"Você Deixa de ser uma Pessoa com Direitos a Partir do Momento em que Fala que é Lésbica": Violência de Gênero Contra Mulheres Lésbicas / "You Stop Being a Person with Rights When you Say You are a Lesbian": Gender Violence Suffered Against Lesbian Women

Mulheres cisgênero lésbicas são confrontadas em seu cotidiano com situações de dupla violência, relacionadas à desqualificação e desvalor atribuídos tanto ao gênero como à orientação sexual. Este estudo teve por objetivo compreender os significados atribuídos às experiências de preconceito e discriminação sofridas por mulheres lésbicas de camadas médias. Trata-se de um estudo clínico-qualitativo fundamentado no olhar interseccional dos estudos de gênero. Participaram seis mulheres brancas de 22 a 59 anos de camadas médias, que se autoidentificavam como lésbicas. Para construção do corpus de análise foram realizadas entrevistas individuais gravadas em áudio. Os dados foram analisados e discutidos na perspectiva da análise temática reflexiva. Foram construídas cinco categorias: ambiente de trabalho, família de origem, relações de amizade, serviços de saúde e pessoas desconhecidas. Os resultados mostram que pessoas que perpetram violência contra lésbicas não toleram a possibilidade de que duas mulheres possam manter relacionamento afetivo-sexual e se utilizam de estratégias de apagamento (insultos, deboche, desrespeito, indiferença) para depreciá-las, invisibilizá-las e discriminá-las. Os ataques recorrentes às lesbianidades têm como função manter a hegemonia do modelo heterocentrado. Examinar os significados atribuídos às experiências de preconceito e discriminação sofridas por mulheres lésbicas pode encorajar o desenvolvimento de intervenções culturalmente sensíveis e a efetivação de políticas públicas voltadas a essa população.

Cisgender lesbian women face situations of double violence in their daily lives with situations of double violence, related to the disqualification and devaluation attributed to both gender and sexual orientation. This study aimed to understand the meanings attributed to middle-class lesbian women's experiences of prejudice and discrimination. This is a clinical qualitative study based on the intersectional look of gender studies. Six white, middle-class women ages 22 to 59, who self-identified as lesbians, participated. Individual interviews were conducted and recorded to create the analysis corpus. The data were analyzed and discussed from the perspective of reflective thematic analysis. Five categories were constructed: work environment, family of origin, friendship relations, health services, and unknown people. The results show that people who perpetrate violence against lesbians do not tolerate the possibility that two women can have an affective-sexual relationship and use erasure strategies (insults, debauchery, disrespect, indifference) to depreciate, invisibilize them, and discriminate against them. The recurrent attacks on lesbianities have the function of maintaining the hegemony of the heterocentric model. Examining the meanings attributed to the experiences of prejudice and discrimination suffered by lesbian women can encourage the development of culturally sensitive interventions and public policies targeting this population.

Motivación Intrínseca y Perspectiva Temporal de Universitarios del Noroeste de México / Intrinsic Motivation and Temporal Perspective of University Students in Northwestern Mexico

Resumen Se buscó identificar el perfil de motivación intrínseca (MI) y su relación con la perspectiva temporal en estudiantes universitarios del noroeste de México. En una muestra no probabilística por conveniencia de 553 estudiantes, se puso a prueba un modelo de motivación intrínseca, autoeficacia, orientación al logro, percepción escolar, morosidad y orientaciones temporales (pasado, presente y futuro). Se conformó un modelo estructural de MI que posee bondad de ajuste práctica adecuada. El modelo explica 48% de la variabilidad de la motivación intrínseca; destaca el efecto positivo de la orientación al logro (peso estructural=.65*) y el efecto negativo e indirecto (a través de la autoeficacia) de la morosidad (peso estructural=-.53*) sobre la MI. Y un efecto positivo de las orientaciones temporales (pasado negativo, presente hedonista y presente fatalista) sobre la morosidad (peso estructural=.54*). El estudio ofrece información sobre los aspectos que deben ser desarrollados en los estudiantes universitarios en relación con la motivación intrínseca.

Abstract The purpose of this study was to identify the intrinsic motivation (IM) profile and its relationship with time perspective in a non-probabilistic convenience sample of 553 students university students from a northwestern region in Mexico. Structural equation models were fitted for intrinsic motivation, with self-efficacy, achievement orientation, school perception, procrastination and temporal orientations (past, present and future) as direct and indirect predictors. A structural model of IM was formed that has adequate practical goodness-of-fit. The overall model explained 48% of the variance for intrinsic motivation. Achievement orientation was positively associated (structural weight =.65*) with intrinsic motivation while procrastination was negatively and indirectly (through self-efficacy) related (structural weight =.53*) to IM. Temporal orientations (negative past, hedonistic present and fatalistic present) were positively related to procrastination (structural weight =.54*). This study provides information regarding important predictors of intrinsic motivation that can be targeted among university students.

Alteraciones del comportamiento como contenido en la formación de estudiantes para la orientación a las familias

La formación de estudiantes para la prevención de las alteraciones del comportamiento en los niños de la primera infancia, es imprescindible porque contribuye a elevar la calidad de la atención educativa de salud y educación en ambas modalidades de atención educativa de la primera infancia. El artículo que se presenta tiene como objetivo exponer acciones dirigidas a los estudiantes en formación que los prepara para la orientación de las familias, en función de la prevención de las alteraciones del comportamientoen niños de infancia preescolar. Las acciones se aplicaron durante el periodo del 2019 al 2022 como parte de la preparación para la práctica laboral, lo que posibilitó que se elevara la calidad de la orientación familiar en función de la prevención de las alteraciones del comportamiento en los niños de infancia preescolar, en ambas modalidades de atención educativa.

