The politics of medical curriculum accreditation : thoughts, not facts?

The medical profession needs to adapt to the socio-political challenges of the 21st century. These have been described as the ‘Health Society’. Medical professionalism, however, is characterised by conservative values that are perpetuated by the professional attributes of autonomy, authority, and state-sanctioned altruism. The medical education enterprise is a replication and continuation of these values, sanctioned by its accreditation agencies. The Australian Medical Council through its accreditation standards only sanctions the formal curriculum. The status quo, however, is maintained by social, cultural and political parameters enmeshed in the informal and hidden curricula. By not addressing informal and hidden value constructs that maintain elitist medical arrogance the accreditation agency fails to uphold its remit. This paper explores the philosophical and empirical bases of these phenomena and illustrates them by means of a case study. Medical education and its sanctioning structure and agency are confirmed as forceful political enterprises. We conclude that explicit review of the informal and hidden curriculum is a feasible and necessary prerequisite for medical education reform and change.

Craft groups: sites of friendship, empowerment, belonging and learning for older women

This article reports on a qualitative research project conducted in Victoria, Australia, with nine older women. The purpose of the research was to explore the women’s experience of involvement in craft groups, and specifically, the impact of this involvement on their sense of well-being. Traditionally the health of older people has been examined in relation to medical markers of physical well-being, and often, decline. We were interested to widen this perspective to understand the impact of social connection, belonging and ongoing learning and development on the ageing experience.

While the focus of the groups was on domestic craftwork, the process of coming together as a collective appeared to have significant bearing on the holistic health of the women involved. Consistent with feminist groupwork literature, the findings indicated that the women we interviewed experienced the group setting as affirming and generative in a number of ways. These include providing an avenue for mutual aid, addressing isolation, affirming individual and collective strength and wisdom, while acquiring new skills, and normalising concerns regarding health and family.

Sex-linked neuroanatomical basis of human altruistic cooperativeness

Human altruistic cooperativeness, one of the most important components of our highly organized society, is along with a greatly enlarged brain relative to body size a spectacular outlier in the animal world. The "social-brain hypothesis" suggests that human brain expansion reflects an increased necessity for information processing to create social reciprocity and cooperation in our complex society. The present study showed that the young adult females (n = 66) showed greater Cooperativeness as well as larger relative global and regional gray matter volumes (GMVs) than the matched males (n = 89), particularly in the social-brain regions including bilateral posterior inferior frontal and left anterior medial prefrontal cortices. Moreover, in females, higher cooperativeness was tightly coupled with the larger relative total GMV and more specifically with the regional GMV in most of the regions revealing larger in female sex-dimorphism. The global and most of regional correlations between GMV and Cooperativeness were significantly specific to female. These results suggest that sexually dimorphic factors may affect the neurodevelopment of these "social-brain" regions, leading to higher cooperativeness in females. The present findings may also have an implication for the pathophysiology of autism; characterized by severe dysfunction in social reciprocity, abnormalities in social-brain, and disproportionately low probability in females.

"Sometimes cathartic. Sometimes quite raw": Benefit and harm in an intimate partner violence trial

 Research on intimate partner violence (IPV) has increased over the past two decades, however empirical research on potential harm to participants is limited. The aim of this study was to assess whether 272 women involved in a general practice based IPV intervention trial (weave) reported more benefit or harm, whether this differed by intervention or comparison group, and what types of benefit and harm were reported. Feedback was obtained via adapted Consequences of Screening Tool, visual analogue scale and open-ended question in baseline, 6-month, 12-month and 24-month surveys (all participants), and semi-structured interviews (subset of 28 participants). Participants in both the intervention and comparison groups tended to respond positively on all quantitative items, although on a number of items, the intervention group responded even more positively. At 6 and 12 months, 51.1% and 54.7% of all participants, respectively, reported their quality of life as becoming better and over 40% of women at each time-point, indicated they felt more positive about themselves as a result of some aspect of their involvement in weave. 42% of all participants reported their home lives becoming less difficult. In qualitative analyses, positive themes identified were altruism, value, evaluation of relationship, validation, self-awareness, empowerment, positive reinforcement, catharsis, motivation to seek help, and response to the research process. Negative themes identified were short-term emotional reactions, long-term emotional reactions, recall, retraumatization and minimization. Many participants indicated short-term negative emotions had been balanced by longer-term positive benefits. Further research is needed regarding characteristics and experiences of the small minority of participants who did not report positive benefit. © 2014 Elsevier Ltd. All rights reserved.

