Travestis na atenção primária: o cuidado em saúde na cidade de Natal

Among the deviant a heteronormative ideal, transvestites are the ones that suffer abuse and discrimination. Have been found that health services often present themselves as places that maintains and reproduce such discrimination, which makes transvestites only sought medical care in the latter case. Based on the guidelines of the SUS and the National Humanization Policy as well as the inclusion and leadership of the users, we conducted a qualitative study seeking to understand the experience of transvestites in seeking health care within primary care in Natal-RN. We use as techno-methodological instruments in depth interview and workshop with use of "scenes". For interpretative analysis of the narratives we use to Hermeneutics-Dialectic. From the dialogue with the narrative we come to the following themes: 1) Understanding the meaning of being a transvestite; 2) The experience transvestite in search of health; 3) Transvestites and humanized health care. In the first point they reveal the daily struggle of transvestites between prejudice and the search for respect, as well as the meanings of being a transvestite, who appeared as: Being gay, being feminine, not transsexual and accept themselves as they are. In the second axis, expressed difficulties in access to and use of health services: the embarrassment by not using the social name; fear of going out during the day; the association of transvestites to HIV; and pain caused by discrimination from health professionals. It was also possible to identify simple demands such as illnesses from day to day, the demand for hormone therapy, which involves treatment needs as well as the vital need to have their rights XVII respected. The third axis, for the range of a humanized care identified that the respectful gaze guarantee their dignity and their right to health in a humane way, but it identified some necessary changes: Training of professionals, dialogue with the social movement, publicity campaigns and rapprochement with the transvestite. Finally, it is expected that the research will contribute to the field of knowledge know-how in health care transvestites, inside and outside of the university

Avaliação do acesso aos serviços de reabilitação física para vítimas de acidentes de trânsito: caminhos para melhoria da qualidade do sistema de saúde

The Physical Rehabilitation services (PR) are of fundamental importance in combating the global epidemic of Traffic Accidents (TA). Considering the numerous physical and social consequences of the survivors, quality problems in access to PR are a hazard to recovery of victims. It is necessary to improve the management of quality of services, assessing priority dimensions and intervening in their causes, to ensure rehabilitation available in time and suitable conditions. This study aimed to identify barriers to access to rehabilitation considering the perception of TA victims and professionals. The aim is also to estimate the access to rehabilitation and their associated factors. This is a qualitative and quantitative study of exploratory nature developed in Natal / RN with semi-structured interviews with 19 health professionals and telephone survey to 155 victims of traffic accidents. To explore barriers to access the speeches were transcribed and analyzed using the Alceste software (version 4.9). During the interviews used the following guiding question: “What barriers hinder or prevent access to physical rehabilitation for victims of traffic accidents?”. The names of classes and axes resulting from Alceste was performed by ad hoc query to three external researchers with subsequent consensus of the most representative name of analysis. We conducted multivariate analysis of the influence of the variables of the accident, sociodemographic, clinical and assistance on access to rehabilitation. Associations with p <0.20 in the bivariate analysis were submitted to logistic regression, step by step, with p <0.05 and confidence interval (CI) of 95%. The main barriers identified were: “Bureaucratic regulation”, “Long time to start rehabilitation”, “No post-surgery referral” and “inefficiency of public services”. These barriers were divided into a theoretical model built from the cause-effect diagram, in which we observed that insufficient access to rehabilitation is the product of causes related to organizational structure, work processes, professional and patients. Was constructed two logistic regression models: “General access to rehabilitation” and “Access to rehabilitation to public service”. 51.6% of patients had access to rehabilitation, and 32.9% in public and 17.9% in the private sector. The regression model “General access to rehabilitation” included the variables Income (OR:3.7), Informal Employment (OR:0.11), Unemployment (OR:0.15), Perceived Need for PR (OR:10) and Referral (OR: 27.5). The model “Access to rehabilitation in the public service” was represented by the “Referral to Public Service” (OR: 23.0) and “Private Health Plan” (OR: 0.07). Despite the known influence of social determinants on access to health services, a situation difficult to control by the public administration, this study found that the organizational and bureaucratic procedures established in health care greatly determine access to rehabilitation. Access difficulties show the seriousness of the problem and the factors suggest the need for improvements in comprehensive care for TA survivors and avoid unnecessary prolongation of the suffering of the victims of this epidemic.