The training of students for the prevention of behavioral disorders in early childhood children is essential because it contributes to raising the quality of educational health care and education in both modalities of early childhood educational care. The article that is presented aims to expose actions aimed at students in training that prepare them for the orientation of families, based on the prevention of behavioral disorders in preschool children. The actions were applied during the period from 2019 to 2022 as part of the preparation for labor practice, which made it possible to raise the quality of family guidance based on the prevention of behavioral disorders in preschool children, in both modalities of educational attention.

Características do trabalho do agente comunitário de saúde na pandemia de COVID-19 em municípios do Nordeste brasileiro / Characteristics of the community health agent's work in the COVID-19 pandemic in municipalities of Northeastern Brazil

Resumo Os agentes comunitários de saúde (ACS) compuseram uma força de trabalho na linha de frente dos sistemas de saúde no combate a COVID-19. O trabalho identificou as condições estruturais para organização e caracterização do trabalho dos ACS em três municípios do Nordeste brasileiro no período pandêmico. Realizou-se um estudo qualitativo de casos múltiplos. Foram entrevistados 28 sujeitos entre agentes comunitários e gestores municipais. A produção dos dados cotejou as entrevistas com a análise documental. As categorias operacionais que emergiram da análise dos dados foram: condições estruturais e características das atividades. Os resultados deste estudo revelaram escassez nas condições estruturais das unidades de saúde, que durante a pandemia passou por adaptações improvisadas em seus espaços internos. Quanto às características do trabalho, evidenciaram-se ações permeadas por aspectos burocráticos de cunho administrativo no interior das unidades de saúde, acarretando o esvaziamento de sua função vincular de articulação territorial e mobilização comunitária. Assim, as alterações em seu trabalho podem ser vistas como sinalizadores da fragilização do sistema de saúde e, especialmente, da atenção primária à saúde.

Abstract The community health agents (CHAs) comprised the workforce at the forefront of health systems in the fight against COVID-19. The study identified the structural conditions for organizing and characterizing the work of CHAs in three municipalities of northeastern Brazil during the pandemic period. A qualitative study of multiple cases was carried out. Twenty-eight subjects were interviewed, including community agents and municipal managers. Data production assessed the interviews with document analysis. The operational categories that emerged from the data analysis were: structural conditions and characteristics of the activities. The results of this study disclosed the scarcity of the structural conditions in the health units, which during the pandemic made improvised adaptations of the internal spaces. As for the work characteristics, actions permeated by bureaucratic aspects of an administrative nature were evidenced in the health units, resulting in the elimination of their binding function of territorial articulation and community mobilization. Thus, changes in their work can be seen as signs of the fragility of the health system and, especially, of primary health care.

A Comparative Study Regarding the Impact of Covid-19 on Latin American College Students

COVID-19 has changed educational opportunities for students around the world, and, in the process, affected their lifestyle, happiness, and engagement. The present research is part of a project from six universities in different countries across Latin America to examine the impact of COVID-19 on university students. Objectives: The purpose of this study was to assess and compare the impact of COVID-19 on lifestyle changes, orientations to happiness, and student engagement among a sample of college students in Mexico, El Salvador, Colombia, the Dominican Republic, Peru, and the US. Methods: Participants were 1764 students from the six previously identified countries. Data were collected using the Student Health Behavior Inventory, the Orientations to Happiness Scale, and the University Student Engagement Inventory. Results: Student respondents were mostly female, with a median age of 22. Most reported no changes in academic performance and statistically significant changes in some lifestyle behaviors such as nutrition and physical activity. Conclusions: The global pandemic led to behavioral changes among college students in Latin America, and it affected their orientations to happiness and engagement. Institutions of higher learning are called to create opportunities for their students to reintegrate into an in-person learning environment to facilitate positive lifestyle changes for their students.

El COVID-19 ha cambiado las oportunidades educativas para los estudiantes de todo el mundo y en el proceso afectó su estilo de vida, felicidad y compromiso. La presente investigación es parte de un proyecto de seis universidades en diferentes países de América Latina para determinar el impacto de COVID-19 en estudiantes universitarios. Objetivos: El propósito de este estudio fue evaluar y comparar el impacto del COVID-19 en los cambios de estilo de vida, las orientaciones hacia la felicidad y el compromiso de los estudiantes entre una muestra de estudiantes universitarios en México, El Salvador, Colombia, República Dominicana, Perú y Estados Unidos. Métodos: Los participantes fueron 1764 estudiantes de los seis países previamente identificados. Los datos se recolectaron utilizando el Inventario de Conducta de Salud del Estudiante, la Escala de Orientaciones a la Felicidad y el Inventario de Participación de los Estudiantes Universitarios. Resultados. Los estudiantes encuestados eran en su mayoría mujeres con una edad promedio de 22 años. La mayoría informó que no hubo cambios en el rendimiento académico y cambios estadísticamente significativos en algunos comportamientos de estilo de vida, como la nutrición y la actividad física. Conclusiones: La pandemia global provocó cambios de comportamiento entre los estudiantes universitarios de América Latina y afectó sus orientaciones hacia la felicidad y su compromiso. Las instituciones de educación superior están llamadas a crear oportunidades para que sus estudiantes se reintegren en un entorno de aprendizaje en persona para facilitar cambios positivos en el estilo de vida de sus estudiantes.

