coordination model where Accredited Health Social Activist (ASHA) Sahyoginis are expected to support two other frontline workers (FLWs) i.e. the Anganwadi Workers from the Integrated Child Development Services and the Auxiliary Nurse Midwives from the Health department to improve child health. This thesis focuses on examining the existing coordination between the three groups of FLWs in Rajasthan by exploring FLWs' participation in child immunisation and Vitamin A supplementation (two common activities), service coverage and beneficiary's' knowledge (expected outcomes), and the challenges faced and areas that need improvement for better frontline coordination. A mixed methods design was used. Sixteen villages from two blocks (tribal and non-tribal) of Udaipur district (Rajasthan) were selected using multistage purposive sampling. The formative stage included 12 FLWs' in-depth interviews (IDIs) as well as a review of FLWs' job descriptions to understand the process and government expectations on their participation in routine childhood immunisation, polio camps, routine Vitamin A supplementation and Vitamin A campaigns. The next stage included data collection from the 16 selected villages i.e. structured questionnaire survey of FLWs (46), observations of Maternal and Child Health and Nutrition Day (16), review of FLWs' immunisation and Vitamin A registers (32) and a structured questionnaire survey of registered infants' mothers (321)-all to ascertain the actual participation of FLWs in these four activities and the outcomes. IDIs with FLWs (46) and FLWs' line managers (17) were conducted to understand their experience, issues and solutions for better frontline coordination. The participation of FLWs in three of the four activities (except Polio Camps) was found to be limited. The FLWs and their line managers were also dissatisfied with coordination between FLWs. Poor outcomes also indicated unsatisfactory coordination. Overall, frontline participation and outcomes were better in tribal than non-tribal villages. A variety of factors (i.e. personal, professional, organisational, and geo-socio-cultural) appeared to affect coordination between FLWs. Appropriate recruitment, training, monitoring and supervision and rewards to the FLWs along with greater political commitment for coordinated approached and addressing intra-departmental challenges are proposed to improve frontline coordination and child health in Rajasthan.

Submitted by SBI Biblioteca Digital (sbi.bibliotecadigital@puc-campinas.edu.br) on 2017-04-12T18:25:43Z No. of bitstreams: 1 HELOISA APARECIDA DE SOUZA.pdf: 1392683 bytes, checksum: 48e5ce3f21710277540177f37dd97013 (MD5) / Made available in DSpace on 2017-04-12T18:25:43Z (GMT). No. of bitstreams: 1 HELOISA APARECIDA DE SOUZA.pdf: 1392683 bytes, checksum: 48e5ce3f21710277540177f37dd97013 (MD5) Previous issue date: 2017-04-21 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Despite extensive evidence that the current working conditions can lead to mental exhaustion and illness among workers, public policies that specifically address this issue are still limited and ineffective in Brazil. Although there is no protocol to follow, there are many public health professionals who are concerned about the increase in work-related mental disorders. This thesis evaluated healthcare professionals working in the Sistema ?nico de Sa?de (SUS, Brazilian Unified Health System) seeking to investigate their conceptions and actions that are aimed at reducing and preventing mental health problems related to working conditions. This is a Work-related Mental Health qualitative research based on the ?theme-field? concept, in which the field is not a predetermined physical space, and dialogues and social interactions are used to address the topic investigated. The ?theme-field? approach was used by carrying out a document analysis, participating in different spaces and events, making contacts, and conducting interviews with several professionals in different health services provided by the SUS. Information gained by experience and observation was documented in a field diary; the interviews were recorded and transcribed. The material was analyzed based on the hermeneutic dialectic process. The results obtained reveal the importance of healthcare professionals? ethical and political commitment to carrying out actions that contribute to the protection of workers? subjectivity and to the development and implementation of public policies addressing this problem. Among the various possibilities of actions carried out in the public health system are those aimed at providing care, making referrals, preventing work-related mental exhaustion, promoting mental health in the workplace, encouraging workers to organize a resistance movement against mental illness, and investigating the association between mental illness and working conditions. The present study also discusses the challenges to the adoption of practices to promote mental health of workers who use the services provided by the SUS, the importance of solid