Viver e esperar viver: corpo e identidade na transição de gênero de homens trans

This work seeks to understand how trans men build their identities and live the transsexual experience in the relationships they establish daily onto “man” category. It could be observed that for it they engenders a specific gender transition in the midst of male transsexuality. Despite being under a complex amalgam of relations of exploitation and disciplinary domination, ways of being man are brokered for a living and entry into spaces where they are expelled for not conform the bodies that gender norms require. It is understood that gender transition is a process at the same time of organic and prosthetic body management and the assumption of your own identity. Thus, they build a politic of identity that creatively fixes a person's category as rights holder. The "transition" is therefore to transact from nonexistence to a place of humanity. This dissertation describes how this process takes place in the experiences of the speakers, observing the practices that bring out the male, front of class positions on the labor market, access to health, hormonization and own identity. Thereby, theories that fix them as expressing female masculinities or marginal to the hegemony do not find exactitude in their lives. The research methodologically started performing "multilocated ethnographies" that gave possibilities to in-depth interviews with 15 stakeholders from the Northeast, Midwest, Southeast and South of Brazil. Between 2014 and 2015, from the applying of network technique to the first dialogues in research, it was possible to build a participant observation by the trans men’s everyday life. Wherewith I was capable to behold their own private activities, as well as their public agency amid a trans activism collective in northeast, and the follow-up actions in which they were involved during the XII Encontro Nacional em Universidades de Diversidade Sexual e de Gênero (ENUDSG) held in Mossoró/RN. Therefore, the thesis engages to describe and understand the different ways of constructing trans male gender transitions in access to transsexuality and therefore a way of explaining their own trajectories in terms of people that exist as such, even though in the midst of narratives marked by emotions linked to "not live", to suffering and dehumanization.

O aprimoramento cognitivo como bem primário em Rawls

The main thesis to be demonstrated in this work is that cognitive enhancement through the use of drugs can be included as a primary good within Rawls' thinking. To develop such notion, the text is structured in two parts. The first part intends to describe the theory of justice as equity in its elements directly related to primary goods. The first information to be verified is the unity of the notion of primary goods in all of Rawls' work. Some elements are modified, for example the distinction of natural and social primary goods. Natural primary goods are intelligence, health, imagination, vigor and chance (luck) and social primary goods are law and liberty, opportunity and power, income and wealth and the social fundaments of self-respect. The perception of some talents such as intelligence has also undergone changes, being altered from "higher intelligence" to "educated intelligence". Such fact highlights education as a primary good that permeates all of Rawls' work in different perspectives. Freedom and self-respect are social-primary goods that will also be deepened. The second part presents the definition of improvement and as to show that the distinction between enhancement and treatment is controversial. The part presents the definition of improvement and as the distinction between enhancement and treatment is controversial. Thus, we have deepened the problems related to practice improvement (enhancement) showing how the concepts of Rawls' primary goods as freedom and self-respect are not in opposition to the practice of improvement, particularly cognitive enhancement. We have shown, instead, that the ban of cognitive improvement could lead to denial of these primary goods. But how could we consider cognitive improvement as a primary social good? What we have done in this thesis is to show how cognitive enhancement is important to ensure that primary products are accessible to citizens, and we rebuilt the process that Rawls uses for choosing his primary goods to test that cognitive enhancement through drugs could perfectly be introduced as such.