A climate-compatible approach to development practice by international humanitarian NGOs

If current climate-change predictions prove accurate, non-linear change, including potentially catastrophic change, is possible and the environments in which international humanitarian NGOs operate will change figuratively and literally. This paper proposes that a new approach to development is required that takes changing climate into account. This 'climate-compatible approach' to development is a bleak shift from some of the current orthodox positions and will be a major challenge to international humanitarian NGOs working with the most vulnerable. However, it is necessary to address the challenges and context such NGOs face, and the need to be resilient and adaptive to these changes.

Beyond indifferent players: on the existence of prisoners dilemmas in games with amicable and adversarial preferences

Why don’t agents cooperate when they both stand to gain? This question ranks among the most fundamental in the social sciences. Explanations abound. Among the most compelling are various configurations of the prisoner’s dilemma (PD), or public goods problem. Payoffs in PD’s are specified in one of two ways: as primitive cardinal payoffs or as ordinal final utility. However, as final utility is objectively unobservable, only the primitive payoff games are ever observed. This paper explores mappings from primitive payoff to utility payoff games and demonstrates that though an observable game is a PD there are broad classes of utility functions for which there exists no associated utility PD. In particular we show that even small amounts of either altruism or enmity may disrupt the mapping from primitive payoff to utility PD. We then examine some implications of these results.

A influência do capital social e do comportamento de cidadania organizacional na satisfação de vida e desempenho no trabalho: um estudo comparativo entre Brasil e Portugal

Desde à muito, os temas, capital social e comportamento de cidadania organizacional (CCO) têm sido extensivamente pesquisado e estudados nos EUA, no entanto estes têm recebido pouca relevância a nível de outros contextos internacionais. Se por um lado, a sua importância e inferência na performance dentro do contexto empresarial têm sido crescente, caracterizando a necessidade de um entendimento cada vez maior por parte das empresas, por outro, o investimento das corporações de grande porte, caminham cada vez mais em direção dos países com crescimento exponencial sustentado, como são o BRIC, o que cna uma necessidade fomentada de pesquisa nesta área de pesquisa para estas regiões. Este estudo pretendeu investigar, avaliar e mapear a influência do capital e do CCO na satisfação de vida e desempenho no trabalho do funcionário de nível superior, no contexto empresarial brasileiro e português, com o objetivo de identificar quais as diferenças existentes nestes duas realidade, devido ao investimento crescente do segundo para com o primeiro. Genericamente, encontramos clara influência das dimensões do CCO tanto para o desempenho no trabalho como para a satisfação de vida do trabalhador, assim como presença também marcada das duas dimensões do capital Social. Mais especificamente, foi entendido pelo nosso estudo que a realidade empresarial brasileira necessita que as empresas criem mecanismos que fomentem os laços entre colegas, a conscienciosidade, altruísmo e virtude cívica dos seus funcionários, pois assim aumentará o desempenho. Já para o contexto português, apenas a conscienciosidade e a virtude apresentaram significativa relação. Desta forma, conclui-se que para o investimento das empresas português no Brasil, estas precisam ter atenção à dimensão estrutural - relação com colegas - promovendo-a e à necessidade patente que os brasileiros têm de ajudar os seus colegas - comportamento altruísta - para aumentar o desempenho no trabalho. No que se refere a satisfação de vida, que se mostrou estreitamente relacionada com o desempenho, o brasileiro apenas precisa notar confiança nos colegas, senti-se altruísta e consciencioso, ao passo que o português necessita criar fortes laços com os colegas, mas não fomentar o comportamento altruístico. Desta forma as empresas investidoras apenas precisam ter atenção mais uma vez a necessidade de prestar ajuda especifica que o brasileiro sente, promovendo workshops com os próprios funcionários, por forma a estes passarem o seu conhecimento, monitorias, estágios, entre outros. Estes resultados demonstraram que cada continente, país (possuidor ou não da mesma língua) e/ou cultura comporta diferenças significativas no contexto empresarial, assim tornase difícil implementar técnicas e comportamentos internacionais e esperar que os resultados sejam exatamente iguais. Este estudo espera dar alguns instrumentos de comparação para que as empresas portuguesas entendam, a este nível, a realidade brasileira.