and permanent education of healthcare professionals, and the role of psychology in actions aimed at protecting workers' mental health. / Apesar de las numerosas evidencias de que las condiciones de trabajo en la actualidad generan desgaste y enfermedad mental en los trabajadores, las pol?ticas p?blicas que abordan espec?ficamente dicha tem?tica todav?a son fr?giles en Brasil. Sin embargo, a?n sin un protocolo de acci?n que los oriente, existen muchos profesionales de la red p?blica de salud que son sensibles al aumento de los casos de enfermedad ps?quica relacionada con el trabajo. Esos profesionales son los protagonistas de esta tesis, que tiene como objetivo general analizar las concepciones y acciones de trabajadores del Sistema ?nico de Salud (SUS) que conllevan al enfrentamiento de los perjuicios a la salud mental relacionados a las condiciones de trabajo. Se trata de una investigaci?n cualitativa, situada en el campo de la Salud Mental Relacionada con el Trabajo (SMRT) y basada en la concepci?n de campo-tema, que no elige un lugar delimitado, buscando, a trav?s de di?logos e interacciones sociales, una leg?tima aproximaci?n con el tema estudiado. De esta forma, la inserci?n en el campo-tema se dio mediante el an?lisis de documentos, participaci?n en distintos espacios y eventos, contacto y entrevistas com diversos profesionales de diferentes servicios del SUS. Las observaciones y vivencias en el transcurso de la investigaci?n fueron registradas en diario de campo y las entrevistas fueron grabadas y transcritas. Todo ese material fue analizado apoy?ndose en la propuesta de la hermen?utica-dial?ctica. Los resultados de la investigaci?n revelan la importancia del compromiso ?tico y pol?tico de los profesionales de la salud con la realizaci?n de acciones que contribuyen a la protecci?n de la subjetividad de los trabajadores y a la necesidad de consolidar pol?ticas p?blicas que aborden el asunto. Entre las diferentes posibilidades de actuaciones realizadas en la red p?blica de salud, se destacan aquellas que propenden al atendimiento, remisi?n y prevenci?n de los casos de desgaste mental relacionados com el trabajo, as? como las acciones de promoci?n de la salud ps?quica en el ambiente de trabajo, el est?mulo a la resistencia de los trabajadores y el establecimiento de la relaci?n entre la enfermedad mental y las condiciones laborales. Asimismo, la investigaci?n tambi?n discute los desaf?os para la constituci?n de pr?cticas orientadas a la salud mental de los trabajadores del SUS, la importancia de la formaci?n inicial y permanente de los profesionales de la salud y el papel de la Psicolog?a en las acciones dirigidas a la protecci?n de la salud mental de los trabajadores. / Apesar das in?meras evid?ncias de que as situa??es de trabalho na atualidade geram desgaste e adoecimento mental nos trabalhadores, as pol?ticas p?blicas que abordam especificamente essa tem?tica ainda s?o fr?geis no Brasil. Entretanto, mesmo sem um protocolo de a??o que os oriente, existem muitos profissionais da rede p?blica de sa?de que s?o sens?veis ao aumento dos casos de adoecimento ps?quico relacionado ao trabalho. Esses profissionais s?o os protagonistas desta tese, que possui o objetivo geral de analisar as concep??es e as a??es de trabalhadores do Sistema ?nico de Sa?de (SUS) que visam ao enfrentamento do adoecimento mental relacionado ao trabalho. Trata-se de uma pesquisa qualitativa, situada no campo da Sa?de Mental Relacionada ao Trabalho (SMRT) e baseada na concep??o de campo-tema, que n?o elege um lugar delimitado, buscando, por meio de di?logos e intera??es sociais, uma genu?na aproxima??o com o tema estudado. Assim, a inser??o no campo-tema se deu por meio de an?lise de documentos, participa??o em diferentes espa?os e eventos, contatos e entrevistas com diversos profissionais inseridos em diferentes servi?os do SUS. As observa??es e vivencias no decorrer da pesquisa foram registradas em di?rio de campo e as entrevistas foram gravadas e transcritas. Todo esse material foi analisado apoiando-se na proposta da hermen?utica-dial?tica. Os resultados da pesquisa revelam a import?ncia do comprometimento ?tico e pol?tico dos profissionais da sa?de com a realiza??o de a??es que contribuam para a prote??o da subjetividade dos trabalhadores e para a necessidade de consolida??o de pol?ticas p?blicas que abordam o assunto. Entre as diferentes possibilidades de atua??es realizadas na rede p?blica de sa?de, destacam-se aquelas que visam ao atendimento, ao encaminhamento e ? preven??o dos casos de desgaste mental relacionados ao trabalho, bem como as a??es de promo??o da sa?de ps?quica no ambiente de trabalho, o est?mulo ? resist?ncia dos trabalhadores e o estabelecimento de rela??o entre o adoecimento mental e as situa??es laborais. A pesquisa discute ainda os desafios para o estabelecimento de pr?ticas que visam ? sa?de mental dos trabalhadores no SUS, a import?ncia da forma??o inicial e permanente dos profissionais da sa?de e o papel da Psicologia nas a??es que t?m o objetivo de proteger a sa?de mental dos trabalhadores.