O aprimoramento cognitivo como bem primário em Rawls

The main thesis to be demonstrated in this work is that cognitive enhancement through the use of drugs can be included as a primary good within Rawls' thinking. To develop such notion, the text is structured in two parts. The first part intends to describe the theory of justice as equity in its elements directly related to primary goods. The first information to be verified is the unity of the notion of primary goods in all of Rawls' work. Some elements are modified, for example the distinction of natural and social primary goods. Natural primary goods are intelligence, health, imagination, vigor and chance (luck) and social primary goods are law and liberty, opportunity and power, income and wealth and the social fundaments of self-respect. The perception of some talents such as intelligence has also undergone changes, being altered from "higher intelligence" to "educated intelligence". Such fact highlights education as a primary good that permeates all of Rawls' work in different perspectives. Freedom and self-respect are social-primary goods that will also be deepened. The second part presents the definition of improvement and as to show that the distinction between enhancement and treatment is controversial. The part presents the definition of improvement and as the distinction between enhancement and treatment is controversial. Thus, we have deepened the problems related to practice improvement (enhancement) showing how the concepts of Rawls' primary goods as freedom and self-respect are not in opposition to the practice of improvement, particularly cognitive enhancement. We have shown, instead, that the ban of cognitive improvement could lead to denial of these primary goods. But how could we consider cognitive improvement as a primary social good? What we have done in this thesis is to show how cognitive enhancement is important to ensure that primary products are accessible to citizens, and we rebuilt the process that Rawls uses for choosing his primary goods to test that cognitive enhancement through drugs could perfectly be introduced as such.

L’accès aux ressources alimentaires : facteurs prédicteurs de l’insécurité alimentaire sévère parmi les ménages bénéficiers des programmes communautaires en sécurité alimentaire à Montréal

Objectif : Examiner la relation entre l’accès aux ressources alimentaires et le degré de l’insécurité alimentaire du ménage parmi les nouveaux utilisateurs des organismes communautaires d’intervention en sécurité alimentaire de Montréal. Méthode : Étude observationnelle transversale. Elle consiste en une analyse secondaire de données (n=785) qui proviennent du premier temps de mesure de l’enquête sur les effets des interventions en sécurité alimentaire à Montréal menée entre 2011 et 2012. La variable dépendante a été l’insécurité alimentaire. Les variables indépendantes ont été le mode de transport utilisé pour transporter les aliments, l’emplacement de l’épicerie la plus fréquentée par le participant, la distance entre l’organisme communautaire fréquenté par le participant et son domicile, la proximité de l’épicerie la plus fréquentée, la satisfaction quant à l’acceptabilité et le caractère abordable des aliments dans l’épicerie la plus fréquentée, et les difficultés d’accès aux aliments. Des régressions logistiques furent effectuées afin d’évaluer la relation entre les variables indépendantes et le degré de l’insécurité alimentaire, en utilisant l’insécurité sévère comme catégorie de référence. Résultats : Nos données suggèrent que la sévérité de l’insécurité alimentaire est associée à la difficulté d’accès aux aliments à cause de la cherté des aliments (pour la sécurité alimentaire, OR=0.13; CI : 0.07-0.25 et pour l’insécurité alimentaire modérée, OR=0.42; CI : 0.28-0.63), au fait de faire l’épicerie à l’extérieur du quartier ou de faire rarement l’épicerie (pour l’insécurité alimentaire modérée, OR=0.50, CI : 0.30-0.84), au fait d’avoir accès au transport collectif (pour l’insécurité alimentaire modérée, OR=1.73; CI : 1.09-2.73), au fait de résider à une distance moyenne (soit entre 1000 et 2000 mètres) d’un organisme communautaire en sécurité alimentaire (pour l’insécurité alimentaire modérée, OR=1.83; CI : 1.14-2.92), et à la difficulté d’accès aux aliments à cause de contraintes de transport (pour la sécurité alimentaire, OR=0.18, CI : 0.06-0.52). Conclusion : L’accès aux ressources alimentaires est associé au degré de l’insécurité alimentaire des nouveaux ménages participant aux interventions en sécurité alimentaire à Montréal.

Application of an Education Research Lab (ERL) Model to a Community Sailing Program

This presentation showcases the application of a university-based education research lab (ERL) model to the evaluation of a community sailing program for individuals with disabilities. Presenters conceptualize the ERL model as a mutually beneficial relationship between universities and community education agencies.

Student Loans : the Empirical Record (Working Paper 6)

Student loan programmes have been the target of a good deal of attention in recent years and one important set of concerns has focussed on the levels of borrowing and the associated debt loads. This paper presents the results of an empirical investigation of borrowing and repayment patterns of four recent cohorts of post-secondary graduates based on the National Graduates Survey (NGS) databases. The paper should be relevant to those interested in access to post-secondary education and the well-being of students, the financing of the higher education more generally, and a range of related issues.