Three essays on local demand for public services

Local provision of public services has the positive effect of increasing the efficiency because each locality has its idiosyncrasies that determine a particular demand for public services. This dissertation addresses different aspects of the local demand for public goods and services and their relationship with political incentives. The text is divided in three essays. The first essay aims to test the existence of yardstick competition in education spending using panel data from Brazilian municipalities. The essay estimates two-regime spatial Durbin models with time and spatial fixed effects using maximum likelihood, where the regimes represent different electoral and educational accountability institutional settings. First, it is investigated whether the lame duck incumbents tend to engage in less strategic interaction as a result of the impossibility of reelection, which lowers the incentives for them to signal their type (good or bad) to the voters by mimicking their neighbors’ expenditures. Additionally, it is evaluated whether the lack of electorate support faced by the minority governments causes the incumbents to mimic the neighbors’ spending to a greater extent to increase their odds of reelection. Next, the essay estimates the effects of the institutional change introduced by the disclosure on April 2007 of the Basic Education Development Index (known as IDEB) and its goals on the strategic interaction at the municipality level. This institutional change potentially increased the incentives for incumbents to follow the national best practices in an attempt to signal their type to voters, thus reducing the importance of local information spillover. The same model is also tested using school inputs that are believed to improve students’ performance in place of education spending. The results show evidence for yardstick competition in education spending. Spatial auto-correlation is lower among the lame ducks and higher among the incumbents with minority support (a smaller vote margin). In addition, the institutional change introduced by the IDEB reduced the spatial interaction in education spending and input-setting, thus diminishing the importance of local information spillover. The second essay investigates the role played by the geographic distance between the poor and non-poor in the local demand for income redistribution. In particular, the study provides an empirical test of the geographically limited altruism model proposed in Pauly (1973), incorporating the possibility of participation costs associated with the provision of transfers (Van de Wale, 1998). First, the discussion is motivated by allowing for an “iceberg cost” of participation in the programs for the poor individuals in Pauly’s original model. Next, using data from the 2000 Brazilian Census and a panel of municipalities based on the National Household Sample Survey (PNAD) from 2001 to 2007, all the distance-related explanatory variables indicate that an increased proximity between poor and non-poor is associated with better targeting of the programs (demand for redistribution). For instance, a 1-hour increase in the time spent commuting by the poor reduces the targeting by 3.158 percentage points. This result is similar to that of Ashworth, Heyndels and Smolders (2002) but is definitely not due to the program leakages. To empirically disentangle participation costs and spatially restricted altruism effects, an additional test is conducted using unique panel data based on the 2004 and 2006 PNAD, which assess the number of benefits and the average benefit value received by beneficiaries. The estimates suggest that both cost and altruism play important roles in targeting determination in Brazil, and thus, in the determination of the demand for redistribution. Lastly, the results indicate that ‘size matters’; i.e., the budget for redistribution has a positive impact on targeting. The third essay aims to empirically test the validity of the median voter model for the Brazilian case. Information on municipalities are obtained from the Population Census and the Brazilian Supreme Electoral Court for the year 2000. First, the median voter demand for local public services is estimated. The bundles of services offered by reelection candidates are identified as the expenditures realized during incumbents’ first term in office. The assumption of perfect information of candidates concerning the median demand is relaxed and a weaker hypothesis, of rational expectation, is imposed. Thus, incumbents make mistakes about the median demand that are referred to as misperception errors. Thus, at a given point in time, incumbents can provide a bundle (given by the amount of expenditures per capita) that differs from median voter’s demand for public services by a multiplicative error term, which is included in the residuals of the demand equation. Next, it is estimated the impact of the module of this misperception error on the electoral performance of incumbents using a selection models. The result suggests that the median voter model is valid for the case of Brazilian municipalities.

On the impossibility of prisoner's dilemmas in adversarial preference games

Why don't agents cooperate when they both stand to gain? This question ranks among the most fundamental in the social sciences. Explanations abound. Among the most compelling are various configurations of the prisonerís dilemma (PD), or public goods problem. Payoffs in PDís are specified in one of two ways: as primitive cardinal payoffs or as ordinal final utility. However, as final utility is objectively unobservable, only the primitive payoff games are ever observed. This paper explores mappings from primitive payoff to utility payoff games and demonstrates that though an observable game is a PD there are broad classes of utility functions for which there exists no associated utility PD. In particular we show that even small amounts of either altruism or jealousy may disrupt the mapping from primitive payoff to utility PD. We then examine some implications of these results ñ including the possibility of conflict inducing growth.

Fertility and the value of Life

The value of life methodology has been recently applied to a wide range of contexts as a means to evaluate welfare gains attributable to mortality reductions and health improvements. Yet, it suffers from an important methodological drawback: it does not incorporate into the analysis child mortality, individuals’ decisions regarding fertility, and their altruism towards offspring. Two interrelated dimensions of fertility choice are potentially essential in evaluating life expectancy and health related gains. First, child mortality rates can be very important in determining welfare in a context where individuals choose the number of children they have. Second, if altruism motivates fertility, life expectancy gains at any point in life have a twofold effect: they directly increase utility via increased survival probabilities, and they increase utility via increased welfare of the offspring. We develop a manageable way to deal with value of life valuations when fertility choices are endogenous and individuals are altruistic towards their offspring. We use the methodology developed in the paper to value the reductions in mortality rates experienced by the US between 1965 and 1995. The calculations show that, with a very conservative set of parameters, altruism and fertility can easily double the value of mortality reductions for a young adult, when compared to results obtained using the traditional value of life methodology.