Variables predictoras de la satisfacción vital: Comparaciones entre estudiantes universitarios de minorías sexuales en Chile / Predictors of life satisfaction: Comparisons between university students from sexual minorities in Chile

Resumen En tiempos recientes, la literatura en psicología sobre orientación sexual ha pasado de centrarse en aspectos negativos experimentados por personas no heterosexuales a examinar factores que potencien el bienestar de estas. Estos estudios se han enfocado mayoritariamente en lesbianas y hombres gay (orientación hacia un único género o monosexual), mientras la inclusión de otras orientaciones, como bisexual y pansexual (orientaciones hacia más de un género o plurisexual) es un interés emergente. En Latinoamérica, un tema poco explorado en este sentido es la satisfacción vital y las variables asociadas, como el apoyo social y el revelar la orientación sexual, y cómo estas pueden variar entre personas de distintas orientaciones no heterosexuales. Por ello, el objetivo general de este estudio fue comparar el grado de revelación de la orientación sexual, el apoyo social percibido, la conexión con la comunidad LGBTIQ+ (sigla que incluye a lesbianas, gay, bisexual, transgénero, transexual, travesti, intersexual y queer) y la satisfacción vital entre estudiantes universitarios lesbianas y gays (LG), y bisexuales y pansexuales (BP). La muestra fue tomada entre 82 estudiantes universitarios LGBP, quienes respondieron un cuestionario en línea que incluía datos sociodemográficos y escalas destinadas a evaluar las variables en estudio. Los resultados mostraron que estudiantes universitarios LG revelan más su orientación sexual que estudiantes BP. Igualmente, se destaca la asociación positiva entre el apoyo social percibido y satisfacción vital, y entre la conexión con la comunidad LGBTIQ+ y la revelación de la orientación sexual. Este estudio contribuye al conocimiento sobre variables asociadas a la satisfacción vital según la orientación sexual, diferenciando entre estudiantes universitarios lesbianas y gays y estudiantes bisexuales y pansexuales.

Abstract In recent years, there has been a growing shift in research on sexual orientation. This focus has moved from centering on negative experiences, related to psychopathology and stigmatization, to examining subjective well-being factors in individuals belonging to these populations. In Latin American countries such as Chile, a scarcely explored link in this regard is satisfaction with life -the cognitive component of subjective well-being- and associated variables. The minority stress model indicates that individuals who belong to minority groups are exposed to additional stressors to which the general population is not exposed. These specific stressors are related to the marginalization, prejudice and exclusion suffered by the minority group of belonging. Researchers have shown that these stressors and their consequences may result in lower life satisfaction in non-heterosexual people compared to their heterosexual peers. Furthermore, different non-heterosexual orientations face specific forms of prejudice and, therefore, could experience a different impact on their life satisfaction. In this paper, the distinction is made between individuals with a monosexual orientation (towards one gender) and those with a plurisexual orientation, (towards more than one gender or independently of gender); namely, lesbians and gay men (LG) on the one hand, and bisexuals and pansexuals (BP) on the other. Research indicates that BP people experience lower levels of well-being than LG individuals. Compared to the latter, BP individuals tend to disclose their sexual orientation to a lesser extent, perceive less social support, and experience greater exclusion from community spaces destined to the general community of lesbian, gay, bisexual, transgender, intersex, and other queer identities (LGBTIQ+). Moreover, these differences between non-heterosexual orientations in terms of life satisfaction have been little explored in Latin American university students. To fill this gap in the literature, the general objective of this study was to compare the levels of disclosure of sexual orientation, perceived social support, connectedness with the LGBTIQ+ community, and life satisfaction among lesbian, gay, bisexual, and pansexual university students. Four hypotheses were proposed that addressed the comparisons between LG and BP participants for these variables. A non-probability sample of 82 LGBP university students was recruited to answer an online questionnaire. Of the sample, 32.9 % were lesbian or gay, and 67.1 % were bisexual or pansexual. Most participants were women (67.1 %), compared to 29.3 % men and 3.7 % of another gender. The questionnaire consisted of a section of sociodemographic data, a sexual orientation disclosure scale, the Multidimensional Scale of Perceived Social Support, the LGBTIQ + Community Connectedness Scale, and the Life Satisfaction Scale. Analyses included comparisons of means between groups. A confirmatory factor analysis (CFA) was conducted for the Connectedness Scale to test its validity. Results showed that LG and BP students reported similar levels of perceived social support, community connectedness, and life satisfaction, while LG students tended to disclose their sexual orientation to more people than BP students. A positive association was also found between perceived social support and life satisfaction, and between connectedness and disclosure of sexual orientation. The CFA showed that the Connectedness Scale is valid for its use in university samples in Chile and other Latin American populations. Limitations regarding sample size and recommendations for future research are discussed. This study contributes to the knowledge about variables associated with life satisfaction in non-heterosexual university students, highlighting the differential needs for support of those with a monosexual orientation (lesbians and gays) and those with a plurisexual orientation (bisexual and pansexual).