The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

Varumärkesstärkande samhällsansvar : En studie om hur CSR påverkar konsumenters attityder

Företags samhällsansvar (CSR) har utvecklats från ett fokus på etik till prestation och att således kunna fungera som ett strategiskt verktyg för differentiering och det är idag allmänt vedertaget för företag att använda sig av CSR med antagandet att detta genererar konkurrensfördelar. Samtidigt som CSR påvisats kunna skapa mervärde till ett företags varumärke ställs numera också krav från konsumenter att företag tar ett samhällsansvar. Det har däremot uppmärksammats att konsumenters medvetenhet om företags CSR-initiativ är låg, vilket kan anses problematiskt i och med de investeringar företag lägger på CSR och om detta således tas i beaktande vid konsumenters utvärdering av företag. Uppsatsens syfte är därmed att förklara om och hur CSR påverkar konsumenters attityd till ett företags varumärke samt ifall detta innebär ett mervärde och därmed varumärkesstärkande. För att uppnå syftet genomfördes en kvantitativ undersökning och enkäter skickades ut till studenter vid Högskolan Dalarna där totalt 682 respondenter slutförde enkäten. Resultaten visar en låg grad av medvetenhet, men att konsumenter med en högre grad av medvetenhet uppvisar mer fördelaktiga attityder till företag som tar ett samhällsansvar. Det framkommer också att dessa attityder genererar företag immateriella värden vilket senare teoretiskt förklaras innebära ett mervärde och därmed varumärkesstärkande. Studien landar i att CSR kan användas av företag för att stärka sitt varumärke, men finner dock en begränsning gällande konsumenters låga medvetenhet om företags CSR-initiativ.

Representações e Atitudes sobre Igualdade de Género no Trabalho e nas Organizações dos Funcionários e das Funcionárias de um Município Português

Em Portugal, as iniciativas no âmbito da conciliação trabalho-família e a igualdade entre mulheres e homens têm-se fortificado nos últimos anos. A presente dissertação estuda as “Representações e atitudes sobre igualdade de género dos funcionários e funcionárias de um município português”, tendo partido do desafio de acompanhamento de um processo de planeamento e mudança organizacional - Plano para a igualdade de género - para a eliminação da desigualdade de género numa Câmara do interior centro do país. Analisaram-se os dados de um inquérito por questionário respondido por 206 colaboradores/as da autarquia, dos quais 51,2% são homens e 48,8% mulheres. Com uma escala composta de 34 itens procurámos conhecer a extensão e a expressão dos valores e da estereotipia de género, bem como o reconhecimento da desigualdade e o acolhimento de práticas e políticas igualitárias por parte deste universo. Concluiu-se que ao mesmo tempo que já se admite e se aceita cada vez mais o facto de numa família, os dois cônjuges trabalharem fora e se dedicarem a uma carreira profissional, ainda está presente nas pessoas inquiridas a ideia de que as tarefas vinculadas ao âmbito doméstico são responsabilidades das mulheres, ainda que elas já recebam auxílio dos seus companheiros. Assim, percebemos que embora o mundo público seja cada vez mais ocupado por mulheres, ainda se vincula o espaço “profissional” aos homens e as responsabilidades ligadas ao lar e aos filhos às mulheres. Foi também possível concluir uma forte estereotipia de género que justifica de forma essencialista aquilo que são, na realidade, efeitos da desigualdade de género. Este diagnóstico permitiu desenhar um plano de formação organizacional com enfoque no combate à estereotipia de género e seus efeitos nefastos na gestão das pessoas, na igualdade de oportunidades e no desenvolvimento organizacional. / In Portugal, the initiatives in the scope of the bond work-family and the equity between men and women have been strengthened in the last few years. The present thesis studies the “Representations and attitudes about gender equity between men and women employees of a Portuguese city”, that started with the challenge of overlooking a process of planning and organizational change – Plan for gender equity – in order to eliminate the gender inequity within a City Hall in the interior of the country. Data collected from a questionnaire was analysed. This questionnaire was answered by 206 City Hall employees, of which 51,2% are men and 48,8% are women. With a scale composed of 34 items we sought to understand the extent and the expression of the values and gender stereotyping, as well as the inequity acknowledgement and the reception of equity practices and policies by this universe of people. It is concluded that although, more and more, it is allowed and accepted that in a family both spouses work and dedicate themselves to a professional career, within the people surveyed the idea that the household chores are of the women’s responsibility is still present, the “professional” field is still linked to the men and the responsibilities related to the home and the children are linked to the women. It was also possible to conclude that a strong gender stereotyping justifies, in an essentialist way, what are, in reality, the effects of gender inequity. This diagnosis enabled the design of an organizational training program, with the emphasis on the battle against gender stereotyping and its adverse effects in people management, in equal opportunities between men and women and in the organizational development.