The spenders-hoarders theory of capital accumulations, wealth distribution and fiscal policy

This paper proposes a simple OLG model which is consistent with the essential facts about consumer behavior, capital accumulation and wealth distribution, and yields some new and surprising conclusions about fiscal policy. By considering a society in which individuais are distinguished according to two characteristics, altruism and wealth preference, we show that those who in the long run hold the bulk of private capital are not so rnuch motivated by dynastic altruism as by preference for wealth. Two types of social segmentation can result with different wcalth distribution. To a large extcnt our results seem to fit reality better than those obtained with standard optimal growth models in which dynastic altruism ( or r ate o f impatience) is the only source of heterogeneity: overaccumulation can appear, public debt and unfunded pensions are not neutra!, estate taxation can improve the welfare of the top wealthy.

A relação de amizade nas redes sociais de estudantes universitários de Natal/RN

The basis of sociability in humans is based on cooperation. The relationship of friendship is vital to the social, emotional and cognitive development of an individual and can be understood as a consequence of selection for reciprocal altruism in humans. The period of adulthood is considered very suitable and appropriate for the investigation of the relations of friendship, but the Brazilian literature on friendship in adults is still nascent. Therefore, the objective was to characterize the relationship of friendship among college students. The study gathered 500 students from higher education institutions in the city of Natal-RN, Brazil, and 250 women (average age 24.1 ± 7.66 years) and 250 men (mean age 26.77 ± 9.64 years). Two questionnaires anonymously and individual were applied: a sociodemographic questionnaire and the other with the desired characteristics in idealized friends. Study 1 assessed the degree of importance of characteristics in the process of choosing a friend of the same sex and opposite sex of the participant. Study 2 investigated the relationship between patterns of idealization of friends and self-assessment of participants. Overall, were the preferred characteristics "Companionship" and "Sincerity" to idealized friends. We also found the influence of sex on the characteristics attributed to an female ideal friend, with emphasis on men for "Beauty/Good looks" and "Intelligence" and women to "Companionship" and "Sincerity". Finally, we observed a positive correlation between participants' self-assessment and preferences for the characteristics of the friends devised. This study revealed important elements for understanding the relationship of friendship, specifically the process of choosing friends. The results reinforce the importance of studying the relationship of friendship to a better understanding of human social behavior.

A influência do feedback verbal na cooperação em crianças

Human cooperation is a hallmark of this species due to its wide extension to genetically unrelated individuals and complex division of labor. It is considered an evolutionary puzzle, because the theory of evolution by natural selection predicts that self-interested individuals tend to be selected. Different theories have been proposed to explain the evolution of cooperation, which the most important are kin selection and reciprocal altruism. Considering the evolutionary continuity between species, humans and other primates have several common traits that help to promote cooperation between individuals of these species. Two features, however, seem to be particularly humans: inequality aversion and preferences in relation to others. Although human cooperation is not necessarily related to morality, cooperative traits are the basis for moral tendencies. The development of human morality is a combination of early prosocial tendencies, cooperative skills displayed at different ages, social learning and cultural transmission of norms. The social stimulus seems to be particularly important in promoting cooperative behavior in children and adults. In order to study the influence of social stimuli, as verbal feedback, on children cooperation, a study was conducted with children in a public goods game. 407 children from public schools in Natal / RN, divided into 21 groups, between six and nine years, participated in eight rounds of this game. After each round, seven groups received praise for larger donations, seven groups have been criticized by smaller donations, and the other seven received no comment. Children cooperated more when criticized, without significant differences between sexes, although young children have cooperated more negative than older children. The results are likely related to the anticipation and avoidance of punishment associated with the feedback (although this did not occur), and greater sensitivity to the authority in younger children. Nevertheless, the cooperation decreased in all groups until the last day of play. The results suggest an early sensitivity to moral punishment, whose role in the maintenance of social relations must have been important in the evolution of cooperation in humans

Colony defensive behavior by the social wasp Polybia (Trichothorax) sericea (Hymenoptera, Vespidae)

This work aimed at evaluating the aggressive response of Polybia sericea, incited by mechanical means, as well as collecting information on the biological and population parameters of this species in Caatinga environments. There were positive correlations (P < 0.05) between the number of aggressors and the number of eggs, larvae and adults present in the nests. These results showed that the magnitude of the defense response exhibited by P. sericea is proportional to the energetic investment carried out by the colony in making young forms. The positive significant correlation between the number of aggressors and the total number of adults of the colony corroborates the hypothesis that colonies with a large population of adults have greater potential to perform what is called defensive altruism.