"Mi viaje": Procesos de revelación y aceptación de la orientación sexual en las familias / "My journey": Processes of disclosure and acceptance of the sexual orientation in families

Resumen Según el informe realizado por la Asociación Internacional de Lesbianas, Gays, Bisexuales, Trans e Intersex (ILGA) en el año 2017, menos del 25 % de los territorios del planeta reconocen a la población Lesbianas, Gays, Bisexuales, Transexuales e Intersexuales (LGBTI+) y, de igual forma, aún hay numerosos países, en su mayoría del continente africano, que penalizan, discriminan y rechazan la homosexualidad. Además, diferentes estudios han evidenciado que para muchas familias es difícil separarse de la tradición heteronormativa y aceptar la orientación sexual de un hijo gay o una hija lesbiana o bisexual. Esta investigación buscó comprender el proceso de revelación y aceptación de la orientación sexual en 15 familias con integrantes gays, lesbianas y bisexuales en Cali-Colombia, a través de una entrevista semiestructurada y una línea de tiempo denominada Mi viaje en la que los participantes plasmaban sus narrativas en dibujos. En el presente estudio participaron 15 familias, las cuales estuvieron conformadas tanto por hijos/as entre los 19 y 26 años como por padres/cuidadores entre 41 y 64 años. A partir del análisis temático de las entrevistas realizadas de manera individual, se evidencia que los procesos de revelación de la orientación sexual se generan durante la adolescencia temprana, media y tardía, y la madre fue aquella integrante de la familia a quien le revelaron en un primer momento. Además, se presentan las formas a través de las cuales se dio la revelación, que fueron directas o indirectas y en algunos casos derivaron en secretos familiares. Se concluye que los procesos que atraviesan las familias frente a la revelación y aceptación de la orientación sexual de un hijo gay o una hija lesbiana o bisexual cuentan con fases dinámicas que pueden presentarse en distintos momentos y de diferentes formas, según las características particulares de cada familia y su contexto.

Abstract According to the report carried out by the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA) in 2017, less than 25 % of the territories of the planet recognize Lesbian, Gay, Bisexual, Transgender and Intersex (the LGBTI + population) and, in the same way, there are still numerous countries, mostly from the African continent, who penalize, discriminate and reject homosexuality. In Colombia, between the years 2016, 2017 and until February 2018, 139 homicides of LGBTI+ people were reported. Additionally, in several of its cities, among which are Barranquilla, Medellín, Bogotá and Cali, there has been violence by the National Police against LGBTI+ people because of their sexual orientation and gender identity. In this regard, 21 cases have been reported between 2008 and 2017, of which two were against gay men and three against lesbian women. In addition, in Valle del Cauca, 195 homicides were reported up to the year 2017 which were related to the sexual orientation and gender identity of the victims, specifically located in the city of Santiago de Cali, in which nine murders were reported, four of which were gay men, two lesbian women and three trans women (Colombia Diversa, 2018). Furthermore, different studies have shown that it is difficult for many families to separate from the heteronormative tradition and accept the sexual orientation of a gay son or a lesbian or bisexual daughter. This research sought to characterize the process of disclosure and acceptance of sexual orientation in 15 families with gay sons and lesbian and bisexual daughters in Cali-Colombia, using a semi-structured interview and a timeline called My Journey in which the participants reflected their narratives in drawings. The research was qualitative, with a narrative design by topics (Hernández, Fernández & Baptista, 2014). The results are articulated to the macro project called "Family dynamics in the process of disclosure and acceptance of the sexual orientation of gay sons and lesbian daughters in the city of Cali-Colombia" In the present study, 15 families participated, which were made up of both children and parents / caregivers. From the thematic analysis of the interviews carried out individually, the descriptions made by the families of the moment in which the sons and daughters revealed their sexual orientation are mentioned. This moment corresponds to early, middle and late adolescence, and the mother was the one to whom the sexual orientation was revealed at first. In addition, the forms through which the revelation was given are presented, which were direct or indirect and, in some cases, led to family secrets. It is concluded that the processes that families go through in the face of the disclosure and acceptance of the sexual orientation of a gay son or a lesbian or bisexual daughter have dynamic phases that can occur at different times and in different ways depending on the particular characteristics of each family and its context. It is recommended to promote associations of families and friends united in favor of gender diversity, in such a way that they are configured as elements for decision-making in public policies and actions, which generate care routes for other families that require guidance in any of the stages they are going through and that can provide social support to gay sons, lesbian daughters and their families. From the field of health professionals who accompany families in affirmative processes, it is necessary to strengthen training with a gender perspective and in future studies address the experiences of families with transgender members, taking into account their specific needs and from an intersectional perspective.

Servicio de atención psicológica a niños y adolescentes convalecientes a la COVID-19 en Villa Clara

Fundamento: los niños y los adolescentes constituyen una población sensible a los impactos psicológicos de la pandemia de COVID-19. Reconocerlo implica la necesidad de evaluación, seguimiento e intervención, especialmente cuando se trata de infantes que padecieron la enfermedad y requieren una atención pediátrica integral. Objetivo implementar un servicio de atención psicológica a niños y adolescentes convalecientes a la COVID-19. Métodos: se aplicó un diseño de investigación acción participativa desde un enfoque cualitativo constructivo-interpretativo. Está integrado por tres ejes de acciones: evaluación psicológica, intervención psicoterapéutica y apoyo social. Su diseño e implementación siguió etapas y se realizó de forma colaborativa. Los participantes implicados establecieron relaciones simétricas y siguieron un proceso cíclico de planificación-actuación-observación-reflexión; procedimiento base para atender y perfeccionar la práctica. Resultados: los resultados se obtuvieron con respecto a la evaluación y las acciones de intervención psicológica. Sobre la evaluación se destacan alteraciones clínico psicológicas con afectación de las funciones psíquicas y necesidades de preservación de la salud en los ámbitos personal y familiar. Respecto a la intervención psicológica, la totalidad de los beneficiarios recibió acciones de orientación psicológica y los diagnosticados con afección psiquiátrica recibieron acciones psicoterapéuticas. Todas las familias recibieron apoyo social. Conclusiones: se constató reducción o remisión de la intensidad de síntomas psicológicos, elaboración del duelo ante la pérdida, adecuación de afrontamientos o modificación de comportamientos, fortalecimiento de la capacidad de las redes sociales de apoyo, ampliación del conocimiento de la familia, y creación de canales de información entre la familia y la escuela.

