Médicos e terceirização: percepções de trabalhadores e gestores sobre as transformações recentes no mercado de trabalho / Doctors and outsourcing: perceptions of workers and managers on recent transformations in the labor market / Médicos y tercerización: percepciones de trabajadores y directivos sobre los cambios recientes en el mercado laboral

Resumo O artigo examina as tendências recentes da forma de inserção dos médicos no mercado de trabalho à luz da regulação das relações trabalhistas na percepção de informantes-chave que atuam nos setores público e privado do sistema de saúde no estado de São Paulo. O estudo mostrou que, na percepção dos entrevistados, há uma tendência crescente de inserção de médicos como pessoa jurídica condicionada pela regulação das relações de trabalho e pela política de contratação dos estabelecimentos provedores de serviços de assistência à saúde. Em geral, a 'pejotização' de médicos foi associada à perda de autonomia desses profissionais em relação aos termos de contratação e às condições de realização do trabalho. O artigo conclui que a inserção 'pejotizada' de médicos se apresenta como parte do movimento mais geral de barateamento da força de trabalho associado à terceirização, e indica que há espaço para a exploração de políticas voltadas à gestão de trabalhadores que busquem atrair e fixar médicos no Sistema Único de Saúde.

Abstract The article examines recent trends in the way doctors enter the labor market in the light of the regulation of labor relations in the perception of key informants who work in the public and private sectors of the health system in the state of São Paulo, Brazil. The study showed that, in the perception of the interviewees, there is a growing trend of insertion of doctors as a legal entity conditioned by the regulation of labor relations and the contracting policy of establishments providing health care services. In general, the 'pejotização' (hiring free of labor rights/illegal hiring) of doctors was associated with the loss of autonomy of these professionals in relation to the terms of employment and the conditions for performing the work. The article concludes that the illegal hiring and insertion of doctors is presented as part of the more general movement of cheapening the workforce associated with outsourcing, and indicates that there is room for the exploitation of policies aimed at the management of workers who seek to attract and fix doctors in the Unified Health System.

Resumen El artículo examina las tendencias recientes acerca de como se dá la inserción de los médicos en el mercado de trabajo, a la luz de la regulación de las relaciones laborales, en la percepción de informantes clave que actúan en los sectores público y privado del sistema de salud del estado de São Paulo, Brasil. El estudio mostró que, en la percepción de los entrevistados, existe una tendencia creciente hacia la inclusión de los médicos como persona jurídica condicionada por la regulación de las relaciones laborales y por la política de contratación de los establecimientos que prestan servicios de asistencia a la salud. En general, la 'pejotización' de los médicos estuvo asociada a la pérdida de autonomía de estos profesionales en relación a los términos de contratación y a las condiciones de ejercicio del trabajo. El artículo concluye que la inserción 'pejotizada' de los médicos se presenta como parte del movimiento más general de abaratamiento de la mano de obra asociado a la tercerización, e indica que hay espacio para la exploración de políticas dirigidas a la gestión de trabajadores que busquen atraer y retener a los médicos en el Sistema Único de Salud.

Social Sciences in One Health: Insights From Multiple Worlds Perspectives on the Dam Rupture in Brumadinho-Brazil.

Concepts that integrate human, animal, and ecosystem health - such as One Health (OH) - have been highlighted in recent years and mobilized in transdisciplinary approaches. However, there is a lack of input from the social sciences in OH discussions. This is a gap to overcome, including in Latin America. Therefore, this paper incorporates recent studies from economics and anthropology to the debate, contributing to the opening of transdisciplinary dialogues for the elaboration of OH theory and practice. As a starting point, we explore the recent case of a tailings dam breach, making considerations about how and why this event was experienced in different ways by the affected Indigenous and non-Indigenous worlds. From economics, we show how different theories perceive and impact these different worlds, presenting some existing alternatives to the hegemonic thinking of domination and exploitation. From anthropology, we present the perspectivism concept, deriving from the field of relational ontologies, suggesting there are significant and inevitable disagreements-equivocations-among different worlds. Thus, we discuss how the social sciences can help address challenging factors that need to be considered in health approaches that intend to deal with complex global problems. In conclusion, OH should incorporate social science discussions, considering relating practice to the multiple realities in which a particular problem or conflict is inserted. Overcoming the barriers that hinder transdisciplinary dialogue is fundamental and urgent for an effective approach to the multiple and distinct interconnections among humans, animals and environments.

Can sterilization help to prevent roaming in owned dogs and cats?

In many locations, the highest proportion of roaming dogs and cats, might have owners. The prevention of roaming in owned dogs and cats is a key intervention to reduce the number of unsupervised animals in public spaces. Sterilization is an important population management intervention but it is unclear if, apart from its effects on birth rates and animal behavior, it also affects the roaming status of owned dogs and cats. We formulated a directed acyclic graph to represent a causal hypothesis regarding the effect of sex, age and sterilization on roaming behavior in owned dogs and cats. The causal hypothesis was tested using survey data and Bayesian multilevel logistic regressions. The odds of roaming were lower in sterilized dogs and cats but the credible interval (CI) supported the effect of sterilization only for dogs. The odds of roaming were higher in both male dogs and cats and the CI supported the effect of sex. The CI did not support the effect of age on roaming, irrespective of species. If the observed association between sterilization and roaming was causal, then sterilization may contribute to a reduction in roaming. Studies on other populations and the exploration of other potential determinants of roaming are required to better understand the causal relationship between sterilization and roaming.