Made available in DSpace on 2016-04-29T14:16:15Z (GMT). No. of bitstreams: 1 Maria da Conceicao Clarindo Cavalcante da Silva.pdf: 1331053 bytes, checksum: c7d86511bd9938c62b2e60790e811239 (MD5) Previous issue date: 2012-08-27 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This thesis aims to investigate and analyze the health of the Public Servant and the Integral Health Care Politics to Federal Public Servants (IHCPFPS) concerning these Servants developed by the Reference Unit of Integral Health Care Subsystem of Servants, deployed at the Federal University of Alagoas (Ufal), responsible for health actions directed to the Public Servants and recommended byIHCPFPS. To investigate and analyze the situations of health and work social conditions to which public servants are exposed in the Brazilian state apparatus, placed in the University Hospital Professor Alberto Antunes (Hupaa) of that university. Because it is a social category fragmented and stratified hierarchy of dominant and dominated the working class, was selected one of the positions with which the research would be developed. It was used as a parameter for the selection of social subjects, those who needed most to be absent at work due to health issues, therefore they have health issues and diseases. Assistants and Nurses fromUniversity Hospital - hupaa-Ufal- were interviewed. The socioeconomic and cultural profiles of these workerswere designed as well as it was found what are the possibilities of their role as a social determinant in the effectiveness of the IHCPFPS, so as to promote changes in social relations of work, overcoming the precarious conditions and present subalternity. Suggestions are presented to effect a policy which focus on labor relations and the participation of these workers. Without a leading role, it is concluded that the State, through the IHCPFPS, will fulfill its role on control the health of the public servants, but their health shall not become effective in its entirety, bringing up the work processes and social determinants, as it means, the social health of the public servant / Esta tese pretende investigar e analisar a saúde do servidor e a Política de Atenção Integral à Saúde do Servidor Público Federal (Pass), desenvolvida pela unidade de Referência do Subsistema Integral de Atenção à Saúde do Servidor Público (Siass), implantada na Universidade Federal de Alagoas (Ufal), responsável pelas ações de saúde direcionadas ao servidor público e preconizadas pela Pass. Conhecer e analisar as situações de saúde e as condições sociais e de trabalho às quais estão expostos os servidores públicos no aparelho do Estado brasileiro, personificado no Hospital Universitário Professor Alberto Antunes (Hupaa) da referida universidade. Por se tratar de uma categoria social fragmentada e hierarquicamente estratificada da classe trabalhadora dominante e dominada, selecionou-se um dos cargos com os quais seria desenvolvida a pesquisa. Utilizou-se como parâmetro, para a escolha desses sujeitos sociais, aqueles que mais necessitam de afastamento do trabalho por licença de saúde e, consequentemente, apresentam agravos e doenças. Chegou-se, então, aos auxiliares e técnicos de enfermagem do Hupaa-Ufal. Traçouse o perfil socioeconômico e cultural desses trabalhadores e verificou-se quais são as possibilidades do seu protagonismo como determinante social na efetivação da Pass, de maneira a promover as transformações nas relações sociais do trabalho, superando as condições precárias e de subalternidade vigentes. Apresentam-se sugestões, para efetivar uma política que tenha centralidade nas relações de trabalho e na participação desses trabalhadores. Sem esse protagonismo, conclui-se que o Estado, por meio da Pass, cumprirá o papel no controle de saúde do servidor, mas a saúde do trabalhador não se efetivará na sua integralidade, trazendo à tona os processos de trabalho e os determinantes sociais, ou seja, a dimensão social da saúde do servidor público