Análise da organização da rede de saúde da Paraíba a partir do modelo de regionalização

Este artigo analisa a organização da rede de saúde da Paraíba a partir do modelo de regionalização proposto pelo estado da Paraíba. Material e Métodos: Trata-se de um estudo documental que tomou por base, prioritariamente, o Plano Diretor de Regionalização da Paraíba e os documentos oficiais do Ministério da Saúde que orientam a construção dos mesmos pelos Estados. Resultados: A análise dos dados revelou alguns limites no processo de implantação do PDR/ PB, tais como a ausência de análise das características sociais, econômicas e culturais durante a escolha das sedes das regiões de saúde e a inexistente descrição da organização da assistência à saúde do território estadual. Conclusão: O processo de regionalização e a formulação do PDR da Paraíba não seguiram a Instrução Normativa do Ministério da Saúde em alguns aspectos, desconsiderando as especificidades de cada região de saúde, o que pode resultar em problemas no acesso e na articulação da rede de serviços com vistas à legitimação das regiões de saúde desse Estado

Leverage, Volatile Future Earnings Growth and Expected Stock Returns

We provide theory and evidence to complement Choi's [RFS, 2013] important new insights on the returns to equity in `value' firms. We show that higher future earnings growth ameliorates the value-reducing effect of leverage and, because the market for earnings is incomplete, reduces the earnings-risk sensitivity of the default option. Ceteris paribus, a levered firm with low (high) earnings growth is more sensitive to the first (second) of these effects thus generating higher (lower) expected returns. We demonstrate this by modeling equity as an Asian-style call option on net earnings and find significant empirical support for our hypotheses.

Formación profesional y desigualdad de oportunidades educativas por clase

Tras un repaso a las reflexiones sociológicas sobre la FP y su relación con el origen socioeconómico y el género, así como su plasmación en los debates de política educativa en España, mostramos las tasas de estudiantes o graduados de FP a los 19 y 20 años según clase social de origen y género, desde los nacidos en 1957 hasta 1992. Durante todo este periodo, la desigualdad de oportunidades sociales en el acceso a la FP ha permanecido más bien constante por clase social mientras que ha disminuido por género a partir de las personas nacidas en 1961, pero en mayor medida en las nacidas después de 1970. Los datos muestran que la reforma introducida por la LOGSE, que endureció los requisitos académicos para cursar FP, disminuyó la probabilidad de cursar FP en todas las clases sociales, y que es posible que haya perjudicado en mayor medida a la clase obrera que al resto de clases. Por otro lado, las mujeres cuya familia social de origen pertenece a las clases intermedias optan en menor medida por los estudios de FP que lo que cabría esperar por su género y por su clase social.

Análise da organização da rede de saúde da Paraíba a partir do modelo de regionalização

Este artigo analisa a organização da rede de saúde da Paraíba a partir do modelo de regionalização proposto pelo estado da Paraíba. Material e Métodos: Trata-se de um estudo documental que tomou por base, prioritariamente, o Plano Diretor de Regionalização da Paraíba e os documentos oficiais do Ministério da Saúde que orientam a construção dos mesmos pelos Estados. Resultados: A análise dos dados revelou alguns limites no processo de implantação do PDR/ PB, tais como a ausência de análise das características sociais, econômicas e culturais durante a escolha das sedes das regiões de saúde e a inexistente descrição da organização da assistência à saúde do território estadual. Conclusão: O processo de regionalização e a formulação do PDR da Paraíba não seguiram a Instrução Normativa do Ministério da Saúde em alguns aspectos, desconsiderando as especificidades de cada região de saúde, o que pode resultar em problemas no acesso e na articulação da rede de serviços com vistas à legitimação das regiões de saúde desse Estado