Background: children and adolescents constitute a sensitive population to the psychological impacts of the COVID-19 pandemic. Recognizing it implies the need for evaluation, monitoring and intervention, especially when it comes to infants who have suffered from the disease and require comprehensive pediatric care. Objective: to implement a psychological care service for children and adolescents convalescent from COVID-19. Methods: a participatory action research design was applied from a constructive-interpretive qualitative approach. It is made up of three lines of action: psychological evaluation, psychotherapeutic intervention and social support. Its design and implementation followed stages and was carried out collaboratively. The participants involved established symmetrical relationships and followed a cyclical process of planning-acting-observing-reflecting; basic procedure to attend and improve the practice. Results: the results were obtained regarding the evaluation and the actions of psychological intervention. Regarding the evaluation, clinical-psychological alterations with affectation of the psychic functions and needs for the preservation of health in the personal and family spheres stand out. Regarding the psychological intervention, all the beneficiaries received psychological counseling actions and those diagnosed with a psychiatric condition received psychotherapeutic actions. All families received social support. Conclusions: The psychological symptoms intensity reduction or remission was verified, elaboration of grief in the loss, adaptation of coping or behavior modification, strengthening of the social support networks' capacity, expansion of family knowledge, and creation of information channels between the family and the school.

Need for comprehensive language with respect to sexual orientation, gender identity and expression in Indian healthcare

In spite of the Supreme Court’s recognition of transgender and LGBTQIA+ rights, there has been a negligent and insensitive attitude in India to the question of rendering respect to individuals of all sexual and gender identities. No framework for ensuring better protection from societal discrimination faced by the LGBTQIA+ community has been drawn up; hence discrimination continues in society and in healthcare. This article aims to provide an understanding of the terms frequently encountered with the LGBTQIA+ population and orient healthcare professionals to be better equipped at using the correct terms in their everyday practice, as a step towards a more inclusive healthcare system.

Applicability of an immersive virtual reality system to assess egocentric orientation of older adults / Aplicabilidade de um sistema de realidade virtual imersivo para avaliar a orientação egocêntrica de idosos

Abstract Background Spatial orientation is a cognitive domain frequently compromised in patients with Alzheimer disease (AD) and may be one of its first clinical manifestations. Some studies have shown that allocentric integration with egocentric spatial information seems to be impaired in this pathology. There is no consensus on how best to assess spatial orientation and traditional tests lack ecological validity, but, recently, virtual reality (VR) has provided new opportunities for this assessment. Objectives To analyze the applicability and stability of an immersive virtual task developed to assess spatial orientation, the Spatial Orientation in Immersive Virtual Environment Maze Test (SOIVET-Maze) in older adults with and without mild cognitive impairment. Methods Forty-three older adults were included in the study, 24 without cognitive impairment and 19 with mild cognitive impairment. Applicability was assessed by the Witmer and Singer Sense of Presence Questionnaire and a questionnaire for adverse events of cybersickness. To assess stability, participants were assessed twice with an interval of 7 to 14 days, and the intraclass correlation coefficient was calculated between visits. The t test or the Mann-Whitney test was used to compare applicability and stability between groups. Results There was no significant difference between the groups regarding applicability. A strong correlation between the first and second day of testing was found in the mild cognitive impairment group. Conclusion The SOIVET-Maze task showed excellent applicability and good stability, favoring its clinical application for the evaluation of spatial orientation in older adults.

Resumo Antecedentes A orientação espacial é um domínio cognitivo frequentemente comprometido em pacientes com doença de Alzheimer (DA) e pode ser uma das suas primeiras manifestações clínicas. Alguns estudos demonstraram que a integração alocêntrica com informações espaciais egocêntricas parece prejudicada nessa patologia. Não há um consenso sobre qual a melhor forma de avaliar a orientação espacial e os testes tradicionais carecem de validade ecológica; porém, recentemente, a realidade virtual (RV) proporcionou novas oportunidades para esta avaliação. Objetivos Analisar a aplicabilidade e estabilidade de uma tarefa virtual imersiva desenvolvida para avaliar a orientação espacial, o Spatial Orientation in Immersive Virtual Environment Maze Test (SOIVET-Maze) em idosos com e sem comprometimento cognitivo leve. Métodos Quarenta e três idosos foram incluídos no estudo, 24 sem comprometimento cognitivo e 19 com comprometimento cognitivo leve. A aplicabilidade foi avaliada pelo Witmer and Singer Sense of Presence Questionnaire e um questionário para eventos adversos de cybersickness. Para avaliar a estabilidade, os participantes foram avaliados 2 vezes com intervalo de 7 a 14 dias, e o coeficiente de correlação intraclasse foi calculado entre as visitas. O teste t ou o teste de Mann-Whitney foi utilizado para comparar a aplicabilidade e estabilidade entre os grupos. Resultados Não houve diferença significativa entre os grupos quanto à aplicabilidade. Uma forte correlação entre o primeiro e o segundo dia de teste foi encontrada no grupo de comprometimento cognitivo leve. Conclusão A tarefa SOIVET-Maze apresentou excelente aplicabilidade e boa estabilidade, favorecendo sua aplicação clínica para avaliação da orientação espacial em idosos.

7. Rainbow Network for Rehabilitation Specialists (Nijiiro Rehab Net) / 医学教育

Rainbow Network for Rehabilitation Specialists (Niijiro Rehab Net) is a voluntary organization of rehabilitation professionals interested in SOGI (Sexual Orientation & Gender Identity).　Members from various professions and fields have come together under the common understanding that SOGI is important in rehabilitation. Since its establishment in 2020, journal clubs, online training sessions, and education at schools have been conducted.　"Rehabilitation" means "total restoration of human rights". It is necessary to continue extending our activities, focusing on how professionals could contribute to people with various SOGI conditions so they may "live as they are".

6. Postgraduate Training and CME : Nijiiro Doctors Initiative / 医学教育

Nijiiro Doctors offered a six-month LGBTQ healthcare training course for physicians in their third year of post-graduate studies or above, with the goal of implementing practice at their institutions. In addition to lectures, the course included dialogues with LGBTQ individuals, role-plays in which the LGBTQ individuals played the role of mock patients and reviews in small groups in each session.

4. Pilot Education Programs Regarding SOGI for Social Worker Students and Occupational Therapy Students / 医学教育

The number of medical and social work professional training schools that provide SOGI education is quite few. This paper introduces pilot SOGI education programs for social workers and occupational therapists. In order to improve understanding of the situations in which Sexual and Gender Minority (SGM) are placed, SOGI education programs have consisted of knowledge of SGM, health disparities among SGM, majority privilege theory, social justice theory, etc. Educational practices increased and improved the amount of knowledge about SGM, awareness of SGM existence, and the need for more knowledge. The Importance of pre-graduate education of SOGI for the medical and social work students was discussed.

2. Basic Knowledge about Sexual Orientation and Gender Identity, and the Status of Undergraduate Medical Education in Japan and Abroad / 医学教育

LGBTQ people are less visible in Japan and are exposed to minority stress and health disparities due to societal prejudice and discrimination. It is important for healthcare providers to learn about diverse sexual orientations and gender identities to achieve DE&I, in addition to providing equitable healthcare. In Japan, education on LGBTQ topics in medical schools is poor compared to the U.S. and Canada, and there is an urgent need to train faculty to teach this topic, create educational resources, and develop guidelines for medical education.

Mortality rates by gender and sexual orientation reveal a disproportionally high mortality among cisgender men of unknown sexual orientation and men who have sex with women in a cohort of people living with HIV in Rio de Janeiro, Brazil

ABSTRACT Background: Antiretroviral therapy use has led to a decline in HIV-related mortality yet disparities by gender and/or sexual orientation may exist. In this study, we estimated hazards of death in people living with HIV (PLWH) according to gender and sexual orientation. Methods: We included PLWH ≥ 18 years enrolled between 2000 and 2018 at INI/Fiocruz, Rio de Janeiro, Brazil. Participants were grouped as cisgender or transgender women, cisgender men who have sex with men (MSM) or men who have sex with women, or cisgender men with unknown sexual orientation. We assessed disparities in the hazard of death using Cox proportional hazards models. Results: Among 5,576 PLWH, median age at enrollment was 35 years, 39% were MSM, 28% cisgender women, 23% men who have sex with women, 5% transgender women, and 5% men with unknown sexual orientation. A total of 795 deaths occurred in 39,141 person-years of follow-up. Mortality rates per 1,000 person-years were: 82.4 for men with unknown sexual orientation, 24.5 for men who have sex with women, 18.3 for cisgender, 16.6 for transgender women, and 15.1 for MSM. Compared to MSM, men with unknown sexual orientation had the highest death hazard ratio (adjusted hazard ratio [aHR] 2.93, 95% confidence interval [CI] 2.35-3.81), followed by men who have sex with women (aHR 1.17, 95%CI 0.96, 1.43); death hazard ratios for cisgender and transgender women were not statistically different. Conclusion: We observed disparities in the hazard of death for men with unknown sexual orientation and men who have sex with women despite universal access to antiretroviral therapy in Brazil. Future work should characterize and assist men with unknown sexual orientation with tailored policies and interventions. Increased hazard of death was not observed for transgender women, which probably results from interventions implemented in our service to reach, engage, retain, and support this population.

Sexuality and fertility desire in a large cohort of individuals with 46, XY differences in sex development

Abstract Objective: To analyze aspects of sexual life and fertility desire among 46, XY DSD people, including those who changed their gender. Methods: It is a cross-sectional study including 127 adults (> 16 years of age) with 46, XY DSD (83 females; 44 males) from a Single Brazilian Tertiary-Care Medical Center. Results: Sexual fantasies and masturbation were more frequent in 46, XY DSD males, whereas orgasm and sexual life satisfaction were similar in both genders. More 46, XY DSD men than women had a long-term romantic relationship. 46, XY DSD women with prenatal androgen exposure reported more fear of being romantically rejected. External genitalia appearance at birth did not impact the sexuality of 46, XY DSD women after surgical genital treatment had been completed. Overall, the sexual life was similar between 46, XY men assigned as males and those who changed to the male gender. Regarding sexual orientation, most self-reported as heterosexual (91% and 92% of women and men, respectively). The desire for fertility had a similar prevalence in both genders, but more women than men considered infertility a barrier to a long-term romantic relationship. Twelve individuals (7 males) had children; 10 out of 12 have adopted children. Conclusion: Fertility desire was shared among 46, XY DSD people, regardless of gender. Prenatal androgen exposure reduced the desire for motherhood in 46, XY women. 46, XY DSD people who changed from female to male gender presented similar sexual parameters as those assigned as males. Among females, virilized genitalia at birth did not affect sexuality once the surgical treatment is completed.

Does the Other of the Lacan oriented analyst not exist? / O Outro do analista de orientação lacaniana não existe? / L'Autre de l'analyste d'orientation lacanienne n'existe pas? / El Otro del analista de orientación lacaniana no existe?

The structure of the unconscious and the circuit of) drive both indicate that the symbolic and imaginary dimensions merge in the direction of a real referent - that, even in the best formalizations, keeps its singularity - and, at the end of an analysis, may allow the emergence of the "analyst's desire". For their optimal understanding, I used the reports of the Pass device, from the World Association of Psychoanalysis regarding the appearance of the "analyst's desire" in the end of their treatments. I pointed out that, quite contradictorily, today's "singularities" follow a standard. The "analyst's desire" is confused with the "desire to put oneself on display and become a celebrity". This is the conclusion that led me to the ask: which is the post-modern Lacan oriented analyst's Other?

A estrutura do inconsciente e o circuito da pulsão nos indicam que as dimensões do simbólico e do imaginário convergem em direção a um referente real - que, por melhor formalizado que seja, é sempre singular - e, ao final de uma análise, pode dar lugar à emergência do "desejo do analista". Para apreendê-los, recorri aos relatórios do dispositivo do passe da Associação Mundial de Psicanálise e dos testemunhos de analistas sobre o advento do "desejo do analista" ao final de suas análises. Destaquei que, contraditoriamente, as "singularidades" hoje seguem um padrão. O "desejo do analista" confunde-se com o "desejo de exibir-se e de se tornar uma celebridade". Essa conclusão me conduziu a interrogar: Qual é o Outro do analista lacaniano na pós-modernidade?

La structure de l'inconscient et le circuit de la pulsion indiquent que les dimensions symbolique et imaginaire convergent vers un référent réel - qui, aussi bien formalisé qu'il soit, est toujours singulier - et peuvent donner lieu, à la fin d'une analyse, à l'émergence du "désir de l'analyste". Pour les appréhender, j'ai me suis servie des rapports du dispositif de passe de l'Association mondiale de psychanalyse et des témoignages d'analystes sur l'avènement du "désir de l'analyste" à la fin de leurs analyses. J'ai souligné que, par contre, les "singularités" suivent aujourd'hui un schéma. Le "désir de l'analyste" est confondu avec le "désir de se montrer et de devenir une célébrité". Cette conclusion m'a conduit à me poser la question suivante : quel est l'Autre de l'analyste lacanien dans la post-modernité?

La estructura del inconsciente y el circuito pulsional indican que las dimensiones simbólica e imaginaria convergen hacia un referente real - que, por muy formalizado que esté, siempre es singular - y, al final de un análisis, puede dar lugar a la aparición del "deseo del analista". Para aprehenderlos, recurrí a los informes del dispositivo de pases de la Asociación Mundial de Psicoanálisis y a los testimonios de analistas sobre el advenimiento del "deseo del analista" al final de sus análisis. Subrayé que, contradictoriamente, las "singularidades" actuales siguen un padrón. El "deseo del analista" se confunde con el "deseo de presumir y convertirse en una celebridad". Esta conclusión me llevó a preguntarme: ¿Cuál es el Otro del analista lacaniano en la posmodernidad?

El lugar vacante del concepto de sujeto en la clínica psicoanalítica del autismo / O lugar vago do conceito de sujeito na clínica psicanalítica do autismo / The vacant place of the concept of subject in the psychoanalytic clinic of Autism / La place vacante du concept de sujet dans la clinique psychanalytique de l'autisme

Frente a la hegemonía de abordajes behavioristas y cognitivistas en el acompañamiento precoz del autismo, muchos psicoanalistas tomaron la palabra para criticar dicha universalización, y defender el lugar que el psicoanálisis ocupa. Para ello, se utiliza a menudo el término "sujeto": estas prácticas, dicen los psicoanalistas, excluyen al sujeto, mientras que el psicoanálisis apuesta por su emergencia. Ahora bien, ¿Cuál es el estatuto del sujeto en la clínica psicoanalítica del autismo? A través de una revisión de textos, se puso de manifiesto que para muchos psicoanalistas el sujeto dividido, definido por Lacan, no operaría en el autismo. Al mismo tiempo, no contamos con muchas elaboraciones que propongan un estatuto especifico de sujeto para el autismo. Por consiguiente, se llegó a la conclusión que existe un lugar vacante de dicho concepto en la clínica psicoanalítica del autismo en la orientación lacaniana. En este artículo se proponen tres caminos para reducir la distancia entre una promoción del psicoanálisis como clínica del sujeto y nuestras elaboraciones teóricas sobre el sujeto en el autismo.

Resumos Diante da hegemonia das abordagens behavioristas e cognitivistas no acompanhamento precoce do autismo, muitos psicanalistas têm se manifestado para criticar essa universalização e defender o lugar ocupado pela psicanálise. Para isto, utiliza-se frequentemente o termo "sujeito": essas práticas, dizem os psicanalistas, excluem o sujeito, enquanto a psicanálise aposta em sua emergência. No entanto, qual é o estatuto do sujeito autista na clínica psicanalítica? Através de uma revisão da literatura, verificou-se que para muitos psicanalistas o sujeito dividido, definido por Lacan, não operaria no autismo. Ao mesmo tempo, não temos muitas elaborações que proponham um estatuto de sujeito específico para o autismo. Portanto, concluiu-se que há um lugar vago do conceito de sujeito na clínica psicanalítica do autismo de orientação lacaniana. Neste artigo, três caminhos são propostos para diminuir a distância entre a promoção da psicanálise como clínica do sujeito e nossas elaborações teóricas sobre o sujeito no autismo.

Given the hegemony of behavioral and cognitive approaches in the early accompaniment of autism, many psychoanalysts criticize this universalization and defend the place occupied by psychoanalysis. To do this, the term "subject" is often used: these practices, say psychoanalysts, exclude the subject, whereas psychoanalysis bets on its emergence. However, what is the autistic subject's status in the psychoanalytic clinic? From a texts' review, it appeared that for many psychoanalysts the divided subject, defined by Lacan, would not operate in autism. At the same time, we do not have many elaborations that propose a specific subject status for autism. Therefore, it was concluded that there is a vacant place of the concept of subject in the psychoanalytic clinic of autism of Lacanian orientation. In this article, three paths are proposed to reduce the distance between a promotion of psychoanalysis as a clinic of the subject and our theoretical elaborations on the subject in autism.

Face à l'hégémonie des approches comportementalistes et cognitivistes dans le suivi précoce de l'autisme, de nombreux psychanalystes se sont manifestés pour critiquer cette universalisation et défendre la place occupée par la psychanalyse. Pour cela, le terme « sujet ¼ est souvent utilisé : ces pratiques, disent les psychanalystes, excluent le sujet, alors que la psychanalyse fait le pari de son émergence. Mais quel est le statut du sujet autiste dans la clinique psychanalytique ? Une revue de la littérature a permis de constater que pour de nombreux psychanalystes, le sujet divisé, défini par Lacan, ne serait pas opérant dans l'autisme. En même temps, nous n'avons pas beaucoup d'élaborations qui proposent un statut de sujet spécifique pour l'autisme. On peut donc conclure que la place du concept de sujet dans la clinique psychanalytique de l'autisme d'orientation lacanienne est vacante. Dans cet article, trois pistes sont proposées pour combler le fossé entre la promotion de la psychanalyse comme clinique du sujet et nos élaborations théoriques sur le sujet dans l'autisme..

Entre "crushes", "ficadas" e "contatinhos": gênero e orientação sexual nas experiências de paquera de jovens estudantes / Among "crushes", "causal datings" and "hook up": gender and sexual orientation in the flirting experiences of young students / Entre "crushes", "quedadas" y "amigovios": género y orientación sexual en las experiencias de coqueteo de jóvenes estudiantes

Resumo Esse artigo é fruto de pesquisa desenvolvida em uma escola pública de ensino médio e discute como os marcadores de gênero e orientação sexual atravessam as experiências de paquera nessa instituição. Foram analisados materiais produzidos a partir de entrevistas, rodas de conversa e observações de inspiração etnográfica. A temática surge a partir do trabalho de campo quando os/as jovens apontam as relações de paquera como prática e assunto recorrente entre os/as estudantes. Sendo a escola um importante espaço de socialização juvenil, identificamos que para relações de paquera heterossexuais parece haver um roteiro que reitera as expectativas e normas de gênero. Já entre pessoas do mesmo gênero, a paquera é marcada por distintos agenciamentos para que possam vivenciar suas relações afetivo-sexuais, além de terem que lidar com experiências de discriminação.

Abstract This article is the result of research developed in a public high school and discusses how the markers of gender and sexual orientation cross the experiences of flirting in this institution. It analyzes materials from interviews, conversation circles and observations inspired on ethnographic methods. The theme arises from fieldwork when young people point to flirting relationships as a practice and a recurring issue among students. As the school is an important space for youth socialization, we identified that for heterosexual flirting relationships there seems to be a script that reiterates gender expectations and norms. In contrast, among people of the same gender, flirting is marked by different assemblages so they can experience affective-sexual relationships, in addition they have to deal with experiences of discrimination.

Resumen Este artículo es fruto de investigación desenvuelta en una escuela secundaria pública y discute cómo los marcadores de género y de orientación sexual atraviesan las experiencias de coqueteo en esta institución. Han sido analizados materiales producidos a partir de entrevistas, ruedas de conversación y observaciones de inspiración etnográfica. La temática surge a partir del trabajo de campo cuando los jóvenes apuntan las relaciones de coqueteo como práctica y tema recurrente entre los estudiantes. Siendo la escuela un importante espacio de socialización juvenil, identificamos que para relaciones de coqueteo heterosexuales parece haber un rotero que reitera las expectativas y las normas de género. Ya entre personas del mismo género, el coqueteo es marcado por distintas mediaciones para que puedan vivir sus relaciones afectivo-sexuales, además de necesitaren lidiar con experiencias de discriminación.

Just World, Trust in Institutions and Socioeconomic and Political Moderations / Mundo Justo, Confiança nas Instituições e Moderações Socioeconômicas e Políticas

Abstract This study investigates the system justifying role through belief in a just world (BJW), testing whether institutional trust is related to this belief and whether this relationship depends on specific socioeconomic and political factors. A research with 381 university students, aged 18 to 64 years (M = 22.4, SD = 6.25), explored their BJW and their degree of institutional trust. Regression and moderation analyses revealed that BJW relates to institutional trust only in left-wing and with lower income participants. We believe this occurs because they need more an ideology that justifies the system to trust the institutions. This phenomenon can prevent these people from pursuing structural social changes since the system is now seen as fair.

Resumo Este estudo investiga o papel justificador do sistema através da crença no mundo justo (CMJ), testando se a confiança institucional está relacionada com essa crença e se esta relação depende de fatores socioeconômicos e políticos específicos. Uma pesquisa com 381 universitários, com idades de 18 a 64 anos (M = 22,4, DP = 6,25), explorou seus graus de CMJ e confiança institucional. Análises de regressão e moderação revelaram que a CMJ se relaciona com a confiança institucional apenas naqueles de esquerda e menores rendimentos. Acreditamos que isso ocorra porque estas pessoas precisam mais de uma ideologia justificadora do sistema para poder confiar nas instituições. Este fenômeno pode lhes indispor a buscar mudanças sociais estruturais, já que o sistema passa a ser visto como justo.